What is the relationship between body image and the quality of life of women who underwent surgery for breast cancer? A scoping review.

PURPOSE: This review aimed to identify, characterize, map, and summarize existing knowledge about the relationship of perceived body image with the quality of life (QoL) of women who have undergone surgical treatment for breast cancer. METHODS: A scoping review was conducted following the PRISMA-ScR guidelines. PubMed, PsycINFO and Scopus databases were searched, and articles published until August 2022 were included. RESULTS: The search resulted in 796 records, and 51 articles were included for analysis. A significant negative impact on body image perception and QoL after surgical treatment for breast cancer was found in the majority of studies. Sociodemographic variables such as age, education, socioeconomic status, unstable attachment styles and time after the surgery may have an effect on a worsening of the overall body image and QoL score of women. It was found that there was greater dissatisfaction with body image in women who underwent mastectomy compared to those who underwent conservative surgery. CONCLUSION: Evidence has shown that breast cancer surgery affects the perceived body image and QoL of patients worldwide. Age, education, socioeconomic status, and the type of surgery are potential factors influencing these outcomes. It is worth noting that the review encompassed articles from various countries, reflecting a significant cultural diversity among the studied populations. However, most of these articles did not delve into an analysis of these cultural disparities. This review also indicated insufficient details regarding the assessment instruments used to assess perceived body image.

Propiedades psicométricas del cuestionario de gratitud (gq-6) para Brasil / Psychometric Properties of the Gratitude Questionnaire (gq-6) to Brazil / Propriedades psicométricas do questionário de gratidão (gq-6) para o Brasi

Este estudio tuvo como objetivo adaptar el Cuestio-nario de Gratitud (gq-6) a la población brasileña. La muestra estuvo constituida por 1 850 participantes con una edad media de 25.13 años (dt = 5.36), 50 % mujeres y 50 % hombres, con representación de todos los estados brasileños. Se realizó análisis factorial exploratorio (afe) y análisis factorial confirmatorio (afc), y correlaciones entre gratitud (gq-6) y satisfac-ción con la vida (swls), optimismo (lot-r), esperanza (ahs), felicidad (shs), afectos positivos y negativos (panas), y personalidad (bfi). Los resultados de efay cfa indicaron una solución unidimensional con los elementos que soportan cargas (λ > 0.39) en el factor y un ajuste aceptable para la solución de un factor (χ2(9) = 59, p < 0.001; cfi= 0.956, rmsea= 0.078). Las correlaciones indican una asociación con variables externas relevantes. Se concluye que el cuestionario presenta evidencia de validez y confiabilidad para su uso en investigación en el contexto brasileño

This study aimed to evaluate the psychometric properties of the Gratitude Questionnaire (gq-6) to the Brazilian population. The sample consisted of 1 850 participants with a mean age of 25.13 years (sd = 5.36), 50 % female and 50 % male and the sample represents all Brazilian states. Exploratory factor analysis (efa) and confirmato-ry factor analysis (cfa) were run, along with correlations between gratitude (gq-6) and life satisfaction (swls), optimism (lot-r), hope (ahs), happiness (shs), positive and negative affects (panas), and personality (bfi). The efa and cfa results indicated a one-dimensional solu-tion with the items loading satisfactorily (λ > 0.39) in the factor and acceptable fit for the one-factor solution (χ2 (9) = 59, p < 0.001; cfi= 0.956, rmsea= 0.078). Correlations indicate relevant relationships with exter-nal variables. In conclusion, the questionnaire shows evidence of validity and reliability for research use in the Brazilian context

Este estudo investigou as propriedades psicométricas do Questionário de Gratidão (gq-6) na população bra-sileira. Participaram 1 850 respondentes com média de idade de 25.13 anos (dp= 5.36), sendo 50 % do sexo feminino e 50 % do sexo masculino e com representação de todos os estados brasileiros. Foram rodadas análi-ses fatoriais exploratória (efa) e fatorial confirmatória (cfa), e correlações entre gratidão (gq-6) e satisfação com a vida (swls), otimismo (lo-r), esperança (ahs), felicidade subjetiva (shs), afetos positivos e negativos (panas) e personalidade (bfi). Os resultados da efa e da cfa indicaram uma solução unidimensional com os itens carregando com cargas adequadas (λ > 0.39) no fator e ajuste aceitável para a solução unifatorial (χ2 (9) = 59, p < 0.001; cfi= 0.956, rmsea = 0.078). As correlações indicaram relações com variáveis externas relevantes. Conclui-se que a escala apresenta evidências de validade e fidedignidade para uso em pesquisa no Brasil.

Development, feasibility testing and perceived benefits of a new app to help with adherence to antiretroviral therapy in people living with HIV in Brazil.

BACKGROUND: Despite the availability of antiretroviral therapy (ART) in many countries, people living with HIV still experience difficulties with treatment. We propose a new smartphone mobile application to assist in adherence to ART. This study aimed to describe this new mobile application's development (content construction and usability), feasibility testing (recruitment, retention rates [attendance], satisfaction) and primary perceived benefits. METHODS: Two consecutive studies were conducted. First, people living with HIV, health care workers and experts in information technology provided feedback to improve the content and usability of the app. After changes in the app were implemented according to the feedback, a second study was performed to assess the feasibility and perceived benefits. Effects on self-reported adherence and perceived well-being were also assessed. RESULTS: Scores of participants (N = 11) showed differences in adherence (effect size .43) and well-being (effect size .45) after using the app. However, the differences did not reach statistical significance. Observing scores individually, six out of 11 participants improved their overall adherence scores, and seven out of 11 participants improved their perceived well-being scores. Recruitment was 95%, and attendance at sessions was 62.5%. In general, the participants were satisfied with the intervention and viewed the app as an informative tool. CONCLUSION: The results are promising and allow us to recommend further studies with the app.

Gender differences in the pathway of childhood trauma, impulsivity and adult eating behaviour: a cross-sectional study.

Objective: The current cross-sectional study aimed to examine the association between childhood trauma, impulsivity, binge eating symptoms, and body mass index (BMI) in a sample of males and females. We also aimed to investigate the indirect association of childhood trauma with binge eating through impulsivity while controlling for BMI.Method: Participants were 410 young adults (mean age = 20.9 years, range 18-24; female = 73.9%) who completed online measures of childhood trauma, impulsivity, binge eating symptoms, and self-reported height and weight. Mediation models were tested using multi-group structural equation modelling.Results: Childhood trauma and impulsivity were associated with an increased risk of binge eating symptoms in females but not males, corroborating previous studies. There was a significant difference in the binge eating symptoms index between sexes, but not regarding the index of childhood trauma and impulsivity. Additionally, adverse childhood experiences were associated with impulsivity and the association of childhood trauma with binge eating was mediated by impulsivity in the female sample.Conclusions: Our results suggest sex-dependent patterns and risk factors that may impact binge eating symptoms. The implications of our results suggest that impulsivity might be a vulnerability factor for binge eating, especially for females.

Habilidades relacionais para atendimento em saúde: relato de experiência do processo de construção de oficinas práticas / Relational skills for healthcare: experience report of practical workshops construction process / Habilidades relacionales para la salud: informe de experiencia del proceso de construcción de talleres prácticos

Habilidades relacionais para atuação em campos de trabalho são consideradas competências essenciais que se somam e permitem o processo de aplicação de ferramentas técnicas. Tais habilidades são essenciais em diversos contextos de saúde com potenciais impactos no processo de adesão aos planos de tratamento aplicados. O presente relato tem como objetivo descrever o processo de construção de oficinas práticas voltadas a alunos de cursos da área da saúde visando o desenvolvimento de habilidades relacionais para atendimento clínico. Método: as oficinas abordaram conteúdos relacionados ao desenvolvimento de habilidades de comunicação, postura empática e inteligência emocional enquanto ferramentas de trabalho, assim como resiliência e trabalho em equipe enquanto variáveis componentes do fazer em saúde. Os critérios de avaliação foram: adequação do conteúdo teórico, a capacidade das atividades em operacionalizar as temáticas abordadas e permitir aprendizagem de habilidades de trabalho, a clareza dos materiais de apoio utilizados, as apresentações feitas pelas facilitadoras e possibilidade de indicação das oficinas a colegas. De forma geral os participantes indicaram satisfação com o trabalho entregue. O trabalho proporcionou aos estudantes oportunidades de aprendizagem de forma a construir conhecimento e desenvolver habilidades relacionais de trabalho pertinentes à realidade das atividades clínicas e buscou aproximar os estudantes de um contexto real de atuação. (AU)

Relational skills for acting in work fields are considered essential competencies that add to and enable the process of applying technical tools.. Such skills are essential in different health contexts with potential impacts on the process of adherence to the treatment plans. The present report aims to describe the process of building practical workshops aimed at students of courses in the health context seeking the development of relational skills for clinical care. Method: the workshops addressed content related to the development of communication skills, empathic posture, and emotional intelligence as work tools, as well as resilience and teamwork as components of health care. The evaluation criteria were: adequacy of the theoretical content, the ability of the activities to operationalize the topics addressed and facilitate the learning of work skills, the clarity of materials, the presentations made by the facilitators, and the possibility of indicating the workshops to colleagues. In general, the participants indicated satisfaction with the work delivered. The work provided students with learning opportunities in order to build knowledge and develop work relational skills relevant to the reality of clinical activities and sought to bring students closer to a real context of action. (AU)

Las habilidades relacionales para actuar en el ámbito laboral se consideran competencias esenciales que suman y permiten el proceso de aplicación de las herramientas técnicas.. Tales habilidades son esenciales en diferentes contextos de salud con impactos potenciales en el proceso de adherencia a los planes de tratamiento. El presente informe tiene como objetivo describir el proceso de construcción de talleres prácticos dirigidos a estudiantes de cursos en el contexto de la salud que buscan el desarrollo de habilidades relacionales para la atención clínica. Método: los talleres abordaron contenidos relacionados con el desarrollo de habilidades comunicativas, la postura empática y la inteligencia emocional como herramientas de trabajo, así como la resiliencia y el trabajo en equipo como componentes del cuidado de la salud. Los criterios de evaluación: la adecuación del contenido teórico, la capacidad de las activi-dades para operacionalizar los temas abordados y el aprendizaje de compe-tencias laborales, la claridad de los materiales, las presentaciones realizadas por los facilitadores y la posibilidad de indicar los talleres a los colegas. En general, los participantes indicaron satisfacción con el trabajo entregado. El trabajo brindó a los estudiantes oportunidades de aprendizaje para construir conocimientos y desarrollar habilidades relacionales de trabajo pertinentes a la realidad de las actividades clínicas y buscó acercar a los estudiantes a un contexto real de acción. (AU)

Fatores psicossociais associados ao Estilo de Vida Saudável em Servidores Públicos Universitários / Psychosocial factors associated with Healthy Lifestyle in University Public Workers / Factores psicosociales asociados a un estilo de vida saludable en servidores públicos universitarios

INTRODUÇÃO: No âmbito da saúde do trabalhador, é necessária a compreensão de quais aspectos influenciam a adoção de um estilo de vida saudável. OBJETIVO: Investigar se estresse relacionado ao trabalho, lócus de controle da saúde e autopercepção de saúde estão associados com estilo de vida saudável em servidores de uma instituição federal de ensino superior. MÉTODO: Trata-se de um estudo transversal por meio de questionário online, de amostra não-probabilística. Participaram deste estudo 898 servidores. Foram utilizados os seguintes instrumentos: questionário com características sociodemográficas e laborais; FANTASTIC Lifestyle Checklist (estilo de vida); Multidimensional Health Locus of Control Scale (lócus de controle da saúde); Health Safety Executive - Indicator Tool (avaliação dos riscos psicossociais do trabalho); e SF-12 Short-Form Health Survey - 12 (saúde física e mental percebida). A amostra foi dividida entre aqueles que apresentaram Perfil Saudável e Perfil de Risco em estilo de vida. Para identificar as variáveis com maior associação com o Perfil Saudável de estilo de vida foi empregado o modelo de Regressão Logística Múltipla Binária. RESULTADOS: Apontou-se que menor estresse relacionado ao trabalho, as dimensões Acaso e Outros Poderosos do lócus de controle da saúde, melhor autopercepção em saúde física e mental, e maior escolaridade estão associados com estilo de vida saudável. DISCUSSÃO: O estudo contribui com a literatura ao apresentar fatores que podem ter efeitos sobre o estilo de vida de servidores públicos em contexto universitário e ao oferecer dados que dialogam com uma perspectiva biopsicossocial da saúde do trabalhador.

INTRODUCTION: In the context of workers' health, understanding which aspects influence the adoption of a healthy lifestyle can guide health promotion actions and organizational policies. OBJECTIVE: To investigate whether work-related stress, locus of control to health, and perceived health are associated with a healthy lifestyle in employees of a federal institution of higher education. METHOD: This is a cross-sectional study using an online questionnaire with a sample of 898 participants. The instruments used were: a questionnaire with sociodemographic and work characteristics; FANTASTIC Lifestyle Checklist, Multidimensional Health Locus of Control Scale, Health Safety Executive - Indicator Tool; and SF-12. Participants were grouped according to their lifestyle: Healthy Profile or Risk Profile. To identify the variables with association with the Healthy Lifestyle Profile, the Multiple Binary Logistic Regression model was used. RESULTS: it was pointed out that less work-related stress, Chance and Other Powers dimensions of the locus of health control, better self-perception of physical and mental health, and higher education are associated with a healthy lifestyle. DISCUSSION: The study contributes to the literature by presenting factors that may affect the lifestyle of public workers in a university context and by offering data that dialogue with a biopsychosocial perspective of workers' health.

INTRODUCCIÓN: En el ámbito de la salud de los trabajadores, es necesario comprender qué aspectos influyen en la adopción de un estilo de vida saludable. OBJETIVO: Investigar si el estrés laboral, el locus de control de la salud y la autoevaluación de la salud están asociados con un estilo de vida saludable en empleados de una institución federal de educación superior. MÉTODO: Se trata de un estudio transversal mediante cuestionario online, con muestra no probabilística. 898 servidores participaron en este estudio. Se utilizaron los siguientes instrumentos: cuestionario con características sociodemográficas y laborales; FANTASTIC Lifestyle Checklist (estilo de vida); Multidimensional Health Locus of Control Scale (locus de control), Health Safety Executive - Indicator Tool (evaluación de riesgos psicosociales en el trabajo); and SF-12 (salud física y mental percibida). La muestra se dividió entre quienes presentaban un Perfil Saludable y un Perfil de Riesgo en el estilo de vida. Para identificar las variables con mayor asociación con el Perfil de Estilo de Vida Saludable se utilizó el modelo de Regresión Logística Binaria Múltiple. RESULTADOS: Se apuntó que menor estrés laboral, las dimensiones Azar y Otros Poderosos del locus de control de la salud, mejor autopercepción en salud física y mental, y mayor escolaridad se asocian con estilo de vida saludable. DISCUSIÓN: El estudio contribuye a la literatura al presentar factores que pueden tener efecto sobre el estilo de vida de los servidores públicos en un contexto universitario y al ofrecer datos que dialogan con una perspectiva biopsicosocial sobre la salud de los trabajadores.

Pharmaceutical care and evaluation of adherence to antiretroviral therapy in people living with HIV/AIDS

Abstract Highly Active Antiretroviral therapy (HAART) depends on optimal adherence to be effective. Pharmacotherapeutic follow-up can be used as a strategy for treatment fidelity. To provide pharmaceutical care for HAART patients, to assess adherence, to identify and resolve drug related problems (DRP). This is a prospective, interventional study aimed at people on HAART. Data was collected using the pharmacotherapeutic follow-up form and CEAT-VIH. There was a predominance of women (59%), older than 33 years (75%), mostly single (43%). Regarding adherence, 64% had insufficient adherence at the start of the study, while 36% had strict/adequate adherence. After the pharmacotherapeutic follow-up, 70% presented strict/adequate adherence. Regarding HAART, the relationship between adhesion versus time of HAART and adherence versus regimen used was significant, considering that less time of therapy and regimen containing protease inhibitors are predictors for insufficient adherence. Regarding the DRP identified (f=77), missed pills (32%), untreated disease, incorrect management frequency, and undue self-medication (12%) were the most frequent. Pharmaceutical interventions (f=137) were predominantly advising related to specific pharmacological treatment (32%), non-pharmacological measures (20%), and medication suspension (9%). Pharmaceutical care was shown to be animportant strategy, within the multi professional team, to improve adherence, besides identifying and resolving DRP.

Factors that increase risk for poor adherence to phenylketonuria treatment in Brazilian patients.

Neurotoxic effects caused by high phenylalanine (Phe) in patients with phenylketonuria (PKU) can be avoided through dietary treatment. However, achieving the recommended Phe levels has been a challenge. This study aimed to investigate factors associated with adherence to PKU treatment among patients followed at a medical genetics public service in southern Brazil. Twenty-nine patients (early diagnosed, n = 20; late-diagnosed, n = 9) with classical (n = 16) or mild PKU (n = 13) aged 6-34 years (16.4 ± 7.5) and 16 caregivers were included. Blood Phe levels were recorded, and assessment tools measuring barriers to treatment, IQ, knowledge about disease, treatment, and perceived adherence were collected. Classical PKU patients showed higher current blood Phe levels than mild PKU patients (U = 37.000, p = 0.003). Lifetime and childhood Phe levels were associated with recent metabolic control (τ = 0.76, p = 0.000; τ = 0.70, p = 0.000, respectively). The perception of barriers to treatment was associated with a higher blood Phe level (τ = 0.39, p = 0.003). Tolerance to Phe, metabolic control throughout childhood, and perceived difficulty in living with demands of treatment are important factors of greater vulnerability to poor adherence in PKU patients.

[Association of empathy and occupational stress with burnout among primary health care professionals]. / Associação da empatia e do estresse ocupacional com o burnout em profissionais da atenção primária à saúde.

There are indications that burnout syndrome affects primary health care (PHC) professionals. The scope of this study was to investigate the association of empathy and occupational stress with the burnout of PHC professionals. A total of 348 workers filled out an an online assessment including occupational stress, empathy, and burnout scales. The empathetic-concern and perspective-taking empathy dimensions were negatively correlated with burnout (p<.01), while personal anguish was positively related to it (p<.01). The reward and effort occupational stress dimensions revealed greater weight in explaining the job disillusion and psychic exhaustion burnout subscales (p<.001), respectively, while empathetic concern and personal anguish revealed the greatest weight for the explanation of indolence and guilt (p<.001). Reward was the significant predictor of Profile 1 (p=.008), the less severe form of the syndrome, while personal anguish (p=.028) and effort (p=.012) revealed the same weight in the model for Profile 2, namely the most severe level of burnout. The results suggest interventions that focus on both work stressors and the empathy of the professionals involved.

Massive open online course for Brazilian healthcare providers working with substance use disorders: curriculum design.

BACKGROUND: Interpersonal and technical skills are required for the care of people living with substance use disorders. Considering the applicability and usability of online courses as continuing professional education initiatives, this study aimed to describe the content design process of an introductory-level healthcare-centered Massive Open Online Course (MOOC). METHODS: The content of the course was informed through needs assessment, by using three sources: (a) narrative literature review, (b) Delphi health experts panel consensus, and (c) focus groups conducted with people living with substance use disorders. The data from the empirical research phases were analyzed through qualitative Thematic Analysis. RESULTS: The product of this research project is the introductory-level Massive Open Online Course "Healthcare: Developing Relational Skills for the Assistance of People Living with Substance Use Disorders" which approaches health communication and empathetic relational professional skills as a means of reducing stigmatization of people living with substance use disorders. CONCLUSIONS: Diverse strategies for designing distance education initiatives have to consider different views on the subject being approached in such courses. The product presented in this paper has the potential to be an educational tool for topics traditionally not addressed in Brazilian continuing education and can be used as a model to the design of online courses directed to the development of work-related skills for the healthcare professions.

Development of an inventory to assess perceived barriers related to PKU treatment.

BACKGROUND: According to studies of phenylketonuria (PKU), the Brazilian population's metabolic control shows unsatisfactory indexes from childhood. Research on patients' perceived difficulties or barriers to adherence to treatment can help us to comprehend how these outcomes are associated. The present study aimed to: (1) describe the development of an inventory for identifying the most frequent and relevant perceived barriers to PKU treatment from the perspective of patients, caregivers, and healthcare professionals; (2) evaluate certain psychometric characteristics of the new measure; and, (3) explore potential predictors (sociodemographic and medical characteristics) that may contribute to increasing the number of perceived barriers and examine whether the number of barriers is associated with the degree of adherence shown by the patient. RESULTS: Participants in the study were 23 patients with PKU (M age = 18.0 years; SD = 7.3; range 6 to 34 years; 69% early-treated) in classical (n = 11) and mild (n = 12) form, and 11 caregivers. The inventory, developed to ascertain perceived barriers to treatment, was completed by patients (≥ 13 years) and caregivers of patients aged 6 to 17 years. Analyses were conducted to investigate whether barrier inventory scores were associated with adherence to treatment as measured by phenylalanine levels in patients' medical records. Scores on the inventory differed across the patient age groups: adolescents had lower scores (i.e. reported fewer barriers) compared with those of adults (U = 8.000, p = 0.008); patients with better recent metabolic control also reported fewer perceived barriers than did patients with poor adherence (U = 20.000, p = 0.009); and the number of perceived barriers was positively associated with recent blood phenylalanine concentration (Kendall's taub = 0.41; p = 0.001). CONCLUSIONS: These results suggest that the inventory has merit in assessing perceived barriers and support the need for further research on barriers perceived by PKU patients.

Associação da empatia e do estresse ocupacional com o burnout em profissionais da atenção primária à saúde / Association of empathy and occupational stress with burnout among primary health care professionals

Resumo Há evidências de que a Síndrome de Burnout afeta profissionais da atenção primária à saúde (APS). Objetivou-se investigar a associação da empatia e do estresse ocupacional com o Burnout de profissionais da APS. 348 trabalhadores responderam a versões online de escalas de estresse ocupacional, empatia e Burnout. As dimensões de empatia preocupação empática e tomada de perspectiva correlacionaram-se negativamente com a síndrome (p<.01), enquanto angústia pessoal demonstrou relação positiva (p<.01). As dimensões de estresse ocupacional recompensa e esforço apresentaram maior peso nos modelos das subescalas de Burnout ilusão pelo trabalho e desgaste psíquico (p<.001), respectivamente, enquanto a preocupação empática e angústia pessoal demonstraram os maiores pesos para a explicação de indolência e culpa (p<.001). Recompensa foi o preditor significativo de Perfil 1 (p=.008), forma menos grave da síndrome, enquanto angústia pessoal (p=.028) e esforço (p=.012) demonstraram o mesmo peso no modelo para Perfil 2, nível mais severo de Burnout. Os resultados sugerem intervenções que enfoquem tanto estressores do trabalho quanto a empatia dos profissionais.

Abstract There are indications that burnout syndrome affects primary health care (PHC) professionals. The scope of this study was to investigate the association of empathy and occupational stress with the burnout of PHC professionals. A total of 348 workers filled out an an online assessment including occupational stress, empathy, and burnout scales. The empathetic-concern and perspective-taking empathy dimensions were negatively correlated with burnout (p<.01), while personal anguish was positively related to it (p<.01). The reward and effort occupational stress dimensions revealed greater weight in explaining the job disillusion and psychic exhaustion burnout subscales (p<.001), respectively, while empathetic concern and personal anguish revealed the greatest weight for the explanation of indolence and guilt (p<.001). Reward was the significant predictor of Profile 1 (p=.008), the less severe form of the syndrome, while personal anguish (p=.028) and effort (p=.012) revealed the same weight in the model for Profile 2, namely the most severe level of burnout. The results suggest interventions that focus on both work stressors and the empathy of the professionals involved.

Adesão ao Tratamento, Resiliência e Percepção de Doença em Pessoas com HIV, / Treatment Adherence, Resilience and Illness Perception in People with HIV

Resumo O objetivo deste estudo foi investigar variáveis preditoras da adesão ao tratamento antirretroviral entre aspectos sociodemográficos, clínicos e psicológicos (resiliência e percepção de doença) em pessoas com o vírus da imunodeficiência humana (HIV). Participaram 155 pacientes, sendo 72,9% homens. Roteiros de entrevista sobre aspectos sociodemográficos e clínicos e instrumentos validados para a população brasileira foram aplicados. Três variáveis foram preditoras da adesão: resiliência, percepção de doença como preditor negativo, e idade, totalizando 29% de variância explicada. O estudo tem implicações para a prática de psicólogos e de equipes de saúde que atuam na área, com base na implementação de intervenções visando à adesão e ao autocuidado, bem como à adaptação e à resiliência em pessoas que vivem com HIV.

Abstract The objective of this study was to investigate predictive variables of adherence to antiretroviral treatment among sociodemographic, clinical and psychological aspects (resilience and perception of disease) in people living with the human immunodeficiency virus (HIV). Participants were 155 patients, 72.9% men. Interview scripts about sociodemographic and clinical aspects and validated instruments for the Brazilian population were applied. Three variables were predictors of adherence: resilience, perceived illness as a negative predictor, and age, with 29% explained variance. The study has implications for the practice of psychologists and health teams working in the field, based on the implementation of adherence and self-care interventions, as well as adaptation and resilience in people living with HIV.

Health-related quality of life of people living with HIV infection in Spain: a gender perspective.

Studies exploring gender differences in health-related quality of life (HRQOL) of people living with HIV/AIDS (PLWHA) are scarce and contradictory. This study evaluated gender differences in HRQOL of 744 PLWHA with median (IQR) age 44 (37-48) years and HIV infection diagnosed 12 (5-20) years earlier. Results showed important differences between genders (p < .05). Better male physical health was related to being employed, not having economic worries, not receiving psychological support, not having injected drugs in past, low negative mood HIV-related, low HIV illness representation and internalized stigma, and high body image satisfaction and health behavior. For women, variables were fewer years since HIV diagnosis and low enacted stigma-personal experience of rejection. Mentally, variables in men were being employed, not having injected drugs, having a stable partner, high health behavior, use of problem-solving coping, personal autonomy and personal meaning. In women, better mental health was related to high CD4 cells, self-esteem and body image satisfaction, and negative mood HIV-related. Men and women coincided in absence of past opportunistic infections being related to better physical and mental health, and absence of side effects for physical health and low HIV-related stress and HIV illness representation for mental health. Our results highlight the need for detailed study of gender differences that identify the bio-psycho-socio inequalities that affect HRQOL.

Health-related quality of life in children and adolescents living with Gaucher disease and their parents.

Objective: The health-related quality of life (HRQoL), clinical status and perceived burden of disease in children and adolescents with Gaucher Disease (GD) were assessed. Method: A Spanish multicenter collaboration study involving 13 hospitals was performed to evaluate pediatric patients with GD (n = 17, ages 5-18; n = 3, ages 2-4) and their parents (n = 20) using a HRQoL measure (PedsQL 4.0) and a survey on the perceived burden of the disease. Three children under five years old were evaluated by parent proxy-report. Relevant medical and socio-demographical characteristics were recorded. Results: Sixty-nine percent of the participants with GD had mild and 31% had moderate severity level, all receiving enzyme replacement therapy (ERT). HRQoL was associated with the severity score index and was adjusted for age. Age was related to school functioning (older patients had lower scores), and female patients reported worse school functioning than males. Symptoms such as bone, joint or abdominal pain, bleeding, and fatigue were negatively associated with HRQoL. Perceptions of the burden related to GD, such as feeling ill and feeling sad, were negatively associated with HRQoL. Although the PedsQL scores of children and parents showed concordance, patterns of association between symptoms and perceived burden differed between children and parents. No associations were observed between HRQoL scores and time on ERT or ERT dosage. Conclusion: HRQoL perceptions were affected by clinical status, observable and subjective symptoms, feelings of burden related to the disease, and patient characteristics (e.g. age and gender). Aspects of the disease that affect HRQoL may be perceived differently by children and parents.

Couple relationship education program "Living as Partners": evaluation of effects on marital quality and conflict.

Relationship education programs are strategies that can favor better marital quality and conflict management between spouses. The relationship education program "Living as Partners: Turning Challenges into Opportunities" seeks to promote the couples' learning of conflict resolution strategies and better quality levels in the relationship. This study evaluates the capacity of this program to produce results regarding marital quality and three dimensions of the couple's conflict: frequency, intensity, and resolution strategies. Data from 41 couples were analyzed before and after the program, and a follow-up after 5 months (n = 33 couples) were conducted as well (single group, pre-test, post-test, and follow-up quasi-experimental design). Results show that the program produced immediate effects in all the outcome variables, which remained significant after 5 months, except for marital quality and for the strategy of compliance. These outcomes showed effect sizes ranging from low to high levels. The study presents evidence about the ability of the "Living as Partners" program to produce improvements in couple's conflict indicators, addressing an unexplored field of research and intervention focused on Brazilian cultural specificities.

Couple relationship education program "Living as Partners": evaluation of effects on marital quality and conflict

Abstract Relationship education programs are strategies that can favor better marital quality and conflict management between spouses. The relationship education program "Living as Partners: Turning Challenges into Opportunities" seeks to promote the couples' learning of conflict resolution strategies and better quality levels in the relationship. This study evaluates the capacity of this program to produce results regarding marital quality and three dimensions of the couple's conflict: frequency, intensity, and resolution strategies. Data from 41 couples were analyzed before and after the program, and a follow-up after 5 months (n = 33 couples) were conducted as well (single group, pre-test, post-test, and follow-up quasi-experimental design). Results show that the program produced immediate effects in all the outcome variables, which remained significant after 5 months, except for marital quality and for the strategy of compliance. These outcomes showed effect sizes ranging from low to high levels. The study presents evidence about the ability of the "Living as Partners" program to produce improvements in couple's conflict indicators, addressing an unexplored field of research and intervention focused on Brazilian cultural specificities.