Intercultural Communication between Long-Stay Immigrants and Catalan Primary Care Nurses: A Qualitative Approach to Rebalancing Power.

There is a gap between the preferences of immigrant patients and their experiences with intercultural communication. This study aims to explore the experiences and perspectives of long-stay immigrants on intercultural communication in encounters with primary care (PC) nurses. Participants were selected by purposive sampling at the Maresme Primary Care Center. A focus group and five in-depth interviews with long-stay immigrants from eight countries were carried out. Data collection was guided by a script previously validated by a group of experts. We conducted a qualitative analysis following Charmaz's approach, and data saturation was reached with 11 patients (one focus group and five interviews). Long-stay immigrants would like closer and more personalized communication exchanges with greater humanity, as well as polite and respectful manners as they perceive signs of an asymmetrical care relationship. Those who had negative communication experiences tried to justify some of the behaviors as a result of having free access to public health services. This is one of the few existing studies from the point of view of long-stay immigrants. Achieving effective intercultural communication requires a process of self-reflection, awareness-raising and commitment, both on a personal and institutional level, to eliminate the asymmetry in the nurse-patient relationship. Nurses should be trained in person-centered intercultural communication.

Psychological Distress and Somatization in Immigrants in Primary Health Care Practices.

The process of international migration causes a situation of vulnerability in people's health and greater difficulty in coping with disease. Furthermore, the adversities suffered during migration can trigger reactive signs of stress and cause anxious, depressive, confusional and somatic symptoms. This article studies the relationships between psychosocial risk, psychological distress and somatization in immigrants from four communities: Maghrebis, Sub-Saharans, South Americans and South Asian. A cross-sectional study was carried out with questionnaires on 602 immigrants who were surveyed in the primary care centers of an urban area of Catalonia. The instruments used were the Demographic Psychosocial Inventory (DPSI), the Brief Symptom Inventory (BSI) and the Somatic Symptom Inventory (SSI). The average psychosocial risk obtained was 0.35, with the highest values in the Sub-Saharan community. Psychological distress showed a mean value of 0.66, with the Sub-Saharan community scoring the lowest in all dimensions except depression. The average somatization values were 1.65, with the Sub-Saharan community scoring the least. The female gender is a risk factor for somatization and psychological distress. Perceived psychosocial risk is a predictor of psychological distress, but not somatization, suggesting that the use of more adaptive coping strategies could minimize the effect of the migration process on somatizations.

Trastorno límite de la personalidad e inteligencia emocional en adolescentes institucionalizados / Borderline Personality Disorder and Emotional Intelligence in Institutionalized Adolescents

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This study analyzed the prevalence of Borderline Personality Disorder between the mentioned collective and the relationship between Emotional Intelligence and this disorder. A total of 61 participants between 13-17 years old, took part in this study. The results showed a important prevalence of borderline symptomatology as well as a negative correlation between Borderline Personality Disorder and general life satisfaction. Results of this study showed that an important prevalence of Borderline Personality Disorder on institutionalized children in the sample used. Furthermore, there would be a link between child abuses as well as child neglect and Borderline Personality Disorder, which would lead to a great emotional discomfort to the person who suffers it

Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad (segunda parte) / Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities (second part)

La inclusión de las personas con discapacidad es un eje prioritario en las políticas de desarrollo social, tanto en España como en el resto del mundo, también en la práctica de las actividades físicas y deportivas, donde ya son un ejemplo extrapolable a otros ámbitos de la sociedad. Actualmente las Federaciones Deportivas Internacionales (unideportivas) están desarrollando sus procesos inclusivos para acoger a los deportistas con discapacidad de sus modalidades deportivas, este proceso ya se ha convertido en un hecho generalizado e irreversible a nivel deportivo mundial. También las federaciones deportivas españolas, tanto de deporte como las plurideportivas de personas con discapacidad han iniciado, a distintos niveles, este proceso inclusivo. Esta situación está siendo conducida por el Consejo Superior de Deporte y el Comité Paralímpico Español, proceso que ha de culminar con la incorporación, a estas federaciones nacionales por deporte, de todas las personas discapacitadas o no, que quieren practicar sus modalidades, en un sólo modelo organizativo. En su primera parte, "Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad", ya se remarca que la estructura y organización Servicios Médicos Federativos (SMF) no debe ser ajena al proceso inclusivo y de adecuación en las estructuras federativas. Por lo cual, ahora, se completan el resto de acciones y adaptaciones necesarias y significativas, como en la fisioterapia, ortopedia y de ayudas técnicas, atención sanitaria, psicológica y también de adaptaciones estructurales de los SMF. Esta revisión, en conjunto, tiene como objetivo principal garantizar, a través de sus recomendaciones, unos servicios de calidad, que puedan ser ofrecidos en la misma medida a deportista con o sin discapacidad en igualdad de trato. Aportando recomendaciones y más conocimiento al proceso de inclusión en el deporte federado español, para que éste alcance el éxito, y pueda garantizar un buen servicio a todos sus deportistas, siguiendo los criterios más actuales de buenas prácticas inclusivas

The inclusion of people with disabilities is a priority axis in social development policies, both in Spain and in the rest of the world. Also, in practice of physical and sports activities, where they are already an example that can be extrapolate to other areas of the society. Currently the International Sports Federations (one-sport) are developing their inclusive processes to accommodate athletes with disabilities of their sport; this process has already become a widespread and irreversible worldwide sport movement. This situation is being conducted by the "Consejo Superior de Deportes" (Spanish Sport Council) and the Spanish Paralympic Committee, a process that must culminate with the incorporation, to these national federations by sport, of all people disabled or not, who want to practice their modalities, in a single sport organizational model. In its first part, "Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities", it already pointed out that the structure and organization of Federative Medical Services (SMF) must not be alien to the inclusive process and adaptation in all the federative structures. Therefore, now, the rest of the necessary and significant actions and adaptations are complete, as in physiotherapy, orthopedics and technical aids, health care, psychology and structural adaptations of the SMF also. This review, as a whole, has as main objective to guarantee, through its recommendations, quality services, which can be offer in the same measure to athlete with or without disability in equal treatment. Providing recommendations and more knowledge to the process of inclusion in the federated Spanish sport, so that it reaches success, and can guarantee a good service to all its athletes, following the most current criteria of good inclusive practices

Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad (primera parte) / Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities (first part)

El proceso de inclusión del deporte adaptado repercute a diversos niveles de los Servicios Médicos Federativos (SMF), que deben de adaptarse a la presencia de los deportistas con discapacidad en las federaciones unideportivas españolas. En esta primera parte de las "Recomendaciones a los Servicios Médicos de federaciones españolas unideportivas, para la inclusión de deportistas con discapacidad" se presentan las bases en que fundamentar las necesarias adaptaciones, desde un modelo general de inclusión - integración, desde la dimensión del deportista, con diversos tipos de discapacidad, y de la modalidad deportiva. Se presentan los aspectos más significativos a tener en cuenta por los SMF en el proceso de inclusión de los deportistas con discapacidad, referidos a las adaptaciones específicas y diferenciales sobre el control fisiológico y el rendimiento deportivo: reconocimiento médico y funcional, pruebas de rendimiento deportivo, reconocimiento médico-deportivo, valoraciones y clasificaciones funcionales, y nutrición, hidratación y ayudas ergogénicas. Finalmente, se comentan aspectos específicos del control antidopaje en deportistas con discapacidad: autorizaciones de usos terapéuticos y adaptaciones específicas en las técnicas de recogida de muestras. La segunda parte, en un segundo artículo, tratará de otras acciones específicas en los SMF y otras acciones y adaptaciones que garanticen la igualdad de condiciones entre los deportistas

The inclusion process in adapted sport, affects at several levels on the Medical Services in Spanish Sport Federations (SMF), due to the presence of disabled athletes. This is a first part of the article titled Recommendations to the Medical Services in Spanish federations by sport, for the inclusion of athletes with disabilities. New significant aspects related with specific and differential adaptations on physiological control and sports control, are presented: medical and functional recognition, sports performance tests, sports-medical examination, functional classifications and assessments. Subsequently, nutrition, hydration and ergogenic supplements specific aids are explained. Finally, specific aspects of anti-doping control in disabled athletes are discussed: therapeutic uses exemption and specific adaptations to the sample collection techniques. The second part, in a second article, will deal with other specific actions in the SMF and with other actions and adaptations that guarantee equality of conditions among athletes

Engagement y trayectoria profesional en técnicos de deporte adaptado / Engagement and career path in adapted sports coaches

El presente estudio abre futuras líneas de investigación en el ámbito de la psicología positiva en el deporte. Se realizó un análisis descriptivo de la trayectoria del técnico de deporte adaptado y se profundizó en conocer su nivel de Engagement y las tres dimensiones que conforman este constructo. Posteriormente se realizó un análisis comparativo con técnicos de deporte general. En el estudio participaron 45 técnicos de deporte adaptado y 45 técnicos de deporte general, seleccionados de forma no probabilística e intencional. Para la medición del Engagement se utilizó el cuestionario Engagement: Utrecht Work Engagement Scale (Schaufeli y Bakker, 2003); y para profundizar en el perfil del técnico, un breve cuestionario sobre la trayectoria profesional de los técnicos de deporte, a partir del modelo de Pérez-Ramírez (2002b). Los resultados muestran que los participantes presentan altos niveles de Engagement y se identifican elementos comunes entre los técnicos de deporte adaptado y el resto de técnicos. Más de la mitad del grupo estudiado han sido deportistas de competición, no se dedican exclusivamente a entrenar y presentan un perfil más polideportivo (AU)

The current study opens future lines of research in the field of positive Psychology in Sports. A descriptive analysis of the adapted sports coach career path was conducted, going in depth into their level of Engagement and the three dimensions that make up this construct. Later, a comparative analyses with general sports coaches was completed. The study was developed with a sample of 45 adapted sports coaches and 45 general sports coaches. The Engagement: Utrecht Work Engagement Scale (Schaufeli y Bakker, 2003) was used to measure de level of Engagement, and a brief questionnaire drawn on that from Pérez-Ramirez (2002b) about the career path of sports coaches was applied to explore the coaches’ profile. The participants show high levels of Engagement and common elements are identified among both groups. More than a half of the group have been competitive athletes, do not work exclusively as a coach and have a multisport profile (AU)

O presente estudo abre futuras linhas de investigação no âmbito da psicologia positiva no desporto. Realizou-se uma análise descritiva da trajetória do técnico do desporto adaptado e estudou-se a fundo o seu nível de Engagement e as três dimensões que defiem este constructo. Posteriormente, realizou-se uma análise comparativa com técnicos do desporto em geral. O estudo foi realizado com uma amostra de 45 técnicos de desporto adaptado e 45 técnicos de desporto geral, selecionados de forma não probabilística e intencional. Para a medição de Engagementutilizou-se o inquérito Engagement: Utrecht Work Engagement Scale (Schaufeli y Bakker, 2003); e para estudar a fundo o perfil do técnico, um breve inquérito sobre a trajetória profissional dos técnicos do desporto, a partir do modelo PérezRamirez (2002b). Os resultados mostram que os participantes apresentam altos níveis de Engagement e identificam-se elementos comuns entre os técnicos de desporto adaptado e o resto de técnicos. Mais de metade do grupo estudado foi desportista de competição, não se dedica exclusivamente a treinar e apresenta um per#l mais polidesportivo (AU)

Level of distress, somatisation and beliefs on health-disease in newly arrived immigrant patients attended in primary care centres in Catalonia and definition of professional competences for their most effective management: PROMISE Project.

BACKGROUND: Newly arrived immigrant patients who frequently use primary health care resources have difficulties in verbal communication. Also, they have a system of beliefs related to health and disease that makes difficult for health care professionals to comprehend their reasons for consultation, especially when consulting for somatic manifestations. Consequently, this is an important barrier to achieve optimum care to these groups. The current project has two main objectives: 1. To define the different stressors, the level of distress perceived, and its impact in terms of discomfort and somatisation affecting the main communities of immigrants in our area, and 2. To identify the characteristics of cross-cultural competence of primary health care professionals to best approach these reasons for consultation. METHODS/DESIGN: It will be a transversal, observational, multicentre, qualitative-quantitative study in a sample of 980 people from the five main non-European Union immigrant communities residing in Catalonia: Maghrebis, Sub-Saharans, Andean South Americans, Hindustanis, and Chinese. Sociodemographic data, level of distress, information on the different stressors and their somatic manifestations will be collected in specific questionnaires. Through a semi-structured interview and qualitative methodology, it will be studied the relation between somatic manifestations and particular beliefs of each group and how these are associated with the processes of disease and seeking for care. A qualitative methodology based on individual interviews centred on critical incidents, focal groups and in situ questionnaires will be used to study the cross-cultural competences of the professionals. DISCUSSION: It is expected a high level of chronic stress associated with the level of somatisations in the different non-European Union immigrant communities. The results will provide better knowledge of these populations and will improve the comprehension and the efficacy of the health care providers in prevention, communication, care management and management of resources.

Tratamiento psicológico grupal para los trastornos de ansiedad en el ámbito de la salud pública / Group therapy for anxiety disorders in public mental health setting

Este trabajo evalúa los cambios de una intervención psicoterapéutica grupal para pacientes con trastornos de ansiedad generalizada, trastorno de pánico con o sin agorafobia y trastorno adaptativo con sintomatología ansiosa o depresiva asociada. Un total de 107 pacientes participaron en el estudio, de los cuales 73,8% eran mujeres y el 26,2% hombres con edades comprendidas entre los 21 y 62 años, provenientes de un Centro de Salud Mental y un Centro de Atención Primaria del Consorci Sanitari del Maresme (Barcelona). El tratamiento cognitivo-conductual se compuso de 20 sesiones con periodicidad semanal de 90 minutos de duración. Los participantes completaron a través de una entrevista semiestructurada medidas clínicas de ansiedad, depresión, somatización, inteligencia emocional percibida y medidas protectoras de salud tales como autoestima y satisfacción vital. Los resultados obtenidos muestran mejoras significativas en términos de reducción sintomática, además de un incremento de la autoestima y la satisfacción general con la vida para todos los grupos diagnósticos (AU)

The aim of the current study is to assess the outcome of a group psychotherapy intervention in patients with generalized anxiety disorder, panic disorder with or without agoraphobia and adjustment disorder with anxious or depressive symptoms. A total of 107 patients were included in the study, 73,8% were women and 26,2% men, aged form 21 and 62, form a Mental Health Center and a Primary Care Center, both of which are part of the Maresme Sanitary Consortium (Barcelona). The cognitive-behavioral therapy consisted of twenty 90 minute weekly sessions. The participants completed a semistructures interview that included clinical measures of anxiety, depression, somatization, perceived emotional intelligence and other measures related with health (self-esteem and life satisfaction). The results showed significant improvements in symptom reduction, as well as an increase in self-esteem and perceived quality of life (p<0.01) for all diagnostic groups (AU)

Las intervenciones motivacionales en el tratamiento psicoterapéutico de la fase inicial de la esquizofrenia / Motivational intervention in the initial phase of schizophrenia

Son muchos los estudios que en los últimos quince años han demostrado la efectividad de los programas de intervención precoz en la esquizofrenia y su impacto sobre el pronóstico de la enfermedad. De hecho, la intervención preventiva en la fase prodrómica y posterior al primer episodio se ha convertido en una de las líneas principales de investigación y de aplicación clínica para el abordaje de la esquizofrenia. Durante la fase inicial de la esquizofrenia, quedan paralizadas muchas áreas de actividad y relacionales a las cuales el paciente deberá enfrentarse durante la fase de recuperación. Su grado de motivación en esta fase será de vital importancia para el tratamiento. En el presente trabajo se presenta una revisión y algunas consideraciones a cerca de las intervenciones motivacionales en la esquizofrenia

Many studies have shown the effectiveness of early intervention programs for schizophrenia and its impact on illness outcome. In fact, the preventive intervention in the prodromical period and after the first episode of psychosis has become the main way for the research and clinical procedures for schizophrenia treatments. During the initial phase of schizophrenia, many activity and relational areas are affected. Patient motivation could be very important to face de treatment during this period. So, the current article presents a literature revision and some considerations about the motivational interventions in the schizophrenia

Las intervenciones motivacionales en el tratamiento psicoterapéutico de la fase inicial de la esquizofrenia / Motivational intervention in the initial phase of schizophrenia

Son muchos los estudios que en los últimos quince años han demostrado la efectividad de los programas de intervención precoz en la esquizofrenia y su impacto sobre el pronóstico de la enfermedad. De hecho, la intervención preventiva en la fase prodrómica y posterior al primer episodio se ha convertido en una de las líneas principales de investigación y de aplicación clínica para el abordaje de la esquizofrenia. Durante la fase inicial de la esquizofrenia, quedan paralizadas muchas áreas de actividad y relacionales a las cuales el paciente deberá enfrentarse durante la fase de recuperación. Su grado de motivación en esta fase será de vital importancia para el tratamiento. En el presente trabajo se presenta una revisión y algunas consideraciones a cerca de las intervenciones motivacionales en la esquizofrenia

Many studies have shown the effectiveness of early intervention programs for schizophrenia and its impact on illness outcome. In fact, the preventive intervention in the prodromical period and after the first episode of psychosis has become the main way for the research and clinical procedures for schizophrenia treatments. During the initial phase of schizophrenia, many activity and relational areas are affected. Patient motivation could be very important to face de treatment during this period. So, the current article presents a literature revision and some considerations about the motivational interventions in the schizophrenia

Valores personales y profesionales en médicos de familia y su relación con el síndrome del burnout / Personal and professional values in primary care physicians and your relation with burnout syndrome

El objetivo de este estudio es analizar si existen diferencias en los valores de los médicos de Atención Primaria con niveles altos o bajos de burnout. La muestra quedó constituida por 61 médicos que habían participado anteriormente en un estudio longitudinal iniciado en 1999. En la primera evaluación participaron 528 médicos de la provincia de Barcelona y en la presente se han evaluado aquellos que obtuvieron las puntuaciones extremas en desgaste profesional. Para la recogida de datos se aplicó un cuestionario de datos sociodemográficos, la versión española del MBI (Maslach Burnout Inventory) y un cuestionario de valores validado con trabajadores del ICS (Institut Català de la Salut). Se observan diferencias significativas entre ambos grupos en los valores de Altruismo (p=0,01), Confidencialidad (p=0,013) y Abnegación (p=0,036). Asimismo se aprecia una correlación directa entre Inmediatez Cansancio Emocional (p<0,05), una relación inversa entre Altruismo Cansancio Emocional (p<0,01) y Altruismo Despersonalización (p<0,05). En suma, todo parece indicar que algunos valores personales y profesionales se asocian a la presencia o ausencia de burnout. Paralelamente, la percepción de conflicto entre los valores personales y los profesionales podría favorecer la presencia de burnout

The aim of the current study was to analyse the differences in values of Primary Care doctors with high or low scores in burnout. 61 Primary Care doctors with extremely scores in burnout who participated in a longitudinal study started in 1999 were chose. In the first assessment were interviewed 528 subjects from Barcelona’s northern countries. There were used a sociodemographic questionnaire data, the Spanish version of the Maslach Burnout Inventory (MBI) and a values questionnaire that was validated in ICS (Institut Català de la Salut) workers sample. Statistically meaningful differences were observed in the following values between groups: Altruism (p=0,01), Confidentiality (p=0,013) y Abnegation (p=0,036). Data shows a direct correlation between Impatience-Emotional Exhaustion (p<0,05), inverse relations between Altruism Emotional Exhaustion (p<0,01) and Altruism Depersonalisation (p<0,05). The study shows some personal and professional values are associated with high or low levels of burnout. In the same way the conflict perception between personal and professional values could be associated with high scores in burnout