Efecto de una intervención cognitivo-conductual en cuidadores de niños con TEA: depresión, ansiedad, estrés y calidad de vida / Effect of a cognitive-behavioral intervention on caregivers of children with ASD: depression, anxiety, stress, and quality of life

Este estudio tuvo como objetivo evaluar el efecto de una intervención cognitivo conductual en la sintomatología de depresión, ansiedad y estrés, la sobrecarga percibida y la calidad de vida en cuidadores de niños con trastorno del espectro autista. Se realizó un estudio experimental con grupo intervención y control, con mediciones de autorreporte pretest-postest. Participaron en el estudio un total de 53 cuidadores: 22 en el grupo experimental y 31 en el grupo control en lista de espera. La mayoría de los participantes fueron mujeres de entre 35 y 64 años, casadas o en una relación formal, con estudios profesionales o superiores y que realizaban alguna actividad remunerada. Los resultados del análisis intergrupal mostraron una disminución de la sintomatología asociada al estrés y sobrecarga percibida y un aumento en la calidad de vida en el grupo experimental. Los datos intragrupales dan cuenta de que, los sujetos del grupo control no tuvieron cambios en ninguna variable, por el contrario, en el grupo experimental se observa una disminución significativa en los índices de ansiedad, estrés y sobrecarga percibida y un aumento en la calidad de vida. Todos estos cambios ocurrieron con tamaños de efecto mediano y grande. Se analizan los mecanismos de cambio y se discuten los hallazgos del estudio a la luz de sus limitaciones. Se concluye que una intervención cognitivo conductual es una estrategia con efectos positivos para brindar apoyo psicológico a los cuidadores de niños con autismo. (AU)

This study aimed to evaluate the effect of a cognitive behavioral intervention on symptoms of depression, anxiety and stress, perceived overload and quality of life in caregivers of children with autism spectrum disorder. An experimental study was conducted out with an intervention and control group, with self-report pretest-posttest measurements. A total of 53 caregivers participated in the study: 22 in the experimental group and 31 in the waiting list control group. The majority of participants were women between 35 and 64 years old, married or in a formal relationship, with professional or higher education and who carried out some paid activity. The results of the intergroup analysis showed a decrease in the symptoms associated with stress and perceived overload and an increase in the quality of life in the experimental group. Intra-group data showed that the subjects of the control group had no change in any variable, in contrast, in the experimental group there was a significant decrease in anxiety, stress and perceived overload indices and an increase in the quality of life. All these changes occurred with medium and large effect sizes. The mechanisms of change are analyzed and the study's findings are discussed in light of its limitations. It is concluded that a cognitive behavioral intervention is a strategy with positive effects for providing psychological support to caregivers of children with autism. (AU)

[Factors associated with caregiver burden in primary caregivers of older adults with type2 diabetes]. / Factores asociados a la sobrecarga del cuidador en cuidadores primarios de personas adultas mayores con diabetes tipo2.

OBJECTIVE: To characterize the profile of the informal primary caregiver (IPC) of adult patients with type2 diabetes (T2D) and the possible factors associated with caregiver collapse (CC). DESIGN: Observational, descriptive, cross-sectional and analytical study. SITE: Ambulatory Care Medical Unit. PARTICIPANTS: Mexican CPIs of adult patients with T2D. MAIN MEASUREMENTS: Data were collected through a prolective design using the Zarit scale and a structured survey on sociodemographic factors. A descriptive statistical analysis and univariate and multivariate logistic regression models were performed. RESULTS: The CPI profile is assumed by: women, people aged 36-58, daughters, people with a secondary and high school educational level, married, Catholic, with income <8,900 Mexican pesos, own home, inhabited by a maximum of 5 inhabitants, with support networks, who have dedicated >5years to the care of their patient, without training and with chronic diseases. The risk factors that increase the risk of CC are: being a woman (OR=11.03; 95%CI: 1.49-81.95), having a history of more than 5years of having assumed the role of caregiver (OR=2, 65; 95%CI: 1.07-6.55), living in one's own house (OR=3.03; 95%CI: 1.04-8.82), with 6 or more inhabitants (OR=2.41; 95%CI: 1.08-5.38). The support of other family members and/or friends was associated as a protective factor (OR=0.15; 95%CI: 0.07-0.33). CONCLUSIONS: Prevention programs are required to avoid CC and complications, as well as interventions to improve the quality of life of the CPI and patients in care, incorporating strategies to generate and/or increase their family and social support networks.

Suffering Depression: Illness Perception of Informal Primary Caregivers of Medical Students With Major Depressive Disorder.

When a family member has depression at a level that generates disability in various functional spheres, the informal primary caregiver (IPC) is the individual who provides the majority of emotional and basic needs of the patient. This person is usually a relative and is extremely important in the health-disease-care process. This phenomenological qualitative study aimed to analyze the illness perception, in IPCs of undergraduate medical students previously diagnosed with mild depression. It was found that IPCs generate perceptions about depression based on a lack of knowledge of the disorder, which leads to feelings of sorrow, anger, frustration, and fear, that could interfere with the evolution of patients. Psychiatric disorders, such as depression, strongly impact both patients and people around them. For mental health professionals, in order to provide a more complete clinical approach, it is important to understand the illness perceptions not only of patients but of family IPCs as well.

Relación entre la sobrecarga y el índice depresivo de cuidadores primarios de pacientes con enfermedades neuromusculoesqueléticas / The relationship between the overload and the depressive index of primary caregivers of patients with neuromusculoskeletal diseases

Resumen Introducción Una enfermedad neuromusculoesquelética no solo afecta a la persona que la padece, sino que también repercute de manera directa en la familia y en particular al cuidador primario informal. Las labores de cuidado incrementan la morbilidad psicológica y el estrés de los cuidadores primarios. El objetivo del presente estudio consiste en identificar la relación entre la sobrecarga y el índice de depresión presente en los cuidadores primarios informales de pacientes con enfermedad neuromusculoesquelética. Material y Métodos Se realizó un estudio exploratorio que incluyó a 18 cuidadores primarios informales de pacientes con enfermedad neuromusculoesquelética, y que asistieron a consulta en la Unidad Universitaria de Rehabilitación de la Universidad Autónoma de Yucatán. Resultados Entre las características sociodemográficas predominaron las cuidadoras del sexo femenino (83%) con parentesco familiar con el paciente. Además, predomino entre los cuidadores primarios el estado civil casado y un nivel de estudios de licenciatura. La relación entre la sobrecarga y el índice de depresión fue elevada y significativa (r=0.72, p=0.0007). En conclusión, estos resultados sugieren que, a mayor sobrecarga producida por las labores del cuidado, mayor será el grado de afectación en el estado anímico del cuidador primario informal. Este estudio ayudará en la elaboración de un programa de intervención para prevenir la sobrecarga en cuidadoras primarias informales.

Abstract Introduction A neuromusculoskeletal disease not only affects the person who suffers it but also directly affects the family and in particular with the informal primary caregiver. Care work increases the psychological morbidity and stress of primary caregivers. The aim of the present study was to identify the relationship between overload and the rate of depression present in informal primary caregivers of patients with the neuromusculoskeletal disease. Methods An exploratory study was carried out that included 18 informal primary caregivers of patients with the neuromusculoskeletal disease, and who attended a consultation at the University Rehabilitation Unit of the Autonomous University of Yucatan. Results Among the sociodemographic characteristics, female caregivers prevailed (83%) with a family relationship with the patient. Also, primary married status and a bachelor's degree level predominated among primary caregivers. The relationship between overload and depression index was high and significant (r = 0.72, p = 0.0007). In conclusion, these results suggest that the greater the overload produced by the tasks of care, the greater the degree of involvement in the state of the informal primary caregiver. This study will help in the development of an intervention program to prevent overload in informal primary caregivers.

Prácticas de autocuidado para mejorar la calidad de vida asociada a la salud de los cuidadores primarios informales de niños y adolescentes con parálisis cerebral GMFCS IV-V: revisión sistemática / Self-care practices to improve quality of life of informal primary caregivers of children and adolescents with GMFCS IV-V cerebral palsy: a systematic review

Introduction: Children and young people with cerebral palsy (CP), GMFCS IV-V, are considered dependent individuals requiring long-term care by their families due to significant motor function limitations that prevent them from performing basic and instrumental activities of daily life. The task of taking care of another person implies excess work and the development of health-related quality of life problems for informal primary caregivers due to physical and emotional burden. Strategies used for improving health-related quality of life of caregivers include self-care practices. Objective: To describe self-care practices and their effect on health-related quality of life in individuals taking care of 0 to 20 year-old children and adolescents with GMFCS IV-V CP. Method: A systematic review, including clinical trials and cohort studies with informal primary caregivers of 0 to 20 year-old children and adolescents with GMFCS IV-V CP, assessing self-care practices for improving life quality of caregivers. Results: No studies were found in compliance with the inclusion criteria. Conclusions: No conclusive evidence was found describing self-care practices and their effect on health-related quality of life problems for caregivers of 0 to 20 year-old children and adolescents with GMFCS IV-V CP. It is necessary to carry out high-quality methodological studies on this topic.

Introducción: Los niños y adolescentes con parálisis cerebral (PC), GMFCS IV-V, son considerados como individuos dependientes, que requieren de cuidados de larga duración por parte de las familias debido a que presentan importantes limitaciones motoras que les impiden realizar actividades básicas e instrumentales de la vida diaria. La tarea de cuidar a otro, supone un exceso de trabajo generando la aparición de problemas en la calidad de vida asociados a la salud (CVRS) de los cuidadores primarios informales a raíz de la sobrecarga física y emocional. Dentro de las estrategias que se utilizan para mejorar la calidad de vida asociada a la salud en éstos, se incluye el autocuidado y sus distintas prácticas. Objetivo: Describir las prácticas de autocuidado y su efecto en la CVRS de los cuidadores de niños y adolescentes con PC de 0-20 años de edad, clasificación GMFCS IV-V. Método: Revisión sistemática. Se incluyeron ensayos clínicos y cohortes cuya población estuviera constituida por cuidadores primarios informales de niños y adolescentes con PC de 0-20 años de edad, clasificación GMFCS IV-V y que evaluarán prácticas de autocuidado para mejorar la calidad de vida asociada a la salud de éstos. Resultados: No se obtuvieron estudios que cumplieran los criterios de inclusión. Conclusiones: No se encontró evidencia concluyente que describiera las prácticas de autocuidado y su efecto en la CVRS de los cuidadores de niños y adolescentes con PC de 0-20 años de edad, clasificación GMFCS IV-V. Es necesario realizar estudios de buena calidad metodológica respecto de este tema.