Validation of the Spanish Version of the Trauma and Loss Spectrum Self-Report (TALS-SR): A Study on Healthcare Workers Facing the COVID-19 Pandemic.

Background: The present study aimed at reporting about the validity and reliability of the Spanish version of the Trauma and Loss Spectrum-Self Report (TALS-SR), an instrument based on a multidimensional approach to Post-Traumatic Stress Disorder (PTSD) and Prolonged Grief Disorder (PGD), including a range of threatening or traumatic experiences and significant losses, besides the spectrum of peri-traumatic stress reactions and post-traumatic stress symptoms that may occur. Methods: A sample of 87 Health Care Workers (HCWs) employed in the COVID-19 Emergency Department at the Virgen de la Arrixaca and Reina Sofia Hospitals (Murcia, Spain) during the pandemic, was consecutively recruited and fulfilled the TALS-SR. Assessments also included the Impact of Event Scale-Revised (IES-R), to examine post-traumatic stress symptoms and probable PTSD. Nineteen HCWs fulfilled the TALS-SR again after three weeks from baseline for test-retest reliability. Results: This study provides evidence of good internal consistency and test-retest reliability of the Spanish version of the TALS-SR. Strong support for the internal validity structure was obtained, with positive and significant correlations between the five symptomatologic domains and the symptomatologic total score. Significant and good correlations between the TALS-SR symptomatologic domains and the IES-R total and single domains' scores were found. The Questionnaire also demonstrated to discriminate between subjects with and without PTSD, with subjects with PTSD showing significantly higher mean scores in each domain of the TALS-SR. Conclusion: This study validates the Spanish version of TALS-SR, providing a useful instrument for a spectrum approach to PTSD and confirms the potential utility of this psychometric tool in both clinical practice and research settings.

El constructo binomial «cuidados en salud-educación» en la épica norteamericana del Western, como realidad geopolítica / The binomial construct “health care-education” in the North American epic of the Western as a geopolitical reality

El Western, como reflejo de la sociedad norteamericana, narra en forma de épica la historia de la conquista del Oeste, articulando un discurso en torno a la cultura de la población aborigen y del héroe de frontera, como los más significativos elementos de la realidad geopolítica. En esta investigación, a través del discurso fílmico del Western, hemos establecido como Objetivo principal, el análisis del constructo binomial: «cuidados en salud-educación», examinándolo a través del método panofskyano y gadameriano, con una muestra que atiende al paradigmático clasicismo de John Ford en el film Centauros del desierto y ocupándonos, a su vez, de la propuesta educativa y sanitaria que ofrece. Hemos concluido que el constructo binomial «cuidados en salud-educación» es un elemento universal en el discurso del Western, actuando como agente civilizador y como vector esencial para el asentamiento de nuevos grupos sociales en los territorios de frontera, durante la conquista del Oeste (AU)

The Western, as a reflection of American society, depicts the story of the conquest of the West epically, framing a narrative around the culture of the indigenous population and the frontier hero as the most significant elements of the geopolitical reality. In this investigation, through the filmic discourse of Westerns, our main Objective is the analysis of the binomial construct: “health care-education", looking at it through the Panofsky and Gadamerian method, following the paradigmatic classicism of John Ford in the film The Searchers and, at the same time, addressing the educational and health approach it offers. We have concluded that the binomial construct "health care-education" is a universal element in the filmic discourse of the Western, acting as a civilizing agent and as an essential means for the settlement of new social groups in the frontier territories during the conquest of the West (AU)

El constructo binomial «cuidados en salud-educación» en la épica norteamericana del Western, como realidad geopolítica / The binomial construct “health care-education” in the North American epic of the Western as a geopolitical reality

El Western, como reflejo de la sociedad norteamericana, narra en forma de épica la historia de la conquista del Oeste, articulando un discurso en torno a la cultura de la población aborigen y del héroe de frontera, como los más significativos elementos de la realidad geopolítica. En esta investigación, a través del discurso fílmico del Western, hemos establecido como Objetivo principal, el análisis del constructo binomial: «cuidados en salud-educación», examinándolo a través del método panofskyano y gadameriano, con una muestra que atiende al paradigmático clasicismo de John Ford en el film Centauros del desierto y ocupándonos, a su vez, de la propuesta educativa y sanitaria que ofrece. Hemos concluido que el constructo binomial «cuidados en salud-educación» es un elemento universal en el discurso del Western, actuando como agente civilizador y como vector esencial para el asentamiento de nuevos grupos sociales en los territorios de frontera, durante la conquista del Oeste. (AU)

The Western, as a reflection of American society, depicts the story of the conquest of the West epically, framing a narrative around the culture of the indigenous population and the frontier hero as the most significant elements of the geopolitical reality. In this investigation, through the filmic discourse of Westerns, our main Objective is the analysis of the binomial construct: “health care-education", looking at it through the Panofsky and Gadamerian method, following the paradigmatic classicism of John Ford in the film The Searchers and, at the same time, addressing the educational and health approach it offers. We have concluded that the binomial construct "health care-education" is a universal element in the filmic discourse of the Western, acting as a civilizing agent and as an essential means for the settlement of new social groups in the frontier territories during the conquest of the West. (AU)

Quality of Life, Perception of Disease and Coping Strategies in Patients with Hemophilia in Spain and El Salvador: A Comparative Study.

BACKGROUND: Hemophilia is characterized by the development of joint bleeds that cause long-term joint damage (hemophilic arthropathy). Joint damage leads to disability and affects psychosocial aspects in patients with hemophilia. OBJECTIVE: To compare the clinical situation, perception of disease and quality of life, and coping strategies in adult patients with hemophilia in El Salvador and Spain. METHODS: In this comparative clinical study, 43 patients with hemophilia aged between 18 and 50 years old from Spain and El Salvador participated. After obtaining the patients' consent, they completed the Illness Perception Questionnaire-Revised (IPQ-R), Hemophilia-QoL and Inventory of Coping strategies questionnaires. Joint status was assessed using the Hemophilia Joint Health Score and based on a record of clinical and treatment data. RESULTS: Hemophilia patients from Spain showed an improved perception of quality of life (p <0.05), although there were only differences in the self-criticism variable (p = 0.04) for coping strategies. Joint damage and age correlated (p <0.05) negatively with perception of disease, perceived quality of life and coping strategies in both populations. There were differences (p <0.05) between the two populations based on HIV and HCV coinfections in perception of disease and perceived quality of life. CONCLUSION: Patients with hemophilia in El Salvador exhibit a poorer perception of disease and quality of life. Despite differences in access to treatment from one country to the other, there is no difference in coping with the disease. Older patients are better able to adapt to the disease.

Validation of the Spanish Version of the VERITAS-PRN Scale to Assess Adherence to on Demand Regimens in Patients with Hemophilia.

INTRODUCTION: The episodic or on-demand administration of clotting factor concentrates in hemophilia patients in the event of hemorrhage is employed to restore hemostasis. Adherence to on-demand treatments needs to be assessed in order to improve patient management, avoiding adverse effects and serious clinical complications. AIM: To validate the Spanish version of the treatment adherence scale in patients with hemophilia, namely, Validated Hemophilia Regimen Treatment Adherence Scale-PRN (VERITAS-PRN). METHODS: Eighty-five patients were recruited in three hemophilia patient associations in Spain. The VERITAS-PRN scale was adapted through a back-translation process from English to Spanish. A native Spanish bilingual translator translated the scale from English to Spanish, and subsequently another native English bilingual translator translated the scale from Spanish to English. The scale was applied twice (two months apart) to assess test-retest reliability. RESULTS: Internal consistency reliability was slightly lower in the VERITAS-PRN in Spanish (0.80) versus the English version (0.85). There were no differences (p > 0.05) between the means of the dimensions or in the total scores between the sample of patients in Spain and the USA. The test-retest reliability coefficient of the scores on the total scale was 0.80 [CI, 0.74-0.86]. The test-retest reliability coefficient was greater than 0.90 in all subscales. CONCLUSION: The Spanish version of VERITAS-PRN has high consistency and empirical validity. This scale is useful for assessing the degree of adherence to treatment in adult patients with hemophilia following episodic infusion treatment.

Haemo-Adhaesione: A New Measure of Adherence for Adolescent and Adult Patients with Haemophilia.

PURPOSE: To build a multidimensional questionnaire of adherence for a patient with hemophilia that includes not only clinical but also psychosocial aspects. PATIENTS AND METHODS: One hundred and forty-six patients with haemophilia (A and B) were recruited from several Hemophilia Treatment Centers for this study. The recruitment was performed through a personal interview (20-25 mins for each patient). A literature review was carried out (different databases). In the first version (136 items), all items were subjected to an external judgment (experts in hemophilia) and also presented and discussed with a group of patients. It was made a study of content validity and homogeneity index and reliability coefficients of score were calculated with an alpha coefficient. Empirical validation was made with Pearson correlation. RESULTS: The Haemo-Adhaesione scale was composed of 5 dimensions and 10 questions about basic haemophilia concepts. It was shown to be valid and reliable to assess adherence in the Spanish population. Its internal consistency was good in all dimensions. The Rasch model was used to confirm the multidimensional structure of the scale. Significant and negative correlations were observed with the VERITAS-Pro and VERITAS-PRN scale in all dimensions, and in the total score. CONCLUSIONS: The Haemo-Adhaesione scale is a good measure of adherence for PWH. Its multidimensional structure favors the inclusion of the objective and subjective aspects implicit in its definition, as well as its dynamic nature. Patients with greater adherence are those who have more awareness of their disease, and as a result, they are more compliant with prescription and their self-care. It also discriminates between patients who follow one treatment or another.

Coping strategies in young and adult haemophilia patients: A tool for the adaptation to the disease.

INTRODUCTION: Chronic diseases, after diagnosis, involve changes that have to favour coping with the new situation. The resources used will help control, manage and adapt to the disease. The psychological aspects may be influencing how the individual faces the situation. AIM: To assess whether perceptions or beliefs and illness behaviour influence the choice of coping strategies for young and adult patients with haemophilia. METHODS: Multicenter cross-sectional descriptive study. We recruited 63 patients with haemophilia A and B, adolescents, young and adults, and both types of treatment. A clinical and sociodemographic data sheet, the Coping Strategies Inventory (CSI), the Illness Perception Questionnaire-revised (IPQ-R) and the Illness Behaviour Questionnaire (IBQ) were used. RESULTS: Patients with haemophilia use appropriate coping strategies, both cognitive and behavioural. Most of them are on-demand treatment, and despite arthropathy, they perceive good control of haemophilia. However, patients in prophylactic treatment are those employed more maladaptive coping strategies, less perception of control and hypochondriacal behaviour to the disease. The age variable may be relevant but we did not find significant differences. CONCLUSIONS: Coping strategies used by patients with haemophilia are adequate. Although it is noted that the perception of the disease, its controllability or not, affects illness behaviour and consequently how coping with haemophilia. These are based on personal characteristics, cognitive and attitudinal dispositions that the individual consciously use to solve or face adverse situations. The analysis of coping styles of patients could be a tool for professionals to manage properly the disease.

Validation of the VERITAS-Pro treatment adherence scale in a Spanish sample population with hemophilia.

PURPOSE: We aimed to conduct a validation in Spanish of the Validated Hemophilia Regimen Treatment Adherence Scale - Prophylaxis (VERITAS-Pro) questionnaire for use in patients with hemophilia under prophylactic treatment. PATIENTS AND METHODS: The VERITAS-Pro scale was adapted through a process of back translation from English to Spanish. A bilingual native Spanish translator translated the scale from English to Spanish. Subsequently, a bilingual native English translator translated the scale from Spanish to English. The disagreements were resolved by agreement between the research team and translators. Seventy-three patients with hemophilia, aged 13-62 years, were enrolled in the study. The scale was applied twice (2 months apart) to evaluate the test-retest reliability. RESULTS: Internal consistency reliability was lower on the Spanish VERITAS-Pro than on the English version. Test-retest reliability was high, ranging from 0.83 to 0.92. No significant differences (P>0.05) were found between test and retest scores in subscales of VERITAS-Pro. In general, Spanish patients showed higher rates of nonadherence than American patients in all subscales. CONCLUSION: The Spanish version of the VERITAS-Pro has high levels of consistency and empirical validity. This scale can be administered to assess the degree of adherence of prophylactic treatment in patients with hemophilia.

Effectiveness of an Educational Physiotherapy and Therapeutic Exercise Program in Adult Patients With Hemophilia: A Randomized Controlled Trial.

OBJECTIVE: To assess the efficacy of an educational physiotherapy home exercise intervention for physical improvement, pain perception, quality of life, and illness behavior in patients with hemophilic arthropathy. DESIGN: Single-blind randomized controlled trial. SETTING: Home. PARTICIPANTS: Patients with hemophilia (N=20) were randomly allocated to an educational intervention group or to a control group. INTERVENTIONS: The educational intervention was performed every 2 weeks over a 15-week period, and home exercises were carried out once a day, 6 days a week, over the same period. MAIN OUTCOME MEASURES: Joint status was evaluated using the Gilbert scale; pain was assessed using the visual analog scale; illness behavior was evaluated using the Illness Behavior Questionnaire; and the perception of the quality of life was evaluated using the A36 Hemophilia-QoL questionnaire. RESULTS: We observed significant differences in the intervention group and the control group for both quality of life and illness behavior. There was no significant improvement in joint status; however, an improvement was noted in terms of perception of pain in the ankle. CONCLUSIONS: A physiotherapy program based on educational sessions and home exercises can improve the perception of pain in patients with hemophilic arthropathy of the ankle. It improves some variables in the perception of the quality of life and illness behavior.

Sporting Activities and Quality of Life in Children With Hemophilia: An Observational Study.

INTRODUCTION: Sports activities are part of multidisciplinary treatments in people with hemophilia. AIM: The objective of this study was to assess the incidence of sports activities in the quality of life as perceived by children with hemophilia. METHODS: A total of 53 children with hemophilia aged 7 to 13 years and 51 children without hemophilia were evaluated. The perception of quality of life, clinical variables, and the frequency of sports activities were registered. The joint condition of patients with hemophilia was measured with the Spanish version of the Haemophilia Joint Health Score. RESULTS: There were no significant differences in the perception of quality of life between children with hemophilia and children without hemophilia. Sports activities in people with hemophilia promoted a greater health satisfaction. CONCLUSIONS: Sports activity in children with hemophilia is associated with an improved quality of life and joint health. It is also associated with improved psychosocial wellness.