Dolor y alteración de la imagen corporal en adolescentes con escoliosis idiopática / Pain and body image alteration in adolescents with idiopathic scoliosis

Objetivo: explorar la vivencia del dolor y de la autopercepción corporal en jóvenes afectados de escoliosis idiopática atendidos en la Unidad del Raquis del Hospital de Traumatología y Rehabilitación de Vall d'Hebron (Barcelona).Método: estudio cualitativo fenomenológico realizado en 2011. Se incluyeron, mediante muestreo por conveniencia, jóvenes de 15 a 24 años diagnosticados de escoliosis idiopática ingresados para cirugía correctora en la unidad. Se realizaron entrevistas semiestructuradas una semana tras la cirugía, en la habitación del paciente y con una duración de entre 15 y 25 minutos, que fueron grabadas y transcritas. Un análisis preliminar determinó saturación del discurso. Se llevó a cabo análisis temático.Resultados: participaron 13 mujeres y dos hombres. Las categorías encontradas fueron: “sentimientos y emociones”, “enfermedad y anormalidad”, “adolescencia”, además de las dos descritas en este artículo “Escoliosis” (sintomatología y descubrimiento) e “Imagen corporal y belleza”. El dolor estuvo presente solo en algunas personas con una intensidad variable y no fue clave en el descubrimiento de la enfermedad (que se asociaba más a la presencia de deformidad o a un hallazgo casual), ni en la elección de cirugía correctora (que derivaba más de la preocupación estética). Las personas buscaban ocultar la deformidad mediante el vestido, modificación postural o restricciones sociales, conductas que mantenían, aunque supusiesen un esfuerzo considerable.Conclusión: existe una gran preocupación estética, la deformidad altera la autopercepción corporal y genera comportamientos de ocultación y adaptaciones sociales. Esta preocupación parece más determinante que el dolor a la hora de tomar decisiones, si bien este resulta muy limitante en algunos casos.(AU)

Objective: to explore the experience of pain and body self-perception in young patients with idiopathic scoliosis managed at the Rachis Unit from the Orthopedic Surgery and Rehabilitation Hospital Vall d´Hebron (Barcelona).Method: a qualitative phenomenological study conducted in 2011. Through convenience sampling, the study included young patients, from 15 to 24 years of age, who had been diagnosed with idiopathic scoliosis and admitted to the hospital unit for corrective surgery. Semi-structured interviews were conducted one week after surgery, in the patient’s room and with a duration between 15 and 25 minutes, which were recorded and transcribed. A preliminary analysis determined speech saturation; thematic analysis was conducted.Results: the participants were 13 women and two men. The categories found were: “feelings and emotions”, “disease and abnormality”, “adolescence”, alongside those two described in this article “Scoliosis (symptomatology and discovery)” and “Body image and beauty”. Pain was only present in some patients, with varying intensity, and it was not a key factor in the discovery of the disease (which was mainly associated with the presence of deformity or a casual finding), or with the choice of corrective surgery, which derived mostly from esthetic concerns. Patients tried to hide their deformity through clothes, posture modification or social restrictions, and they maintained these behaviours even if they entailed a major effort.Conclusion: there is a great esthetic concern; deformity alters the body self-perception and generates concealment behaviours and social adaptations. This concern seems to be a greater driver than pain at the time of making decisions; however, it can be very limiting in some cases.(AU)

Using mixed-methods research to study the quality of life of coeliac women.

AIMS AND OBJECTIVES: To research the quality of life of Spanish women with coeliac disease. BACKGROUND: Women with coeliac disease express lower quality of life than men with coeliac disease. DESIGN: Explanatory sequential approach using mixed methods and with a gender perspective. METHODS: The research was carried out between May and July 2015. In its quantitative stage, it aimed to determine the health-related quality of life in a representative sample (n = 1097) of Spanish adult women with coeliac disease using a specific questionnaire named Coeliac Disease-Quality of Life. In its qualitative phase, it aimed to describe the life experiences of a woman with coeliac disease in a qualitative manner by means of interviews (n = 19) with a semistructured script. Quantitative data were analysed using spss version 20 and presented in descriptive statistics. Qualitative data were analysed using the directed content analysis. RESULTS: The quantitative process gave us the values on the four aspects studied: dysphoria, disease limitations, health problems and inadequate treatment. These aspects allowed us to create a qualitative process, based on which we generated an interview, from which four larger categories emerged. These categories were feelings at diagnosis, limitations in day-to-day life, social perceptions of the disease and personal meanings of coeliac disease. Thus, both phases of our project are totally connected. There was a high level of congruence between quantitative scores and narratives. CONCLUSION: This study shows us the strong points of mixed-methods strategy in health sciences. The mixed-methods strategy gave us a wider view of the experience of women living with coeliac disease. In our case, a strength and not a limitation is having performed the quality of life study in women with coeliac disease using a mixed methodology, approaching the experience of being a woman with coeliac disease in Spain in two different but complementary ways. The quantitative and qualitative data allowed us to interpret the experiences of our participants.

Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain

Background: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. Methods: An observational, cross-sectional study of a nonrandomized, representative sample of adult celiac patients throughout all of Spain’s Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the selfadministered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. Results: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. Conclusions: The HRQL level of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet (AU)

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Health-related quality of life and determinant factors in celiac disease. A population-based analysis of adult patients in Spain.

BACKGROUND: Celiac disease (CD) has a negative impact on the health-related quality of life (HRQL) of affected patients. Although HRQL and its determinants have been examined in Spanish CD patients specifically recruited in hospital settings, these aspects of CD have not been assessed among the general Spanish population. METHODS: An observational, transversal study of a non-randomized, representative sample of adult celiac patients throughout all of Spain's Autonomous Regions. Subjects were recruited through celiac patient associations. A Spanish version of the self-administered Celiac Disease-Quality of Life (CD-QOL) questionnaire was used. Determinant factors of HRQL were assessed with the aid of multivariate analysis to control for confounding factors. RESULTS: We analyzed the responses provided by 1,230 patients, 1,092 (89.2%) of whom were women. The overall mean value for the CD-QOL index was 56.3 ± 18.27 points. The dimension that obtained the most points was dysphoria, with 81.3 ± 19.56 points, followed by limitations with 52.3 ± 23.43 points; health problems, with 51.6 ± 26.08 points, and inadequate treatment, with 36.1 ± 21.18 points. Patient age and sex, along with time to diagnosis, and length of time on a gluten-free diet were all independent determinant factors of certain dimensions of HRQL: women aged 31 to 40 expressed poorer HRQL while time to diagnosis and length of time on a gluten-free diet were determinant factors for better HRQL scores. CONCLUSIONS: The HRQL of adult Spanish celiac subjects is moderate, improving with the length of time patients remain on a gluten-free diet.

[Psoriasis]. / Psoriasis. Tipología, tratamiento y cuidados de enfermería.

The authors provide a review, description and synthesis of the diverse classes of psoriasis and the treatments which have been developed, from the most common ones to the most recent ones. The authors describe the most frequent nursing treatments. Bearing in mind the chronic nature of this disease, its evolution by outbreaks and the physical as well as psychological effects psoriasis has on its sufferers, the role of nurses is essential to help patients adapt to and develop some degree of independence while suffering from psoriasis.