Viabilidad de una intervención psicológica individualizada para personas mayores con demencia y discapacidad visual / Feasibility of an individualised psychological intervention for older adults with dementia and visual impairment

INTRODUCCIÓN: Ante el fenómeno del envejecimiento de la población, los problemas de salud relacionados con la edad tales como las demencias o la discapacidad visual asociada a enfermedades crónicas han ido aumentando progresivamente. El presente trabajo describe y analiza la eficacia y viabilidad de una intervención individualizada dirigida a dos varones usuarios de un centro de día con un diagnóstico de demencia y discapacidad visual severa que les dificulta la realización de las actividades propias del centro. MATERIAL Y MÉTODO: El proyecto tuvo una duración de tres meses y contó con una fase de evaluación pre- y postintervención. Para la evaluación se utilizaron los instrumentos Mini-Examen Cognoscitivo, Escala de Depresión Geriátrica y un instrumento de registro observacional basado en el Dementia Categorization Recordin Observational System. La fase de intervención tuvo una duración de ocho semanas y se realizaron diferentes dinámicas adaptadas a los gustos e intereses de los participantes. RESULTADOS Y CONCLUSIONES: Tras la fase de intervención se observó una reducción clínicamente significativa de la sintomatología depresiva de ambos usuarios, así como una disminución en la frecuencia de conductas apáticas durante las horas que pasaban en el centro. Asimismo, se observó un aumento en las conductas de tipo prosocial y en las de implicación con las tareas realizadas. Los resultados obtenidos apuntan a que la personalización de las actividades que se realizan en centros a usuarios concretos incrementa la estimulación de los participantes, mejorando su bienestar mediante pequeñas adaptaciones poco costosas de las intervenciones que se realizan

INTRODUCTION: The ageing of the population has led to a progressive increase in age-related diseases, such as dementia or visual impairment, due to chronic diseases. This work describes and analyses the efficacy and feasibility of an individualised intervention carried out with two male users of a day-care centre with a diagnosis of dementia and a severe visual impairment, which made it difficult for them to take part in the regular activities of the centre. MATERIAL AND METHOD: The intervention process had a time frame of three months, and had an assessment phase before and after the intervention. For the assessment, use was made of the Mini-Mental State Examination, Geriatric Depression Scale, and an observational tool based on the Dementia Categorization Recording Observational System. The intervention lasted for eight weeks, and consisted of different dynamics adjusted to the preferences of the participants. RESULTS AND CONCLUSIONS: After the intervention, a clinically significant reduction in the depressive symptomatology was observed for both participants, along with a reduction in the frequency of apathetic behaviour during the time they spent in the centre. Furthermore, an increase was observed in the prosocial behaviour and on the engagement with the task. The results show that the personalisation of the activities for particular users increases the stimulation of the participants, improving their well-being through small and inexpensive adaptations to the interventions that are carried out in the centres

From concept to practice, is multidimensional care the leading principle in hospice care? An exploratory mixed method study.

BACKGROUND: Hospice care (HC) aims to optimise the quality of life of patients and their families by relief and prevention of multidimensional suffering. The aim of this study is to gain insight into multidimensional care (MC) provided to hospice inpatients by a multiprofessional team (MT) and identify facilitators, to ameliorate multidimensional HC. METHODS: This exploratory mixed-method study with a sequential quantitative-qualitative design was conducted from January to December 2015. First a quantitative study of 36 patient records (12 hospices, 3 patient records/hospice) was performed. The outcomes were MC, clinical reasoning and assessment tools. Second, MC was qualitatively explored using semistructured focus group interviews with multiprofessional hospice teams. Both methods had equal priority and were integrated during analysis. RESULTS: The physical dimension was most prevalent in daily care, reflecting the patients' primary expressed priority at admission and the nurses' and physicians' primary focus. The psychological, social and spiritual dimensions were less frequently described. Assessment tools were used systematically by 4/12 hospices. Facilitators identified were interdisciplinary collaboration, implemented methods of clinical reasoning and structures. CONCLUSIONS: MC is not always verifiable in patient records; however, it is experienced by hospice professionals. The level of MC varied between hospices. The use of assessment tools and a stepped skills approach for spiritual care are recommended and multidimensional assessment tools should be developed. Leadership and commitment of all members of the MT is needed to establish the integration of multidimensional symptom management and interdisciplinary collaboration as preconditions for integrated multidimensional HC.

Using the Scharff-technique to elicit information: how to effectively establish the «illusion of knowing it all»? / La utilización de la técnica de Scharff para extraer información: cómo crear la «ilusión de saberlo todo» de un modo eficaz?

The Scharff-technique is used for eliciting information from human sources. At the very core of the technique is the «illusion of knowing it all» tactic, which aims to inflate a source's perception of how much knowledge an interviewer holds about the event to be discussed. For the current study, we mapped the effects following two different ways of introducing this particular tactic; a traditional way of implementation where the interviewer explicitly states that s/he already knows most of the important information (the traditional condition), and a new way of implementation where the interviewer just starts to present the information that s/he holds (the just start condition). The two versions were compared in two separate experiments. In Experiment 1 (N=60), we measured the participants’ perceptions of the interviewer's knowledge, and in Experiment 2 (N=60), the participants’ perceptions of the interviewer's knowledge gaps. We found that participants in the just start condition (a) believed the interviewer had more knowledge (Experiment 1), and (b) searched less actively for gaps in the interviewer's knowledge (Experiment 2), compared to the traditional condition. We will discuss the current findings and how sources test and perceive the knowledge his or her interviewer possesses within a framework of social hypothesis testing (AU)

La técnica de Scharff se utiliza para extraer información de fuentes humanas. En el meollo de la técnica está la táctica de la «ilusión de saberlo todo», que apunta a engordar la percepción de una fuente sobre cuánto conocimiento posee un entrevistador sobre el hecho que se aborda. Para realizar este estudio cartografiamos los efectos derivados de la introducción de esta táctica particular, un método tradicional de aplicación, en el que el entrevistador afirma de modo explícito que ya conoce casi toda la información importante (la condición tradicional) y una manera nueva de implementación, en la que el entrevistador empieza a presentar la información que posee (la condición de simplemente iniciar la condición). Se comparó ambas versiones en dos experimentos distintos. En el experimento 1 (N=60) medimos la percepción que tenían los participantes de los conocimientos del entrevistador y en el experimento 2 (N=60) la percepción que tenían los participantes de las lagunas de conocimiento del entrevistador. Se halló que los participantes de la condición de «simplemente iniciar» (a) creían que el entrevistador poseía más conocimientos (experimento 1) y (b) buscaban de un modo menos activo las lagunas de conocimiento del entrevistador (experimento 2), en comparación con la condición «tradicional». Comentaremos estos resultados y cómo perciben y ponen a prueba las fuentes los conocimientos de su entrevistador, en el marco de la prueba de hipótesis social (AU)

Instauración y tareas de un servicio de psicología del deporte en un club de fútbol profesional / Creation and tasks of a sport psychology department in a profesional soccer club / Instauração e tarefas de um serviço de psicologia do desporto num clube de futebol profissional

El objetivo de este estudio es describir la instauración y los principales logros de un servicio de psicología del deporte en un club de fútbol desde su inicio. Además se explican las dos principales herramientas que utiliza el servicio: 1) una adaptación del Coach Behavioral Assessment System (CBAS) (observación de los entrenadores) y 2) el Programa de Seguimiento Semanal (PSS) (evaluación de los jugadores a través de los 20 entrenadores del club). Se desarrollan de forma descriptiva los logros que demuestran la posibilidad de introducir características psicológicas en los procedimientos técnicos de un club formativo a través de la inclusión de criterios psicosociales para controlar la evolución y progresión de los jóvenes, así como prevenir el abandono

The aim of this study is to describe the establishment and fundamental achievements of a sport psychology department in a football club from its introduction. Moreover, this study explains the two main tools which are used: 1) An adaptation of the Coach Behavioral Assessment System (CBAS) (observing coaches) and 2) the Weekly Monitoring Program (PSS) (evaluating players through the 20 coaches at the club). In this study, the achievements that demonstrate the possibility of introducing psychological features into the technical procedures of a training club through the inclusion of psychosocial criteria in order to control the development and progression of youngsters, as well as to prevent abandonment, were obtained in a descriptive way

O objectivo deste estudo é descrever a instauração e os principais êxitos de um serviço de psicologia do desporto num clube de formaçãodesde o seu início. Adicionalmente são explicadas as duas principais ferramentas utilizadas neste serviço: 1) uma adaptação do Coach BehavioralAssessment System (CBAS) (observação dos treinadores) e 2) o Programa de Acompanhamento Semanal (PSS) (avaliação dos jogadores através dos 20treinadores do clube). São abordados descritivamente os êxitos alcançados que demonstram a possibilidade de introduzir características psicológicasnos procedimentos técnicos de um clube formativo através da inclusão de critérios psicossociais para monitorizar a evolução e progressão dos jovens,assim como prevenir o abandono

Post-operative condition of breast cancer patients from standpoint of psycho-oncology--preliminary results.

INTRODUCTION: Information on being diagnosed to have cancer is always shocking for the patient, and it always causes a lot of psychosocial problems during its treatment. In these moments, patients need understanding, support and someone who can help them to apprehend all available options and choices clearly. The purpose of this study is to show the psychological states of patients with breast cancer after breast surgery, the importance of the psychological support, and first experiences in psycho-oncological management of breast cancer patients. MATERIAL AND METHODS: The study sample included 46 women, their average age being 52.32 (+/- 8.98), who had answered questions in a questionnaire in the period after surgery. RESULTS: The patients experienced fears and worries associated with almost every part of cancer treatment likely to happen in the near future. The fear of chemotherapy and radiotherapy (67%), the horror of losing hair (59%) and the fear of relapse or disease progression (57%) were evident. Moreover, the patients dreaded the forthcoming pathological results and the decisions to be made by the Oncology Commission (57%), with accompanying insomnia caused by disturbing thoughts in 39% of the patients. CONCLUSION: These findings suggest that psychological support is important in this early period after breast surgery due to the vulnerability of the patients, and because it can diminish the risk of potential escalation of distress.

Funciones y situación actual de la intervención de los psicólogos en cuidados paliativos / No disponible

Los psicólogos tienen un papel crucial en los procesos de fin de vida. Dentro de éstos, los cuidados paliativos son una de las áreas con más desarrollo en los últimos años, proponiendo un cuidado holístico e integral. Sin embargo, las funciones y roles de los psicólogos no están del todo claros. Por ello, se ha realizado una revisión teórica, buscando los estudios que ponen de relevancia su papel, funciones, así como la formación específica que deberían tener los psicólogos que trabajen en esta área. La mayoría subrayan la triple intervención con el paciente, la familia y el equipo sanitario. Funciones de evaluación e intervención psicológica, así como de prevención del burnout y del duelo aparecen como destacadas. La formación no está reglada aunque se está intentando buscar un currículum común

Psychologists have a crucial role in end-of-life processes. Within them, palliative care is one of the most developed areas and it is based on an holistic approach. However, the role of psychologists in this area is not clear. In order to clarify their function, a theoretical review has been carried out. The objective was to identify and integrate into a narrative the roles and functions of psychologist working in palliative care, as well as topics related to specific formation. Most of the articles reviewed outlined an intervention based on three axis: the patient, the family and the health care team. Functions such as psychological assessment, prevention of burnout and intervention on bereaved people appears as central. Specialized training and formation is not regulated, although recent proposals are trying to elaborate a common curriculum

Bayesian item selection in constrained adaptive testing using shadow tests

Application of Bayesian item selection criteria in computerized adaptivetesting might result in improvement of bias and MSE of the abilityestimates. The question remains how to apply Bayesian item selectioncriteria in the context of constrained adaptive testing, where large numbersof specifications have to be taken into account in the item selection process.The Shadow Test Approach is a general purpose algorithm for administeringconstrained CAT. In this paper it is shown how the approach can be slightlymodified to handle Bayesian item selection criteria. No differences inperformance were found between the shadow test approach and the modifiedapproach. In a simulation study of the LSAT, the effects of Bayesian itemselection criteria are illustrated. The results are compared to item selectionbased on Fisher Information. General recommendations about the use ofBayesian item selection criteria are provided(AU)

Optimización en Psicología Evolutiva y de la Salud aplicada al desarrollo prenatal / No disponible

En los últimos años se ha constatado un gran avance en lo referido a la detección de las alteraciones o trastornos en el desarrollo psicológico, que se ha hecho extensivo al periodo prenatal y neonatal. Al considerar la etiología de los trastornos del desarrollo psicológico, se repara en que muchos de ellos tienen todavía una etiología poco definida o incluso desconocida. El periodo prenatal es un momento adecuado para trabajar diferentes aspectos preventivos de la etiología de muchos trastornos del desarrollo psicológico, por ello, es necesario valorar este periodo para poder intervenir, de forma precoz, en los potenciales riesgos posteriores, con el fin de minimizarlos y corregirlos. La optimización evolutiva del ciclo vital cobra una especial importancia para la implementación de programas preventivos, desde la perspectiva de la educación y promoción de la salud, en este periodo. Se describe, a nivel teórico, un modelo de trabajo aplicado a los trastornos del desarrollo psicológico en el periodo perigestacional (AU)

In recent years, detection and intervention of alterations or disorders in psychological development has experienced a remarkable growth. When the etiology of psychological development disorders is considered, it becomes clear nowadays that there are a lot of disorders with a poorly defined etiology or even entirely unknown. The prenatal period is an appropriate moment to implement preventive strategies to treat many disorders found during psychological development. Therefore, it is necessary to assess this period for an early prevention of subsequent potential risks, bearing in mind risk reduction or even correction. The developmental optimization of the life cycle becomes especially important for the implementation of preventive programs ?particularly from the point of view of both education and health improvement. A model plan applied to developmental psychological disorders over the peri-gestational period is outlined (AU)

Sobre los primeros tiempos del encuentro analítico / Concerning the initial moments of the psychoanalytic encounter

Este artículo intenta mostrar la importancia de los primeros tiempos entre un paciente y un analista, donde el conocimiento yel ajuste se van realizando poco a poco. La autora enfatiza la importancia de las entrevistas previas, como una manera de ver, no sólo la posible analizabilidad del paciente, sino la de proporcionar algún atisbo o señal que le dé al paciente un nuevo significado sobre lo que le ocurre. Haciendo un paralelismo con el modelo de Bion, resalta la articulación entre el psiquismo del paciente y el del analista, mostrando a través de un caso cómo en estos primeros tiempos del proceso, la escucha analítica junto con la prudencia y la espera del momento propicio para la interpretación, darán lugar a que se instale la neurosis de transferencia (AU)

This article aims to show the importance of the first moments between a patient and ana analyst, when the awareness and the adjustment of both participants are slowly achieved. The author highlights the relevance of the preliminary interviews as a way of detecting not only the possible and analyzability of the patient, but also of providing a hint or a sign that gives the patient a new understanding of what is happening to him/her. Drawing a parallel with Bion´s concept of maternal reverie, the articulation between the two participants stands out. By means of a clinical case the author tries to show how in these first moments of the process, analytical listening together with prudence and the anticipation of the best moment for interpretation will facilitate the establishment of the transference neurosis (AU)

La inteligencia emocional como predictor del rendimeinto académico en estudiantes univesitarios / Emotional intelligence as predictor of academic achievement in university student

Este trabajo tiene como objetivo principal el análisi de la contribución específica de la inteligencia emocional a la predicción del rendimiento académico. Los participantes fueron 250 estudantes universitarios de estudios técnicos y humanísticos. Se emplearon dos pruebas de inteligencia emocional, el TMMS-24 y la prueba de Schutte et al. (1998), junto con el test de factor g de Cattell, y diferentes indicadores globnales de rendimiento académico. Los resultados mostraron la existnecia de correlaciones prácticamente nulas enre le cociente intelectual y los diferentes factores de la inteligenica emocional evaluados en este estudio. Además el análisis de regresión jerárquica ostró relaciones signficativas d elas medidas de inteligencia emocional conalgunos indicadores de rendimiento académico, incluso cuando se controló el efecto del CI. Estos resultados indican la contribución independiente de la inteligenci emocional a la predicción y /o explicación del rendimietno académcio en estudiantes universitarios(AU)

The present work hs as its main objective the analysis of the specific contribution of emotionl intelligence to the prediction of academic achievement. The participants were 250 universiy students of technical and humanistic studies. Two test of emotional intelligence were used, the TMMS-24, and the Scutte et al (1998) test, along with the g factor test of Cattell y Cattell, and different global academic results showed that practically null correlations were obseved between the intellectual quotient and the different factors of emotinal intellience evaluated in this stdy. In addiction, the hiearchic regression technique showed significant relations of emotional intelligence measures and some indictors of academic performance, even when the effect of the IQ was controlled. Thses results indicate the independent contribution of emotional intelligente to the explanation or prediciton of academic achievement, herarchic regression(AU)

Providing psychological treatments in general practice: how will it work?

Provision of "Focussed Psychological Strategies" by general practitioners is one component of the recent Better Outcomes in Mental Health Care (BOiMHC) initiative. The BOiMHC initiative requires GPs to undertake minimum training requirements before they may provide services under the new Medicare Benefits Schedule item number. We argue that GPs need further training and ongoing clinical interaction with mental health specialists (beyond the minimum training requirements) for refinement of psychological skills. Research focusing on GP training and how GPs interact with specialist services in the provision of psychological treatments is urgently required.

Investigación y docencia en salud mental (11): ¿Queda algún futuro para la "Asistencia Centrada en el Consultante" y el pensamiento clínico? / No disponible

El trabajo parte de una reflexión epistemológica sobre la investigación en psicoterapia y una descripción de las áreas, métodos y condicionantes para el futuro de la misma. Se describen asimismo algunas consecuencias ilustrativas de los sesgos que han venido mostrándose anteriormente, tanto de la "perspectiva Bambi" como de la "perspectiva Godzilla". Se plantean como ejemplos ilustrativos los siguientes: la santificación del "managed care"; el efecto Utah en el lanzamiento de nuevos neurolépticos y antidepresivos; los resultados negativos de los metaanálisis de una técnica que sigue practicándose y defendiéndose, como es la TEC; los resultados positivos pero poco conocidos de algunas técnicas psicológicas elementales en el cuidado de los pacientes graves y sus familiares así como de la depresión puerperal; los resultados negativos o inciertos de determinadas técnicas "contraculturales" etc. Para terminar, se realizan una serie de propuestas integradoras, tanto para la investigación como para la docencia en salud mental, orientadas por un intento de soslayar los dogmatismos y sectarismos habituales(AU)

Paper begins with an epistemological reflection on psychotherapy research and a description of areas, methods and condition ants for its future. Sorne shunts of Bambi's perspective and Godzilla's perspective are described. Some illustrative examples are considered: the sanctification of"managed care", the Utah effect on marketing of new neuroleptics and antidepressants, the meta-analysis negative results about ECT, the positive but almost unknown effects of some elementary psychological techniques on severe disorders care and on puerperal depression, the negative results of some "contra cultural" techniques... To end, a series of integrative proposals for research and teaching in mental health are developed -with the common objective to avoid the sectarian and dogmatic trends almost habitual in that field(AU)