Adverse Childhood Experiences in Mexico: Prevalence and Association with Sociodemographic Variables and Health Status.

Background: Adverse Childhood Experiences (ACEs) refer to a semantic field of negative childhood events that, in conjunction with insufficient personal, family, or contextual coping resources, have the potential of becoming traumatic. Objective: To assess the prevalence of Adverse Childhood Experiences (ACEs) and their association with sociodemographic variables and physical and mental illnesses in a Mexican sample. Design: A cross-sectional design was used. The sample included 917 Mexican adults who responded to the Adverse Childhood Experiences International Questionnaire (ACE-IQ). Most of the participants were female (79.3%) with an average age of 37 years, a monthly income between 500 and 2,500 USD (59.2%), had completed university education (45.6%) and were married or in a common-law marriage (53.1%). Data was collected through Google Forms, and the link to the form was shared through electronic social networks. Results: A total of 48.3% of the participants presented seven to nine types of ACEs. Among their responses, the most prevalent categories were emotional neglect (95.1%), family violence (83.3%), and emotional abuse (78.6%). A significant association was found between the number of ACEs and the mental illness diagnosis (x2(20) = 15.16; p<001). Women were found to report more experiences of sexual abuse (z = -6.62, p<. 001), whereas men reported more experiences of community violence (z= -4.27, p < .001) and collective violence (z = -3.94, p<.001). Conclusions: The prevalence of ACEs in the Mexican population is high. However, men and women reported differences in certain types of ACEs. It was found that people with a diagnosis and family history of mental illnesses presented a higher number of ACE categories.

[Spanish-language version of the health belief model scale for testicular cancer and testicular self-examinationEscala em espanhol do modelo de crenças em saúde para câncer e autoexame testicular]. / Escala del modelo de creencias de salud en español para el cáncer y la autoexploración testicular.

The objective of this study was to adapt and validate the health belief model scale for testicular cancer and testicular self-examination (TSE) in university students in Mexico and to determine the sociodemographic, clinical, and health belief model variables that influence TSE performance. Translation and back translation were conducted, and 72 items were obtained and reviewed by experts, following which 39 items were selected and applied to a group of 30 students to assess comprehension and application time. Finally, this version was applied to 803 students at a public university. A scale consisting of 38 items was obtained, and the items were divided across six factors consistent with the health belief model: susceptibility (α = 0.77), seriousness (α = 0.82), benefits (α = 0.80), barriers (α = 0.83), self-efficacy (α = 0.88), and health motivation (α = 0.71). These factors explain 44% of the variance and show an internal consistency ranging from acceptable to good. The variable that most strongly influenced the performance of testicular self-examination was self-efficacy. The Spanish-language version of the health belief model scale for testicular cancer and testicular self-examination yielded evidence of validity and reliability in this sample of university students.

O objetivo deste estudo foi adaptar e validar a escala do modelo de crenças em saúde para o câncer e o autoexame testicular (AT) em estudantes universitários no México e determinar as variáveis sociodemográficas, clínicas e do modelo de crenças que influenciam a realização do AT. Realizou-se o processo de tradução e retrotradução, do qual foram obtidos 72 itens que foram revisados por especialistas. Posteriormente, foram escolhidos 39 itens que foram aplicados em um grupo de 30 estudantes para verificação da compreensão e do tempo de aplicação. Por último, esta versão foi aplicada a 803 alunos de uma universidade pública. Obteve-se uma escala de 38 itens, divididos em 6 fatores consistentes com o modelo de crenças em saúde: suscetibilidade (α = 0,77), seriedade (α = 0,82), benefícios (α = 0,80), barreiras (α = 0,83), autoeficácia (α = 0,88) e motivação para a saúde (α = 0,71), que explicam 44% da variância e apresentam consistência interna de adequada a boa. A variável que mais influenciou a realização do autoexame testicular foi a autoeficácia. A versão em espanhol da escala do modelo de crenças em saúde para câncer e autoexame testicular obteve evidências de validade e confiabilidade nesta amostra de estudantes universitários.

Escala del modelo de creencias de salud en español para el cáncer y la autoexploración testicular

[RESUMEN]. El objetivo de este estudio fue adaptar y validar la escala del modelo de creencias de salud para el cáncer y autoexploración testicular (AT) en estudiantes universitarios en México y determinar las variables sociodemográficas, clínicas y del modelo de creencias que influyen en efectuar la AT. Se realizó el proceso de traducción y retraducción de la cual se obtuvieron 72 ítems, que fueron revisados por expertos y se eligieron 39 ítems, los cuales fueron aplicados en un grupo de 30 estudiantes para revisar la comprensión y el tiempo de aplicación; por último, esta versión se aplicó en 803 estudiantes de una universidad pública. Se obtuvo una escala de 38 ítems divididos en 6 factores congruentes con el modelo de creencias de salud: susceptibilidad (α = 0,77), seriedad (α = 0,82), beneficios (α = 0,80), barreras (α = 0,83), autoeficacia (α = 0,88) y motivación para la salud (α = 0,71) que explican el 44% de la varianza y presentan una consistencia interna de adecuada a buena. La variable que más influye en la realización de la autoexploración testicular fue la autoeficacia. La versión en español de la escala del modelo de creencias de salud para el cáncer y la autoexploración testicular obtuvo evidencias de validez y confiabilidad en esta muestra de estudiantes universitarios.

[ABSTRACT]. The objective of this study was to adapt and validate the health belief model scale for testicular cancer and testicular self-examination (TSE) in university students in Mexico and to determine the sociodemographic, clinical, and health belief model variables that influence TSE performance. Translation and back translation were conducted, and 72 items were obtained and reviewed by experts, following which 39 items were selected and applied to a group of 30 students to assess comprehension and application time. Finally, this version was applied to 803 students at a public university. A scale consisting of 38 items was obtained, and the items were divided across six factors consistent with the health belief model: susceptibility (α = 0.77), seriousness (α = 0.82), benefits (α = 0.80), barriers (α = 0.83), self-efficacy (α = 0.88), and health motivation (α = 0.71). These factors explain 44% of the variance and show an internal consistency ranging from acceptable to good. The variable that most strongly influenced the performance of testicular self-examination was self-efficacy. The Spanish-language version of the health belief model scale for testicular cancer and testicular self-examination yielded evidence of validity and reliability in this sample of university students.

[RESUMO]. O objetivo deste estudo foi adaptar e validar a escala do modelo de crenças em saúde para o câncer e o autoexame testicular (AT) em estudantes universitários no México e determinar as variáveis sociodemográficas, clínicas e do modelo de crenças que influenciam a realização do AT. Realizou-se o processo de tradução e retrotradução, do qual foram obtidos 72 itens que foram revisados por especialistas. Posteriormente, foram escolhidos 39 itens que foram aplicados em um grupo de 30 estudantes para verificação da compreensão e do tempo de aplicação. Por último, esta versão foi aplicada a 803 alunos de uma universidade pública. Obteve-se uma escala de 38 itens, divididos em 6 fatores consistentes com o modelo de crenças em saúde: suscetibilidade (α = 0,77), seriedade (α = 0,82), benefícios (α = 0,80), barreiras (α = 0,83), autoeficácia (α = 0,88) e motivação para a saúde (α = 0,71), que explicam 44% da variância e apresentam consistência interna de adequada a boa. A variável que mais influenciou a realização do autoexame testicular foi a autoeficácia. A versão em espanhol da escala do modelo de crenças em saúde para câncer e autoexame testicular obteve evidências de validade e confiabilidade nesta amostra de estudantes universitários.

Mammography Stages Adoption and Health Beliefs in Mexican Women / Etapas de Cambio en el Uso de la Mamografía y Creencias de Salud en Mujeres Mexicanas

Abstract Objective. To identify associations between sociodemographic variables and stages of change and evaluate differences between health belief model variables and these stages. Methods. This cross-sectional descriptive study included 612 women aged 40 years and older admitted to a public hospital in the Northeast of Mexico. The participants answered the health belief model scale and selected the statement that best reflected their experience with mammography screening. The association between sociodemographic and clinical variables and the mammography stages of change was assessed using X2, and the groups of stages of change were compared using one-way ANOVA and Games-Howell post-hoc tests. Results. There was a significant association between age and the stages of action and maintenance. Breast cancer screening methods such as breast self-examination and clinical breast examination were more common among women in the stages of maintenance and relapse. There were differences between pre-contemplation and the more advanced stages in all dimensions except in the perceived seriousness p <.001. Self-efficacy and health motivation were different among women at the stage of contemplation, maintenance, and relapse. Conclusions. Perceived self-efficacy and health motivation may increase adherence to mammography screening.

Resumen El objetivo de la investigación fue identificar la asociación entre las variables sociodemográficas y las etapas de cambio para el uso de la mamografía y evaluar si existen diferencias entre las dimensiones del modelo de creencias en salud y las etapas de cambio. El diseño de este estudio es transversal descriptivo, se realizó de enero de 2017 a enero de 2018, incluyó a 612 mujeres de 40 años en adelante que asistían a un hospital de atención terciaria en el noreste de México. Las participantes firmaron el consentimiento informado y respondieron a la escala del modelo de creencias en salud y seleccionaron la declaración que mejor reflejaba su experiencia con la mamografía. La asociación entre las variables sociodemográficas y clínicas y las etapas de cambio de la mamografía se evaluó mediante X2, y los grupos de etapas de cambio se compararon mediante pruebas post hoc de ANOVA unidireccional y Games-Howell. Se encontró una asociación significativa entre la edad y las etapas de cambio de acción y mantenimiento. Los métodos de detección del cáncer de mama, como la autoexploración de mama y el examen clínico de mama, fueron más comunes entre las mujeres en las etapas de mantenimiento y recaída. Se obtuvieron diferencias significativas entre las etapas de pre-contemplación y las etapas más avanzadas en todas las dimensiones de creencias de salud, excepto en la seriedad percibida p <.001. La autoeficacia y la motivación para la salud fueron diferentes entre las mujeres en la etapa de contemplación, mantenimiento y recaída. La identificación de las etapas de cambio para la adopción de mamografías puede ayudar a desarrollar e implementar estrategias de intervención más efectivas. Además, la autoeficacia percibida y la motivación para la salud pueden aumentar la adherencia a la mamografía como método de detección del cáncer de mama.

Internet-Delivered Cognitive Behavioral Therapy and Psychoeducation Program for Patients with Gastrointestinal Stromal Tumors.

Gastrointestinal stromal tumors (GIST) account for 0.2-3% of all cancer diagnoses and are thus considered a rare type of cancer. Severe levels of fatigue occur in 33% of patients on imatinib, but besides treatment, fatigue is also associated with psychological distress. As far as we know, only one previous study has reported on the design of a psychoeducational intervention for caregivers and patients with GIST. The current study was conducted to compare the preliminary effectiveness of an Internet-delivered cognitive behavioral stress management intervention and psychoeducation program for anxiety, depression, fatigue, and quality of life in patients with gastrointestinal stromal tumors (GIST). This study had an experimental pre-test post-test design with a control group. Ninety-nine patients were randomly allocated to an Internet-delivered cognitive program (n = 50) or psychoeducation control group (n = 49). Participants completed the questionnaires at three time points (pre-test, post-test, and 3-month follow-up). Twenty-seven participants completed the intervention. A significant interaction effect between groups and time was found for general fatigue [F(2, 28) = 8.2, p < 0.001, ƞ2p = 0.25], reduced motivation [F(2, 28) = 3.5, p < 0.05, ƞ2p = 0.12], distress [F(2, 28) = 3.4, p < 0.05, ƞ2p = 0.12], and global health status [F(2, 28) = 3.8, p < 0.05, ƞ2p = 0.13]. Both intervention programs showed reductions in the dimensions of fatigue and improvements in distress and dimensions of quality of life. Additional research on a larger sample size is needed to confirm the effects obtained in this study.

Psychological Distress, Fatigue and Quality of Life in Patients with Gastrointestinal Stromal Tumors.

Background: Gastrointestinal stromal tumors (GIST) represent 1% of all gastrointestinal tumors and are included in the list of rare diseases. Objective: 1) To evaluate levels of psychological distress, fatigue, and quality of life. 2) To identify the variables that most influence distress among Mexican patients with GIST. Design: A cross-sectional study was conducted with a consecutive sample of 100 patients with GIST, who completed the following questionnaires online: Hospital Anxiety and Depression Scale (HADS) as a measure of distress, Multidimensional Fatigue Inventory (MFI), and Quality of Life Questionnaire (QLQ C30). Results: Distress was present in 31% of patients. No association was found between distress and sociodemographic/clinical variables. The patients with distress demonstrated higher scores in all fatigue dimensions and, regarding quality of life, had more symptoms and were lower functioning. Distress was positively associated with all fatigue dimensions and with QLQ C30 symptoms. Negative associations were found between distress and QLQ C30 functioning dimensions. The predictors of psychological distress were general fatigue, reduced motivation, and emotional functioning. Conclusion: The percentage of patients with distress was akin to the levels found in patients with the most common types of cancer. Fatigue in patients with GIST should be evaluated and managed to improve distress levels.

Post-traumatic Stress Symptoms, Distress, and Optimism in Mexican Colorectal Cancer Patients.

Background: The diagnosis and treatment of colorectal cancer are considered highly stressful and potentially traumatic events that can generate post-traumatic stress symptoms and distress among patients. Objective: This study assessed levels of post-traumatic stress symptoms, distress, and optimism, as well as differences between these conditions relative to sociodemographic and medical variables, in Mexican patients with colorectal cancer. Design: A cross-sectional descriptive study design was employed, in which 192 colorectal cancer patients over the age of 18 years participated. They filled out the following questionnaires in person: a sociodemographic and medical data questionnaire; the Event Impact Scale-Revised (EIE-R); the Hospital Anxiety and Depression Scale (HADS); and the Life Orientation Test (LOT-R). Results: The results showed that 32.3% of the patients reported post-traumatic stress symptomatology, and 21.4% reported distress. Post-traumatic stress symptoms and distress varied according to age and monthly income. Significant differences between the sexes were also observed in the levels of post-traumatic stress symptoms and distress. Post-traumatic stress was positively and significantly related to distress, and negatively and significantly to optimism. Conclusion: Based on these data, we concluded that a significant percentage of colorectal cancer patients present high levels of post-traumatic stress symptoms as well as distress, and that these levels may vary according to sociodemographic and medical characteristics.

Escala del modelo de creencias de salud en español para el cáncer y la autoexploración testicular / Spanish-language version of the health belief model scale for testicular cancer and testicular self-examination / Escala em espanhol do modelo de crenças em saúde para câncer e autoexame testicular

RESUMEN El objetivo de este estudio fue adaptar y validar la escala del modelo de creencias de salud para el cáncer y autoexploración testicular (AT) en estudiantes universitarios en México y determinar las variables sociodemográficas, clínicas y del modelo de creencias que influyen en efectuar la AT. Se realizó el proceso de traducción y retraducción de la cual se obtuvieron 72 ítems, que fueron revisados por expertos y se eligieron 39 ítems, los cuales fueron aplicados en un grupo de 30 estudiantes para revisar la comprensión y el tiempo de aplicación; por último, esta versión se aplicó en 803 estudiantes de una universidad pública. Se obtuvo una escala de 38 ítems divididos en 6 factores congruentes con el modelo de creencias de salud: susceptibilidad (α = 0,77), seriedad (α = 0,82), beneficios (α = 0,80), barreras (α = 0,83), autoeficacia (α = 0,88) y motivación para la salud (α = 0,71) que explican el 44% de la varianza y presentan una consistencia interna de adecuada a buena. La variable que más influye en la realización de la autoexploración testicular fue la autoeficacia. La versión en español de la escala del modelo de creencias de salud para el cáncer y la autoexploración testicular obtuvo evidencias de validez y confiabilidad en esta muestra de estudiantes universitarios.

ABSTRACT The objective of this study was to adapt and validate the health belief model scale for testicular cancer and testicular self-examination (TSE) in university students in Mexico and to determine the sociodemographic, clinical, and health belief model variables that influence TSE performance. Translation and back translation were conducted, and 72 items were obtained and reviewed by experts, following which 39 items were selected and applied to a group of 30 students to assess comprehension and application time. Finally, this version was applied to 803 students at a public university. A scale consisting of 38 items was obtained, and the items were divided across six factors consistent with the health belief model: susceptibility (α = 0.77), seriousness (α = 0.82), benefits (α = 0.80), barriers (α = 0.83), self-efficacy (α = 0.88), and health motivation (α = 0.71). These factors explain 44% of the variance and show an internal consistency ranging from acceptable to good. The variable that most strongly influenced the performance of testicular self-examination was self-efficacy. The Spanish-language version of the health belief model scale for testicular cancer and testicular self-examination yielded evidence of validity and reliability in this sample of university students.

RESUMO O objetivo deste estudo foi adaptar e validar a escala do modelo de crenças em saúde para o câncer e o autoexame testicular (AT) em estudantes universitários no México e determinar as variáveis sociodemográficas, clínicas e do modelo de crenças que influenciam a realização do AT. Realizou-se o processo de tradução e retrotradução, do qual foram obtidos 72 itens que foram revisados por especialistas. Posteriormente, foram escolhidos 39 itens que foram aplicados em um grupo de 30 estudantes para verificação da compreensão e do tempo de aplicação. Por último, esta versão foi aplicada a 803 alunos de uma universidade pública. Obteve-se uma escala de 38 itens, divididos em 6 fatores consistentes com o modelo de crenças em saúde: suscetibilidade (α = 0,77), seriedade (α = 0,82), benefícios (α = 0,80), barreiras (α = 0,83), autoeficácia (α = 0,88) e motivação para a saúde (α = 0,71), que explicam 44% da variância e apresentam consistência interna de adequada a boa. A variável que mais influenciou a realização do autoexame testicular foi a autoeficácia. A versão em espanhol da escala do modelo de crenças em saúde para câncer e autoexame testicular obteve evidências de validade e confiabilidade nesta amostra de estudantes universitários.

Development and Validation of a Mexican Version of the Champion's Health Belief Model Scale for Breast Cancer Screening.

Although the Champion's Health Belief Model Scale for breast cancer screening has been adapted and validated in different populations worldwide, a Spanish version for the Latin American population is still not available. The aim of this study was to adapt and validate the Spanish version of the Champion's Health Belief Model Scale for mammograms for use with Mexican women and determine the sociodemographic, clinical, and health belief model variables which influence undergoing a mammogram. A descriptive, cross-sectional study was designed. Participants included 612 women aged 40 years and above who attended a public tertiary hospital. An exploratory factor analysis was conducted, from which six factors with adequate loadings were obtained. In addition, Cronbach's alpha was used to obtain a reliability coefficient of 0.68-0.94. To obtain criterion validity, a binary logistic regression analysis was conducted, with the mammogram being the dependent variable and sociodemographic, clinical, and health belief model dimensions being the predictors; perceived benefits was the variable that most influenced the obtaining of mammography. This Spanish version of the Champion's Health Belief Model Scale for breast cancer screening for Mexican women was found to be valid and reliable, which means it could be a useful tool in identifying beliefs surrounding breast cancer screening.

Quality of life in Mexican colorectal cancer patients: analysis with sociodemographic, medical, and psychological variables.

In this study, we evaluated the influence of sex, age, clinical stage, and colostomy/ileostomy variables on the quality of life of Mexican patients with colorectal cancer. Using a descriptive cross-sectional design, 192 colorectal cancer patients were included in the study. Significant differences were observed in emotional functioning between patients with rectal cancer and those with colon cancer. Presence of colostomy/ileostomy was associated with significantly impaired social functioning. Body image was significantly different based on gender and diagnosis. Likewise, significant differences were observed with respect to symptoms of the general and specific quality of life modules for colorectal cancer: these included significant difference between male and female patients with respect to taste; significant difference between rectal and colon cancer with respect to presence of blood and mucous in stool, urinary incontinence, and buttock pain; and significant difference between patients with and without colostomy/ileostomy with respect to constipation, stool frequency, sore skin, and embarrassment. We observed significant correlation of dimensions of the quality of life with distress, post-traumatic stress, and optimism. Interventions for improving the quality of life of patients with colorectal cancer should be individualized based on the specific diagnosis and the presence/absence of colostomy/ileostomy.

Adaptation and Validation of the Health Belief Model Scale for Breast Self-Examination in Mexican Women.

OBJECTIVES: In Mexico, breast cancer is often not detected until it is already at an advanced stage. Many women know about breast self-examination (BSE), but few do it correctly. BSE can assist in the early detection of breast cancer, and a valid and reliable instrument to help determine the factors of the Health Belief Model that affect the practice of BSE in Mexican women would thus be advantageous. This study evaluates the psychometric properties of the Spanish version of the Health Belief Model Scale (HBMS) for BSE and identifies the factors that influence its practice. METHODS: A cross-sectional design was used; 738 Mexican women aged 20 years and older who attended a tertiary public hospital were evaluated. The HBMS of Champion was translated into Spanish. Focus groups of women were consulted, and experts' judgments were gathered to determine content validity. RESULTS: In the exploratory factor analysis, a structure of 6 factors was obtained, and Cronbach's alpha scales ranged between 0.65 and 0.84. BSE practice was associated with age (odds ratio [OR] 1.05; confidence interval [CI] 1.03-1.07), self-efficacy (OR 1.16; CI 1.12-1.20), barriers (OR 0.953; CI 0.912-0.996), and health motivation (OR 0.907; CI 0.837-0.983). CONCLUSION: The Spanish version of the HBMS is an adequate, valid, and reliable instrument for the Mexican population that allows us to evaluate their beliefs about breast cancer and BSE, and it should also be applicable to other Spanish-speaking people. Perceived barriers, self-efficacy, and health motivation in particular should be considered in the development of health promotion programs for Mexican women.

Hypnosis in Women with Breast Cancer: Its Effects on Cytokines.

The aim of the present study was to evaluate the effects of hypnosis on the cytokine levels of women with breast cancer during chemotherapy. Patients with a recent breast cancer diagnosis were assigned to either a control group (n = 20) or to a hypnosis group (n = 20). The control group received standard medical care, while the hypnosis group received 24 sessions of hypnosis over 6 months as an adjuvant therapy to standard medical care. Three blood samples were obtained, one before the initiation of chemotherapy, the second a month after beginning treatment, and the third at the end of treatment. At the end of chemotherapy treatment, the control group showed significantly higher levels of tumor necrosis factor alpha (TNF-α) and granulocyte colony stimulation factor (G-CSF) compared to the hypnosis group. Stabilized G-CSF and TNF-α levels during chemotherapy in the hypnosis group could be considered as beneficial because high levels of these cytokines have been associated with increased levels of tumor growth and metastasis in cancer patients.

Cognitive Behavioral Stress Management intervention in Mexican colorectal cancer patients: Pilot study.

OBJECTIVE: Determine the feasibility and the preliminary effects of brief cognitive behavioral stress management (CBSM) intervention, compared with psychoeducation (PE) group in posttraumatic stress, distress, optimism, and quality of life in patients with colorectal cancer. METHODS: Ninety-four patients were randomized: 40 in CBSM intervention and 54 in PE. They answered psychological questionnaires before and after the intervention and 3 months later for follow-up. RESULTS: Of the included participants, 23.40% (22) completed the sessions (11 in each group). A significant effect was obtained in the variable of optimism F2,28  = 4.0, P = 0.03, ƞ2p  = 0.22 and a significant interaction effect between the groups in the avoidance behavior F2,28  = 6.0, P = 0.01, ƞ2p  = 0.30 and hyperactivation F2,30  = 3.91, P = 0.03, ƞ2p  = 0.20, with a large effect size in both. A significant interaction effect was found in the quality of life symptoms subscale for patients with colorectal cancer with a stoma F3,20  = 21.8, P = 0.00, ƞ2p  = 0.68. CONCLUSIONS: The CBSM intervention and PE are feasible therapies, albeit with some modifications. Preliminary effects are observed in the dimensions of posttraumatic stress and symptoms of quality of life.

Escala del Modelo de Creencias de Salud para la Autoexploración de Mama en Estudiantes Universitarias / The Health Beliefs Model Scale for Breast Self-Examination in University Students

Resumen El objetivo de este estudio fue adaptar la escala del modelo de creencias de salud para la autoexploración de mama (AEM) en estudiantes universitarias y determinar su validez y confiabilidad. La escala de modelo de creencias de salud sobre la AEM de 39 ítems fue aplicada en 994 estudiantes de licenciatura. La confiabilidad se evaluó a través del Alfa de Cronbach, la validez de constructo mediante el Análisis Factorial Exploratorio. Se detectó una estructura de 6 factores con un valor de Kaiser-Meyer-Olkin de .839 y la prueba de esfericidad de Bartlett fue significativa [χ2(496)= 5379.608, p<.0001]. Los factores tuvieron valores de consistencia interna entre .67 a .87. Por lo que se concluye que la escala del modelo de creencias para la AEM en mujeres jóvenes mexicanas presenta la misma estructura factorial que la original siendo válida y confiable para propósitos de investigación.

Abstract The objective of this study was to adapt the health belief model scale for breast self-examination (BSE) in university students and determine its validity and reliability. The health beliefs model scale of 39 items was applied in 994 undergraduate students. Reliability was assessed through Cronbach's Alpha, construct validity through Exploratory Factor Analysis. A structure of six factors with a Kaiser-Meyer-Olkin value of .839 was detected and Bartlett's Sphericity Test was significant [χ2 (496) = 5379.608, p <.0001]. The factors had internal consistency values between .67 and .87. Therefore, it can be concluded that the belief model scale for BSE in young Mexican women presents the same factorial structure as the original, being valid and reliable for research purposes.

Prevalencia de Trastornos de Sueño en Relación con Factores Sociodemográficos y Depresión en Adultos Mayores de Monterrey, México / Prevalence of Sleep Disorders in Relation to Socio-Demographic Factors and Depression in Senior Citizens of Monterrey, Mexico / Prevalência de Transtornos do Sono com relação a Fatores Sociodemográficos e Depressão em Idosos de Monterrey, México

La prevalencia de síntomas de trastornos, calidad de sueño y depresión se evaluó en 313 adultos mayores en la ciudad de Monterrey, México con el Cuestionario de Trastornos de Sueño Monterrey, el Índice de Calidad del Sueño de Pittsburgh y la Escala de Depresión Geriátrica de Yesavage. Los resultados indicaron que los adultos mayores presentaron 50% ronquido, 24% piernas inquietas e insomnio, 44.1% mala calidad de sueño, y 62% síntomas de depresión. Los trastornos de sueño son los que más afectan la calidad de sueño en esta población, por lo que es importante la detección y tratamiento de estos trastornos en los adultos mayores.

This study evaluated the prevalence of symptoms of sleep disorders; the quality of sleep, and the levels of depression in 313 older adults in the city of Monterrey, Mexico, using the Monterrey Questionnaire of Sleep Disorders, the Pittsburgh Sleep Quality Index, and the Yesavage Geriatric Depression Scale. Results indicated that among older adults 50% snored, 24% had leg restlessness and insomnia, 44.1% had poor quality of sleep, and 62% presented symptoms of depression. Sleep disorders are the factor that affects sleep quality the most among this population, which is why it is important to detect and treat these disorders in older adults.

A prevalência de sintomas de transtornos, qualidade do sono e depressão foi avaliada em 313 idosos na cidade de Monterrey (México) com o Questionário de Transtornos do Sono Monterrey, o Índice de Qualidade do Sono de Pittsburgh e a Escala de Depressão Geriátrica de Yesavage. Os resultados indicaram que os idosos apresentaram 50% de ronquidão, 24% de pernas inquietas e insônia, 44.1% de má qualidade do sono e 62% de sintomas de depressão. Os transtornos do sono são os que mais afetam a qualidade do sono nessa população, razão pela qual é importante detectá -los e tratá-los nos idosos.

Variación diurna del cortisol y su relación con estrés, optimismo y estrategias de afrontamiento en mujeres con cáncer de mama / Diurnal cortisol variation and its relationship with stress, optimism and coping strategies in women with breast cancer / Variação diurna do cortisol e sua relação com o estresse: otimismo e estratégias de enfrentamento em mulheres com câncer de mama

El ritmo diurno del cortisol se ha visto alterado en los pacientes con cáncer. Factores como el avance de la enfermedad y los niveles de estrés se han considerado para explicar esta condición; sin embargo, los resultados no son claros. El objetivo de este estudio fue evaluar y determinar si existen diferencias en los niveles de cortisol en mujeres con cáncer de mama en diferentes estadios, y analizar la relación entre los niveles de cortisol y el estrés, el optimismo y las estrategias de afrontamiento. Se recolectaron muestras de cortisol salival durante dos días, y se aplicaron cuestionarios psicológicos de estrés percibido (PSS), optimismo disposicional (LOT-R) y estrategias de afrontamiento (MAC) a 17 mujeres con cáncer de mama en estadio I, II y III. Los resultados muestran que las pacientes con cáncer de mama en los tres estadios presentan un ritmo diurno de cortisol normal y no difieren significativamente en los niveles de cortisol. Respecto a las variables psicológicas, solo difieren en la variable de optimismo. Las estrategias de afrontamiento espíritu de lucha y evitación cognitiva son las variables que tienen más influencia en los niveles de cortisol, y explican un 55% de la varianza. Se discuten las implicaciones de estos resultados.

Diurnal cortisol rhythm has been altered in patients with cancer. Factors such as disease progression and stress levels are regarded as possible causes to explain this condition, however results are not clear. The aim of this study was to assess and determine whether there are differences in cortisol levels in women with breast cancer in different stages and analyze the relationship between cortisol levels and stress, optimism and coping strategies. Salivary cortisol samples were collected for two days and psychological questionnaires of perceived stress (PSS), dispositional optimism (LOT-R) and coping strategies (MAC) were administered to 17 breast cancer women in stage I, II and III of the disease. The results show that patients with breast cancer in the three stages have a normal diurnal cortisol rhythm and do not differ significantly in cortisol levels. Regarding the psychological variables, they differ only in optimism. Coping strategies such as fighting spirit and cognitive avoidance are the variables that have more influence on cortisol levels, explaining 55% of variance. The implications of these results are discussed.

O ritmo diurno do cortisol vem sendo visto alterado nos pacientes com câncer. Fatores como o avanço da doença e os níveis de estresse estão sendo considerados para explicar essa condição; contudo, os resultados não são claros. O objetivo deste estudo foi avaliar e determinar se existem diferenças nos níveis de cortisol em mulheres com câncer de mama de diferentes estágios, bem como analisar estratégias de enfrentamento. Foram coletadas amostras de cortisol salival durante dois dias e aplicados questionários psicológicos de estresse percebido, otimismo disposicional e estratégias de enfrentamento a 17 mulheres com câncer de mama em estágio I, II e III. Os resultados mostram que as pacientes com esse câncer nos três estágios apresentam um ritmo diurno de cortisol normal e não se diferenciam significativamente na variável de otimismo. A respeito das variáveis psicológicas, só diferem na variável de otimismo. As estratégias de enfrentamento -espírito de luta e evitação cognitiva- são as variáveis que têm mais influência nos níveis de cortisol e explicam 55% da variação. Discutem-se as implicações desses resultados.

Trastornos y calidad de sueño en trabajadores industriales de turno rotatorio y turno fijo diurno / Sleep disorders and sleep quality in shift and daytime industrial workers

El objetivo de este estudio fue estimar la prevalencia de los trastornos de sueño y conocer su relación con la calidad de sueño, el estrés, la depresión y variables médicas en una muestra de personal operativo, así como comparar dichas variables entre trabajadores con turno rotatorio (173) y trabajadores con turno fijo (153). Se encontró que los trabajadores con turno rotatorio presentan más trastornos del sueño como insomnio, ronquido, excesiva somnolencia diurna, entre otros; reportan una peor calidad de sueño y tienen una puntuación mayor en depresión en comparación con los trabajadores con turno habitual. Es importante continuar con investigaciones dirigidas a los trabajadores por turnos con el fin de buscar estrategias para mejorar su calidad de vida.

The aim of this study was to estimate the prevalence of sleep disorders and their relationship with the sleep quality, stress, depression and medical variables in a sample of operational staff and compare these variables among shift workers (173 ) and fixed workers (153). We found that shift workers have more sleep disorders such as insomnia, snoring, excessive daytime sleepiness, among others, reported a poorer quality of sleep and have a higher score on depression compared with usual fixed workers. It is important to continue research with shift workers to seek strategies to improve their quality of life.

El efecto de la hipnoterapia en la calidad de sueño de mujeres con cáncer de mama / The effect of hypnotherapy in the sleep quality of women with breast cancer

Objetivo: El propósito de este estudio es comprobar la eficacia de la hipnoterapia en la calidad de sueño de mujeres con cáncer de mama, mientras recibían tratamiento médico estándar. Método: Participaron 40 pacientes con cáncer de mama en los primeros estadios, programadas para quimioterapia. Se conformaron dos grupos de 20 pacientes cada uno, a uno de los grupos se le aplicó una fase intensiva de 12 sesiones de hipnoterapia grupal durante un mes y una segunda fase de 12 sesiones cada quince días, durante seis meses mientras que el otro grupo (control) solo recibió tratamiento médico estándar. La calidad de sueño de las pacientes de ambos grupos fue evaluada con el Índice de Calidad de Sueño de Pittsburgh (ICSP) que se aplicó antes de la intervención, así como al término de las 12 y 24 sesiones. Resultados: Al finalizar el primer bloque de 12 sesiones, el grupo de hipnoterapia mostró una mejoría clínica y estadísticamente significativa en los componentes de latencia, duración, eficiencia y calidad global de sueño del ICSP. Posteriormente, a las 24 sesiones solo se mantuvo la significancia en el componente de eficiencia de sueño y en los otros tres componentes únicamente se mantuvo la mejoría clínica. En comparación con el grupo control, que a las 12 sesiones mostró un aumento en los componentes lo que indica una peor calidad de sueño, manteniendo estos resultados a las 24 sesiones. Conclusiones: La hipnoterapia es una técnica psicoterapéutica útil para mejorar la calidad de sueño de mujeres con cáncer de mama que reciben quimioterapia. Sin embargo es importante, diseñar un estudio experimental aleatorizado que confirme estos datos

Objective: The purpose of this study is to test the effectiveness of hypnotherapy in sleep quality in breast cancer women while receiving standard medical treatment. Method: Participants were 40 breast cancer patients in the early stages, scheduled for chemotherapy. Two groups of 20 patients each, one group was applied an intensive phase of 12 sessions of group hypnotherapy for a month and a second phase of 12 sessions every fortnight for six months while the other group was formed (control) received only standard medical treatment. Sleep quality of patients in both groups was assessed with the Quality Index Pittsburgh Sleep (ICSP) that was applied before surgery and at the end of 12 and 24 sessions. Results: At the end of the first block of 12 sessions, the hypnotherapy group showed a clinically and statistically significant in the components of latency, duration, efficiency and overall quality of sleep ICSP improvement. Later, at only 24 sessions’s significance in the sleep efficiency component and the other three components shall be maintained clinical improvement was maintained. These results compared with the control group, at 12 sessions that showed an increase in components indicating a poorer quality of sleep, keeping these results to 24 sessions

Ritmos circadianos en pacientes oncológicos / Circadian rhythms in cancer patients

Los ritmos circadianos mantienen la homeostasis del organismo a través de ciclos hormonales, metabólicos y celulares que regulan la proliferación celular. A su vez, estos son mediados por condiciones psicológicas que pueden alterar su funcionamiento y dejar al organismo susceptible a enfermedades como el cáncer. El objetivo de este artículo es revisar la relación de los ritmos circadianos con el cáncer; enfatizando en aquellos ritmos que guardan relación con comportamientos como el ritmo sueño-vigilia y el ritmo circadiano del cortisol. Se busca identificar con esta revisión, posibles repercusiones en la incidencia y pronóstico del cáncer. Así mismo se comentarán los mecanismos psicobiológicos que mantienen la relación entre estos ritmos circa-dianos y cáncer.

Circadian rhythms maintain homeostasis of the body through hormonal, metabolic and cell cycle regulating cell proliferation. In turn, these are mediated by psychological conditions that may affect its operation and leave the body susceptible to diseases like cancer. The aim of this article is to review the relationship of circadian rhythms to cancer; with emphasis on those rhythms that are related to behaviors such as sleep-wake rhythm and the circadian rhythm of cortisol. This review will seek to identify, potential impact on the incidence and prognosis of cancer. Also psychobiological mechanisms that maintain the relationship between the circadian rhythms and cancer will be discussed.