Facilitators and barriers to modifying dietary and hygiene behaviours as adjuvant treatment in patients with depression in primary care: a qualitative study.

BACKGROUND: Major depression is a highly prevalent condition. Its pathogenesis is related to a wide variety of biological and psychosocial factors and among these is factors related to lifestyle. Lifestyle-based interventions seem to be appropriate strategies as coadjutant treatment. The objective of this study is to explore and identify expectations and experiences of both patients and healthcare professionals that can point to the main barriers and facilitators with regard to the promotion of healthy dietary and hygiene behaviours in patients suffering from major depression. METHODS: A qualitative design was used to collect information from a wide range of purposefully and theoretically guided samples of depressed patients and health professionals from Primary Care (PC). Both in-depth interviews and discussion groups were used. A standardized protocol was designed to guide the interviews and groups, including the preparation of a topic list to be addressed, with previously tested, open suggestions that could be of interest. A thematic analysis was performed from grounded theory in order to explore, develop and define until saturation the emergent categories of analysis derived from the individual interview and group data. RESULTS: Both patients as well as PC professionals noted a series of central aspects with respect to the implementation of a programme for the acquisition of healthy dietary and hygiene habits for depressive patients, which may be organized around 'personal', 'programmatic', and 'transversal' aspects. As for the personal aspects, categories regarding 'patient history', and 'disposition' were found; the programmatic aspects included categories such as 'presentation and monitoring', and modification of 'cognitive' and 'behavioural' habits; whereas the transversal aspects comprised the possibilities of 'social support' and defining categories of 'objectives'. CONCLUSION: The implementation of intervention programmes that combine dietary and hygiene-related factors in patients with depression is complex, given the nature of the disorder itself, and its symptoms such as apathy and feelings of guilt or incompetence. Key issues exist for the success of the intervention, such as the simplicity of guidelines, tailoring through motivational interviewing, prolonged and intense monitoring throughout the different stages of the disorder, and the provision of adequate feedback and social support. PC could be an appropriate level in which to implement these interventions.

Validación de la cordancia electroencefálica en la evaluación, pronóstico y tipología de fibromialgia / Validation of electroencephalic cordance for evaluation, prognosis and classification of fibromyalgia

Objetivo: Determinar los indicadores específicos para mejorar el diagnóstico y la evaluación de la gravedad de la fibromialgia, buscando la relación con distintos aspectos psíquicos. Material y método: En el primer estudio se comparó un grupo de 13 pacientes de fibromialgia con un grupo control de 13 individuos. En el segundo estudio se analizaron 56 pacientes antes y después del tratamiento psicoterapéutico ACT. Se calcularon los valores de intensidad de cordancia y se les evaluó mediante diversos cuestionarios psicológicos. Se obtuvieron, mediante el EEG cuantitativo, los valores de cordancia para los distintos electrodos y bandas de frecuencias, así como las correlaciones con los resultados de las pruebas psicológicas. Resultados: Los pacientes con mayor gravedad clínica mostraron valores de la cordancia prefrontal en la banda theta significativamente mayores que los enfermos menos graves. Encontramos una correlación negativa entre los valores prefrontal izquierdo y derecho de la cordancia en la banda theta (Fp1 y Fp2) y el estado global de salud (SF-36). Tras la terapia se observó una disminución significativa de la cordancia de los pacientes en varias regiones, fundamentalmente en prefrontales. Conclusión: Este estudio pone de manifiesto el interés de estudiar la cordancia como método de diagnóstico y tipificación de la fibromialgia (AU)

Objective: The main goal has been to determine specific indicators and to contribute to the diagnosis and assessment of severity of fibromyalgia, also looking for establishing its relationship with several psychological and neuropsychiatric tests. Material and method: In the first study a group of 13 patients with fibromyalgia was compared with a control group of 13 subjects. In the second study, we compared a group of 56 patients before and after Psychotherapy ACT. We calculated the intensity values of cordance and the correlations with various psychological questionnaires. The values of cordance for the different electrodes and frequency bands, as well as the correlations with the results of psychological tests, were obtained from EEG recordings. Results: Patients with clinical severity showed higher values of the prefrontal cordances in the theta band, significantly higher than less severe patients. There is also a strong negative correlation between left and right prefrontal values of concordance in the theta band (Fp1 and Fp2) and global health status (SF-36). After therapy, there was a significant decrease in the cordance of patients in several regions, particularly in the prefrontal regions. Conclusion: This study is the first step for the acceptance of cordance as a new tool for diagnostic and classification of fibromyalgia and other neuropsychiatric disorders (AU)

Double-blind single-session neurofeedback training in upper-alpha for cognitive enhancement of healthy subjects.

This paper reports on a single-session neurofeedback (NF) training procedure on the user-specific upper alpha band for cognitive enhancement in healthy users. A double-blind study was designed using a NF group and an active control group. Control group performed as the NF group but received sham feedback, minimizing the non-specific factors of training. This design aimed to (i) investigate upper alpha as a NF parameter, (ii) evaluate the NF effects on upper alpha during the execution of a cognitive task, and (iii) evaluate the effects on cognitive performance by means of a cognitive task and a battery of psychological tests. Results of EEG analysis show the key role of the feedback: only the NF group enhanced upper alpha during the training, and it led to a desynchronization increase during the execution of the cognitive task. Regarding the behavioral results, a strong learning effect was observed, with the NF group performing better in almost all measurements but many of them without statistical significance.

Estrés y otros factores psicológicos asociados en estudiantes de fisioterapia / Stress and other associated psychological factors in physiotherapy students

ResumenLa implantación del Plan Bolonia ha supuesto cambios en el proceso de enseñanza-aprendizaje.ObjetivosAnalizar la asociación entre la percepción del estrés y satisfacción de los alumnos de fisioterapia, tanto de grado como de diplomatura.Material y métodosEstudio descriptivo transversal. Las variables del estudio y los instrumentos utilizados fueron: 1. variables sociodemográficas; 2. variables relacionadas con el estrés y ansiedad de los alumnos mediante la utilización del Inventario SISCO de Estrés Académico y el Cuestionario de ansiedad estado-rasgo de Spielberg (STAI), y 3. satisfacción de los alumnos en relación con el aprendizaje, evaluada mediante la Escala de Engagement en el Trabajo de Utrecht. (UWES-S).ResultadosLa media obtenida del nivel de intensidad del estrés académico de los estudiantes es de 3,65 sobre 5, que se puede considerar media-alta. Las situaciones estresoras destacadas son la sobrecarga de trabajos, la evaluación de los profesores y al tiempo limitado para la realización de los trabajos. Respecto a las reacciones al estrés destacadas son la somnolencia o una mayor necesidad de dormir y la inquietud. La satisfacción de los estudiantes se encuentra en valores medios (3,03 puntos). La única diferencia significativa entre los estudiantes de grado y diplomatura aparece en la ansiedad estado, evaluada mediante el cuestionario STAI, siendo superior en los primeros.ConclusionesLa identificación y análisis de la presencia de estrés puede ayudar, a establecer programas de ayuda y entrenamiento para que los alumnos aprendan a manejar la ansiedad, lo que permitirá mejorar su salud física y mental y su rendimiento académico (AU)

AbstractThe implementation of the Bologna Process has led to several changes in the teaching-learning process.ObjectivesTo analyze the association between perceived stress and satisfaction of both degree and diploma physiotherapy students. Methods: Cross-sectional study. The study variables and instruments used were: 1. Demographic variables, 2. Variables related to stress and anxiety of students, measured by SISCO Academic Stress Inventory and Spielberg State-Trait Anxiety Inventory (STAI) and 3. Student satisfaction in relationship to learning, measured by the Utrecht Work Engagement Scale (UWES-S).ResultsThe average intensity level obtained from the students’ academic stress is 3.65 out of 5, which can be considered as medium-high. Top stressor situations are overwork, evaluation of the teachers and the limited time to perform the work. Regarding stress reactions, these are drowsiness or greater need for sleep and worry. The satisfaction values of the students were average (3.03 points). The only significant difference between degree and diploma students is the anxiety state, assessed by the STAI questionnaire, this being higher in the degree students.ConclusionsIdentification and analysis of the presence of stress can help to provide assistance and training programs so that the students can learn how to manage anxiety, which will improve their physical, mental and academic performance (AU)