Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties.

BACKGROUND: Family caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools. AIM: This study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC). DESIGN: Multicentre, cross-sectional study. SETTINGS/PARTICIPANTS: Family caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA). RESULTS: 138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach's alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale. CONCLUSIONS: The DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

Caregiver emotional distress: external open-behaviour signs.

OBJECTIVES: To determine whether specific external signs of emotional distress (ESED) can be an indirect measure of emotional distress in caregivers. METHODS: A cross-sectional multicentre design was used. 148 primary caregivers of advanced cancer patients attended in four Spanish palliative care units participated in this study. The emotional distress of caregivers was measured using both the Emotional Distress of Caregivers Scale and a psychological interview. Health professionals collected data using a standard clinical interview process after a brief training period. RESULTS: More than half the caregivers (60%) presented with emotional distress. A positive correlation (r=0.566) was found between the intensity of ESED and emotional distress per se. Caregivers who presented emotional distress showed more ESED than those that did not (p<0.01). The study found significant differences for the categories 'visible signs of sadness, fear, crying, feeling overwhelmed' (p<0.001), 'difficulty in separating from the patient: family refuses to let the patient make decisions and insists on care' (p<0.001) and 'visible signs of anger, irritability or frequent disagreement with therapeutic measures' (p<0.001). No significant differences were found with respect to gender. The set of items to measure these external signs presented an adequate reliability assessed using Cronbach's alpha (α=0.773). CONCLUSIONS: The assessment of ESED in caregivers could serve as a useful method to assess their emotional distress. Incorporating the systematic assessment of these external signs as part of the assessment of the emotional distress of primary caregivers could improve the overall assessment and treatment provided to these caregivers.

Consenso sobre el estándar de atención psicooncológica, complejidad psicosocial y actividad asistencial en el Instituto Catalán de Oncología / Consensus on the standard of psycho-oncological care, psychosocial complexity and care activity at the Catalan Institute of Oncology

Introducción: La atención psicosocial de las personas con enfermedad oncológica y la familia debe formar parte de todo modelo integral de atención que pretenda reducir el impacto vital del cáncer. Las intervenciones psicosociales han probado su eficacia en la ayuda a pacientes y familiares para afrontar las situaciones de alta complejidad psicosocial emergentes a consecuencia de un diagnóstico de cáncer. Objetivo: Definir y explicar el modelo de Atención Psicosocial del Comité Psicosocial del Instituto Catalán de Oncología (ICO) utilizando criterios de vulnerabilidad, complejidad y derivación; enmarcado y basado en los valores del ICO (centrados en las necesidades de pacientes con cáncer y sus familias). Método: El modelo que se presenta en este documento consta de cinco pilares: 1) Principios de la Práctica Psicosocial en Oncología; 2) Áreas de actuación en la Atención Psicosocial del paciente con cáncer y la familia; 3) Cribado de malestar emocional y derivación del paciente con cáncer y la familia para una atención psicooncológica específica; 4) Comité Psicosocial: (objetivos; funciones; organización; composición; disciplinas participantes; criterios de derivación y niveles de complejidad; y procedimiento); y 5) Índice de productividad. Resultados: Pacientes y familiares atendidos por el CPS mostraron mejoría estadísticamente significativa en los niveles del malestar emocional, pasando de una media inicial de 8,12/10 (EVA/ENV) a una media 6,27/10 (EVA/ENV). Asimismo, se constata que las intervenciones derivadas del comité psicosocial redujeron el porcentaje de casos iniciales de alta complejidad, pasando de un 69,3% a un 49,3% (AU)

Introduction: Psychosocial care for cancer patients and their families should be part of all comprehensive model of care that aims to reduce the life impact of cancer. Psychosocial interventions have proven to be effective in helping patients and families to cope with the highly complex psychosocial situations that arise as a result of a cancer diagnosis. Aim: To define and explain the model of Psychosocial Care in the Psychosocial Committee of the Catalan Institute of Oncology (ICO) using criteria of vulnerability, complexity and referral; framed and based on the values of the ICO (focused on patients and family’s needs). Method: The model presented in this document consists of five pillars: 1) Principles of Psychosocial Practice in Oncology; 2) Areas of action in the Psychosocial Care of the cancer patient and family; 3) Screening for emotional distress and referral of the cancer patient and family for specific psycho-oncological care; 4) PsychosocialCommittee: (objectives; functions; organization; composition; participating disciplines; referral criteria and levels of complexity; and procedure); and 5) Productivity index. Results: Patients and relatives who were attended by the CPS showed statistically significant improvement in the levels of emotional distress, going from an initial mean of 8.12 / 10 (VAS / ENV) to a mean of 6.27 / 10 (VAS / ENV). It also shows that the interventions derived from the psychosocial committee reduced the percentage of initial cases of high complexity, from 69.3% to 49.3% (AU)

¿Telecuidados paliativos? / Telepalliative care?

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Profesionales sanitarios: afrontando el impacto emocional por la COVID-19 en un centro monográfico de cáncer / Healthcare professionals: dealing with the emotional impact of COVID-19 in a cancer monographic center

INTRODUCCIÓN: El impacto psicológico de la pandemia de la COVID-19 es incuestionable, especialmente entre los grupos de mayor vulnerabilidad. Uno de estos grupos es el de profesionales sanitarios. El objetivo es describir la puesta en marcha de un plan de intervención psicológica destinado en la protección de la salud mental de los profesionales sanitarios durante la crisis de la COVID-19 realizada por la Unidad de Psicooncología, en un hospital monográfico de cáncer. MÉTODO: Proceso de tres fases: 1) revisión narrativa de la literatura; 2) descripción de la elaboración de un plan de atención y soporte psicológico a profesionales, tanto individual como grupal; 3) descripción de la puesta en práctica del plan centrado fundamentalmente en facilitar un espacio reparador y normalizador del sufrimiento, legitimando y normalizando sus reacciones emocionales, proporcionando estrategias simples para hacer frente a la situación. RESULTADOS: Se realizaron 67 intervenciones en 20 espacios grupales, y 20 intervenciones individuales, lideradas por profesionales especialistas en Psicología Clínica. Participaron profesionales de la medicina, enfermería, auxiliares de enfermería y de administración. El miedo a contagiarse o contagiar a otro se consideró la principal manifestación, junto con el miedo a la atención inadecuada de los pacientes. El malestar emocional al inicio de la pandemia se puntuó con una EVA de 5/10 (pésimo-excelente). El 100 % de los profesionales que asistieron a las sesiones consideraron que les ayudaron mucho, puntuando con una EVA de 8/10. Asimismo, mostraron una satisfacción muy alta (9/10). El 100 % consideraron que este tipo de sesiones deberían realizarse de nuevo en situaciones similares futuras. CONCLUSIONES: El plan de soporte psicológico ofrecido a los sanitarios durante la pandemia impresiona (subjetivamente) terapéutico. Se recomiendan realizar estrategias de atención y prevención permanentes y estables con el objetivo de proteger la salud mental de colectivos más vulnerables, así como estudios específicos en caso de nuevas pandemias

INTRODUCTION: The psychological impact of the COVID-19 pandemic is unquestionable, especially among the most vulnerable groups. Healthcare workers conform one of these groups. The aim of this paper is to describe the implementation of a psychological intervention plan designed to protect the mental health of healthcare professionals during the COVID-19 crisis, carried out by the Psycho-Oncology Unit in a monographic cancer hospital. METHOD: This is a 3-phase process: 1) narrative review of the literature; 2) description of the development of a plan of care and psychological support for professionals, both individually and in groups; 3) description of the implementation of the plan focused primarily on providing a restorative space for suffering relief, and for both legitimizing and normalizing emotional reactions providing simple strategies to cope with the situation. RESULTS: A total of 67 interventions were performed for 20 groups and 20 individuals by a clinical psychologist. Medical, nursing, nursing assistance, and administrative staff participated. Fear of self contagion or contagion to another was considered the main manifestation, together with fear of inadequate patient care. Emotional distress at the onset of the pandemic was assessed with an EVA score of 5/10 (very bad-excellent). In all, 100 % of the professionals who attended the sessions felt that they were very helpful, scoring an EVA of 8/10. They also showed very high satisfaction levels (9/10). A total of 100 % considered that this type of session should be done again in similar situations in the future. CONCLUSIONS: The psychological support plan offered to healthcare workers during the pandemic is (subjectively) therapeutic. Permanent prevention strategies focused on protecting mental health in the most vulnerable groups are recommended, as well as specific studies in case of a new pandemic

Abordaje de la complejidad psicosocial en pacientes con cáncer / Approaching psychosocial complexity in patients with cancer

ANTECEDENTES Y OBJETIVO: Evaluar el malestar emocional y el nivel de complejidad de pacientes presentados al Comité de Atención Psicosocial. MATERIALES Y MÉTODOS: Estudio pre-post con un solo grupo en pacientes con cáncer. De los 144 pacientes, 27 fueron derivados por el comité a especialistas del área psicosocial, y sus niveles de malestar emocional y de complejidad fueron revisados un mes después. RESULTADOS: Tras ser atendidos según indicaciones del comité, los pacientes mostraron un descenso significativo de los valores en malestar emocional: la media inicial de 8 puntos en la escala visual analógica de malestar emocional descendía a 5,8 puntos. El descenso se reflejó también en los niveles de complejidad: antes de ser revisados, el 70,4% de los pacientes mostraban un alto nivel de complejidad y el 7,4%, un nivel bajo. Después de ser atendidos, los porcentajes de pacientes con alta complejidad se redujeron al 48,1% en los enfermos con alta complejidad, y aumentaron al 22,3% en los de baja complejidad. CONCLUSIONES: El comité ofrece un instrumento para derivar los casos de mayor complejidad que requieren atención preferente y multidisciplinar, permitiendo optimizar recursos, por su eficacia en la resolución de casos complejos

BACKGROUND AND AIM: To assess emotional distress and complexity of patients referred to the Psychosocial Committee. MATERIAL AND METHODS: A pre-post single group study was performed in a sample of oncological patients. From the 144 patients referred to the committee, 27 were attended by psychosocial specialists. The patients' levels of emotional distress and psychosocial complexity were reviewed one month later. RESULTS: After having been attended according to the committee's indications, the patients showed significant decreases in emotional distress. The initial mean of 8 points on the emotional distress scale decreased to 5.81 points after having been referred to the specialist. This decline was also observed in psychosocial complexity. Before attendance, 70.4% patients showed high levels of complexity, and 7.4% showed low levels. After attendance, the percentages of patients with high levels of psychosocial complexity reduced to 48.1% and patients with low complexity increased to 22.2%. CONCLUSIONS: The committee provides an instrument to refer patients who show high levels of psychosocial complexity and require preferential and multidisciplinary attention. The committee optimizes resources due to its efficiency in resolving complex cases

Approaching psychosocial complexity in patients with cancer. / Abordaje de la complejidad psicosocial en pacientes con cáncer.

BACKGROUND AND AIM: To assess emotional distress and complexity of patients referred to the Psychosocial Committee. MATERIAL AND METHODS: A pre-post single group study was performed in a sample of oncological patients. From the 144 patients referred to the committee, 27 were attended by psychosocial specialists. The patients' levels of emotional distress and psychosocial complexity were reviewed one month later. RESULTS: After having been attended according to the committee's indications, the patients showed significant decreases in emotional distress. The initial mean of 8 points on the emotional distress scale decreased to 5.81 points after having been referred to the specialist. This decline was also observed in psychosocial complexity. Before attendance, 70.4% patients showed high levels of complexity, and 7.4% showed low levels. After attendance, the percentages of patients with high levels of psychosocial complexity reduced to 48.1% and patients with low complexity increased to 22.2%. CONCLUSIONS: The committee provides an instrument to refer patients who show high levels of psychosocial complexity and require preferential and multidisciplinary attention. The committee optimizes resources due to its efficiency in resolving complex cases.

Evaluación de las propiedades psicométricas de la Escala de Detección de la Soledad Existencial en pacientes con enfermedades avanzadas / Assessment of the psychometric properties of the Scale of Detection of Existential Loneliness in patients with advanced diseases

Objetivo: Analizar las propiedades psicométricas y la utilidad clínica de la Escala de Soledad Existencial (EDSOL) en enfermos hospitalizados con enfermedad avanzada. Método: Para determinar las propiedades psicométricas de la escala, se administró la escala EDSOL junto con otros instrumentos a 103 pacientes adultos con enfermedades avanzadas ingresados en 5 unidades de cuidados paliativos de hospitales catalanes. Resultados: La escala presenta una excelente fiabilidad medida a través del alfa de Cronbach (0,902) y una adecuada estabilidad temporal (r=0,71). La escala mostró correlaciones positivas y significativas con ansiedad y depresión de la escala HADS y con la suma total de la misma, así como con la valoración clínica psicológica (p<0,01). A través del análisis estadístico de las curvas ROC se determinó que la escala presentaba una sensibilidad del 79,8% y una especificidad del 74,6% y se sugiere que el punto de corte para la detección de la EDSOL sea una puntuación de 5. Conclusiones: La EDSOL presenta unas buenas propiedades psicométricas, es sencilla, breve, fiable y fácil de administrar. Consideramos que es una escala útil para detectar la presencia de soledad existencial en enfermos hospitalizados que padecen enfermedades avanzadas

Aim: To analyze the psychometric properties and the clinical utility of the Scale of Existential Loneliness (EDSOL) in hospitalized patients with advanced disease. Method: To determine the psychometric properties of the scale, the EDSOL scale was administered along with other instruments to 103 adult patients with advanced diseases admitted to 5 palliative care units of Catalan hospitals. Results: The scale presents an excellent reliability measured through Cronbach’s alpha (0.902) and adequate temporal stability (r = 0.71). The scale showed positive and significant correlations with anxiety and depression of the HADS scale and with the overall score of HADS, as well as with the clinical psychological assessment (p <0.01). Through the statistical analysis of the ROC curves, it was determined that the scale had a sensitivity of 79.8% and a specificity of 74.6% and it is suggested that the cut-off point for the detection of EDSOL be a score of 5. Conclusions: The EDSOL scale has good psychometric properties, is simple, brief, reliable and easy to administer. We consider that is an useful scale to detect the presence of existential loneliness in hospitalized patients suffering from advanced diseases

Development of a tool to identify and assess psychosocial and spiritual needs in end-of-life patients: The ENP-E scale.

OBJECTIVE: The goal of this study is to describe the development of a new tool, the Psychosocial and Spiritual Needs Evaluation scale Instrumento de Evaluación de Necesidades Psicosociales y Espirituales del Enfermo al Final de Vida (ENP-E), designed to assess the psychosocial needs of end-of-life (EOL) patients. And, secondarily, to describe the face validity and psychometric properties of this instrument in the Spanish-speaking context. METHOD: The scale was developed through a seven-stage process: (1) literature review; (2) expert panel establishment; (3) discussion and agreement on the most relevant dimensions of psychosocial care; (4) description of key indicators and consensus-based questions to evaluate such dimensions; (5) assessment of the scale by external palliative care (PC) professionals; (6) evaluation by patients; and (7) analysis of scale's psychometrics properties. To assess content validity, 30 PC professionals and 20 patients evaluated the questionnaire. To determine psychometric properties, 150 participants completed these scales: the ENP-E; the Hospital Anxiety and Depression Scale; item 15 from the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative; and the Distress Thermometer. RESULT: All respondents evaluated the tool as "excellent." In terms of construct validity, the internal consistency (Cronbach's alpha = 0.74) and temporal stability (test-retest r = 0.74, p < 0.1) were both adequate. On the factorial analysis, four factors (emotional-wellbeing, social support, spiritual, and information) explained 58.4% of the variance. This scale has a sensitivity of 76.3%, specificity of 78.9%, and the cutoff is 28. SIGNIFICANCE OF RESULTS: To provide quality PC to EOL patients, it is essential to determine the psychosocial factors that influence well-being. This requires the use of reliable and specific instruments. The ENP-E is a novel tool that provides a systematic, holistic assessment of the psychosocial needs of EOL patients. Its routine use would allow clinicians to monitor such needs over time. This would, in turn, permit comprehensive, highly individualized interventions to improve effective PC approach.

Desarrollo de la escala "EDSOL" para la detección de la soledad existencial en enfermos al final de la vida / Development of the EDSOL scale for the detection of existential loneliness in patients at end of life

Objetivo: Presentar el desarrollo de la escala de detección de la soledad existencial (EDSOL) en personas con enfermedades avanzadas en tratamiento paliativo. Método: Se describe el proceso de elaboración de la escala Detección de la Soledad Existencial EDSOL. Para ello, 1) se ha revisado la bibliografía existente sobre el tema; 2) se ha establecido un marco teórico de referencia; 3) se han definido los criterios que debía cumplir el instrumento de cribado; y 4) se ha consultado con expertos y enfermos la adecuación de los ítems de la escala. Resultados: Se presenta a la escala EDSOL, que consta de dos partes: 1) tres preguntas dirigidas a los enfermos; y 2) diferentes observaciones realizadas por el personal sanitario acerca de la presencia de signos externos de soledad existencial. La escala final fue revisada por enfermos y profesionales. Conclusión: La escala EDSOL es una herramienta apropiada para identificar la presencia de Soledad Existencial en pacientes al final de la vida. En este caso, se propondrá su uso sistemático en la detección temprana de la Soledad Existencial y la implementación de intervenciones asistenciales específicas (AU)

Aim: This paper presents the development of Detection of Existential Loneliness Scale (EDSOL) of patients with advanced disease/terminal illness that receiving palliative care. Method: The process of preparing the scale is described. For this: 1) the literature on the subject has been revised, 2) theoretical framework has been established, 3) it has been defined the criteria to be met by the screening tool, and 4) the final scale was reviewed by patients and experts. Results: The EDSOL scale consists of two parts: 1) three questions addressed to patients and; 2) several questions addressed to health staff about the observation of external signs of Existential Loneliness. The final scale was reviewed by patients and experts (facie validity) showing good validity. Conclussion: The EDSOL scale will be an appropriate tool for identifying the Existential Loneliness of patients at the end of life or advanced illness. In this case, we will propose the systematic use of EDSOL for early detection and specific interventions on existential loneliness experiences (AU)

Manual para la atención psicosocial y espiritual a personas con enfermedades avanzadas: Intervención psicológica y espiritual

Manual que pretende servir de guía a los profesionales de la salud que se dedican a la atención paliativa y, en particular, a los que ejercen la psicología y que resulte una herramienta útil para todas aquellas personas que, desde la praxis profesional, intentan aliviar el sufrimiento y promover el bienestar de pacientes y familiares, previniendo a la par el desgaste emocional de los profesionales y optimizando su competencia. Contiene: Psicología de la salud y cuidados paliativos, muerte, cultura y cuidados paliativos, breve historia de la psicología paliativa en España, fundamentos antropológicos, éticos y relacionales de la intervención psicológica en cuidados paliativos, situación de enfermedad avanzada. Identificación de los pacientes oncológicos y no oncológicos y transiciones al final de la vida, modelos de encuadre en cuidados paliativos, evaluación psicológica en cuidados paliativos, modelos de intervención psicológica específicos al final de la vida, competencias del psicólogo, situaciones clínicas psicosociales prevalentes. Intervención psicológica, información y comunicación, familia y entorno afectivo, duelo, dimensión ética, espiritualidad, atención paliativa pediátrica. Consideraciones especiales, cuidados paliativos no oncológicos. Consideraciones especiales, equipo de cuidados paliativos y burnout.

Evidence for validity of the brief resilient coping scale in a young spanish sample

The aim of the present study was to provide evidence of validity of the Brief Resilient Coping Scale for use in Spanish young population. A total of 365 university students responded to the Spanish version of the BRCS as well as to other tools for measuring personal perceived competence, life satisfaction, depression, anxiety, negative and positive affect, and coping strategies. Confirmatory factor analysis confirmed the unidimensional structure of the scale. Internal consistency reliability and temporal stability through Cronbach’s alpha and test-retest correlations, respectively, were comparable to those found in the initial validation of the tool. The BRCS showed positive and significant correlations with personal perceived competence, optimism, life satisfaction, positive affect (p < .01), and some coping strategies (p < .05). Significant negative correlations were observed with depression, anxiety and negative affect. (p < .01). Multiple regression analysis with stepwise method showed that positive affect, negative affect, optimism and problem solving explained 41.8% of the variance of the BRCS (p < .001). The Spanish adaptation of the BRCS in a young population is satisfactory and comparable to those of the original version and with the Spanish version adapted in an elderly population. This supports its validity as a tool for the assessment of resilient coping tendencies in young people who speak Spanish and offers researchers and professionals interested in this area of study a simple tool for assessing it (AU)

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Sufrimiento en el paciente oncológio al final de la vida / No disponible

Objetivo general: El objetivo general de este trabajo es, profundizar en el conocimiento de la experiencia de sufrimiento en el ámbito del paciente con cáncer avanzado al final de su vida. Objetivos específicos: 1. Realizar un estudio de campo para la identificación y descripción de qué factores se asocian a la percepción de que el paciente muera o no en paz en una Unidad de Cuidados Paliativos (UCP), desde la doble perspectiva de sus familiares y del personal de enfermería que le asistió durante el proceso de morir. 2. Propuesta, desarrollo y validación de un instrumento para la detección de malestar emocional en pacientes oncológicos con enfermedad avanzada. 3. Realizar una revisión de la literatura sobre el sufrimiento y los factores relacionados para entender de una manera más integrada la naturaleza del mismo en el contexto del paciente con cáncer avanzado al final de la vida. 4. Realizar una propuesta integradora de Modelo de Atención al final de la Vida centrado en la relación terapéutica directa profesional-paciente que describa de manera sistemática los netelementos esenciales del modelo de excelencia y de ética de máximos, con el objetivo fundamental de atender las Necesidades Esenciales del paciente oncológico, así como garantizar la calidad de atención y la transmisión en acciones docentes. Resultados: De acuerdo con el primer objetivo el resultado del mismo se materializa con la Publicación 1 que lleva por título: ¿A qué se atribuye que los enfermos oncológicos de una unidad de cuidados paliativos mueran en paz? De acuerdo con el segundo objetivo, las publicaciones resultantes corresponden a la Publicación Nº 2 titulada: «Elaboración y propuesta de un instrumento para la detección de malestar emocional en enfermos al final de la vida (DME)», y a la Publicación Nº 3 titulada: «Evaluación de las propiedades psicométricas del cuestionario de Detección de Malestar Emocional (DME) en pacientes oncológicos». El tercer objetivo se concreta con la Publicación Nº 4, titulada: «Suffering and distress at the end-of-life». Finalmente, con el último objetivo (Objetivo 4) se presenta una novedosa propuesta de modelo de atención al final de la vida concretado en la Publicación Nº 5 titulada: «The Institut Català d'Oncologia (ICO) Model of Palliative Care: An integrated and comprehensive framework to address essential needs of patients with advanced cáncer». Conclusiones. La mayoría de los familiares y de los sanitarios considera que el paciente «murió en paz». Sin embargo, difieren en las razones de dicha percepción. Mientras los sanitarios valoran más los aspectos somáticos relacionados con el buen control sintomático, los familiares destacan otros aspectos de carácter psicosocial (como la ausencia de conciencia y el estar rodeado de su familia). La escala DME presenta unas buenas propiedades psicométricas y ha demostrado su utilidad clínica. Es sencilla, comprensible y de fácil manejo para la identificación del malestar emocional en enfermos oncológicos avanzados ingresados en Unidades de Cuidados Paliativos. Se sugiere que esta escala también se podría aplicar a otros enfermos y ámbitos de la atención sanitaria, como, por ejemplo la atención domiciliaria o atención primaria en enfermos crónicos. Muchos factores son los que interactúan en la persona que hace frente a una enfermedad que amenaza su vida, ya sean internos o externos, variables o estables. Estos factores están intrínsecamente relacionados y se suman a un conjunto que parece ser más que la simple suma de sus partes, escapando de la fragmentación. Teniendo en cuenta esta naturaleza del sufrimiento, su abordaje ha de ser necesariamente multidisciplinar, y ha de abarcar tanto al enfermo como a su familia o seres queridos

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Evidence for validity of the brief resilient coping scale in a young Spanish sample.

The aim of the present study was to provide evidence of validity of the Brief Resilient Coping Scale for use in Spanish young population. A total of 365 university students responded to the Spanish version of the BRCS as well as to other tools for measuring personal perceived competence, life satisfaction, depression, anxiety, negative and positive affect, and coping strategies. Confirmatory factor analysis confirmed the unidimensional structure of the scale. Internal consistency reliability and temporal stability through Cronbach's alpha and test-retest correlations, respectively, were comparable to those found in the initial validation of the tool. The BRCS showed positive and significant correlations with personal perceived competence, optimism, life satisfaction, positive affect (p < .01), and some coping strategies (p < .05). Significant negative correlations were observed with depression, anxiety and negative affect. (p < .01). Multiple regression analysis with stepwise method showed that positive affect, negative affect, optimism and problem solving explained 41.8% of the variance of the BRCS (p < .001). The Spanish adaptation of the BRCS in a young population is satisfactory and comparable to those of the original version and with the Spanish version adapted in an elderly population. This supports its validity as a tool for the assessment of resilient coping tendencies in young people who speak Spanish and offers researchers and professionals interested in this area of study a simple tool for assessing it.

Evaluación de las propiedades psicométricas del cuestionario de Detección de Malestar Emocional (DME) en pacientes oncológicos / Assessment of the psychometric properties of the Detection of Emotional Distress Scale in cancer patients

Objetivo Con el fin de valorar y aliviar el malestar emocional al final de la vida, se necesitan instrumentos de cribado sencillos, de fácil uso por los sanitarios y comprensibles por los enfermos. En el presente estudio multicéntrico se analiza la utilidad clínica del cuestionario de Detección del Malestar Emocional (DME) en enfermos hospitalizados con cáncer avanzado. Métodos Para determinar las propiedades psicométricas de la escala se administró, a la vez que otros instrumentos y procedimientos, a 105 pacientes con enfermedad oncológica avanzada ingresados en unidades de cuidados paliativos de cinco hospitales de Cataluña. Resultados Se observó que el 58,3% presentaba malestar emocional moderado o muy intenso, similar al objetivado con otras escalas, como el termómetro emocional. El análisis estadístico de las curvas ROC sugiere que el punto de corte para la detección de malestar emocional que muestra el DME equivale a una puntuación ≥ 9 puntos, con una sensibilidad y una especificidad superiores al 75%.ConclusionesEl DME es útil y de fácil manejo para la identificación del malestar emocional en los enfermos oncológicos avanzados ingresados en unidades de cuidados paliativos. Se sugiere que esta escala también se podría aplicar a otros enfermos y ámbitos de la atención sanitaria, por ejemplo la atención domiciliaria o la atención primaria en enfermos crónicos (AU)

Objective To evaluate and alleviate the emotional distress suffered by advanced cancer patients, simple screening methods that can be easily used by health staff and easily understood by patients are required. The objective of this multicenter study was to analyze the psychometric properties and clinical utility of the Detection of Emotional Distress (DED) scale in advanced cancer patients attending a palliative care unit. Methods The DED scale was administered to 105 advanced cancer patients attended in five palliative care units in Catalonia (Spain).Results A total of 58.3% of the patients had moderate to severe emotional distress, a result similar to those of other scales such as the emotional thermometer. Statistical analysis of ROC curves suggested that the cutoff for the detection of emotional distress by the DED scale was equivalent to a score of ≥ 9 points, with a sensitivity and specificity above 75%.ConclusionsThe DED scale is useful and easy to use in the identification of emotional distress in advanced cancer patients attended in palliative care units. This scale could also be applied in other patients and health care fields, such as patients with chronic diseases, home care, and primary care (AU)

[Assessment of the psychometric properties of the Detection of Emotional Distress Scale in cancer patients]. / Evaluación de las propiedades psicométricas del cuestionario de Detección de Malestar Emocional (DME) en pacientes oncológicos.

OBJECTIVE: To evaluate and alleviate the emotional distress suffered by advanced cancer patients, simple screening methods that can be easily used by health staff and easily understood by patients are required. The objective of this multicenter study was to analyze the psychometric properties and clinical utility of the Detection of Emotional Distress (DED) scale in advanced cancer patients attending a palliative care unit. METHODS: The DED scale was administered to 105 advanced cancer patients attended in five palliative care units in Catalonia (Spain). RESULTS: A total of 58.3% of the patients had moderate to severe emotional distress, a result similar to those of other scales such as the emotional thermometer. Statistical analysis of ROC curves suggested that the cutoff for the detection of emotional distress by the DED scale was equivalent to a score of ≥ 9 points, with a sensitivity and specificity above 75%. CONCLUSIONS: The DED scale is useful and easy to use in the identification of emotional distress in advanced cancer patients attended in palliative care units. This scale could also be applied in other patients and health care fields, such as patients with chronic diseases, home care, and primary care.