Factor structure and psychometric properties of the TFEQ in morbid obese patients, candidates to bariatric surgery.

BACKGROUND: To analyze the factor structure and psychometric properties of the TFEQ in a morbid obese Spanish sample of bariatric surgery candidates. METHOD: Multi-trait/ multi-item analyses and alpha coefficients were conducted to test the convergent /discriminant validity and the internal consistency reliability. Principal components analyses (varimax) were used to explore the factor structure. Sub-group factor analyses by gender, age and body mass index (BMI) were conducted to identify unstable items. RESULTS: The internal structure of the original TFEQ factors was unsatisfactory, especially the Disinhibition Scale. Most Disinhibition and Hunger items were grouped on one factor labeled “Dysregulation Eating”. Cognitive Restraint was split into two factors. The first one, related to the behavioral component of Restraint, labeled “Restrained Behaviour” and the second one related to weight and eating concerns called “Predisposition to Restraint”. CONCLUSIONS: The original factor structure of the TFEQ was not replicated. A revised 23-item instrument, representing the three new derived factors is offered as a valid screening instrument for severely obese patients.

Factor structure and psychometric properties of the TFEQ in morbid obese patients, candidates to bariatric surgery / Estructura factorial y propiedades psicométricas del TFEQ en pacientes con obesidad mórbida candidatos a cirugía bariátrica

BACKGROUND: To analyze the factor structure and psychometric properties of the TFEQ in a morbid obese Spanish sample of bariatric surgery candidates. METHOD: Multi-trait/ multi-item analyses and alpha coefficients were conducted to test the convergent /discriminant validity and the internal consistency reliability. Principal components analyses (varimax) were used to explore the factor structure. Sub-group factor analyses by gender, age and body mass index (BMI) were conducted to identify unstable items. RESULTS: The internal structure of the original TFEQ factors was unsatisfactory, especially the Disinhibition Scale. Most Disinhibition and Hunger items were grouped on one factor labeled «Dysregulation Eating». Cognitive Restraint was split into two factors. The first one, related to the behavioral component of Restraint, labeled «Restrained Behaviour» and the second one related to weight and eating concerns called «Predisposition to Restraint». CONCLUSIONS: The original factor structure of the TFEQ was not replicated. A revised 23-item instrument, representing the three new derived factors is offered as a valid screening instrument for severely obese patients

ANTECEDENTES: analizar la estructura factorial y las propiedades psicométricas del TFEQ en una muestra española de obesos mórbidos candidatos a cirugía bariátrica. MÉTODO: se realizó un análisis multi-rasgo/multi-ítem y de coeficientes alpha para probar la validez convergente/discriminante y la consistencia interna. Se utilizó un análisis de componentes principales (varimax) para estudiar la estructura factorial. Se llevó a cabo también un análisis de factores de subgrupos por género, edad e IMC para identificar aquellos ítems inestables. RESULTADOS: la estructura interna original de los 3 factores TFEQ fue insatisfactoria, especialmente en la escala de Desinhibición. La mayoría de los ítems de Desinhibición y Hambre se agruparon en un mismo factor denominado «Desregulación en la ingesta». La Restricción Cognitiva se dividió en dos factores. El primero, relacionado con el componente de Restricción, se denominó «Restricción Activa» y el segundo, relacionado con el peso y las preocupaciones de la ingesta, se llamó «Predisposición a la Restricción». CONCLUSIONES: la estructura factorial original del TFEQ no se replica. En este artículo se presenta un instrumento revisado de 23 ítems, que representa los tres nuevos factores derivados, como instrumento de cribado válido para pacientes obesos graves

El proceso de duelo: educación para la salud, la vida y la muerte / The grieving process. Education for health, life and death

El duelo, una experiencia humana universal, es el proceso adaptativo intencional que sigue a una pérdida significativa (y a veces la precede) que tiene por objeto elaborarla, aprender de la experiencia y aceptar la desaparición de los aspectos propios que también se han desvanecido con esa persona insustituible. El objetivo del presente trabajo es ayudar al profesional sanitario a conocer mejor este complejo problema y sus repercusiones tanto en la práctica clínica como en su propia salud y en el funcionamiento del equipo asistencial (AU)

Mourning, a universal human experience is the intentional adaptive process following a significant loss (and sometimes above) that aims to develop such a loss, learn from the experience and accept the loss of the unique aspects that have also lost with that person irreplaceable. The aim of this study is to help health professionals to better understand this complex problem and its implications for both clinical practice and in their own health and the functioning of the healthcare team (AU)

Coping strategies and quality of life among liver transplantation candidates / Estrategias de afrontamiento y calidad de vida en candidatos para trasplante de hígado

The maintenance of self-reported quality of life (QL) among people on the liver transplantation waiting list is one of the priority objectives of transplantation teams. Although there are different determinant factors of QL, results are not conclusive. In our study, the goal was to evaluate both the influence of cirrhosis etiology (ethylic and non-ethylic) and the coping strategies used concerning QL. A sample of 93 patients was selected, divided into two groups: ethylic cirrhosis (EC) and non-ethylic cirrhosis (NEC). QL was evaluated through the SF-36 Health Survey, and coping strategies through the Medical Coping Modes Questionnaire (MCMQ). Our results indicated that subjects with EC obtained similar QL levels to subjects with NEC, on all the SF-36 and MCMQ subscales. Furthermore, negative correlations were found between avoidance and acceptance-resignation coping strategies with the SF-36 components. Consequently, the acceptance-resignation strategy was associated with a worse perception of physical functioning, general and mental health, and vitality and role-emotional. Overall, these results suggest that cirrhosis etiology is not a determinant factor of QL, whereas the acceptance-resignation coping strategy might lead to lower self-perception of QL (AU)

El mantenimiento de la calidad de vida (CV) autopercibida en las personas en lista de espera para trasplante hepático es uno de los objetivos prioritarios de los equipos de trasplante. Aunque existen diferentes factores que determinan la CV, los resultados no son concluyentes. Nuestro objetivo fue evaluar la influencia de la etiología (cirrosis etílica y no-etílica) y las estrategias de afrontamiento empleadas sobre la CV. Seleccionamos una muestra de 93 pacientes, dividida en dos grupos: cirrosis etílica (CE) y cirrosis no-etílica (CNE). La CV se evaluó mediante la Escala de Salud SF-36 y las estrategias de afrontamiento con el Cuestionario Médico de Estrategias de Afrontamiento (MCMQ). Nuestros resultados indicaron que los sujetos con CE obtenían niveles de CV similares a los sujetos con CNE, en todas las escalas del SF-36 y MCMQ. Además, se encontraron correlaciones negativas entre las estrategias de afrontamiento de evitación y aceptación-resignación, con los componentes del SF- 36. Así, aceptación-resignación se asociaba con una peor percepción del funcionamiento físico, salud general y mental, vitalidad y rol-emocional. Estos resultados sugieren que la etiología de la cirrosis no es determinante de la CV, mientras que la aceptación-resignación como estrategia de afrontamiento conllevaría una autopercepción de la CV más baja (AU)

Coping strategies and quality of life among liver transplantation candidates.

The maintenance of self-reported quality of life (QL) among people on the liver transplantation waiting list is one of the priority objectives of transplantation teams. Although there are different determinant factors of QL, results are not conclusive. In our study, the goal was to evaluate both the influence of cirrhosis etiology (ethylic and non-ethylic) and the coping strategies used concerning QL. A sample of 93 patients was selected, divided into two groups: ethylic cirrhosis (EC) and non-ethylic cirrhosis (NEC). QL was evaluated through the SF-36 Health Survey, and coping strategies through the Medical Coping Modes Questionnaire (MCMQ). Our results indicated that subjects with EC obtained similar QL levels to subjects with NEC, on all the SF-36 and MCMQ subscales. Furthermore, negative correlations were found between avoidance and acceptance-resignation coping strategies with the SF-36 components. Consequently, the acceptance-resignation strategy was associated with a worse perception of physical functioning, general and mental health, and vitality and role-emotional. Overall, these results suggest that cirrhosis etiology is not a determinant factor of QL, whereas the acceptance-resignation coping strategy might lead to lower self-perception of QL.