[Study of migratory grief in immigrant patients seen in primary care clinics. Presentation of a migratory grief evaluation questionnaire]. / Estudio del duelo migratorio en pacientes inmigrantes que acuden a las consultas de atención primaria. Presentación de un cuestionario de valoración del duelo migratorio.

OBJECTIVES: To validate a questionnaire designed to show the existence of migratory grief (MG) and its dimensions in the immigrant population, and to study its relationship with certain sociodemographic variables. DESIGN: A descriptive, cross-sectional, multicentre study. EMPLACEMENT: Consultations in Primary Health Care. PATIENTS: The study included 290 Primary Health Care immigrant patients over 18-years old. There were 12 rejections due to, lack of time, absence of a translator, and lack of understanding. PRINCIPAL MEASUREMENTS: An MG questionnaire with 17 questions was employed, carrying out a factor analysis with final extraction of 4 factors explaining 52.1% of overall variance. Sociodemographic variables were collected: gender, age, marital status, nationality, social network, time in Spain, legal and work situation and communication difficulties. Multivariate analysis was performed using the sociodemographic variables. RESULTS: Four factors were found (fear, homesickness, concern and loss of identity), showing that non-communality was < 0.30 and considering that the 4 factors represent the group of variables from the questionnaire. After analysing the correlations between the different factors, it was observed that concern is related to fear and homesickness, this latter being independent from fear. The loss of identity had a low correlation with other factors. Cronbach's alpha showed good consistency in factors 1, 2 and 3. Some sociodemographic variables are associated with the presence of each factor. CONCLUSIONS: We present a validated instrument to study and characterise MG, adapted to study the different dimensions of the grief in immigrant population.

[Psychosocial nature of chronic illnesses in the dependent elderly]. / Tipología psicosocial de las enfermedades crónicas en los mayores dependientes.

OBJECTIVE: To find the psychosocial nature of chronic diseases in elderly dependent persons. DESIGN: Transversal, observational study. SETTING: Two urban health districts in Granada and Jaén, Spain. PARTICIPANTS: One hundred five patients included in the Family and Home Care programme for elderly dependent persons. MAIN MEASUREMENTS: The type of chronic illness was analysed through the modified Rolland classification. Types of incapacity, demographic variables and the presence of multi-pathologies were recorded. RESULTS: 47.6% of the 105 participants were between 70 and 79 years old. On their psychosocial nature, 94.2% had some kind of disability, 78% had a gradual start, 61% had a progressive course of disease, and 63.8% had a possibly fatal prognosis. Psychosocial type B -- incapacitating, gradual start, progressive and possibly fatal -- was the most common (44.7%). CONCLUSION: The study of psychosocial type in elderly dependent persons is an important instrument for the analysis of families with chronic illnesses within them. Questions relating to its progressive course and the fatal prognosis may have a more determining prognostic weight.

[Factors underlying psycho-social problems]. / Factores que intervienen en la producción de los problemas psicosociales.

OBJECTIVE: To investigate personal and family variables involved in the appearance of psychosocial problems (PSP) and the role of stressful life events (SLE) and Social Network and Support in its genesis; and to construct a profile of a PSP patient. DESIGN: Transversal, descriptive study. SETTING: Almanjayar Health Centre, Granada, Spain. PARTICIPANTS: Three hundred fourteen patients over 18 selected by systematic sampling in on-demand consultation. MAIN MEASUREMENTS: Every patient had an interview, filling in the GHQ-28 (with scores>or=8 considered indicative of PSP), the family Apgar test (Family Function study), the Holmes-Rahe Social Readjustment Scale (SLE in the last year), the DUKE-UNC questionnaire (Social Support), and Social Network (number of people). The Structure and Stage of the Family Life Cycle, social-economic and cultural level, work and income were also determined. A descriptive analysis of each variable and its association with the GHQ-28 through the chi2 test were also conducted. To find what categories were associated independently with high scores on the GHQ, a multivariate analysis was carried out. RESULTS: Categories of age (between 30 and 59 years old), gender (being a woman) and social-economic level (unskilled workers) entail greatest risk of PSP. Similarly, single-parent families, perception of family dysfunction, high levels of stress (OR=3.02; 95% CI, 1.76-5.18), and low social support affect PSP. CONCLUSIONS: The profile of a PSP patient in our setting is of a middle-aged woman forming part of a single-parent and/or dysfunctional family, who has suffered major SLEs and has insufficient social support.