RESUMO
Some motivational models understand health behavior as a result of the interaction between goal preferences and mood. However, this perspective has not been explored in fibromyalgia. Furthermore, in chronic pain, it has only been explored with regard to negative affect. Thus, our aims were: (1) to develop a Spanish version of the Goal Pursuit Questionnaire (GPQ); (2) to explore the relationships between goal preferences and health outcomes, testing the moderator role of affect and the mediating role of chronic pain activity patterns. We conducted two cross-sectional studies. In Study 1, after a double translation/back-translation process, we interviewed 94 women attending the Fibromyalgia Unit of the Community of Valencia in order to identify the cultural feasibility and the content validity of the GPQ. Study 2 comprised 260 women. We explored the GPQ structure and performed path analyses to test conditional mediation relationships. Eight activities from the original GPQ were changed while maintaining the conceptual equivalence. Exploratory factor analysis showed two factors: 'Pain-avoidance goal' and 'Mood-management goal' (37 and 13% of explained variance, respectively). These factors refer to patients' preference for hedonic goals (pain avoidance or mood-management) over achievement goals. Robust RMSEA fit index of the final models ranged from 0.039 for pain to 0.000 for disability and fibromyalgia impact. Pain avoidance goals and negative affect influenced pain mediated by task-contingent persistence. They also affected disability mediated by task and excessive persistence. Pain avoidance goals and positive affect influenced fibromyalgia impact mediated by activity avoidance. We also found a direct effect of negative and positive affect on health outcomes. Preference for pain avoidance goals was always related to pain, disability and fibromyalgia impact through activity patterns. Affect did not moderate these relationships and showed direct and indirect paths on health outcomes, mainly by increasing persistence and showing positive affect as an asset and not a risk factor. Intervention targets should include flexible reinforcement of achievement goals relative to pain avoidance goals and positive affect in order to promote task-persistence adaptive activity patterns and decreased activity avoidance.
RESUMO
La terapia por Presión Negativa es un sistema de cicatrización no invasivo y activo que utiliza una presión inferior al valor de la presión atmosférica normal, localizada y controlada, para estimular la curación de heridas. Esto se realiza a través de un sistema de bomba de vacío con una serie de componentes y con un protocolo de aplicación determinado. La Terapia por Presión Negativa está indicada en todos aquellos casos en los que convenga eliminar exudado y reducir edema, aumentar la microcirculación de la herida, estimular el tejido de granulación, mejorar el lecho de la herida y reducir la complejidad y tamaño de la misma. Numerosos estudios realizados demuestran las ventajas de esta terapia tanto a nivel socio-económico. Por el contrario, tras la realización de este trabajo, es evidente la falta de estudios centrados en la aplicación de la Terapia de Presión Negativa en podología (sobre todo en el pie diabético), por tanto, los resultados son insuficientes para establecer con claridad los beneficios terapéuticos y económicos de esta terapia en nuestra disciplina. El objetivo principal de este trabajo es hacer una presentación actualizada de la Terapia por Presión Negativa, de sus fundamentos biológicos y las aplicaciones clínicas actuales más frecuentes y, en consecuencia, la posibilidad de aplicación en el campo podológico (AU)
The Negative-Pressure Therapy is a non-invasive system of cicatrization that uses pressure below the normal atmospheric pressure. It is localized and controlled and also used to cure wounds. This is carried out through a vacuum system with a series of components and with a determined protocol of application. The Negative-Pressure Therapy is used in all those cases where we need to eliminate exude and reduce edema, to increase the microcirculation of the wound, to simulate the granulate tissue, to improve the wound, to stimulate the granulate tissue, to improve the wound and reduce the complexity and size of it. Numerous studies demonstrate the benefits of this therapy both at a clinical and socio-economics level. However, after the completion of this research, it is obvious that there is a lack of study focusing on the application of Negative-Pressure Therapy in podiatry (especially in the diabetic foot), therefore the results is insufficient to stablish therapeutic benefits and economic impact of this therapy in our discipline. The main goal of this article is to present an up-to-date perspective of the Negative-Pressure Therapy, its biological foundations and the most frequent clinical applications today, and as a result, the possibility of this application in the podiatry field (AU)
