How primary and secondary appraisals of daily stressful eventsinfluence negative and positive affect / ¿Cómo la evaluación primaria y secundaria de los eventos estresantes cotidianos influyen en el afecto negativo y positivo?

The aim of this study was to evaluate the influence of primary and secondary appraisal, and of coping strategies, on daily stress, taking in-to account any possible effect of the big five personality traits. Over 10 days, a cohort of 122 people filled out an on-line diary in which they rec-orded the most important stressful event each day, their primary and sec-ondary appraisal of this, and how they coped with it. The results indicate that negative affect is influenced by a high degree of primary appraisal, lim-ited secondary appraisal and a high rate of refusal, with no significant in-fluence of personality traits. Positive affect ismainly influenced by a lower extent of primary appraisal, more secondary appraisal, and by a low rate of refusal and of social support seeking. Moreover, a low level of neuroticism was a predictor of greater positive affect. These data are discussed, high-lighting the importance of a situational assessment of stressful episodes at each moment to not only understand the effects of stress on health but al-so, to develop effective interventions.(AU)

El objetivo de este estudio fue evaluar la influencia de la evaluación primaria, secundaria y de las estrategias de afrontamiento sobre el estrés diario, teniendo en cuenta cualquier posible efecto de los cinco grandes rasgos de personalidad. Durante 10 días, una cohorte de 122 personas llenó un diario en línea en el que registraron el evento estresante más importante de cada día, su evaluación primaria y secundaria y cómo lo afrontaron. Los resultados indican que el afecto negativo está influido por una evaluación primaria alta, una evaluación secundaria limitada y una alta tasa de rechazo, sin influencia significativa de los rasgos de personalidad. El afecto positivo está influido principalmente por un menor grado de valoración primaria, una evaluación secundaria alta, por una baja tasa de rechazo y de búsqueda de apoyo social. Además, un nivel bajo de neuroticismo fue el mejor predictor del afecto positivo. Se discuten estos datos, destacando la importancia de una evaluación situacional de episodios estresantes en cada momento para no sólo comprender los efectos del estrés en la salud sino también, para desarrollar intervenciones efectivas.(AU)

When and how do hospital nurses cope with daily stressors? A multilevel study.

BACKGROUND: During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses. OBJECTIVES: To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses. DESIGN: This study uses descriptive, correlational, two-level design with repeated measures. SETTINGS: Wards of two University hospitals. PARTICIPANTS: A random cohort of 113 nurses was studied. METHODS: An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships. RESULTS: Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task. CONCLUSIONS: The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.

A spanish adaptation of the implicit positive and negative affect test (ipanat) / Adaptación para población española de la escala de afecto positivo y negativo implícitos (IPANAT)

BACKGROUND: Self-report measures of affective states (i.e., explicit measure) underlie a variety of cognitive biasing factors. Therefore, measures for the indirect assessment of affect (i.e., implicit) have previously been developed, such as the Implicit Positive and Negative Affect Test. The IPANAT asks participants to make judgments about the degree to which artificial non-sense words sound like affective states, and has demonstrated good reliability and validity. METHODS: We created a Spanish version of this test (IPANAT-SPAIN). After adapting artificial words to Spanish language, based on preliminary studies, the IPANAT-SPAIN was administered to a representative sample of N = 468 adults from Spain (225 men). Competing models of its latent structure were evaluated using confirmatory factor analysis. To assess convergent validity, we correlated the IPANAT-SPAIN with explicit measures of affect. RESULTS: The best-fitting model consisted of two factors corresponding to positive implicit affect (PA) and negative implicit affect (NA). Reliability of the IPANAT-SPAIN was a = .94 for PA, and a = .88 for NA. The pattern of relationships between the IPANAT-SPAIN and explicit affect measures were consistent with previous findings. CONCLUSIONS: The results indicate that the Spanish adaptation of the IPANAT has satisfactory psychometric properties

ANTECEDENTES: el uso de cuestionarios autoinformados para medir estado afectivo (i.e., medición explícita) puede conllevar sesgos cognitivos. Por ello, se han desarrollado medidas indirectas (i.e., implícitas), como el Test de Afecto Implícito Positivo y Negativo. En el IPANAT las personas deben realizar valoraciones acerca del grado en que creen que palabras artificiales expresan distintos estados afectivos, y ha demostrado buena fiabilidad y validez. MÉTODO: para crear la versión española se realizaron estudios preliminares para adaptar las palabras artificiales. La nueva versión adaptada se administró a una muestra representativa de personas adultas residentes en España (N = 468, 225 hombres). Se realizaron análisis factoriales confirmatorios para corroborar la estructura del instrumento. Asimismo, se correlacionaron las medidas de afecto implícitas con medidas explícitas, para estudiar su validez de convergencia. RESULTADOS: el mejor modelo corresponde a dos factores (PA: afecto implícito positivo y NA: afecto implícito negativo), con coeficientes de fiabilidad de a = .94 y a = .88, respectivamente. Las relaciones entre las medidas del IPANAT-España y las medidas de afecto explícito fueron consistentes con hallazgos previos. CONCLUSIONES: los resultados indican que el IPANAT-España tiene propiedades psicométricas adecuadas

A Spanish adaptation of the implicit positive and negative affect test (IPANAT).

BACKGROUND: Self-report measures of affective states (i.e., explicit measure) underlie a variety of cognitive biasing factors. Therefore, measures for the indirect assessment of affect (i.e., implicit) have previously been developed, such as the Implicit Positive and Negative Affect Test. The IPANAT asks participants to make judgments about the degree to which artificial non-sense words sound like affective states, and has demonstrated good reliability and validity. METHODS: We created a Spanish version of this test (IPANAT-SPAIN). After adapting artificial words to Spanish language, based on preliminary studies, the IPANAT-SPAIN was administered to a representative sample of N = 468 adults from Spain (225 men). Competing models of its latent structure were evaluated using confirmatory factor analysis. To assess convergent validity, we correlated the IPANAT-SPAIN with explicit measures of affect. RESULTS: The best-fitting model consisted of two factors corresponding to positive implicit affect (PA) and negative implicit affect (NA). Reliability of the IPANAT-SPAIN was a = .94 for PA, and a = .88 for NA. The pattern of relationships between the IPANAT-SPAIN and explicit affect measures were consistent with previous findings. CONCLUSIONS: The results indicate that the Spanish adaptation of the IPANAT has satisfactory psychometric properties.

Hierarchy of the main factors predicting the decision to go to the doctor in a general population sample: A factorial survey design.

OBJECTIVE: To obtain a hierarchy of the main factors that predict the decision to go to the doctor when symptoms are not yet linked to a specific disease. METHOD: 64 representative vignettes, combinations of nine factors, were presented to 168 adults between 28-60 years of age. RESULTS: Multilevel multiple regression models were used to rank the main factors predicting urgency to see a doctor in order of importance: the interference of symptoms in daily activities (B = -1.29; p < .001), fear (B = -0.96; p < .001), pain (B = -0.90; p < .001), access to medical care (B = -0.64; p < .001) and confidence in the doctor (B = -0.27; <.05). Moreover, gender (B = 0.56; p < .05) and educational level (B =-0.31; p < .05) explained part of the interindividual variation in the daily symptoms' interference. CONCLUSION: When a specific disease has not yet been diagnosed, daily symptoms' interference is the factor that most strongly increases the urgency to visit a doctor, especially among men and among people with a higher level of education. PRACTICE IMPLICATIONS: To reduce delay, generic health prevention campaigns should place more emphasis on possible interference in daily activities than on the meaning of symptoms for health.

Influencia de la inteligencia emocional percibida en el afrontamiento del estrés cotidiano / Influence of the perceived emotional intelligence on the coping of the daily stress

INTRODUCCIÓN Y OBJETIVOS: El presente estudio investiga la influencia de cada una de las dimensiones de la inteligencia emocional percibida (IEP) sobre las estrategias de afrontamiento ante situaciones de estrés cotidiano. MATERIAL Y MÉTODOS: La muestra estuvo formada por 50 personas entre 18 y 25 años. La inteligencia emocional se evaluó a través de la escala TMMS-24 que contiene 3 dimensiones: atención emocional, claridad emocional y reparación emocional. Se realizó una evaluación ecológica momentánea durante 4 días en la que se registraron los estresores diarios con el DISE, el estado afectivo con el PANAS y el afrontamiento del estrés cotidiano mediante la escala MoCope. Se evaluaron 4 tipos de afrontamiento: afrontamiento centrado en el problema, búsqueda de apoyo social, aceptación de las emociones y rechazo. El diseño fue cuasiexperimental con medidas repetidas y los datos se analizaron mediante regresiones múltiples. RESULTADOS: Los resultados mostraron que: a) las personas con alta claridad emocional usaron más el afrontamiento centrado en el problema, la aceptación de las emociones y menos el rechazo, b) las personas con alta reparación emocional usaron más el afrontamiento centrado en el problema, la búsqueda de apoyo social y menos el rechazo; y c) las personas con alta atención emocional usaron más la aceptación de emociones y la búsqueda de apoyo social. CONCLUSIONES: Estos resultados apoyan la hipótesis de que la inteligencia emocional favorece el bienestar emocional al promover el afrontamiento adaptativo frente al estrés cotidiano

BACKGROUND AND AIMS: The purpose of the present study is to investigate the influence of each perceived emotional intelligence dimension on coping strategies in the face of daily stress. MATERIAL AND METHODS: The sample was comprised of 50 people aged 18 to 25 years. PEI was assessed through the TMMS-24 that evaluates three dimensions: emotional attention, emotional clarity and emotional repair. A momentary ecological assessment was carried out in which the daily stressors were recorded with the DISE; the affective state with the PANAS; and the coping with the daily stress using the MoCope scale. The assessment lasted four days. Four types of coping were evaluated: Problem-focused coping, seeking social support, acceptance of emotions, and rejection. The design was quasi-experimental with repeated measures. The data were analysed by multiple regressions. RESULTS: The results showed that: a) People with high emotional attention used more acceptance of emotions and seeking social support; b) people with high emotional clarity used more problem-focused coping and acceptance of emotions but less rejection; and c) people with high emotional repair used more problem-focused coping and seeking social support but less rejection. CONCLUSIONS: These results support the hypothesis that PEI strengthens emotional well-being because it promotes adaptive coping ability of daily stress

How does emotional exhaustion influence work stress? Relationships between stressor appraisals, hedonic tone, and fatigue in nurses' daily tasks: A longitudinal cohort study.

BACKGROUND: Work-related stress is a prevalent condition in the nursing profession, and its influence may vary according to changeable individual and situational factors. It is, therefore, important to investigate the real-time momentary changes in these factors and their relationship to emotional exhaustion experienced by nurses. OBJECTIVES: We aim to analyse how their perceptions of demand, control, effort and reward change according to the task performed through real-time assessment and interact with the emotional exhaustion level of ward nurses. DESIGN: The research design was longitudinal. METHOD: A three-level hierarchical model with a repeated measures design was used to assess the momentary self-reports of 96 hospital ward nurses, completed using a smartphone programmed with random alarms. RESULTS: Findings show that demand, effort, and control appraisals depend on the task performed. The task appraised as most demanding, effortful, and controllable was direct care. Reward appraisal depends on the task performed and personal variables, i.e. emotional exhaustion. The situations perceived as more rewarding were rest and direct care. Momentary hedonic tone can be explained by the task performed, demand, reward, emotional exhaustion and by the interaction between emotional exhaustion and demand appraisal. Momentary fatigue can be explained by the task performed, demand, reward, and the emotional exhaustion. CONCLUSIONS: This study highlights the importance of using momentary measures to understand complex and changeable inter-relationships. While also clarifying the targets of intervention programmes aimed at preventing burnout within the nursing profession.

Adaptación cultural y validación de la versión española de la Escala de Autoconcepto en BRCA en mujeres portadoras con alto riesgo de cáncer de mama y ovario hereditario / Cultural scale adaptation and validation of the Spanish version of the BRCA Self-Concept Scale in women carriers at high risk for hereditary breast and ovarian cancer

Fundamento y objetivo: Tener una predisposición hereditaria al cáncer puede asociarse a un impacto psicológico. Uno de los objetivos del consejo genético es favorecer la adaptación psicológica a la nueva situación, siendo necesarios instrumentos validados en este contexto. Por ser el autoconcepto un buen indicador de adaptación a la enfermedad o al riesgo de tenerla, y una variable relevante en oncología, el objetivo es adaptar culturalmente al castellano y validar la BRCA Self-Concept Scale. Material y método: Ciento sesenta y cinco portadoras de mutación en los genes BRCA respondieron al cuestionario previamente sometido a un proceso de traducción-retrotraducción, y a la Escala de Preocupación por el Cáncer (EPC) como medida de validez convergente. Se valoró la estructura del cuestionario mediante una prueba de expertos y un análisis factorial confirmatorio (AFC), se calculó el α de Cronbach de las 3 subescalas (Estigma, Vulnerabilidad y Control), y se correlacionaron con la EPC. Resultados: La prueba de expertos y el AFC no confirman la estructura original del cuestionario. El modelo reespecificado (con los ítems 10 y 13 en Vulnerabilidad) muestra mejor ajuste: comparative fit index 0,973;Tucker-Lewis index 0,968; root mean square error of approximation 0,067. El α de Cronbach es de 0,83 para Estigma, de 0,84 para Vulnerabilidad, y de 0,61 para Control. Se encuentra evidencia de validez convergente con la EPC (rho de Spearman 0,631 para Estigma, 0,683 para Vulnerabilidad, y −0,363 para Control; p < 0,001). Conclusiones: Los resultados apoyan la validez de la escala modificada de autoconcepto BRCA, siendo una medida potencialmente útil para valorar la adaptación a tener una alta predisposición hereditaria al cáncer (AU)

Background and objective: Having an inherited predisposition to cancer may have a psychological impact, and one goal of genetic counseling is to promote psychological adjustment to the new situation. Thus, in the genetic context, validated measures of adjustment are required. Given that self-concept is a good indicator of adjustment to the disease or to the risk for it, and a relevant variable in oncology, the goal of the study is to culturally adapt and validate the BRCA Self-Concept Scale. Material and Method: One hundred and sixty-five BRCA carriers’ women answered to the questionnaire, previously adapted through a process of forward/back-translation, and to the Cancer Worry Scale (CWS) as a measure of convergent validity. Theoretical structure of BRCA Self-Concept Scale was assessed by expert judges, and submitted to a confirmatory factor analysis (CFA). Cronbach's α was calculated for each subscale (Stigma, Vulnerability and Control), and correlations with CWS were performed. Results: Expert judges’ structure and CFA do not support the original structure of the questionnaire. The respecificity model (with items 10 and 13 loading on Vulnerability factor) show a better fit: comparative fit index 0.973; Tucker-Lewis index 0.968; root mean square error of approximation 0.067. The Cronbach's α is 0.83 for Stigma, 0.84 for Vulnerability, and 0.61 for Control. Evidence of convergent validity with CWS has been obtained (Spearman's rho 0.631 for Stigma, 0.683 for Vulnerability, and −0.363 for Control; P < .001). Conclusions: Results support the validity of the modified Spanish BRCA Self-Concept Scale, which is a potentially useful measure for the study of psychological adjustment to high risk for hereditary breast and ovarian cáncer (AU)

[Cultural scale adaptation and validation of the Spanish version of the BRCA Self-Concept Scale in women carriers at high risk for hereditary breast and ovarian cancer]. / Adaptación cultural y validación de la versión española de la Escala de Autoconcepto en BRCA en mujeres portadoras con alto riesgo de cáncer de mama y ovario hereditario.

BACKGROUND AND OBJECTIVE: Having an inherited predisposition to cancer may have a psychological impact, and one goal of genetic counseling is to promote psychological adjustment to the new situation. Thus, in the genetic context, validated measures of adjustment are required. Given that self-concept is a good indicator of adjustment to the disease or to the risk for it, and a relevant variable in oncology, the goal of the study is to culturally adapt and validate the BRCA Self-Concept Scale. MATERIAL AND METHOD: One hundred and sixty-five BRCA carriers' women answered to the questionnaire, previously adapted through a process of forward/back-translation, and to the Cancer Worry Scale (CWS) as a measure of convergent validity. Theoretical structure of BRCA Self-Concept Scale was assessed by expert judges, and submitted to a confirmatory factor analysis (CFA). Cronbach's α was calculated for each subscale (Stigma, Vulnerability and Control), and correlations with CWS were performed. RESULTS: Expert judges' structure and CFA do not support the original structure of the questionnaire. The respecificity model (with items 10 and 13 loading on Vulnerability factor) show a better fit: comparative fit index 0.973; Tucker-Lewis index 0.968; root mean square error of approximation 0.067. The Cronbach's α is 0.83 for Stigma, 0.84 for Vulnerability, and 0.61 for Control. Evidence of convergent validity with CWS has been obtained (Spearman's rho 0.631 for Stigma, 0.683 for Vulnerability, and -0.363 for Control; P<.001). CONCLUSIONS: Results support the validity of the modified Spanish BRCA Self-Concept Scale, which is a potentially useful measure for the study of psychological adjustment to high risk for hereditary breast and ovarian cancer.

Impact when receiving a diagnosis: additive and multiplicative effects between illness severity and perception of control.

Based on Lazarus' transactional model of stress, this study examined how the information provided in a medical diagnosis (the severity of the illness, the effectiveness of the treatment and the self-efficacy to follow this treatment) are combined to generate perception of stress. Twenty-seven scenarios were presented to 152 volunteer students and their level of perceived stress was recorded. Results revealed that the lack of efficacy of the treatment raises the perception of stress proportionally to the different degrees of illness severity, but having a low perceived ability to follow the treatment triggers high levels of stress, particularly when the diagnosis is serious.

Assessing self-reported adherence to HIV therapy by questionnaire: the SERAD (Self-Reported Adherence) Study.

The relationship between adherence to highly active antiretroviral therapy (HAART) and RNA-HIV viral load outcomes has been extensively shown. Although there are different procedures for assessing treatment adherence, there is no ideal method. We present the SERAD (Self-Reported Adherence) questionnaire, a qualitative and quantitative self-reported instrument designed to provide an easier adherence measurement. We also compared the questionnaire to three other methods to evaluate adherence to HAART regimens in HIV-infected patients. Two prospective, observational, longitudinal studies were developed: a single-center pilot study followed by a multicenter study. A total of 530 HIV-infected outpatients was prospectively included, 66 in the pilot study and 464 in the multicenter study. Four methods were used to study adherence to HAART regimens: the SERAD questionnaire, pill count, electronic monitoring, and plasma drug monitoring. Pearson's correlations and Bland and Altman's method were developed. The SERAD questionnaire showed good feasibility and significant validity. Adequate levels of agreement between methods were observed, particularly when adherence was high. Differences increased as adherence fell. Moreover, the questionnaire was completed correctly, the interviewers did not report uncovered aspects, and the information was collected easily. Our results suggest that the SERAD questionnaire is a feasible and useful instrument for assessing adherence to HAART regimens in HIV-infected patients, and makes it possible to obtain reliable qualitative and quantitative information related to treatment adherence.

Unrealistic optimism and perceived control: role of personal competence.

This work analyzed the effects of unrealistic optimism in the interaction between the emotional valence of future events, the perception of control over these events, and the person with whom one compares oneself. It was hypothesized that, if the person of comparison is judged as very competent, a pessimistic bias should be produced. Likelihood of four different types of events (positive and controllable, positive and uncontrollable, negative and controllable, and negative and uncontrollable) were rated by 133 university students (22 men and 111 women) for themselves, for an average student, for their best friend, and for a bright friend. A pessimistic bias was observed on the relative likelihood of the events when the comparison was made between oneself and a competent and bright friend, when events were perceived as controllable, especially positive ones. Not enough is known, however, to provide meaningful interpretation at present; that must await further data and theoretical development.