Síndrome de burnout en una unidad de gestión clínica de obstetricia y ginecología / Burnout syndrome in an obstetrics and gynaecology management unit

Objetivo. Conocer la prevalencia del síndrome de burnout entre los integrantes de una UGC de Obstetricia y Ginecología. Material y método. Estudio transversal anónimo utilizando un cuestionario sociodemográfico y la versión española del Maslach Burnout Inventory. Resultados. La encuesta fue contestada por 21 médicos, 11 matronas, 14 DUE, 22 auxiliares de clínica, 2 administrativas y 1 celador, lo que supone una tasa de respuesta del 43,2% Los valores medios fueron de 20,1 puntos para el agotamiento emocional, 7,6 puntos para la despersonalización y 42,1 puntos para la realización personal. Se encontraron valores más elevados de agotamiento emocional y despersonalización en el colectivo de médicos en relación con las demás categorías profesionales. Conclusiones. Consideramos preocupante que el 33,8% de los integrantes del estudio presente cifras elevadas de agotamiento emocional y que este sea alto en el 52,3% de los médicos especialistas. Valores elevados de satisfacción profesional hacen que solo en el 2,8% coincidan puntuaciones altas de las 3 subescalas(AU)

Objective. To determine the prevalence of the Burnout Syndrome among the members of an Obstetrics and Gynaecology Unit. Material and methods. Cross-sectional study using an anonymous questionnaire and socio-Spanish version of the Maslach Burnout Inventory. Results. The survey was answered by 21 doctors, 11 matrons, 14 DUE, 22 nurses, 2 administrative officers and 1 watchman, with a response rate of 43.2%. Average values were 20.1 points for the emotional exhaustion, depersonalization 7.6 points to 42.1 points and for personal fulfilment. We found higher values of emotional exhaustion and depersonalization in the group of doctors in relation to other professional groups. Conclusion. We believe that 33.8% is an alarmingly high level of emotional exhaustion in the members of the present study, and this level is even higher in medical specialists (52.3%). Only the 2.8% of the professionals had high values in the three sub-scales(AU)

La Fibromialgia. Más allá de la depresión / Fibromyalgia: beyond the depression

Podría ser la fibromialgia una forma más de manifestarse la depresión? o ¿estaríamos hablando de un grado superior de lesión en el cuerpo que se manifestaría de esta forma debido a la depresión continuada, a lo largo de la vida, como consecuencia de las dificultades experimentadas por las mujeres? Es lo que identificamos como más allá de la depresión. Ésta presenta varias maneras de manifestarse: trastornos afectivos, cognitivos, alteración del sueño, dificultad en la sexualidad, cambios en el apetito y en el comportamiento, dolor, parestesias, cefaleas, vértigos, trastornos gastrointestinales, cardiovasculares, respiratorios, neurovegetativos, etc. Objetivo: conocer las causas que atribuyen las mujeres como origen de la fibromialgia. Comparar el nivel actual de ansiedad y depresión, y salud percibida del grupo de mujeres diagnosticadas de depresión y del de fibromialgia. Material y método: entrevistas en profundidad a 20 mujeres con fibromialgia, y a 52 mujeres con depresión, dentro del ámbito de Atención Primaria. Muestreo sistemático en los diferentes grupos de edad en distintos conglomerados – cupos de pacientes– con reposición de la no respuesta. Análisis de fuentes secundarias. Resultados: las mujeres con fibromialgia presentan mayor sobrecarga familiar y laboral, violencia y dificultades percibidas en la infancia que aquellas a quienes sólo se les ha diagnosticado depresión. También expresan una percepción más baja de su salud. Conclusión: las mujeres diagnosticadas de fibromialgia han percibido enormes dificultades psicosociales a lo largo de sus vidas que han identificado como factores causantes. Lo más importante será que la sociedad y los médicos comprendan la enfermedad(AU)

Introduction: Depression has several ways to manifest: affective disorders, cognitive, sleep disturbance, difficulty in sexuality, appetite changes, behavioral changes, pain, paresthesia, headache, dizziness, gastrointestinal, cardiovascular, respiratory, neurovegetative etc. Can fibromyalgia be another way to manifest depression? Or would we be talking about a higher degree of injury to the body that is manifested in this way because of the depression continued throughout life as a result of difficulties experienced by women? Is what we identify as beyond depression. Objective: To determine the causes of women who attributed the cause of fibromyalgia. Compare the current level of anxiety and depression, perceived health status of the group of women diagnosed with depression and those diagnosed with fibromyalgia. Materials and methods: in-depth interviews with 20 women with fibromyalgia, 52 women with depression in primary care. Systematic sampling in different age groups in different clusters-quota-patients with non-response replenishment. Analysis secondary sources. Results: Women with fibromyalgia have increased work and family stress, perceived violence, perceived difficulties in childhood that women are only diagnosed depression. They also have a lower perception of their health. Conclusion: Women diagnosed with fibromyalgia have made enormous psychosocial difficulties throughout their lives that have been identified as causative factors. The most important thing is that the society and physicians understand the disease(AU)

Factores psicosociales, sociodemograficos, culturales y familiares asociados a Síndrome de Intestino Irritable / Psychosocial, sociodemographic, cultural and family factors associated with Irritable Bowel Syndrome

Objetivo. Describir los factores psicosociales, demográficos, culturales y familiares asociados al síndrome de intestino irritable en adultos. Método. Estudio de casos y controles en 754 pacientes, 256 diagnosticados con Síndrome de Intestino Irritable (casos) y 498 pacientes sin la enfermedad (controles) entre los 30 y 60 años en tres instituciones privadas de salud de Cartagena de Indias seleccionados aleatoriamente, quienes no debían presentar discapacidad cognitiva, diagnóstico de cáncer de colon, gástrico, páncreas, recto ni padecer alteraciones del tracto gastrointestinal. Se diligenció un cuestionario que incluyó el Test de Golberg (ansiedad y depresión), la escala de reajuste social de Holmes y Rahe (estrés) y el APGAR Familiar (funcionalidad familiar). Se realizó análisis univariado y bivariado y se midió la fuerza de asociación calculando odds ratio, con intervalos de confianza del 95 % y la prueba χ2 para buscar el valor de p. Resultados. El 79,1 % de los casos presentaron estrés, 71,48 % depresión y 73,49 % ansiedad. Todos estos factores se comportaron como factores de riesgo para la enfermedad (OR = 8,54; IC 95 %: 5,8-12,45; p = 0,000) (OR = 5,76; IC 95 %: 4,07-8,17; p = 0,000) (OR = 6,25; IC 95 %: 4,4-8,91; p = 0,000) respectivamente, al igual que la disfuncionalidad familiar, el no soporte de amigos y los hábitos sociales como el café (OR = 1,44; IC 95 %: 1,04 – 1,99; p = 0,02), (OR = 1,67; IC 95 %:1,21 – 2,31; p = 0,001) (OR = 1,78; IC 95 %: 1,29 – 2,44; p = 0,002) respectivamente. Conclusiones. Factores psicosociales como la depresión, ansiedad y estrés son factores de riesgo que predisponen a desarrollar o complicar el Síndrome de Intestino Irritable (AU)

Objective. To describe the psychosocial factors, demographic, cultural and family associated with irritable bowel syndrome in adults. Method. Case-control study in 754 patients, 256 diagnosed with Irritable Bowel Syndrome (cases) and 498 patients without disease (controls) between 30 and 60 years in three private health institutions Cartagena randomly selected, non should be cognitively impaired, diagnosis of cancer of the colon, stomach, pancreas, rectum or suffer from gastro intestinal tract. Measurements. We filled out a questionnaire that included the test Golberg (anxiety and depression), social adjustment scale of Holmes and Rahe (stress) and the Family APGAR (family functioning). Was performed univariate and bivariate analysis was measured by calculating the strength of association Odd ratio, confidence intervals 95 %, χ2 to find the value of p. Results. 79.1% of cases had stress, 71.48 % depression and 73.49 % anxiety. All these factors acted as risk factors for disease (OR= 8,54; 95 % CI 5,8-12,45, p = 0,000) (OR= 5,76; 95 % CI 4,07-8,17; p = 0,000) (OR= 6,25; 95 % CI 4,4-8,91; p = 0,000) respectively, as dysfunctional families, friends do not support and the social habits such as coffee (OR = 1,44; 95 % CI: 1,04 – 1,99, p = 0,02 ) (OR = 1,67; 95 % CI 1,21 – 2,31; p = 0,001) (OR = 1,78; 95% CI 1,29 -2,44; p = 0,002) respectively. Conclusions. Psychosocial factors such as depression, anxiety and stress are risk factors that predispose to or complicate develop Irritable Bowel Syndrome (AU)

El usuario como experto: concepto, modalidades y experiencia desde el Proyecto Emilia / User as an expert: concept, modalities and the experience from the Emilia Project

Se relata la experiencia del proyecto EMILIA y se ofrece una visión global de qué se entiende por "usuario experto" y "implicación de los usuarios" en salud mental. Se discuten sus implicaciones para los profesionales, usuarios y el sistema sanitario (AU)

The experience of the EMILIA project is explained and a global vision is offered so as to gain a better understanding about the "Expert by Experience" and user involvement in mental health, the implications for professionals, users and the health system (AU)

Mecanismos neurofisiológicos de la transmisión del dolor / Neuro-physiolocial mechanisms involved in the transmission of pain

Se analiza la importancia del dolor como mecanismo de defensa ante un estímulo nocivo, sus componentes (sensorio-discriminativo, afectivo-emocional, cognitivo y conductual) y cómo se lleva a cabo la transmisión de los impulsos dolorosos mediante los receptores periféricos, las vías neuronales de conducción y la recepción e interpretación. También se exponen los objetivos de enfermería en el tratamiento del mismo(AU)

The author analyzes the importance of pain as a defense mechanism against a noxious stimulus; its sensory-discriminatory, affective-emotional, cognitive and behavior components; and how the transmission of pain impulses by means of peripheral receptors occur; neuronal ways of conduction; and the reception and interpretation of pain. The author also states the objectives nurses have in treating pain(AU)

Validez de una encuesta telefónica para determinar la prevalencia y la estacionalidad de la dermatitis atópica en España / Validity of a Telephone Survey for Determining the Prevalence of Atopic Dermatitis and Its Seasonal Variation in Spain

Introducción. La dermatitis atópica (DA) es una enfermedad eccematosa de la piel que debuta en la infancia cursando a brotes. La UK Working Party definió los criterios diagnósticos de DA utilizados habitualmente. El objetivo de este estudio fue evaluar la prevalencia de DA según estos criterios. Métodos. Estudio epidemiológico, transversal, mediante entrevista telefónica asistida por ordenador, con dos fases. Primera fase: participaron padres de niños ≤ 14 años, con objeto de calcular la prevalencia de la DA en España. Segunda fase: realizada 6 meses después, se entrevistó a aquellos padres con diagnóstico de DA en la primera fase según la UKWP, para determinar la existencia de estacionalidad en las lesiones de DA entre ambas fases. Resultados. Participaron 1.979 padres. Un total de 8,6 % (intervalo de confianza [IC]95 %: 7,4-9,8) de los niños fue diagnosticado de DA mediante entrevista telefónica. El 49,2 % de los niños tenía antecedentes familiares de atopia. El 41,3 % de los niños había sido diagnosticado de DA por un médico. En un 75,3 % coincidió el diagnóstico del médico con el realizado mediante entrevista. En este estudio se observó que, de los factores asociados a la DA, el aumento de la temperatura corporal, los periodos de estrés, el polvo, el uso/ contacto con prendas de lana o fibras y el uso de determinados jabones o productos de higiene personal presentan diferencias estacionales. Conclusiones. La prevalencia estimada de DA en niños de 0-14 años en España fue del 8,6 %. Algunos factores asociados a la exacerbación de la DA presentan carácter estacional (AU)

Background. Atopic dermatitis is a eczematous disease of the skin with onset during childhood and subsequent flares. The UK Working Party (UKWP) defined the diagnostic criteria normally used for atopic dermatitis. The objective of this study was to assess the prevalence of atopic dermatitis according to these criteria. Methods. This was a 2-phase cross-sectional, epidemiologic computer-assisted telephone survey. Parents of children aged 14 years or less participated in the first phase to determine the prevalence of atopic dermatitis in Spain. In the second phase, 6 months later, parents of children with diagnosis of atopic dermatitis according to the UKWP diagnostic criteria in phase 1 were interviewed to assess seasonal variations in disease activity between the 2 phases. Results. In total, 1979 parents participated; 8.6 % of the children (95 % confidence interval, 7.4 %-9.8 %) were diagnosed with atopic dermatitis by telephone. Of these, 49.2 % had a family history of atopy and 41.3 % had been diagnosed with atopic dermatitis by a physician. Diagnosis by the physician and that made by interview agreed in 75.3 % of these cases. Of the factors associated with atopic dermatitis, it was found that increased body temperature, periods of stress, dust, use of/contact with wool or fiber clothes, and use of certain soaps and hygiene products showed seasonal variations. Conclusions. The estimated prevalence of atopic dermatitis in children between 0 and 14 years old in Spain was 8.6 %. Certain factors associated with disease flares showed seasonal variations (AU)

Evaluación del estrés infantil: Inventario Infantil de Estresores Cotidianos (IIEC) / Assessment of stress in childhood: Children’s Daily Stress Inventory (Inventario Infantil de Estresores Cotidiano, IIEC)

El presente estudio ofrece una nueva medida para la evaluación del estrés cotidiano en población escolar mediante el desarrollo del Inventario Infantil de Estresores Cotidianos (IIEC). La administración del instrumento se realizó en una muestra de 1.094 alumnos de Educación Primaria. La versión final del inventario se compone de 25 ítems dicotómicos referentes a los ámbitos de salud, escuela/iguales y familia. Su puntuación se obtiene sumando el número de respuestas afirmativas. Se presenta un análisis de sus propiedades psicométricas, incluyendo análisis de ítems, consistencia interna, fiabilidad test-retest y diversas evidencias externas de validez basadas en sus relaciones con otras variables. Los resultados muestran propiedades psicométricas adecuadas para la evaluación del estrés cotidiano en la población infantil (AU)

The present study introduces the Children’s Daily Stress Inventory (Inventario Infantil de Estresores Cotidianos, IIEC) as a measure that assesses daily stress in primary school children. The inventory was applied to a sample of 1094 primary school students. The final version includes 25 dichotomic items covering the areas of health, school/peers, and family. The score is obtained by adding the total of positive answers. Analyses of items, reliability and several external pieces of evidence of validity based on relations with other variables are presented. The results show adequate psychometric properties for the assessment of daily stress in children (AU)

El marco sanitario y el entorno psicosocial de la población inmigrante magrebí en Cataluña / Study of the healthcare background and psychosocial environment of the Maghrebian immigrant population in Catalonia [Spain]

Introducción: Este estudio pretende obtener información sobreel marco sanitario y el entorno psicosocial de la población inmigrantemagrebí en Cataluña, para orientar las actuacionesen planificación y provisión de servicios sociales y de las organizacionesque apoyan a este colectivo.Método: Se utilizó un cuestionario de creación propia queexplora aspectos sanitarios y psicosociales, incluidos los factoresestresores y de apoyo social. La recogida de datos serealizó mediante encuestadores y en lengua árabe.Resultados: Se realizaron 403 entrevistas. La mayoría delos encuestados tenían tarjeta sanitaria y sabían a dónde acudirpara recibir asistencia. Los servicios más utilizados sonlos de atención primaria y urgencias hospitalarias. En atenciónprimaria, casi todos los encuestados reciben explicaciones,pero un 30% no las comprende adecuadamente. Se percibeque los profesionales sanitarios no tienen muy en cuenta lasdiferencias culturales o religiosas. Trabajo, vivienda, alejamientofamiliar y legalización son factores estresores para más de lamitad de esta población. El apoyo social es bajo. Tres cuartaspartes de los encuestados se sienten solos. Más de la mitadde esta población ve cumplidas total o parcialmente sus expectativasmigratorias y un 11% considera estar peor.Conclusiones: Las principales áreas de acción pasan por reforzarla información sobre condiciones de acceso al sistemasanitario, fomentar la interacción social y el asociacionismoentre los inmigrantes, especialmente durante las primeras fasesdel proceso migratorio, y facilitar las actividades religiosas. Pareceimportante formar a los profesionales sanitarios sobrelas culturas de origen(AU)

Introduction: The aim of this study was to gather informationon the healthcare background and social environment ofthe Maghrebian immigrant population in Catalonia in order toguide the management and provision of social services andthe work of the organizations supporting this collective.Methods: To gather data, we used a questionnaire exploringhealthcare and social variables, including stressors and socialsupport. Data collection was performed by pollsters in Arabic.Results: We performed 403 interviews. Most interviewees hada health card providing access to public healthcare and knewwhere to access healthcare. The most frequently used serviceswere primary care and emergency departments. In primarycare, almost all of the interviewees were provided explanations,but 30% were unable to understand them properly.Health professionals seemed to have inadequate awarenessof cultural and religious differences. Work, housing, distancefrom the family, and legal status were stressful factors for morethan half of this population. Social support was low. Three quartersof the interviewees felt lonely. More than half of this populationhad completely or partially fulfilled their expectationsof migration, while 11% felt they were in a worse situation.Conclusions: The main areas for improvement are the provisionof information on conditions of healthcare access, promotionof social interaction, the use of associations for immigrants—especially during the first phases of the migrationprocess— and facilitating religious activities. Health professionalsshould be provided with training in intercultural issues(AU)

Estrés psicosocial: algunos aspectos clínicos y experimentales / Psychosocial stress: some clinical and experimental aspects

El presente trabajo aborda conceptos actuales del estrés, resaltando el de tipo social. El estrés psicosocial es un factor que predispone al desarrollo de diversas enfermedades en el ser humano cuyos efectos impactan sobre su calidad de vida y de salud. Se han identificado y diferenciado algunos de los factores sociales que producen estrés. Sin embargo, dadas las dificultades metodológicas y éticas para estudiar los efectos del estrés psicosocial en el ser humano, ha sido necesario diseñar modelos animales en los que se emplean estresores psicosociales a los que se enfrentan los animales cuando viven en grupo, por ejemplo el modelo de derrota social. Los datos provenientes de estos modelos han permitido entender algunos de los mecanismos neurobiológicos que subyacen al desarrollo de psicopatologías derivadas del estrés social, identificándose algunas de las estructuras participantes, como la amígdala del lóbulo temporal y a partir de estudios clínicos en seres humanos se ha identificado el papel que desempeña la corteza prefrontal en la toma de decisiones y en la planeación de respuestas conductuales socialmente apropiadas

The present revision approaches the definition of the concept of stress generated by different social factors. Psychosocial stress induces diverse pathologies in human being, contributing to health perturbation. The study of the effects of psychosocial stress in the human is limited since methodological and ethical considerations; however, the observation of the strategies to cope with stress in animal models, as well as its neurobiological correlates is a useful tool for the neurobiological study of psychosocial stress. For example, in the social defeat the display some signs suggesting an increased anxiety and despair, both processes involve the participation of the amygdala, and from some clinical studies in human it has additionally been suggested the involvement of the prefrontal cortex portion, in the decisionmaking process and the selection of the socially appropriated response

¿Paliar el déficit de médicos? Sí, pero ¿a qué precio? / No disponible

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[Stress related mucosal disease prophylaxis in intensive care unit patients]. / Profilaktyka owrzodzen stresowych zoladka u chorych leczonych na oddziale intensywnej terapii.

Among the patients admitted to the Intensive Care Unit there frequently occur disturbances of the upper gastrointestinal tract. They can be found as stress ulcerations which in turn may lead to bleeding. The high incidence of stress ulcers and bleedings from the upper gastrointestinal tract is associated with disturbances of gastric acid secretion, an interrupted integrity of gastric mucosa and abnormal motor activity of gastrointestinal tract. The presence of clinically important bleeding results in prolonged hospitalization and increased mortality. The aim of this study is twofold; first, the pathogenesis and the consequences of stress-related mucosal disease are elucidated. Afterwards, the prophylaxis modalities are presented on the basis of the latest medical literature.

[Exposure to neurotoxic substances versus stress]. / Narazenie na substancje neurotoksyczne a stres.

It has long been known that exposure to a stressor may initiate progressive and long-lasting (or even permanent) functional changes in the central nervous system. They are manifested by an altered, decreased or increased responsiveness of the body not only to the generating stressor, but also to other unrelated stressors. Numerous experimental studies have shown that the sensitivity of the body to chemical stressors may be influenced by a prior exposure to nonchemical stressors, e.g., physical or psychological, and vice versa. The purpose of this work is to point out the implications of this observation for epidemiological and experimental studies on health effects of chemical exposure and for establishing the hygiene standards of exposure.

Serum lipids and glucose disturbances at professional drivers exposed to occupational stressors.

The aim of this study is to find association between some groups of occupational stressors and serum lipids and glucose concentrations in professional drivers in road traffic. The study included 417 male professional drivers (162 inter city bus drivers, 36 suburban bus drivers, 33 city bus drivers, 81 truck drivers, 71 official car drivers and 34 professional taxi drivers). Occupational stressors were identified and total occupational stress index score was measured by standardized questionnaire authorized by Karen Belkic. Occupational stressors were divided into seven groups (underload, high demand, strictness, extrinsic time pressure, noxious exposures, avoidance and conflict). Serum glucose and lipids concentrations (total cholesterol, LDL cholesterol, HDL cholesterol and triacylglycerols) were measured in study group of drivers. Maximal total OSI values were achieved in group of professional truck drivers. The highest values of serum glucose, total cholesterol, LDL cholesterol and triacylglycerols and the lowest values of serum HDL cholesterol were found at professional truck drivers. With the increase of occupational stress index, there is an increase of the serum glucose, total cholesterol, LDL cholesterol and triacylglycerols concentration in the exposed group of drivers. Specific analytes thresholds' level of occupational stress index exists.

E-PASS for predicting postoperative risk with hip fracture: a multicenter study.

UNLABELLED: This multicenter study of 813 consecutive patients with hip fracture was performed to estimate the effectiveness and reproducibility of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system to assess postoperative risk in patients with hip fracture. E-PASS is comprised of a preoperative risk score, a surgical stress score, and a comprehensive risk score based on the preoperative risk score and surgical stress score. Postoperative complications developed in 163 patients (20.0%); 13 (1.6%) died. Hospital postoperative morbidity and mortality rates increased linearly with the preoperative risk score and comprehensive risk score; the correlation was significant. The severity of postoperative complications and the incidence of higher grades of complications increased significantly with rising preoperative risk score and comprehensive risk score. Each E-PASS score also was related significantly with the length of postoperative hospitalization and costs. These results suggest E-PASS is useful for predicting postoperative risk, estimating costs, and for comparing the outcome in patients having surgical treatment of hip fractures. LEVEL OF EVIDENCE: Level II, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence.

La práctica del «estar atento» (mindfulness) en medicina. Impacto en pacientes y profesionales / The practice of 'being attentive' (mindfulness) in medicine. Impact on patients and professionals

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“Ganarás el pan con el sudor de tu frente " / “It’s by the sweat of your brow that you will eat your food ”

Hoy día tenemos suficientes evidencias de que la exposición mantenida a ambientes psicosocialesadversos en el trabajo provoca reacciones sostenidas de estrés con nefastas consecuenciaspara la salud. Un gran número de enfermedades se han relacionado con la exposición a tales condicionespsicosociales adversas (sobre todo cardiovasculares, musculoesqueléticas y mentales). Lainvestigación del estrés relacionado con el ambiente laboral desfavorable difiere sustancialmentede la investigación biomédica tradicional de las enfermedades profesionales, y precisa definir conceptosteóricos para delimitar las características laborales estresantes y, a continuación, trasladartales conceptos a medidas, con la ayuda de métodos selectivos de investigación psicológica ysociológica (cuestionarios, técnicas de observación, etc). Entre los modelos teóricos desarrolladosmerecen especial atención el modelo “demanda-control”, el modelo “desequilibrio esfuerzo-recompensa”y el modelo “justicia organizativa”. En este artículo se describen las características más importantesde tales modelos y se discuten las implicaciones políticas subsiguientes orientadas a la promociónde la salud en el puesto de trabajo

Currently there is sufficient evidence that maintained exposure to psychosocial factors at workmay cause sustained reactions of stress with devastating consequences for ones health. Many diseaseshave been related to adverse psychosocial conditions in the workplace (above all coronary heartdiseases, musculoskeletal disorders, and mental illness).There have been several different approachesto measurement of work stress and, more recently, research has tended to focus on a few explicittheoretical concepts.Among these, the model of job demand-control, effort-reward imbalance and organizationaljustice model have received special attention. These theoretical concepts are operationalizedusing standardized methods of social and behavioral sciences (e.g. structured interviews, systematicobservation, standardized questionnaires (so called paper and pencil tests))This article describes the most important characteristics of the models mentioned above and thepolicy implications of the findings for improved worksite health promotion are discussed

Pathophysiologic mechanisms of fibromyalgia and its related disorders.

This article reviews current findings regarding the pathophysiologic abnormalities that contribute to the enhanced pain responses of individuals with fibromyalgia as well as the relationships between fibromyalgia and commonly co-occurring disorders. Risk factors for fibromyalgia or enhanced pain responses include genetic and family influences, environmental triggers, and abnormal neuroendocrine and autonomic nervous system function. These risk factors also are associated with several disorders that frequently co-occur with fibromyalgia, such as major depressive disorder, migraine, and irritable bowel syndrome. Indeed, fibromyalgia and these co-occurring conditions may be part of a group of affective spectrum disorders that share important common, and perhaps heritable, causal factors. Recent research strongly suggests that alterations in central processing of sensory input also contribute to the cardinal symptoms of fibromyalgia, persistent widespread pain and enhanced pain sensitivity. Exposure to psychosocial and environmental stressors, as well as altered autonomic nervous system and neuroendocrine responses, also may contribute to alterations in pain perception or pain inhibition. Understanding the pathophysiology of fibromyalgia and co-occurring disorders may help clinicians provide the most appropriate treatment to their patients.

Autoeficacia para el afrontamiento del estrés en una muestra adulta española / Coping with stress self-efficacy in a Spanish adult sample

Se presenta en este trabajo el constructor de “autoeficacia específica para el afrontamiento del estrés”, así como los resultados descriptivos obtenidos en población adulta con la Escala de Autoeficacia para el Afrontamiento del Estrés (EAEAE). Ochocientos doce adultos de 18 a 64 años (M=26.46; dt= 9.93; 62.6% mujeres) procedentes de diferentes contextos contestatron la EAEAE en una única administración. Se presentan los resultados descriptivos obtenidos con la muestra completa así como las diferencias encontradas entre subgrupos de la muestra, hombre y mujeres y grupos de edad. Los resultados señalan que la muestra presenta una moderada autoeficacia para el afrontamiento del estrés, siendo ligera pero significativamente superiores sus puntuaciones en el componente de expectativas de resultado, y siendo significativamente superiores las puntuaciones en hombre que en mujeres y en los participantes de más edad en comparación con los más jóvenes. En comparación con la población general, las personas sometidas a un elevado estrés cotidiano (laboral) que les exige constantes esfuerzos de resolución y autosuperación muestran significativamente mayores niveles en estas variables, mientras que las personas sometidas a situaciones de estrés mantenidas, incontrolables y debilitantes (enfermos con dolor crónicos) presentan puntuaciones significativamente inferiores. Se confirma de esta manera la idoneidad de la escala EAEAE como instrumento para la evaluación e investigación sobre la autoeficacia específica para el afrontamiento del estrés en contextos de investigación y clínicos

This paper presents the theoretical construct of “doping with stress specific self-efficacy” along with descriptive results obtained from an adult sample with the Escala de Auroeficacia para el Afrontamiento del Estrés (EAEAE) [Coping with Stress Self-efficacy Scale]. Eight hundred and twelve individuals, aged 18 to 64 years old (M= 26.46; sd-9.93; 62.6% females), recruited from different settings, completed the EAEAE in a unique administration. Descriptive results obtained from the entire sample are presented, as well as differences found between subsamples, males and females and age groups. Results indicate that participants possessed moderate self-efficacy for coping with stress. Their scores in the efficacy expectations component were slightly but significantly higher than their scores in the outcome expectations component. Total and subtotal scores were significantly higher for males than for females as well as for older participants than for younger participants. Compared to the general population, individuals, who are exposed to elevated levels of daily stress which demand continuous problem-solving and self-improvement efforts (work-related stress) demonstrated significantly higher levels of coping with stress self-efficacy. On the other hand, individuals who are exposed to maintained, uncontrollable and self-weakening stressful situations (chronic pain) scored significantly lower on self-efficacy for coping with stress. The results confirm the appropriateness of the EAEAE scale for the assessment and investigation on coping with stress self-efficacy in research as well as clinical context