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The massive deployment of smart meters in most Western countries in recent decades has allowed the creation and development of a significant variety of applications, mainly related to efficient energy management. The information provided about energy consumption has also been dedicated to the areas of social work and health. In this context, smart meters are considered single-point non-intrusive sensors that might be used to monitor the behaviour and activity patterns of people living in a household. This work describes the design of a short-term behavioural alarm generator based on the processing of energy consumption data coming from a commercial smart meter. The device captured data from a household for a period of six months, thus providing the consumption disaggregated per appliance at an interval of one hour. These data were used to train different intelligent systems, capable of estimating the predicted consumption for the next one-hour interval. Four different approaches have been considered and compared when designing the prediction system: a recurrent neural network, a convolutional neural network, a random forest, and a decision tree. By statistically analysing these predictions and the actual final energy consumption measurements, anomalies can be detected in the undertaking of three different daily activities: sleeping, breakfast, and lunch. The recurrent neural network achieves an F1-score of 0.8 in the detection of these anomalies for the household under analysis, outperforming other approaches. The proposal might be applied to the generation of a short-term alarm, which can be involved in future deployments and developments in the field of ambient assisted living.
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Inteligência Ambiental , Humanos , Inteligência , Redes Neurais de Computação , SonoRESUMO
We explored the experiences of women with fibromyalgia during the COVID-19 pandemic from a qualitative approach by interviewing eighteen women. We identified seven main themes after performing a thematic analysis: pain description, pain triggers, impact, coping strategies, treatment for pain, pain onset and general situation. In general, pain worsened during the pandemic, and activity restrictions and changes in social interactions were particularly related with that. Pain negatively impacted different life domains: mental health, physical health, cognitive status, social activities and daily activities. Coping strategies varied slightly after the pandemic outbreak, and treatment was interrupted for some women. Results reflect that the pandemic was challenging for women living with fibromyalgia, and highlight the need to develop specific interventions for them in the context of potential future health emergencies.
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This work presents the CODEUS platform, which includes a simulation tool together with an online experimental demonstrator to offer analysis and testing flexibility for researchers and developers in Ultrasonic Indoor Positioning Systems (UIPSs). The simulation platform allows most common encoding techniques and sequences to be tested in a configurable UIPS. It models the signal modulation and processing, the ultrasonic transducers' response, the beacon distribution, the channel propagation effects, the synchronism, and the application of different positioning algorithms. CODEUS provides results and performance analysis for different metrics and at different stages of the signal processing. The UIPS simulation tool is specified by means of the MATLAB© App-Designer environment, which enables the definition of a user-friendly interface. It has also been linked to an online demonstrator that can be managed remotely by means of a website, thus avoiding any hardware requirement or equipment on behalf of researchers. This demonstrator allows the selected transmission schemes, modulation or encoding techniques to be validated in a real UIPS, therefore enabling a fast and easy way of carrying out experimental tests in a laboratory environment, while avoiding the time-consuming tasks related to electronic design and prototyping in the UIPS field. Both simulator and online demonstrator are freely available for researchers and students through the corresponding website.
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Processamento de Sinais Assistido por Computador , Ultrassom , Algoritmos , Simulação por Computador , HumanosRESUMO
Upon depolarization of chromaffin cells (CCs), a prompt release of catecholamines occurs. This event is triggered by a subplasmalemmal high-Ca2+ microdomain (HCMD) generated by Ca2+ entry through nearby voltage-activated calcium channels. HCMD is efficiently cleared by local mitochondria that avidly take up Ca2+ through their uniporter (MICU), then released back to the cytosol through mitochondrial Na+/Ca2+ exchanger (MNCX). We found that newly synthesized derivative ITH15004 facilitated the release of catecholamines triggered from high K+-depolarized bovine CCs. Such effect seemed to be due to regulation of mitochondrial Ca2+ circulation because: (i) FCCP-potentiated secretory responses decay was prevented by ITH15004; (ii) combination of FCCP and ITH15004 exerted additive secretion potentiation; (iii) such additive potentiation was dissipated by the MICU blocker ruthenium red (RR) or the MNCX blocker CGP37157 (CGP); (iv) combination of FCCP and ITH15004 produced both additive augmentation of cytosolic Ca2+ concentrations ([Ca2+]c) K+-challenged BCCs, and (v) non-inactivated [Ca2+]c transient when exposed to RR or CGP. On pharmacological grounds, data suggest that ITH15004 facilitates exocytosis by acting on mitochondria-controlled Ca2+ handling during K+ depolarization. These observations clearly show that ITH15004 is a novel pharmacological tool to study the role of mitochondria in the regulation of the bioenergetics and exocytosis in excitable cells.
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Cálcio , Catecolaminas , Células Cromafins , Exocitose , Mitocôndrias , Animais , Bovinos , Cálcio/metabolismo , Sinalização do Cálcio , Catecolaminas/metabolismo , Células Cultivadas , Células Cromafins/citologia , Células Cromafins/efeitos dos fármacos , Exocitose/efeitos dos fármacos , Mitocôndrias/efeitos dos fármacos , Cultura Primária de CélulasRESUMO
OBJECTIVE: Although functional abdominal pain (FAP) is one of the most common pain problems in children, there is a lack of qualitative studies on this topic. Our aim was to increase knowledge in this field by testing an innovative written narrative methodology designed to approach the experiences of children with FAP and their parents. METHODS: We analyzed the FAP experiences of 39 families who completed a written narrative task (children and parents separately). Some of the families (N = 20) had previously completed an online psychosocial intervention, whereas others had not, because a complementary objective was to explore possible differences between parent and child narratives, and between those who had and had not completed the intervention. RESULTS: Families wrote about abdominal pain (characteristics, triggers, pain consequences, and coping strategies), their well-being, the diagnostic process, future expectations, and the positive effects of an online psychosocial intervention. Children tended to mention pain characteristics more, whereas parents tended to write more about triggers and the diagnostic process. CONCLUSIONS: A written narrative methodology was found to be a useful approach for understanding families' experiences. Results confirmed that FAP affects families at the emotional, behavioral, and social levels and that an online psychosocial intervention can help families.
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Adaptação Psicológica , Pais , Dor Abdominal/diagnóstico , Criança , Emoções , Família , HumanosRESUMO
BACKGROUND: Chronic pain is prevalent in our society, with conditions such as fibromyalgia being notably widespread. The gold standard for aiding individuals dealing with chronic pain involves interdisciplinary approaches rooted in a biopsychosocial perspective. Regrettably, access to such care is difficult for most of the people in need. Information and communication technologies (ICTs) have been used as a way of overcoming access barriers (among other advantages). OBJECTIVE: This study addressed the little explored area of how individuals with fibromyalgia use and perceive different types of ICTs for pain management. METHODS: A cross-sectional study was conducted using an online survey. This survey was created to assess the use of different ICT tools for pain management, satisfaction with the tools used, and perceived advantages and disadvantages. In addition, data collection encompassed sociodemographic variables and pain-related variables, pain intensity, the impact of pain on daily life activities, and fear of movement/injury beliefs. In total, 265 individuals diagnosed with fibromyalgia completed the survey. RESULTS: Only 2 (0.75%) participants reported not having used any ICT tool for pain management. Among those who used ICT tools, an average of 10.94 (SD 4.48) of 14 different tools were used, with the most used options being instant messaging apps, websites dedicated to managing fibromyalgia, phone calls with health professionals, and online multimedia resources. Satisfaction rates were relatively modest (mean 2.09, SD 0.38) on a scale from 0 to 5, with instant messaging apps, phone calls with health professionals, fibromyalgia management websites, and online multimedia resources being the ones with higher satisfaction. Participants appreciated the ability to receive treatment from home, access to specialized treatment, and using ICTs as a supplement to in-person interventions. However, they also highlighted drawbacks, such as a lack of close contact with health professionals, difficulty expressing emotions, and a lack of knowledge or resources to use ICTs. The use of ICTs was influenced by age and educational background. Additionally, there was a negative correlation between satisfaction with ICT tools and fear of movement/injury. CONCLUSIONS: People with fibromyalgia are prone to using ICTs for pain management, especially those tools that allow them to be in contact with health professionals and have access to online resources. However, there is still a need to improve ICT tools since satisfaction ratings are modest. Moreover, strategies aimed at older people, those with lower levels of education, and those with higher levels of fear of movement/injury can be useful to potentiate the use of ICTs among them.
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PURPOSE: To explore the experiences of individuals with fibromyalgia (FM) through written narratives (WN) and to preliminarily investigate the potential value of these narratives for healthcare professionals in assessing the overall perceived severity and disability experienced by individuals with FM. MATERIALS AND METHODS: This cross-sectional study was conducted with 46 participants with a FM diagnosis. They were asked to complete a WN task that aimed to capture their personal experiences. The degree of severity and disability expressed in their texts was assessed by researchers, and participants were also asked to complete the Revised Fibromyalgia Impact Questionnaire (FIQR), the Hospital Anxiety and Depression Scale (HAD), and the Tampa Scale for Kinesophobia. RESULTS AND CONCLUSIONS: Eight main themes were identified after qualitatively analysing the narratives provided by participants: story of their illness, FM characteristics, other illnesses, impact, coping strategies, social support, pain triggers and treatments. Pain emerges as a profound symptom affecting mental, physical, and social well-being, with diverse triggers and coping mechanisms. Participants highlighted difficulties in the diagnostic process, used multiple treatment strategies, and expressed a lack of understanding from healthcare professionals and society. There were significant correlations between researchers' assessments of severity and disability of the writings and FIQR and HAD scores. This study emphasises the value of narratives in capturing the multifaceted nature of FM experiences and hints at their potential for clinical understanding and management.
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Fibromialgia , Narração , Humanos , Fibromialgia/psicologia , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Adulto , Masculino , Adaptação Psicológica , Idoso , Inquéritos e QuestionáriosRESUMO
Background: Chronic neck and low back pain are very common and have detrimental effects for people and society. In this study, we explore the experiences of individuals with neck and/or back pain using a written narrative methodology. Materials & methods: A total of 92 individuals explained their pain experience using written narratives. Narratives were analyzed through thematic analysis and text data mining. Results: Participants wrote about their experience in terms of pain characteristics, diagnosis process, pain consequences, coping strategies, pain triggers, well-being and future expectations. Text data mining allowed us to identify concurrent networks that were basically related with pain characteristics, management and triggers. Conclusion: Written narratives are useful to understand individuals' experiences from their point of view.
[Box: see text].
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Dor Crônica , Dor Lombar , Narração , Cervicalgia , Humanos , Dor Lombar/psicologia , Dor Lombar/terapia , Dor Lombar/diagnóstico , Masculino , Feminino , Dor Crônica/psicologia , Dor Crônica/terapia , Dor Crônica/diagnóstico , Cervicalgia/psicologia , Cervicalgia/terapia , Cervicalgia/diagnóstico , Adulto , Pessoa de Meia-Idade , Adaptação Psicológica , Idoso , Adulto Jovem , Pesquisa QualitativaRESUMO
OBJECTIVE: This study aimed to evaluate the effectiveness of an online multicomponent intervention called FATIGUEWALK (FaW) compared to treatment as usual (TAU) in patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME). METHOD: FaW included pain neuroscience education, therapeutic exercise, cognitive restructuring, and mindfulness training. A total of 428 patients with CFS/ME were randomized into two study arms: online FaW plus TAU versus TAU alone. A single-blinded randomized controlled trial was conducted. Validated patient-reported outcome measures of fatigue, pain, anxiety, depression, and physical function were collected at baseline and posttreatment, following the FaW intervention, which lasted 12 weeks. RESULTS: Statistically significant improvements (with small-to-moderate effect sizes) were observed in online FaW versus TAU alone with respect to multidimensional aspects of fatigue (Cohen's d ranging from 0.25 to 0.73) and most secondary outcomes (pain and fatigue intensity, depressive and anxious symptomatology, functional impairment, kinesiophobia, physical functioning). The absolute risk reduction in FaW versus TAU was 19%, 95% confidence interval (CI) [12.19, 25.80] with number needed to treat = 6, 95% CI [3.9, 8.2]. Overall, similar clinical improvements were observed in sensitivity analyses including a subgroup of patients without comorbidity with fibromyalgia (n = 70). CONCLUSIONS: This is the first study to assess the short-term effectiveness of an online multicomponent intervention added to TAU, compared to TAU alone, for the management of CFS/ME. Further trials, including active control groups with an equivalent treatment dose, and assessing the long-term effectiveness of the online FaW, are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Síndrome de Fadiga Crônica , Humanos , Síndrome de Fadiga Crônica/terapia , Qualidade de Vida , Terapia por Exercício/métodos , Depressão/terapia , DorRESUMO
BACKGROUND: Acceptance and Commitment Therapy (ACT) has been found to be beneficial for individuals dealing with chronic pain. The theoretical mechanisms of change proposed by ACT are based on the Hexaflex model. To comprehensively reflect this model, the Multidimensional Psychological Flexibility Inventory (MPFI) and Psy-Flex have been developed. The study aimed to adapt the MPFI-24 and the Psy-Flex for Spanish-speaking populations with chronic pain and to examine their dimensionality, internal consistency, convergent validity and incremental validity. METHODS: This cross-sectional study involved 309 Spanish-speaking adults with chronic pain who completed an online survey. The majority of the participants were women (88.3%). The ages ranged from 18 to 79 years. RESULTS: Factor analysis showed that the Spanish version of the MPFI-24 has 12 factors, consisting of six flexibility and six inflexibility factors, similar to the original version, but lacking second-order general factors. The Psy-Flex demonstrated a single-factor structure, maintaining the general factor of psychological flexibility seen in the original version. The MPFI-24 showed good internal consistency and adequate convergent validity, with the exception of the Acceptance and Experiential Avoidance subscales. The Psy-Flex showed good internal consistency and convergent validity. Notably, both the MPFI-24 and Psy-Flex scores significantly explained additional variance in psychological distress beyond other ACT-related measures of Hexaflex processes; however, only the Psy-Flex explained pain interference. CONCLUSIONS: The Spanish adaptations of the MPFI-24 and Psy-Flex are valid and reliable instruments for assessing the Hexaflex model processes in Spanish-speaking adults with chronic pain. SIGNIFICANCE STATEMENT: Practitioners and researchers in chronic pain will find the Spanish versions of the MPFI-24 and the Psy-Flex here, along with recommendations for their use and scoring based on a robust psychometric rationale. It should be noted that these measures surpass the Chronic Pain Acceptance Questionnaire (CPAQ) and the Psychological Inflexibility in Pain Scale (PIPS), which are considered gold standards in chronic pain assessment.
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AIMS AND OBJECTIVES: To explore the quality of life and mental health of caregivers of children with cerebral palsy and to examine the impact of self-efficacy and coping strategies on these outcomes. BACKGROUND: Few studies analyse the impact of caring for a child with cerebral palsy on the caregivers' quality of life besides mental health. Also, less attention has been paid to the influence of caregiver's personal resources like self-efficacy or coping strategies on how they adjust to the child's illness and the care situation. DESIGN: Cross-section correlational design. METHODS: Sixty two parents of children with cerebral palsy completed measures to assess the quality of life (i.e. physical, environmental and social relationships), mental health (i.e. general mental health, depression and anxiety), self-efficacy and coping strategies. RESULTS: Parents of children with cerebral palsy had, in general terms, low levels of quality of life and mental health. Self-efficacy was related to most of the outcomes, whereas any of the coping strategies assessed was significantly related to the outcomes. CONCLUSIONS: Quality of life and mental health can be affected in caregivers of children with CP. Personal resources like self-efficacy also need attention as they can help in the understanding of the differences in these outcomes and the design of effective interventions. RELEVANCE OF CLINICAL PRACTICE: Self-efficacy should be a key element in interventions addressed to parents of children with CP to elicit a process of empowerment that can improve the well-being of the family as a whole.
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Adaptação Psicológica , Paralisia Cerebral/psicologia , Saúde Mental , Pais/psicologia , Qualidade de Vida , Autoeficácia , Adulto , Cuidadores , Criança , HumanosRESUMO
Background: Currently, most people who might need mental health care services do not receive them due to a number of reasons. Many of these reasons can be overcome by telepsychology, in other words, the use of ICT technologies for therapy (e.g., phone, videoconferencing, and apps); given that it facilitates access to specialized interventions. In fact, telepsychology is currently offered as an active service in many psychotherapy centers. However, its usage, how it is perceived, and who uses it are still largely unknown. Objective: The aim of this study was (1) to determine if any pattern exists in the usage of telepsychology and face-to-face psychology, (2) to clarify people's perception of telepsychology in terms of the advantages, barriers and efficacy of online psychotherapy, and (3) to examine usage patterns in terms of individual characteristics and identify patients' profiles. Methods: An online survey was conducted on a convenience sample of 514 subjects recluted by using an online advertisement. The inclusion criteria were: (1) to be older than 18 years old and (2) to answer completely the questionnaire. Cluster analysis, ANOVAs, and discriminant analysis were performed to test our research objectives. Results: Three usage clusters were found: (1) face-to-face psychotherapy (57%; n = 292); (2) non-therapy (36.8%; n = 189); and (3) combined face-to-face psychotherapy and telepsychology (6.4%; n = 33). In addition, the perception of telepsychology varied among usage clusters, but a common perception emerged about the main telepsychology advantages, barriers and efficacy. Finally, the results showed that personal characteristics differentiated people in each of these clusters. Conclusion: The most common form of access to psychotherapy is the face-to-face form but the second way of delivery was a combination between face to face and online psychotherapy (research objective 1). People who combine face to face with online psychotherapy perceives this last as more efficient and with less barriers to access (research objective 2). Finally, some characteristic as eHealth experience and sociodemographic variables can help to identify people that will attend telepsychology initiatives (research objective 3). These clusters provide insight into opportunities for face-to-face and online patient engagement strategies.
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BACKGROUND: Telepsychology is increasingly being incorporated in clinical practice, being offered in many psychotherapy centers, especially after the impact of the pandemic. However, there seems to be a remarkable discrepancy between the offer, or interest in, and real-world uptake of e-mental health interventions among the population. A critical precondition is clients' willingness to accept and use telepsychology, although this issue has thus far been overlooked in research. OBJECTIVE: The aim of this study was to examine people's acceptance and use of telepsychology by adopting an extended model of the unified theory of acceptance and use of technology (UTAUT) that integrates perceived telepsychology advantages and barriers, usefulness perceptions, behavioral intention, and telepsychology use. METHODS: An online survey was conducted with a convenience sample of 514 participants. Structural equation models were computed to test a mediation model. RESULTS: Results supported the UTAUT model to explain participants' acceptance and use of telepsychology. They showed a causal chain in which perceived telepsychology advantages and barriers were related to telepsychology use through the perceived usefulness of and intention to use telepsychology. CONCLUSIONS: Telepsychology use may be explained according to the UTAUT model when coupled with participants' perceptions of telepsychology advantages and barriers. Mental health stakeholders could consider these factors in order to increase the acceptance and use of telepsychology.
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BACKGROUND: In Latin America, the prevalence of end-stage kidney disease (ESKD) has risen tremendously during the last decade. Previous studies have suggested that receiving dialysis at high altitude confers mortality benefits; however, this effect has not been demonstrated at >2000 m above sea level (masl) or in developing countries. METHODS: This historical cohort study analyzed medical records from six Peruvian hemodialysis (HD) centers located at altitudes ranging from 44 to 3827 masl. Adult ESKD patients who started maintenance HD between 2000 and 2010 were included. Patients were classified into two strata based on the elevation above sea level of their city of residence: low altitude (<2000 masl) and high altitude (≥2000 masl). Death from any cause was collected from national registries and Cox proportional hazards models were built. RESULTS: A total of 720 patients were enrolled and 163 (22.6%) resided at high altitude. The low-altitude group was significantly younger, more likely to have diabetes or glomerulonephritis as the cause of ESKD and higher hemoglobin. The all-cause mortality rate was 84.3 per 1000 person-years. In the unadjusted Cox model, no mortality difference was found between the high- and low-altitude groups {hazard ratio [HR] 1.20 [95% confidence interval (CI) 0.89-1.62]}. After multivariable adjustment, receiving HD at high altitude was not significantly associated with higher mortality, but those with diabetes as the cause of ESKD had significantly higher mortality [HR 2.50 (95% CI 1.36-4.59)]. CONCLUSIONS: In Peru, patients receiving HD at high altitudes do not have mortality benefits.
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We explored the impact of an interactive VR environment on pain cognitions (in vivo catastrophizing and pain self-efficacy) and pain-related measures: pain threshold, pain tolerance, Pain Sensitivity Range (PSR), pain intensity and time estimation in a sample of healthy students. Sense of presence is essential to conduct a psychological treatment; if patients are not able to involve themselves in a virtual world they cannot experience relevant emotions, and the desired processes that are necessary for most psychological treatments will not occur. However, some authors argue that presence must be distinguished from the degree of engagement, involvement in the portrayed environment. The results obtained in our study are consistent with this view, since the Involvement scale of the IPQ did not correlate with any of the measures related with the treatment's efficacy.
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Manejo da Dor , Dor/psicologia , Interface Usuário-Computador , Humanos , Inquéritos e Questionários , Resultado do TratamentoRESUMO
BACKGROUND: Juvenile Idiopathic Arthritis (JIA) and its related symptoms (e.g. pain) have been associated with interference in the daily life of adolescents with JIA including their friendships. There is little research in that sense and in consequence, interventions designed to improve this area. The objectives of this study are 1) to gain knowledge about the needs of adolescents with JIA, particularly focused on their friendships; 2) to explore the potential of the Internet to help them, and 3) to determine what kind of online resource would be the best and what elements it should include. METHODS: To achieve the proposed objectives we designed a qualitative study including two phases: the first one exploratory (semi-structured interviews) and the following, confirmatory (online focus group). RESULTS: 14 adolescents were interviewed and 7 participated in the focus group. They reported some social challenges related to their illness: feeling different, criticized by peers, or not believed. Additionally, they specified some of the coping strategies they used, such as disclosing to others that they have JIA, using communication skills, maintaining activities with friends, trying to minimize pain, and ignoring negative comments. Adolescents considered an online resource useful and mentioned that they would like to find general information and to have the possibility to interact with others. They considered Instagram and WhatsApp as good platforms to implement the online resource. CONCLUSIONS: According to their perceptions, adolescents with JIA can benefit from an online resource which delivers information, strategies and facilitates interaction with others.
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Artrite Juvenil/psicologia , Amigos , Intervenção Baseada em Internet , Avaliação das Necessidades , Apoio Social , Adaptação Psicológica , Adolescente , Artrite Juvenil/complicações , Criança , Revelação , Feminino , Grupos Focais , Humanos , Masculino , Grupo AssociadoRESUMO
The corona virus disease 2019 (COVID-19) pandemic is one of the most important healthcare and societal challenges to have emerged in the last century. It may have effects on both physical and psychosocial health, but studies considering the impact on vulnerable populations, such as people with chronic pain, are needed. In this cross-sectional study, an online survey of relevant chronic pain domains, coping strategies, triggers and potential related variables was answered by 502 Spanish individuals with chronic pain. Participants were mainly women (88%) with longstanding chronic pain and moderate to high pain intensity and disability. The perception of pain aggravation and the most pain-related outcomes were observed. Contextual variables such as job insecurity, worries about the future, people cohabiting, being close to someone who had passed away, or being potentially infected with COVID-19 were related to worse outcomes. More than half the participants altered their pain management style (e.g., increased medication intake) and several changes occurred with respect to pain triggers (cognitions, feelings of insecurity and loneliness, and sleeping problems were more frequently reported as triggers during lockdown). Our preliminary results highlight the negative effects of lockdown on patients with chronic pain as well as the need to make available cost-effective and remotely accessible healthcare resources for counteracting them.
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Giving less importance to pain and focusing on achieving objectives in accordance with values can help people to live their lives in spite of the pain. We present a rationale for this orientation and several techniques that can help people achieve this. Specifically, we present the importance of starting the intervention by educating people about pain and setting objectives in line with each person's personal values. After that, we present some techniques that can help people deal with triggers and barriers that can make it difficult to stay on track when it comes to giving less importance to pain and more to achieving objectives.
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Adaptação Psicológica , Dor Crônica/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Educação de Pacientes como Assunto , Logro , HumanosRESUMO
PURPOSE: To evaluate post-treatment efficacy of DARWeb (online psychosocial intervention for children with functional abdominal pain) using a randomized clinical trial design and combining quantitative and qualitative data. PATIENTS AND METHODS: Twenty-five families with children with FAP in the experimental group (EG: accessed to DARWeb) and 36 in the control group (CG: wait-list) were compared. Children and parents completed measures of abdominal pain severity (primary outcome), quality of life, and satisfaction. Moreover, children completed measures of depression, functional disability, catastrophizing and coping strategies; parents completed measures about parental responses to their children's pain. Families also answered open questions and were interviewed. RESULTS: A higher percentage of children in the EG achieved a significant clinical change in abdominal pain severity from the parents' perspective (28% in the EG vs 8.33% in the CG). There was a significantly greater reduction in pain frequency in the EG compared to the CG (both from the children's and parents' perspectives) from mixed repeated-measures analyses of variance (there was not a significant interaction in total scores of pain severity). A higher percentage of children in the EG improved in quality of life and depression compared to the CG (results from mixed methods repeated-measures analyses of variances were not significant). However, there were no differences for disability, pain catastrophizing or the coping strategies assessed from the children's perspective; neither from the parents' assessment of quality of life. There were significant interactions for parents' solicitousness responses and promotion of well behaviors in the expected directions. Families were quite satisfied with the intervention, and the qualitative results confirmed an improvement in pain and having learned important coping strategies. CONCLUSION: Our results support the efficacy of our intervention, but future studies are needed with different profiles of initial severity of the pain problem, longer follow-ups, and other conditions.
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El artículo define brevemente la fibromialgia dentro de un contexto más amplio incluyendo las raíces históricas del concepto y su posible etiología, así como su interpretación dentro de los modelos biopsicosociales más actuales, con implicaciones terapéuticas de alto interés.(AU)