Spanish validation of the cardiac self-efficacy scale: a gender invariant measure.

The aim is to validate the Spanish version of the Cardiac Self-Efficacy (S-CSE) Scale by examining its psychometric properties and to test the invariance for women and men. Two groups - 722 and 522- of patients completed the S-CSE Scale and other psychosocial measures during a medical revision several months after being diagnosed with cardiovascular disease. Construct validity was psychometrically evaluated using exploratory factor analysis (EFA) with a split of the first sample and confirmatory factor analysis (CFA) with a second split of the same sample. Scale structure was confirmed using the second sample. Convergent, discriminant, and external validity were tested. Results revealed that the S-CSE Scale was represented by three dimensions (control symptoms, control illness, maintain functioning) obtaining excellent reliability indexes and it appeared to be invariant for women and men. The S-CSE scale is a useful tool for monitoring the general well-being of these patients to promote individualized interventions.

Testing the Ferguson model for the cold-hardiness of dormant grapevine buds in a temperate and subtropical valley of Chile.

A dynamic thermal time model (DTTM) has been developed to predict cold-hardiness in dormant grapevine buds, which uses daily mean temperatures as the only input variable. However, it has been recently reported that cold-hardiness in grapevine buds depends not only on low temperatures (LTs), but also on the content of the plant phytohormone abscisic acid (ABA). An important parameter in the DTTM is the ecodormancy boundary (EDB), which represents the chilling degree days (DDc) required for the transition of the buds from endo to ecodormancy. In this study, the bud cold-hardiness of grapevines was measured by the low-temperature exotherm (LTE) in the subtropical Elqui and in the temperate Maipo valleys of Chile, and the values fitted to the DTTM. Moreover, the ABA content was determined in dormant buds throughout the dormant season. The results demonstrated that the DTTM worked better in the Maipo than in the Elqui valley, and that the content of ABA in the buds was higher in the vines grown in the Elqui valley. On the other hand, the optimized EDB parameter value varied from year to year when it was estimated as chilling accumulated, but when it was estimated as time, it remained constant in the Maipo valley. Based on the results, we conclude the following: (a) the proper functioning of the DTTM requires that the ABA content profile in the dormant buds should be kept constant from year to year, (b) the highest content of ABA in the buds collected in the Elqui valley is probably due to abiotic stresses, (c) the EDB parameter corresponds to the accumulated cold until before the buds begin their deacclimation process and not until they release from endodormancy, (d) the release of the buds from endodormancy does not depend on the accumulated cold, but on the elapsed time.

Abscisic acid (ABA) and low temperatures synergistically increase the expression of CBF/DREB1 transcription factors and cold-hardiness in grapevine dormant buds.

BACKGROUND AND AIMS: It has been reported that low temperatures (LTs) and the plant hormone abscisic acid (ABA) induce the expression of CBF/DREB1 transcription factors in vegetative tissues and seedlings of Vitis vinifera and Vitis riparia and that foliar applications of ABA to V. vinifera increase the freezing tolerance or cold-hardiness of dormant buds. However, the combined effect of ABA and LTs on the expression of CBF/DREB1 transcription factors and on the acquisition of freezing tolerance in dormant grapevine buds has not been investigated. The objective of this study was to analyse the combined effect of ABA and LT treatments on the expression of CBF/DREB transcription factors and the acquisition of freezing tolerance. METHODS: In vitro experiments with single-bud cuttings of grapevines were used to analyse the effect of ABA, ABA + LT and LT on the expression of CBF/DREB transcription factors, dehydrin and antioxidant genes, the acquisition of freezing tolerance and the endogenous content of ABA. Gene expression analysis was performed by quantitative real-time PCR and freezing tolerance was determined by measuring the low-temperature exotherm by differential thermal analysis. ABA levels were determined by gas chromatography coupled to an electron capture detector. KEY RESULTS: The LT treatment and exogenous application of ABA to grapevine dormant buds increased the expression of the CBF/DREB1 transcription factors VvCBF2, VvCBF3, VvCBF4 and VvCBF6. The joint application of LT and ABA produced a huge increase in the expression of these transcription factors, which was greater than the sum of the increases produced by them individually, which indicates the existence of a synergistic effect between ABA and LT on the activation of these transcription factors. This synergic effect was also observed on the increase in bud cold-hardiness and on the expression of antioxidant and dehydrin genes. CONCLUSIONS: The synergy between ABA and LT on the expression of CBF/DREB1 transcription factors VvCBF2, VvCBF3, VvCBF4 and VvCBF6 plays a key role in cold acclimatization of grapevine buds. The results highlight the importance of the combination of stimuli in the improvement of genetic and physiological responses and help us to understand the adaption of plants to complex environments.

Feasibility study of a mobile application (ACT-ON) to complement acceptance and commitment therapy (ACT) intervention in cancer patients.

OBJECTIVE: Psychological and physical distress commonly affect cancer patients. Acceptance and commitment therapy (ACT) has shown promising results when it comes to ameliorating symptoms that may develop as a result of this. Meanwhile, it has come to light that the impact of psychological interventions may be enhanced by the use of mobile applications. However, to date no mobile applications have been developed to support ACT-based interventions in cancer patients. The aim of the present study is to develop and test the usability of a mobile application designed to complement face-to-face ACT-based therapy in a group of cancer patients undergoing treatment. MATERIALS AND METHODS: A total of thirty-nine patients were recruited to participate in this pilot study. Participants had to be: 18 years of age or over, currently undergoing treatment for breast, lung or colorectal cancer, in stage I-III, a smartphone user with daily internet access. The intervention sessions were administered for a period of eight weeks, one hour per week to groups of four to six participants. Patients had the ACT-ON mobile application at their disposal, which provided them with access to therapy-related activities: mindfulness, metaphors and exercises to clarify values. RESULTS: The application obtained adequate adoption (61.54%) and usage (54.17%) rates. Usability and ease of learning scores were as follows: good usability (M = 79.81, SD = 11.87); high usability (M = 80.53, SD = 14.04); ease of learning (M = 37.5, SD = 23.85). DISCUSSION: This is the first study to develop and evaluate the usability of an application designed to support ACT-based interventions in cancer patients undergoing treatment. The results show that the ACT-ON app is a feasible tool which achieves high levels of usability. However, said results ought to be confirmed by studies that include a larger number of cancer patients.

Effectiveness of an eHealth intervention to improve subjective well-being and self-efficacy in cardiovascular disaease patients: A pilot non-randomized controlled trial.

AIM: To evaluate the effectiveness of a multicomponent, eHealth-based self-efficacy intervention to promote subjective well-being and self-efficacy in patients with cardiovascular disease, exploring sex differences. DESIGN: A pilot study of a two-arm non-randomized controlled trial. METHODS: Forty-two cardiovascular patients (31% women) participated in the study. The experimental group received a personalized psychoeducational session and a 14-days eHealth intervention. Subjective well-being (positive and negative affect) and self-efficacy (chronic and cardiac) were assessed at baseline, post-psychoeducational session, post-eHealth intervention and at two follow-ups. RESULTS: The levels of the experimental group in positive affect, at post-eHealth and follow-up 1, and self-efficacy, at post-eHealth, and both follow-ups, were statistically significantly higher compared to the control group (all ps < .05). When considering sex, the intervention was effective only for men. The results highlight the potential of eHealth interventions for cardiac patients and underline the importance of considering a gender perspective in their treatment.

Hypoxia and hydrogen cyanamide induce bud-break and up-regulate hypoxic responsive genes (HRG) and VvFT in grapevine-buds.

It has been reported that dormancy-breaking compound hydrogen cyanamide (HC) stimulates the fermentative pathway and inhibits respiration in grapevine-buds, suggesting in this way, that a respiratory stress must be involved in the release of buds from dormancy. Here, we tested low-oxygen effect (hypoxia) on the bud-break response of endodormant grapevine buds, and HC and hypoxia effects on the expression of hypoxic responsive genes (HRG) PYRUVATE DECARBOXYLASE (VvPDC), ALCOHOL DEHYDROGENASE (VvADH2), SUCROSE SYNTHASE (VvSUSY), non-symbiotic HEMOGLOBIN (VvnsHb), and on FLOWERING LOCUS T (VvFT), a transcription factor related to dormancy release in Vitis. Hypoxia as HC, induce transiently the expression of HRG and VvFT and hasten the sprouting of endodormant grapevine-buds. During the first 24 h after treatment, HRG and VvFT were strongly induced by hypoxia, subsequently, their expressions fell, and 14 days post-treatment increased again above control levels. These results indicate that in the short-term, a respiratory stress, caused either by oxygen deprivation or by inhibitors of respiration, induces transiently the expression of HRG and VvFT, and in the long-term, along with the advancement of bud-break, the expression of these genes move forward in treated buds, suggesting that these second induction that occurs just before bud-break is developmentally regulated.

Hypoxia induces H2O2 production and activates antioxidant defence system in grapevine buds through mediation of H2O2 and ethylene.

Paradoxically, in eukaryotic cells, hydrogen peroxide (H(2)O(2)) accumulates in response to oxygen deprivation (hypoxia). The source of H(2)O(2) under hypoxia varies according to the species, organs, and tissue. In non-photosynthetic tissues, H(2)O(2) is mainly produced by activation of NAD(P)H-oxidases or by disruption of the mitochondrial electron transport chain (m-ETC). This study showed that hypoxia, and inhibitors of respiration like potassium cyanide (KCN) and sodium nitroprusside (SNP), trigger the production of H(2)O(2) in grapevine buds. However, diphenyleneiodonium, an inhibitor of NAD(P)H-oxidase, did not reduce the H(2)O(2) levels induced by KCN, suggesting that, under respiratory stress, H(2)O(2) is mainly produced by disruption of the m-ETC. On the other hand, γ-aminobutyric acid (GABA), a metabolite that in plants alleviates oxidative stress by activating antioxidant enzymes, reduced significantly the levels of H(2)O(2) induced by KCN and, surprisingly, repressed the expression of genes encoding antioxidant enzymes such as ASCORBATE PEROXIDASE (VvAPX), GLUTATHIONE PEROXIDASE (VvGLPX), SUPEROXIDE DISMUTASE (VvSOD), and one of the CATALASE isoforms (VvCAT1), while VvCAT2 was upregulated. In contrast to GABA, hypoxia, H(2)O(2), and ethylene increased dramatically the expression of genes encoding antioxidant enzymes and enzymes of the alternative respiratory pathway such as ALTERNATIVE NADH-DEHYDROGENASES (VvaNDs) and ALTERNATIVE OXIDASES (VvAOXs). Hence, it is concluded that H(2)O(2) production is stimulated by respiratory stress in grapevine buds, that H(2)O(2) and ethylene act as signalling molecules and activate genes related to the antioxidant defence system, and finally that GABA reduces H(2)O(2) levels by up-regulating the expression of VvCAT2.

Sucrose accumulation and endodormancy are synchronized events induced by the short-day photoperiod in grapevine buds.

At the end of the summer season, grapevine buds (Vitis vinifera L) grown in temperate climates enter a state of winter recess or endodormancy (ED), which is induced by the shortening of the photoperiod, and during this period, the buds accumulate sucrose. In this study, we investigated whether the shortening of the photoperiod regulates the accumulation of sucrose in the buds in the same way as it regulates its entry into the ED. Because sucrose accumulation is regulated by genes that control its transport and degradation, the effect of the SD photoperiod and the transition of buds from paradormancy (PD) to ED on the expression of sucrose transporter (VvSUTs) and invertase genes (VvINVs) was studied. To analyze the possible role of sucrose during ED development, its effect on bud swelling and sprouting was studied on dormant and nondormant buds under forced growth conditions. The results showed that the SD photoperiod upregulates the expression of the VvSUT genes and downregulates that of the VvINV genes in grapevine buds. Additionally, during the transition of buds from PD to ED, the sucrose content increased, the expression of the VvINV genes decreased, and the expression of the VvSUT genes did not change significantly. Sucrose delayed bud swelling and sprouting when applied to dormant buds but had no effect when applied to nondormant buds. Therefore, we concluded that ED development and sucrose accumulation were synchronized events induced by the SD photoperiod and that a sucrose peak marks the end of ED development in grapevine buds.

Effectiveness of Mindfulness and Positive Strengthening mHealth Interventions for the Promotion of Subjective Emotional Wellbeing and Management of Self-Efficacy for Chronic Cardiac Diseases.

Intervention in health prevention and treatment via mobile phones is becoming a key element on health promotion. Testing the efficacy of these mobile health (mHealth) psychological interventions for cardiovascular health is necessary as it is a chronic pathology, and it can influence the affective and cognitive states of patients. This research aimed to analyze the effectiveness of two brief psychological interventions-mindfulness and positive strengthening-to promote subjective emotional wellbeing and disease management self-efficacy using mHealth. This was a three-arm intervention and feasibility study, with a pre-post design and three follow-up measures with 105 patients (93 completed all phases) with cardiovascular diseases. Group 1 and 2 received the mindfulness or strengthening intervention, and Group 3 was the control group. The positive-negative affect and management self-efficacy for chronic and cardiovascular diseases were analyzed over time, while anxiety and depression levels were assessed at the beginning of the study. The results showed that mindfulness and positive strengthening interventions both had a positive effect on participants' affective state and management self-efficacy for the disease in comparison with the control group over time, even after controlling for baseline anxiety and depression levels. Positive strengthening seems to be more effective for improving cardiac self-efficacy, while mindfulness practice was significantly more effective at reducing negative affect at the first face-to-face evaluation.

A Brief mHealth-Based Psychological Intervention in Emotion Regulation to Promote Positive Subjective Well-Being in Cardiovascular Disease Patients: A Non-Randomized Controlled Trial.

The emotional impact that a cardiovascular disease may have on a person's life can affect the prognosis and comorbidity of the disease. Therefore, emotion regulation is most important for the management of the disease. The aim of this study was to analyze the effectiveness of a brief mHealth psychological intervention in emotion regulation to promote positive subjective well-being in cardiovascular disease patients. The study sample (N = 69, 63.7 ± 11.5 years) was allocated to either the experimental group (n = 34) or control group (n = 35). The intervention consisted of a psychoeducational session in emotion regulation and an mHealth-based intervention for 2 weeks. Positive subjective well-being as a primary outcome and self-efficacy to manage the disease as a secondary outcome were assessed at five time points evaluated over a period of 6 weeks. The experimental group showed higher improvement in positive subjective well-being and self-efficacy for managing the disease compared to the control group over time. The experimental group also improved after the intervention on all outcome measures. Brief mHealth interventions in emotion regulation might be effective for improving positive subjective well-being and self-efficacy to manage the disease in cardiovascular patients.

Hydrogen Peroxide Increases during Endodormancy and Decreases during Budbreak in Grapevine (Vitis vinifera L.) Buds.

Changes in the level of hydrogen peroxide (H2O2) is a good indicator to monitor fluctuations in cellular metabolism and in the stress responses. In this study, the changes in H2O2 content during bud endodormancy (ED) and budbreak were analysed in grapevine (Vitis vinifera L.). The results showed a gradual increase in the H2O2 content during the development of bud ED, which was mainly due to an increase in the activity of peroxidases (PODs). The maximum H2O2 content reached in the grapevine buds coincided with the maximum depth of bud ED. In contrast, during budbreak, the H2O2 content decreased. As the plant hormones cytokinin (CK) and auxin play an important role in budbreak and growth resumption in grapevine, the effect of exogenous applications of H2O2 on the expression of genes involved in CK and auxin metabolism was analysed. The results showed that H2O2 represses the expression of the CK biosynthesis genes VvIPT3a and VvLOG1 and induces the expression of the CK-inactivating gene VvCKX3, thus reducing potentially the CK content in the grapevine bud. On the other hand, H2O2 induced the expression of the auxin biosynthesis genes VvAMI1 and VvYUC3 and of the auxin transporter gene VvPIN3, thus increasing potentially the auxin content and auxin transport in grapevine buds. In general, the results suggest that H2O2 in grapevine buds is associated with the depth of ED and negatively regulates its budbreak.

Positivity and Self-Efficacy Beliefs Explaining Health-Related Quality of Life in Cardiovascular Patients.

BACKGROUND: Psychological well-being and health-specific self-regulation have been associated with cardiovascular health. This study aimed to examine the longitudinal relationship of positivity and health-specific self-regulatory variables to health-related quality of life in patients with cardiovascular disease. METHODS: A sample of 550 cardiac patients completed a number of instruments (positivity, regulatory emotional self-efficacy, and cardiac self-efficacy scales, and the general health questionnaire SF-12) on two occasions 9 months apart, assessing their level of positivity, health-specific self-efficacy beliefs, and health-related quality of life. RESULTS: Mediational analyses demonstrated that health-specific self-efficacy beliefs mediate the relationship between positivity and health-related quality of life. In terms of self-efficacy in managing negative affect, the despondency-distress factor showed both direct and indirect effects on health, while the anger factor showed only an indirect effect. The results of the structural equation model demonstrated suitable indices of fit. CONCLUSIONS: Positivity may act as a disposition helps patients to use motivational strategies related to health, be more confident in their ability to regulate their emotions, and follow the recommendations of their cardiac medical team, enabling them to perceive a higher quality of life. These findings indicate the need to promote psychosocial interventions that include these variables.

Emotion regulation in patients with cardiovascular disease: development and validation of the stress and anxiety regulation strategies scale (STARTS).

BACKGROUND AND OBJECTIVES: Anxiety and stress influence the onset and prognosis of cardiovascular disease (CVD), but little is known about what CVD patients do when experiencing stress/anxiety. This study aimed to identify the behavioral strategies CVD patients use to regulate these emotions. DESIGN: Instrumental and longitudinal. METHODS: A theoretically-guided scale, the Stress and Anxiety Regulation Strategies (STARTS), was developed considering the target population's characteristics. CVD patients were recruited at three different points (NT1 = 721, NT2 = 566, NT3 = 311). RESULTS: At T1 exploratory factor analysis was conducted (random sample 1). The validity of the most parsimonious three-factor solution was subsequently found via confirmatory factor analysis at T1 (random sample 2), T2, and T3, revealing good and stable model fit. The factors represented strategies differentiated by the type and level of activity required (passive, intellectual, and physical strategies). The scale showed good test-retest reliability and internal consistency. Correlation and regression analyses with positive and negative affect, psychological wellbeing (stress, anxiety, depression), and cardiac self-efficacy provided evidence for the validity of STARTS score. Physical and passive strategies showed opposite patterns. CONCLUSIONS: The scale shows adequate psychometric properties for assessing the strategies used by CVD patients to regulate stress and anxiety.

Positive psychological profiles based on perceived health clustering in patients with cardiovascular disease: a longitudinal study.

OBJECTIVES: Psychological well-being and sociodemographic factors have been associated with cardiovascular health. Positive psychological well-being research is limited in the literature; as such, this study aimed to investigate how patients with cardiovascular disease could be classified according to their perceived mental and physical health, and to identify positive psychological profiles based on this classification and test their stability over time. DESIGN AND SETTING: Longitudinal study with patients from a public hospital located in Córdoba (Spain). PARTICIPANTS: This study comprised 379 cardiovascular patients (87.3% men) tested at three measurement points. OUTCOME MEASURES: Participants reported their sociodemographic variables (age, sex, educational level, employment and socioeconomic status) at phase 1, while their perceived health and variables relating to positive psychological well-being were tested at this and two subsequent time points (average interval time: 9 months). RESULTS: The two-step cluster analysis classified participants into three groups according to their mental and physical health levels, p<0.001: high (n=76), moderate (n=113) and low (n=189) perceived health clusters. Low perceived health was the largest cluster, comprising almost half of patients. Clusters significantly differed according to sex, p=0.002, and socioeconomic level, p=0.004. The profile analysis indicated that participants in the high perceived health cluster showed high positive affect, positivity, life satisfaction, and self-efficacy in emotion regulation, and less negative affect and use of passive strategies over the three measurement points (95% CI, all ps<0.01). Moreover, psychological profile stability for each cluster was generally found over an 18-month period, all ps<0.05. CONCLUSION: Cardiovascular patients may differ in terms of their perceived health and, accordingly, in terms of other relevant variables. Perceived health clusters generated varying and generally stable psychological profiles based on positive psychological well-being variables. Psychological interventions should be adapted to patients' requirements.

The Role of Emotional Regulation and Affective Balance on Health Perception in Cardiovascular Disease Patients According to Sex Differences.

One of the challenges of aging is the increase of people with chronic diseases, such as cardiovascular disease (CVD). Men and women experience the disease differently. Therefore, it has an impact on how CVD is treated and its outcomes. This research analyzed the relationship between psychosocial variables and health promotion among cardiovascular patients, paying special attention to sex differences. A longitudinal study with cardiovascular patients (747 in phase 1 (122 women) and 586 in phase 2 (83 women)) was carried out. Participants were evaluated based on their sociodemographic characteristics, affective balance, regulatory negative affect self-efficacy, stress and anxiety regulation strategies, and perceived global health. Results showed that men presented significantly higher scores in positive affect, affective balance, and self-efficacy to regulate negative emotions, while women presented significantly higher scores in negative affect and the use of passive strategies to cope with stressful situations. Regression analyses showed that all psychological variables studied in phase 1 were significant predictors of health perception in phase 2. According to the results, it is necessary to include strategies to improve cardiovascular health through education and emotional regulation, with a gender focus.

Correction: A longitudinal study on perceived health in cardiovascular patients: The role of conscientiousness, subjective wellbeing and cardiac self-efficacy.

[This corrects the article DOI: 10.1371/journal.pone.0223862.].

Influence of Self-Efficacy and Motivation to Follow a Healthy Diet on Life Satisfaction of Patients with Cardiovascular Disease: A Longitudinal Study.

Today, cardiovascular disease has a great impact on the global population due to its high prevalence. One challenge that cardiovascular patients face to achieve a better prognosis is to follow a healthy diet. This study focused on psychological factors linked to adaptation to a healthy diet in these patients. The main objective was to analyze the interrelationship between motivation to follow a healthy diet and self-efficacy to adhere to the Mediterranean diet with life satisfaction over time. The sample consisted of cardiovascular patients who were assessed at three measurement moments (NT1 = 755; NT2 = 593; NT3 = 323, average interval time: nine months). Correlation analyses showed that self-efficacy, motivation, and life satisfaction followed a pattern of positive relations across the three measurements. A time effect over the study variables was also observed. The results of path analyses showed that self-efficacy positively predicted autonomous motivation, which in turn was associated with patients' life satisfaction. This interrelation was stable over a period of 18 months. Moreover, life satisfaction predicted self-efficacy nine months later. Psychological interventions might be a positive resource for cardiovascular patients, since psychological variables influence their life satisfaction and their subsequent quality of life in their new health condition.

ABA promotes starch synthesis and storage metabolism in dormant grapevine buds.

In grapevine (Vitis vinifera L.) buds, the short day (SD)-photoperiod induces endodormancy and increases the level of ABA and the expression of ABA key biosynthesis genes, which suggests that ABA could be the mediator of the photoperiodic induction of endodormancy. In the present study, it was established that during the development of the endodormancy, the content of ABA and the accumulation of starch increased in parallel in the buds; however, these increases occurred after the buds were already in the state of endodormancy. Despite this finding the exogenous applications of ABA to single-bud cuttings increased the starch content and up-regulated the expression of starch synthesis genes (VvSS1 and VvSS3) and down-regulated the expression of sucrose metabolism genes, invertase (VvINV) and sucrose phosphate synthase (VvSUPS). In addition, the manipulation of the endogenous content of ABA in the grapevine buds by applications of hydrogen cyanamide and uniconazole-P, revealed that the depth of the endodormancy depends on the ABA levels. Taken together, the results indicate that the development of the endodormancy in grapevine buds is associated with the accumulation of starch and a shift in metabolism towards a storage metabolism; as ABA stimulates both processes, it must play an important role in the maintenance and release but not the induction of endodormancy in grapevine buds.

A longitudinal study on perceived health in cardiovascular patients: The role of conscientiousness, subjective wellbeing and cardiac self-efficacy.

Cardiovascular disease (CVD) is the world's most prevalent chronic disease and the leading chronic cause of morbidity. There are several psychosocial factors associated with quality of life during CVD. Our main objectives were to analyze the roles of conscientiousness, subjective wellbeing and self-efficacy beliefs. The sample comprised 514 patients (mean age 63.57 years) who were assessed twice over a nine-month interval. At Time 1, participants answered a questionnaire assessing conscientiousness, perceived subjective wellbeing (positive and negative affect, life satisfaction), cardiac self-efficacy and health-related quality of life (HRQoL). The same variables (except for conscientiousness) were re-assessed at Time 2. Results showed that conscientiousness had a positive relation with subjective wellbeing, cardiac self-efficacy, and HRQoL at Time 1. Moreover, cardiac self-efficacy at Time 1 had a positive longitudinal effect on HRQoL at Time 2, while controlling for autoregressive effects. Mediation analyses indicated that the relationship between conscientiousness and HRQoL was mediated by positive affect and cardiac self-efficacy. These results suggest the usefulness of psychosocial interventions aimed at promoting positive affect and self-efficacy beliefs among CVD patients.

Psychoeducational Interventions in Children and Adolescents with Type-1 Diabetes: A Systematic Review / Las intervenciones psicoeducativas en los menores y adolescentes con diabetes tipo 1: una revisión sistemática

The effectiveness of psychoeducational interventions in children and adolescents with type 1 diabetes is unclear. A systematic review was developed in accordance with PRISMA. Relevant databases (Pubmed, Cochrane, PsycINFO, and PsyARTICLES) were analyzed. Articles of the last decade with type 1 diabetes population between 6 and 18 years participating in psychoeducational interventions were the inclusion criteria. Twenty studies were reviewed, and improvements were found in glycosylated hemoglobin, diabetes knowledge, and psychosocial variables. The results support the positive effect of these interventions. The characteristics that seem to be behind the success of these interventions are the design appropriate to the characteristics of the population, the participation of psychologist and educators, the continuity of the program over time, and the use of digital tools and interaction strategies. Further studies need to be carried out and replicated in different groups of children and adolescents.

Hay dudas acerca de la efectividad de las intervenciones psicoeducativas en menores y adolescentes con diabetes tipo 1, motivo por el cual se realizó una revisión sistemática de acuerdo con el protocolo PRISMA. Se analizaron distintas bases de datos (Pubmed, Cochrane, PsycINFO y PsyARTICLES) con los siguientes criterios de inclusión: artículos de los últimos diez años, con población con diabetes tipo 1 de edades comprendidas entre los 6 y 18 años que hubieran participado en cualquier intervención psicoeducativa. Se revisaron 20 estudios y los resultados mostraron una mejora en la hemoglobina glicosilada, en el conocimiento de la enfermedad y en algunas variables psicosociales tras estas intervenciones. Las características que parecen estar detrás del éxito de estas intervenciones psicoeducativas son el diseño adecuado a las características de la población, la participación de profesionales de la psicología y de la educación, la continuidad del programa en el tiempo y el uso de herramientas digitales y otras estrategias de interacción. Se destaca la necesidad de realizar más estudios y que sean replicados en diferentes grupos de menores y adolescentes.