Factors associated with the desire to undergo post-mastectomy breast reconstruction in a Mexican breast cancer center.

PURPOSE: To assess the proportion of breast cancer patients treated with total mastectomy who are interested in undergoing breast reconstruction, the factors associated with their desire to undergo this procedure, and the motives stated for their decision. METHODS: Women with stage I-III breast cancer, public health insurance, and history of total mastectomy treated at a center in Monterrey, Mexico, were invited to answer a series of questionnaires regarding their clinical and demographic characteristics, information received about breast reconstruction, body image, and relationship satisfaction. RESULTS: A total of 100 patients were interviewed, of which 68% desired to undergo breast reconstruction. Only 35% recalled talking about this procedure with a physician and 85% claimed not to have enough information to make an informed decision. Those who desired breast reconstruction were younger (p < 0.001), more likely to be in a relationship (p = 0.025), and had a higher probability of having talked to a physician about the procedure (p = 0.019). Furthermore, they felt less sexually attractive (p < 0.001), more deformed (p = 0.006), and less feminine (p = 0.005) since the mastectomy. The main motives to undergo this procedure were to have breast symmetry and greater freedom on which clothes to wear, while the main deterrent was the high economical cost. CONCLUSIONS: Insufficient information about the procedure and high economical cost were identified as potential barriers to undergo breast reconstruction. The findings of this study emphasize the pressing need to optimize patient care by providing information in a standardized manner and improving access to breast reconstruction within the Mexican public healthcare system.

Brief version of the coping health inventory for parents (CHIP) among family caregivers of children with chronic diseases.

BACKGROUND: The Coping Health Inventory for Parents (CHIP) has demonstrated good psychometric properties in several language forms and has been used to assess the coping behaviors of families facing disease. However, the CHIP has not been validated in Mexico among families of children with chronic conditions, where it could be useful for research and intervention. The objectives of this instrumental study were to obtain a version of the CHIP for the Spanish language in Mexico, establish the factor structure of the Mexican version of the CHIP, probe its internal consistency reliability, and assess its concurrent construct validity. METHODS: A nonprobability sample of 405 family caregivers of children with chronic diseases responded to a battery of measurement instruments that included the CHIP, the Beck Anxiety Inventory, and the Beck Depression Inventory. The sample was randomly divided into two parts. In one subsample (190 participants), an exploratory factor analysis was performed using a principal component analysis and oblique rotation. In the second subsample (215 participants), a confirmatory factor analysis was performed using maximum likelihood estimation. RESULTS: The scale was reduced to 16 items (CHIP-16) with factorial loads greater than .50. The empirical criteria used to determine the number of factors converged on the following five factors: belief and trust (McDonald ω = .85), spouse/partner relationship (ω = .79), home care (ω = .77), family involvement (ω = .75), and security/stability (ω = .79). The overall internal consistency was good (ω = .88). The five-factor model showed acceptable fit indices and high parsimony. The mean CHIP-16 scores and the Spouse/partner relationship scores among the caregivers with anxiety were greater than those among the caregivers without anxiety. The mean home-care scores among the women were greater than those among men. CONCLUSIONS: The 16-item version of the CHIP showed good internal consistency and construct validity; thus, the CHIP-16 is a useful instrument for measuring and assessing coping in family caregivers of children with chronic diseases.

The measurement scale of resilience among family caregivers of children with cancer: a psychometric evaluation.

BACKGROUND: Resilience to disease is a process of positive adaptation despite the loss of health, it involves the development of vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, cancer is the leading cause of death in children. Both the diagnosis and the treatment of childhood cancer affect the health of family caregivers. However, resilience is a personality trait that can be protective in these situations. Therefore, resilience is an important psychological construct to measure, evaluate and develop in specific populations and contexts. In Mexico, a scale to assess this trait has been developed. This study aimed to test the reliability and factor structure of the Mexican Measurement Scale of Resilience (RESI-M), describe its distribution, evaluate its relationship with sociodemographic variables, and verify its concurrent validity with psychological well-being, depression, anxiety and parental stress and its independence from social desirability. METHODS: A cross-sectional study was conducted involving an intentional nonprobability sample of 330 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. The participants responded to a sociodemographic variables questionnaire, the Mexican Measurement Scale of Resilience RESI-M, and five other assessment scales. RESULTS: Overall internal consistency was very high (ordinal alpha = .976). The confirmatory factor analysis demonstrated that the five-factor model had a close fit to the data: NFI = .970, CFI = .997, SRMR = .055, and RMSEA = .019. The distributions of the RESI-M total score followed a normal distribution. The RESI-M total score correlated positively with psychological well-being and negatively with depression, parental stress and anxiety. The overall RESI-M total score also correlated positively with age, but there was no difference in means between women and men. Resilience was independent of social desirability. CONCLUSIONS: The RESI-M shows reliability and construct validity in family caregivers of children with cancer and does not show a bias in relation to social desirability.

Validity and reliability of the Mexican resilience measurement scale in families of children with chronic conditions.

BACKGROUND: The resilience to face disease is a process of positive adaptation despite the loss of health. It involves developing vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, the Mexican Resilience Measurement Scale (RESI-M) has been validated with a general population and has a five-factor structure. However, this scale does not allow evaluation of resilience in specific subpopulations, such as caregivers. METHOD: This study investigated the psychometric properties of RESI-M in 446 family caregivers of children with chronic diseases. A confirmatory factor analysis (CFA) was performed, internal consistency values were calculated using Cronbach's alpha coefficient, and mean comparisons were determined using t-tests. RESULTS: The expected five-factor model showed an adequate fit with the data based on a maximum likelihood test. The internal consistency for each factor ranged from .76 to .93, and the global internal consistency was .95. No average difference in RESI-M and its factors was found between women and men. CONCLUSION: The RESI-M showed internal consistency and its model of five correlated factors was valid among family caregivers of children with chronic diseases.

[Maternal Predictors of Body Mass Index of Pre-school and School Age Children]. / Predictores maternos del índice de masa corporal del hijo pre-escolar y escolar.

The objective was to identify maternal variables that could be used as predictors of the child's body mass index (BMI). We considered the following variables: (a) socio-demographic (age, education, occupation, marital status and family income); (b) anthropometric (BMI); and (c) upbringing strategies (monitoring and limits for eating habits, monitoring and sedentary behavior limits, discipline and control in feeding. A predictive correlational study was carried out with 537 dyads (mother-child). Children enrolled in 4 public schools (2 for pre-school children and 2 for primary school children) were selected for probabilistic, random sampling. The mothers answered the Feeding and Activity Upbringing Strategies Scale, giving socio-demographic information and the dyads' weight and height was measured. The data were analyzed for correlations and path analysis. It was found that the average age of mothers was 34.25 years (SD=6.91), with 12.40 years of education (SD=3.36), 53.3% mentioned that they were housewives and 46.7% had a paid job outside of the home; 38.5% showed pre-OB and 27.3% some degree of OB. The child's average age was 7.26 years (SD=2.46), and 3.2% showed low weight, 59.6% normal weight and 37.2% OW-0B. It was found that working outside the home, having a higher maternal BMI, less control and more discipline in feeding are variables that predict higher BMI in the child. We recommend the design of interventions to reduce and treat the child's OW-OB taking into account the predictors that were found.

Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory.

Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.

Risk and protective factors of dissocial behavior in a probability sample.

The aims of this study were to know risk and protective factors for dissocial behavior keeping in mind that the self-report of dissocial behavior is biased by the impression management. A probability sample of adolescents that lived in two neighborhoods with high indexes of gangs and offenses (112 male and 86 women) was collected. The 27-item Dissocial Behavior Scale (ECODI27; Pacheco & Moral, 2010), Balanced Inventory of Desirable Responding, version 6 (BIDR-6; Paulhus, 1991), Sensation Seeking Scale, form V (SSS-V; Zuckerman, Eysenck, & Eysenck, 1978), Parent-Adolescent Communication Scale (PACS; Barnes & Olson, 1982), 30-item Rathus Assertiveness Schedule (RAS; Rathus, 1973), Interpersonal Reactivity Index (IRI; Davis, 1983) and a social relationship questionnaire (SRQ) were applied. Binary logistic regression was used for the data analysis. A third of the participants showed dissocial behavior. Belonging to a gang in the school (schooled adolescents) or to a gang out of school and job (total sample) and desinhibition were risk factors; being woman, perspective taking and open communication with the father were protective factors. School-leaving was a differential aspect. We insisted on the need of intervention on these variables.

Resilience measurement scale in family caregivers of children with cancer: Multidimensional item response theory modeling.

Background: Currently, information about the psychometric properties of the Resilience Measurement Scale (RESI-M) in family caregivers of children with cancer according to item response theory (IRT) is not available; this information could complement and confirm the findings available from classical test theory (CTT). The objective of this study was to test the five-factor structure of the RESI-M using a full information confirmatory multidimensional IRT graded response model and to estimate the multidimensional item-level parameters of discrimination (MDISC) and difficulty (MDIFF) from the RESI-M scale to investigate its construct validity and level of measurement error. Methods: An observational study was carried out, which included a sample of 633 primary caregivers of children with cancer, who were recruited through nonprobabilistic sampling. The caregivers responded to a battery of tests that included a sociodemographic variables questionnaire, the RESI-M, and measures of depression, quality of life, anxiety, and caregiver burden to explore convergent and divergent validity. Results: The main findings confirmed a five-factor structure of the RESI-M scale, with RMSEA = 0.078 (95% CI: 0.075, 0.080), TLI = 0.90, and CFI = 0.91. The estimation of the MDISC and MDIFF parameters indicated different values for each item, showing that all the items contribute differentially to the measurement of the dimensions of resilience. Conclusion: That regardless of the measurement approach (IRT or CTT), the five-factor model of the RESI-M is valid at the theoretical, empirical, and methodological levels.

Medical outcomes study social support survey (MOS-SSS) in patients with chronic disease: A psychometric assessment.

Purpose: Currently, information on the psychometric properties of the Medical outcomes study-social support survey (MOS-SSS) for patients with chronic disease in primary health care, suggests problems in the dimensionality, specifically predominant unidimensionality in a multidimensional measure. The aim of this study was to determine the internal structure (dimensionality, measurement invariance and reliability) and association with other variables. Methods: A total of 470 patients with chronic disease from a Family Medicine Unit at the Instituto Mexicano del Seguro Social, IMSS, with a mean age of 51.51 years were included. Participants responded to the Questionnaire of Sociodemographic Variables (Q-SV), SF-36 Health-Related Quality of Life Scale-version 1.1, and MOS-SSS. Results: Non-parametric (Mokken scaling analysis) and parametric (confirmatory factor analysis) analyses indicated unidimensionality, and three-factor model was not representative. A new 8-item version (MOS-S) was developed, where measurement invariance, equivalence with the long version, reliability, and relationship with the SF-36 were satisfactory. Conclusion: The MOS-SSS scale is unidimensional, and the shortened version yields valid and reliable scores for measuring social support in patients with chronic disease at the primary health care.

Psychosocial Factors Predicting Resilience in Family Caregivers of Children with Cancer: A Cross-Sectional Study.

Chronic diseases in childhood can affect the physical and mental health of patients and their families. The objective of this study was to identify the sociodemographic and psychosocial factors that predict resilience in family caregivers of children with cancer and to define whether there are differences in the levels of resilience derived from these sociodemographic variables. Three hundred and thirty family caregivers of children with cancer, with an average age of 32.6 years were interviewed. The caregivers responded to a battery of tests that included a questionnaire of sociodemographic variables, the Measuring Scale of Resilience, the Beck Depression Inventory, the Inventory of Quality of Life, the Beck Anxiety Inventory, an interview of caregiver burden and the World Health Organization Well-Being Index. The main findings indicate that family caregivers of children with cancer reported high levels of resilience, which were associated positively with quality of life, psychological well-being and years of study and associated negatively with depression, anxiety and caregiver burden. The variables that predicted resilience in families of children with cancer were quality of life, psychological well-being, depression and number of children. Family caregivers who were married and Catholic showed higher resilience scores. We conclude that being a caregiver in a family with children with cancer is associated with symptoms of anxiety and with depressive episodes. These issues can be overcome through family strength, well-being, quality of life and positive adaptation processes and mobilization of family resources.

Factor structure of the STAXI-2-AX and its relationship to burnout in housewives.

This study was conducted in order to determine factor structure and reliability of STAXI-2-AX/EX (Spielberger, 1999) and to calculate the correlation between STAXI-2-AX/EX and the Housewives Burnout Questionnaire (CUBAC). The study sample included 226 housewives. Dimensional structure was estimated using exploratory and confirmatory factor analysis. Factor analysis results of STAXI-2-AX/EX showed that a four related factors model had an adequate goodness of fit, eliminating three items. Regarding the CUBAC, a two related factors structure presented the best goodness of fit, which improve if five items were eliminated. Finally, as we expected, the correlation between the two scales was positive (r = .38). We suggest that this study should be replicated in other countries.

Predictive Model of Clinical Attachment Loss and Oral Health-Related Quality of Life through Depressive Symptomatology, Oral Hygiene Habits, and Proinflammatory Biomarkers: A Pilot Study.

Subjective aspects such as oral health-related quality of life (OHRQoL) and depression are important aspects in the periodontal care. The objectives of the study were to test a predictive model of clinical attachment loss and OHRQoL in a pooled sample of dental patients with periodontitis and mental health patients with depressive symptomatology, and test the invariance of the model across both types of patients. Three self-report scales were applied to assess depression, OHRQoL and oral hygiene habits, saliva samples were collected for three proinflammatory biomarkers, and the clinical attachment loss was measured in 35 patients with periodontitis and 26 patients with depressive symptomatology. Data were analyzed through structural equation modeling. The one-group analysis revealed a psychosomatic complaint model of disagreement between the complaint and the clinically observable. In the multi-group analysis, the model was not invariant. It was necessary to introduce a singularity in relation to depressive symptomatology for each population. Thus, a good and equivalent fit was achieved between the six nested models in constraints, as well as equivalent parameters between both types of patients. The study of a dental population in conjunction with a mental health population with a psychosomatic risk factor reveals interesting and unexpected results.

The Social Support Networks Scale (SSNS) for Family Caregivers of Children with Cancer: A Psychometric Evaluation.

Currently, information about the psychometric properties of the Social Support Networks Scale (SSNS) for family caregivers of children with cancer is not yet available; therefore, there is no empirical evidence of its validity and reliability to support its use in this population. The aim of this study is to determine a factorial model of the SSNS, estimate its internal consistency reliability, describe its distribution, and check its concurrent validity. A convenience sample of 633 family caregivers of children with cancer hospitalized in a National Institute of Health in Mexico City was collected. The SSNS, a sociodemographic variables questionnaire, and three instruments that evaluated family functioning, quality of life, and resilience were applied. The five-factor model had a poor data fit and lacked discriminant validity. The sample was divided. In a subsample of 316 participants, exploratory factor analysis suggested a four-factor model. When testing the four-factor model through confirmatory factor analysis, religious support was independent of family support, friend support, and lack of support. In the other subsample of 317 participants, the one-factor model for religious support had a good fit, and the correlated three-factor model, with the remaining factors, showed an acceptable fit. Reliability ranged from acceptable (Guttman's λ2 = 0.72) to good (λ2 = 0.88). Socio-family support and its three factors were correlated with family functioning, resilience, and quality of life. Religious support was correlated with four factors of resilience and quality of life. A scale of socio-family support with three factors and an independent scale for religious support are defined from the SSNS, and they showed internal consistency and construct validity.

Predictors of Quality of Life among Parents of Children with Chronic Diseases: A Cross-Sectional Study.

Quality of life (QOL) is a key aspect of the health care process for children with chronic diseases and their families. Although clinical evidence regarding the impact of chronic disease on children exists, few studies have evaluated the effects of the interaction between sociodemographic and psychosocial factors on the family caregiver's QOL, indicating a significant gap in the research literature. The present study aimed to identify the predictors of the QOL of parents of children with chronic diseases. Three parental sociodemographic predictors (age, schooling, and family income) and four psychosocial predictors (family functioning, social support, depression, and resilience) were examined. In this cross-sectional study, 416 parents of children with chronic diseases who were hospitalized at a National Institute of Health in Mexico City were interviewed. The participants completed a sociodemographic variables questionnaire (Q-SV) designed for research on family caregivers of children with chronic disease. The predicted variable was assessed through the World Health Organization Quality of Life Questionnaire. The four psychosocial predictors were assessed through the Family Functioning Scale, Social Support Networks Scale, Beck Depression Inventory, and Measurement Scale of Resilience. The regression model explained 42% of the variance in parents' QOL. The predictors with positive weights included age, schooling, monthly family income, family functioning, social support networks, and parental resilience. The predictors with negative weights included depression. These findings suggest that strong social relationships, a positive family environment, family cohesion, personal resilience, low levels of depression, and a family income twice the minimum wage are variables associated with better parental QOL.

Validity and Reliability of the Beck Anxiety Inventory (BAI) for Family Caregivers of Children with Cancer.

Currently, information about the psychometric properties of the Beck Anxiety Inventory (BAI) in family caregivers of children with cancer is not available; thus, there is no empirical evidence of its validity and reliability to support its use in this population in Mexico or in other countries. This study examined the psychometric properties of the BAI in family caregivers of children with cancer and pursued four objectives: to determine the factor structure of the BAI, estimate its internal consistency reliability, describe the distribution of BAI scores and the level of anxiety in the sample and test its concurrent validity in relation to depression and resilience. This cross-sectional study was carried out with convenience sampling. A sociodemographic questionnaire, the BAI, the Beck Depression Inventory and the Measurement Scale of Resilience were administered to an incidental sample of 445 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. Confirmatory factor analysis using the maximum likelihood method was performed to determine the factor structure and exploratory factor analysis using axis factorization with oblique rotation was conducted. The two-, three- and four-factor models originally proposed for the BAI did not hold. The exploratory factor analysis showed a model of two correlated factors (physiological and emotional symptoms). Confirmatory factor analysis revealed a lack of discriminant validity between these two factors and supported a single-factor model. The internal consistency of the scale reduced to 11 items (BAI-11) was good (alpha = 0.89). The distribution of BAI-11 scores was skewed to the left. High levels of symptoms of anxiety were present in 49.4% of caregivers. The scale was positively correlated with depression and negatively correlated with resilience. These findings suggest that a reduced single-factor version of the BAI is valid for Mexican family caregivers of children with cancer.

A Sociodemographic variables questionnaire (Q-SV) for research on family caregivers of children with chronic disease.

BACKGROUND: Chronic diseases in childhood can affect the physical and mental health of patients and their families. The literature on pediatric chronic diseases has found important associations between the sociodemographic variables of children and their caregivers and negative health consequences in families. METHODS: In this study, we aimed to design and validate a questionnaire on sociodemographic variables that would be useful for research on pediatric chronic diseases; and investigate the relationship between sociodemographic variables and psychosocial variables among family caregivers. First, we created a questionnaire that consists of 20 demographic, medical, and family-related items based on a literature review and expert evaluations. This questionnaire was then validated by 335 expert reviewers in the field of Social Work, who work daily with the families of patients with chronic diseases in 10 National Institutes of Health of Mexico. The validation was based on three empirical criteria created specifically for this study, and the reviewers evaluated the usefulness, relevance, and permanence of the items. In a second cross-sectional, correlational and comparative study, a total of 446 family caregivers of children with chronic diseases were interviewed, and they completed the Sociodemographic Variables Questionnaire for research on family caregivers of children with chronic sociodemographic diseases and four psychosocial measurement instruments for evaluating anxiety, depression, caregiver burden and quality of life. RESULTS: Based on the results of the first study, we created the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic diseases, and it includes 17 items that assess demographic, medical, and family characteristics. The results of the second study showed that the 17 sociodemographic variables obtained in the validation by expert judges are useful for measuring and evaluating the relationship between psychosocial variables in families of children with chronic diseases. CONCLUSIONS: Psychosocial and sociodemographic factors are relevant for the development of research processes for families that care for children with chronic diseases.

Factors associated with anxiety in family caregivers of children with chronic diseases.

BACKGROUND: Currently, information on factors associated with anxiety in family caregivers of children with chronic diseases is unavailable, indicating a significant gap in the literature. Therefore, this study aims to identify the psychosocial and sociodemographic variables associated with anxiety in family caregivers of children with chronic diseases. METHODS: In 2018, a nonprobability sample of 446 family caregivers was recruited at the National Institute of Health in Mexico City. The participants completed a sociodemographic variable questionnaire, clinical questions, and 18 psychosocial assessment scales, including a scale to assess family caregiver anxiety. RESULTS: Family caregiver anxiety was correlated with almost all psychosocial variables and one out of three clinical variables but with none of the sociodemographic variables. Furthermore, a multiple linear regression model with five psychosocial variables was established to predict family caregiver anxiety. CONCLUSIONS: Some psychosocial variables have effects on caregiver anxiety that are relevant for interventions. Clinical interventions should be implemented based on the psychosocial variables associated with family caregiver anxiety.

El orden de nacimiento como factor de riesgo para ser víctima de trata sexual en el triángulo norte de Centroamérica / Birth order as a risk factor for being victim of sex trafficking in the northern triangle of Central America

RESUMEN Las redes de tráfico humano para la prostitución captan a menores vulnerables, en especial, a quienes consideran no les queda otra opción que emigrar al norte para hacer frente a problemas económicos graves. El objetivo del presente trabajo fue establecer si el orden de nacimiento representó un factor de riesgo, asociado a la vulnerabilidad para la trata sexual de menores centroamericanas, traficadas a Estados Unidos. Las entrevistadas mostraban vulnerabilidades vinculadas con estructuras sociales y conductas individuales. Por una parte, todas crecieron en hogares caracterizados por la pobreza extrema. Por otra parte, también presentaban vulnerabilidades relacionadas con el embarazo adolescente, la falta de educación, la disfuncionalidad familiar y la participación en mercados ilegales. Ocupar el primer lugar en orden de nacimiento eleva la vulnerabilidad de las menores a ser traficadas a Estados Unidos para el comercio sexual. Por el contrario, ocupar el último lugar disminuye este riesgo.

ABSTRACT Human trafficking networks for prostitution recruit vulnerable underage girls, especially those who are considered with no choice but to migrate north to cope with serious economic problems. The aim of this work was to determine if birth order represented a risk factor associated to the vulnerability for sex trafficking of Central American female minors. The interviewees presented vulnerabilities associated to social structures and individual behaviors. On the one hand, all of them grew up in house holds characterized by extreme poverty. On the other hand, they also had vulnerabilities related to teenage pregnancy, lack of education, family dysfunction and participation in illegal markets. Findings suggest that occupying the first place in the order of birth raises the vulnerability of minors to being trafficked to the United States for sex trade. On the contrary, occupying the last place decreases this risk.

Psychological, interpersonal, and clinical factors predicting time spent on physical activity among Mexican patients with hypertension.

BACKGROUND: It is widely known that physical activity is the key to the optimal management and clinical control of hypertension. PURPOSE: This research was conducted to identify factors that can predict the time spent on physical activity among Mexican adults with hypertension. METHODS: This cross-sectional study was conducted among 182 Mexican patients with hypertension, who completed a set of self-administered questionnaires related to personality, social support, and medical adherence and health care behaviors, body mass index, and time since the disease diagnosis. Several path analyses were performed in order to test the predictors of the study behavior. RESULTS: Lower tolerance to frustration, more tolerance to ambiguity, more effective social support, and less time since the disease diagnosis predicted more time spent on physical activity, accounting for 13.3% of the total variance. The final model shows a good fit to the sample data (pBS =0.235, χ2/gl =1.519, Jöreskog and Sörbom's Goodness of Fit Index =0.987, adjusted modality =0.962, Bollen's Incremental Fit Index =0.981, Bentler-Bonett Normed Fit Index =0.946, standardized root mean square residual =0.053). CONCLUSION: The performance of physical activity in patients with hypertension depends on a complex set of interactions between personal, interpersonal, and clinical variables. Understanding how these factors interact might enhance the design of interdisciplinary intervention programs so that quality of life of patients with hypertension improves and they might be able to manage and control their disease well.

["Consumption of restricted foods" in Mexican hypertensive patients]. / "Consumo de alimentos restringidos" en pacientes mejicanos hipertensos.

BACKGROUND: Strict adherence to personal health recommendations is necessary to improve the clinical control of arterial hypertension. OBJECTIVE: To identify predictors of the behavior to avoid the "consumption of restricted foods" in a sample of hypertensive patients from Tamaulipas, Mexico. METHOD: Participants were 183 patients with arterial hypertension diagnosis, who completed two self-administered questionnaires and different questions regarding adherence and self-care behaviors. A trajectory analysis was used for the interpretation of data. RESULTS: Less tolerance to frustration, a major affective social support and a lower body mass index were behavior predictors to avoid the consumption of restricted foods (pBS= 0.294, χ2/gl= 1.417, GFI = 0.993, AGFI = 0.965, NFI = 0.934, IFI = 0.980 y SRMR = 0.040), explaining approximately 20% of the variance in the study behavior. CONCLUSION: The study of adherence and self-care behaviors demands to identify what and how some personal and interpersonal variables are influencing in their daily practice, which can contribute to improve the interdisciplinary interventions programs in clinical and communitarian settings for attending patients living with arterial hypertension.