It is estimated that more than 300,000 people have died because of COVID-19 globally. The vast majority of documented deaths have occurred within hospitals, leading to psychological impacts on both family members and health care workers. This paper describes the actions (online death notification education, remote crisis intervention, and support for health care professionals) taken at a hospital in Mexico to address the psychological impacts of the notification of a COVID-19 -related death on both the deceased's relatives and the health care personnel involved.

El objetivo de este estudio fue proporcionar una descripción del sistema PICO, ejemplificar el uso del mismo para la formulación de preguntas clínicas relevantes y la búsqueda de artículos en el área de la psicooncología. A lo largo del escrito, se describen los principales elemento del sistema PICO y la forma en la cual se pueden integrar para formular preguntas clínicas relevantes. De igual forma, se ejemplifica por medio de un caso de la práctica psicooncológica diaria, la forma en la cual se desarrollan los pasos en PICO y las bases de datos en las cuales se pueden realizar la búsqueda de información, para solventar las preguntas planteadas. Finalmente, se describen las críticas a la herramienta y las posibles áreas de investigación en un futuro. Palabras clave: Sistema PICO, práctica basada en la evidencia, preguntas clínicamente relevantes.

The purpose of this study was to assess the effect of a tailored cognitive-behavioral therapy (CBT) for depression and anxiety symptoms in Mexican terminal cancer patients. A non-concurrent multiple baseline design across individuals was used. Nine patients participated in the study, and they received four to six therapy sessions. The effect size of the intervention range (NAP and Tau indexes) in the nine patients indicated that the intervention had from weak to moderate impact for anxiety and depression symptoms in this population. Similarly, the overall standardized mean difference was also moderate, with a reduction of 0.54 and 0.76 standard deviations in depression and anxiety symptoms, respectively. This study provides initial evidence supporting the positive effect of CBT for patients with terminal cancer and with mood problems when facing their impending death.

SUMMARYDepression is one of the most common emotional problems in palliative patients. Due to the advanced nature of the disease, several physical symptoms presented by patients overlap with symptoms of depression, making it difficult to evaluate and diagnose the problem. The aim of this paper was to conduct a narrative review of the main instruments used to assess depression when it is present in palliative patients, with a special consideration of the Mexican context. Based on the available data and the scholarly literature, it is more appropriate to conduct an assessment of depression focused on emotional aspects than somatics aspects in palliative patients. Internationally, a number of depression assessments place greater emphasis on anhedonia and emotions, such as hopelessness, than on somatic aspects of depression. In Mexico, a considerable gap remains in the development of instruments to identify depression in the palliative setting. Finally, we describe alternative assessments of depression, which could be evaluated and considered in the future in the palliative care setting.

Introduction:Stress is a variable that may play an important role in the development of obesity and in the quality of life of patients who are candidates for bariatric surgery, since stress is linked to the consumption of hypercaloric foods, sedentariness and higher incidence of psychological disorders. Objective: To describe the most common types of stress coping strategies in patients who are candidates for bariatric surgery and establish their relationship with body mass index and quality of life perception. Method: One-hundred and one patients with severe obesity who were candidates for bariatric surgery were evaluated by means of the Stress Coping Questionnaire and the Quality of Life and Health Inventory. Results: The most commonly used coping type is action and the most common strategy is focus on problem solving. Five coping strategies were significantly associated with quality of life; there was no significant association with body mass index. Conclusion: There is an association between some coping styles and quality of life in individuals who are candidates for bariatric surgery.

ResumenCuidar de un familiar con cáncer avanzado trae consigo una serie de problemas familiares, laborales, económicos, y sociales que impactan negativamente sobre la calidad de vida y la salud física y psicológica de los cuidadores primarios. El objetivo de la presente investigación fue evaluar la eficacia de una intervención basada en la terapia de solución de problemas sobre la adquisición de habilidades de autocuidado, la calidad de vida, y la sintomatología ansiosa y depresiva en cuidadores primarios de pacientes que reciben cuidados paliativos. Se utilizó un diseño de N=1 de medidas repetidas, con evaluación pre y post-test con los inventarios de ansiedad y depresión de Beck, el inventario de calidad de vida WHOQol Bref y un cuestionario de conductas de autocuidado diseñado ex profeso para esta investigación. Se identificaron mejorías clínicamente significativas en las medidas de sintomatología ansiosa y depresiva, un incremento en la calidad de vida y la identificación de la Terapia de Solución de Problemas como una herramienta útil para afrontar las problemáticas derivadas de las actividades de cuidado. La principal limitante para el desarrollo de la intervención fue que el AbstractCaring for a relative with terminal cancer brings a series of problems in the family, work, financial and social arenas. These problems, in turn, cause a negative impact on the Quality of Life (QOL) of the patients' primary caregivers, including their physical and psychological health. The purpose of the present study was to examine the effects of an intervention based on Problem Solving Therapy on QOL, anxious and depressive symptoms and on the acquisition of self-care skills by terminal cancer patients' primary caregivers. A repeated measures N=1 design was used on pre and post intervention measurements on Beck's anxiety and depression inventories, the WHOQOL-Bref and a questionnaire on self-care expressly designed for the study. Results revealed clinically significant improvements on anxious and depressive symptoms and improvement on the participants' QOL. Problem Solving Therapy resulted a viable and effective approach to cope with the problems posed by caring for a terminal patient and improving self-care skills. A possible drawback of the procedures includes a lengthy intervention

Around the world, the COVID-19 pandemic has generated clinical challenges for health personnel in general and hospital personnel in particular. In Mexico, the clinical psychologists who are part of the local hospital systems have adapted professional practices to provide mental health care in COVID-19 frontline hospitals. This text describes the actions and challenges arising from treating patients, families, and health workers in six COVID-19 hospitals in Mexico. It highlights the main problems identified, strategies to address them, and the barriers encountered during this pandemic. Finally, this document may be useful for planning clinical psychological activities within COVID-19 hospitals in places where new waves of contagion appear.

Communicating bad news is one of the most frequent activities in hospitals, for which some recommendations have been adapted to the needs within the coronavirus-2 disease context. This document presents nine steps to deliver bad news (face to face or remotely) adapted to the COVID-19 context from two international protocols (SPIKES and GRIEV_ING). The importance of promoting physical and emotional self-care skills in health personnel is also described, as well as psychological first aid strategies to address the emotional response of the family member who receives the news. Finally, the limitations and advantages of the proposal should be considered.