ResumenObjetivo: Conocer en profundidad el fenómeno del duelo complicado o patológico, y recabar aquellos indicadores de detección y evaluación que nos permitan su pronta identificación en la práctica clínica.Método: Tras una amplia revisión de la literatura científica aparecida en los últimos años, y a la luz de nuestra experiencia profesional, se realizó una recopilación de los indicadores más significativos.Resultados: Presentamos los principales criterios diagnósticos e instrumentos de medida utilizados en la actualidad, que permiten a los profesionales del ámbito de la salud valorar con precisión posibles complicaciones en el proceso de duelo.Conclusiones: Contamos con importantes indicadores e instrumentos de valoración del duelo complicado, siendo cada vez mayor el reconocimiento de este diagnóstico clínico como una entidad propia, por parte de la comunidad científica. Resulta fundamental el desarrollo de la investigación en duelo complicado con miras a optimizar las posibilidades de apoyo emocional.Palabras clave: El final de la vida, duelo complicado, indicadores de detección, factores protectores, factores de riesgo, criterios diagnósticos, instrumentos de medida. Abstract Aim: A thorough study of the complicated or pathological grief phenomenon and a recapitulation of those detection and assessment indicators enabling a speedy identification in the clinical practice.Method: A compilation of the most significant indicators was carried out after a large research on the scientific literature appeared latterly and the results derived from our professional experience.Results: A presentation of the major diagnosis criteria and tools used at present, which allow professionals of the field of health to a more precise valuation of possible complications happening during the grief process.Conclusions: We rely on important indicators and grief assessment tools since the recognition of such clinical diagnosis is gaining in importance, thus becoming a matter of significance within the scientific community. Consequently, a development in the investigation of the complicated grief aimed at optimizing the possibilities of the emotional support should be considered a must.
A chronic illness in childhood has a negative impact on the paediatric patient and on family functioning. Psychological stress in parents influences the level of adjustment to the illness of their children. The Pediatric Inventory for Parents (PIP) was designed to measure stress in parents whose child has a chronic illness or requires prolonged medical monitoring. The main objective of this study is to provide a brief version of the Spanish translation of the PIP, across a sample consisting of 465 main familial caregivers (85.2% female, n = 396) between 27 and 67 years old ( = 44.13; SD = 5.35) of paediatric patients between 9 and 18 years old ( = 12.10, SD = 2.20; 56.8% men, n = 264) diagnosed with diabetes mellitus type I (20.9% of the sample; n = 97), short stature (32.5% of the sample; n = 151), or a chronic respiratory disease (asthma, cystic fibrosis, bronchiolitis obliterans and bronchiectasis) (46.6% of the sample; n = 217). After performing several EFAs (Exploratory Factor Analyses) and CFAs (Confirmatory Factorial Analyses), it was decided that 30 items need to be removed. Reliability and validity results suggest that the new 12-item version possesses appropriate psychometric properties. Cronbach’s alpha value ranging between α = .42 and α = .81 and fit values obtained indicate a good fit: χ2/df (88.393/48) = 1.84 (α < .01); S-B χ2(df) = 88.393 (48); CFI = .95; IFI = .95; RMSEA = .05 (.033 - .074) for the frequency scales and χ2/df (72.002/48) = 1.5 (α < .01); S-Bχ2(df) = 72.002 (48); CFI = .97; IFI = .97; RMSEA = .04 (.011 - .063) for the difficulty scales. The PIP also showed predictive ability in regards to anxiety and depression, a positive relationship between the instrument's own scales and a negative relationship with the caregiver's age. Finally, depending on the paediatric patient's diagnosis, differences in stress levels were found.
Purpose: adolescence is a time of change and it generally entails a greater family vulnerability thus; the aim of this study was to identify the risk factors for poor emotional adjustment to COVID among parents of adolescents. Design and methods: 94 parents of adolescents (11-18 years old, M = 13.90, SD = 1.85) participated at different times during the state of alert in Spain. 91.5% were mothers. Their ages ranged from 35 to 63 years (M = 46.54; SD = 5.09). The variables assessed were anxiety, depression and stress (DASS), moods (MOOD), somatization (SCL) and resilience (CD-RISC). Descriptive analyses, t-tests, ANOVAs, correlations, and hierarchical regressions were performed. All this by means of a cross-sectional and longitudinal study design. Results: at the beginning of the confinement parents showed low levels of emotional distress and moderate levels of positive emotionality and resilience. However, those with a prior psychological problem, who had lost their job, or had lost someone to the pandemic, showed worse emotional adjustment. Resilience was relevant in predicting anxiety-depressive symptoms, and a low level of happiness was relevant in predicting stress. Emotional symptoms improved over time, and resilience remained stable. Conclusions: the emotional impact of COVID over time is influenced by mood, mental health, and resilience. In addition, parents who had a previous health problem, had lost their job or a loved one, had a worse adjustment. Practical implications: it is important to carry out intervention programs that increase resilience, treating parents who require it, since their emotional adjustment has repercussions on the emotional adjustment of family system.
Objective: the objective of the study was to assess the psychometric properties of the Brief Illness Perception Questionnaire in a sample of adolescents with chronic endocrine or pneumological conditions and to analyze the dimensionality and reduce the scale elaborating scales by sex and medical diagnosis. Method: we evaluated 510 patients aged 9-16 years using the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. We carried out tests of reliability, construct and criterion validity and a comparison of means based on the diagnosis and socio-demographic variables. The reliability and validity analyses showed adequate psychometric properties for this scale, with better results obtained for a single dimension after eliminating 3 items. Results: adolescents with type 1 diabetes and girls were found to have an increased threat perception of their illness. Anxiety/depression was positively associated with the perception of illness. Conclusion: this questionnaire is a useful and practical tool for evaluating adjustment to illness in pediatric patients.
Background: Patients at the end of life and their families experience a strong emotional impact. The well-being of these patients and that of their family caregiver are related.Aim: To study the variables related with the emotional well-being of patients with and without cognitive impairment at the end of life and that of their primary family caregivers.Design: Cross- sectional study.Participants: Data was collected from 202 patients at the end of life with different diagnosis (COPD, cancer, and frail elderly) as well as from their respective 202 primary family caregivers.Results: Structural equation models indicated that the emotional state of the patients was best predicted by their functional independence and the burden of their family caregivers. In addition, the emotional state of the primary family caregiver was predicted by their burden and not by the cognitive state or the functional independence of the patient. Nevertheless, the burden of the family caregiver, which is the only variable predicting both the emotional state of the patient and that of the caregiver, was directly related with the functional independence of the patient and indirectly with the patient’s cognitive state.Conclusion: The family caregiver’s burden is an important factor to take into consideration when aiming to reduce the emotional distress of patients at the end of life with different diagnosis -whether or not they present significant cognitive impairment- and that of their family caregivers.
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