Physical activity and sedentary behavior as predictors of fear of falling and risk of sarcopenia in older adults / Atividade física e comportamento sedentário como preditores do medo de cair e do risco de sarcopenia em idosos

Abstract Introduction Low-level physical activity and sedentary behavior are factors that can impact the fear of falling and risk of falls in older adults. Objective This study aimed to determine whether the duration and frequency of physical activity and sedentary behavior predict the fear of falling and risk of sarcopenia in older people. Methods This was a cross-sectional study with 116 older individuals from southern and southeastern Brazil. A sociodemographic and health questionnaire, the International Physical Activity Questionnaire (IPAQ - short version), the Falls Efficacy Scale - International (FES-I), and the SARC-f were used. Data were analyzed by bootstrapping procedures, Pearson's correlation, and regression analysis (p < 0.05). Results Walking days (β = -0.38; p < 0.001) and moderate activity days (β = -0.23; p < 0.001) showed a negative prediction of fear of falling. Walking days also had a significant and negative prediction of the risk of sarcopenia (β = -0.34; p < 0.001). Conclusion We conclude that weekly walking and the practice of moderate-intensity physical activity negatively predict the fear of falling in older adults. Weekly walking also negatively predicts the risk of having sarcopenia. Sedentary behavior was not a predictor of fear of falling and risk of sarcopenia.

Resumo Introdução A prática de atividade física e o compor-tamento sedentário são fatores que podem impactar o medo de cair e o risco de quedas em idosos. Objetivo Verificar se a duração e a frequência de atividade física e o comportamento sedentário predizem o medo de cair e o risco de sarcopenia de idosos. Métodos Trata-se de uma pesquisa transversal realizada com 116 idosos da região sul e sudeste do Brasil. Utilizou-se um questionário sociodemográfico e de saúde, o Questionário Internacional de Atividade Física (IPAQ - versão curta), a Falls Efficacy Scale - International (FES-I) e o SARC-f. Os dados foram analisados por procedimentos de bootstrapping, correlação de Pearson e análise de regressão (p<0,05). Resultados Os dias de caminhada (β= ‐0,38; p<0,001) e de atividades moderadas (β=‐0,23; p<0,001) apresentaram predição negativa sobre o medo de cair. Os dias de caminhada também apresentaram predição significativa e negativa sobre o risco de sarcopenia (β= ‐0,34; p<0,001). Conclusão A frequência semanal de caminhada e de prática de atividade física de intensidade moderada predizem negativamente o medo de cair dos idosos pesquisados. A frequência semanal de caminhada também prediz negativamente o risco de o idoso ter sarcopenia. O comportamento sedentário não se mostrou como um preditor do medo de cair e do risco de sarcopenia nos idosos.

Dificuldades no engajamento às medidas contra a COVID-19: o papel dos medos da compaixão / Difficulties to engage with measures against COVID-19: the role of fears of compassion / Dificultades para comprometerse con las medidas contra COVID-19: el papel de los miedos a la compasión

Como motivação pró-social, a compaixão tende a promover maior envolvimento em mentalidades de cuidado e ações de senso coletivo, capacidades prejudicadas pelos medos da compaixão. O estudo objetivou investigar o papel dos medos da compaixão em fatores envolvidos no engajamento às medidas de distanciamento social. Duzentos e oitenta e quatro adultos (idade média = 36,47) responderam as escalas de medos da compaixão, escala de dificuldades de regulação emocional e um questionário sobre engajamento aos protocolos contra a COVID-19. Um modelo de path analysis explicou 32% da variância na adesão aos protocolos por duas vias: o medo de ser compassivo por outros diminui o engajamento por motivações pró-sociais; enquanto os medos de expressar compaixão por si e outros predizem maiores dificuldades de regulação emocional, diminuindo a aderência por exaustão emocional. Oportunizar o desenvolvimento da compaixão pode contribuir para um enfrentamento mais saudável às dificuldades emocionais suscitadas pela pandemia e no envolvimento em ações coletivas

As a prosocial motivation, compassion enables to engage in care and collaborative behaviors, what can be impaired in people facing fears of compassion. This study proposed to investigate factors involved in the difficulties to engage in distancing measures, evaluating the role of the fears of compassion. 284 adults (mean age = 36,47) answered fears of compassion scales, difficulties in emotion regulation scale and a questionnaire about the engagement to social distancing measures. A path analysis model explained 32% of the variance on the recommended measures in two ways: fear of expressing compassion to others reduces the compliance with the recommendations decreasing prosocial motivations to follow the measures; fears of expressing compassion to self and others predicted stronger difficulties on emotional regulation, reducing the adherence to protocols because of emotional exhaustion. Providing the development of compassion can help to promote healthier emotional strategies to deal with the pandemic and to promote a more collaborative society to engage in social actions

Como una motivación prosocial, la compasión tiende a promover una mayor participación en las mentalidades de cuidado y sentido colectivo, capacidades que pueden estar afectadas por el miedo a la compasión. Este estudio tuvo como objetivo investigar el papel de los miedos a la compasión en el compromiso en seguir medidas de distanciamiento social en contra COVID-19. 284 adultos (edad media = 36,47) respondieron escalas de miedo a la compasión, escala de dificultades de regulación emocional y un cuestionario sobre compromiso con protocolos contra COVID-19. Un modelo de path analysis explicó 32% de la variación en la adhesión a los protocolos de dos maneras: el miedo a ser compasivo con los demás disminuye el compromiso debido a motivaciones prosociales; mientras que los miedos a expresar compasión por uno mismo y por los demás predicen mayores dificultades en la regulación emocional, disminuyendo la adherencia por agotamiento emocional. Ofrecer el desarrollo de la compasión puede contribuir a afrontar de manera más saludable las dificultades emocionales planteadas por la pandemia y en la participación en acciones colectivas

A COVID-19 Allegory: Is that what you are really worried about?

@#This allegorical poem describes the fears and uncertainties faced by the author in the COVID-19 circuit breaker period, from compliance to health advisories as understanding of the contagion evolved, from conflict of responsibilities to family, patients and teaching, and from managing the CME points requirements of the resilience webinars. Four bonsai compositions of legendary Chinese figurines are used as metaphors for the themes of the webinars.

Future time perspective in female prison inmates convicted for the crime of terrorism in Lima, Peru / Perspectiva temporal futura en mujeres sentenciadas por el delito de terrorismo en un establecimiento penitenciario de lima (perú)

RESUMEN La perspectiva temporal futura plantea un espectro de motivaciones ubicadas cognitivamente en el futuro. Este estudio la describe veinticuatro mujeres sentenciadas por el delito de terrorismo en un establecimiento penitenciario de Lima. Para ello, se utilizó el método de inducción motivacional que usando frecuencias porcentuales categoriza y jerarquiza las metas de las participantes. La conclusión principal es que la distribución general y la extensión de las metas muestran proporciones similares con la población no penitenciaria estudiada en nuestro medio. Esto contradice la opinión pública, cuya imagen de las participantes es que su único interés corresponde a los fines del partido en el cual han militado.

ABSTRACT Future Time Perspective (PTF) formulates a spectrum of goals, cognitively located in the future. This study describes the PTF of 24 female prison inmates convicted for the crime of terrorism in Lima. To do so, we used the Motivational Induction Method, which categorizes and hierarchizes the goals of the participants using percentage frequencies. Our main conclusion is that proportions regarding the general distribution and the extension of the goals are similar to the non-prisoned society groups studied by Martínez (2004c). This is opposite to the public's opinion of the participants, according to which their only interest corresponds with the goals of the party they have been ascribed to.

Specific and social fears in children and adolescents: separating normative fears from problem indicators and phobias

Objective: To distinguish normative fears from problematic fears and phobias. Methods: We investigated 2,512 children and adolescents from a large community school-based study, the High Risk Study for Psychiatric Disorders. Parent reports of 18 fears and psychiatric diagnosis were investigated. We used two analytical approaches: confirmatory factor analysis (CFA)/item response theory (IRT) and nonparametric receiver operating characteristic (ROC) curve. Results: According to IRT and ROC analyses, social fears are more likely to indicate problems and phobias than specific fears. Most specific fears were normative when mild; all specific fears indicate problems when pervasive. In addition, the situational fear of toilets and people who look unusual were highly indicative of specific phobia. Among social fears, those not restricted to performance and fear of writing in front of others indicate problems when mild. All social fears indicate problems and are highly indicative of social phobia when pervasive. Conclusion: These preliminary findings provide guidance for clinicians and researchers to determine the boundaries that separate normative fears from problem indicators in children and adolescents, and indicate a differential severity threshold for specific and social fears.

A influência da escuta terapêutica sobre a ansiedade e os medos relacionados à cirurgia em pacientes no pré-operatório de cirurgia colorretal: um ensaio clínico aleatorizado / The influence of therapeutic listening on anxiety and fears related to surgery in patients in the preoperative to colorectal surgery: randomized clinical trial

O objetivo do estudo foi avaliar o efeito da escuta terapêutica na ansiedade pré-operatória e nos medos relacionados à cirurgia em pacientes hospitalizados para tratamento cirúrgico de câncer colorretal. Tratou-se de um ensaio clínico aleatorizado realizado em um hospital geral. Os participantes foram aleatorizados em dois grupos: experimental (GE) (n=25) e controle (GC) (n=25). No GE era realizada a escuta terapêutica, de modo que os pacientes tinham 30 minutos para falar com a pesquisadora sobre sua experiência com a hospitalização para o tratamento da doença. No GC os pacientes eram informados que teriam alguns dados coletados, em seguida a pesquisadora se ausentaria por 30 minutos e que, após este intervalo, a mesma retornaria para a conclusão da pesquisa. As variáveis dependentes (alfa-amilase, cortisol, frequência de pulso, frequência respiratória, pressão arterial, ansiedade estado e medos relacionados à cirurgia) foram coletadas antes e após a realização da intervenção no GE e antes e após o intervalo supracitado no GC. Na comparação das variáveis dependentes no GE em relação ao GC no momento pós-intervenção, não foram identificadas diferenças significativas para nenhuma das variáveis estudadas. Na comparação das variáveis no GE e GC nos momentos pré e pós-intervenção, constatou-se diferenças significativas apenas entre os momentos no GC para as variáveis cortisol (Z=-2,023; p=0,043), frequência de pulso (FP) (Z=-2,121; p=0,034) e medos relacionados à cirurgia (Z=-2,171; p=0,030), com redução dos valores destas variáveis. Na relação entre as variáveis estudadas obteve-se significância entre a ansiedade estado e as variáveis cortisol, idade, escolaridade e religião; os medos relacionados à cirurgia foram relacionados ao sexo, tempo de confirmação do diagnóstico de câncer colorretal, nível de escolaridade, cortisol, estado civil e à pressão arterial diastólica. Apenas a variável renda familiar mensal apresentou diferença significativa em suas distribuições no GE e no GC, no entanto, esta não teve influência sobre as variáveis dependentes. A maioria dos pacientes referiu satisfação quanto ao desenvolvimento da intervenção. Conclui-se que, no momento pré-operatório, nas condições investigadas neste estudo, os dados evidenciaram que a mensuração das variáveis imediatamente após a intervenção de escuta terapêutica de 30 minutos não evidenciou a redução esperada dos valores das variáveis estudadas; estudos com medidas dessas variáveis após um tempo para o paciente processar os efeitos da intervenção poderão confirmar se a mensuração imediata ou uma hora após a intervenção, por exemplo, conduziria a resultados distintos. Contudo, houve redução dos valores de cortisol, frequência de pulso e medos relacionados à cirurgia nos participantes do GC, o que pode ser atribuído ao contato da pesquisadora com tais participantes durante os momentos de coleta de dados

he aim of the study was to evaluate the effect of therapeutic listening on preoperative anxiety and fears related to surgery in patients hospitalized for surgical treatment of colorectal cancer. This is a randomized clinical trial conducted in a general hospital. Participants were randomized in two groups: experimental (n=25) and control (n=25). In the experimental group was performed therapeutic listening. The patients had thirty minutes to talk to the researcher about their experience with hospitalization for the treatment of disease. In the control group patients were informed that they would have some data collected, then the researcher would be gone for thirty minutes and after this range, she would return to complete the research. The dependent variables (alpha-amylase, cortisol, pulse rate, respiratory rate, blood pressure, anxiety state and fears related to surgery) were collected before and after the intervention in experimental group and before and after the break in control group. In comparing the dependent variables in the experimental group compared to the control group in the post-intervention time, no significant differences were identified for any of the variables studied. In comparing the variables in the experimental group and the control group in the pre and post-intervention, there was significant differences only between times in the control group for cortisol (Z=-2,023; p=0,043), pulse rate (Z= -2,121; p=0,034) and fears related to surgery (Z= -2,171; p=0,030), with reduced of these variables. In the relationship between the studied variables, there was a significant difference between state anxiety and the variables cortisol, age, education level and religion; the fears related to the surgery were related to sex, time of confirmation of the diagnosis of colorectal cancer, education level, cortisol, marital status and diastolic blood pressure. Only the variable monthly income showed a significant difference in their distributions in the experimental group and the control group, however, this had no influence on the dependent variables. Most patients report satisfaction with the development of the intervention. It was concluded that, in the preoperative period, under the conditions investigated in this study, the data showed that the measurement of the variables immediately after the intervention of 30 minutes of therapeutic listening did not show the expected reduction of the values of the studied variables; Studies with measures of these variables after a time for the patient to process the effects of the intervention could confirm whether the immediate measurement or one hour after the intervention, for example, would lead to different results. However, there was reduction of cortisol levels, pulse rate and fears related to surgery in the control group, which can be attributed to contact the researcher with these participants during times of data collection

Inventário de medos III: avaliação das qualidades psicométricas em uma amostra portuguesa / Fear survey schedule -III: evaluation of the psychometric properties in a Portuguese sample

Este estudo teve como objetivo avaliar as qualidades psicométricas do Fear Survey Schedule-III, em uma amostra portuguesa. Participaram 1.980 sujeitos selecionados por conveniência a partir de uma população adulta normativa. As idades dos participantes estavam compreendidas entre os 18 e os 80 anos (M = 39,5, DP = 8,5), sendo 59% do sexo feminino. As qualidades psicométricas da escala foram avaliadas em suas facetas de sensibilidade psicométrica, validade de construto e confiabilidade. A validade externa de construto foi avaliada com análise multigrupos em amostra aleatória e independente da amostra de validação inicial. O modelo fatorial original proposto apresentou um ajustamento inaceitável à amostra de validação. Procedeu-se ao refinamento do modelo de medida em uma parte da amostra, selecionada aleatoriamente. Em conclusão, o modelo de medida simplificado apresentou uma boa qualidade de ajustamento fatorial e foi invariante em uma segunda amostra independente da primeira. Propôs-se uma nova estrutura hierárquica, com fator de 2ª ordem designado por "Medos", que revelou boas qualidades psicométricas (sensibilidade, validade de construto e confiabilidade).

This study aimed at evaluating the psychometric properties of the Fear Survey Schedule-III in a Portuguese sample. A total 1,980 subjects, selected by convenience sampling from a normative adult population, participated in this study. The participants are aged between 18 and 80 years (M = 39.5, SD = 8.5) and 59% of them are female. The psychometric properties of the scale were evaluated regarding psychometric sensitivity, construct validity, and reliability. The external construct validity was evaluated with multigroup analysis in a random sample, independent from the initial validation sample. The originally proposed factor model presented an unacceptable adjustment to the validation sample. Thus, it was proceeded the refinement of the model with a part of the sample which was randomly selected. In conclusion, the simplified model presented as a good factorial goodness of fit, and was invariant in a second sample, independent from the first. A new hierarchical structure was proposed with a 2nd order factor called "Fears" which showed good psychometric properties (sensitivity, construct validity and reliability).

Application of Logistic Regression on the Analysis of Chilean Children's Fears / Aplicación de la regresión logística al análisis de los miedos de los niños chilenos

The research aimed at finding some deciding factors in Chilean children's fears. For carrying out this study, a survey was administered to children be' tween 6 and 11 years old through personal interviews, under their teachers' supervision and parents' permission. The measuring instrument was based on the questionnaire adaptation "Fear Survey for Children; revised, FSSC-R". The sample consisted of 729 children of both genders and from different socioeconomic strata and areas (urban and rural). For its examination, a Factorial Analysis of Main Components was applied, resulting that fears can be grouped into five factors: Daily life, Supernatural facts, Health, Natural disasters and Self-esteem. Thanks to this, a weighted index of fears was built. Through a Logistic Regression Model, some possible deciding factors in children's fears were analysed. For example, it was found that living in the city or in the country is not a significant factor when determining children's fears. On the other hand, the factors that turned out to be significant are: the gender, finding terrifying images on the internet, the socioeconomic level that each child belongs to and, being able to manage on his or her own when the child confronts a frightening event.

La investigación tuvo como objetivo encontrar algunos factores determinantes del miedo en los niños chilenos. Para realizar el estudio, se administró una encuesta a 729 niños entre los 6 y 11 años de edad. El instrumento de medición se basó en una adaptación del cuestionario "Fear Survey Schedule for Children - Revised, FSSC - R". Luego, para el examen de los datos se realizó un análisis factorial exploratorio que agrupó los miedos en cinco factores los que posteriormente permitieron construir un índice ponderado de miedos. Finalmente, a través de un modelo de regresión logística y usando una categorización del índice ponderado de miedos como variable dependiente, se encontraron algunos factores determinantes de los miedos infantiles. Entre estos están: el género, encontrar imágenes atemorizantes en internet, el nivel socioeconómico y la auto'suficiencia para enfrentar situaciones de miedo.

Correlation between osteoporosis knowledge and activities and fear of falling in the community elderly / 中华行为医学与脑科学杂志

Objective To explore the relationship between osteoporosis knowledge and activities and fear of falling of elderly in the community.Method 420 elders in community were investigated with osteoporosis knowledge assessment tool (OKAT) and the modified survey of activities and fear of falling in the elderly (MSAFFE).Result The overall average score of MSAFFE was (25.36±4.58),and exercise capacity dimension scored higher (13.89±2.41).The overall average score of OKAT was (9.11±3.81).The correlation coefficient of MSAFFE and OKAT was-0.11～ 0.58(P＜0.05).The level of knowledge osteoporosis could explain 24％,18％,16％ variation of activities and fear of falling in each dimension.Conclusion The level of knowledge osteoporosis in the elderly is closely related to activity and fear of falling.Health education should be strengthened to improve the life quality of older people.

Atitudes infantis face aos cuidados de saúde e perceção de dor: papel mediador dos medos médicos / Children's attitudes regarding health care and perception of pain: the mediating role of medical fears

O presente estudo pretende contribuir para a compreensão das atitudes e opiniões das crianças acerca dos cuidados de saúde, com enfoque nos procedimentos médicos, instituições e eficácia dos profissionais. Participaram no estudo 381 crianças, recrutadas em diversas instituições escolares da área de Lisboa. As atitudes mais negativas foram atribuídas às instituições, enquanto as mais positivas incidiram na eficácia dos profissionais. Os procedimentos médicos foram considerados menos dolorosos comparativamente aos potenciais acidentes do quotidiano. Os níveis mais elevados de dor percebida foram reportados pelas crianças do sexo feminino e pelas do 1º ciclo de escolaridade. Os medos médicos mediaram significativamente a relação entre a perceção de dor e as atitudes infantis face aos cuidados de saúde. A maior perceção de dor mostrou estar associada a atitudes mais negativas, porém, esta relação ficou enfraquecida quando contemplados os medos infantis face a temáticas médicas. Em suma, é fundamental poder avaliar as atitudes infantis face aos cuidados de saúde, o que poderá contribuir para o desenvolvimento de programas de intervenção no âmbito da promoção de comportamentos.

This study sought to contribute to a better understanding of children's attitudes and opinions regarding health care, mainly in terms of medical procedures, institutions and the efficacy of health professionals. The sample included 381 children, recruited from different schools in Lisbon. The more negative attitudes were attributed to institutions, while positive attitudes were related to the efficacy of health professionals. Medical procedures were considered less painful compared to potential day-to-day accidents. Higher levels of pain were reported by children of the female sex and by children during the primary education phase. Medical fears mediated the relationship between the perception of pain and children's attitudes with respect to health care. Higher levels of pain perception were seen to be related to more negative attitudes regarding health care. However, this relationship was diminished when children's fears about medical issues were contemplated. In conclusion, a translated instrument to assess children's attitudes regarding health care is needed, as it may even contribute to the development of intervention programs within the scope of the promotion of attitudes towards health care.

The Questionnaire about Interpersonal Difficulties for Adolescents: Reliability and Validity Evidence in Colombian Adolescent / El Cuestionario de Dificultades Interpersonales para adolescentes: evidencia de fiabilidad y validez en una muestra colombiana

The aim of this study was to analyze reliability and validity evidence of scores on the Colombian version of the Questionnaire about Interpersonal Difficulties for Adolescents (QIDA) in a sample of 1,628 adolescents (65.7% boys), ranging in age from 12 to 18 years. Confirmatory factor analyses replicated the correlated five-factor structure of the QIDA: Assertiveness, Heterosexual Relationships, Public Speaking, Family Relationships, and Close Friendships. Internal consistency for the QIDA and subscales scores was excellent. Girls reported higher level of perceived anxiety in heterosexual relationships, whereas boys showed more anxiety in close friendships and decreased interpersonal anxiety during adolescence. Results support the reliability and validity of the scores on the Colombian version of the QIDA.

Este objetivo de este estudio fue analizar la evidencia de fiabilidad y validez de las puntuaciones de la versión colombiana del Cuestionario de Dificultades Interpersonales para Adolescentes (QIDA) en una muestra de 1.628 adolescentes (65.7% chicos) de 12 a 18 años. Los análisis factoriales confirmatorios replicaron la estructura factorial de cinco factores relacionados: Asertividad, Relaciones Heterosexuales, Hablar en Público, Relaciones Familiares y Amigos Íntimos. La consistencia interna del QIDA y sus sub-escalas fue excelente. Las chicas informaron mayores niveles de ansiedad percibida en relaciones heterosexuales, mientras los chicos mostraron más ansiedad en relaciones con amigos íntimos. La ansiedad interpersonal disminuyó durante la adolescencia. Los resultados apoyan la fiabilidad y validez de las puntuaciones de la versión colombiana del QIDA.

Metáforas y paradojas de los miedos en los sujetos docentes / Metaphors and paradoxes of professors’ fears

A partir de unos testimonios de vida se abordan los miedos de docentes universitarios colombianos, toda vez que ha sido un país signado por una fuerte violencia instaurada desde la colonización, transitada por la independencia y radicalizada hasta nuestro primer decenio del siglo XXI. Esta investigación abordada entre el 2010-2012, dentro del interés potencial de conocer los Lenguajes del poder y los miedos que generan y administran. ¿En qué consisten los miedos de los docentes universitarios de Manizales y Pereira, en Colombia e impactos en su ejercicio docente? Las conclusiones nos sorprenden, los docentes hasta no ser preguntados, no son conscientes de enseñar el miedo. Identifican que el miedo es un estilo de vida y, por tanto, no sólo lo enseñan, también lo generan y lo administran. Son portadores y parteros del miedo.

We deal with the fears felt by Colombian University professors using as point of departure some life testimonies, considering that this is a country that has been characterized by a lot of violence since colonial times, going through the independence struggles and radicalizing in the first decade of the 21st Century. This research covers the period between 2010-2012, with the potential interest of knowing the language of power and the fears it generates and manages. What do the fears felt by University professors from Manizales and Pereira, Colombia consist in? What is their impact on their teaching practice? The conclusions come to us as a surprise: until they were asked, the professors were not aware of the fact that they had been feeling fear. They identify that fear is a life style and therefore, they not only teach it but also generate and manage it. They are carriers and midwives of fear.

Medical fear and influencing factors of school-age children in hospital in Lanzhou area / 中国实用护理杂志

Objective To study medical fear and its influencing factors in hospitalized school-age children in Lanzhou area.Methods Children's Medical Fear Scale was used to investigate 110 cases of hospitalized school-age children,and the investigation result underwent analysis.Results The total score of children's medical fears was (50.43±7.34),the three items with the highest score among 30 items were surgery,death,being deprived of education,homework delay,surgery and death tied for first.Conclusions Medical fear of school-age children was related with age and gender,female was significantly higher than that of male.No relationship with the family education environment,duration of illness,area of residence.

Temor a la madurez en la anorexia nerviosa / Maturity fears in anorexia nervosa

El temor a la madurez (TM) es un rasgo relevante en pacientes portadoras de anorexia nerviosa (AN). Se analiza descriptivamente la presencia de TM y sus implicancias evolutivas en la AN, efectuándose una revisión de la literatura disponible en PubMed y textos de consulta especializados. Los modelos de Bruch (1974) y Crisp (1997) relacionan la inmadurez psicosexual en la AN con la regresión a un cuerpo prepubescente como mecanismo maladaptativo para enfrentar los cambios biopsicosociales inherentes a la transición hacia la adultez, además de la vulnerabilidad individual, dinámica familiar y vínculo madre-hija deficitario. Según los hallazgos, el TM se asocia significativamente con inicio precoz de la patología, amenorrea primaria, anorexia nerviosa restrictiva, rol de género femenino, ascetismo, autodisciplina, hipercontrol, conductas auto-agresivas, abandono del tratamiento y desenlace negativo. Hubo mejoría significativa en el TM en anorécticas adolescentes sometidas a un programa de psico-educación y terapia familiar. Una de las características nucleares de la AN es el TM, enfatizado en los paradigmas clásicos y fundamentados en la evidencia científica actual. El TM debería considerarse un aspecto terapéutico central e índice pronóstico en la AN.

Maturity fears (MF) is a relevant feature of patients suffering from anorexia nervosa (AN). The presence of MF and its implications in the outcome of AN is described. A review of specialized textbooks and the available literature in PubMed was made. Bruch (1974) and Crisp (1997) models have related the psychosexual immaturity to the regression to a prepubescent body as a maladaptative mechanism to confront the bio-psycho-social changes due to the transition to adulthood; as well as the individual vulnerability, family dynamics and deficits in mother/daughter bond. These findings show that MF are significantly correlated to an early onset of the disorder, primary amenorrhea, restrictive subtype of AN, feminine gender role, asceticism, self-discipline, hypercontrol, self-injury behaviors, treatment drop out, and negative outcome. There was a significant improvement of MF in anorexic adolescents included in a psycho educational programme and family therapy. One of the core characteristics of the AN is the MF underlined in classical paradigms and based on the current scientific evidence. MF should be considered a central therapeutic aspect and a prognostic index in AN.

Estudio de traducción, adaptación y evaluación psicométrica del Inventario de Miedos FSSC-II en una muestra de estudiantes de educación media superior / Translation, adaptation and psychometric properties of the Fear Inventory FSCC-II in a Mexican sample of high school students

Normal fear is defined as a reaction to a real or imagined threat and is considered an integral and adaptive feature related to the primary function of survival. Nevertheless, when fear is intense and maladaptive, it may lose its role for survival and may progress in a phobic disorder with a negative impact for the individual who suffers it. According to some researchers, childhood and adolescence are the main life periods where phobias and other anxiety disorders develop. It is estimated that up to 50% of children and adolescents report one or more intense fears and more than 20% of these meet diagnostic criteria for specific phobias, frequently related to the development of future mental disorders during adulthood. In the assessment of fear, it is important to consider the evaluation of its intensity as well as its frequency among three main dimensions: the subjective dimension (including feelings and thoughts), the physical dimension (e.g., tachycardia and paleness) and the behavioral dimension (e.g., avoidant behaviors). So far, the main fear assessment methods include self-reports, observation and psychophysiological registers. In the area of mental health, the Fear Survey Schedule for Children II (FSSC-II) is the most widely used instrument for the assessment of fears in youth population. The cultural adaptation of an internationally instrument such as the FSSC-II brings the opportunity for subsequent comparison of investigation findings with other populations. The FSSC-II is an updated version of the original instrument as it includes other type of fears such as fear of war and/or AIDS designed to both children and adolescents. Since it is possible that some mental disorders in adulthood are conditioned by the presence of fears in early stages of life, it is important to have an objective characterization of the main fears in our culture. On this basis, adequate psychopathology prevention programs and treatment strategies can be designed and tested. In general, psychopathology is influenced by the cultural context and fears are not the exception as they tend to manifest differently from one cultural context to another. Therefore, the aim of the present work was to translate, culturally adapt and examine the psychometric properties of the FSSC-II in a Mexican sample of high school students. Method A total of 5030 high school students who accepted to participate in the study were recruited. Age ranged between 14 and 24 years old. The FSSC-II is composed of 78 items scored in a three-point Likert scale that assess frequency and intensity of different fears classified in five main dimensions: fear of death and danger, fear of the unknown, fear of failure or criticism, fear of animals and physical stress-medical fears. Before the enrollment procedure, the FSSC-II was adapted for Mexican population. First, translation-back translation was performed by two independent translators. Some items of the instrument were culturally adapted by consensus to reach the final version of the instrument. A principal component analysis with varimax rotation was performed to determine the construct validity of the instrument in Mexican population. Cronbach's alpha was used to determine the internal consistency of each domain and total score of the FSSC-II. All analyses were performed with the 10th version of the SPSS-X. Results A total of 2992 women and 2038 men participated. Mean age was of 16.43±1.2 years old. For the Mexican adaptation of the FSSC-II, 1 1.53% of the items (n=18) were culturally adapted. Factor analysis showed five factors for the instrument. These factors were consistent with those described in the original version: fear of death and danger, fear of animals or injuries, fear of failure or criticism, fear of the unknown and medical fears. Internal consistency of the FSSC-II was .96. Alpha coefficients for four dimensions were above .80, except the "medical fears" dimension (.70). Discussion The Spanish version of the FSSC-II among Mexican high school students showed adequate psychometric properties. The adaptation process implicated the modification of some items of the original instruments in order to reach a correct assessment of the proposed constructs of the instrument according to the predominant cultural patterns of Mexico. On the other hand, some items were not modified and were taken literally from either U.S. or Australian versions. Although more than 10% of the items were adjusted, the factor structure of the instrument remained congruent with the original version and the U.S version of the FSSC-II. The Mexican version was totally compatible with the five constructs found in the U.S. version; nevertheless it is important to remark that the content of the Mexican version was more compatible with the content of the items of the Australian version. Some of the inconsistencies found between the three versions may be the result of the subjects' age in the studies. The U.S. study included subjects with ages between 8 and 11 years, the Australian study included subjects between 7 and 18 years old, while our study included subjects with ages between 14 and 24 years old. The way children experience reality is not the same as that of adolescents or adults. It is possible to assume that the fears of children are more related to immediate, concrete stimuli, while the ones of adolescents and young adults are related to anticipatory or abstract stimuli. For example, the item of "Fear of being scolded by the principal" can be experienced by a child as something extremely dangerous and, therefore, the item will classify in the dimension "fear of death and danger" and not in the dimension of "fear of failure or criticism" where the answer of an adolescent or a young adult is most likely to be classified. Despite the disparities between the three versions, the FSSC-II showed high internal consistency values and an adequate percentage of explained variance in our sample. These results highlight the utility of the FSSC-II for the assessment of the frequency and intensity of fears in both adolescents and young adults in Mexico. It would be desirable to perform future studies among children.

El miedo es una emoción que se experimenta a lo largo de la vida y en ocasiones posibilita la adaptación. No obstante, el miedo puede tornarse desadaptativo y evolucionar hacia un trastorno fóbico que impacta negativamente en el individuo que lo padece. La infancia y la adolescencia son las etapas en las que típicamente inician las fobias, las cuales se han asociado al desarrollo de otros trastornos mentales en la vida adulta. En la evaluación del miedo es necesario evaluar tanto su intensidad como su frecuencia en tres dimensiones principales: la subjetiva, la física y la conductual. Los principales métodos de valoración del miedo han sido los autoinformes, la observación externa y los registros psicofisiológicos. En el área de la salud mental, la escala más utilizada para la evaluación de miedos en población juvenil es el Inventario de Miedos para Niños II (Fear Survey Schedule for Children II, FSSC-II). La adaptación cultural de un instrumento internacionalmente utilizado como éste brinda la oportunidad de realizar comparaciones subsecuentes de los hallazgos de investigación con otras poblaciones. Dado el impacto del miedo en el futuro desarrollo de trastornos mentales, es importante contar con una caracterización de los principales miedos en nuestra población para la elaboración de futuros programas preventivos y de tratamiento efectivos. De esta forma, el objetivo del presente estudio fue traducir al español, adaptar culturalmente y evaluar psicométricamente el Inventario de Miedos para Niños FSSC-II en una muestra de adolescentes y adultos jóvenes mexicanos. Método La muestra estuvo conformada por estudiantes de preparatoria de ambos sexos, entre 14 y 24 años de edad, que aceptaron participar en el estudio de manera anónima. Dos traductores independientes realizaron la traducción-retraducción y adaptación cultural del FSSC-II y posteriormente fue aplicado a los estudiantes. Se obtuvo la consistencia interna del instrumento mediante el alpha de Cronbach y la validez de constructo mediante un análisis de componentes principales. Resultados Se incluyeron 2992 mujeres y 2038 hombres, con una edad promedio de 16.43 años. El 11.53% de los reactivos de la versión original del FSSC-II se adaptaron para su uso en población mexicana. El análisis factorial mostró cinco factores agrupados de acuerdo con lo teóricamente esperado: miedo a la muerte o peligro, miedo a los animales o lesiones, miedo al fracaso escolar o a la crítica, miedo a lo desconocido y miedos médicos. Todos los factores del FSSC-II mostraron elevados valores de consistencia interna (>.80) con excepción del área de miedos médicos (.70). El alpha de la puntuación total de la escala fue de .96. Discusión La estructura de cinco factores del instrumento resultó congruente con la versión australiana original y la estadounidense, siendo compatible en su totalidad con la versión de Estados Unidos. No obstante, en cuanto al contenido de los reactivos, la versión mexicana del FSSC-II fue más similar a la versión australiana del instrumento. Estas inconsistencias pueden deberse a las diferencias de edades de las muestras sujetas a estudio, siendo distintas las realidades que vive un niño a las que vive un adolescente o un adulto joven. A pesar de estas divergencias, la alta consistencia interna y varianza explicada del instrumento muestran su utilidad para evaluar la frecuencia e intensidad de miedos en adolescentes y adultos jóvenes en nuestro país. Es deseable dirigir futuros estudios para evaluar a niños de menores edades.

Evaluation of the application effect of evidence-based nursing model in improvement of preoperative fears and perioperative quality of life for patients undergoing general surgery / 中国实用护理杂志

Objective To observe the effect of evidence-based nursing on improvement of preoperative fears and perioperative quality of life in patients undergoing general surgery. Methods 160 cases of general surgery patients in our hospital from September 2009 to September 2010 were chosen as the research object.The 160 cases were divided into the control group and the observation group with 80 cases in each group.The control group was taken with perioperative routine care.The observation group was given evidence-based nursing.The preoperative fear score (FAVS),perioperative quality of life (QOL)score and treatment compliance for the two groups were compared. Results The fear scores for the two groups of patients before treatment were compared.The score in the observation group was significantly lower than the control group,the difference was significant.The scores of preoperative and postnperative quality of life for the two groups were compared.The patients of the observation group were significantly higher than the patients of the control group,the difference between the two groups was significant.The treatment compliance of the observation group was better than that of the control group. Conclusions The evidence- based nursing model can improve preoperative fears and perioperative quality of Wife of patients undergoing general surgery,improve patients' treatment compliance,and promote the success of operation and recovery of patients.It is worthy of clinical application.

Miedos dentales / Dental fears

El miedo al dentista no es tan infrecuente como la mayoría de la gente puede pensar. Una mala experiencia puede crear una fantasía horrible en la mente de una persona que programó, o debe programar, una visita a una clínica dental. OBJETIVO: describir la actitud de los pacientes en relación a diferentes factores subyacentes a los miedos dentales. MÉTODO: se realiza una encuesta a una muestra de 218 pacientes en el Consultorio 1, Santiago, Chile. Se utiliza un cuestionario con 17 ítem. El tratamiento estadístico se desarrolla con el programa SPSS 12. RESULTADOS: al analizar la estructura factorial de la escala de miedos dentales se encuentran cuatro factores. El principal factor está relacionado con "mala praxis profesional", mientras que los "aspectos inherentes al tratamiento" generan menos miedo. CONCLUSIONES: ha sido posible diferenciar cuatro factores que pueden generar o contribuir al miedo dental. La dimensión más trascendente es la denominada ""aspectos inherentes al tratamiento"", aunque los otros factores explorados pueden generar temor en menor grado. Las técnicas de manejo conductual son métodos para controlar las conductas de pacientes derivadas del miedo. Estas técnicas son necesarias para ayudar a modelar conductas.

Fear of the dentist, isn't as uncommon as most people might think. One bad experience can create a horrific fantasy in the mind of a person who is scheduled, or should be scheduled, to see go to a dental clinic. The aim of the current study is to describe the patient's attitude regarding several factors hidden in dental fears. METHOD: a survey has been performed among 218 patients who visited the Consultorio 1, Santiago, Chile. The questionnaire used included 17 items. The statistical data processing was carried out with the help of software SPSS 12. RESULTS: analyzing the factorial composition of dental fears scale, we detected four factors. The main factor is related to bad professional praxis, while "inherent actions to the treatments" factor generate less fear. CONCLUSION: among dental fears, it has been possible to differentiate four aspects or dimensions that could represent answers to the title: Dental Fears. One of these dimensions, which generate less level fear, is called "treatment inherent aspects". However, the others three dimensions do provoke a certain degree of fear. Behavioral management techniques are methods to control patient's behavior. These techniques are necessary to help modeling behaviors.

Validación de una lista de miedos en población mexicana / Validation of a fear checklist in Mexican population / Validação de uma lista de medos em população mexicana

El miedo es una respuesta emocional a las amenazas, y su estudio es importante debido a que al ser un evento disposicional, cambia la probabilidad de la conducta y puede llegar a tener consecuencias en la salud física y psicológica de las personas. Entre las aproximaciones teóricas al estudio del miedo, destaca la propuesta por Lang (1970), quien sostiene que las reacciones de miedo constituyen un sistema de tres componentes: activación fisiológica, reactividad subjetiva y evitación conductual, y que éstos componentes interactúan de manera flexible (Rachman, 2004). Este estudio se enfoca a la validación de una Lista de miedos en español, con 31 palabras que aludían a temas evocadores potenciales de miedo. Participaron 605 personas entre 14 y 60 años, que asignaron a cada palabra un número del 0 al 5, en función del grado evocador de miedo que generaban. Se hizo un análisis de reactivos mediante el cuál se eliminaron 3 de ellos y el análisis factorial de los 28 reactivos restantes, arrojó 4 factores con cargas superiores a .44 que en su conjunto explicaron 68% de la varianza total, con una confiabilidad de .967. Los cuatro factores de miedo fueron: a la pérdida afectiva, a ser víctima de eventos no contingentes, a la vulnerabilidad y a la muerte. Las mujeres reportaron mayor miedo para todas subescalas (menos la de la muerte). Se concluye que esta lista es un instrumento potencialmente útil, de fácil comprensión y rápida aplicación, y que puede servir para la exploración del tema de miedo en población hispano hablante.

Fear is an emotional response to negative challenge; as a dispositional event it affects the probability of behavior and it might have consequences for the physical and psychological health of the individual. Lang (1970) theoretical approach to the study of fear holds the notion that fear reactions belong to a triple system involving physiological arousal, subjective reactivity and behavioral avoidance, and that these components interact in a flexible manner (Rachman, 2004). The purpose of this study was to validate a Fear Checklist written in Spanish, with 31 terms related to topics potentially fear evoking. Participants were 605 people whose ages ranged from 14 to 60 years. Their task consisted of assigning a score from 0 to 5 to each term, according to the degree of fear associated with each word. An item analysis was carried out which resulted in the discharge of three items. The remaining 28 items were subjected to factor analysis and led to four factors with loadings above .44, thus explaining 68% of the total variance, with a reliability index of .967. Resulting fear factors were affective loss, becoming a victim of non-contingent events, vulnerability and death. Women got higher scores in all subscales, with the exception of death. The study concluded that the Fears' Checklist is an instrument easy to comprehend and to apply that could be potentially useful for exploring fears in the Spanish speaking population.

O medo é uma resposta emocional às ameaças. O seu estudo é importante porque, ao ser um evento de disposição, muda a probabilidade do comportamento e pode ocasionar conseqüências à saúde física e psicológica das pessoas. Entre as aproximações teóricas ao estudo do medo, ressalta a proposta por Lang (1970), ao afirmar que as reações de medo conformam um sistema de três componentes: ativação fisiológica, reatividade subjetiva e evitação comportamental, que interatuam com flexibilidade (Rachman, 2004). Este estudo é orientado à validação de uma lista de medos em espanhol, com 31 palavras que faziam alusão a temas evocadores potenciais de medo. Participaram 605 pessoas entre 14 e 60 anos, que atribuíram a cada palavra um número entre 0 e 5, de acordo com o grau de medo evocado. Com uma análise de reativos foram eliminados 3 destes. A análise fatorial dos 28 restantes revelou 4 fatores com cargas superiores do que 0.44, que, em conjunto, explicaram 68% da variância total, com uma confiabilidade de 0.967. Os 4 fatores de medo foram: à perdida afetiva, a ser vítima de eventos não-contingentes, à vulnerabilidade e à morte. As mulheres reportaram maior medo para todas as sub-escalas (exceto a da morte). Conclui-se que esta lista é um instrumento potencialmente útil, de fácil compreensão e rápida aplicação e pode servir para a exploração do tema do medo me população hispanoparlante.

Percepciones y conceptos acerca de la práctica anestésica: una mirada desde la perspectiva del paciente / Perceptions and concepts about anesthetic practice: a look from the patient's perspective

La atención integral de los pacientes incluye el conocimiento de sus características tanto demográfcas, personales como socioculturales. Este estudio fue realizado a partir de esta inquietud, enfocado en uno de los eventos más críticos en la atención de pacientes, el anestésico y el quirúrgico. Se llevó a cabo en la Fundación Santa Fé de Bogotá, en 144 pacientes, en quienes se aplicó un cuestionario antes de la consulta preanestésica, en el cual se indagaba sobre los principales temores y preocupaciones frente a la práctica anestésica, así como sobre los alcances y la preparación de los médicos anestesiólogos. Se obtuvieron resultados que muestran un reconocimiento claro a los médicos anestesiólogos como médicos especialistas y su importancia equiparable a la del cirujano; igualmente, se evidenciaron cuáles son los temores en la población al enfrentarse a un procedimiento anestésico.

Integral attention to patients includes obtaining all possible information about them such as demographics and personal and socio-cultural information. This study was done considering the concems that patients have regarding the two most critical events in patients’ attention: anesthesia and surgery. The study was done at the Fundación Santa Fé de Bogotá on 144 patients to whom a questionnaire was given before the pre-anesthetic consultation. The questionnaire contained questions about their main fears and concems when faced with anesthesia and on what they thought regarding the skills and training of the anesthesiologist. Results show that anesthesiologists are clearly recognized as doctors with a specialty. They are regarded as having the same importance as that of the surgeon. Also, results show the specific fears of patients regarding being anesthetized.