A randomized trial to assess the efficacy of a psychoeducational intervention on caregiver burden in schizophrenia.

BACKGROUND: Patient's relatives usually care for patients with schizophrenia, and as informal caregivers they experience negative consequences. The aim of the EDUCA-III trial is to test the efficacy of a psychoeducational intervention program (PIP) versus standard care to reduce the caregiver burden at post-intervention (4 months), and at follow-up (8 months). METHOD: A two-arm, evaluator blind, multicentre, randomized controlled trial. The PIP group had 12 weekly group sessions. The control intervention group had the usual support and standard care. Primary outcomes were change scores since baseline on the Zarit Burden Interview (ZBI) and the Involvement Evaluation Questionnaire (IEQ). RESULTS: One hundred and nine caregivers were randomized to PIP and 114 to control condition from 23 research sites. The decrease of ZBI scores was significantly higher on the PIP arm at 4 months (mean difference [MD]=-4.33; 95% CI -7.96, -0.71), and at 8 months (MD=-4.46; 95% CI -7.79, -1.13). There were no significant decreases in the IEQ scores (MD at 4 months=-2.80; 95% CI -6.27, 0.67; MD at 8 months=-2.85; 95% CI -6.51, 0.81). CONCLUSIONS: The PIP condition seems to reduce caregiver burden. TRIAL REGISTRATION: ISRCTN32545295.

Análisis factoriales confirmatorios de la escala de sobrecarga de zarit / No disponible

Introducción. La escala de sobrecarga de Zarit (ZBi) se utiliza para evaluar la sobrecarga que experimentan los cuidadores informales de personas con discapacidades o dependencias. como escala acumulativa, la ZBi debería evaluar el constructo latente de sobrecarga desde una perspectiva unidimensional. Sin embargo, diferentes análisis factoriales han indicado que presenta una estructura multidimensional, lo que puede ser importante para una correcta interpretación de la escala. Objetivos. Analizar y comparar el ajuste de las diferentes estructuras factoriales propuestas para la ZBi mediante Análisis Factorial confirmatorio (..) (AU)

Introduction. The Zarit Burden interview (ZBi) is usually applied to assess the burden experienced by caregivers of persons with severe functional limitations. As a measurement scale giving a total score, the ZBi implicitly assumes that the latent construct it measures is unidimensional. However several factorial analyses of the ZBi have reported instead a multidimensional structure, what can be relevant for a correct interpretation. Aims. to analyze and to compare the fit of the factorial structures so far reported for the ZBi by using confirmatory factor analyses (cFA) applied to (..) (AU)

Estudio piloto de la validez, fiabilidad y valores de referencia normativos de la escala PRO-NEURO en adultos mayores sin alteraciones cognitivas / Pilot study of the validity, reliability and normative data for PRO-NEURO scale in adult-elderly people without cognitive impairments

Introducción. Se presentan datos preliminares de la validez,fiabilidad y valores normativos del protocolo de evaluaciónneuropsicológica (PRO-NEURO), que incluye las siguientesfunciones cognitivas: orientación, atención ymemoria, cálculo mental, comprensión verbal, escritura, denominación,razonamiento, fluidez verbal, praxias y gnosiascon el propósito de equilibrar el tiempo de aplicación y laextensión de las áreas evaluadas.Material y métodos. Se aplicaron el Mini-Mental StateExamination (MMSE), la Escala de Depresión Geriátrica deYesavage, el Test de Acentuación de Palabras, los subtests deFiguras Incompletas y Vocabulario del Wechsler Adult IntelligenceScale (WAIS) y la escala PRO-NEURO a una muestrade 273 voluntarios (137 hombres y 136 mujeres) cognitivamentesanos mayores de 55 años. Los datos normativos seobtuvieron para tres grupos de edad (55-65, 66-75 y>75 años) y dos niveles educativos: bajo (hasta 6 años de escolarización)y medio/alto (más de 7 años de escolarización).Resultados. La validez de PRO-NEURO según la pruebaMorillama de acuerdo interjueces es del 93 %, la fiabilidadtest-retest es de r=0,74 y la consistencia interna (alfa deCronbach) es de 0,79. El grupo de menor edad (55-65) y losde nivel educativo más alto puntúan significativamente mejory tardan menos en realizar PRO-NEURO. No aparecen diferenciasdependiendo del sexo. Se presentan los datos descriptivosde PRO-NEURO en esta muestra normativa.Conclusiones. PRO-NEURO puede ser una herramientaútil para una primera evaluación de algunas de las más importantesfunciones cognitivas en la práctica clínica (AU)

Introduction. We present preliminary data on validity,reliability and normative values of a short neuropsychologicalprotocol in Spanish called PRO-NEURO includingdifferent cognitive functions: orientation,attention and memory, mental calculation, verbal comprehension,writing, naming, reasoning, verbal fluency,praxias, and gnosias. The purpose is to more suitably balancethe time of application and the extension of thecognitive areas to be evaluated.Material and methods. Different Spanish versions ofclassical measurements (used as control) and PRO-NEUROwere applied of a sample of 273 (137 men and 136women) volunteers, cognitive healthy («normal subjects»)adult and elderly people over 55. Normative data were obtainedfor three age groups (55-65, 66-75 and >75 years)and two educational levels: low (to 6 years of school)and medium/high (more than 7 years of school).Results. The validity of PRO-NEURO according toMorillama’s method is 93% interrater agreement, test-retestreliability is r=0.74 and internal consistency reliability(Cronbach’s alpha) is 0.79. The age-group of younger-elderly subjects (55-65) and those with highereducational level score significantly better and theyspend less time in PRO-NEURO performance. Conversely,no-significant differences by sex are observed. Descriptivedata of PRO-NEURO for this normative sample areshown.Conclusions. The PRO-NEURO scale can be useful asscreening protocol and help for short and reliable assessmentof some important cognitive functions in clinicalpractice (AU)

[Pilot study of the validity, reliability and normative data for PRO-NEURO scale in adult-elderly people without cognitive impairments]. / Estudio piloto de la validez, fiabilidad y valores de referencia normativos de la escala PRO-NEURO en adultos mayores sin alteraciones cognitivas.

INTRODUCTION: We present preliminary data on validity, reliability and normative values of a short neuropsychological protocol in Spanish called PRO-NEURO including different cognitive functions: orientation, attention and memory, mental calculation, verbal comprehension, writing, naming, reasoning, verbal fluency, praxias, and gnosias. The purpose is to more suitably balance the time of application and the extension of the cognitive areas to be evaluated. MATERIAL AND METHODS: Different Spanish versions of classical measurements (used as control) and PRO-NEURO were applied of a sample of 273 (137 men and 136 women) volunteers, cognitive healthy (<>) adult and elderly people over 55. Normative data were obtained for three age groups (55-65, 66-75 and >75 years) and two educational levels: low (to 6 years of school) and medium/high (more than 7 years of school). RESULTS: The validity of PRO-NEURO according to Morillama's method is 93% interrater agreement, test-retest reliability is r=0.74 and internal consistency reliability (Cronbach's alpha) is 0.79. The age-group of younger- elderly subjects (55-65) and those with higher educational level score significantly better and they spend less time in PRO-NEURO performance. Conversely, no-significant differences by sex are observed. Descriptive data of PRO-NEURO for this normative sample are shown. CONCLUSIONS: The PRO-NEURO scale can be useful as screening protocol and help for short and reliable assessment of some important cognitive functions in clinical practice.

[Postvaccinal reactions to simultaneous administration of the triple viral, oral polio and diphtheria-tetanus vaccines compared with their administration in sequence]. / Reacciones posvacunales tras la administración simultánea de vacunas triple vírica y antipolio oral-difteria-tétanos, frente a su administración secuencial.

OBJECTIVE: To compare the frequency and characteristics of post-vaccination reactions, between on the one hand the simultaneous administration of the Oral Antipolio (OP), the Triple Virus (TV) and the Anti-Diphtheria and Anti-Tetanus (DT) vaccines; and on the other hand, their administration in sequence. DESIGN: Prospective study with interventions, with a non-random, non-blind determination. SITE. Survey covering the mothers of infants vaccinated at 24 vaccination centres in Mála province. PARTICIPANTS: 490 infants vaccinated during their second year of life. 263 had the vaccines administered simultaneously and 227 in sequence. INTERVENTIONS: Simultaneous administration of the TV, OP and DT vaccines at 15 months; as against the administration of TV at 15 months, followed by OP and DT at 18 months. MAIN RESULTS: 78 infants (29.66%) suffered a reaction that could be attributed to the vaccination after the simultaneous administration of TV, OP and DT; and 86 infants (37.88%) after one of the two occasions of vaccination in the administration in sequence: 27.31% after the TV, 17.18% after the OP-DT and 6.62% after both. CONCLUSIONS: The safety of simultaneous administration, taken together with data coming from other studies on its immunogenic effectiveness, reaffirms the usefulness of simultaneous administration of TV, OP and DT vaccines at 15 months, as a strategy to improve vaccine coverage of infants in their second year of life.