Evaluación del Miedo a la Recurrencia del cáncer en español: el Cuestionario de Miedo a la Recurrencia del Cáncer y Escala General del Miedo a la Recurrencia del Cáncer: un estudio piloto / Assessment of fear of cancer recurrence in Spanish: Fear of Recurrence Questionnaire and he General Scale of Fear of Cancer Recurrence: A pilot study

El objetivo de este estudio es la elaboración de un cuestionario de evaluación del miedo a la recurrencia del cáncer en español. Método: se presenta un estudio piloto de diseño correlacional trasversal elaborado en dos fases: 1) creación del cuestionario del miedo a la recurrencia del cáncer (CMRC) y de la Escala General del Miedo a la Recurrencia del Cáncer (EGMRC); 2) evaluación de sus propiedades psicométricas. Resultados: para la elaboración de los cuestionarios se utilizó el acuerdo entre expertos medido por la V de Aiken. El CMRC queda finalmente configurado con 8 ítems que se responden con una escala tipo Likert de 0-4 y un Alfa de Cronbach de 0,85. La EGMRC de una sola pregunta que se responde con una escala de 0-100 correlaciona hasta un 0,84 con el CMRC. Se utilizó una muestra de 50 mujeres supervivientes de cáncer ginecológico seleccionadas en el Hospital Universitario Clínico San Carlos de Madrid. Ambas escalas correlacionan con el nivel de ansiedad de las pacientes y la función emocional de calidad de vida. No se hallan correlaciones con los niveles de depresión. Conclusiones: El CMRC y la EGMRC son dos instrumentos que pueden ser válidos para la evaluación del miedo a la recurrencia del cáncer en pacientes supervivientes de cáncer ginecológico (AU)

The objective of this study is the elaboration of a questionnaire for the evaluation of the fear of recurrence of cancer in Spanish. Method: A pilot study with a cross-sectional correlational design is presented, elaborated in two phases: 1) creation of the Fear Cancer recurrence Questionnaire (CMRC) and the General Scale of Fear of Cancer Recurrence (EGMRC); 2) evaluation of their psychometric properties. Results: for the elaboration of the questionnaires, the agreement between experts was used, measured by Aiken’s V. The CMRC questionnaire is finally configured with 8 items that are answered with a Likert-type scale of 0-4 and a Cronbach’s Alpha of 0.851. The EGMRC consists of a single question that is answered with a scale of 0-100 correlates up to 0.84 with the CMRC. A sample of 50 female survivors of gynecological cancer selected from the Hospital Universitario Clínico San Carlos in Madrid was used. Both scales correlate with the level of anxiety of the patients and the emotional function of quality of life. No correlations with levels of depression were found. Conclusions: The CMRC and the EGMRC are two instruments that may be valid for the evaluation of FCR in Spanish for survivors of gynecological cancer (AU)

Psychological well-being in palliative care: A systematic review.

OBJECTIVE: To review which are the most influential variables in achieving levels of psychological well-being at the end of life and to verify whether, as certain studies suggest, spirituality, resilience and social support are the pillars on which the psychological well-being construct is based. METHOD: A systematic search through the Scopus, Pubmed and PsycInfo electronic databases was carried out using keywords such as: "wellbeing" OR "psychological-well-being" AND "resilience" AND "spirituality" AND "social support" AND "palliative care" and their multiple combinations. RESULTS: Eleven studies were selected, in which terms such as spiritual well-being, absence of discomfort and quality of life were used in substitution of psychological well-being and a certain consensus was found regarding whether resilience, spirituality and social support are predictive variables of psychological well-being. CONCLUSIONS: Resilience, social support and spirituality are highly relevant variables at the end of life and contribute decisively towards psychological well-being.

Aplicación de hipnosis al miedo al contagio por COVID-19 en un cuidador de paciente oncológico / Hypnosis applied to the fear of COVID-19 in a cancer caregiver

Objetivo: Se presenta el caso de un familiar de paciente oncológico durante la situación generada por la pandemia de COVID-19, con el que se utiliza un programa multicomponente en el que se incluye la hipnosis clínica como herramienta para gestionar el miedo al contagio y la adaptación a la enfermedad oncológica en el cuidador principal. Método: Una intervención a través de hipnosis clínica para el manejo del miedo al contagio durante el proceso oncológico de su enfermedad. Resultado: Se produce la reducción de la sintomatología ansiosa, en relación con el miedo al contagio, permitiendo a PS abordar diferentes situaciones sin aplicar un afrontamiento evitativo, usando su miedo como una estrategia de protección frente al COVID-19. Ha conseguido mejorar el insomnio, reduciendo los problemas de conciliación y mejorar su autoestima y reforzar el autoconcepto. Conclusión: La hipnosis se revela como una técnica útil rápida y eficaz, que permite manejar de manera adecuada la sintomatología de carácter ansioso dentro de un programa multicomponente. (AU)

Objective: Treatment of fear of contagion during the COVID-19 pandemic and the adaptation to the oncological disease through a multicomponent program that includes clinical hypnosis, in the main caregiver. Method: An intervention using clinical hypnosis to manage the fear of contagion during the process of caring for an oncological patient. Results: There is a reduction in anxiety symptoms, in relation to the fear of contagion, which allows the patient to address different situations without applying avoidant coping, using fear as a protection strategy against COVID-19. Insomnia problems were improved, reducing problems with conciliation insomnia, improving self-esteem and reinforcing self-concept. Conclusion: Hypnosis is revealed as a useful, fast and effective technique that allows to adequately manage anxiety symptoms within a multicomponent program. (AU)

Eutanasia y Psicología. Algunas claves para la intervención en Procesos Adelantados de Muerte / Euthanasia and psychology Some keys for intervention in hastened processes of death

Los países que han optado por regular los Procesos Adelantados de Muerte (PAM) van en aumento en los últimos años. Este tipo de legislaciones implican directamente a los equipos sanitarios. Los psicólogos incluidos en estos equipos están en contacto con estos procesos, por lo que se torna imprescindible dilucidar, mediante la escasa literatura existente, si los PAM presentan variables diferenciales con otros procesos de muerte, que sean necesarias tener en cuenta durante la asistencia psicológica. Esta recopilación de literatura pretende plantear las diferencias que en la actualidad están contrastadas y plantear qué opciones de intervención psicológica están a nuestra disposición para realizar el acompañamiento a estas personas, sus cuidadores y los equipos sanitarios que los asisten. (AU)

The countries that have chosen to regulate advanced death processes (PAM) have been increasing in recent years. This type of legislation directly involves health teams. The psychologists included in these teams are in contact with these processes, so it becomes essential to elucidate, through the scarce existing literature, if the PAM present differential variables with other death processes, that it is necessary to take into account during psychological assistance. This compilation of literature aims to present the differences that are currently contrasted and to propose what psychological intervention options are available to us to carry out the accompaniment of these people, their caregivers and the health teams that assist them. (AU)

Spanish Version of the Death Attitude Profile-Revised. Translation and Validation Into Spanish.

The Death Attitude Profile-Revised (DAP-R) was developed in English-speaking cultures with the aim of measuring attitudes towards death. This measure consists of 32 items, grouped into five factors (Fear of Death, Avoidance of Death, Neutral Acceptance, Approach Acceptance, and Escape Acceptance). The DAP-R was translated and adapted to Spanish (DAP-RSp), and the psychometric properties were analyzed accross a general sample. The face validity was evaluated by 20 experts in palliative care. N = 417 (X = 39.06 years) took part in the validation. DAP-RSp showed adequate internal consistency (Cronbach's alpha ranging from 0.67 for Neutral Acceptance to 0.95 for Escape a Acceptance, and 0.88 for the total), a multitrait scaling analysis and a confirmatory factor analysis reproduced the five dimensions of the original scale. The Spanish version of the DAP-R can be used as a valid scale to assess attitudes towards death in Spanish speaking population.

El papel del conocimiento de diagnóstico y pronóstico sobre la resiliencia y el apoyo social en pacientes paliativos / Influence of diagnosis and prognosis awareness on resilience and social support in palliative patients

Objetivo: Estudiar cómo el conocimiento de la información relativa al diagnóstico y pronóstico va a favorecer la aparición de una respuesta de afrontamiento resiliente, además de promover la búsqueda de apoyo social. Además de estudiar la relación de las variables de información y las variables sociodemográficas y clínicas. Método: Las variables analizadas son la resiliencia (BRCS), el apoyo social (MOS) y las variables de información. La muestra constaba de 192 pacientes ingresados en una unidad de cuidados paliativos, con una media de edad de 69,05 años (DT = 15,106), el 50,5 % hombres, de los cuales el 82,8 % tenía un diagnóstico oncológico, el 45,3 % con pareja, el 5,6 % con nivel cultural bajo y PPS medio de 49,11. Resultados: Existe relación entre apoyo emocional con conocimiento del pronóstico (0,151; p = 0,036) y tener percepción de muerte próxima (0,186; p = 0,010). La resiliencia también se correlaciona positivamente con el conocimiento del pronóstico (0,258; p = 0,000) y la percepción de muerte próxima (0,146; p = 0,044). Conclusiones: La importancia del apoyo emocional pone el foco en el personal sanitario como proveedor de información, adaptando su estilo de comunicación a las necesidades de información del paciente y su familia. Asimismo el afrontamiento resiliente ayuda al manejo de la información y posterior adaptación a la situación de final de vida. (AU)

Objective: To study how awareness of diagnosis and prognosis may help develop resilient coping and promote social support seeking. Also, to study the relationships between information variables and both sociodemographic and clinical variables. Methods: Analyzed variables include resilience (BRCS), social support (MOS), and informational variables. Our sample was made up of 192 patients admitted to a palliative care unit, with a mean age of 69.05 years (SD = 15.106). A total of 50.5 % were men, of which 82.8 % had a cancer diagnosis, 52.6 % had a low education level, and 45.3 % were married. Their average Palliative Performance Scale (PPS) score was 49.11. Results: There is a relationship between emotional support, prognosis awareness (0.151; p = 0.036) and perceived proximity of death (0.186; p = 0.010). Resilience was also positively correlated with prognosis awareness (0.258; p = 0.000) and perceived proximity of death (0.146; p = 0.044). Conclusion: The significance of emotional support highlights the role of health professionals as providers of information, adapting their communication style to the information needs of patients and their families. Also, resilient coping helps in the management of information and its subsequent adjustment to the end-of-life situation. (AU)

A screening method for sleep disturbances at the end-of-life.

OBJECTIVE: To evaluate sleep disturbances and to verify the accuracy of three screening tests to detect them in patients at the end-of-life admitted in a hospital palliative care unit. METHOD: The level of sleep disturbances was evaluated through the Pittsburgh Sleep Quality Index (PSQI) in 150 palliative patients. This questionnaire was the criterion variable for testing the three screening tests used: Edmonton Symptom Assessment System (ESAS-Sleep subscale); the single question "How much do you worry about your sleep problems?" which is answered on a scale of 0-10 (Sleep-Worry-Q) and another single question: "Do you think you have sleep problems?" with two response categories, Yes/No (Sleep-Problem-Q). RESULTS: According to the PSQI (cut-off point: 8), 87% of patients presented sleep disturbances. The ESAS-Sleep (cut-off point: 3) showed a sensitivity of 0.87, a specificity of 0.58, and an AUC of 0.729; the Sleep-Worry-Q (cut-off point: 4) showed a sensitivity of 0.95, a specificity of 0.68, and an AUC of 0.854; the Sleep-Problem-Q obtained a sensitivity of 0.92 and a specificity of 0.65. SIGNIFICANCE OF RESULTS: Patients at the end-of-life, near the time of death, have high levels of sleep disturbances that can be detected early, with better diagnostic accuracy, with the Sleep-Worry-Q. Although from a clinical point of view, the application of the Sleep-Problem-Q may be more advantageous, as it presents good diagnostic accuracy, greater simplicity, and brevity.

Use of hypnosis for the placement of a midline catheter in a patient at the end of life.

OBJECTIVE: The case of a non-oncological patient at the end of his life, admitted to a Palliative Care Unit (PCU), is presented. After a failed attempt to place a central venous catheter (CVC) and another placement of a peripherally inserted central catheter (PICC), the patient exhibited high anxiety regarding a midline catheter (MC) and refused its placement, even though this was necessary for the administration of intravenous drugs to control dyspnea and other complex symptoms that he presented. METHOD: An intervention through clinical hypnosis for successful MC placement and symptom control is described. RESULT: Through clinical hypnosis and interdisciplinary teamwork, it was possible to place a MC, necessary for symptomatic control of a complex patient. SIGNIFICANCE OF RESULT: This case exemplifies hypnosis as a simple procedure that is easy to apply, accepted by the patient, and effective in the implementation of invasive procedures and symptom control in PCUs.

Espiritualmente resilientes. Relación entre espiritualidad y resiliencia en cuidados paliativos / Spiritually resilient. Relationship between spirituality and resilience in palliative care

El objetivo de este artículo es analizar la relación entre la resiliencia y la espiritualidad en sus tres dimensiones (intrapersonal, interpersonal y transpersonal) y al mismo tiempo explorar si existe alguna relación con las variables sociodemográficas estudiadas. Se trata de un estudio descriptivo-correlacional de corte transversal en pacientes que se encuentran ingresados en una unidad de cuidados paliativos. Las variables analizadas son la resiliencia (BRCS) y la espiritualidad (GES). La muestra constaba de 105 pacientes ingresados en una unidad de cuidados paliativos, con una media de edad de 65.88 años (DT = 5.51), 53.3% mujeres, de los cuales 86.7% tenían un diagnóstico oncológico, 56.2% sin pareja, 59% nivel cultural bajo y PPS medio de 54.2. Los resultados muestran una relación entre resiliencia y espiritualidad: con GES total y GES intra al 57.7%, con GES inter al 36.3% y con GES trans al 37.3% (correlación de Pearson). Se concluye que hay una correlación positiva entre resiliencia y espiritualidad, en consonancia con los estudios previos. La mayor correlación se produce con su dimensión intrapersonal

This paper aims to analyse if there is a positive relationship between resilience and spirituality in its three dimensions (intrapersonal, interpersonal, and transpersonal) as shown in previous studies. At the same time, it explores if there is a relationship with sociodemographic variables. A descriptive, correlational, cross-sectional study in hospitalised palliative patients was carried out. Resilience (BRCS) and Spirituality (GES) were used as variables. A sample of 105 hospitalised palliative patients was chosen, of which the average age was 65.88 and 53.3% were women. Oncologic diagnosis = 86.7%, low cultural level = 59%; single = 56.2%, and average PPS = 54.2. Concerninn the relationship between resilience and spirituality, GES total and GES intra was 57.7%, GES inter 36.3%, and GES trans 37.3% (Pearson's correlation). As a conclusion, there is a positive correlation between resilience and spirituality, as it was proved in previous studies. However, the intrapersonal dimension has the strongest relationship with resilience

¿Qué es para usted un psicólogo? Responden enfermosy cuidadores principales / What is a psychologist for you? Responses from patients and primary caregivers

Objetivo: Valorar el conocimiento que enfermos y cuidadores principales tienen sobre el roldel psicólogo y sus funciones. Detectar qué tipo de demandas realizan y recoger el grado de satisfacción percibido en la intervención. Método y material: Estudio descriptivo analítico transversal. Se empleó una encuesta voluntaria de elaboración propia que fue cumplimentada por un total de 152 sujetos (84 pacientes y68 cuidadores principales), todos ellos atendidos en la Unidad de Cuidados Paliativos (UCP) del Hospital Virgen de la Poveda y en las Unidades de Cuidados Paliativos Domiciliarios (UCPD) de la AECC de las áreas VIII y V de la Comunidad de Madrid. Resultados: El 73,81% de la población de enfermos estudiados conoce al menos una función de las que desempeña el psicólogo de la salud en cuidados paliativos y solicita ayuda específica de este. El 98% de la población estudiada manifiesta haber percibido una ayuda real por parte de este profesional. Paralelamente en cuidadores principales, el 76,47% conoce al menos una función del psicólogo (..) (AU)

Objective: To assess the knowledge that patients and primary caregivers have about the role and functions of a psychologist. To detect the types of demands made by the participants and assess their level of satisfaction with the psychological intervention received. Method and material: A descriptive cross-sectional study. A questionnaire developed for the purpose of the study was completed for a total of 152 participants (84 patients and 68 caregivers). All participants were being treated in the Palliative Care Unit (PCU) at Virgen de la Poveda Hospital or by the Palliative Home Care Service (PHCS) of the Asociación Española Contra el Cáncer (AECC) in areas VIII and V of Madrid county. Results: 73.81% of the patients knew at least one role of the health psychologist in palliative care and requested specific support from this healthcare professional. 98% of the patients say they perceived real support from this healthcare professional. In parallel 76.47% of primary (..) (AU)