Value-Based Healthcare in Ostomies.

In order to achieve significant improvements in quality, cost, and accessibility (the health "iron triangle"), innovation in organizational and service delivery models is necessary to increase the value of healthcare. The aim of this study is to evaluate the efficiency of a model of organizational innovation based on advanced practice nurse in the care of people with ostomies (APN-O) versus usual care. An observational, exploratory, analytical, prospective study with a six-month follow-up was carried out at 12 hospitals that implemented this model in Andalusia. A total of 75 patients who had undergone a digestive elimination ostomy and/or a urinary ostomy were followed for six months. Clinical outcomes, healthcare resources, health-related quality of life, and willingness to pay (WTP) were analyzed. The economic evaluation was conducted from a societal perspective, including healthcare costs and indirect costs. The cost difference between the two models was €136.99 and the quality-adjusted life year (QALY) gained was 0.05965 (€2297 per QALY gained). At six months, the mean of WTP was €69 per APN-O consultation. This model contributes to increasing the value-based healthcare in ostomies. Results of this study suggested that APN-O is an effective patient management model for improving their health status and is highly efficient.

Versión entrevista clínica versus autoinforme de la Liebowitz Social Anxiety Scale for children and adolescents / Comparison of the psychometric characteristics of the clinical interview and self-report version of the Liebowitz's Social Anxiety Scale for children and adolescents (LSAS-CA)

El objetivo de este estudio es comparar las características psicométricas de las versiones entrevista clínica y autoinforme de la Escala de Ansiedad Social de Liebowitz para Niños y Adolescentes (LSAS-CA; Masia, Hofmann, Klein, Liebowitz, 1999) en una muestra de 178 sujetos escolarizados en centros de estudios de educación primaria y secundaria de los cuales 99 presentaban Fobia Social. La edad media de los participantes es de 12.36 años, siendo la mayoría chicas (64%).Se aplicaron las versiones de la escala teniendo en cuenta el orden y tiempo de administración. Los resultados muestran que la LSAS-CA es un buen instrumento tanto en su versión administración clínica como en la versión autoinforme, existiendo escasas diferencias entre ambos formatos (AU)

The aim of this study is to compare the psychometrics characteristics of the versions in clinical administration and self-report of the Liebowitz's Social Anxiety Scale for Children and Adolescents (LSAS-CA; Masia, Hofmann, Klein, Liebowitz, 1999) in a sample of 178 subjects enrolled in school in centers of studies of primary and secondary education of which 99 were presenting Social Phobia. The middle ages of the participants are 12.36 years, being the majority girls (64 %). The versions of the scale were applied bearing the order in mind and time of administration. The results show that the LSAS-CA is a good instrument so much in his version clinical administration as in the self-report version, there are few differences between the two formats (AU)

Psychometric properties of the social phobia and anxiety inventory for children in a spanish sample

The objectives of the present study were to adapt and analyze the factor structure, reliability, and validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C; Beidel, Turner, & Morris, 1995) in a Spanish population. The SPAI-C was applied to a sample of 1588 children and adolescents with ages ranging from 10 to 17 years. The confirmatory factor analysis (CFA) showed a four-factor structure: Public performance, Assertiveness, Fear and avoidance/escape in social encounters, and Cognitive and psychophysiological interferences. Internal consistency was high (.90) and test-retest reliability was moderate (.56). Significant differences were found in the variables sex and age, although the effect size was small in both variables and their interaction. Overall, the increase of the age value was inversely proportional to that of social anxiety measured with the SPAI-C; in participants of the same age, values were higher for girls than for boys. Results suggest that the Social Phobia and Anxiety Inventory For Children is a valid and reliable instrument to assess social anxiety in Spanish children and adolescents (AU)

Los objetivos de este estudio fueron adaptar y analizar la estructura factorial, fiabilidad y validez del Inventario de Ansiedad y Fobia Social para niños (Social Phobia And Anxiety Inventory For Children, SPAI-C; Beidel, Turner y Morris 1995) en población española. El SPAI-C fue aplicado a una muestra de 1588 niños y adolescentes con edades entre 10 y 17 años. El análisis factorial confirmatorio determinó una estructura de cuatro factores: Actuación en público, Asertividad, Miedo y evitación/escape en los encuentros sociales e Interferencias cognitivas y psicofisiológicas. La consistencia interna fue alta (0.90) y la fiabilidad test-retest moderada (0.56). Se encontraron diferencias significativas en las variables sexo y edad, aunque con un tamaño del efecto bajo para ambas variables y su interacción. En general, el incremento del valor de la edad se muestra inverso al de la ansiedad social medida con el SPAI-C, mostrando las chicas valores más elevados para una misma edad que los chicos. Los resultados sugieren que el Inventario de Ansiedad y Fobia Social para niños es un instrumento válido y fiable para evaluar ansiedad social en niños y adolescentes españoles (AU)

Psychometric properties of the Social Phobia and Anxiety Inventory for Children in a Spanish sample.

The objectives of the present study were to adapt and analyze the factor structure, reliability, and validity of the Social Phobia and Anxiety Inventory for Children (SPAI-C; Beidel, Turner, & Morris, 1995) in a Spanish population. The SPAI-C was applied to a sample of 1588 children and adolescents with ages ranging from 10 to 17 years. The confirmatory factor analysis (CFA) showed a four-factor structure: Public performance, Assertiveness, Fear and avoidance/escape in social encounters, and Cognitive and psychophysiological interferences. Internal consistency was high (.90) and test-retest reliability was moderate (.56). Significant differences were found in the variables sex and age, although the effect size was small in both variables and their interaction. Overall, the increase of the age value was inversely proportional to that of social anxiety measured with the SPAI-C; in participants of the same age, values were higher for girls than for boys. Results suggest that the Social Phobia and Anxiety Inventory For Children is a valid and reliable instrument to assess social anxiety in Spanish children and adolescents.

Eficacia de un programa para la detección/intervención temprana en niños/adolescentes con fobia social generalizada / Effectiveness of a program for early detection/intervention in children/adolescents with generalized social phobia

El objetivo de este trabajo es estudiar los efectos del tratamiento psicológico Intervención en Adolescentes con Fobia Social (IAFS; Olivares, 2005) en su versión 10-14 años, analizando también sus efectos sin el componente de reestructuración cognitiva. La muestra la componen 82 niños y adolescentes (73% chicas; 27% varones) con Fobia Social Generalizada y una edad media 11.91 años (DT=1.33; rango: 10-14 años). Los participantes fueron asignados aleatoriamente a tres condiciones experimentales: 25 al Grupo Control Lista de Espera, 28 a la condición IAFS completo y 29 a la condición IAFS sin reestructuración cognitiva. Los resultados muestran cambios significativos (mejoría) en todas las variables dependientes evaluadas en las dos condiciones de tratamiento (AU)

The aim of this paper is to study the effects of the psychological treatment Intervención en Adolescentes con Fobia Social / Intervention in Adolescents with Social Phobia (IAFS / IASP; Olivares, 2005) in the version for 10-14 year olds, analysing its effects without the cognitive restructuring component. The sample is composed of 82 children and adolescents (73% female; 27% male) with generalized social phobia and a mean age of 11.91 years (SD = 1.33; range: 10-14 years). Participants were randomly assigned to three experimental conditions: 25 to the wait list control group, 28 to the complete IAFS condition and 29 to the IAFS without cognitive restructuring condition. The results show significant changes (improvement) in all the dependent variables evaluated in the two treatment conditions(AU)

The Liebowitz Social Anxiety Scale for Children and Adolescents / La Escala de Ansiedad Social de Liebowitz para Niños y Adolescentes

The purpose of this study was to analyze the component structure and reliability of the Liebowitz Social Anxiety Scale for Children and Adolescents, self-report version (LSAS-CA-SR), in a Spanish community population. The sample was made up of 422 students from elementary and high schools, aged between 10 and 17 years. Exploratory factor analysis isolated one component for the Anxiety subscale and one component for the Avoidance subscale. Medium-strong associations were found between the total score and subscale scores. LSAS-CA-SR scores had stronger associations with instruments of social anxiety. Internal consistency for the Fear subscale was .91, and for the Avoidance subscale, it was .89. Gender and age effects were assessed for LSAS-CA-SR scores. Effect sizes for age and gender and interaction of age and gender were very low on both the Fear and the Avoidance subscales. There were significant differences between female and male means on the Fear subscale. The findings suggest that the LSAS-CA-SR is reliable and valid (AU)

El objetivo de este estudio fue analizar la estructura factorial y la fiabilidad de la Escala de Ansiedad Social para Niños y Adolescentes de Liebowitz en su versión autoinforme (LSAS-CA-SR), en una muestra comunitaria española de 422 estudiantes entre 10 y 17 años. El análisis factorial exploratorio aisló un componente para la subescala de ansiedad y un componente para la subescala de evitación. Las correlaciones entre la puntuación total y las puntuaciones de las subescalas fueron de medias a elevadas. Las puntuaciones de la LSAS-CA-SR obtuvieron correlaciones elevadas con otras medidas de ansiedad social. La consistencia interna en la subescala de miedo fue de 0,91, y en la subescala de evitación de 0,89; los tamaños del efecto para la edad y el género y su interacción fueron bajos en ambas. Sin embargo, se encontraron diferencias significativas entre varones y mujeres en la subescala de miedo. Los hallazgos sugieren que la adaptación de la LSAS-CA-SR es fiable y válida (AU)

The Liebowitz Social Anxiety Scale for Children and Adolescents.

The purpose of this study was to analyze the component structure and reliability of the Liebowitz Social Anxiety Scale for Children and Adolescents, self-report version (LSAS-CA-SR), in a Spanish community population. The sample was made up of 422 students from elementary and high schools, aged between 10 and 17 years. Exploratory factor analysis isolated one component for the Anxiety subscale and one component for the Avoidance subscale. Medium-strong associations were found between the total score and subscale scores. LSAS-CA-SR scores had stronger associations with instruments of social anxiety. Internal consistency for the Fear subscale was .91, and for the Avoidance subscale, it was .89. Gender and age effects were assessed for LSAS-CA-SR scores. Effect sizes for age and gender and interaction of age and gender were very low on both the Fear and the Avoidance subscales. There were significant differences between female and male means on the Fear subscale. The findings suggest that the LSAS-CA-SR is reliable and valid.

"Escala para la Detección de la Ansiedad Social (EDAS)": Estructura factorial y fiabilidad / No disponible

El objetivo principal de este estudio fue analizar la estructura factorial y la fiabilidad de la Escala para la Detección de la Ansiedad Social (EDAS). La escala fue aplicada a una muestra de 3.181 estudiantes de Educación Secundaria Obligatoria entre 14 y 18 años. El autoinforme está integrado por 26 ítems y una escala de respuesta de 5 puntos. El análisis factorial exploratorio aisló 2 factores: Ansiedad Social e Interferencia, los cuales explicaron el 40.52% de la varianza. La consistencia interna fue alta (0,92). No se encontraron diferencias significativas debidas al sexo, a la edad y a la interacción entre el sexo y la edad, a excepción del efecto debido al género en la subescala de Ansiedad Social (las chicas muestran mayor puntuación que los chicos). Los resultados apoyan la fiabilidad y validez de la EDAS en la evaluación de la ansiedad social en adolescentes españoles (AU)

No disponible