4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis.

Background Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4 DSP) into Spanish. Methods A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4 DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. Results The S-4DSP was fully completed by 108 participants (mean age 34 ± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. Conclusions The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.

Perception of patients with retinal pathology on aspects of visual function and their management.

BACKGROUND AND OBJECTIVE: Age-related macular degeneration (AMD) and diabetic retinopathy (DR) are highly prevalent. OBJECTIVE: To explore perceptions of patients with AMD or DR about the impact of the disease and treatment on their daily living activities. MATERIALS AND METHODS: Semi-structured interviews with a questionnaire developed from validated patient reported outcomes questionnaires. The questionnaire consisted of 19 questions about the disease and 9 about the treatment. The questions (items) were answered on a scale from 1 to 9. In addition, the patient interviewed was invited to make free comments on each question. Nine patients with AMD and 9 with DR were interviewed by videoconference or telephone call. A quantitative analysis of the responses and a qualitative analysis of the comments were carried out. RESULTS: The most relevant item for patients with AMD or DR is "Recognize people when they are nearby", and "Read text in normal size font in a newspaper or book", followed, in patients with AMD, by "Do things what you would like" and, in patients with DR, "Feeling frustrated by the vision problems." Regarding the treatment, the most relevant aspects for both groups is that the treatment works and receiving appropriate information before and after the treatment. The qualitative comments were focused to the disease, the treatment, and to the role of doctors and the health system. CONCLUSION: Quantitative responses and free comments can be useful to improve the care of patients with AMD or DR by physicians and the health system.

4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis. / 4 Domain Sports PROM en español: adaptación transcultural en la población chilena y análisis de confiabilidad.

BACKGROUND: Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4DSP) into Spanish. METHODS: A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. RESULTS: The S-4DSP was fully completed by 108 participants (mean age 34±10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. CONCLUSIONS: The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.

Consenso internacional sobre medidas de resultado de tratamientos de depresión y ansiedad en población infantojuvenil: recomendaciones para su aplicación en Chile / International consensus on outcome measures for the treatment of depression and anxiety in children and adolescents: recommendations for their application in Chile

El Consorcio Internacional para la Medición de Resultados en Salud (ICHOM, por sus siglas en inglés) se especializa en el desarrollo de conjuntos de medidas de resultado de tratamientos para condiciones de salud con el objetivo de mejorar la práctica clínica. ICHOM desarrolló una propuesta de medidas de resultado para depresión, ansiedad, trastorno obsesivo-compulsivo y trastorno por estrés postraumático, en población infanto-juvenil de entre 6 y 24 años que fue publicada el 2021. Un grupo de trabajo internacional de 27 personas expertas en clínica, en investigación y por experiencia vivida, alcanzó el consenso a través del método Delphi adaptado con votación anónima iterativa, apoyada por insumos de investigación. Se propone evaluar síntomas, pensamientos y conductas suicidas y funcionalidad a través de siete medidas de resultado informadas primariamente por el o la paciente. Las recomendaciones fueron validadas a través de una encuesta que involucró a 487 participantes en 45 países. Este artículo presenta sugerencias para su aplicación en Chile. Palabras claves: Depresión, ansiedad, infanto-juvenil, medidas de resultado, consenso internacional.

Abstract: The International Consortium for Health Outcomes Measurement (ICHOM) specializes in developing sets of outcome measures for health conditions with the goal of improving clinical practice. ICHOM developed a proposal for outcome measures for depression, anxiety, obsessive-compulsive disorder and post-traumatic stress disorder in children and young people aged 6 to 24 years that was published in 2021. An international working group of 27 clinical, research, and lived experience experts, reached consensus through the adapted Delphi method, and iterative anonymous voting, supported by research inputs. It is proposed to assess symptoms, suicidal thoughts, and behavior, and functioning through seven primarily patient-reported outcome measures. The recommendations were validated through a survey involving 487 participants across 45 countries. This article presents suggestions for their application in Chile.Keywords: depression, anxiety, child and youth, outcome measures, international consensus

Standardizing health outcomes for chronic kidney disease. Adaptation of the international consortium for health outcomes measurement standard set to the Spanish setting / Estandarización de los resultados de salud en la enfermedad renal crónica. Adaptación del conjunto de variables de resultados del International Consortium for Health Outcomes Measurement al entorno español

Background and objectives: We aim to adapt the International Consortium for Health Outcomes Measurements standard set for chronic kidney disease (CKD) patients to the Spanish setting and supplement it with those variables agreed upon through initiatives proposed by the Spanish Society of Nephrologists (S.E.N.). Material and methods: The working group defined a first standard set of variables based on a literature review. The S.E.N. members then assessed the suitability of each variable for inclusion (Consensus≥75%). A second draft of the standard set was generated and evaluated by the Patient advocacy group Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón (ALCER). Lastly, the working group established the final standard set of variables (Consensus≥75%). Results: The standard set targets patients with very high-risk CKD (G3a/A3 and G3b/A2-G5) in pre-end-stage kidney disease (pre-ESKD), hemodialysis (HD), peritoneal dialysis (PD), kidney transplantation (KT) or conservative care (CC). The essential follow-up variables agreed for all patients (All) were patient survival, hospitalizations, cardiovascular events, smoking status, health-related quality of life, pain, fatigue, physical function, daily activities, depression, renal function and hemoglobin. Additionally, it was agreed to collect PD survival (in PD patients), peritonitis (PD), infection/bacteremia (PD, HD, KT), vascular access type (HD), vascular access survival (HD), acute rejection (KT), post-transplant cancer (KT), albuminuria (KT) and kidney allograft survival (KT). (AU)

Antecedentes y objetivos: El objetivo del estudio es adaptar el conjunto de variables de resultados del International Consortium for Health Outcomes Measurements para pacientes con enfermedad renal crónica al ámbito español y complementarlo con aquellas variables consensuadas en iniciativas de la Sociedad Española de Nefrología. Material y métodos: El grupo de trabajo definió un primer conjunto de variables a partir de una revisión bibliográfica. Seguidamente, los miembros de la Sociedad Española de Nefrología valoraron la idoneidad de cada variable para su inclusión (consenso≥75%). Posteriormente, se generó un segundo borrador que fue evaluado por la asociación de pacientes Federación Nacional de Asociaciones para la lucha contra las enfermedades del riñón. Por último, el grupo de trabajo estableció el conjunto de variables final (consenso≥75%). Resultados: El conjunto de variables se dirige a pacientes con enfermedad renal crónica y muy alto riesgo de progresión (G3a/A3 y G3b/A2-G5) en estadios previos al tratamiento renal sustitutivo, hemodiálisis (HD), diálisis peritoneal (DP), trasplante renal (TR) o tratamiento conservador. Las variables esenciales de seguimiento acordadas para todos los pacientes fueron la supervivencia del paciente, las hospitalizaciones, los eventos cardiovasculares, el hábito tabáquico, la calidad de vida relacionada con la salud, el dolor, la fatiga, la función física, las actividades diarias, la depresión, la función renal y la hemoglobina. Además, se acordó recoger la supervivencia en DP (en pacientes en DP), peritonitis (DP), infección/bacteriemia (DP, HD, TR), tipo de acceso vascular (HD), supervivencia del acceso vascular (HD), rechazo agudo (TR), cáncer postrasplante (TR), albuminuria (TR) y supervivencia del aloinjerto renal (TR). Las variables opcionales acordadas para todos los pacientes fueron los niveles de fósforo y potasio y el control de la diabetes (en pacientes con diabetes). (AU)

Papel de la persona navegadora del paciente en el cáncer de pulmón / The Role of the Navigator Person for a Patient with Lung Cancer

Introducción: la medicina basada en el valor ha logrado mejorar la calidad de atención del paciente y/o la satisfacción de las personas, reduciendo costos y obteniendo mejores resultados. Se apoya sobre tres pilares básicos: la medicina basada en la evidencia, la atención centralizada en el paciente, y la sustentabilidad. Sin embargo, existen pocas publicaciones sobre la estrategia de personas navegadoras para pacientes con cáncer de pulmón, que podrían ser una herramienta clave para brindar apoyo, asegurando que tengan acceso al conocimiento y los recursos necesarios a fin de completar la vía de atención clínica recomendada. Estado del arte: se trata de una intervención en salud cuyo objetivo principal es lograr vencer las barreras relacionadas con la atención (p. ej., logísticas, burocrático-administrativas, de comunicación y financieras) para poder mejorar la calidad y el acceso a la salud en el marco de la atención del cáncer. Estas personas cumplen un papel de guía para pacientes durante el proceso de diagnóstico y tratamiento activo. Su labor consiste en vincular al paciente con los proveedores clínicos, brindar un sistema de apoyo, asegurar un acompañamiento individualizado, garantizar que tengan acceso al conocimiento y a los recursos necesarios para completar el seguimiento y/o tratamiento adecuado. Discusión/Conclusión: indudablemente, es un elemento cada vez más reconocido en los programas de cáncer, centrado en el paciente y de alta calidad. Su implementación será de especial interés en la Unidad de Práctica Integrada para personas con cáncer de pulmón. (AU)

Introduction: Value-based medicine has succeeded in improving the quality of patient care and or patient satisfaction, reducing costs, and obtaining better outcomes. It rests on three fundamental pillars: evidence-based medicine, patient-centered care, and sustainability. However, there are few publications on the people navigator strategy for lung cancer patients, which could be a crucial tool for providing support, ensuring that they have access to the knowledge and resources needed to complete the recommended clinical care pathway. State of the art: It is a health intervention whose main objective is to overcome care-related barriers (e.g., logistical, bureaucratic-administrative, communication, and financial) to improve quality and access to health in the context of cancer care. These individuals play a guiding role for patients during the diagnostic and active treatment process. Their job is to link the patient with clinical providers, provide a support system, ensure individualized accompaniment, and guarantee that they get access to the knowledge and resources necessary to complete the appropriate follow-up and, or treatment. Discussion/Conclusion: Undoubtedly, patient navigators represent an increasingly recognized element of high-quality, patient-centered cancer programs. Its implementation will be of specific interest in the Integrated Practice Unit for people with lung cancer. (AU)

Disease control in patients with psoriatic arthritis in real clinical practice in Spain: MiDAS study.

OBJECTIVE: MiDAS study assessed the percentage of psoriatic arthritis (PsA) patients treated in routine clinical practice who achieved control of disease activity according to Disease Activity in Psoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA). METHODS: Observational, non-interventional, cross-sectional, multicenter study conducted under conditions of routine clinical practice in 36 centers with outpatient rheumatology clinics in Spanish public hospitals. Patients included were adults (≥18 years) with ≥6 months PsA diagnosis according to classification for PsA (CASPAR) criteria and undergoing treatment ≥3 months. The main variable evaluated was the percentage of patients under remission and low disease activity, assessed through DAPSA and MDA. RESULTS: 313 patients with PsA were included: 54.3% male; with mean age of 54.1±12.2 years and mean disease duration of 10.5±9.0 years. Mean C-reactive protein (CRP) serum levels were 4.9±7.3mg/L. At the study visit, 58.5% of patients were in monotherapy (17.6% biological and 40.9% non-biological) and 41.2% were receiving biological and non-biological therapy. 59.4% of patients showed low disease activity (DAPSA≤14) and 19.8% were on remission (DAPSA≤4). Moreover, 51.4% of the patients reached an MDA status (≥5 MDA). CONCLUSIONS: Around 40% of PsA patients presented uncontrolled disease, highlighting the need to improve the management of these patients in clinical practice.

Disease control in patients with psoriatic arthritis in real clinical practice in Spain: MiDAS study / Control de la enfermedad en pacientes con artritis psoriásica en práctica clínica real en España: estudio MiDAS

Objective: MiDAS study assessed the percentage of psoriatic arthritis (PsA) patients treated in routine clinical practice who achieved control of disease activity according to Disease Activity in Psoriatic Arthritis (DAPSA) and Minimal Disease Activity (MDA). Methods: Observational, non-interventional, cross-sectional, multicenter study conducted under conditions of routine clinical practice in 36 centers with outpatient rheumatology clinics in Spanish public hospitals. Patients included were adults (≥18 years) with ≥6 months PsA diagnosis according to classification for PsA (CASPAR) criteria and undergoing treatment ≥3 months. The main variable evaluated was the percentage of patients under remission and low disease activity, assessed through DAPSA and MDA. Results: 313 patients with PsA were included: 54.3% male; with mean age of 54.1±12.2 years and mean disease duration of 10.5±9.0 years. Mean C-reactive protein (CRP) serum levels were 4.9±7.3mg/L. At the study visit, 58.5% of patients were in monotherapy (17.6% biological and 40.9% non-biological) and 41.2% were receiving biological and non-biological therapy. 59.4% of patients showed low disease activity (DAPSA≤14) and 19.8% were on remission (DAPSA≤4). Moreover, 51.4% of the patients reached an MDA status (≥5 MDA). Conclusions: Around 40% of PsA patients presented uncontrolled disease, highlighting the need to improve the management of these patients in clinical practice.(AU)

Objetivo: El estudio MiDAS evaluó el porcentaje de pacientes con artritis psoriásica (APs) tratados en práctica clínica habitual que lograron el control de la actividad de la enfermedad de acuerdo con Disease Activity in Psoriatic Arthritis (DAPSA) y Minimal Disease Activity (MDA). Métodos: Estudio observacional, no intervencionista, transversal, multicéntrico, realizado en condiciones de práctica clínica habitual en 36 centros con consultas externas de reumatología de hospitales públicos españoles. Los pacientes incluidos eran adultos (≥18 años) con ≥6 meses de diagnóstico de APs según los criterios de clasificación de la APs (CASPAR) y en tratamiento durante ≥3 meses. La variable principal evaluada fue el porcentaje de pacientes en remisión y baja actividad de la enfermedad, evaluados mediante DAPSA y MDA. Resultados: Se incluyeron 313 pacientes con APs: 54,3% varones; con una edad media de 54,1±12,2 años y una duración media de la enfermedad de 10,5±9,0 años. Los niveles séricos medios de proteína C reactiva fueron de 4,9±7,3mg/L. En la visita del estudio, el 58,5% de los pacientes estaban siendo tratados con monoterapia (17,6% biológicos y 40,9% no biológicos) y el 41,2% recibían terapia biológica y no biológica. El 59,4% de los pacientes mostró baja actividad de la enfermedad (DAPSA≤14) y el 19,8% estaban en remisión (DAPSA≤4). Además, el 51,4% de los pacientes alcanzó un estado de MDA (≥5 MDA). Conclusiones: Alrededor del 40% de los pacientes con APs presentaban enfermedad no controlada, destacando la necesidad de mejorar el manejo de estos pacientes en la práctica clínica.(AU)

Standardizing health outcomes for chronic kidney disease. Adaptation of the international consortium for health outcomes measurement standard set to the Spanish setting.

BACKGROUND AND OBJECTIVES: We aim to adapt the International Consortium for Health Outcomes Measurements standard set for chronic kidney disease (CKD) patients to the Spanish setting and supplement it with those variables agreed upon through initiatives proposed by the Spanish Society of Nephrologists (S.E.N.). MATERIAL AND METHODS: The working group defined a first standard set of variables based on a literature review. The S.E.N. members then assessed the suitability of each variable for inclusion (Consensus≥75%). A second draft of the standard set was generated and evaluated by the Patient advocacy group Federación Nacional de Asociaciones para la Lucha Contra las Enfermedades del Riñón (ALCER). Lastly, the working group established the final standard set of variables (Consensus≥75%). RESULTS: The standard set targets patients with very high-risk CKD (G3a/A3 and G3b/A2-G5) in pre-end-stage kidney disease (pre-ESKD), hemodialysis (HD), peritoneal dialysis (PD), kidney transplantation (KT) or conservative care (CC). The essential follow-up variables agreed for all patients (All) were patient survival, hospitalizations, cardiovascular events, smoking status, health-related quality of life, pain, fatigue, physical function, daily activities, depression, renal function and hemoglobin. Additionally, it was agreed to collect PD survival (in PD patients), peritonitis (PD), infection/bacteremia (PD, HD, KT), vascular access type (HD), vascular access survival (HD), acute rejection (KT), post-transplant cancer (KT), albuminuria (KT) and kidney allograft survival (KT). The optional variables agreed were phosphorus (All), potassium (All), diabetes control (All with diabetes), and albuminuria (pre-ESKD). CONCLUSIONS: This standard set may constitute a highly efficient tool allowing the evaluation of patient outcomes and helping to define strategies to enhance CKD patients' quality of care in the Spanish healthcare system.

Dor e articulação do punho na artrite reumatoide: O impacto na capacidade funcional / Pain and wrist joint in rheumatoid arthritis: The impact on functional capacity / Dolor y articulación de la muñeca en la artritis reumatoide: El impacto en la capacidad funcional

Resumo Enquadramento: Artrite reumatoide (AR), doença autoimune, inflamatória e crónica. Caracteriza-se por poliartrite, dor crónica e dificuldade em mobilizar as articulações, que levam à incapacidade funcional dos doentes. Objetivos: Avaliar a influência da mobilidade articular do punho e da dor, na capacidade funcional de doentes com AR. Metodologia: Estudo quantitativo, descritivo e correlacional, constituído por uma amostra de 105 doentes, com aplicação do Índice de Incapacidade - Questionário Avaliação de Saúde (HAQ-DI); Escala Visual Analógica da Dor (EVA) e medição da amplitude articular do punho, com goniómetro. Resultados: A mobilidade articular do punho é representativa na funcionalidade (p < 0,05), no entanto, a sua extensão e flexão, não influenciam diretamente a dor (p > 0,05). Observou-se que a dor é impactante na capacidade funcional dos doentes (p = 0,010). Conclusão: A mobilidade articular do punho e a dor afetam as atividades diárias dos doentes com AR, expressas através da capacidade funcional de avaliação de saúde.

Abstract Background: Rheumatoid arthritis (RA) is a chronic, autoimmune, and inflammatory disease. Symptoms include polyarthritis, chronic pain, and difficulty in joint mobilization, which lead to functional disability in patients. Objectives: To assess the influence of wrist joint mobility and pain on the functional capacity of patients with RA. Methodology: Quantitative, descriptive, and correlational study in a sample of 105 patients. Health Assessment Questionnaire - Disability Index (HAQ-DI) and Visual Analog Pain Scale (VAS) were applied, and the wrist joint range of motion was measured with a goniometer. Results: Joint wrist mobility is representative of functionality (p < 0.05). However, wrist joint extension and flexion do not directly influence pain (p > 0.05). Pain was observed to impact the functional capacity in patients (p = 0.010). Conclusion: Joint wrist mobility and pain affect the daily activities of patients with RA, expressed through the functional capacity for health assessment.

Resumen Marco contextual: Artritis reumatoide (AR), una enfermedad autoinmune, inflamatoria y crónica. Se caracteriza por la poliartritis, el dolor crónico y la dificultad para movilizar las articulaciones, lo que provoca la incapacidad funcional de los pacientes. Objetivos: Evaluar la influencia de la movilidad articular de la muñeca y el dolor en la capacidad funcional de los pacientes con AR. Metodología: Estudio cuantitativo, descriptivo y correlacional, compuesto por una muestra de 105 pacientes, en el que se aplicó el Índice de Discapacidad - Cuestionario de Evaluación de la Salud (HAQ-DI); la Escala Visual Analógica del Dolor (EVA) y la medición de la amplitud articular de la muñeca, con un goniómetro. Resultados: La movilidad articular de la muñeca es representativa en la funcionalidad (p < 0,05), sin embargo, la extensión y la flexión no influyen directamente en el dolor (p > 0,05). Se observó que el dolor tiene un impacto en la capacidad funcional de los pacientes (p = 0,010). Conclusión: La movilidad articular de la muñeca y el dolor afectan las actividades diarias de los pacientes con AR, expresadas a través de la capacidad funcional de evaluación de la salud.

Estudio sobre el uso de tecnologías de la información y comunicación en personas mayores / Study on the use of information and communication technologies in elderly people

Objetivos: las Tecnologías de la Información y la Comunicación tienen un desarrollo exponencial, formando parte de nuestra vida cotidiana; no obstante, esta incorporación de las tecnologías al día a día se está produciendo a tal velocidad que genera desigualdades entre diferentes grupos de edad como las personas mayores. El objetivo fue indagar sobre el uso de las Tecnologías de la Información y Comunicación en personas mayores, en Porto do Son (La Coruña, España). Métodos: La muestra quedó formada por 237 personas, 57,8 % mujeres y 42,2 % hombres, con una edad media de 74,8 años (SD=6,85). Se empleó un cuestionario sociodemográfico y el Cuestionario Sobre el Uso de Tecnologías-Consumidor. Resultados: se encontraron como factores predictores de uso de tecnologías: el acercamiento a estas mediante cursos de alfabetización digital y a través de un amigo; la percepción por parte de las personas mayores de que las actividades que realizan les resultan satisfactorias y de que la tecnología les acerca a la gente, y usar tecnología concreta en la vida diaria. No se obtuvieron datos significativos con respecto a la influencia de las características personales/sociales. Se observó una relación directa entre el uso de tecnologías y el nivel cultural e inversa con la edad. Conclusiones: la mayor diferencia en la percepción del uso de tecnología por parte de la población adulta se produce a favor de los grupos con menor edad y un nivel cultural superior. (AU)

Objective: Information and Communication Technologies have an exponential development, forming part of our daily life; however, this incorporation of technologies into everyday life is taking place at such speed that it generates inequalities between different age groups such as the elderly. The objective was to investigate the use/non-use of Information and Communication Technologies in the elderly, in Porto do Son. Methods: The sample was made up of 237 people, 137 women and 100 men, with a mean age of 74.8 years (SD=6.85). A sociodemographic questionnaire and the Questionnaire on the Use of Technologies-Consumer were used.Results: The predictive results of the use of technologies were found: the approach to these through digital literacy courses and through a friend; the satisfactory perception of all their common activities and that technology brings them closer to people and the concrete use of technology in daily life. No significant data was obtained regarding the influence of personal/social characteristics on the use/non-use of Information and Communication Technologies.Conclusions: The greatest difference in the perception of the use of technology by the adult population occurs in favor of younger groups and a higher cultural level. (AU)

Calidad de vida relacionada con la salud en pacientes con artritis reumatoide, artritis psoriásica y espondilitis anquilosante tratados con certolizumab pegol / Health-related quality of life in patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis treated with certolizumab pegol

Objetivo: Las enfermedades articulares inflamatorias causan dolor y discapacidad. El objetivo fue medir la calidad de vida de los pacientes conart ritis reumatoide, artritis psoriásica, espondilitis anquilosante en tratamientocon certolizumab pegol y compararla con la de la población general.Método:Con un diseño transversal se recogieron variables sociodemográficasy clínicas, adherencia al tratamiento y calidad de vidamediante el cuestionario Euroqol-5d-5L (EQ-5D). La calidad de vida dela población general se obtuvo de la Encuesta Nacional de Salud. ElEQ-5D se analizó en ambos grupos mediante modelos de dos partesque miden la probabilidad de tener una salud perfecta y la disutilidadcausada por la enfermedad.Resultados: La muestra incluyó 59 pacientes con una adherencia alta(92,3%). La utilidad media fue de 0,78 y el dolor resultó la dimensión másafectada. La reducción de utilidad (índice EQ-5D) de los pacientes conenfermedades articulares inflamatorias respecto a la población generalfue de 0,127.Conclusiones: Los pacientes muestran una calidad de vida significativamentemenor que la población general a pesar del buen control de laenfermedad. Los modelos de dos partes facilitan la interpretación de losestudios de calidad de vida mediante EQ-5D.

Objective: Inflammatory joint diseases cause pain and disability. Theobjective of this study was to measure the quality of life of patients withrheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis treatedwith certolizumab pegol and compare the results with those of the generalpopulation.Method: Using a cross-sectional design and sociodemographic andclinical variables, adherence to treatment and quality of life data werecollected using the Euroqol-5d-5L (EQ-5D) questionnaire. The quality oflife of the general population was obtained from the Spanish NationalHealth Survey. Answers to the EQ-5D questionnaire were analyzed inboth groups using two-part models, which measure the probability ofhaving perfect health as well as the disutility caused by the disease.Results: The sample included 59 patients with high adherence (92.3%).The mean utility value was 0.78 and pain was the most affected dimension. The reduction in utility (EQ-5D index) of patients with inflammatoryjoint disease as compared to the general population was 0.127.Conclusions: The subjects of the study showed a significantly lowerquality of life than the general population despite effective control of thedisease. Two-part models facilitate the interpretation of quality-of-life studiesusing the EQ-5D.

Psychometric Properties of the PDRQ-9 in Cancer Patients: Patient-Doctor Relationship Questionnaire / Propiedades Psicométricas del PDRQ-9 en Pacientes con Cáncer: Cuestionario de Relación Médico-Paciente

Background: The patient-doctor relationship is an important concept in health care. The aim of this study was to evaluate the psychometric properties, convergent validity, and factorial invariance of the Patient-Doctor Relationship Questionnaire (PDRQ-9). Method: Confirmatory factor analysis was conducted to explore the scale’s dimensionality and test for strong measurement invariance across sex, age, and tumor site in a prospective, multicenter cohort of 560 patients who completed the PDRQ-9, Health-related Quality of Life Questionnaire (EORTC-QLQ-C30), and Brief Symptom Inventory (BSI) scales. Results: The data supported a unidimensional structure. Thresholds and factor loadings could be constrained to be invariant across sex, age, and tumor site, indicating strong measurement invariance. Scores derived from the unidimensional structure exhibited satisfactory degrees of reliability and determinacy. Evidence of convergent validity was supported by modest positive correlations with functional (p<.001) and global quality-of-life (p<.001) and negative correlations with psychological distress (p<.001). Low satisfaction with the oncologist was associated with anxiety (p=.006), and depression (p=.004). Conclusions: The PDRQ-9 is a suitable, valid instrument for assessing the quality of patient-doctor relationships in cancer patients. (AU)

Antecedentes: la relación médico-paciente es un concepto importante en cuidado de la salud. El objetivo de este estudio fue evaluar las propiedades psicométricas, la validez y la invariancia factorial del Cuestionario de Relación Médico-Paciente (PDRQ-9). Método: se realizó un análisis factorial confirmatorio para explorar la dimensionalidad de la escala y la invariancia de medición a través del sexo, la edad y la localización del tumor en una cohorte prospectiva multicéntrico de 560 pacientes que completaron el PDRQ-9, el Cuestionario de Calidad de Vida (EORTC-QLQ-C30) y la Inventario Breve de Síntomas (BSI-18). Resultados: los datos apoyaron una estructura unidimensional. Los umbrales y las cargas de los factores podían considerarse invariantes en función del sexo, la edad y localización de tumor (invariancia fuerte). Las puntuaciones derivadas de la estructura unidimensional mostraron grados satisfactorios de confiabilidad y determinación. La evidencia de validez convergente fue apoyada por correlaciones positivas modestas con la escala funcional (p<.001) y la calidad de vida (p<.001) y correlaciones negativas con malestar psicológico (p<.001). La baja satisfacción con el oncólogo estuvo asociada a mayor ansiedad (p =.006) y depresión (p= .004). Conclusiones: el PDRQ-9 es un instrumento válido y adecuado para evaluar la calidad en la relación médico-paciente en pacientes con cáncer. (AU)

The association between patient-therapist MATRIX congruence and treatment outcome.

Objective: The present study aimed to examine the association between patient-therapist micro-level congruence/incongruence ratio and psychotherapeutic outcome. Method: Nine good- and nine poor-outcome psychodynamic treatments (segregated by comparing pre- and post-treatment BDI-II) were analyzed (N = 18) moment by moment using the MATRIX (total number of MATRIX codes analyzed = 11,125). MATRIX congruence was defined as similar adjacent MATRIX codes. Results: the congruence/incongruence ratio tended to increase as the treatment progressed only in good-outcome treatments. Conclusion: Progression of MATRIX codes' congruence/incongruence ratio is associated with good outcome of psychotherapy.