Social and mental health characteristics of adolescents living with HIV in Mexico: Implications for adherence to antiretroviral treatment.

Mexico is the third Latin American country with the most children and adolescents living with human immunodeficiency virus (ALHIV). There is a lack of information on the characteristics of this population. We aimed to describe the social and mental health characteristics of Mexican ALHIV. A census was conducted of all adolescent patients with HIV at a pediatric hospital (n = 47; mean age 14.39, S.D. = 3.65) and their caregivers. We collected data on socio-demographic characteristics, family, intelligence, mental health, adverse life events, substance use, treatment, knowledge of Antiretroviral Treatment (ART) and HIV, and biomarkers. Most cases were transmitted vertically and self-reported ART adherence was above 90%. Some obstacles to adherence were medicine discomfort, believing that they did not need it, and forgetfulness. The vulnerabilities were intellectual disability, adverse life events, possible mental health problems, and little knowledge of their illness and treatment. These findings suggest the importance of interventions to improve the perception and knowledge of HIV and ART to increase ART adherence.

Necesidad de apoyo psicológico y calidad de vida en el cuidador primario de pacientes pediátricos con cáncer / Need of psychological support and assessment of quality of life of family caregivers of children with cancer

El cáncer infantil es un problema de salud pública en México. Esta enfermedad es motivo de angustia y problemas psicosociales tanto en el paciente como en su cuidador primario. Si las necesidades del cuidador no son identificadas y atendidas se impacta sobre el bienestar y la salud del infante. EI objetivo de la presente investigación fue evaluar las necesidades de apoyo (NA) y calidad de vida del cuidador primario informal (CPI) de pacientes pediátricos con cáncer. Método: El diseño fue no experimental y correlacional. Participaron 100 CPIs de pacientes pediátricos con cáncer hospitalizados, la mayoría fueron mujeres y madres de los pacientes. Resultados: Se encontró que las NA mayormente insatisfechas fueron la necesidad de resolver las preocupaciones por el futuro, seguido por las necesidades emocionales y las necesidades de información. Aquellas percibidas con una menor urgencia por resolver fueron las necesidades relacionadas con el acceso médico de los pacientes. El funcionamiento emocional, físico y social fueron las áreas más afectadas en la calidad de vida (CV). Con respecto al impacto familiar, las relaciones familiares mostraron ser uno de los dominios menos afectados. El análisis de regresión múltiple por método intro demostró que las necesidades emocionales y de información no satisfechas, las preocupaciones, actividades diarias, y relaciones familiares de los CPIs explican el 74% de la varianza en calidad de vida. Conclusión: Se recomienda integrar a su protocolo clínico de rutina la detección de necesidades, evaluación de CV, así como la implementación de intervenciones psicoeducativas y, en su caso, la atención psicológica personalizada (AU)

Children’s cancer is a public health problem in Mexico. This disease is also cause of distress and psychosocial problems for the patient, as well as their primary caregiver. The family is the first circle of support for a patient, therefore, if their needs are unmet, the infant’s health and wellbeing will suffer in turn. The purpose of this investigation project was to evaluate supportive needs (SN) and quality of life (QOL) of family caregivers (FCs) of pediatric cancer patients. Method: This investigation’s design was correlational and non-experimental. The study’s participants were 100 FCs for pediatric cancer patients currently hospitalized at the National Institute of Pediatrics in Mexico City, the majority were women and mothers of the patients. Results: The results showed that facing the worries about the future, emotional needs, as well as information needs were the most unsatisfied SN’s. The one with least urgency to solve was the patients access and medical continuity needs. Proper emotional, physical and social function were the most affected areas of their quality of life. On the other hand, the family relationship of the family impact domain was one of the less affected. Furthermore, intro multiple regression showed that unmet needs relating to information and emotions, in addition to worries, daily activities and family relationships explained 74% of the variance in QOL. Conclusion: It is advised that detection of needs, evaluation of quality of life, psychological support and the implementation of psychoeducational interventions be integrated into routine clinical attention in this population (AU)

Efectos conductuales de la Terapia de Aceptación y Compromiso con pacientes de un hospital pediátrico / Behavioral Effects in pediatric hospital patients after Acceptance and Commitment Therapy

Actualmente existe una alta demanda de atención hospitalaria de pacientes pediátricos con comorbilidad de trastornos mentales. Por ello, se han desarrollado alternativas de tratamientos psicológicos, como la Terapia de Aceptación y Compromiso (ACT, por sus siglas en inglés). Esta se ha utilizado en poblaciones con diferentes diagnósticos médicos y psicológicos, y la evidencia ha mostrado resultados en población infantil. El presente estudio es cualitativo con enfoque fenomenológico, se usaron técnicas de observación con observadores como participantes, entrevista semiestructurada y registros conductuales previos y posteriores a la intervención. El objetivo de esta terapia grupal basada en ACT fue conocer los efectos conductuales en pacientes pediátricos que contaran con diagnósticos médicos y/o psicológicos. Participaron cinco pacientes escolares con condiciones médicas y problemas en el área afectiva, conductual y/o social. Los resultados muestran que los participantes presentaron mejorías conductuales, principalmente en la regulación emocional, conductas prosociales, habilidades sociales con pares y en la comunicación, las cuales se mantuvieron seis meses después. Asimismo, se observó mayor flexibilidad psicológica. Este estudio propone un nuevo protocolo de intervención basado en ACT, en formato grupal, pictórico y adaptado a pacientes en etapa escolar

At the present time, research literature has reported a high demand for pediatric patients, for hospital attention, but who are also diagnosed with mental disorders. Due to this, several psychological treatments have been developed, such as the Acceptance and Commitment Therapy (ACT). This therapy, whose evidence has shown results in child population, has been used in groups with different medical and psychological diagnoses. The present phenomenological qualitative study used the observation method, observers as participants, a semi-structured interview, and behavioral recordings before and after the intervention. The aim of this ACT based group intervention was to find out about the behavioral effects in pediatric patients with medical and psychological diagnoses. Five scholar patients with medical conditions and problems in the affective, behavioral and/or social areas, participated. Results report that the participants showed behavioral improvement mainly in emotional regulation, prosocial behavior, peer social and communication skills, all of which were maintained six months after, also psychological flexibility increased as well. This study suggests a new ACT based intervention protocol, in group format, pictorial-like, and adapted to school age patients