La toma de decisión emocional afecta negativamente la eficacia de la primera ayuda psicológica, más allá del perfil psicológico del rescatista / Emotional Decision Making Negatively Affects the Effectiveness of Psychological First Aid, Irrespective the Rescuer's Psychological Profile / A tomada de decisão emocional afeta negativamente a eficácia dos primeiros auxílios psicológicos, além do perfil psicológico do socorrista

El protocolo de primera ayuda psicológica basado en el modelo de las 4 C (PAP-4C) establece pautas para brindar apoyo y rescatar a individuos afectados en el lugar y momentos inmediatos posteriores a un desastre. Los objetivos de esta investigación fueron estudiar los efectos de la toma de decisión y el entrenamiento presencial breve en la PAP-4C sobre la propensión al comportamiento eficaz de rescate según ese modelo, evaluada una semana después de la capacitación recibida; e identificar otras variables psicológicas que se vinculan con dicha propensión. Para este estudio, se adoptó un enfoque explicativo, que involucró la implementación de un diseño experimental factorial 2x2, con los factores toma de decisión y entrenamiento presencial breve en la PAP-4C, en una muestra de 175 estudiantes universitarios de una academia militar sin entrenamiento previo en rescate en situaciones de desastre. Los resultados de un ancova mostraron que la toma de decisión basada en la emoción perjudica la propensión al comportamiento eficaz en la PAP-4C en comparación con una toma de decisiones basada en la racionalidad, luego de controlar estadísticamente a las covariables. Con relación a la identificación de estas, una serie de características psicológicas se habían mostrado asociadas con la propensión al comportamiento eficaz de rescate. En este sentido, se habían hallado correlaciones positivas con tenacidad, honestidad, apertura, jovialidad, agradabilidad, la atracción afectiva hacia los demás y la toma de la perspectiva del otro. Además, se habían hallado asociaciones positivas con las estrategias de afrontamiento cognitivo dirigido a cambiar la situación, y cognitivo y conductual motor para reducir la emoción. Finalmente, se habían encontrado también asociaciones negativas con la aversión afectiva hacia los demás y el afrontamiento evitativo. En conclusión, por una parte, los resultados de este estudio apuntan a mostrar la importancia de que los líderes de grupos de rescate indiquen a los rescatistas que, cuando realizan la tarea del rescate de personas afectadas por desastres, eviten tomar decisiones emocionales. Por otra parte, los resultados también ofrecen orientación para la selección de personal sin experiencia previa en la asistencia en situaciones de desastre, ya que se identificó una amplia serie de variables psicológicas asociadas a la propensión al comportamiento eficaz en la PAP-4C. En suma, esta investigación proporciona un valioso aporte al campo de la asistencia psicológica en situaciones de crisis, al identificar factores y variables psicológicas que podrían influir en los comportamientos de los rescatistas no profesionales y sin experiencia previa cuando se debe rescatar y brindar apoyo psicológico a personas afectadas por un desastre.

The psychological first aid protocol based on the 4 Cs model (PAP-4C) establishes guidelines for providing support and rescue to affected individuals at the scene and in the immediate aftermath of a disaster. The ob-jectives of this research were to study the effects of decision making and brief training in the PAP-4C on the propensity for effective rescue behaviour according to that model, assessed one week after the training received; and to identify other psychological variables that are linked to that propensity. For this study, an explanatory approach was adopted, involving the implementation of a 2x2 factorial experimental design, with the factors decision making and brief face-to-face training in the PAP-4C, in a sample of 175 university students from a military academy with no previous training in disaster rescue. The results of an ancova showed that emotionbased decision making impaired the propensity for effective behaviour in PAP-4C compared to rationality-based decision making, after statistically controlling for covariates. In relation to the identification of covariates, a number of psychological characteristics had been shown to be associated with the propensity for efficient rescue behaviour. In this regard, positive correlations were found with tenacity, honesty, openness to experience, cheerfulness, agreeableness, affective attraction to the other and taking the other's perspective. In addition, positive associations were found with cognitive coping strategies aimed at changing the situation, and cognitive and behavioural motor coping strategies aimed at reducing the emotion. Finally, negative associations were also found with an affective aversion towards the other and avoidant coping. In conclusion, on the one hand, the results of this study aim to show the importance of rescue team leaders instructing rescuers to avoid making emotional decisions when carrying out rescuing disaster affected people. On the other hand, the results provide guidance for the selection of personnel with no previous expe-rience in disaster relief, as a wide range of psycho-logical variables associated with the propensity for effective behaviour in PAP-4C were identified. In sum, this research provides a valuable contribution to the field of psychological assistance in crisis situations by identifying psychological factors and variables that may influence the behaviours of non-professional and inexperienced rescuers when rescuing and providing psychological support to disaster-affected people.

O protocolo de primeiros auxílios psicológicos baseado no modelo 4 C (PAP-4C) estabelece diretrizes para fornecer apoio e resgatar indivíduos afetados no local e imediatamente após um desastre. Os objetivos desta pesquisa foram estudar os efeitos da tomada de decisão e do breve treinamento presencial no PAP-4C sobre a propensão para um comportamento de resgate eficaz de acordo com esse modelo, avaliado uma semana após o treinamento recebido; e identificar outras variáveis psicológicas que estão ligadas a essa propensão. Para este estudo foi adotada uma abordagem explicativa, que envolveu a implementação de um desenho experi-mental fatorial 2x2, com os fatores tomada de decisão e breve treinamento presencial sobre o PAP-4C, em uma amostra de 175 estudantes universitários de uma academia militar sem treinamento prévio em resgate em situações de desastre. Os resultados de uma ancova mostraram que a tomada de decisão baseada na emoção, prejudica a propensão para um comportamento eficaz no PAP-4C em comparação com a tomada de decisão baseada na racionalidade, após controlar estatisticamente as covariáveis. Em relação à identificação destas, uma série de características psicológicas mostraramse associadas à propensão para comportamentos de resgate eficazes. Nesse sentido, foram encontradas correlações positivas com tenacidade, honestidade, abertura, jo-vialidade, simpatia, atração emocional pelos outros e tomada de perspectiva do outro. Além disso, foram en-contradas associações positivas com estratégias de enfrentamento cognitivas destinadas a mudar a situação e estratégias de enfrentamento comportamentais cog-nitivas e motoras para reduzir a emoção. Finalmente, também foram encontradas associações negativas com aversão afetiva em relação aos outros e enfrentamento evitativo. Concluindo, por um lado, os resultados deste estudo pretendem mostrar a importância de os líderes dos grupos de resgate dizerem aos socorristas que, ao realizarem a tarefa de resgatar pessoas afetadas por de-sastres, devem evitar tomar decisões emocionais. Por outro lado, os resultados também oferecem orientação para a seleção de pessoal sem experiência anterior em assistência em situações de desastre, uma vez que foi identificada uma ampla série de variáveis psicológicas associadas à propensão para comportamentos eficazes no PAP-4C. Em resumo, esta investigação proporciona uma valiosa contribuição para o campo da assistência psicológica em situações de crise, ao identificar fato-res e variáveis psicológicas que podem influenciar os comportamentos de socorristas não profissionais e sem experiência prévia, ao resgatar e prestar apoio psicoló-gico a pessoas afetadas por um desastre

Fortalezas del carácter y estresores de la práctica clínica como predictores en un modelo lineal del estrés percibido en estudiantes militares de Enfermería / Character strengths and stressors in clinical practice as predictors in a linear model of perceived stress among military Nursing students

Objetivo principal: Identificar diferentes estresores y fortalezas del carácter que permitan predecir el estrés percibido de estudiantes de Enfermería. Metodología: Se realizó un modelo de predicción basado en las 24 fortalezas medidas a partir del Inventario de Virtudes y Fortalezas y en los nueve estresores de las prácticas clínicas evaluados a partir del Inventario de Kezkak. La muestra estuvo conformada por 47 estudiantes de enfermería (59,5 % mujeres). La edad promedio fue de 22.76 años (DT=2,47 años). Resultados principales: Los estudiantes experimentaron más estrés debido a la inseguridad y a su autopercepción de falta de competencia profesional. El estresor sobrecarga de tareas y las fortalezas de gratitud, amor y perspectiva predijeron el 30 % de la variabilidad de estrés percibido. Conclusión principal: El hallazgo principal de este trabajo radica en la identificación de las fortalezas del carácter que actúan como moderadores significativos del estrés percibido por los estudiantes de la Carrera de Enfermería Militar.(AU)

Main Objective: Identify different stressors and character strengths that allow predicting the perceived stress of nursing students. Methodology: A prediction model was developed based on the 24 strengths measured from the Virtues and Strengths Inventory and the nine stressors of clinical practices assessed from the Kezkak Inventory. The sample consisted of 47 nursing students (59.5% women). The average age was 22.76 years (SD=2.47 years). Main Results: Students experienced more stress due to insecurity and their self-perception of lack of professional competence. The task overload stressor and the strengths of gratitude, love, and perspective predicted 30% of the variability of perceived stress. Main Conclusion: The primary discovery of this study lies in the identification of character strengths that act as significant moderators of the stress perceived by students of the Military Nursing Career.(AU)

Evaluation of stress, burnout and hair cortisol levels in health workers at a University Hospital during COVID-19 pandemic.

In the critical context of COVID-19 pandemic, healthcare workers are on the front line, participating directly in the care, diagnosis, and treatment of patients with COVID-19. This exposes them to a higher risk of developing chronic stress, psychological distress, and any other mental health symptoms. OBJECTIVE: to evaluate stress and burnout in a health workers population and, in addition, to measure hair cortisol concentration as a current biomarker of stress. MATERIALS AND METHODS: 234 health workers from Hospital de Clínicas "José de San Martín", Buenos Aires University, were included in this study. In this population hair samples were obtained from the posterior vertex as close to the scalp as possible and the individuals completed the following surveys: perceived stress, social support, burnout scale, life event scale, and sociodemographic data. Hair cortisol was measured by an automated chemiluminescent method. The studied population was divided into three groups considering those individuals below the healthy reference sample range (< 40 pg/mg hair), within the healthy reference range (40-128 pg/mg hair) and above the reference range (> 128 pg/mg hair). This study used a transversal and observational design. RESULTS: Our results show that 40% of the studied population presented hair cortisol values outside of the healthy reference range. In the whole studied population, a direct correlation was found between hair cortisol concentration and perceived stress as well as between hair cortisol concentration and the emotional exhaustion component of burnout (r = 0.142, p = 0.030; r = 0.143, p = 0.029, respectively). 12% of the studied population showed Burnout (52% doctors and residents, 19% nurses, 19% administrative personnel). Higher values in hair cortisol levels were found in the group with burnout versus individuals without burnout (p = 0.034). Finally, a mediation analysis was performed, finding that depersonalization is a mediating variable in the relationship between self-perceived stress and hair cortisol level (F = 4.86, p = 0.0086; indirect effect IC: 0.0987-1.8840). CONCLUSION: This is the first study in which a stress biomarker such as hair cortisol is evaluated in this population and in this context. Healthcare workers are subjected to increased levels of stress and burnout. High depersonalization, emotional exhaustion, and decreased personal sense of accomplishment characterize this population. It is the responsibility of the health authorities to implement strategies to manage this psychological emergency.

La toma de decisiones de rescatistas y la efectividad en primera ayuda psicológica / The decision making of the rescuers and effectiveness in the first psychological aid

Resumen Se realizó un estudio explicativo y transversal con el objetivo de analizar la efectividad y los tiempos en la toma de decisiones al momento de brindar una primera ayuda psicológica (PAP) en las fases iniciales de un desastre en función del estilo y el proceso decisorio implicados. Se tomó una muestra no probabilística intencional de 165 voluntarios rescatistas de cuatro cuarteles de la zona de AMBA, se los dividió aleatoriamente en dos grupos (capacitados y no capacitados en PAP) y, a su vez, dichos grupos fueron divididos aleatoriamente respecto de la consigna impartida en la evaluación sobre el proceso decisorio a utilizar (decidir en función de lo que se piensa o de que lo que se siente). Asimismo, cada rescatista fue clasificado como "racional" o "afectivo" según el estilo decisorio urgente medido por el instrumento Bases for Urgent Decisions under Extreme Circumstances Inventory (BUDECI). Los resultados mostraron que los menos efectivos y más lentos fueron aquellos rescatistas capacitados con un estilo urgente decisorio afectivo, bajo una consigna que apelaba también a lo emocional. Este último grupo no presentó diferencias respecto de su efectividad cuando se lo comparó con el grupo de los no capacitados. La mayor efectividad la obtuvieron aquellos grupos que tenían un estilo o una consigna de tipo racional. La capacitación en PAP ha posibilitado la adquisición de estrategias de acción sencillas. Se concluye que el estilo decisorio y/o una inducción decisoria racionales favorecen una mayor efectividad de las acciones de PAP en las fases iniciales de un desastre.

Abstract The protocol on Psychological First Aid (PFA) establishes a number of actions to take on victims who are in the area of an event. Through these actions, the victims are assisted and helped to feel calm but not passive. Regarding the implementation of PFA in disaster situations, the type of decision-making, analytic or intuitive, could represent an important factor in the effectiveness of the actions of aid provided by volunteers in emergencies and disaster situations. Modifications of a PFA protocol are presented to apply to victims in the early stages of a disaster; these modifications are intended to clear the life-saving area for the rescuer and reduce the risk of post-traumatic stress disorder (PTSD). Starting from the premises of the original model of Farchi, known as the Model of the 6 Cs, a simplified version for its application in Argentina was denominated the Model of the 4 Cs. In the same way, it is considered that, when assisting a person in a situation of crisis or disaster, the objective is to promote the activity of the prefrontal cortex and decrease the action of the limbic system. To do this, four guidelines are proposed: 1) Cognitive Communication, 2) Control and Challenge, 3) Commitment and 4) Continuity. Likewise, a PFA protocol based on the above mentioned model is presented. An explanatory and cross-sectional study was carried out with the objective of analyzing the effectiveness and the decision times when providing a PFA in the initial phases of a disaster, depending on the style and decision process involved. An intentional non-probabilistic sample, composed of 165 rescue volunteers from 4 fire stations in the AMBA area (Metropolitan Area and Greater Buenos Aires) and a headquarters of the Red Cross of the party of Tigre (San Fernando), was randomly divided into 2 groups (trained and untrained in PFA). Each volunteer was evaluated through the Software of the First Aid Interactive Psychological System (SIPAPSI); this consisted of a simulation of different crisis situations during which the participants must decide between different options presented in audiovisual format. The user must select the video that most closely approximates to what he or she would do in the presented situation. Then, the rescuers were randomly divided with respect to the slogan about the decision-making process used in the evaluation ("decide based on what you think", rational, or "decide based on what you feel", affective). The software SIPAPSI recorded the participant's response and the response time for each scene. Likewise, each volunteer was evaluated using the test Bases for Urgent Decisions under Extreme Circumstances Inventory (BUDECI). The BUDECI is composed of 8 elements that evaluate the decision-making style in unexpected and very important situations according to two dimensions: affective and rational. Rescuers were divided according to their urgent decision-making style: affective or rational. Therefore, the volunteers were classified according to whether or not they presented an adjustment between the decision-making style and the decision-making process induced by the slogan. This allowed us to study the influence of this adjustment on the effectiveness and decision time in disaster situations. The results showed that the least effective and, at the same time, slowest were those trained rescuers with an urgent affective decision style but induced under an emotional process. The PFA training has enabled the acquisition of simple action strategies in emergencies and disaster situations. It is concluded that the rational decision-making style or a rational decision induction favors a greater effectiveness of the PFA actions. These results allow us to build an optimal decisional profile for the rescuer's performance in crisis intervention tasks.

Programa para mejorar el afrontamiento del estrés de los estudiantes, los docentes y los no docentes de la Facultad de Farmacia y Bioquímica de la Universidad de Buenos Aires / Stress management program for students, teachers and non-teachers of the Faculty of Pharmacy and Biochemistry of the University of Buenos Aires

INTRODUCCIÓN Y OBJETIVOS: Los programas para mejorar el afrontamiento del estrés incluyen una serie de técnicas tales como entrenamiento en relajación, reestructuración cognitiva y manejo del tiempo, entre otras. Su aplicación ha mostrado su importancia en el campo de la Psicología de la Salud. El objetivo de este trabajo es verificar la efectividad y establecer la importancia de un programa teórico-práctico de entrenamiento para el manejo del estrés, destinado a profesionales, docentes, no docentes y estudiantes de las carreras de Farmacia y Bioquímica. MATERIAL Y MÉTODOS: Se implementó un programa de 5 sesiones destinado a mejorar el afrontamiento del estrés. Se utilizaron como indicadores de eficacia mediciones pre-post de cortisol en cabello y nivel de ansiedad. RESULTADOS: Al finalizar el programa disminuyeron significativamente los valores de cortisol en cabello, de ansiedad estado y de ansiedad rasgo en aquellos participantes que completaron el programa. En el grupo control se observó solamente un aumento significativo en los niveles de cortisol en cabello. CONCLUSIONES: Este programa resultó efectivo para disminuir el nivel de estrés y ansiedad en los participantes, ayudando a mejorar la calidad de vida de los estudiantes y los profesionales docentes y no docentes que participaron en él

INTRODUCTION AND AIMS: Programs to improve stress coping include a series of techniques such as relaxation training, cognitive restructuring, and time management, among others. Its application has shown its importance in the field of Health Psychology. In the present study we show the beneficial results of a theory-practice pilot training program of stress management for professionals, teachers, non teachers and students of Pharmacy and Biochemistry. MATERIAL AND METHODS: A program of 5 sessions was implemented with the objective of improving stress management. To assess efficacy, we used hair cortisol level and anxiety level tests before and after the program. RESULTS: After the program, both hair cortisol and anxiety levels significantly decreased among participants. Hair cortisol significantly increased in the control group. CONCLUSIONS: This type of program was proved to be effective for all participants, helping to reduce stress and improving their quality of life

Hair cortisol: A new tool for evaluating stress in programs of stress management.

AIMS: Longitudinal and experimental studies have shown that chronic stress contributes to the onset and progression of different diseases. Although it is not possible to eliminate stress completely, people can learn to manage it by participating in different kinds of stress management interventions. This study examined the effectiveness of stress management interventions on neuroendocrine responses in stressed students and health professionals, by measuring hair cortisol in comparison to salivary cortisol. MAIN METHODS: Salivary and hair cortisol measurements were performed in 37 subjects (31women, 6 men; mean age 34.0±10.6) who attended to a Coping Stress and Quality of Care Program at the University of Buenos Aires. Cortisol was measured at the beginning and at the end of the program. The State-Trait Anxiety Inventory STAI was used to evaluate state and trait anxiety. KEY FINDINGS: In subjects who completed the program, no differences were observed in salivary cortisol levels between the first and the last session. However, in these subjects, hair cortisol obtained in the last session was significantly lower than hair cortisol in the first session. SIGNIFICANCE: Hair cortisol appears to be a better biomarker than salivary cortisol for evaluation of the effectiveness of a stress reduction program and it seems to be a better indicator of stress system dysregulation as well.

Psychological and physiological response of students to different types of stress management programs.

PURPOSE: To design, implement, and examine the psychoneuroendocrine responses of three different types of stress management programs. DESIGN: Randomly assigned. A pre/post experimental design comparing variables between three different programs and a control group. The first program included training in deep breathing, relaxation response, meditation, and guided imagery techniques (RRGI). The second program included training in cognitive behavioral techniques (CB). The third program included both RRGI and CB (RRGICB). SETTING: The study was conducted at Buenos Aires University. SUBJECTS: Participants (N  = 52) were undergraduate students. MEASURES: Anxiety, anger, hopelessness, neuroticism, respiration rate, and salivary cortisol levels were assessed. ANALYSIS: Wilcoxon signed rank test was used to investigate differences in pre and post variables. RESULTS: Subjects in the RRGI group showed significantly lower levels of anxiety (p < .011), anger (p < .012), neuroticism (p < .01), respiratory rate (p < .002), hopelessness (p < .01), and salivary cortisol (p < .002) after the treatment. Subjects in the CB group showed significantly lower levels of anxiety (p < .018), anger (p < .037), and neuroticism (p < .03) after the treatment. Subjects in the RRGICB group showed significantly lower levels of anxiety (p < .001), anger (p < .001), neuroticism (p < .008), hopelessness (p < .01), respiratory rate (p < .001), and salivary cortisol (p < .002) after the treatment. Subjects in the control group showed only one variable modification, a significant increase in cortisol levels (p < .004). CONCLUSIONS: The combination of deep breathing, relaxation response, meditation, and guided imagery techniques with CB seems to be effective at helping people to deal with stress.

Características de la investigación psicológica en los estudios estesiométricos de Alfredo Calcagno / Esthesiometric research in the work of Alfredo Calcagno

Examinar las características de la investigación psicológica desarrollada por Alfredo Calcagno (1919, 1924, 1925) en el campo de la estesiometría. Método: Examen de fuentes -Revistas Archivos de Pedagogía y Ciencias Afines, y I1:I20 Resultados: la investigación psicológica es concebida por Calcagno en la tradición de los primeros laboratorios de psicología experimental, dándole un papel central a la psicofisiología, en un marco evolucionista, ligada a un proyecto pedagógico e incluye un aspecto tecnológico: los aparatos de psicología diseñados por Calcagno fueron los primeros de autor argentino presentados en 1919 a un Congreso sudamericano. Se analiza el marco dado por el Laboratorio de la Sección de Pedagogía de la Universidad de La Plata, en el que se desarrolló su trabajo. Se establecen paralelos entre su concepción de la psicología y la de la investigadora belga Josefa Ioteyko...