Personal assistance, independent living, and people with disabilities: An international systematic review (2013-2023).

BACKGROUND: The article discusses the contribution of personal assistance for the independent living of people with disabilities. This right is evolving at different speeds internationally, presents controversial aspects, and is under continuous debate. OBJECTIVE: To synthesize the evidence relating to the promotion of self-determination and independent living through personal assistance. METHODS: A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search for relevant literature published was conducted during March 2023 across nine databases. The findings of the included studies were coded and analyzed via inductive content analysis. RESULTS: 26 articles were included, mostly qualitative, from four different continents. The analysis revealed six different key themes. The social framework highlighted the influence of international agreements and disability activism on cultural shifts in understanding disability. Secondly, healthy relationships and life or service expectations were emphasized. Key agents included users, personal assistants, family members, service providers, and other professionals. Personal assistants' work context explored ethical dilemmas, training, and working rights. Decision-making about personal assistance involved factors like lack of information, access requirements, and funding. Lastly, the implications underscored the positive impact of personal assistance on independent living, while identifying threats, and best practices for improvement. CONCLUSIONS: This systematic review was the first to explore the promotion of independent living of people with disabilities through personal assistance schemes and highlights the need for governments to prioritize and coordinate efforts to ensure access for all, emphasizing the ethical imperative to progress toward social justice.

Aspectos éticos de la asistencia personal, una visión desde el Trabajo Social / Ethical Aspects of Personal Assistance, a View from Social Work

El propósito de este estudio es, desde la óptica del Trabajo Social, identificar los principales problemas éticos que se le presentan a las profesionales de la asistencia personal al desarrollar sus funciones de ayuda o apoyo a las personas con discapacidad, así como detectar si las profesionales consideran necesaria una mayor formación ética. Para ello, se optó por un procedimiento mixto mediante la aplicación de dos cuestionarios ad hoc. El primero, de preguntas abiertas, se dirigió a 31 profesionales en activo de la asistencia personal en España en la fase de recogida de información. El segundo, de preguntas cerradas o respuesta breve, se dirigió a 52 profesionales con experiencia previa en dicha figura profesional. Mediante el análisis de su discurso se corroboró la necesidad de afrontar diferentes conflictos y problemas éticos durante la prestación del servicio de asistencia personal en distintos ámbitos y situaciones. Podemos concluir que la formación ética de las profesionales es insuficiente para el desarrollo de sus funciones en condiciones de calidad y respecto a la dignidad y la autonomía personal de las personas usuarias. (AU)

The purpose of this study is, from the point of view of Social Work, to identify the main ethical problems that personal assistance professionals face when developing their functions of helping or supporting people with disabilities, as well as detecting whether professionals consider that greater ethical training is necessary. To do this, a mixed method was chosen through the application of two ad hoc questionnaires. The first, with open questions, was addressed to 31 active personal assistance professionals in Spain in the information collection phase. The second, with closed questions or short answers, was addressed to 52 professionals with previous experience in said professional figure. Through the analysis of their speech, the need to face different conflicts and ethical problems during the provision of the personal assistance service in different areas and situations was corroborated. We can conclude that the ethical training of professionals is insufficient for the development of their functions in quality conditions and with respect to the dignity and personal autonomy of the users. (AU)

Self-esteem and socialisation in social networks as determinants in adolescents' eating disorders.

Eating disorders are mental health illnesses that are influenced by various individual, family and social factors. The present study aimed to examine the influence of self-esteem and socialisation through social networks on eating disorder behaviours in adolescence. The sample was made up of 721 secondary school students (49.1% girls). The sample age ranged between 12 and 18 years (M = 13.89, SD = 1.37). Participants completed the Eating Attitudes Test-26 (EAT-26) to measure disordered eating attitudes and behaviours, the Rosenberg Self-Esteem Scale and the ESOC-39 scale, which measures socialisation through social networks, in addition to a brief initial sociodemographic survey. Descriptive and multivariate analyses were carried out with MANOVA. Low self-esteem was shown to increase behaviours linked to eating disorders globally. Likewise, high socialisation through social networks was also associated with a general increase in eating disorders during adolescence. The findings of the study provide empirical support for the need to develop prevention strategies that address the improvement in self-esteem and adequate socialisation through social networks during adolescence. The development of effective interventions along these lines could be helpful to treat the behaviours and attitudes that are observed in eating disorders.

Psychometric properties of the Maslach Burnout Inventory - Human Services in Social Work professionals in Spain.

The burnout syndrome has traditionally been identified in the service sector professions, among which is Social Work. In order to determine this syndrome, different measuring instruments have emerged, including the Maslach Burnout Inventory. The main objective of this study was to evaluate the psychometric properties of this instrument and to find evidence of its validity (corroborating the original factorial structure and its convergent validity) and reliability (internal consistency). The Spanish adapted version of the Maslach Burnout Inventory was used. Four hundred social workers participated, randomly divided into two samples of 200 individuals (Sample 1: M = 43.06, SD = 9.04 and Sample 2: M = 40.89, SD = 8.78). We carried out principal components exploratory factor analysis with Varimax rotation. The results identified a factorial structure with four factors (Emotional Exhaustion, Depersonalization, Personal Realization, and Interpersonal Psychological Stress) (χ2 /df = 1.73, CFI = 0.929, NNFI = 0.859, SRMR = 0.069, RMSEA = 0.061), different from that of the original questionnaire, which indicated three dimensions. The data also show a high internal consistency (α = 0.882). The four factors were directly and moderately associated with each other (r between 0.328 and 0.534). In conclusion, this study provides new data of a valid and reliable tool for evaluating professional burnout or exhaustion.

[Influence of personal and family variables on eating disorders.] / Influencia de variables personales y familiares en los trastornos de conducta alimentaria.

OBJECTIVE: Eating disorders (EDs) usually begin during puberty and adolescence, a time when attention should be paid to the factors that influence the development of the disease. The aim of this study was to assess attitudes towards eating and the risk of developing EDs, taking into account personal and family variables in a population of secondary school students. METHODS: A total of 790 Compulsory Secondary School students enrolled in the 2019/2020 academic year in secondary schools in the Autonomous Community of Galicia participated, of whom 410 were male and 380 female (M=13.84; SD=1.37). In this descriptive-cross-sectional study, eating disorders were assessed using Garner's Eating Attitudes Test (EAT-26), adapted to Spanish subjects. The statistical treatment of the data was carried out by means of a multivariate analysis of variance (MANOVA), which took the form of frequency analysis and contingency tables. RESULTS: With regard to the personal variables analysed, no significant differences in eating disorders were found across adolescents' gender (p>0.05), but there were significant differences in age (p<0.001), school year (p<0.001) and use of social networks (p<0.05). Similarly, the data do showed significant differences in eating disorders according to the level of studies of the families (p<0.01) and their family relationship (p<0.001). CONCLUSIONS: The results obtained in this research confirm an influence of personal and family variables in attitudes associated with EDs. Further investigation of these variables may facilitate better intervention, as well as improve the design of preventive strategies.

OBJETIVO: Los trastornos de la conducta alimentaria (TCA) se inician normalmente durante la pubertad y la adolescencia, momento en el que se debe prestar atención a los factores que influyen en el desarrollo de la enfermedad. El objetivo de este trabajo fue evaluar las actitudes hacia la alimentación y el riesgo de padecer TCA, teniendo en cuenta las variables personales y familiares en una población de estudiantes de educación secundaria. METODOS: Participaron un total de 790 estudiantes de Educación Secundaria Obligatoria (ESO) matriculados en el curso 2019/2020 en institutos de la comunidad autónoma de Galicia, de los cuales 410 eran varones y 380 mujeres (M=13,84; DT=1,37). En este estudio descriptivo-transversal los TCA fueron valorados mediante el Eating Attitudes Test (EAT-26) de Garner, en la versión adaptada a sujetos españoles. El tratamiento estadístico de los datos se desarrolló mediante un análisis multivariado de varianza (MANOVA), que se plasmó a través de análisis de frecuencias y tablas de contingencia. RESULTADOS: Atendiendo a las variables personales analizadas, no se encontraron diferencias estadísticamente significativas de los trastornos de conducta alimentaria en el género de los adolescentes (p>0,05), pero sí en la edad (p<0,001), curso escolar (p<0,001) y uso de redes sociales (p<0,05). Del mismo modo, los datos sí presentaron diferencias estadísticamente significativas en los trastornos de conducta alimentaria según el nivel de estudios de las familias (p<0,01) y su relación familiar (p<0,001). CONCLUSIONES: Los resultados obtenidos en la investigación verifican una influencia de las variables personales y familiares sobre las actitudes asociadas a los TCA. Continuar ahondando en estas variables puede facilitar una mejor intervención, así como mejorar el diseño de estrategias preventivas.

Dolor crónico en personas mayores institucionalizadas: influencia del apoyo social y de variables afectivas / Chronic pain in the elderly nursing home population: the influence of social support and affective variables

Objetivo: Analizar si la ansiedad es la variable de mayor peso específico en la sensación de dolor, así como establecer de una manera clara el papel que desempeñan las variables de clima social y de interacción social en el proceso de dolor. Metodología: La muestra seleccionada fue de 74 ancianos (37 manifestaban dolor crónico y 37 no). Se recogieron también de cada sujeto datos demográficos, clínicos y test psicológicos (cuestionario STAI y Escala de MOS). Resultados: Las mayores diferencias entre los sujetos que manifiestan tener o no tener dolor se encuentran en las variables de ansiedad y en la ansiedad rasgo. Existe una alta correlación negativa entre la ansiedad y el clima social. El apoyo emocional y el clima social general son las variables de clima que más correlacionan negativamente con la ansiedad. Para el grupo de personas con dolor, la variable tenencia de familiares cercanos es la que actúa concomitantemente con las variables de clima social. Conclusiones: Se demuestra que la ansiedad es el predictor más importante del grado en que un sujeto informa tener dolor. Se considera que determinados instrumentos de medida del clima social, como es el caso de la Escala de MOS, son de gran ayuda para predecir la aparición de dolor crónico, y que manipulando sus variables integrantes el personal de los equipos de salud puede disponer de formas útiles que ayuden a mejorar positivamente a las personas mayores en la mejora de su calidad de vida (AU)

Objective: To analyse whether anxiety is the variable with the greatest specific weight in the sensation of pain, as well as to establish in a clear way the role that social climate and social interaction variables in the pain process. Methodology: The selected sample consisted of 74 elderly people (37 with chronic pain (37 had chronic pain and 37 did not). Demographic, clinical and and psychological tests (STAI questionnaire and MOS scale) were also collected from each subject. Results: The greatest differences between subjects who reported having or not having pain were found in the anxiety and trait anxiety variables. There is a high negative correlation between anxiety and social climate. Emotional support and general social climate are the climate variables that correlate most negatively with anxiety. For the group of people in pain, the variable having close relatives is the one that acts concomitantly with anxiety. Conclusions: Anxiety is shown to be the most important predictor of the degree to which a subject predictor of the degree to which a subject reports having pain. It is considered that certain instruments for measuring social climate, such as the MOS Scale, are the MOS Scale, are considered to be of great help in predicting the appearance of chronic pain, and that by manipulating its chronic pain, and that by manipulating its constituent variables, health team personnel can have ways to health care teams can have useful ways of helping to positively improve the elderly in the positively help older people to improve their quality of life (AU)

Prevalencia del burnout en el Sistema de Servicios Sociales: estudio transversal en servicios sociales comunitarios / Prevalence of burnout in the Social Services System: cross-sectional study in community social services

Objetivo principal: evaluar la prevalencia del síndrome de burnout en las trabajadoras sociales que ejercen su actividad laboral en los servicios sociales comunitarios. Metodología: diseño de enfoque descriptivo y transversal, utilizando el cuestionario Maslach Burnout Inventory. Dicho cuestionario mide tres dimensiones relacionadas con el burnout: Agotamiento emocional, Despersonalización y Realización personal. La recogida de datos se realizó a través de una aplicación de encuestas, entre trabajadoras sociales colegiadas. Resultados: participaron 209 trabajadoras sociales, de las cuales el 92,8% son mujeres y un 7,2% hombres; sus edades están comprendidas entre los 23 y los 64 años. Los datos de prevalencia arrojan unos resultados elevados en los factores que componen el constructo de burnout, especialmente en la dimensión de Agotamiento Emocional. Conclusiones: el síndrome de burnout se encuentra presente en un porcentaje elevado de trabajadoras sociales del Sistema de Servicios Sociales. (AU)

Objective: to assess the prevalence of burnout syndrome in the professional group of social workers who perform their work in the community social services. Methods: a descriptive and cross-sectional design was proposed, using as the main instrument the Maslach Burnout Inventory. This inventory measures three dimensions related to burnout: Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Data collection was carried out through a survey among the social workers registered. Results: 209 social workers participated in the study, of which 92.8% of the population under study are women and 7.2% are men; their ages ranging between 23 and 64 years. The study prevalence data yields high results in the factors that make up the burnout construct, especially in the Emotional Exhaustion dimension. Conclusions: burnout syndrome is present in a high percentage of social workers in the social services system. (AU)

Personality Variables as Predictors of Health Services Consumption.

Expenditure on healthcare and services can be a serious problem for public health. Personality variables should be included as indicators to be considered when studying the consumption of health resources and their planning. This study aims to identify the psychological and psychosocial variables that identify people who can be considered high consumers of health resources versus those who barely consume such resources. The sample was made up of a total of 1124 subjects; one half were men, and one half were women, all of legal age and residents in Spain. A battery of tests was created that included a questionnaire of sociodemographic variables and of healthcare consumption, as well as several psychological variables (Zimbardo Time Paradox Inventory, Multidimensional Locus of Control Scale, Psychological Reactance Scale, Coping Responses Inventory, self-efficacy scale applied to health, and the Symptom Checklist-90-R). The following variables of the model were significant predictors (p ≤ 0.05): a negative past, a fatalistic present, psychological cognitive reactance, behavioral coping, health self-efficacy, and the level of somatization. Data from the statistical analyses show how to create a psychological profile of people who are high consumers of healthcare resources that will allow for the creation of intervention programs in this regard.

Perspectiva profesional y protocolos de intervención ante situaciones de maltrato hacia personas mayores / Professional perspective and intervention protocols in situations of abuse towards the elderly

OBJETIVO: Describir la situación actual de maltrato hacia las personas mayores, pormenorizando sobre los protocolos existentes en las diferentes comunidades autónomas del Estado español, así como estudiar la perspectiva de diferentes profesionales que trabajan con personas mayores y personas adultas con discapacidad. METODOLOGÍA: Estudio cualitativo de revisión de documentos administrativos y protocolos de cada comunidad autónoma, así como la realización de entrevistas a 12 profesionales que trabajan directamente con personas mayores o con discapacidad en el ámbito territorial de Galicia. Paralelamente, se ha realizado una investigación de carácter documental y de revisión bibliográfica sobre el tema objeto de estudio, a través de las principales fuentes de investigación. RESULTADOS: Los resultados reflejan la ausencia de medidas y conocimiento profesional sobre cómo intervenir ante situaciones de maltrato hacia personas mayores. Esta situación se ve agravada por la ausencia de protocolos o guías específicas en el 52,94% de las comunidades autónomas. CONCLUSIONES: Adicionalmente a las medidas propuestas por organismos internacionales, se considera necesario prevenir, detectar e intervenir, partiendo estas acciones de la administración pública y apoyándose en la concienciación ciudadana, de forma que se llegue a prestar una atención de calidad a la población mayor

AIM: To describe the current situation of abuse towards the elderly people, detailing the existing protocols in the different autonomous communities of the Spanish State, as well as the perspective of different professionals who work with older people and disabled adults. METHODOLOGY: Qualitative review of the administrative documents and protocols of each Autonomous Community, as well as conducting interviews with 12 professionals who work directly with elderly or disabled people in the territorial area of Galicia. At the same time, a documentary research and literature review on the subject under study has been carried out through the main sources of research. RESULTS: The results reflect the absence of measures and professional knowledge on how to intervene in situations of abuse towards elderly people. This situation is aggravated by the absence of protocols or specific guidelines in 52,94% of the autonomous communities. CONCLUSIONS: In addition to the measures proposed by international organizations, it is considered necessary to prevent, detect and intervene, and these actions of the public administration must be started and supported by citizen awareness; in such a way that we get to provide quality care to the elderly population

Síndrome de burnout en el Sistema de Salud: el caso de las trabajadoras sociales sanitarias / Burnout syndrome in the Health System: the case of social health workers

OBJETIVO: El objetivo general de esta investigación es medir la prevalencia del síndrome de burnout en el colectivo profesional de trabajadoras sociales sanitarias que ejercen su actividad laboral en los diferentes servicios y centros del Servicio Público de Salud de Galicia (España). MÉTODO: Se ha planteado un diseño de enfoque cuantitativo-analítico y transversal, utilizando como instrumento principal el cuestionario Maslach Burnout Inventory, versión Human Services Suvey. Dicho cuestionario mide tres dimensiones relacionadas con el burnout: Agotamiento emocional, Despersonalización y Realización personal. La recogida de datos se realizó a través de una aplicación de encuestas entre las trabajadoras sociales colegiadas en el Colegio Oficial de Trabajo Social de Galicia. RESULTADOS: El 86,2% de la población objeto de estudio son mujeres y un 13,8% hombres, y sus edades están comprendidas entre los 23 y los 63 años. Los datos de prevalencia del estudio arrojan unos resultados elevados, especialmente en la dimensión de Agotamiento Emocional donde más de la mitad de la población objeto de estudio presenta una puntuación considerada alta. CONCLUSIÓN: Al igual que otros colectivos profesionales que ejercen su actividad laboral en el sistema de salud, como es el caso de Enfermería y Medicina, las trabajadoras sociales sanitarias presentan índices elevados de burnout, siendo el Agotamiento Emocional la dimensión más afectada

OBJECTIVE: The general goal of this research is to measure the prevalence of the burnout syndrome in the professional group of social health workers who perform their work in the diverse services and centers of the Public Health Service of Galicia (Spain). METHOD: A quantitative-analytical and cross-sectional design was proposed, using as the main instrument the Maslach Burnout Inventory, Human Services Survey version. This inventory measures three dimensions related to burnout: Emotional Exhaustion, Depersonalization, and Personal Fulfillment. Data collection was carried out through a survey among the social workers registered in the Official Association of Social Work of Galicia. RESULTS: 86.2% of the population under study are women and 13.8% are men; their ages range between 23 and 63 years. The study prevalence data yields high scores, especially in the Emotional Exhaustion dimension, where more than half of the population under study obtained a high score. CONCLUSION: Like other professional groups that perform their work in the health system, as is the case of Nursing and Medicine, social health workers present high rates of burnout, with Emotional Exhaustion being the most affected dimension

[Psychometric properties of the Death Anxiety Scale in patients with ischemic cardiomyopathy]. / Propiedades psicométricas del Death Anxiety Scale en pacientes con cardiopatía isquémica.

OBJECTIVE: Ischemic cardiomyopathy is a major public health concern in Spain. Death from ischemic disease accounts for approximately a third of all deaths due to cardiovascular disease, and imposes a serious burden on already overstretched public health system owing to the tendency to chronicity. This study aimed to evaluate the psychometric properties of Templer's Death Anxiety Scale (DAS) in a sample of patients with ischemic cardiomyopathy (acute myocardial infarction and angina pectoris). METHODS: This study applied the Spanish version of Templer's Death Anxiety Scale (DAS). The sample consisted of 141 patients (61% men) with ischemic cardiomyopathy, mean agede 71.57 years (SD=5.76). A descriptive statistical analysis was performed, and factorial analysis of the principal components. RESULTS: The corrected element-total correlation was positive in all items, with values ranging from 0.32 and 0.54. Four factors jointly explained 51.85% of the data variance. The reliability coefficients were high in all of the variables analysed, with a total Cronbach Alpha of 0.77. CONCLUSIONS: The results obtained in this study revealed ischemic cardiomyopathy was susceptible to the process of death anxiety. This underscores the need for educating patients with this pathology to help them adapt to the process of chronicity, and to develop an understanding of the naturalization process of dying bearing in mind each person's multidimensionality.

OBJETIVO: En España, la cardiopatía isquémica es un problema importante de salud pública. Las muertes por enfermedad isquémica representan, aproximadamente, un tercio del total de muertes debidas a una enfermedad cardiovascular. En todo caso, comportan atenciones e intervenciones importantes en materia de salud, derivadas de su tendencia a la cronicidad. Este estudio tuvo como objetivo evaluar las propiedades psicométricas de la Death Anxiety Scale (DAS) de Templer, en una muestra de pacientes con cardiopatía isquémica (infarto agudo de miocardio y angina de pecho). METODOS: En la presente investigación se utilizó la Death Anxiety Scale (DAS) de Templer, en la versión adaptada a sujetos españoles. Se empleó una muestra total constituida por 141 sujetos con cardiopatía isquémica y con una edad media de 71,57 años (DT=5,76), siendo el 61% de la muestra varones. Se realizaron análisis estadísticos descriptivos, así como un análisis factorial de los componentes principales. RESULTADOS: La correlación elemento-total corregida fue positiva en todos los ítems, con valores entre el 0,32 y 0,54. Se identificaron cuatro factores que, en conjunto, explicaron un 51,85% de la varianza de los datos. Los cocientes de fiabilidad encontrados fueron elevados en todas las variables analizadas, obteniéndose un Alfa de Cronbach total de 0,77. CONCLUSIONES: Los resultados obtenidos en nuestra investigación nos indican que la enfermedad de cardiopatía isquémica no es ajena al proceso de ansiedad ante la muerte. Está justificado, por tanto, promover una educación en pacientes con esta patología para la adaptación al proceso de cronicidad, así como para la naturalización del proceso final del ciclo vital, teniendo presente la multidimensionalidad de la persona.

La asistencia personal como nuevo derecho de ciudadanía: una mirada desde el ámbito de los profesionales de la salud / Personal assistance as a new citizens' right: seen from the health professionals' sphere / Assistência pessoal como novo direito de cidadania: um olhar do campo dos profissionais de saúde

OBJETIVO: El objetivo principal de esta investigación es conocer la figura del asistente personal para personas con discapacidad. Asimismo, se pretende exponer la importancia de los cuidados y el acompañamiento profesionalizado frente a los cuidados familiares. MÉTODO: Abordaje de investigación mixto consistente en la revisión de bases de datos oficiales, así como la realización de entrevistas semiestructuradas a 11 profesionales de la enfermería pertenecientes al Servicio Público de Salud de Galicia (España). RESULTADOS: Los resultados apuntan a que la figura del asistente personal continúa sin ser mayoritaria en la prestación de servicios para personas con discapacidad. El personal de enfermería entrevistado considera que las funciones de asistencia personal deben enfocarse hacia una clara profesionalización por sus características específicas. CONCLUSIONES: Los resultados de este estudio, constituyen un marco propio para la reflexión sobre la intervención y acompañamiento en personas con discapacidad. Sin duda, es necesario el trabajo interdisciplinar dentro de un abordaje conjunto de profesionales con formación sanitaria y social

OBJECTIVE: The main objective of this research is to familiarize ourselves with the figure of the personal assistant for disabled people. It also seeks to reveal the importance of professionalized care and accompaniment compared with family care. METHODS: Joint research consisting of the review of official databases, as well as the performance of semi-structured interviews with 11 professional nurses belonging to the Public Health Service of Galicia (Spain). RESULTS: The results suggest that the figure of the personal assistant is still not predominant in the provision of services for people with disabilities. The interviewed nursing staff considered that the functions of personal assistance should be clearly professionalized due to their specific characteristics. CONCLUSIONS: The results of this study constitute a framework for reflection on intervention and support for people with disabilities. No doubt, interdisciplinary work is necessary within a joint approach of professionals with health and social training

OBJETIVO: O objetivo principal desta pesquisa é conhecer a figura do assistente pessoal para pessoas com deficiência. Da mesma forma, pretende-se expor a importância do cuidado e o acompanhamento profissionalizado versus cuidado familiar. MÉTODO: Abordagem de pesquisa mista composta pela revisão de bases de dados oficiais, bem como entrevistas semiestruturadas a 11 profissionais de enfermagem pertencentes ao Serviço de Saúde Pública da Galiza (Espanha). RESULTADOS: Os resultados sugerem que a figura do assistente pessoal continua sem ser uma maioria na prestação de serviços para pessoas com deficiência. A equipe de enfermagem entrevistada considera que as funções de assistência pessoal devem estar focadas em uma profissionalização clara devido às suas características específicas. CONCLUSÕES: Os resultados deste estudo constituem um marco adequado para a reflexão sobre a intervenção e acompanhamento de pessoas com deficiência. Sem dúvida, o trabalho interdisciplinar é necessário dentro de uma abordagem conjunta de profissionais com formação em saúde e social

Propiedades psicométricas del Death Anxiety Scale en pacientes con cardiopatía isquémica / Psychometric properties of the Death Anxiety Scale in patients with ischemic cardiomyopathy

OBJETIVO: En España, la cardiopatía isquémica es un problema importante de salud pública. Las muertes por enfermedad isquémica representan, aproximadamente, un tercio del total de muertes debidas a una enfermedad cardiovascular. En todo caso, comportan atenciones e intervenciones importantes en materia de salud, derivadas de su tendencia a la cronicidad. Este estudio tuvo como objetivo evaluar las propiedades psicométricas de la Death Anxiety Scale (DAS) de Templer, en una muestra de pacientes con cardiopatía isquémica (infarto agudo de miocardio y angina de pecho). MÉTODOS: En la presente investigación se utilizó la Death Anxiety Scale (DAS) de Templer, en la versión adaptada a sujetos españoles. Se empleó una muestra total constituida por 141 sujetos con cardiopatía isquémica y con una edad media de 71,57 años (DT=5,76), siendo el 61% de la muestra varones. Se realizaron análisis estadísticos descriptivos, así como un análisis factorial de los componentes principales. RESULTADOS: La correlación elemento-total corregida fue positiva en todos los ítems, con valores entre el 0,32 y 0,54. Se identificaron cuatro factores que, en conjunto, explicaron un 51,85% de la varianza de los datos. Los cocientes de fiabilidad encontrados fueron elevados en todas las variables analizadas, obteniéndose un Alfa de Cronbach total de 0,77. CONCLUSIONES: Los resultados obtenidos en nuestra investigación nos indican que la enfermedad de cardiopatía isquémica no es ajena al proceso de ansiedad ante la muerte. Está justificado, por tanto, promover una educación en pacientes con esta patología para la adaptación al proceso de cronicidad, así como para la naturalización del proceso final del ciclo vital, teniendo presente la multidimensionalidad de la persona

OBJECTIVE: Ischemic cardiomyopathy is a major public health concern in Spain. Death from ischemic disease accounts for approximately a third of all deaths due to cardiovascular disease, and imposes a serious burden on already overstretched public health system owing to the tendency to chronicity. This study aimed to evaluate the psychometric properties of Templer's Death Anxiety Scale (DAS) in a sample of patients with ischemic cardiomyopathy (acute myocardial infarction and angina pectoris). METHODS: This study applied the Spanish version of Templer's Death Anxiety Scale (DAS). The sample consisted of 141 patients (61% men) with ischemic cardiomyopathy, mean agede 71.57 years (SD=5.76). A descriptive statistical analysis was performed, and factorial analysis of the principal components. RESULTS: The corrected element-total correlation was positive in all items, with values ranging from 0.32 and 0.54. Four factors jointly explained 51.85% of the data variance. The reliability coefficients were high in all of the variables analysed, with a total Cronbach Alpha of 0.77. CONCLUSIONS: The results obtained in this study revealed ischemic cardiomyopathy was susceptible to the process of death anxiety. This underscores the need for educating patients with this pathology to help them adapt to the process of chronicity, and to develop an understanding of the naturalization process of dying bearing in mind each person's multidimensionality

Determinación de la situación de dependencia funcional. Revisión sobre los instrumentos de evaluación más utilizados / Determination upon functional dependence situation. Reviewing the most used evaluation tools

Introducción: la medición de la situación de dependencia es un acto fundamental para las diferentes administraciones públicas con competencias en el campo de la salud y de los servicios sociales, para así poder planificar de forma idónea las políticas encaminadas a la atención e intervención en este ámbito. Objetivo: el objetivo del presente trabajo es analizar los instrumentos de valoración de la situación de dependencia más utilizados en España, informando de su contenido y sus campos de aplicación más relevantes. Del mismo modo, conocer en qué se diferencian estas escalas de medida, del baremo de valoración de dependencia utilizado como puerta de acceso al Sistema para la Autonomía y Atención a la Dependencia. Método: este estudio se lleva a cabo mediante una revisión bibliográfica en las siguientes bases de datos: Dialnet, Scopus, SciELO y Fisterra.com. Conclusiones: Tras la pertinente revisión de la literatura existente, los resultados apuntan a que, a causa de la variabilidad de contextos en los que se enmarcan las situaciones de dependencia, existen una gran variedad de instrumentos de medida

Background: the measure of the dependence situation is a fundamental act for the different public administration, which are concerned with the health and also the social services; therefore appropriate way to plan the policies toward the assistance and procedure as well at this field. Objective: the aim of the present work is analyzing the most used valuation tools in Spain about the dependence situation. Reporting upon its content and its outstanding application fields is the goal. Knowing about the differences between these measurement scales, in relation to the dependence evaluation rate, is other goal as well. These scales are used to access to the System for Autonomy and Assistance to Dependence. Method: this study is made through a bibliographic review in the following database: Dialnet, Scopus, SciELO and Fisterra.com. Conclusion: after the appropriate reviewing of currently literature, the results indicate a wide variety of measure tools in spite of the fact that there are a huge variety of possible contexts inner dependence

Discapacidad vs dependencia. Terminología diferencial y procedimiento para su reconocimiento / Disability vs dependency. Differential terminology and its recognition process

La discapacidad y la dependencia son situaciones conceptualmente próximas pero no equiparables. Cada una de ellas determina unas condiciones concretas y diferenciadas, con limitaciones específicas para el individuo. Sin embargo, en nuestra praxis diaria observamos que son términos comprendidos erróneamente por las personas usuarias de las Administraciones Públicas y usadas también de forma inapropiada por los profesionales del ámbito social y sanitario. Tras la pertinente revisión de la literatura existente, el presente artículo tiene como objetivo la clarificación conceptual y el análisis crítico de los dos términos exponiendo, asimismo, los procedimientos para el reconocimiento administrativo de ambos

Disability and dependency are near situations upon their concept, however, they cannot be compared between them. Each of them determine particular and differentiated conditions; with specific limitations for the individual. Nevertheless the mention above we realize, through our daily praxis, that the both terms are wrong used by the Public Administration users and by social and health professionals as well. After the review of available current bibliography, this article aims the concept clarification and the critical analysis of the both terms. The processes for the administrative recognition of these terms will be exposed

Self-efficacy and Health: The SEH Scale.

OBJECTIVES: Our objective was to design an instrument to measure coping self-efficacy as manifested by patients experiencing health problems. METHODS: A total of 2784 individuals were interviewed while attending primary healthcare centers in the Autonomous Community of Galicia in Northwest Spain. Of these persons, 54% were women and 46% were men, with a minimum age of 18 years, and a mean age of 37.4 years. A questionnaire was administered comprised of sociodemographic variables, items related to the use of healthcare resources, and a coping self-efficacy scale of health problems (SEH), based on the self-efficacy test by Baessler and Schwarzer. Statistical analysis determined reliability, and whether the SEH scale was efficacious in detecting changes in the use of specific health resources. A parametric ANOVA was performed on 4 groups based on the quartiles of self-efficacy in health, as measured by the SEH scale. RESULTS: The reliability and validity of the 10-item coping self-efficacy scale of health problems (SEH) was confirmed. CONCLUSIONS: Its compliance with relevant psychometric requirements means the SHE scale may have more general utility.