Self-perception of leadership styles and behaviour in primary health care.

BACKGROUND: The concept of leadership has been studied in various disciplines and from different theoretical approaches. It is a dynamic concept that evolves over time. There are few studies in our field on managers' self-perception of their leadership style. There are no pure styles, but one or another style is generally favoured to a greater or lesser degree. In the primary health care (PHC) setting, managers' leadership style is defined as a set of attitudes, behaviours, beliefs and values. The objectives of this study were to describe and learn about the self-perception of behaviours and leadership styles among PHC managers; to determine the influence of the leadership style on job satisfaction, efficiency, and willingness to work in a team; and to determine the relationship between transformational and transactional styles according age, gender, profession, type of manager years of management experience, and the type of organization. METHODS: To describe leadership styles as perceived by PHC managers, a cross sectional study was performed using an 82 items-self-administered Multifactor Leadership Questionnaire (MLQ). This questionnaire measures leadership styles, attitudes and behaviour of managers. The items are grouped into three first order variables (transformational, transactional and laissez-faire) and ten second order variables (which discriminate leader behaviours). Additionally, the questionnaire evaluates organizational consequences such as extra-effort, efficiency and satisfaction. RESULTS: One hundred forty responses from 258 managers of 133 PHC teams in the Barcelona Health Area (response rate: 54.26 %). Most participants were nurses (61.4 %), average age was 49 years and the gender predominantly female (75 %). Globally, managers assessed themselves as equally transactional and transformational leaders (average: 3.30 points). Grouped by profession, nurses (28.57 % of participants) showed a higher transactional leadership style, over transformational leadership style, compared to physicians (3.38 points, p < 0.003). Considering gender, men obtained the lowest results in transactional style (p < 0.015). Both transactional and transformational styles correlate with efficiency and job satisfaction (r = 0.724 and r = 0.710, respectively). CONCLUSIONS: PHC managers' self-perception of their leadership style was transactional, focused on the maintenance of the status quo, although there was a trend in some scores towards the transformational style, mainly among nurse managers. Both styles correlate with satisfaction and willingness to strive to work better.

[Alexithymia and verbal intelligence: a psychometric study]. / Alexitimia e inteligencia verbal: un estudio psicométrico.

INTRODUCTION: Alexithymia is a concept that describes the unability to put emotions into words ant that has been associated with somatization and psychosomatic disorders. METHODS: A sample of 124 outpatients attending the Psychosomatic Unit of a General Hospital was studied in order to test the hypothesis that alexithymic patients have a significantly lower verbal intelligence than nonalexithymics. Alexithymia was assessed by the Toronto Alexithymia Scale (TAS), and verbal, nonverbal and general intelligence were measured by the WAIS. RESULTS: TAS scores were not related to medical and psychiatric diagnoses, and alexithymic patients (n: 53) showed not only significantly lower scores in verbal intelligence than undifferentiated subjects (n: 37) and nonalexithymics (n: 34) but also significantly lower scores in nonverbal and general intelligence. CONCLUSION: The results do not confirm our hypothesis and are discussed in relation to theories that consider alexithymia as a consequence of cerebral asymmetry and interhemispheric dysfunctions.

Alexitimia e inteligencia verbal: un estudio psicométrico / Alexithymia and verbal intelligence: a psychometric study

Introducción: La alexitimia es un concepto que describe la dificultad para verbalizar las emociones, y que se ha asociado a un mayor riesgo de somatizaciones y trastornos psicosomáticos. Material y métodos: Se estudió una muestra de 124 pacientes ambulatorios atendidos en el área de medicina psicosomática de un hospital general, con la finalidad de comprobar si los pacientes alexitímicos presentan menor inteligencia verbal que los no alexitímicos. La alexitimia se evaluó con la Toronto Alexithymia Scale (TAS), y la inteligencia verbal y no verbal se evaluó con el test de WAIS. Resultados: Los puntajes en alexitimia no se relacionaron con el diagnóstico médico y psiquiátrico, y los pacientes alexitímicos (n: 53) no sólo presentaron menores puntajes en inteligencia verbal que los sujetos indiferenciados (n: 37) y no alexitímicos (n: 34), sino que también presentaron menores puntajes en inteligencia no verbal y en inteligencia general. Conclusiones: Los resultados no confirmaron la alexitimia como una consecuencia de asimetría cerebral y de disfunciones interhemisféricas (AU)

La diabetes en atención primaria / Diabetes in primary health care

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Psychological factors and vulnerability to psychiatric morbidity after myocardial infarction.

A sample of 97 males suffering from myocardial infarction was studied in order to determine the influence of psychological variables and emotional states on psychopathology displayed by patients in the course of their cardiological recovery. Discriminant analysis revealed that depression in the coronary unit and nonuse of problem-solving strategies were the most sensitive variables to correctly classify psychiatric and nonpsychiatric cases (76.6% of the total sample). Multiple regression analysis of the psychological variables and emotional states showed that severity of psychopathology was directly related to early depressive reaction and use of avoidant strategies. The prevalence of psychiatric disorders was 55.5%, with depression (RDC) being the most frequent diagnosis (59.4%), followed by 'irritable dysphoria' (27%) and anxiety disorders (RDC; 21.6%).

Denial mechanisms in myocardial infarction: their relations with psychological variables and short-term outcome.

From a selected sample of 97 males suffering from a first myocardial infarction, 67 patients were studied to ascertain the influence of denial mechanisms (DM) on their cardiological and psychological outcome. There were no differences among high deniers and low deniers with respect to the cardiological outcome, but high deniers showed less anxiety and depressive reactions both in the coronary unit and 1 month later, and also presented less psychopathology in general. In the last evaluation, one year after leaving the hospital (N = 52), there was no difference among deniers and non deniers in demand for psychiatric attention.