Modelo de interiorización y exteriorización para explicar el inicio de la psicopatología de los trastornos alimentarios en la adolescencia / An internalizing and externalizing model to explain the psychopathology onset of the eating disorders at adolescence

La etiología de los trastornos del comportamiento alimentario (TCA) es compleja y múltiples modelos han intentado conceptualizarla. El objetivo de este estudio fue determinar si los comportamientos interiorizados y exteriorizados son factores de riesgo generales de psicopatología o específicos de los TCA y que componentes sintomatológicos del TCA están relacionados con estos comportamientos. Para ello, se utilizó un diseño transversal caso-control para comparar los TCA de inicio (n = 50) con tres grupos de control: un grupo con patología psiquiátrica (trastornos depresivos [TD], n = 40), otro con patología psicosomática (asma, n = 40) y un grupo control sin patología (n = 50). La muestra está compuesta por 180 mujeres adolescentes de 12-18 años y sus familias emparejadas por edad y estatus socioeconómico. Los resultados obtenidos indican que la interiorización es un factor de riesgo general para la psicopatología de TCA y TD, y que en los TCA está asociada específicamente con la obsesión por la delgadez, la ineficacia, la conciencia interoceptiva, la depresión, la ansiedad rasgo y la sintomatología obsesivo-compulsiva. Así, se entiende la elevada comorbilidad de los TCA con otros comportamientos interiorizados

The etiology of eating disorders (ED) is complex, and multiple models have attempted to conceptualize it. The objective of this study was to determine whether internalizing and externalizing behaviors are general proximal risk factors for psychopathology or specific for ED, and which symptomatic components of ED are related to these behaviors. Hence, a cross-case-control design was used to compare eating disorders at onset (n = 50) with three control groups: a group with psychiatric pathologies (depressive disorders [DD], n = 40), a group with psychosomatic pathology (asthma, n = 40), and a control group without pathologies (n = 50). The entire sample is made up of 180 adolescent women aged 12-18 years and their families matched by age and socioeconomic status. The results obtained indicate that internalization is a general risk factor for the psychopathology of ED and mood disorders, and that in ED it is specifically associated with a drive for thinness, ineffectiveness, interoceptive awareness, depression, trait-anxiety and obsessive-compulsive symptomatology. Thus, the high comorbidity of ED is associated mainly with other internalizing behaviors

The Design, Prototyping, and Formative Evaluation of an Assistive Robotic Table (ART) for Stroke Patients.

OBJECTIVE: This article presents the results of an exploratory study in which 14 healthcare subject matter experts (H-SMEs) in addition to four research and design subject matter experts (RD-SMEs) at a regional rehabilitation hospital engaged in a series of complementary, participatory activities in order to design an assistive robotic table (ART). BACKGROUND: As designers, human factor experts, and healthcare professionals continue to work to integrate assistive human-robot technologies in healthcare, it is imperative to understand how the technology affects patient care from clinicians' perspectives. METHOD: Fourteen clinical H-SMEs rated a subset of conceptual ART design ideas; participated in the iterative design process of ART; and evaluated a final cardboard prototype, the rehabilitation hospital's current over-the-bed table (OBT), an ART built with true materials, and two therapy surface prototypes. Four RD-SMEs conducted a heuristic evaluation on the ART built with true materials. Data were analyzed by frequency and content analysis. RESULTS: The results include a design and prototype for the next generation ART and a pneumatically controlled therapy surface, a broadened list of specifications for the future design and implementation of assistive robotic furniture, and final observations. CONCLUSION: When compared to the rehabilitation hospital's current OBT, the developed ART in this study was successful. Designing novel features is dependent upon ensuring patient safety. The inclusion of clinicians in the participatory iterative design and evaluation process and the use of personas provided a broadened list of specifications for the successful implementation of assistive robotic furniture.

Examination of How and Why Over-the-Bed Tables Are Used: Use Cases and Needs from Healthcare Providers.

OBJECTIVE: This article presents the results of an exploratory study in which 14 clinical and staff subject matter experts (SMEs) at a regional rehabilitation hospital were interviewed in order to understand how and why over-the-bed tables are used. BACKGROUND: It is important to understand how and why a device or environment is used when designing it, and not just what features and functions are preferred. This knowledge is valuable both for contextualizing user feature and function preferences and for characterizing and prioritizing design challenges and opportunities. METHODS: Fourteen hospital clinical and support staff subject-matter experts participated in semi-structured interviews with scenario enactments in a medium-fidelity, full-scale mock-up of a typical patient room. During these interviews, they interacted with two personas played by actors and were asked to enact an example of a normal visit, from entering the room through treatment/service and then exiting. Data were analyzed via methodological triangulation including frequency analysis, content analysis, and affinity diagramming. RESULTS: The results include a use-case analysis with illustrative sketches, a list of needs statements, and final observations. CONCLUSIONS: Successfully using the over-the-bed table is dependent upon proper positioning, especially in bed during meals. There are fewer problems associated with over-the-bed table use while seated in a chair than when in the bed. The over-the-bed table is a key component in acute care, inpatient therapies. Clinicians are generally open to "smart" furniture in the patient room but question its cost-effectiveness, robustness, and flexibility. KEYWORDS: Evidence-based design, human factors, patient-centered care, quality care, technology.

Confirming, Classifying, and Prioritizing Needed Over-the-Bed Table Improvements via Methodological Triangulation.

OBJECTIVE: This article presents the results of a qualitative study that confirmed, classified, and prioritized user needs for the design of a more useful, usable, and actively assistive over-the-bed table. BACKGROUND: Manganelli et al. (2014) generated a list of 74 needs for use in developing an actively assistive over-the-bed table. This present study assesses the value and importance of those needs. METHODS: Fourteen healthcare subject matter experts and eight research and design subject matter experts engaged in a participatory and iterative research and design process. A mixed methods qualitative approach used methodological triangulation to confirm the value of the findings and ratings to establish importance. Open and closed card sorts and a Delphi study were used. Data analysis methods included frequency analysis, content analysis, and a modified Kano analysis. RESULTS: A table demonstrating the needs that are of high importance to both groups of subject matter experts and classification of the design challenges each represents was produced. Through this process, the list of 74 needs was refined to the 37 most important need statements for both groups. CONCLUSIONS: Designing a more useful, usable, and actively assistive over-the-bed table is primarily about the ability to position it optimally with respect to the user for any task, as well as improving ease of use and usability. It is also important to make explicit and discuss the differences in priorities and perspectives demonstrated between research and design teams and their clients.