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      Funcionamiento y calidad de vida en personas con enfermedades crónicas: poder predictivo de distintas variables psicológicas Translated title: Functioning and quality of life in people with chronic diseases: predictive power of different psychological variables

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          Abstract

          RESUMEN Objetivos Evaluar variables emocionales (ansiedad, depresión), cognitivas (catastrofismo, autoeficacia percibida) y conductuales (estrategias de afrontamiento); conocer de qué modo este tipo de variables influyen en la calidad de vida relacionada con la salud en personas con enfermedades crónicas; analizar si existen diferencias significativas en función del género o del diagnóstico de enfermedad crónica en las variables psicológicas mencionadas; detectar si se dan diferencias significativas en las distintas dimensiones de calidad de vida entre población normal y población con enfermedades crónicas. Método Estudio descriptivo-correlacional realizado en los meses de febrero y marzo de 2015 en el que participaron 35 personas con diferentes diagnósticos de enfermedad crónica, de las cuales 24 (68.6%) eran mujeres y 11 (31.4%) varones. Resultados Los resultados obtenidos sugieren que las variables emocionales repercuten en la calidad de vida, al igual que la autoeficacia y algunas estrategias de afrontamiento. Se encuentra además que las personas evaluadas presentan niveles de calidad de vida significativamente menores que la población general, y que parecen existir pocas diferencias en las variables evaluadas entre personas con diagnósticos diferentes y entre hombres y mujeres. Conclusiones Las variables psicológicas juegan un papel importante en la calidad de vida de las personas con enfermedades crónicas, por lo que es necesario abordarlas. Los resultados obtenidos son acordes a los encontrados en estudios previos, aunque es recomendable seguir investigando con muestras más amplias.

          Translated abstract

          ABSTRACT Objectives To assess emotional variables (anxiety, depression), cognitive variables (catastrophizing, perceived self-efficacy) and behavioral variables (coping); to know in what way these kind of variables influence health-related quality of life in people with chronic conditions; analyze if there are significant differences depending on gender or chronic disease diagnosis on psychological variables mentioned; to detect if significant differences exist in the different dimensions of health-related quality of life between normal population and people with chronic disease. Method Descriptive-correlational study made in February and March 2015 in which 35 people participated with different diagnoses of chronic disease. 24 of them (68.6%) were female and 11 (31.4%) were males. Results The results obtained suggest that emotional variables affect health-related quality of life, as well as perceived self-efficacy and coping strategies. We also find that people who was assessed showed significantly lower levels in health-related quality of life than general population, and that it seem to exist few differences in the variables studied between people with different diagnosis and between men and women. Conclusions Psychological variables play an important role in the quality of life of people with chronic diseases. This shows the importance of addressed these kind of aspects. The results are consistent with others found in previous studies. Further research is needed with larger samples.

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          Common elements in self-management of HIV and other chronic illnesses: an integrative framework.

          HIV/AIDS is widely recognized as a chronic illness within HIV care, but is often excluded from chronic disease lists outside the field. Similar to other chronic diseases, HIV requires lifetime changes in physical health, psychological functioning, social relations, and adoption of disease-specific regimens. The shift from acute to chronic illness requires a self-management model in which patients assume an active and informed role in healthcare decision making to change behaviors and social relations to optimize health and proactively address predictable challenges of chronic diseases generally and HIV specifically. This article reviews literature on chronic disease self-management to identify factors common across chronic diseases, highlight HIV-specific challenges, and review recent developments in self-management interventions for people living with HIV (PLH) and other chronic diseases. An integrated framework of common elements or tasks in chronic disease self-management is presented that outlines 14 elements in three broad categories: physical health; psychological functioning; and social relationships. Common elements for physical health include: a framework for understanding illness and wellness; health promoting behaviors; treatment adherence; self-monitoring of physical status; accessing appropriate treatment and services; and preventing transmission. Elements related to psychological functioning include: self-efficacy and empowerment; cognitive skills; reducing negative emotional states; and managing identity shifts. Social relationship elements include: collaborative relationships with healthcare providers; social support; disclosure and stigma management; and positive social and family relationships. There is a global need to scale up chronic disease self-management services, including for HIV, but there are significant challenges related to healthcare system and provider capacities, and stigma is a significant barrier to HIV-identified service utilization. Recognizing that self-management of HIV has more in common with all chronic diseases than differences suggests that the design and delivery of HIV support services can be incorporated into combined or integrated prevention and wellness services.
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            Depression and Anxiety in Patients with Chronic Renal Failure: The Effect of Sociodemographic Characteristics

            “Do the sociodemographic characteristics relate to the levels of depression and anxiety in patients with chronic renal failure in Athens?” The study investigated in a group of renal disease patients differences referring to self-reported mental health, depression, and anxiety, after controlling for gender, age, education, and marital status. Patient-reported assessments included General Health Questionnaire (GHQ-28) of Goldberg, Center for Epidemiological Studies Depression Scale (CES-D), and State-Trait Anxiety Inventory (STAI I & II) of Spielberger. Female patients reported higher scores in the trait anxiety measure. Elder patients reported higher scores in the GHQ-28 subscale of social dysfunction and in the CES-D depression scale, while less educated patients presented higher scores in the GHQ-28 subscales of anxiety/insomnia and severe depression. Divorced/widowed patients presented higher scores in the severe depression subscale. Findings provide evidence that sociodemographic variables, like being older, less educated, and divorced/widowed, relate to a more compromised mental health.
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              Adaptive coping strategies in patients with chronic pain conditions and their interpretation of disease

              Background We examined which adaptive coping strategies, referring to the concept of 'locus of disease control', were of relevance for patients with chronic pain conditions, and how they were interconnected with patients' life satisfaction and interpretation of disease. Methods In a multicenter cross-sectional anonymous survey with the AKU questionnaire, we enrolled 579 patients (mean age 54 ± 14 years) with various chronic pain conditions. Results Disease as an adverse interruption of life was the prevalent interpretation of chronic pain conditions. As a consequence, patients relied on external powerful sources to control their disease (i.e., Trust in Medical Help; Search for Information and Alternative Help), but also on internal powers and virtues (i.e., Conscious Way of Living; Positive Attitudes). In contrast, Trust in Divine Help as an external transcendent source and Reappraisal: Illness as Chance as an internal (cognitive) strategy were valued moderately. Regression analyses indicated that Positive Attitudes and higher age were significant predictors of patients' life satisfaction, but none of the other adaptive coping strategies. While the adaptive coping strategies were not associated with negative interpretations of disease, the cognitive reappraisal attitude was of significant relevance for positive interpretations such as value and challenge. Conclusions The experience of illness may enhance intensity and depth of life, and thus one may explain the association between internal adaptive coping strategies (particularly Reappraisal) and positive interpretations of disease. To restore a sense of self-control over pain (and thus congruence with the situation), and the conviction that one is not necessarily disabled by disease, is a major task in patient care. In the context of health services research, apart from effective pain management, a comprehensive approach is needed which enhances the psycho-spiritual well-being of patients.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                eg
                Enfermería Global
                Enferm. glob.
                Universidad de Murcia (Murcia, Murcia, Spain )
                1695-6141
                April 2017
                : 16
                : 46
                : 281-294
                Affiliations
                [1] Castilla y León orgnameUniversidad de Salamanca Spain anapascual@ 123456usal.es
                [2] Castilla y León orgnameUniversidad de Salamanca orgdiv1INICO Spain
                Article
                S1695-61412017000200281
                10.6018/eglobal.16.2.243031
                9d3fec12-b493-4b28-85b3-00d11cca3f8f

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 16 November 2015
                : 22 January 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 30, Pages: 14
                Product

                SciELO Spain


                enfermedad crónica,afrontamiento,autoeficacia,calidad de vida relacionada con la salud,health-related quality of life,self-efficacy,chronic disease,coping

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