Carmen Écija Gallardo

Self-Efficacy and Affect as Mediators Between Pain Dimensions and Emotional Symptoms and Functional Limitation in Women With Fibromyalgia

The aim of this study was to investigate the role of self-efficacy and affect as mediators of the relationship between pain and several fibromyalgia (FM) symptoms (functional limitation, depression, and anxiety). We evaluated 144 women with FM for self-reported pain (numerical pain scale), pressure pain sensitivity (pressure pain thresholds), functional limitation (Fibromyalgia Impact Questionnaire), self-efficacy (Chronic Pain Self-Efficacy Scale), depression-anxiety (Hospital Anxiety and Depression Scale), and positive-negative affect (Positive-Negative Affect Scale). Mediating analyses were conducted with ordinary least squares multiple regression analysis. The results demonstrated that self-reported pain and pressure pain sensitivity exhibited significant relationships with functional limitation, anxiety, depression, self-efficacy, and affect. Affect mediated the relationship between pressure pain sensitivity and anxiety, whereas self-efficacy was the mediating variable between self-reported pain and functional limitation and depression. Our results support a complex nature of pain in women presenting with FM, as cognitive and emotional variables have different mediator relationships between pain dimensions and functional and emotional outcomes in women with FM.

Developing a Competency-Based Pan-European Accreditation Framework for Health Promotion

Background. The CompHP Pan-European Accreditation Framework for Health Promotion was developed as part of the CompHP Project that aimed to develop competency-based standards and an accreditation system for health promotion practice, education, and training in Europe. Method. A phased, multiple-method approach was employed to facilitate consensus building with key stakeholders in health promotion across Europe. Consultation processes included focus and discussion groups at European and country levels, an online survey, a web-based consultation, and testing in academic and practice settings. Successive drafts of the Framework (a total of five) were revised based on the feedback from each consultation stage. Findings. A total of 405 participants from 29 of the 34 target countries contributed to the consultation process. The overall response to the Framework was positive, with negative feedback focusing mainly on the barriers that may impact on its implementation. Conclusions. The CompHP Pan-European Accreditation Framework for Health Promotion provides an agreed system to promote quality assurance and competence for health promotion practice and education in Europe. The Framework, which builds on the CompHP Core Competencies and Professionals Standards, outlines the systems and processes for the accreditation of health promotion practitioners and health promotion education and training by accrediting organizations at national and European levels.

Can We Learn to Treat One Another Better? A Test of a Social Intelligence Curriculum.

This paper reports on the first test of the value of an online curriculum in social intelligence (SI). Built from current social and cognitive neuroscience research findings, the 50 session SI program was administered, with facilitation in Spanish by classroom instructors, to 207 students from Universidad Rey Juan Carlos in Madrid as part of their undergraduate classes. All materials were translated into Castilian Spanish, including outcome measures of SI that have been used in prior studies to provide valid estimates of two key components of social intelligence: 1) Sensitivity to others and 2) confidence in one’s capacity to manage social situations. Pre- and Posttest were administered to participants in the SI training, and also to 87 students in similar classes who did not receive the program who served as the control group. Gender and emotional intelligence levels at pretest also were examined as potential individual differences that might affect the impact of the program on study outcomes. Repeated measures ANOVAs on study outcomes revealed significant increases, from pre to post, in most measures of social intelligence for program participants in comparison to controls, with no effects of gender or age on program effectiveness. Prior scores on emotional intelligence were not a prerequisite for learning from the program. Some findings suggest ways the program may be improved to have stronger effects. Nonetheless, the findings indicate that the SI program tested here shows considerable promise as a means to increase the willingness of young adults to take the perspective of others and enhance their efficacy for initiating and sustaining positive social connections.

Anxiety, Depression and Alexithymia in Fibromyalgia: Are There Any Differences According to Age?

This article analyzes the evolution of alexithymia, anxiety, and depression associated with fibromyalgia (FM) in three age groups in comparison to how they evolve in the same age groups in healthy women. A total of 240 women participated in the study (120 diagnosed with fibromyalgia and 120 healthy women), divided into three age groups (≤35 years,>35 and <65 years, and ≥65 years old). Our analysis revealed that alexithymia, anxiety, and depression in FM patients showed increased levels compared to healthy controls. Also, young women with FM (under 35) show lower alexithymia, anxiety, and depression levels in comparison to older patients (≥65). Alexithymia in FM patients follows a similar pattern as in healthy women (although with significantly higher scores), increasing with age. Our results show that depression, anxiety, and alexithymia develop over age in a different way in FM patients than in healthy individuals, increasing over age.

Operationalising and piloting the IUHPE European accreditation system for health promotion

The International Union for Health Promotion and Education (IUHPE) European Accreditation System for Health Promotion aims to promote quality assurance in health promotion practice, education and training. The System is designed to be flexible and sensitive to the different contexts for health promotion practice, education and training in Europe, while maintaining robust criteria. These competency-based criteria were developed in the CompHP Project (2009–2012) that developed core competencies, professional standards and an accreditation framework for health promotion practice, education and training in the context of workforce capacity development in Europe. This paper describes how consultations undertaken with the health promotion community informed the structure and processes of the IUHPE Accreditation System. An overview of its development, key functions and the piloting of its implementation, which was co-funded by the European Union in the context of the EU Health Programme, is presented. Feedback from consultations with key health promotion stakeholders in Europe indicated overall support for the development of an accreditation system for health promotion. However, a number of potential barriers to its implementation were noted including: absence of dedicated practitioners and professional bodies in some countries; lack of clarity about professional boundaries; lack of financial resources required to facilitate capacity building; and concerns about the costs, objectivity and transparency of the system. Feedback from the consultations shaped and informed the process of designing an operational accreditation system to ensure that it would be responsive to potential users’ needs and concerns. Based on the agreed structures and processes, a web-based application system was developed and managed at IUHPE headquarters. A governance structure was established together with agreed policies and procedures for the System. During the pilot period, applications from 20 health promotion practitioners, two health promotion education programmes and one national accreditation organisation were processed. Feedback from the piloting stage will inform further refinement of the system. While recognising the challenges, the overall positive feedback and the commitment demonstrated by the health promotion community form a constructive platform for the implementation of the IUHPE Accreditation System in Europe and internationally.

Evolution of childbirth expectations in Spanish pregnant women

PURPOSE To analyze the change of childbirth expectations over the course of pregnancy as well as their relation to socio-demographic and clinical variables. BACKGROUND The study of expectations in pregnant women is gaining more interest from a biopsychosocial approach because of its consequences on pregnant womens wellbeing. To our knowledge there are no previous studies analyzing the evolution of childbirth expectations over the course of pregnancy. METHODS Longitudinal study (first trimester and third trimester). Women were evaluated for childbirth expectations in their first trimester (n=285) and third trimester (n=122) of pregnancy. They also completed questionnaires collecting socio-demographic information. RESULTS Childbirth expectations appear to remain more or less stable over the course of pregnancy, although they tend to become slightly negative at the end of gestation, specifically referring to personal control and delivery circumstances. Multiparity and planned pregnancy are associated with higher positive expectations. CONCLUSION It seems essential to explore and to try to adjust childbirth expectations to more realistic ones, in order for them to be fulfilled. Midwives and other maternity healthcare providers play a key role in this regard.