Cecilia Peñacoba

Reliability and Validity of the Spanish Version of the Revised Scale for Caregiving Self-Efficacy

This study investigated the reliability and convergent validity of the Revised Scale for Caregiving Self-Efficacy (RSCSE) in a Spanish sample of 180 caregivers of relatives with dementia. The self-efficacy scales were examined in relation to help-seeking behaviors, behavioral problems of the relative, dysfunctional thoughts about caregiving, and depressive symptoms. Good internal consistency indices were found for the RSCSE subscales. Those caregivers with higher scores on the RSCSE reported more help-seeking behaviors, a higher frequency of behavioral problems of their relative, fewer dysfunctional thoughts about caregiving, and less depression. The clinical implications of these results are discussed.

TWO SUCCESSIVE PHASES IN THE THREAT-RELATED ATTENTIONAL RESPONSE OF ANXIOUS SUBJECTS: NEURAL CORRELATES

Background: It is well known that highly anxious individuals are characterized by the allocation of a greater amount of attentional resources to threatening stimulation. However, neural data in relation to the time course of attentional biases in anxiety are still surprisingly scarce and preliminary. The present research explored attentional biases in anxious subjects (grouped according to their scores in trait and state forms of the State–Trait Anxiety Inventory) over time by using event‐related potentials (ERPs) and through the application of source localization methodologies. Methods: Participants (n=27) were asked to perform an indirect visual matching task in a cue‐target paradigm. The targets consisted of three types of emotional pictures: positive arousing, negative arousing, and neutral. ERPs in response to target stimulation were submitted to temporal and spatial principal component analyses. Results: Statistical analyses revealed that negative targets elicited higher amplitudes than positive pictures in P200. Subsequently, greater amplitudes in response to positive than to negative pictures were observed in P500. Source analyses (standardized low resolution brain electro‐magnetic tomography: sLORETA) indicated an involvement of visual association cortical areas (i.e., precuneus and cuneus) both in P200 and P500. Conclusions: The results might be interpreted in line with the orienting‐avoidance hypothesis toward threatening events in anxious subjects. This attentional pattern was only manifested by individuals with high levels of both trait and state anxiety. Further investigation should be done in order to better understand the brain mechanisms underlying the attentional biases in anxiety and to apply this knowledge to the development of cognitive therapies. Depression and Anxiety, 2009.

Do women with fibromyalgia adhere to walking for exercise programs to improve their health? Systematic review and meta-analysis

Abstract Background: Walking is recommended for fibromyalgia, but the rate of adherence to this exercise is not known. Poor adherence to physical exercise can limit the effectiveness in health benefits. Objectives: To examine adherence to interventions that include walking for fibromyalgia and to explore its moderators among the characteristics of patients, of the walking prescription and of the interventions. Data sources: References from 2000 to 2016 have been collected through PubMed, PsycINFO, CINAHL, SPORTDiscus, Cochrane, and Teseo. Study selection: We included quasi-experimental and randomized controlled trials in adults with fibromyalgia that involved walking for exercise. Two authors screened records independently and disagreements were resolved by discussion. Data extraction: Independently extracted by two assessors. Methodological quality of the studies was assessed using an ad hoc scale. Data synthesis: Nineteen trials, 32 experimental groups, recruited a total of 983 participants (96.78% women) with mean ages between 45 and 60.60. Adherence to the intervention program was reported in 19 of 32 experimental groups and ranged, on average, from 73 to 87.20% depending on the type of assessment. Most relevant moderators of adherence were the recruitment of participants through physicians and the nurses as supervisors of exercise. Conclusion: Adherence rates (attendance at sessions) to programs with walking were high. However, a lack of information precludes knowledge of whether participants sustained walking between sessions or after the treatment. Further work is required to examine in greater depth such contextual variables of interventions as the professional-participant relationship or to explore other possible moderators such as patient expectations of the treatment. Implications for rehabilitation Adherence to walking programs is more likely if doctors recommend the attendance at them. The combination with other activities may result in better adherence to walking than those that are only-walking exercise. The adherence to walking programs was larger in those in which nurses supervised the exercise. It is necessary to have adherence as objective, improving the record of adherence during treatment, assessing it between sessions and with a follow-up after the end of treatment.

Erratum to: To walk or not to walk: insights from a qualitative description study with women suffering from fibromyalgia

Walking improves health outcomes in fibromyalgia; however, there is low adherence to this practice. The aim of this research was to explore the beliefs of women suffering from fibromyalgia toward walking, and the meaning that they attribute to the behavior of walking as part of their fibromyalgia treatment. This study is a qualitative description research. Forty-six (46) women suffering from fibromyalgia and associated with local fibromyalgia associations located in four different Spanish cities (Elche, Alicante, Madrid, and Talavera de la Reina) participated in focus group discussions in the summer 2012. Thematic content analysis was performed in transcribed verbatim from interviews. Participants perceived several inhibitors for walking even when they had positive beliefs toward its therapeutic value. Whereas participants believed that walking can generate improvement in their disease and their health in general, they did not feel able to actually do so given their many physical impediments. Furthermore, participants struggled with social isolation and stigma, which was lessened through the conscious support of family. Advice from family doctors was also a very important facilitator to participants. In a health care delivery context that favors person-centered care, and in order to foster adherence to walking-based fibromyalgia treatments, it is recommended that therapeutic walking programs be tailored to each woman’ individual circumstances, and developed in close collaboration with them to help them increase control over their health and their condition.

Confirmatory Factor Analysis of the Long and Short Forms of the Worry Domains Questionnaire

The Worry Domains Questionnaire was proposed as a measure of both pathological and nonpathological worry, and assesses the frequency of worrying about five different domains: relationships, lack of confidence, aimless future, work, and financial. The present study analyzed the factor structure of the long and short forms of the WDQ (WDQ and WDQ-SF, respectively) through confirmatory factor analysis in a sample of 262 students (M age = 21.8; SD = 2.6; 86.3% females). While the goodness-of-fit indices did not provide support for the WDQ, good fit indices were found for the WDQ-SF. Furthermore, no source of misspecification was identified, thus, supporting the factorial validity of the WDQ-SF scale. Significant positive correlations between the WDQ-SF and its subscales with worry (PSWQ), anxiety (STAI-T), and depression (BDI) were found. The internal consistency was good for the total scale and for the subscales. This work provides support for the use of the WDQ-SF, and potential uses for research and clinical purposes are discussed.

Confirmatory factor analysis of the Revised Scale for Caregiving Self-Efficacy in a sample of dementia caregivers

The number of studies aimed at analyzing caregiving distress among carers of people with dementia has grown exponentially in recent years. The study of variables that may help reduce the impact of caregiving demands on the health of caregivers is an issue of special interest for researchers. Self-efficacy is one of these variables. Perceived self-efficacy has been described as the subjective belief that one can organize and execute courses of action to manage given situations. Higher self-efficacy expectations regarding the caregivers own ability to handle caregiving challenges have been significantly related to lower scores on burden, anger, anxiety and depression, even after controlling for objective stressors.

Healthcare Provider Advice to Engage in Walking Regimens and Adherence in Women With Fibromyalgia

Purpose The aim of the study was to analyze the profile of fibromyalgia patients receiving medical advice to walk and who complied with the advice according to a specific clinical pattern. A further aim has been to analyze the elements that increase adherence to walking. Design A cross-sectional study with 920 women with fibromyalgia. Methods Sociodemographic and clinical variables, walking behavior, and medical advice to walk were assessed. Findings and Conclusions Patients who adhere to walking have a lower likelihood of being tired. Regular walkers (patients who walk according to a specific clinical pattern) have a lower likelihood of comorbidity. Patients who receive medical advice to walk are more likely to walk more than 30 minutes and to take a break between bouts. Clinical Relevance Nurses caring for people with fibromyalgia should include strategies to promote walking, especially in patients with low adherence profiles, paying attention to all elements of behavior.

Walking Beliefs in Women With Fibromyalgia: Clinical Profile and Impact on Walking Behavior:

Although exercise is essential for the treatment of fibromyalgia, adherence is low. Walking, as a form of physical exercise, has significant advantages. The aim of this article is to describe, in 920 women with fibromyalgia, the prevalence of certain walking beliefs and analyze their effects both on the walking behavior itself and on the associated symptoms when patients walk according to a clinically recommended way. The results highlight the high prevalence of beliefs related to pain and fatigue as walking-inhibitors. In the whole sample, beliefs are associated with an increased perception that comorbidity prevents walking, and with higher levels of pain and fatigue. In patients who walk regularly, beliefs are only associated with the perception that comorbidity prevents them from walking. It is necessary to promote walking according to the established way (including breaks to prevent fatigue) and to implement interventions on the most prevalent beliefs that inhibit walking.