Jaume Vives

Positive psychology interventions in breast cancer. A systematic review

Positive psychology is an emerging area of empirical study, not only in clinical, but also in health psychology. The present systematic review aims to synthesize the evidence about the positive psychology interventions utilized in breast cancer.

Wording effects and the factor structure of the 12-item General Health Questionnaire (GHQ-12)

The 12-item version of the General Health Questionnaire (GHQ-12) has become a popular screening instrument with which to measure general psychological health in different settings. Previous studies into the factorial structure of the GHQ-12 have mainly supported multifactor solutions, and only a few recent works have shown that the GHQ-12 was best represented by a single substantive factor when method effects associated with negatively worded items were considered. Confirmatory factor analysis was applied to compare competing measurement models from previous research, including correlated traits-correlated methods and correlated traits-correlated uniquenesses approaches, to obtain further evidence about the factorial structure of the GHQ-12. This goal was achieved with data from 3,050 participants who completed the GHQ-12 included in the Catalonian Survey of Working Conditions (Catalonian Labor Relations and Quality of Work Department, 2012). The results showed additional evidence that the GHQ-12 has a unidimensional structure after controlling for method effects associated with negatively worded items. Furthermore, we found evidence for our hypothesis about the spurious nature of the 3-factor solution in Graetzs (1991) model after comparing its fit with that found for alternative models resulting from different combinations of the negatively worded items. An implication of our results is that future research about the factor structure of the GHQ-12 should take method effects associated with negative wording into account in order to avoid reaching inaccurate conclusions about its dimensionality.

Count data in psychological applied research.

As some authors have noticed in fields other than psychology, level of measurement and distributional characteristics of count data are commonly not taken into account, so that they are analysed as normally distributed continuous variables, and therefore some general linear model is applied. In this work, we review a random sample of 457 articles published in the last four years in journals with the highest impact factor in the Journal Citation Reports (JCR Social Sciences Edition) of the Institute for Scientific Information. The goals are to know how often count variables appear in psychological applied research and which data analyses are used when dealing with count response variables. Examination showed that there is a notable presence of count variables, especially in some topics in psychology and a remarkable misapplication of the general linear model. One deals with causes and consequences of this approach to data analysis and suggests the use of specific models to analyse count data.

Positive psychological functioning in breast cancer: An integrative review

This integrative review aimed to analyze the research into positive psychological functioning after breast cancer, and to integrate the most relevant findings relating to sociodemographic, medical and psychosocial factors. Relevant outcomes were identified from electronic databases (Medline, PsycINFO, Web of Science, Scopus, Cochrane, CINAHL, and Wiley Online Library) up to July 2015. A Google search was performed to identify unindexed literature. Dissertations and theses were searched on Proquest Dissertations and Theses, DIALNET and TDX. Selection criteria included empirical studies assessing relationships between breast cancer and positive functioning, without restrictions on type of participants. In total, 134 studies met the inclusion criteria. The sociodemographic, medical, and psychosocial characteristics associated with well-being, posttraumatic growth, finding benefit and meaning were being young, undergoing chemotherapy, and having social support. The last two of these characteristics were time-oriented. The culture of the different samples and positive dispositional characteristics like optimism had an influence on the womens coping styles. Socioeconomic status and level of education were also associated with positive psychological functioning. The perceived impact of breast cancer on patient, as well as the perceived support from significant others can result in better functioning in women with breast cancer. The results highlight that oncology health professionals should take into account not only the individual and medical characteristics, but also the stage of the oncological process and the psychosocial environment of patients in order to promote their positive functioning.

Positive psychotherapy for distressed cancer survivors: Posttraumatic growth facilitation reduces posttraumatic stress

Background/Objective There is increasing evidence that positive life changes, such as posttraumatic growth (PTG), can result from the experience of coping with cancer. However, no interventions have been specifically designed to facilitate the development of PTG in cancer. In this article, we describe and assess the results of Positive Psychotherapy for Cancer (PPC) survivors. It aims to facilitate PTG as a way of achieving significant reductions in the symptoms of emotional distress and posttraumatic stress. In addition, the corroboration of this PTG facilitation is assessed using interpersonal indicators. Method: We allocated 126 consecutive survivors of cancer with high levels of emotional distress and who were seeking psychological support to either an experimental group (PPC) or a waiting list group. Results: The PPC group obtained significantly better results after treatment than the control group, showing reduced distress, decreased posttraumatic symptoms, and increased PTG. The benefits were maintained at 3 and 12 months’ follow-up. Participants’ PTG was correlated to the PTG that their significant others attributed to them, corroborating PTG facilitation. Conclusions: PPC appears to promote significant long-term PTG and can reduce emotional distress and posttraumatic stress in cancer survivors. In addition, PTG facilitation induced by PPC is corroborated by significant others.

Methodological quality is underrated in systematic reviews and meta-analyses in health psychology

OBJECTIVES In this paper, we compile and describe the main approaches proposed in the literature to include methodological quality (MQ) or risk of bias (RoB) into research synthesis. We also meta-review how the RoB of observational primary studies is being assessed and to what extent the results are incorporated in the conclusions of research synthesis. STUDY DESIGN AND SETTING Electronic databases were searched for systematic reviews or meta-analyses related to health and clinical psychology. A random sample of 90 reviews published between January 2010 and May 2016 was examined. RESULTS A total of 46 reviews (51%) performed a formal assessment of the RoB of primary studies. Only 17 reviews (19%) linked the outcomes of quality assessment with the results of the review. CONCLUSION According to the previous literature, our results corroborate the lack of guidance to incorporate the RoB assessment in the results of systematic reviews and meta-analyses. Our recommendation is to appraise MQ according to domains of RoB to rate the degree of credibility of the results of a research synthesis, as well as subgroup analysis or meta-regression as analytical methods to incorporate the quality assessment.

Overdispersion Tests in Count-Data Analysis

Count data are commonly assumed to have a Poisson distribution, especially when there is no diagnostic procedure for checking this assumption. However, count data rarely fit the restrictive assumptions of the Poisson distribution. The violation of much of such assumptions commonly results in overdispersion, which invalidates the Poisson distribution. Undetected overdispersion may entail important misleading inferences, so its detection is essential. In this study, different overdispersion diagnostic tests are evaluated through two simulation studies. In Exp. 1, the nominal error rate is compared under different sample sizes and Λ conditions. Analysis shows a remarkable performance of the χ2 df test. In Exp. 2 and 3, statistical power is compared under different sample sizes, Λ, and overdispersion conditions. χ2 and LR tests provide the highest statistical power.

Instruments to assess the patient comfort during hospitalization: a psychometric review protocol

AIM The aim of this study was to analyse the psychometric properties, outcomes and utility of instruments measuring the patient comfort during hospitalization. BACKGROUND While there are numerous systematic reviews assessing the psychometric properties of healthcare instruments, none of them is devoted to evaluate the psychometric properties of instruments measuring comfort, which is considered an indicator of quality in health care and is associated to quicker discharges, increased patient satisfaction and stronger cost-benefit ratios for the institution. DESIGN Psychometric Systematic review. METHODS Searches will be performed on MEDLINE, CINAHL, PsycINFO, Web of Knowledge, ProQuest Thesis&Dissertations and grey literature and will be focused on questionnaires measuring patient comfort as a holistic experience in any healthcare setting. The assessment will take into account the theoretical model on which the instruments are built, evaluate the psychometric properties of each study according to the COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) and will include the assessment of the quality of instruments outcomes and their cost-efficiency, acceptability and educational impact. The review protocol was registered in PROSPERO, CRD42016036290 and was supported by the Grant PSI2014-52962-P, Spanish Ministry of Economy and Competitiveness (July, 2015). DISCUSSION The results of our psychometric review will categorise the instruments measuring the patient comfort according to their psychometric properties, methodological quality, outcomes and utility, to improve the quality of health care provided and the institutions benefits.

The role of posttraumatic stress and posttraumatic growth on online information use in breast cancer survivors

Changes perceived as both positive (eg, posttraumatic growth [PTG]) and negative (eg, posttraumatic stress symptoms [PTSS]) have been associated with intensive Internet use among breast cancer survivors. In this multicenter study, we analyzed the role of PTG and PTSS on the amount of time spent looking for online cancer information, its content, and its psychological impact.

Three risk of bias tools lead to opposite conclusions in observational research synthesis

OBJECTIVES The aim of this study was to assess the agreement and compare the performance of three different instruments in assessing risk of bias (RoB) of comparative cohort studies included in a health psychology meta-analysis. STUDY DESIGN AND SETTING Three tools were applied to 28 primary studies included in the selected meta-analysis: the Newcastle-Ottawa Scale, quality of cohort studies (Q-Coh), and risk of bias in nonrandomized studies of interventions (ROBINS-I). RESULTS Interrater agreement varied greatly from tool to tool. For overall RoB, 75% of the studies were rated as low RoB with the Newcastle-Ottawa Scale, 11% of the studies with Q-Coh, and no study was found to be at low RoB using ROBINS-I. No influence of quality ratings on the meta-analysis results was found for any of the tools. CONCLUSION Assessing RoB using the three tools may lead to opposite conclusions, especially at low and high levels of RoB. Domain-based tools (Q-Coh and ROBINS-I) provide a more comprehensive framework for identifying potential sources of bias, which is essential to improving the quality of future research. Both further guidance on the application of RoB tools and improvements in the reporting of primary studies are necessary.