Laura Galiana

Development and validation of a new tool for the assessment and spiritual care of palliative care patients.

CONTEXT Spiritual assessment tools and interventions based on holistic approaches are needed to promote healing. Such tools must be adapted to the wide cultural backgrounds of contemporary Western society. OBJECTIVES To develop and validate a new brief measure, simultaneously featuring clinical applicability and adequate psychometric properties. The tool uses six initial questions to establish a climate of trust with patients before they complete an eight-item, five-point Likert scale. The questionnaire is based on a model of spirituality generated by the Spanish Society of Palliative Care (SECPAL) Task Force on Spiritual Care (Grupo de Espiritualidad de la SECPAL), which aims to recognize, share, and assess the spiritual resources and needs of palliative care patients. METHODS Multidisciplinary professionals from 15 palliative care teams across Spain interviewed 108 patients using the Grupo de Espiritualidad de la SECPAL questionnaire. Confirmatory factor analysis techniques were used to study the new tool factor structure and reliability. Additionally, concurrent criterion validity coefficients were estimated considering spiritual well-being, anxiety, depression, resilience, and symptoms. Descriptive statistics on questionnaire applicability were reported. RESULTS Analyses supported a three-factor structure (intrapersonal, interpersonal, transpersonal) with an underlying second-order factor representing a spirituality construct. Adequate reliability results and evidence for construct validity were obtained. CONCLUSION The new questionnaire, based on empirical research and bedside experience, showed good psychometric properties and clinical applicability.

Explaining Method Effects Associated with Negatively Worded Items in Trait and State Global and Domain-Specific Self-Esteem Scales.

Several investigators have interpreted method effects associated with negatively worded items in a substantive way. This research extends those studies in different ways: (a) it establishes the presence of methods effects in further populations and particular scales, and (b) it examines the possible relations between a method factor associated with negatively worded items and several covariates. Two samples were assessed: 592 high school students from Valencia (Spain), and 285 batterers from the same city. The self-esteem scales used were Rosenbergs Self-Esteem Scale, the State Self-Esteem Scale, and Self-Esteem 17. Anxiety was also assessed with the State-Trait Anxiety Inventory, and gender and educational level were taken into account. The models were conducted using a multiple indicators and multiple causes (MIMIC) model framework. The evidence in this research pointed out that method effects were present across the different measures of self-esteem. Moreover, a significant and negative effect of anxiety on method effects was present across scales and samples, whereas no effects of age or educational level where found.

Predicting life satisfaction of the Angolan elderly: A structural model

Satisfaction with life is of particular interest in the study of old age well-being because it has arisen as an important component of old age. A considerable amount of research has been done to explain life satisfaction in the elderly, and there is growing empirical evidence on best predictors of life satisfaction. This research evaluates the predictive power of some aging process variables, on Angolan elderly peoples life satisfaction, while including perceived health into the model. Data for this research come from a cross-sectional survey of elderly people living in the capital of Angola, Luanda. A total of 1003 Angolan elderly were surveyed on socio-demographic information, perceived health, active engagement, generativity, and life satisfaction. A Multiple Indicators Multiple Causes model was built to test variables’ predictive power on life satisfaction. The estimated theoretical model fitted the data well. The main predictors were those related to active engagement with others. Perceived health also had a significant and positive effect on life satisfaction. Several processes together may predict life satisfaction in the elderly population of Angola, and the variance accounted for it is large enough to be considered relevant. The key factor associated to life satisfaction seems to be active engagement with others.

Spirituality in patients with advanced illness: The role of symptom control, resilience and social network

In this study, we analyzed the relationships among clinical, emotional, social, and spiritual dimensions of patients with advanced illness. It was a cross-sectional study, with a sample of 108 patients in an advanced illness situation attended by palliative care teams. Statistically significant correlations were found between some dimensions of spirituality and poor symptomatic control, resiliency, and social support. In the structural model, three variables predicted spirituality: having physical symptoms as the main source of discomfort, resiliency, and social support. This work highlights the relevance of the relationships among spirituality and other aspects of the patient at the end of life.

Predicting perceived health in Angolan elderly: The moderator effect of being oldest old

The objective of this study was to test the predicting effects of variables measuring social support, dependence/active perceptions, and generativity, on this facet of well-being when controlled for socio-demographic variables (age, gender, marital status, and institutionalization). The research tries to extend previous literature by assessing them in a multivariate context, studying differential effects of these variables in young old and oldest old, and offering evidence of the scarcely studied population of Angola. The sample was formed by 737 young old and 266 oldest old. It was built a hierarchical regression, in which, among the different predictors, interactions effects between age and the psychosocial factors were included. Results provide evidence of the qualitative different perceived health and well-being of the young old and oldest old. When predicting perceived health of the Angolan oldest old, psychosocial factors lose much of its importance, and age itself and the limitations that accompanied it seem to be the key point.

Exploring relations among mindfulness facets and various meditation practices: Do they work in different ways?

Several meditation practices are associated with mindfulness-based interventions but little is known about their specific effects on the development of different mindfulness facets. This study aimed to assess the relations among different practice variables, types of meditation, and mindfulness facets. The final sample was composed of 185 participants who completed an on-line survey, including information on the frequency and duration of each meditation practice, lifetime practice, and the Five Facet Mindfulness Questionnaire. A Multiple Indicators Multiple Causes structural model was specified, estimated, and tested. Results showed that the Models overall fit was adequate: χ2 (1045)=1542.800 (p<0.001), CFI=0.902, RMSEA=0.042. Results revealed that mindfulness facets were uniquely related to the different variables and types of meditation. Our findings showed the importance of specific practices in promoting mindfulness, compared to compassion and informal practices, and they pointed out which one fits each mindfulness facet better.

Demoralization Scale in Spanish-Speaking Palliative Care Patients.

CONTEXT Among the approaches to the demoralization syndrome, the one proposed by Kissane et al. is prevalent in the literature. These authors developed the Demoralization Scale (DS) to assess emotional distress, conceived as demoralization. OBJECTIVES To present the Spanish adaptation of the Demoralization Scale in palliative care patients, with a new and more comprehensive approach to its factorial structure. METHODS A cross-sectional study was carried out in 226 Spanish palliative care patients in three different settings: hospital, home care unit, and continued care unit. Outcome measures included the DS and the Hospital Anxiety and Depression Scale. Analyses comprised confirmatory factor analyses to test the original, German, and Irish structure of the DS, exploratory structural equation modeling (ESEM), estimations of internal consistency, and multivariate analyses of variance for criterion-related validity. RESULTS The confirmatory factor analyses showed inappropriate fit for the previous structures when studied in the Spanish version of the DS. With ESEM, the best fitting structure was the five-factor solution, without item 18. Reliability results offered good estimations of internal consistency for all the dimensions except for sense of failure. Cronbach alpha coefficients were appropriate for the dimensions of loss of meaning (0.86), helplessness (0.79), disheartenment (0.88), and dysphoria (0.80), but low reliability was found for sense of failure (0.62). Convergent and discriminant validity showed positive correlations between demoralization, anxiety, and depression. Patients with higher levels of anxiety had higher scores on every dimension of demoralization, and those with higher levels of depression had higher scores on loss of meaning, disheartenment, and sense of failure, but not on dysphoria or helplessness. CONCLUSION The Spanish adaptation of the DS has shown appropriate psychometric properties. It has been useful to differentiate between depression and the demoralization syndrome, pointing to helplessness and dysphoria as unique characteristics of demoralized palliative care patients.

Contextual Factors Related to Alcohol Abuse Among Intimate Partner Violence Offenders.

ABSTRACT Background: The association between alcohol consumption and intimate partner violence (IPV) has been reiterated in numerous studies. Some authors have found higher levels of risk factors in intimate partner violence offenders (IPVOs) with alcohol problems than in IPVOs without such problems. Objective: The aim of this study is to analyze the relationship of contextual variables with harmful alcohol use in a sample of IPVOs. Method: This cross-sectional research analyzes data from 231 IPVOs. In addition to demographic data, information was collected on alcohol use, ethnicity, accumulation of stressful life events and perceived social support and rejection. The sample was divided into hazardous and nonhazardous alcohol users, according to the AUDIT test scale. Results: No differences were found between groups on demographic variables. The results of a hierarchical logistic regression analysis supplemented with ROC curves revealed that Latin American immigrants as opposed to Spanish nationality, accumulating stressful life events, and perceiving low social support significantly increased the likelihood of alcohol abuse, with adequate predictive power. Conclusion: Contextual variables such as ethnicity, accumulation of stressful life events, and lack of social support may explain harmful alcohol consumption. These variables should be taken into account in batterer intervention programs in order to reduce one of the most relevant risk factors of IPV: alcohol abuse.

Socio-Demographic Variables and Successful Aging of the Angolan Elderly.

The proportion of elderly people is growing faster than any other age group. Amongst them, the group of oldest old is indeed the segment of the elderly population with the fastest growth rate. The increase in the proportion of elderly in the Angolan population makes research on this area badly needed. Within the theoretical framework of successful aging, the study aims to test for sociodemographic group differences in perceived health, life satisfaction, and social relations in Angolan elderly. The dependent variables are three of the components of what has been called successful aging. Data came from a cross-sectional survey of elderly people living in Luanda. 1003 Angolan elderly were surveyed on sociodemographic information, perceived health, life satisfaction, and social support. MANOVAs were calculated to test for mean differences in the dependent variables. Results permit to conclude that the factors associated with the largest differences on the Angolan elderlys quality of life and social relations were age (becoming oldest old) and institutionalization. The interactions of several factors with age pointed out that the oldest old were clearly a group in which the decreased quality of life due to becoming oldest old could not be compensated by other factors, as it was the case in the group of young old.

Development and Validation of the Escala de Actitudes Emprendedoras para Estudiantes (EAEE).

During the last few years, entrepreneurship has gained an important role in many economic and social policies, with the consequent growth of entrepreneurial research in many social areas. However, in the Spanish psychometric context, there is not an updated scale including recent contributions to entrepreneurship attitudes literature. The aim of this study is to present and validate a new scale named Escala de Actitudes Emprendedoras para Estudiantes-EAEE, (Entrepreneurial Attitudes Scale for Students, EASS), in two samples of high school and university Spanish students. Data comes from a cross-sectional survey of 524 high school and undergraduate students, from Valencia (Spain). Two confirmatory factor analyses (CFAs) were estimated, together with reliability and validity evidence of the scale. Results offered evidence of the adequate psychometric properties of the EASS. The CFAs showed overall and analytical adequate fit indexes (χ 2 (120) = 163.19 (p < .01), GFI = .906, CFI = .959, SRMR = .044, RMSEA = .040 [CI .022-.054]); reliability indices of the entrepreneurial attitudes were appropriate for most of the entrepreneurial attitudes (α were between .63 and .87 for the different dimensions); and external evidence relating entrepreneurial dimensions to personality traits was similar to in previous studies. The scale could be a useful instrument both for previous diagnosis and effectiveness assessment of programs on entrepreneurship promotion.