RESUMO
El trasplante de órganos es una alternativa terapéutica para pacientes que cursan una insuficiencia terminal de ese órgano producto de una enfermedad crónica o aguda. En tal contexto, la calidad de vida relacionada con la salud es un concepto multidimensional importante para evaluar los beneficios del trasplante. Objetivo: Identificar los cambios en la calidad de vida relacionada con la salud que experimentan los pacientes trasplantados de corazón. Método: Revisión sistemática de estudios transversales, prospectivos y cualitativos publicados en inglés desde enero 2020 a diciembre 2022 en Cochrane Library, Medline, OVID, PubMed y Web of Science, en concordancia con las guías PRISMA. Resultados: Se identificaron 43 artículos, 21 de corte transversal, 10 prospectivos y 12 de índole cualitativa además de incluir información sobre la etapa previa al trasplante. Se comprueba un significativo cambio favorable en la mayor parte de los parámetros de calidad de vida, los que incluso se muestran persistentes después de 20 años. Conclusiones: El trasplante de corazón representa una exitosa alternativa terapéutica que no sólo prolonga la vida sino que permite lograr una adecuada calidad de vida relacionada con la salud. El apoyo familiar y social son elementos cruciales que impactan el ajuste y la calidad de vida durante el proceso pre y postrasplante.
Background: Organ transplantation is a therapeutic alternative for patients with end-stage organ failure resulting from chronic or acute disease. In this context, health-related quality of life is an important multidimensional concept to evaluate the benefits of transplantation. Objective: To identify changes in health-related quality of life experienced by heart transplant patients. Methods: Systematic review of cross-sectional, prospective, qualitative studies published in English from January 2020 to December 2022 in Cochrane Library, Medline, OVID, PubMed, and Web of Science, following PRISMA guidelines. Results: We identified forty-three articles, 21 cross-sectional, 10 prospective, and 12 qualitative, in addition to including information on the pre-transplant stage. A significant favorable change in most quality-of-life parameters is verified, which is persistent even after 20 years. Conclusions: Heart transplantation represents a successful therapeutic alternative that not only prolongs life but also makes it possible to achieve an adequate health-related quality of life. Family and social support are crucial elements that impact adjustment and quality of life during the pre- and post-transplant process.
RESUMO
BACKGROUND: Organ transplantation is a therapeutic alternative for patients with end-stage organ failure resulting from chronic or acute disease. In this context, health-related quality of life is an important multidimensional concept to evaluate the benefits of transplantation. OBJECTIVE: To identify changes in health-related quality of life experienced by heart transplant patients. METHODS: Systematic review of cross-sectional, prospective, qualitative studies published in English from January 2020 to December 2022 in Cochrane Library, Medline, OVID, PubMed, and Web of Science, following PRISMA guidelines. RESULTS: We identified forty-three articles, 21 cross-sectional, 10 prospective, and 12 qualitative, in addition to including information on the pre-transplant stage. A significant favorable change in most quality-of-life parameters is verified, which is persistent even after 20 years. CONCLUSIONS: Heart transplantation represents a successful therapeutic alternative that not only prolongs life but also makes it possible to achieve an adequate health-related quality of life. Family and social support are crucial elements that impact adjustment and quality of life during the pre- and post-transplant process.
Assuntos
Transplante de Coração , Qualidade de Vida , Transplante de Coração/psicologia , Humanos , Transplantados/psicologia , Apoio SocialRESUMO
Background: Bariatric surgery is the most effective method for achieving accelerated weight loss. However, in the short- and medium-term, between 20% and 40% of patients regain a significant percentage of the weight lost. Cognitive and attitudinal psychological variables contribute to explaining weight regain. The aim of this study was to analyze differences in self-efficacy, locus of control, and attributions among bariatric patients, in accordance with weight maintenance or weight regain. Methods: Participants were classified according to weight regain (≥15% weight regain) and weight maintenance (<15% weight regain). A receiver operating characteristic (ROC) curve analysis was employed to assess the diagnostic value of the locus of control for weight loss and to establish a cutoff point to differentiate those who maintained weight loss from those who regained more than 15% of the weight lost. Results: Those who maintained weight loss showed a statistically higher locus of control ratio than those who regained weight. The locus of control ratio was associated with a lower risk of weight regain (odds ratio 0.760, p = 0.018). Using the area under the ROC curve (AUC), the locus of control significantly identified those who maintained weight (AUC = 0.761; p = 0.001). The maximum combination of sensitivity and specificity was shown at the cutoff point of 39. Qualitative results show a difference in the type of attributions and expectations according to current weight maintenance or weight regain status. Conclusion: Participants' self-efficacy expectations, locus of control, and attributions change in accordance with the outcome achieved in terms of weight regain or weight maintenance.
Assuntos
Cirurgia Bariátrica , Derivação Gástrica , Obesidade Mórbida , Derivação Gástrica/métodos , Humanos , Controle Interno-Externo , Motivação , Obesidade Mórbida/cirurgia , Estudos Retrospectivos , Autoeficácia , Aumento de Peso , Redução de PesoRESUMO
Resumen Antecedentes El objetivo de este artículo es comparar el Estilo Personal del Terapeuta (EPT) en psicólogos clínicos de dos enfoques teóricos, cognitivo post-racionalista y psicodinámicos, provenientes de dos países: Chile y Argentina. Además, se analizó el efecto de las variables demográficas y profesionales sobre el EPT. Método Se trabajó con una muestra compuesta por 138 psicoterapeutas, 50% chilenos ( n =69) y 50% argentinos ( n =69). Tanto en la muestra de terapeutas chilenos como argentinos, el 50,7% ( n =35) se identificaron de orientación cognitivo post-racionalista y el 49,3% ( n =34) de orientación psicodinámica. Se utilizó como instrumento el Cuestionario de Estilo Personal del Terapeuta. Resultados Se encontraron puntajes superiores en las Funciones Expresiva e Instruccional en terapeutas de nacionalidad chilena, y en la comparación de psicodinámicos versus terapeutas post-racionalistas, se registraron diferencias en las cinco dimensiones del EPT. Por último, se compararon a los terapeutas de acuerdo con su nacionalidad y enfoque teórico, y se encontraron diferencias en las funciones Expresiva e Instruccional al comparar psicólogos psicodinámicos de Argentina y Chile. Conclusiones Se discuten las implicancias de estos resultados en función de estudios previos.
Abstract Background The purpose of this article is to compare the Personal Style of the Therapist (PST) in clinical psychologists of two different theoretical orientations, post-rationalist cognitive and psychodynamic, from two countries: Chile and Argentina. Additionally, the effects of demographic and professional variables on PST were analyzed. Methods A sample consisting of 138 psychotherapists, 50% Chilean ( n =69) and 50% Argentinean ( n =69) was used. In both Chilean and Argentinean samples, 50.7% ( n =35) identified as having a post-rationalist cognitive theoretical orientation and 49.3% ( n =34) had a psychodynamic orientation. The Personal Style of the Therapist Questionnaire was used as a measure instrument. Results Higher scores were also found in the Expressive and Instructional Functions among Chilean therapists, and in the comparison between the psychodynamic and post-rationalist cognitive orientations, differences were recorded in all five dimensions of PST. Lastly, therapists were compared according to their nationality and theoretical orientation, and differences in the Expressive and Instructional Functions were found when comparing psychodynamic psychologists from Argentina and Chile. Conclusion The implications of these results are discussed based on previous research studies.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Comparação Transcultural , Argentina , Chile , Estudos TransversaisRESUMO
RESUMEN La perspectiva temporal se ha asociado a hábitos relacionados con salud. Específicamente, el futuro ha sido asociado a cambios en el estilo de vida como la incorporación de ejercicio físico. En cambio, el presente hedonista se ha asociado a la perdida sub-óptima de peso en pacientes bariátricos. Objetivo: Evaluar la relación entre las variables de la perspectiva temporal y el porcentaje de peso total perdido; su mantención o re-ganancia desde el nadir, en pacientes bariátricos. Material y métodos: Se aplicó a 97 pacientes bariátricos el Inventario de la Perspectiva Temporal de Zimbardo y Boyd, y un cuestionario de estilo de vida construido para esta investigación. Resultados: Un mayor porcentaje de peso total perdido se asoció significativamente a futuro (r= 0,221; p<0,05) y desviación del perfil temporal negativo (r= 0,324; p<0,05). La pérdida de peso insuficiente estuvo asociada al presente fatalista (t= −2,16; p= 0,033) y desviación del perfil temporal balanceado (t= −2,81; p= 0,006). La re-ganancia del %PTP se asoció significativamente a la desviación del perfil temporal balanceado (t= −2,09; p= 0,045) y al consumo de dulces (X2= 13,42; p= 0,009). Conclusiones: Una mayor desviación de la perspectiva temporal balanceada y un mayor consumo de dulces se asociaron a una pérdida de peso insuficiente y a la recuperación desde el nadir.
ABSTRACT Background: A person's perspective of time has been associated with health-related habits. Specifically, future has been associated with changes in lifestyle as well the incorporation of physical exercise. In contrast, current hedonism is associated with sub-optimal weight loss in bariatric patients. Aim: To evaluate the relationship between seven variables of a time perspective and percentage of total weight loss; maintenance or weight regain among bariatric patients. Material and Methods: A sample of 97 bariatric patients answered the Inventory of Temporary Orientation and lifestyle questionnaires. Results: A greater percentage of total weight loss was significantly associated with future (r= 0.221; p<0.05) and deviations from negative time profile (r= 0.324; p<0.05). Insufficient weight loss was associated with a fatalistic present (t= −2.16, p= 0.033) and deviations from a balanced time perspective (t= −2.81; p= 0.006). Regaining weight was significantly associated to deviations from a balanced time perspective (t= −2.09; p=0.045) and consumption of sweets (X2= 13.42; p= 0.009). Conclusions: Deviations from a balanced time perspective and consumption of sweets are associated with sub-optimal weight loss and regaining weight.
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Adulto Jovem , Alterações do Peso Corporal , Cirurgia Bariátrica , Percepção do Tempo , Comportamentos Relacionados com a Saúde , Aumento de Peso , Redução de Peso , Estudos Transversais , Inquéritos e Questionários , Comportamento Alimentar , Estilo de VidaRESUMO
Resumen La cirugía bariátrica permite una pérdida ponderal significativa y acelerada en el corto plazo. La re-ganancia del peso se observa entre el 15 al 30% de los pacientes. Los factores psicológicos explicarían en mayor medida la recuperación del peso en pacientes bariátricos. El objetivo del presente estudio fue evaluar la capacidad predictiva de las variables "locus de control del peso", "perspectiva temporal" y "autoeficacia, para la re-ganancia del peso en pacientes bariátricos. Estudio multivariado predictivo. Se evalúo a 97 pacientes bariátricos. Los resultados indican que las variables psicológicas "locus de control", "presente fatalista" y "pasado positivo" explican el 27.1% de la varianza de la re-ganancia del peso (p<.001). Este modelo clasifica de forma correcta a un 88.7% de los pacientes. Las variables locus de control del peso, pasado positivo y presente fatalista predicen la re-ganancia del peso.
Abstract Bariatric surgery allows a significant and accelerated weight loss in the short term. The regain of the weight is observed between 15 to 30% of the patients. The psychological factors would explain to a greater extent the recovery of weight in bariatric patients. Aim: To evaluate the predictive capacity of the variables "locus of weight control", "temporal perspective" and "self-efficacy", for the re-gain of weight in bariatric patients. Method: Predictive multivariate study. A total of 97 bariatric patients were evaluated. Results: The psychological variables "locus of control", "present fatalist" and "positive past" explain 27.1% of the variance of the regain of weight (p <.001). This model correctly classifies 88.7% of patients. Conclusion: The variables locus of weight control, positive past and fatalistic present predict the regain of weight.
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Humanos , Masculino , Feminino , Psicologia , Pesos e Medidas , Redução de Peso , Cirurgia BariátricaRESUMO
Background Approximately 15 to 40% of bariatric patients regain a significant percentage of their weight lost after surgery. Among psychological variables, control and self-efficacy loci are associated with behaviors related to weight loss. Also, family support can be a risk or protection factor for the maintenance of weight loss. Aim To evaluate the association between psychological variables with weight maintenance or regain after bariatric surgery. Material and Methods We evaluated 97 patients at 4.1 ± 3.4 years after their bariatric surgery. They answered questionnaires about self-efficacy to lose weight, locus of weight control and family functioning style. Regain after surgery was also calculated, through self-report. Results Seventeen percent of patients gained weight. Locus of control (Z = -3.09, p < 0.01), family identity (Z = -3.71, p < 0.01) and self-efficacy (Z = -2.44, p = 0.01), differentiated patients who maintained weight loss from those who re-gained at least 15% of their lost weight. An inverse and significant relationship was observed between the percentage of weight regain and locus of control (r = -0.42, p < 0.01), family identity (r = -0.36, p < 0.01) and self-efficacy (r = -0.34, p <0.01). Conclusions The psychological variables "locus of weight control" and "family identity" are inversely and moderately associated with weight regain in patients subjected to bariatric surgery.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Obesidade Mórbida/cirurgia , Obesidade Mórbida/psicologia , Redução de Peso , Cirurgia Bariátrica/psicologia , Índice de Massa Corporal , Estudos Transversais , Inquéritos e Questionários , Estudos de CoortesRESUMO
Background Approximately 15 to 40% of bariatric patients regain a significant percentage of their weight lost after surgery. Among psychological variables, control and self-efficacy loci are associated with behaviors related to weight loss. Also, family support can be a risk or protection factor for the maintenance of weight loss. Aim To evaluate the association between psychological variables with weight maintenance or regain after bariatric surgery. Material and Methods We evaluated 97 patients at 4.1 ± 3.4 years after their bariatric surgery. They answered questionnaires about self-efficacy to lose weight, locus of weight control and family functioning style. Regain after surgery was also calculated, through self-report. Results Seventeen percent of patients gained weight. Locus of control (Z = -3.09, p < 0.01), family identity (Z = -3.71, p < 0.01) and self-efficacy (Z = -2.44, p = 0.01), differentiated patients who maintained weight loss from those who re-gained at least 15% of their lost weight. An inverse and significant relationship was observed between the percentage of weight regain and locus of control (r = -0.42, p < 0.01), family identity (r = -0.36, p < 0.01) and self-efficacy (r = -0.34, p <0.01). Conclusions The psychological variables "locus of weight control" and "family identity" are inversely and moderately associated with weight regain in patients subjected to bariatric surgery.
Assuntos
Cirurgia Bariátrica/psicologia , Obesidade Mórbida/psicologia , Obesidade Mórbida/cirurgia , Redução de Peso , Adulto , Idoso , Índice de Massa Corporal , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Background:: Lack of adherence to treatment may hamper the management of type 2 Diabetes Mellitus. Aim To identify if there is a profile of psychological variables associated with adherence to treatment and complications in patients with type 2 diabetes mellitus. Material and Methods: The psychometric instruments Multidimensional Scale of Locus of Control in Health, Locus of Control of Rotter and Inventory of Temporary Orientation of Zimbardo & Boyd were applied to 192 patients aged 64 ± 10 years (78% women) with type 2 diabetes attending public primary health clinics. Adherence to treatment was assessed using glycosylated hemoglobin levels. Results: There was an inverse association between glycosylated hemoglobin and adherence to treatment (p < 0.01). Adherence in patients with renal damage and diabetic foot was associated with the psychological variables Negative Time Perspective Profile (p < 0.05) and External Locus of Control Powerful Other (p < 0.05). Conclusions: A psychological profile associated with adherence was observed in the presence of kidney damage and diabetic foot. A fatalistic present and a negative past are the outstanding features of a negative temporal profile.
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Complicações do Diabetes/psicologia , Diabetes Mellitus Tipo 2/psicologia , Cooperação e Adesão ao Tratamento/psicologia , Escalas de Graduação Psiquiátrica , Psicometria , Valores de Referência , Fatores de Tempo , Comportamentos Relacionados com a Saúde , Chile , Estatísticas não Paramétricas , Complicações do Diabetes/prevenção & controle , Diabetes Mellitus Tipo 2/prevenção & controle , Cooperação e Adesão ao Tratamento/estatística & dados numéricosRESUMO
BACKGROUND: Lack of adherence to treatment may hamper the management of type 2 Diabetes Mellitus. Aim To identify if there is a profile of psychological variables associated with adherence to treatment and complications in patients with type 2 diabetes mellitus. MATERIAL AND METHODS: The psychometric instruments Multidimensional Scale of Locus of Control in Health, Locus of Control of Rotter and Inventory of Temporary Orientation of Zimbardo & Boyd were applied to 192 patients aged 64 ± 10 years (78% women) with type 2 diabetes attending public primary health clinics. Adherence to treatment was assessed using glycosylated hemoglobin levels. RESULTS: There was an inverse association between glycosylated hemoglobin and adherence to treatment (p < 0.01). Adherence in patients with renal damage and diabetic foot was associated with the psychological variables Negative Time Perspective Profile (p < 0.05) and External Locus of Control Powerful Other (p < 0.05). CONCLUSIONS: A psychological profile associated with adherence was observed in the presence of kidney damage and diabetic foot. A fatalistic present and a negative past are the outstanding features of a negative temporal profile.