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espanolIntroduccion: El numero de supervivientes de cancer ha aumentado considerablemente en los ultimos anos. Estas personas presentan necesidades asistenciales especificas, y se sienten vulnerables ante cualquier tipo de problema de salud, por lo que, contrariamente a lo que seria esperable, la finalizacion del tratamiento parece dar inicio a una etapa extremadamente estresante para los supervivientes. Objetivo: Describir las caracteristicas del malestar cotidiano durante situaciones consideradas estresantes para los supervivientes de cancer. Metodologia: Se ha usado una Evaluacion Ecologica Momentanea para recoger informacion sobre las actividades cotidianas de los supervivientes de cancer al final del dia. Muestra: Sesenta supervivientes de varios tipos de cancer, que han contestado a un cuestionario online durante 15 dias consecutivos. Resultados: Los supervivientes han experimentado un evento estresante un 55,12% de los dias registrados, de los cuales el 45,41% de ellos fue atribuido al hecho de ser superviviente y genero niveles de malestar mas elevados. El evento estresante mas frecuente, cuando se atribuye a la supervivencia, ha sido el problema fisico (87,60%). Conclusiones: El problema fisico es claramente un evento estresante relacionado con la fase de supervivencia y, es un problema que no parece resolverse con el tiempo. En general, los eventos estresantes atribuidos a la supervivencia generan mas malestar. EnglishIntroduction: The number of cancer survivors has dramatically increased in recent years. These people have specific healthcare needs, and feel vulnerable to any type of health problems. Contrary to what would be expected, when cancer treatment is finished an extremely stressful stage for survivors begins. Objectives: To describe the characteristics of daily distress during everyday situations considered stressful by cancer survivors. Methodology: Using Ecological Momentary Assessment, information about daily activities of cancer survivors was recorded at the end of the day. Sample: Sixty survivors of various types of cancer, who answered an online survey for a total of 15 consecutive days. Results: Survivors experienced a stressful event at 55,12% of the days recorded, and 45,41% of these days the event was related to the fact of being a survivor and generated higher levels of discomfort. Physical problem was the most frequent stressful event attributed to survival (87.60% of them). Conclusions: the physical problem related to the survival stage is clearly a stressful factor that does not seem to resolve itself over time. To a great extent, stressful events linked to the survival experience, give rise to more distress.

Entre la década de los 80 y los 90, la atención psicológica específica a pacientes oncológicos, la Psicooncología, empezó a establecerse en algunos centros hospitalarios de Cataluña. Las pocas profesionales encargadas de llevar a cabo esta labor, trabajaban dispersas en unos pocos servicios/unidades de Oncología de adultos y pediátricos, así como en algunas ONGs, por lo que la posibilidad de establecer colaboraciones y trabajar de manera conjunta era difícil. Ante dicha dispersión de centros de trabajo y, también, no menos importante, el hecho de que sólo había una profesional vinculada en cada uno de ellos (soledad profesional), surgió la necesidad de agruparse y crear un Grupo como un espacio de encuentro y de comunicación donde compartir inquietudes entorno a la disciplina de la Psicooncología que crecía poco a poco vinculada a los equipos de atención oncológica.

Objetivo: Analizar la validez y la fiabilidad de la adaptación de la escala Perceived Personal Control (PPC) en el contexto español para pacientes portadoras de mutación en los genes BRCA1/2 responsables del cáncer de mama y ovario hereditario (CMOH). Método: Adaptación transcultural y validación de la escala Perceived Personal Control (PPC) desarrollada por Shiloh y colaboraradores mediante traducción, retrotraducción y validación a través de un análisis factorial exploratorio con rotación Oblimin en una muestra de 176 mujeres portadoras de genes BRCA 1/2 para CMOH. Resultados: La versión española de la PPC reduce a seis los nueve ítems de la escala original, dado que esta estructura es la que ofrece una solución factorial más satisfactoria. El análisis factorial mostró un solo factor que explica el 51,07% de la varianza, en el que todos los ítems tenían cargas factoriales por encima de 0,4. El coeficiente α de Cronbach fue de 0,84 para el conjunto de la escala, la cual permite obtener valores que oscilan entre 0 (bajo grado de percepción de control) y 2 (alto grado de percepción de control). Conclusiones: La adaptación española de la Escala de Percepción de Control (PPC6) posee propiedades psicométricas satisfactorias en la versión de 6 ítems con un solo factor, por lo que su utilización en contexto español Consejo Genético para cáncer hereditario parece adecuada. Purpose: The aim of this study was to analyze the reliability and validity of the spanish adaptation of the Perceived Personal Control (PPC) scale in women who were positive for BRCA1/2 genes, which are related with hereditary ovarian and breast cancer (HOBC). Method: PPC original items developed by Shiloh and co-workers were translated and back-translated in order to develop an spanish version which was analyzed by an exploratory factor analysis with Oblimin rotation. Answers to the spanish version were provided by a sample of 176 women who were positive for BRCA1/2 for HOBC. Results: Spanish version contains only six items of the nine original items, since this structure provided the optimal solution to the exploratory factor analysis. This version is a one-factor scale (51.07% of variance explained) and all items had factor loading values >0.4. The scale has good reliability (Cronbach’s Alpha =0.84) and gives a range of values between 0 (low perceived control) and 2 (high perceived control). Conclusions: Spanish adaptation (PPC6) of the original 9-items version has enough reliability and psychometric properties, and it seems to be useful to be applied in Genetic Counseling at spanish cultural settings.

Teniendo en cuenta la idoneidad de un apoyo tecnológico para adolescentes con padres con cáncer, el objetivo general para este trabajo es elaborar una relación de los contenidos básicos que debe tener una página web de apoyo psicológico para adolescentes con padres con cáncer que facilite a los adolescentes, la adaptación a esta situación. Teniendo en cuenta la clasificación de la World Health Organization, que habla de tres fases de la adolescencia: adolescencia temprana (10-13 años), adolescencia media (14 a 16 años) y adolescencia tardía (17 a 19 años), la página web se diseñará para adolescentes con edades entre 10 a 19 años que viven en España y cuyo padre o madre sufre cáncer o ha sufrido cáncer. En este trabajo pretendemos identificar qué elementos debería tener una página web para: 1. Proporcionar a los adolescentes la información que necesiten sobre el cáncer. 2. Dar a conocer posibles pautas y estrategias para afrontar la situación. 3. Ofrecer contacto con adolescentes que están pasando por la misma situación. 4. Acercar los adolescentes a profesionales sanitarios que les ayudan a manejar la situación. 5. Evitar efectos iatrogénicos. When a father or a mother gets diagnosed with cancer, children are affected too. Adolescents are the most vulnerable group to suffer the consequences. They consider that their surrounding do not listen to their necessities. That is why we propose an innovative approach to create the elements of a psychological support website for adolescents with parental cancer. The procedure was based on conducting semi structured interviews with adolescents, affected parents and psycho-oncologist. Results been given from the comparison between the interviews that have been done in this research and the results of the scientific literature. We concluded that the website should include three fundamental elements: Information, coping strategies counseling, and the possibility to interact with other adolescents in the same situation as well as with professionals. It is of great importance to avoid that the website should be iatrogenic. That is the reason why we propose a filter's system that allows to direct the adolescent to the adequate content for his/her situation. These filters avoid, as much as possible, the wrong misinterpretation and expectations that can generate confusion and discomfort.

Identifying patients at increased risk of suicide remains a challenge today. It has been reported that 10% of patients committing a suicide attempt end up dying and that both the risk and the severity of clinical symptomatology increase with the number of attempts. Within the framework of selective and indicated prevention, it is essential to identify the group of patients with an increased risk of recurrence. The objective of this study is to identify factors predicting suicide attempt relapse to improve the decision making process in the therapeutic approach to suicidal behavior. The methodology employed was a longitudinal design aimed at identifying factors, in a binary logistic regression model (stepwise), predicting the repetition of suicidal behavior among a sample of 417 participants aged between 8 and 17 years old, at the six months follow-up. A statistically significant model χ2(3, N = 417) = 18.610; p < .001; Nagelkerke R2 = .096 including the following factors was obtained: current diagnosis of personality disorder/maladaptive personality OR = .806, p = .028, 95% CI [1.091, 4.595], personal history of self-injury OR = .728, p = .043, 95% CI [1.023, 4.192], and family history of psychopathological diagnosis OR = .925, p = .021, 95% CI [1.151, 5.530]. Considering these results, having a diagnosis of personality disorder or maladaptive personality traits, presence or history of self-harm and family history of psychopathology draws a predictive profile of autolytic attempt recurrence during the six months after the initial intervention at the emergency room.

Los supervivientes de tumores del sistema nervioso central (TSNC) presentan peor calidad de vida en relación a la salud (CVRS) que los supervivientes de otras neoplasias y la población normativa. El tipo y gravedad de las secuelas no parecen tener un impacto claro en la CVRS, pero la afectación del cociente intelectual (CI) sí podría modular la CVRS. Además, las estrategias de afrontamiento del paciente y de los progenitores y el malestar emocional parental podrían también actuar sobre la CVRS. Objetivo: Determinar si las estrategias de afrontamiento del adolescente y su CI, y las estrategias de afrontamiento, el estrés general y el malestar emocional parental, modulan las dimensiones psicosociales de la CVRS del superviviente. Método: Estudio transversal descriptivo-correlacional. Se reclutaron 37 adolescentes (12-19 años) que llevaban ≥1 año fuera de tratamiento oncológico y 44 progenitores. Resultados: En la CVRS valorada por los adolescentes, las dimensiones Relación con los Padres y Vida Familiar, Amigos y Apoyo Social, y Entorno Escolar dependen de la estrategia de afrontamiento de resolución del problema usada por el adolescente. La dimensión Aceptación Social depende del estilo de afrontamiento improductivo del adolescente y del estilo de búsqueda de ayuda social de los padres. La CVRS valorada por los padres depende de las secuelas, el CI del adolescente y, el tipo de tratamiento oncológico recibido. Discusión y conclusiones: Las estrategias de afrontamiento centradas en la resolución del problema, deben ser consideradas para valorar e intervenir en la mejora de la CVRS de los supervivientes TSNC. Central Nervous System Tumor (CNST) survivors tend to show worse HRQoLthan survivors of other types of cancer and general population. There are still many doubts about whatvariables and to what extend these are related to their HRQoL. Type and severity of late effects havenot a clear impact on HRQoL. However, Intelligence Quotient (IQ) changes as a specific late effectof this sample population, could modulate their HRQL. Furthermore, coping from both patients andparents, as well as parental distress could play a significant role modulating HRQoL in these survivors.Aim: To study whether survivors' coping strategies and IQ, as well as coping, general stress and cancerrelateddistress of parents could modulate some psychosocial dimensions of their children HRQoL.Methodology: Correlational descriptive cross-sectional study. Thirty-seven teenagers (12-19 years old,both included) ≥1 year free of disease and 44 parents were recruited for the study. Results: When HRQoLis assessed by adolescents, the dimensions Parent Relations and Home Life, Social Support and Peer,and School Environment are related with the use of coping with problem style by adolescents. SocialAcceptance/Bullying dimension is related with nonproductive coping by the adolescent and helpseekingcoping style by parents. HRQoL assessed by parents is related with late effects, adolescents' IQ, andtype of oncological treatment received. Discussion/Conclusion: Coping strategies, and specificallyproblem-solving strategies must be taken into account to assess and to intervene in the improvement ofHRQoL of this sample population.

This study was twofold: 1) to assess parental reactions to childhood cancer throughout the oncological experience and 2) to explore associations between parents’ reactions during treatment and cancer-related distress at survival. A cross-sectional descriptive study collecting data (at survival) from retrospective (perceived social support, optimism, distress, coping in the worst situation) and current variables (general stress, distress regarding cancer, benefit finding) was carried out. Forty-one parents of childhood cancer survivors were assessed. High levels of distress (M= 9.5,SD= 1.32, range 4-10) and self-reported efforts to overcome difficulties occurring during the hospitalization (M= 7.48,SD= 3.01, range 0-10) were found. However, parents received high social support from very different sources. This could explain the satisfactory levels of optimism found (43.9% of the sample,M≥ 16, range 9 – 24). Most parents reported to use engagement (M= 2.57,SD= 0.41, range 1-4) and help-seeking (M= 2.52,SD= 0.53, range 1-4) coping strategies to overcome difficulties. Some parents recognized to use psychological defenses when coping with the distress of cancer. However, this disengagement style was less preferred (M= 1.62,SD= 0.37, range 1-4). Finally, 22% of parents reported positive consequences and 60% reported positive and negative consequences too. When exploring how treatment experiences can influence cancer-related distress in survivorship, we observed that those who received less social support used more disengagement coping and referred higher efforts to overcome difficulties during treatment, displayed persistent distress at survival. These same parents showed higher scores on general stress. Besides, these results were not influenced by child’s sequelae at survival. These findings support the hypothesis that “the end of treatment is not the end”. Consequently, special attention should be placed in screening parents experiences throughout different milestones of cancer to design tailored interventions aimed at reducing persistent distress at survival.

Research findings about health-related quality of life (HRQoL) of childhood cancer survivors are mixed and the features which could modulate these results have not been investigated rigorously. This research aims to improve the knowledge on these topics. Thus, HRQoL between central nervous system (CNST) and non-central nervous system (non-CNST) adolescent cancer survivors was compared. The influence of selected factors (gender and years since diagnosis) on HRQoL was also analysed. In a cross-sectional design, 78 survivors (12-20 years) who were ≥ 1 year free of oncological treatment answered the self-reported version of the KIDSCREEN-52. HRQoL mean scores of CNST survivors were lower in comparison with non-CNST in physical well-being and social support and peers dimensions. Furthermore, female gender was also related to lower HRQoL scores for both types of tumours in physical well-being and autonomy dimensions. Additionally, scores on psychological well-being, social support and peers, parent relations and home life and school environment dimensions decrease with length of time from diagnosis. Therefore, diagnosis of CNST and gender were related to lower HRQoL among survivors in some dimensions, whereas time from diagnosis was related to impaired HRQoL in other features. These results can help to design tailored interventions and psychosocial guidelines to follow-up survivors.

Objetivo: Comparar la efectividad de una intervención de Mindfulness (MBSR) versus una intervención psicoeducativa estándar en pacientes oncológicos. Método: La intervención MBSR (grupo experimental) consistió en 10 sesiones semanales de 2,5 horas cada una de ellas y el paciente debía practicar Mindfulness diariamente y durante 45 minutos en su casa y la intervención psicoeducativa (grupo control) consistió en 8 sesiones semanales de 2,5 horas. Participaron 20 y 17 personas, respectivamente. Se recogieron datos basales y se administraron (pretest-postest) los siguientes cuestionarios a los participantes de ambos grupos: STAI (ansiedad-estado y ansiedad-rasgo), BDI (depresión) y EORT-QLQ C-30 (calidad de vida). Resultados: En el grupo experimental resultaron diferencias estadísticamente significativas indicativas de mejoría en todas las medidas (depresión, ansiedad-estado, ansiedad-rasgo y calidad de vida) mientras que en el grupo de control sólo aparecieron en la variable ansiedad-estado. Conclusiones: Los datos de esta investigación indican que el MBSR produce una mejoría importante en el malestar emocional y en la calidad de vida, superior a la que puede lograrse con una intervención psicoeducativa. No obstante, no puede afirmarse que el MBSR deba ser la técnica de elección para todos los casos, pues no está claro que pueda ser seguida por cualquier tipo de paciente, al requerir una alta implicación por parte del mismo Purpose: To compare the effectiveness of a Mindfulness-Based Stress Reduction (MBSR) intervention versus a psychoeducational standard intervention in oncological patients. Method: MBSR intervention was applied following a 2'5 h-session schedule, across 10 weekly sessions. Patients (n= 20) had to practice mindfulness daily at home during 45 minutes. In the psychoeducational group (n=17) a schedule of 8 weeekly sessions of 2'5 h each was applied. Following a pre-post design, the following questionnaires were applied to both groups of patients: STAI (to assess both state and trait anxiety), BDI (Depression) and EORTC-QLQ-C-30 (quality of life). Results: In the MBSR group, scores in anxiety and depression decreased at post-treatment assessment whereas quality of life scores increased. These differences reached statistical significance. In the psychoeducational group only state anxiety scores decreased at post-treatment, with the difference reaching statistical significance. Conclusions: MBSR produces higher improvements in emotional states and quality of life than those obtained following a psychoeducational standard procedure. However, it cannot be stated that MBSR must be always the intervention to be applied in all cases, since it is not clear that all patients could follow the guidelines, tasks and exercices required by this technique

La necesidad de prevenir muertes evitables y contener el impacto emocional que genera la conducta suicida requiere de estudios que permitan entender mejor el fenómeno, con el fin de incrementar la eficacia de las estrategias preventivas e interventivas. Clasificar la conducta suicida permitiría un mejor abordaje de esta problemática tan heterogénea, con influencias culturales, evolutivas y de género. Este trabajo pretende describir diferentes perfiles psicológicos prototípicos del adolescente con conducta suicida, a partir de una propuesta de clasificación ya existente que se amplía con otras variables clínicas de relevancia. Para ello, se diseñó un estudio transversal descriptivo-correlacional con pacientes de entre 8-17 años, visitados en Urgencias por conducta suicida entre noviembre del 2013 y diciembre del 2014. Los datos se obtuvieron a partir de entrevistas clínicas. La propuesta de clasificación mostró que los adolescentes del grupo I, el más prevalente (60%), se caracterizaron por presentar mayor prevalencia de rasgos desadaptativos de personalidad, trastorno de conducta, más ingresos hospitalarios y autolesiones y la mitad de ellos presentaron antecedentes de conducta suicida. Los del grupo II (30%), presentaron mayor prevalencia de trastornos del estado de ánimo. El grupo III (10%), mostró un alto porcentaje de tentativas autolíticas (>75%) respecto a otras conductas suicidas, identificando los conflictos relacionales como desencadenantes más frecuentes. La obtención de estos perfiles prototípicos y sus correspondientes características clínicas y psicopatológicas, permite sugerir diferentes procesos de tratamiento ajustados a cada uno de los procesos descritos.

The relationship between perceived control and psychological distress in cancer patients has been widely studied, but longitudinal designs are scarce. The aim of this study was to examine whether perceived control could predict changes in the evolution of psychological distress in breast cancer patients at stages I or II. One hundred and one women were assessed on five occasions: one week after surgery, and again 1, 3, 6 and 12 months later, using the Mental Adjustment to Cancer (MAC) Scale, a Self-Efficacy Scale, the Personal Competence Scale, the Hospital Anxiety and Depression Scale (HADS), the Profile of Mood Sates (POMS), and the EORTC questionnaire of quality of life. Latent growth curve (LGC) model analysis was used to test the relationship between perceived control and psychological distress in a longitudinal, 1-year study. The results showed that perceived control increases linearly and that distress also decreases linearly. Moreover, the evolution of distress can be predicted from the initial value and the rate of change of perceived control. This close relationship between perceived control and psychological distress was found to be independent of the evolution of the physical state. These findings suggest that perceived control could be used as an early predictor of psychological adjustment to illness.

Objective: To assess the psychological status of adolescent cancer survivors and examined its associations with selected personal (coping, cancer-related distress) and familial factors (parents’ general stress, cancer-related distress). Method: Using a cross-sectional design, forty-one survivors (12-19 years) answered standardized measures to assess psychological well-being, mood and emotions and self-perception (KIDSCREEN-52), coping (ACS) and cancer-related distress (two numeric scales). Similarly, forty-one parents were assessed for general stress (PSS-14) and cancer-related distress (two numeric scales). Results: Mean scores for all KIDSCREEN psychological dimensions assessed were within normative values (50 ± 10). Regression analyses revealed two models with a range of explained variance between 17.3-31.1% for psychological well-being (F(2,37) = 5.070; p = 0.011) and mood and emotions (F(3,36) = 6.877; p = 0.001) respectively. Conclusion: This study provides tentative evidence that survivors’ psychological status is related to diverse personal and familial factors, especially those concerning adolescent mobilization of coping resources during hospitalization, and parental general stress in survivorship. Although psychological outcomes in survivorship appeared satisfactory compared to normative values; this study revealed that to facilitate positive psychological adaptation in the aftermath of cancer, psychosocial interventions aimed to enhance personal and family strengths to cope with the illness are needed throughout the process.

La investigación ha evidenciado que las emociones positivas pueden mejorar la salud de pacientes con diferentes enfermedades. El objetivo del presente trabajo es analizar si el estado de ánimo positivo (EAP) está relacionado con la calidad de vida de pacientes con cáncer colorrectal (CRC) y si pueden establecerse directrices para desarrollar intervenciones eficaces que mejoren ese estado de ánimo. Se lleva a cabo una revisión de artículos publicados entre enero de 2001 y Marzo de 2012 a partir de las bases de datos Medline, ISI Web of Knowledge, Psycho Inf y Cochrane y las palabras: emociones positivas, EAP, indicadores de salud, calidad de vida CRC y cáncer. Los artículos se clasificaron en dos grupos: a) Artículos descriptivos; b) Artículos de intervención. Los resultados de los artículos descriptivos indican que el estado de ánimo positivo está relacionado con mejor estado de salud, mejor funcionamiento social, mayor crecimiento personal, mayor bienestar, y menores niveles de ansiedad y depresión. El EAP aumenta cuando se realizan diferentes actividades. Los resultados de los artículos de intervención sugieren que las intervenciones pueden ser adecuadas para mejorar el EAP de los pacientes. Se proporcionan algunas orientaciones que pueden ser útiles para los pacientes con CRC It can be stated from the previous research that positive emotions should allow to better health outcomes in sick populations. The aim of the present work is to know the state-of-the-art of how positive affect (PA) relates with quality of life in colorectal cancer (CRC) patients, as well as to give some guidelines to develop more efficacious psychological interventions in CRC patients to enhance positive affect. This review describes a search of published literature from January 2001 to March of 2012 on the Medline, ISI Web of Knowledge, Psycho Inf and Cochrane databases using publications that contain positive emotions, positive affect, health outcomes, quality of life, CRC and cancer. These articles were classified into two groups: a) ―descriptive papers‖ b) ―interventional studies‖. Results from ―descriptive papers‖ suggest that positive affect (PA) was significantly associated with greater levels of general health, better social functioning, benefit finding, positive changes, low depression, less anxiety and greather psychological well-being. PA also increases when different activities are developed. The overall results from interventional studies suggest that the interventions described can be recommended for improving patient's levels of positive affect. The present review offers some suggestions which could be useful for CRC patients

This study assessed the psychosocial outcomes of adolescent cancer survivors and their relationship with personal and socio-familiar factors. Using a cross-sectional design, 41 survivors answered the four psychosocial dimensions of the KIDSCREEN-52 questionnaire and measures for social support and coping. Similarly, 41 parents answered coping and cancer-related distress measures. All psychosocial scores were within normative values (50 ± 10). Multiple linear regression analyses revealed four models with a range of explained variance between 9.4 percent and 31.9 percent that include the informative and emotional support, parental distress, and coping. This study contributes to the understanding of psychosocial outcomes of childhood cancer survivors and its correlates.

This research assesses Health-Related Quality of Life (HRQoL) in a Spanish sample of adolescent cancer survivors, and analyzes the relationship between HRQoL, coping styles and physical exercise. Forty-two survivors (12–19 years), who were ≥ 1 year of remission, completed standardized measures of HRQoL (CHIP-AE), coping strategies (ACS) and physical exercise (AECEF). Mean scores in all HRQoL domains were within normative values. Multiple regression analysis revealed that physical exercise and productive coping were related to higher HRQoL, whereas non-productive coping was related to lower HRQoL. This sample of survivors reported good levels of HRQoL, which are mediated by coping styles and physical exercise.

Objetivo: Analizar los efectos que provoca la primera visita de consejo genético para cáncer hereditario sobre la percepción de riesgo, y el malestar emocional en pacientes que acuden por primera vez a la Unidad de Consejo Genético (UCG) por historia familiar de cáncer de mama, ovario o colon hereditario. Método: Se evaluó la percepción de riesgo de padecer cáncer (al año, a 10 años, y a lo largo de toda la vida), y la intensidad del malestar emocional (evaluada como la ansiedad, tristeza y preocupación por la salud experimentadas durante la última semana) en tres ocasiones: inmediatamente antes de la primera visita de consejo genético (CG), inmediatamente después de la misma, y al cabo de 2-3 semanas. Resultados: El malestar emocional previo a la visita se producía en aproximadamente un 30% de los pacientes, siendo mayor en las personas que no realizaban actividad laboral. Si bien la visita de CG reducía el malestar emocional en muchos casos, ocurría lo contrario en algunos pacientes inmediatamente después de la misma (un 34% se sentía más ansioso, un 32% se sentía más triste, y un 23% se sentía más preocupado), y ello guardaba relación con la preocupación por los hijos (tanto si se tenían como si se pretendía tenerlos en el futuro). No obstante, este malestar se reducía en las 2-3 semanas posteriores. La visita de CG reducía la percepción de riesgo de padecer cáncer a lo largo de toda la vida (p< .01), no existiendo diferencias en función del tipo de cáncer. Conclusiones: Esta primera visita reduce la sobreestimación del riesgo de padecer cáncer que los pacientes tienen antes de la misma, pero, en aproximadamente un tercio de los mismos, no reduce los niveles de malestar emocional, observándose, incluso, un incremento de éste que va disminuyendo durante las semanas posteriores a la visita. Son necesarios más estudios que permitan determinar si este incremento es una consecuencia inevitable del inicio del proceso de CG, o si puede reducirse modificando algún aspecto del protocolo que se aplica en la primera visita. Objective: To analyze how perceived risk and emotional distress were affected by the first visit to a Genetic Counseling Unit in patients with a family history of hereditarian breast cancer, ovarian cancer, or colorectal cancer. Methods: Risk perception of suffering cancer at 1 year, at 10 years, and across the life span, as well as emotional distress (assessed as sadness, anxiety and worries during the last week) was assessed in three moments: before the first visit to the Genetic Counseling Unit, immediately after finishing the visit, and 2-3 weeks after the first visit. Results: Emotional distress prior the first visit was observed in 30% of patients, with higher levels in patients without job. The first visit decreased emotional distress in most cases. However, 34% of patients stated that they were more anxious after the visit, 32% of patients become sadder, and 23% of patients were more worried. Patients who expressed increased levels of emotional distress after the visit were worried about their sons (or sons they wanted to have in the future). In spite of that, this emotional distress decreased at 2-3 weeks. The first visit to a Genetic Counseling Unit decreased risk perception of having cancer across the life span (p

Objectives: To examine whether perceived control produces better adaptation to illness in breast cancer patients in stages I or II. Design: Longitudinal, 1-year following study. Methods: One hundred and one women were assessed on five occasions: one week after surgery, and again 1, 3, 6 and 12 months later, using, among other measures, the Mental Adjustment to Cancer (MAC) and the Hospital Anxiety and Depression Scale (HADS). Results: Structural equation models confirmed that patients with higher perceived control showed better adaptation to illness in all five assessments. Conclusions: These data fit well with previous research and suggest that psychological interventions which emphasize a sense of personal control would be effective in enhancing well-being in breast cancer patients at the early stages.

Background: Health-related quality of life (HRQoL) in cancer has been related to several protective and risk factors such as perceived social support (PSS) and coping. However, their effects on HRQoL once patients are in survivorship have not been fully described in pediatric samples.Objective: To describe and explore the relationship between HRQoL in survivorship and some factors (PSS, coping) present while active treatment.Methods: Cross-sectional study. Forty-one pediatric cancer survivors answered HRQoL measures referred to survivorship, as well as PSS and coping measures referred to treatment period.Results: The discriminant function obtained succeeds to correctly classify 78% of the sample. Survivors who showed high HRQoL were those who, in the hardest moment while hospitalization, perceived satisfactory emotional support (from nurses) and did not deploy a wide range of active coping resources to cope with stressful events (only social action coping strategy showed a significant relationship with HRQoL).Conclusions and implications: Considering these outcomes, educational and counseling interventions to strengthen patients’ social networks and supportive relationships are recommended, specially, among health providers (nurses). These results highlight the importance of not overlooking opportunities to address the emotional needs of patients while hospitalization, since a positive and endurable effect has been observed at survivorship.

Current research on chemotherapy-induced nausea and vomiting in cancer patients is reviewed, and some hypotheses to explain why anticipatory and post-chemotherapy nausea and vomiting appear are suggested. Methodological problems are also discussed. It is suggested that future research should focus on post-chemotherapy nausea and emesis, rather than anticipatory nausea and emesis, in order to achieve a deeper understanding of the psychological factors involved in the development of chemotherapy-induced nausea and vomiting.

Objetivo: Conocer los recursos que poseen los padres afectados por cáncer al comunicar la enfermedad a sus hijos menores y su relación con el malestar emocional de estos pacientes. Método: Se evaluó el estilo de comunicación familiar mediante una subescala del FAD (Mc Master Family Assessment Device). Se elaboró un cuestionario específico para evaluar los recursos de los pacientes, donde cada ítem era valorado con una escala de 0 a 10 (siendo 0 nada en absoluto y 10, la máxima puntuación posible). También se utilizó una escala numérica de valoración del malestar emocional, en forma de un solo ítem (0-10). El conjunto de pruebas se aplicó a 60 pacientes de edades comprendidas entre los 34 y los 60 años todos ellos padres afectados de cáncer con hijos menores a su cargo. Resultados: Los recursos que parecen poseer en mayor medida los padres evaluados son los recursos relacionados con la gestión de la vida doméstica (media = 8,3), seguidos de los que hacen referencia a delegar a terceras personas los cuidados de sus hijos durante momentos difíciles. Al analizar con más profundidad estos dos recursos, detectamos que más del 80% de los padres de la muestra poseen el recurso relacionado con la gestión de la vida doméstica. Por el contrario, el recurso de como informar sobre la situación de enfermedad a los niños, lo tiene poco más de la mitad de los pacientes evaluados (55%). Los datos indican que existe una relación inversa entre la disponibilidad de este recurso y el nivel de malestar emocional, ya que los pacientes que consideran tener recursos para hablar de la enfermedad a sus hijos, presentan un menor malestar emocional. Conclusiones: Los padres recién diagnosticados de cáncer que plantean comunicar la situación de enfermedad a sus hijos menores, poseen más recursos para gestionar la vida doméstica y delegar el cuidado de sus hijos cuando lo precisan a terceras personas, que para informar sobre la enfermedad y sostener emocionalmente a sus hijos. Así mismo, el no disponer de recursos para comunicar el diagnóstico a los hijos se asocia con una mayor presencia de malestar emocional.

Se presenta una revisión de los procedimientos y estrategias que se utilizan para la investigación del dolor en condiciones de laboratorio, llevándose a cabo un análisis crítico de las ventajas, inconvenientes y limitaciones de los mismos. Finalmente, se apuntan algunas consideraciones susceptibles de constituir pautas para el desarrollo de futuras líneas de investigación. A review on procedures and strategies used to investigate pain in lab conditions emphisizing a critical analysis on its advantages, difficulties and limits is focused here. Also guidelines are looked upon for future research.