Validación de dos herramientas para la evaluación de cambios en las actitudes de alumnos en situaciones frecuentes en cuidado paliativo

Objective: To determine the psychometric properties of two scales designed to examine attitudes regarding palliative care: Comfort Scale in Palliative Care (CSPC, Pereira et al.) and Tanatophobia Scale (TS, Merrill et al.)Method: Seventy-seven students who completed an online course on psychosocial aspects of palliative care offered by the Latin American Association of Palliative Care participated in the study. They also completed the scales before and after the course. Construct validity and reliability of the CSPC and the TS were assessed using a Principal Components Analysis, internal reliability coefficient and test-retest reliability. Further, comparative statistics between the pre-course and post-course results were obtained in order to determine changes in attitudes.Results: The Principal Components Analysis showed satisfactory fit to the data. 3 components were extracted: two for the CSPC and one for the TS, which explained 55.37% of the variance. Internal consistency coefficients were satisfactory in all cases and Cronbach´s Alphas were satisfactory for all the scales, particularly for the CSPC. Test-retest reliability in t1 and t2 was found to be non significant, indicating that measures were not related in time. Regarding pre-course/post-course comparisons, significant changes in comfort assisting patients (p = 0.004) and comfort assisting families (p = 0.001) following the course were identified, but changes in thanatophobia were non significant (p > 0.05).Conclusions: both scales are valid and reliable. Attitudes regarding the practice of palliative care and how they change, particularly regarding psychosocial issues, can be accurately measured using the examined scales.

Evaluación de la calidad de un servicio de voluntariado en oncología: un Análisis Importancia-Valoración (IPA)

Objective: Using an Importance-Performance Analysis (IPA), this paper examined a Radiotherapy and Oncological Patient and Non-patient perceived importance and performance of ten Humanization Volunteer Program selection factors in the General Hospital in Spain.Methods: The authors identified a list of seven items from the Health-marketing literature reviews, and each item was rated using a 5-point Likert scale. Responses were obtained of 148 usable interviews.Results: The importance-performance patient grid was corrected with literature recommendations and, in the patient sample, shows three items fall in the “Keep up the good work” quadrant, four items fall into the “Low priority” quadrant, zero items fall into the “Possible overkill” quadrant, and no items fall in the “Concentrate here” quadrant. Non-patient (n=80) factors means shows statistical differences with patient (n=68) means in catering (t=-2.38; df.=146; p<0.05), and information (t=2.16; df146; p<0,05).Conclusions: The results are useful in identifying areas for strategic focus to help Health Services managers develop humanization programs with volunteer workers and different program users. Implication to volunteer programs managers and researchers were discussed.

Intervención cognitivo-conductual para el control de ansiedad ante la biopsia insicional en pacientes con cáncer de mama

Oncological patients are submitted to invasive exams in order to obtain an accurate diagnosis; these procedures may cause maladaptative reactions (fear, anxiety and pain). Particularly in breast cancer, the most common diagnose technique is the incisional biopsy. Most of the patients are unaware about the procedure and for that reason they may focus their thoughts on possible events such as pain, bleeding, the anesthesia, or the later surgical wound care. Anxiety and pain may provoke physiological, behavioral and emotional complications, and because of this reason, the Behavioral Medicine trained psychologist takes an active role before and after the biopsy. The aim of this study was to evaluate the effect of a cognitive-behavioral program to reduce anxiety in women submitted to incisional biopsy for the first time. There were 10 participants from the Hospital Juárez de México, Oncology service; all of them were treated as external patients. The intervention program focused in psycho-education and passive relaxation training using videos, tape-recorded instructions and pamphlets. Anxiety measures were performed using the IDARE-State inventory, and a visual-analogue scale of anxiety (EEF-A), and the measurement of blood pressure and heart rate). Data were analyzed both intrasubject and intersubject using the Wilcoxon test (p≤0.05). The results show a reduction in anxiety (as in punctuation as in ranges) besides, a reduction in the EEF-A.

Terapia de aceptación y compromiso en un caso de tras¬torno mixto de ansiedad y depresión en una paciente con cáncer

This paper introduces the case of a woman with breast cancer who had developed a mixed depressive-anxiety disorder with avoidance behaviors. The patient presented depressive symptoms like listlessness, insomnia, weeping, food disorders and hopelessness though. Also, she exhibited physiological arousal and restlessness feelings. Additionally, the patient had an avoidance patron behavior in relation with all stimulus she believed could hurt her. Based on the Acceptance and Commitment Therapy (ACT) the intervention planted the following objectives: the patient will learn to accept her illness and the emotional distress that she was experiencing, also, the patient will recover the other areas of her life that she had abandoned. The treatment was developed in 14 sessions. The therapist used these techniques: creative hopelessness, disabling verbal functions, values clarification and loss of control over private events. In the results, it was observed a positive change in the behavior of the patient as well as a decrease in emotional distress that was his reason for initial consultation

Effects of a positive emotion-based adjuvant psychological therapy in colorectal cancer patients: a pilot study

Objective: To examine the effectiveness of an “Enhancing Positive Emotions Procedure” (EPEP) based on positive psychology and cognitive behavioral therapy in relieving distress at the time of adjuvant chemotherapy treatment in colorectal cancer patients (CRC). It is expected that EPEP will increase quality of life and positive affect in CRC patients during chemotherapy treatment intervention and at 1 month follow-up.Method: A group of 24 CRC patients received the EPEP procedure (intervention group), whereas another group of 20 CRC patients did not receive the EPEP (control group). Quality of life (EORTC-QLQC30), and mood (PANAS) were assessed in three moments: prior to enter the study (T1), at the end of the time required to apply the EPEP (T2, 6 weeks after T1), and, at follow-up (T3, one-month after T2). Patient’s assessments of the EPEP (improving in mood states, and significance of the attention received) were assessed with Lickert scales.Results: Insomnia was reduced in the intervention group. Treatment group had better scores on positive affect although there were no significantly differences between groups and over time. There was a trend to better scores at T2 and T3 for the intervention group on global health status, physical, role, and social functioning scales. Patients stated that positive mood was enhanced and that EPEP was an important resource.Conclusions: CRC patients receiving EPEP during chemotherapy believed that this intervention was important. Furthermore, EPEP seems to improve positive affect and quality of life. EPEP has potential benefits, and its implementation to CRC patients should be considered.

Bienestar psicológico, optimismo y resiliencia en mujeres con cáncer de mama

Objective: To evaluate the relationship between Perceived Psychological well-being, Optimism and Resilience in women survivors of breast cancer.Method: The sample was composed of 30 women diagnosed with breast cancer who were undergoing adjuvant treatment in Oncology Units General Hospital of Jerez de la Frontera and the University Hospital Puerta del Mar (Cadiz). The average age was 47.47 years (SD = 6,356) and the average of months from diagnosis of the disease was 9.93 (SD = 8,541). Scale of Psychological Well-being administered Perceived Ryff (1989), the Life Orientation Test Revised (LOT-R) Scheier, Carver and Bridges (1994) and the Scale of Resilience Wagnild and Young (1993) to assess psychological well-being the dispositional optimism and resilience respectivelyResults: Descriptive analyzes show that women diagnosed with breast cancer have levels of psychological well-being, dispositional optimism and higher than the average values provided by Resilience scales. On the other hand, regression analyses revealed that only some of the dimensions of resilience allowed to explain and predict some dimensions of psychological wellbeing, not dispositional optimism.Conclusions: The results seem to confirm the idea that if the capacity of women with breast moderate negative affect generated by the diagnosis itself and the consequences of their cancer treatment works and to promote their adaptation to the new situation we can contribute to increasing psychological well-being.

Chemotherapy patient perception regarding communication with the healthcare staff

Purpose: To qualitatively explore the communication between healthcare professionals and oncology patients based on the perception of patients undergoing chemotherapy.Method: Qualitative and exploratory design. Participants were 14 adult patients undergoing chemotherapy at different stages of the disease. A socio-demographic and clinical data form was utilized along with semi-structured interviews. The interviews were audio-recorded, transcribed and content analysis was performed. Two independent judges evaluated the interview content in regards to emerging categories and obtained a Kappa index of 0.834.Results: Three categories emerged from the data: 1) Technical communication without emotional support, in which the information provided is composed of strictly technical information regarding the diagnosis, treatment and/or prognosis; 2) Technical communication, in which the information provided is oriented towards the technical aspects of the patient’s physical condition, while also providing psychological support for the patients’ subjective needs; and 3) Insufficient technical communication, win which there are gaps in the information provided causing confusion and suffering to the patient.Conclusions: Communication with emotional support contributes to greater satisfaction of chemotherapy patients. Practical implications: the results provide elements for the training of healthcare professionals regarding the importance of the emotional support that can be offered to cancer patients during their treatment.

Experiencias de danzaterapia de mujeres que han sufrido cáncer de mama. Un estudio fenomenológico

Objective: This essay aims at identifying, describing and analyzing possible changes both in the experience of the body and in interpersonal relations of women with breast cancer, which result from their participation in Dance Therapy group meetings.Method: This is a phenomenologically oriented qualitative research using Maria Fux´s dance therapy method for group experiences. Eight meetings are described here, and an analysis of descriptions based primarily on Merleau-Ponty and María Fux is provided.Results: The participants have been able to express pain and sorrow over the circumstances that breast cancer and its relational environments have brought to their lives. They have been able to go through moments of creation and surrender to the rhythmic body sensations and experiential environment with different emotions lived separately and jointly. They have revived memories and sensations of their childhood and adolescence, and finally, they have rediscovered their sensitive body through body resignifications marked by the absence of the breast, and by means of feelings of greater acceptance and integration of lived experiences in new gestalts.Conclusions: This project is still under way, but it is already possible to conclude that the life experiences provided in dance therapy have allowed these women to improve their integration and welfare. Likewise, they have felt positive changes in the perception of their corporality and in their way of being in the world and with other subjects, thus experiencing the body in a new and different way.

Net-surplus as a useful tool to analyse financial information in co-op societies

This paper aims to analyse a sample of Galician co-ops to verify whether or not it is possible to deduce different financial behaviours among co-op partners from the amount of net-surplus. To this end, our study adds net-surplus to the variation registered in some account entries so that other residual incomes yielded by the co-op may be considered. The distribution of these revenues shows that partners do not usually choose to fully anticipate residual incomes. This reveals that some firms follow a positive net-surplus strategy, which is actually different from the null net-surplus strategy asserted by the classical financial theory. Furthermore, results show that differences between both strategies are statistically significant. This opens a path to future research on determinants explaining why co-op partners voluntarily renounce to anticipating these residual incomes. Such behaviour only arises when yearly accounts render a positive result, thereby making the accounting net-surplus a useful tool to analyse financial information in co-op societies.

Let's put in order the accounting records and annual accounts of the agrarian processing companies

The substantive legislation on which Agricultural Processing Companies is based has some notable gaps with regard to the pertinent accounting system. There are grey areas concerning compulsory accounting records and their legalization, together with the process for drawing up, checking, approving and depositing the annual accounts.Consequently, in this paper, we will look first at the corporate and accounting records for Agricultural Processing Companies, putting forward proposals in the wake of recent legislation on the legalization of generally applied corporate and accounting documents.A critical analysis will also be made of the entire process of drafting, auditing, approving and depositing the annual accounts and other documents that Agricultural Processing Companies must send each year to their respective regional registries. Legal and mercantile registries will be differentiated from administrative ones and, in this last sense, changes will be suggested with regard to the place and objective of the deposit of such documents.After thirty-four years old, the substantive legislation in economic and accounting matters of the SAT is out of step with the current law, so a review is necessary. Recent regional regulations have not been a real breakthrough in this regard. We assert the existence of a gap between the substantive rules of the SAT and general accounting rules on financial statements, which is unsustainable and it needs a quick legislative action to be canceled.

Las ONG microfinancieras peruanas: ¿siguen manteniendo su misión social?

In recent years, the growth of the microfinance sector has been significant. Either as a cause or as a consequence, some governments have decided to make it part of the financial system adapting regulatory frameworks to allow the sector to continue to expand as the number of formal institutions increases. It is the case in Peru where many NGOs have decided not to become regulated, arguing that this change could leave them to move away from the social aims for which they were created. In an increasingly competitive marketplace, where the legal framework encourages the regulation of microfinance institutions, there appears to be a need to study the potential future role of NGOs in the sector. In consideration of this question, this paper attempts to analyse the social role of those NGOs that have decided not to become regulated institutions. In this study a number of social indicators are analysed; these include the number of female clients, average loan amount and how loans are used, among others. These indicators will be used to attempt to evaluate the social role of unregulated NGOs and their prospects in this new context.

The corporate regimen of labour companies in the New Act 44/2015, on 14th October, of labour and investee companies

Act 44/2015, on 14th October, of labour and investee companies, aims to accommodate the different instruments, limits and requirements with which the legal regime of the labour companies is set, to the current economic and legal context where they must develop their economic activity. The purpose of the law is to preserve their special status, while it seeks to modernize its legal structure to ensure the economic solvency of the business plan, without weakening the social profile that is required. The new law includes two organisational figures, ‘labour companies’ and the calling ‘investee companies’, of the last one, only leaving evidence of what is to be understood by them referring its regulation to a subsequent regulatory development. Until the publication of the regulation, our work has focused on the corporate aspect of the labour companies by analysing the modifications made on the typological elements and legal regime of these organisational figures to determine whether the law is the necessary and sufficient instrument to achieve the challenge proposed.

Special employment centers in Castile and León 2007-2013: effects of the crisis in relation to these centers’ registered legal personalities

The aim of this paper is to carry out an economic and financial study of the Special Employment Centres in Castile and León based on a classification of these entities’ registered legal personalities in order to view how the economic crisis that began at the end of 2007 may have affected them. Various items from the Centres’ financial statements are analysed and the results are compared to those from the period 2007-2013 as to provide a broader perspective of their size, development, growth and behaviour. The following economic figures were used: total assets, turnover and revenue. The variable “employment” is compared with the subsidies received by the Centres, showing that the crisis does affect the Centres depending on their registered legal personalities. Associations and physical persons are the most affected personalities, to the point of possible extinction. An account reversal for the Centres is also included in this article, which measures the percentage of public aid received by the Centres that is returned to society.

Model for integrates community tourism in Ecuador, case study Pastaza

The tourism industry globally has grown steadily in recent decades, showing a progressive interest oriented toward rural areas due to characteristics of tranquility, nature, biodiversity, traditions and culture. Therefore, such aspects should be preserved and can be leveraged through adequate strategic orientation. Within the framework of global tourism trends community tourism is among the options that arise in the tourism market, and is one that is more likely to grow in the future. In the case of Ecuador, community tourism has become more dynamic over the years since many of the natural reserves in the country are in the hands of indigenous communities. Sustainable tourism in this sense is concerned with the maintenance of ethnic, cultural and biological diversity of the country, and current projects and regulatory laws support its development. Therefore, the aim of this paper is to present a strategy for the integrated management of community tourism following the principles of cooperation and collaboration between stakeholders, this study focuses on the Amazon region of Ecuador, specifically the province of Pastaza, in respect to how community tourism contributes to local development

Financial sustainability of cooperatives: a case of portuguese olive oil cooperatives

En Portugal, como en otros países, las cooperativas agrícolas tienen un papel económico importante en el sistema alimentario. Similar a otras organizaciones económicas, las cooperativas agrícolas han sido testigos de cambios estructurales en las últimas décadas en términos de modelos de gobernación y gestión. Las cooperativas agrícolas portuguesas se han visto constreñidas por su contexto a adoptar un modelo tradicional de propiedad y control. El objetivo principal de este estudio era analizar cuestiones relacionadas con la estructura de gestión y desempeño financiero de las cooperativas, basada en los datos recogidos de cooperativas de aceite de oliva situadas en la región interior norte de Portugal. La combinación de un análisis cualitativo de la estructura y toma de decisiones, una evaluación financiera y la aplicación de un enfoque en varios criterios (PROMETHEE II), los resultados están en línea con expectativas (por ejemplo, bajos niveles de participación de los miembros, gestión no profesional, ratios de rentabilidad bajos, bajo apalancamiento y una capacidad para cumplir compromisos financieros), excepto la relación entre la gestión profesional y el desempeño financiero. La existencia de gestión profesional no conduce a mejores resultados financieros. Este resultado refuerza la creencia de que las cooperativas que están estructuradas de diferente manera tienen intereses diferentes y contradictorios a las partes interesadas.