Análisis situacional de los psicólogos de cuidados paliativos

Introducción. Los pacientes con enfermedades crónicas en fase avanzada tienen numerosas necesidades psicológicas, sociales y espirituales, como resultado de su estado físico, condición, curso terapéutico y efectos secundarios del tratamiento, además de distrés psicológico y existencial por lo que la figura del psicólogo en Cuidados Paliativos tiene una gran relevancia. Objetivo. Realizar un análisis situacional de los psicólogos integrados a los equipos de cuidados paliativos del sector público en México. Método. Estudio prospectivo, descriptivo y transversal. Se diseño una encuesta ex profeso de 22 reactivos con respuesta dicotómica y opción múltiple. Resultados. Se analizaron un total de 49 encuestas de psicólogos que prestan sus servicios en unidades de atención médica en México, a través de análisis de frecuencias y porcentajes, chi cuadrada y w de wilcoxon. Conclusiones. Los psicólogos en cuidados paliativos requieren formación y capacitación formal para desarrollar habilidades y competencias específicas en este contexto; y de mayor sistematización y de protocolos de manejo en las evaluaciones e intervenciones psicológicas en el paciente de cuidados paliativos y su familia para evidenciar la contribución de la Psicología en Cuidados Paliativos.

The Emergence of Critical Health Psychology

The purpose of this article is twofold: first to provide an overview of the emergence of critical health psychology for those working in the related social and health sciences and as a review of its major developments for health psychology; and second to discuss critically the potential for critical health psychology to contribute to promoting public health with specific reference to the directives espoused by Prilleltensky (2003) and Murray and Campbell (2003). The identification of three philosophical phases of the emergence of critical health psychology is used to examine the directions of the field and the challenges facing critical health psychology in order to contribute to public and global health.

Psychologists involved in cancer palliative care in Japan: A nationwide survey

Objective:

The aim of this study was to clarify, using a nationwide survey, what is perceived as necessary knowledge and skills for psychologists involved in cancer palliative care in Japan, the expectations of medical staff members, and the degree to which these expectations are met.

Method:

We conducted a questionnaire survey of psychologists involved in cancer palliative care. A total of 419 psychologists from 403 facilities were asked to fill out the questionnaire and return it anonymously. Some 401 psychologists (89 males, 310 females, and 2 unspecified; mean age, 37.2  ±  9.5 years) responded about necessary knowledge and skills for psychologists working in cancer palliative care, the necessity for training, expectations at their current workplace, and the degree to which expectations are met.

Results:

More than 90% of participants responded that many kinds of knowledge and skills related to the field of cancer palliative care are necessary. Over 80% of participants indicated a necessity for training related to these knowledge and skills. Although more than 50% (range, 50.1–85.8%) of participants responded that such services as “cooperation with medical staff within a hospital,” “handling patients for whom psychological support would be beneficial,” and “assessment of patients' mental state” were expected at their workplace, fewer than 60% (31.4–56.9%) responded that they actually performed these roles.

Significance of Results:

Our results show that many psychologists in cancer palliative care feel unable to respond to the expectations at their current workplace and that they require more adequate knowledge and skills related to cancer palliative care to work effectively. No other nationwide surveys have generated this type of information in Japan, so we believe that the results of our study are uniquely important.

Competence-Based Training and Assessment by Portfolio: The Health Psychology Model

All UK postgraduate qualifications in applied areas of psychology will soon be competence-based. This will improve the professional recognition and esteem of applied psychology, and make it easier to transfer qualifications between psychology and other disciplines and between psychology sub-disciplines. However, the changes pose considerable challenges because there is very little clear evidence about the effectiveness of competence-based training and portfolio assessment. Health psychology has led the development of competence-based training in psychology with the ‘stage two’ qualification in health psychology, and this article considers postgraduate health psychology training in the context of what is known about competence-based training and portfolio assessment in professions such as medicine, nursing and education. This raises a number of questions for professional training and qualifications in psychology.

Health psychology and the study of the case: from method to analytic concern

This paper recommends that the study of the case be seen as of primary analytic concern to social scientists, and particularly to health psychologists. Criticism is made of the idea that a case is merely a medical instance or a methodological option. Instead, we argue that health psychologists should re-direct their attention to the 'study of the case' as being central to issues concerning health, illness and healing. There are three reasons for doing this. First, case study is basic to any procedure that involves collecting information about the context in which medicine is practiced. Second, communication between health professionals involves presenting the clinical situation of their patients as storied accounts, so that cases are made, not found. Third, there is presentational work by patients, involving communications of (as well as about) suffering and relief. This last feature is basic to how doctors and health psychologists, especially those engaged in clinical work, understand individuals as 'cases'. The paper explores differences between these different forms of case, while emphasizing portrayal as a key feature of all of them. In justifying the study of the case on conceptual as well as on clinical and methodological grounds, we highlight the position of health psychology in its attempts both to study and to intervene in health-care contexts.

Cardiac rehabilitation: a review of current developments

An overview is given of the current status of cardiac rehabilitation and its effects on morbidity and mortality. While there is an emphasis in most current programs upon physical exercise as an important autonomous risk factor for Coronary Heart Disease (CHD), there is at the same time a tendency in cardiac rehabilitation to go beyond mere physical exercise towards adding more multimodal psychoeducational modules in rehabilitation programs; those approaches are aimed at educating the patient about a less risky and healthier way of life. Such psycho-education is more and more aimed at the "toxic" aspects of negative emotions. The in-between classic Type A Behavior Pattern (TABP) might, in general, be less powerful in predicting later CHD morbidity or mortality than some specific emotional components of TABP, such as anger and hostility. The literature is reviewed as to risk factors and CHD and the role of negative affectivity in development and or maintenance of CHD. Approaches for modification are discussed against the background of their effectivity in cardiac rehabilitation. The recent Dutch guidelines, issued by the Dutch Heart Foundation, appear to incorporate many of the elements mentioned in the research literature on cardiac rehabilitation. On a scientific level they form an excellent audit to evaluate and to contour efficiently the until-now very heterogeneous field of cardiac rehabilitation.