A Spanish adaptation of the implicit positive and negative affect test (IPANAT)

BACKGROUND

Self-report measures of affective states (i.e., explicit measure) underlie a variety of cognitive biasing factors. Therefore, measures for the indirect assessment of affect (i.e., implicit) have previously been developed, such as the Implicit Positive and Negative Affect Test. The IPANAT asks participants to make judgments about the degree to which artificial non-sense words sound like affective states, and has demonstrated good reliability and validity.

METHODS

We created a Spanish version of this test (IPANAT-SPAIN). After adapting artificial words to Spanish language, based on preliminary studies, the IPANAT-SPAIN was administered to a representative sample of N = 468 adults from Spain (225 men). Competing models of its latent structure were evaluated using confirmatory factor analysis. To assess convergent validity, we correlated the IPANAT-SPAIN with explicit measures of affect.

RESULTS

The best-fitting model consisted of two factors corresponding to positive implicit affect (PA) and negative implicit affect (NA). Reliability of the IPANAT-SPAIN was a = .94 for PA, and a = .88 for NA. The pattern of relationships between the IPANAT-SPAIN and explicit affect measures were consistent with previous findings.

CONCLUSIONS

The results indicate that the Spanish adaptation of the IPANAT has satisfactory psychometric properties.

When and how do hospital nurses cope with daily stressors? A multilevel study

BACKGROUND

During their workday, nurses face a variety of stressors that are dealt with using different coping strategies. One criticism of the contextual models of work stress is that they fail to focus on individual responses like coping with stress. Neverthless, little is know about the momentary determinants of coping in nurses.

OBJECTIVES

To identify the momentary predictors of problem-focused approaching coping and emotion-focused approaching coping, as well as those for seeking social support and refusal coping strategies, during the working day in nurses.

DESIGN

This study uses descriptive, correlational, two-level design with repeated measures.

SETTINGS

Wards of two University hospitals.

PARTICIPANTS

A random cohort of 113 nurses was studied.

METHODS

An ecological momentary assessment was made of demand, control, effort, reward, nursing task, coping, mood and fatigue, and of coping style by questionnaire. Multilevel two-level statistical analyses were performed in order to identify both within person and between person relationships.

RESULTS

Different momentary types of coping were associated with different tasks. The problem-focused coping could be explained by the direct care and medication tasks, demand, planning coping style, mood, and negatively by acceptation coping style. Emotion-focused coping could be explained by documentation and medication tasks (negatively), mood, demand, distraction, and disengagement coping styles. Seeking social support coping could be explained by the task of communication, mood, fatigue (negatively), and seeking emotional support as a coping style. Refusal coping could be explained by mood, and the coping style of focusing and venting emotions. Refusal coping is not specific to any task.

CONCLUSIONS

The choice of the coping strategy depends on the task, of their appraisal and on the different styles of coping.

Hierarchy of the main factors predicting the decision to go to the doctor in a general population sample: A factorial survey design

OBJECTIVE

To obtain a hierarchy of the main factors that predict the decision to go to the doctor when symptoms are not yet linked to a specific disease.

METHOD

64 representative vignettes, combinations of nine factors, were presented to 168 adults between 28-60 years of age.

RESULTS

Multilevel multiple regression models were used to rank the main factors predicting urgency to see a doctor in order of importance: the interference of symptoms in daily activities (B = -1.29; p < .001), fear (B = -0.96; p < .001), pain (B = -0.90; p < .001), access to medical care (B = -0.64; p < .001) and confidence in the doctor (B = -0.27; <.05). Moreover, gender (B = 0.56; p < .05) and educational level (B =-0.31; p < .05) explained part of the interindividual variation in the daily symptoms' interference.

CONCLUSION

When a specific disease has not yet been diagnosed, daily symptoms' interference is the factor that most strongly increases the urgency to visit a doctor, especially among men and among people with a higher level of education.

PRACTICE IMPLICATIONS

To reduce delay, generic health prevention campaigns should place more emphasis on possible interference in daily activities than on the meaning of symptoms for health.

How does emotional exhaustion influence work stress? Relationships between stressor appraisals, hedonic tone, and fatigue in nurses' daily tasks: A longitudinal cohort study

BACKGROUND

Work-related stress is a prevalent condition in the nursing profession, and its influence may vary according to changeable individual and situational factors. It is, therefore, important to investigate the real-time momentary changes in these factors and their relationship to emotional exhaustion experienced by nurses.

OBJECTIVES

We aim to analyse how their perceptions of demand, control, effort and reward change according to the task performed through real-time assessment and interact with the emotional exhaustion level of ward nurses.

DESIGN

The research design was longitudinal.

METHOD

A three-level hierarchical model with a repeated measures design was used to assess the momentary self-reports of 96 hospital ward nurses, completed using a smartphone programmed with random alarms.

RESULTS

Findings show that demand, effort, and control appraisals depend on the task performed. The task appraised as most demanding, effortful, and controllable was direct care. Reward appraisal depends on the task performed and personal variables, i.e. emotional exhaustion. The situations perceived as more rewarding were rest and direct care. Momentary hedonic tone can be explained by the task performed, demand, reward, emotional exhaustion and by the interaction between emotional exhaustion and demand appraisal. Momentary fatigue can be explained by the task performed, demand, reward, and the emotional exhaustion.

CONCLUSIONS

This study highlights the importance of using momentary measures to understand complex and changeable inter-relationships. While also clarifying the targets of intervention programmes aimed at preventing burnout within the nursing profession.

[Cultural scale adaptation and validation of the Spanish version of the BRCA Self-Concept Scale in women carriers at high risk for hereditary breast and ovarian cancer]

BACKGROUND AND OBJECTIVE

Having an inherited predisposition to cancer may have a psychological impact, and one goal of genetic counseling is to promote psychological adjustment to the new situation. Thus, in the genetic context, validated measures of adjustment are required. Given that self-concept is a good indicator of adjustment to the disease or to the risk for it, and a relevant variable in oncology, the goal of the study is to culturally adapt and validate the BRCA Self-Concept Scale.

MATERIAL AND METHOD

One hundred and sixty-five BRCA carriers' women answered to the questionnaire, previously adapted through a process of forward/back-translation, and to the Cancer Worry Scale (CWS) as a measure of convergent validity. Theoretical structure of BRCA Self-Concept Scale was assessed by expert judges, and submitted to a confirmatory factor analysis (CFA). Cronbach's α was calculated for each subscale (Stigma, Vulnerability and Control), and correlations with CWS were performed.

RESULTS

Expert judges' structure and CFA do not support the original structure of the questionnaire. The respecificity model (with items 10 and 13 loading on Vulnerability factor) show a better fit: comparative fit index 0.973; Tucker-Lewis index 0.968; root mean square error of approximation 0.067. The Cronbach's α is 0.83 for Stigma, 0.84 for Vulnerability, and 0.61 for Control. Evidence of convergent validity with CWS has been obtained (Spearman's rho 0.631 for Stigma, 0.683 for Vulnerability, and -0.363 for Control; P<.001).

CONCLUSIONS

Results support the validity of the modified Spanish BRCA Self-Concept Scale, which is a potentially useful measure for the study of psychological adjustment to high risk for hereditary breast and ovarian cancer.

Impact when receiving a diagnosis: Additive and multiplicative effects between illness severity and perception of control

Based on Lazarus’ transactional model of stress, this study examined how the information provided in a medical diagnosis (the severity of the illness, the effectiveness of the treatment and the self-efficacy to follow this treatment) are combined to generate perception of stress. Twenty-seven scenarios were presented to 152 volunteer students and their level of perceived stress was recorded. Results revealed that the lack of efficacy of the treatment raises the perception of stress proportionally to the different degrees of illness severity, but having a low perceived ability to follow the treatment triggers high levels of stress, particularly when the diagnosis is serious.

Assessing self-reported adherence to HIV therapy by questionnaire: the SERAD (Self-Reported Adherence) Study

The relationship between adherence to highly active antiretroviral therapy (HAART) and RNA-HIV viral load outcomes has been extensively shown. Although there are different procedures for assessing treatment adherence, there is no ideal method. We present the SERAD (Self-Reported Adherence) questionnaire, a qualitative and quantitative self-reported instrument designed to provide an easier adherence measurement. We also compared the questionnaire to three other methods to evaluate adherence to HAART regimens in HIV-infected patients. Two prospective, observational, longitudinal studies were developed: a single-center pilot study followed by a multicenter study. A total of 530 HIV-infected outpatients was prospectively included, 66 in the pilot study and 464 in the multicenter study. Four methods were used to study adherence to HAART regimens: the SERAD questionnaire, pill count, electronic monitoring, and plasma drug monitoring. Pearson's correlations and Bland and Altman's method were developed. The SERAD questionnaire showed good feasibility and significant validity. Adequate levels of agreement between methods were observed, particularly when adherence was high. Differences increased as adherence fell. Moreover, the questionnaire was completed correctly, the interviewers did not report uncovered aspects, and the information was collected easily. Our results suggest that the SERAD questionnaire is a feasible and useful instrument for assessing adherence to HAART regimens in HIV-infected patients, and makes it possible to obtain reliable qualitative and quantitative information related to treatment adherence.

Unrealistic optimism and perceived control: role of personal competence

This work analyzed the effects of unrealistic optimism in the interaction between the emotional valence of future events, the perception of control over these events, and the person with whom one compares oneself. It was hypothesized that, if the person of comparison is judged as very competent, a pessimistic bias should be produced. Likelihood of four different types of events (positive and controllable, positive and uncontrollable, negative and controllable, and negative and uncontrollable) were rated by 133 university students (22 men and 111 women) for themselves, for an average student, for their best friend, and for a bright friend. A pessimistic bias was observed on the relative likelihood of the events when the comparison was made between oneself and a competent and bright friend, when events were perceived as controllable, especially positive ones. Not enough is known, however, to provide meaningful interpretation at present; that must await further data and theoretical development.

Cardiomyopathy in Cebus apella monkeys experimentally infected with Trypanosoma cruzi

Twenty four Cebus apella monkeys were studied as a biological model for the cardiac chronic form of Chagas' disease. Twelve were inoculated with Trypanosoma cruzi trypomastigotes, seven with the Brazilian Y strain and five with the Argentinian RA strain. Twelve monkeys were uninfected controls. The following parameters were studied: body weight, body temperature, direct parasitemia, xenodiagnosis, specific antibodies by IFA, clinical chemistry, hematology, ECG and chest X-ray. Three monkeys infected with Y strain were sacrificed at 4 months and 4 monkeys at 12 months after inoculation. Monkeys inoculated with RA strain were sacrificed at 48 months. Direct parasitemia was positive within a week after inoculation in all monkeys. Xenodiagnosis was positive until 49.0 +/- 3.0 and 79.0 +/- 6.0 weeks p.i. for Y and RA strains, respectively. In all inoculated monkeys an increase in antibody titers was detected within 3 weeks after inoculation. In all monkeys inoculated with the Y strain and 3/5 with the RA strain abnormal ECGs were observed within 1 or 2 weeks p.i., becoming more severe in the chronic phase. Y strain inoculated monkeys sacrificed at 4 months presented only a slight concentric hypertrophy of the heart left ventricle. Those sacrificed at 12 months had concentric left ventricle hypertrophy and 3/4 had an aneurism of the apex. Four out of 5 RA strain inoculated monkeys had an enlarged, flaccid heart; 3/5 aneurism of the apex and 2/5 concentric hypertrophy of the left ventricle.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Chagas' disease in non-human primates. 1. Chronology of clinical events, clinical chemistry, ECG, radiology, parasitemia, and immunological parameters in the Cebus apella monkey

Forty Cebus apella monkeys free from Chagas' disease were subcutaneously infected with 3 x 10(5) trypomastigotes of the Ypsilon strain of T. cruzi and followed-up for 6 months. Seventeen monkeys were controls. Body weight, temperature, direct parasitemia (DP), IgM and IgG were determined weekly. Hematology was performed weekly up to day 40 p.i. and monthly thereafter. Clinical chemistry was performed every two weeks up to day 33 p.i. and monthly thereafter. ECG was performed weekly up to day 47 p.i. and at 2,3, and 6 months p.i. Chest X-ray was done at 45 days, 4 and 6 months p.i. Xenodiagnosis was only performed after two negative DP. All infected monkeys developed fever, beginning 6.0 +/- 0.6 day p.i. and lasting 21.9 +/- 6.7 days, and lost 14% of their body weight the first month, 11% the third month and 7% the 6th month. DP was already detected 4.4 +/- 0.29 days after infection and it was detectable in all monkeys up to 96.0 +/- 6.9 days p.i. Cyclical peaks of parasitemia were observed throughout the study. IgM and IgG titers which permitted a diagnosis of T. cruzi infection occurred at 33.0 +/- 2.9 days p.i., respectively. Fifty-seven percent of infected monkeys presented ECG alterations one week after inoculation reaching a maximum of 86% at the third week. A normocytic, normochromic anemia was observed in all monkeys being significantly (p less than 0.02) more severe in the infected animals. No effects of T. cruzi on the clinical chemistry were observed.(ABSTRACT TRUNCATED AT 250 WORDS)