Abstract Highly Active Antiretroviral therapy (HAART) depends on optimal adherence to be effective. Pharmacotherapeutic follow-up can be used as a strategy for treatment fidelity. To provide pharmaceutical care for HAART patients, to assess adherence, to identify and resolve drug related problems (DRP). This is a prospective, interventional study aimed at people on HAART. Data was collected using the pharmacotherapeutic follow-up form and CEAT-VIH. There was a predominance of women (59%), older than 33 years (75%), mostly single (43%). Regarding adherence, 64% had insufficient adherence at the start of the study, while 36% had strict/adequate adherence. After the pharmacotherapeutic follow-up, 70% presented strict/adequate adherence. Regarding HAART, the relationship between adhesion versus time of HAART and adherence versus regimen used was significant, considering that less time of therapy and regimen containing protease inhibitors are predictors for insufficient adherence. Regarding the DRP identified (f=77), missed pills (32%), untreated disease, incorrect management frequency, and undue self-medication (12%) were the most frequent. Pharmaceutical interventions (f=137) were predominantly advising related to specific pharmacological treatment (32%), non-pharmacological measures (20%), and medication suspension (9%). Pharmaceutical care was shown to be animportant strategy, within the multi professional team, to improve adherence, besides identifying and resolving DRP.

Resumo Há evidências de que a Síndrome de Burnout afeta profissionais da atenção primária à saúde (APS). Objetivou-se investigar a associação da empatia e do estresse ocupacional com o Burnout de profissionais da APS. 348 trabalhadores responderam a versões online de escalas de estresse ocupacional, empatia e Burnout. As dimensões de empatia preocupação empática e tomada de perspectiva correlacionaram-se negativamente com a síndrome (p<.01), enquanto angústia pessoal demonstrou relação positiva (p<.01). As dimensões de estresse ocupacional recompensa e esforço apresentaram maior peso nos modelos das subescalas de Burnout ilusão pelo trabalho e desgaste psíquico (p<.001), respectivamente, enquanto a preocupação empática e angústia pessoal demonstraram os maiores pesos para a explicação de indolência e culpa (p<.001). Recompensa foi o preditor significativo de Perfil 1 (p=.008), forma menos grave da síndrome, enquanto angústia pessoal (p=.028) e esforço (p=.012) demonstraram o mesmo peso no modelo para Perfil 2, nível mais severo de Burnout. Os resultados sugerem intervenções que enfoquem tanto estressores do trabalho quanto a empatia dos profissionais.

Abstract There are indications that burnout syndrome affects primary health care (PHC) professionals. The scope of this study was to investigate the association of empathy and occupational stress with the burnout of PHC professionals. A total of 348 workers filled out an an online assessment including occupational stress, empathy, and burnout scales. The empathetic-concern and perspective-taking empathy dimensions were negatively correlated with burnout (p<.01), while personal anguish was positively related to it (p<.01). The reward and effort occupational stress dimensions revealed greater weight in explaining the job disillusion and psychic exhaustion burnout subscales (p<.001), respectively, while empathetic concern and personal anguish revealed the greatest weight for the explanation of indolence and guilt (p<.001). Reward was the significant predictor of Profile 1 (p=.008), the less severe form of the syndrome, while personal anguish (p=.028) and effort (p=.012) revealed the same weight in the model for Profile 2, namely the most severe level of burnout. The results suggest interventions that focus on both work stressors and the empathy of the professionals involved.

Resumo O objetivo deste estudo foi investigar variáveis preditoras da adesão ao tratamento antirretroviral entre aspectos sociodemográficos, clínicos e psicológicos (resiliência e percepção de doença) em pessoas com o vírus da imunodeficiência humana (HIV). Participaram 155 pacientes, sendo 72,9% homens. Roteiros de entrevista sobre aspectos sociodemográficos e clínicos e instrumentos validados para a população brasileira foram aplicados. Três variáveis foram preditoras da adesão: resiliência, percepção de doença como preditor negativo, e idade, totalizando 29% de variância explicada. O estudo tem implicações para a prática de psicólogos e de equipes de saúde que atuam na área, com base na implementação de intervenções visando à adesão e ao autocuidado, bem como à adaptação e à resiliência em pessoas que vivem com HIV.

Abstract The objective of this study was to investigate predictive variables of adherence to antiretroviral treatment among sociodemographic, clinical and psychological aspects (resilience and perception of disease) in people living with the human immunodeficiency virus (HIV). Participants were 155 patients, 72.9% men. Interview scripts about sociodemographic and clinical aspects and validated instruments for the Brazilian population were applied. Three variables were predictors of adherence: resilience, perceived illness as a negative predictor, and age, with 29% explained variance. The study has implications for the practice of psychologists and health teams working in the field, based on the implementation of adherence and self-care interventions, as well as adaptation and resilience in people living with HIV.

Resumo Há evidências de que a Síndrome de Burnout afeta profissionais da atenção primária à saúde (APS). Objetivou-se investigar a associação da empatia e do estresse ocupacional com o Burnout de profissionais da APS. 348 trabalhadores responderam a versões online de escalas de estresse ocupacional, empatia e Burnout. As dimensões de empatia preocupação empática e tomada de perspectiva correlacionaram-se negativamente com a síndrome (p<.01), enquanto angústia pessoal demonstrou relação positiva (p<.01). As dimensões de estresse ocupacional recompensa e esforço apresentaram maior peso nos modelos das subescalas de Burnout ilusão pelo trabalho e desgaste psíquico (p<.001), respectivamente, enquanto a preocupação empática e angústia pessoal demonstraram os maiores pesos para a explicação de indolência e culpa (p<.001). Recompensa foi o preditor significativo de Perfil 1 (p=.008), forma menos grave da síndrome, enquanto angústia pessoal (p=.028) e esforço (p=.012) demonstraram o mesmo peso no modelo para Perfil 2, nível mais severo de Burnout. Os resultados sugerem intervenções que enfoquem tanto estressores do trabalho quanto a empatia dos profissionais.

Abstract There are indications that burnout syndrome affects primary health care (PHC) professionals. The scope of this study was to investigate the association of empathy and occupational stress with the burnout of PHC professionals. A total of 348 workers filled out an an online assessment including occupational stress, empathy, and burnout scales. The empathetic-concern and perspective-taking empathy dimensions were negatively correlated with burnout (p<.01), while personal anguish was positively related to it (p<.01). The reward and effort occupational stress dimensions revealed greater weight in explaining the job disillusion and psychic exhaustion burnout subscales (p<.001), respectively, while empathetic concern and personal anguish revealed the greatest weight for the explanation of indolence and guilt (p<.001). Reward was the significant predictor of Profile 1 (p=.008), the less severe form of the syndrome, while personal anguish (p=.028) and effort (p=.012) revealed the same weight in the model for Profile 2, namely the most severe level of burnout. The results suggest interventions that focus on both work stressors and the empathy of the professionals involved.

Abstract Relationship education programs are strategies that can favor better marital quality and conflict management between spouses. The relationship education program “Living as Partners: Turning Challenges into Opportunities” seeks to promote the couples' learning of conflict resolution strategies and better quality levels in the relationship. This study evaluates the capacity of this program to produce results regarding marital quality and three dimensions of the couple's conflict: frequency, intensity, and resolution strategies. Data from 41 couples were analyzed before and after the program, and a follow-up after 5 months (n = 33 couples) were conducted as well (single group, pre-test, post-test, and follow-up quasi-experimental design). Results show that the program produced immediate effects in all the outcome variables, which remained significant after 5 months, except for marital quality and for the strategy of compliance. These outcomes showed effect sizes ranging from low to high levels. The study presents evidence about the ability of the “Living as Partners” program to produce improvements in couple's conflict indicators, addressing an unexplored field of research and intervention focused on Brazilian cultural specificities.

La escala Brief COPE (Carver, 1997) es la versión abreviada, ampliamente utilizada, del COPE Inventory (Carver, Scheier, & Weintraub, 1989), que ha demostrado ser de utilidad para evaluar las estrategias de afrontamiento en investigaciones en salud. La versión en español del Brief COPE (Perczek, Carver, Price, & Pozo-Kaderman, 2000) consta de 12 subescalas compuestas por dos ítems cada una. Se analizan las propiedades psicométricas del Brief COPE, en su versión en castellano, a partir del estudio en una muestra de 203 mujeres adultas pertenecientes a la población general uruguaya. El análisis factorial exploratorio, estudiando los ítems, indica la existencia de cuatro factores para la muestra estudiada. La agrupación resultó considera blemente coincidente con la reportada por los autores de la escala. La fiabilidad y las evidencias de validez obtenidas con el Brief COPE para la presente muestra avalan su uso en el ámbito de la investigación en población del sexo femenino en Uruguay.

The Brief COPE (Carver, 1997) is the widely used brief version of the COPE inventory (Carver, Scheier, & Weintraub, 1989), which has broadly proven to be a useful measure of coping strategies in health-related research. The Brief COPE-Spanish version (Perczek, Carver, Price, & Pozo-Kaderman, 2000) consists of 12 subscales, each of them are composed by two items. Psychometric properties of the Brief COPE Spanish version are reported, derived from a sample of 203 Uruguayan adult women. An Exploratory Factor Analysis conducted with the scale items yielded 4 factors for the current sample. The emerging factor structure was consistent with the one described by the scale’s authors. The use of the Brief COPE for research purposes in Uruguayan female populations is supported by reliability and evidences of validity obtained in the studied sample.

A escala Brief COPE (Carver, 1997) é a amplamente utilizada versão abreviada do COPE inventory (Carver, Scheier, & Weintraub, 1989), que tem demonstrado ser de utilidade para avaliar as estratégias de afrontamento em pesquisas de saúde. O Brief COPE-versão em espanhol (Perczek, Carver, Price, & Pozo-Kaderman, 2000) consta de 12 subescalas compostas por dois itens cada uma. Estudam-se as propriedades psicométricas do Brief COPE, na sua versão em castelhano a partir do estudo em uma amostra de 203 mulheres adultas pertencentes à população geral uruguaia. AAnálise Fatorial Exploratória, analisando os itens, indica a existência de 4 fatores para a amostra estudada. A agrupação resultou consideravelmente coincidente com a reportada pelos autores da escala. Fiabilidade e evidências de validez obtidas com o Brief COPE para a presente amostra avalizam o seu uso no âmbito da investigação em população do sexo feminino no Uruguai.

Health-related quality of life (HRQOL) has been widely studied in the field of dialysis patients. However, there are few studies that include relationships of psychosocial variables and adherence to treatment with HRQOL. The aim of this review is to systematically synthesise available information on the role that psychological variables (depression, anxiety and stress) and adherence to treatment have on HRQOL of dialysis patients through a systematic narrative review. We selected studies that included and related, in their results psychological variables (at least one of the following: depression, anxiety or perceived stress), adherence to treatment and HRQOL in adults on dialysis due to advanced chronic kidney disease (ACKD). The studies included had to incorporate standardised instruments into their assessment protocol. We searched the MEDLINE and PsycINFO databases from January 2002 to August 2012. Thirty-eight studies were included in this review and we assessed their methodological quality. The review revealed that 100% of the studies identified a negative association between indicators of anxiety, depression and stress and HRQL, indicating that these variables are risk factors for quality of life. Adherence to treatment was associated with psychological factors and HRQOL in 8% (N=3) of the studies included and has been demonstrated to be a protective factor for quality of life in 66% of studies (2 of 3) that included this variable. Considering the effect of these variables on HRQOL, it is important to screen for early indicators of anxiety, stress and depression or difficulties in complying with treatment in the ACKD population on dialysis. This will allow preventive interventions to be carried out before HRQOL deteriorates.

La calidad de vida relacionada con la salud (CVRS) ha sido ampliamente estudiada en el ámbito de los pacientes en diálisis. Sin embargo, son pocos los trabajos que incluyen las relaciones de variables psicosociales y de adhesión al tratamiento con la CVRS. El objetivo de esta revisión es sintetizar sistemáticamente la información disponible sobre el rol que las variables psicológicas (depresión, ansiedad y estrés) y la adhesión al tratamiento tienen sobre la CVRS de los pacientes en diálisis a través de una revisión narrativa sistemática. Se seleccionaron los estudios que incluyeron y relacionaron en sus resultados variables psicológicas (al menos una de ellas: depresión, ansiedad o estrés percibido), adhesión al tratamiento y CVRS en población adulta en tratamiento con diálisis debido a su enfermedad renal crónica avanzada (ERCA). Los estudios incluidos debían incorporar en su protocolo de evaluación instrumentos estandarizados. Se efectuaron búsquedas en las bases de datos MedLINE y PsycINFO de enero de 2002 a agosto de 2012. Se incluyeron 38 estudios en esta revisión y fueron sometidos a una evaluación de la calidad metodológica. La revisión ha permitido observar que un 100 % de los trabajos identifica una asociación negativa entre indicadores de ansiedad, depresión y estrés con la CVRS, reflejando que dichas variables son factores de riesgo para la calidad de vida. La adhesión al tratamiento ha sido asociada con factores psicológicos y con la CVRS en un 8 % (N = 3) de los estudios incluidos, mostrándose un factor de protección para la calidad de vida en el 66 % de los estudios (2 de 3) que incluyeron la variable adhesión. Considerando el efecto de dichas variables sobre la CVRS, es importante detectar precozmente indicadores de ansiedad, estrés y depresión o dificultades para cumplir con el tratamiento en la población ERCA en diálisis. Esto permitirá intervenir a tiempo antes de que la CVRS se vea mermada.

El estudio presenta la aplicación del Programa de Intervención Manualizado para la Potenciación de las Fortalezas y los Recursos Psicológicos en una muestra de estudiantes universitarios. Las variables de resultado evaluadas fueron: satisfacción con la vida, estrés percibido, optimismo disposicional, síntomas somáticos, ansiedad e insomnio, disfunción social, depresión, autoestima y quejas de salud subjetivas. También se evaluaron indicadores de implementación de la intervención y medidas de satisfacción con el programa. Se utilizó una metodología cuasi-experimental haciendo uso de un diseño pre-post con un solo grupo (n= 25). El programa fue implementado correctamente y la valoración de la intervención por parte de los participantes fue muy satisfactoria. Los resultados obtenidos por el programa sobre las variables de resultado, indicaron que el programa logró un incremento significativo en el estado de ánimo percibido en las sesiones del programa, así como un incremento en la satisfacción con la vida y el optimismo disposicional, y una reducción de los síntomas pseudoneurológicos y de las quejas de salud subjetivas. En las demás variables de resultado no se observaron diferencias estadísticamente significativas. En conjunto, la información obtenida con este estudio avala la continuidad de la aplicación del programa en otras muestras y contextos.

This paper describes the application of an Intervention Program aimed at enhancing personal strengths and psychological resources in a sample of college students. The variables assessed to detect the changes produced by the program were: life satisfaction, perceived stress, dispositional optimism, somatic symptoms, anxiety and insomnia, social dysfunction, depression, self-esteem and subjective health complaints. Also, indicators for the implementation of the intervention program and measures of satisfaction with the program were assessed. A quasi-experimental methodology was employed, using a pre-post non-experimental design with only one intervention group (n= 25). The program was delivered and implemented correctly. According to the participants' subjective evaluation the program was very satisfactory. Results showed that the intervention program produced an improvement in the participants' perceived mood after most of the program sessions. Likewise, the intervention produced an increase on the variables life satisfaction and dispositional optimism and a decrease on pseudo-neurological symptoms and subjective health complaints. No significant effects were found for the other variables. In summary, the information obtained from this study supports the continued implementation of the program in other samples and settings.

O estudo apresenta a aplicação do Programa de Intervenção Manualizado para a Potenciação das Fortalezas e os Recursos Psicológicos em uma mostra de estudantes universitários. As variáveis de resultado avaliadas foram: satisfação com a vida, estresse percebido, otimismo disposicional, sintomas somáticos, ansiedade e insônia, disfunção social, depressão, autoestima e queixas de saúde subjetivas. Foram avaliados também indicadores de implementação da intervenção e medidas de satisfação com o programa. Utilizou-se uma metodologia quase-experimental usando um desenho pré-pós com somente um grupo (n= 25). O programa foi implementado corretamente e a valoração da intervenção por parte dos participantes foi muito satisfatória. Os resultados obtidos pelo programa sobre as variáveis de resultado,indicaram que o programa obteve um aumento significativo no estado de ânimo percebido nas sessões do programa, assim como um aumento na satisfação com a vida e o otimismo disposicional, e uma redução dos sintomas pseudoneurológicos e das queixas de saúde subjetivas. Nas outras variáveis de resultado não foram observadas diferenças estatisticamente significativas. Em conjunto, a informação obtida com este estudo avaliza a continuidade da aplicação do programa em outras mostras e contextos.

Para identificar hasta qué punto el rasgo de competitividad está relacionado con el rendimiento deportivo en el fútbol, y en qué medida la edad y la categoría deportiva pueden influir sobre estas variables, se ha diseñado un estudio descriptivo-correlacional. Las variables edad, categoría deportiva, rendimiento deportivo, motivación de éxito (Me), motivación para evitar el fracaso (Mef) y competitividad rasgo han sido recogidas en 151 futbolistas varones (entre 14 y 24 años) de un club deportivo madrileño (España). Los resultados indicaron que el rendimiento deportivo asciende de acuerdo con la edad. Consecuentemente, se ha observado una relación directa entre la categoría deportiva y el rendimiento. La Me, Mef y competitividad rasgo se han asociado con el rendimiento y han variado en función de la categoría deportiva. No se ha observado una relación entre la Me, Mef y la competitividad rasgo con la edad de los deportistas.

In order to identify to what extent competitiveness trait is related to sport performance in soccer, and to what extent the age and sport category can influence these variables, a descriptive cross-sectional study has been developed. The variables age, sport category, sport performance, achievement motivation (Me), motivation to avoid the failure (Mef) and competitiveness trait have been assessed in 151 men soccer players (between 14 and 24 y.o.) of a Spanish sport club. The results indicated that the sport performance ascends with age. Consequently, a direct relationship between the sport category and the performance has been observed. Me, Mef and competitiveness trait have been associated with the performance and has varied based on the sport category. No correlation between Me, Mef, competitiveness and age of the sportsmen has been found.

El cáncer de mama es un tumor maligno que surge de células ubicadas en la mama. Un tumor maligno es un grupo de células neoplásicas que puede desarrollarse e invadir tejido circundante o expandirse en forma de metástasis hacia áreas remotas del cuerpo (American Cancer Society, 2009). El objetivo del presente estudio de revisión sistemática fue identificar entre la bibliografía existente, aquellas publicaciones que estudiaran factores psicosociales como las estrategias de afrontamiento al estrés y la sintomatología depresiva que pudieran estar asociados o explicar los resultados en la CVRS en mujeres con cáncer de mama post-cirugía, y pudieran ser modificados a través de la intervención psicosocial. La revisión permitió identificar limitaciones en las investigaciones, y plantear sugerencias para estudios futuros. Los estudios se han clasificado teniendo en cuenta los siguientes criterios: considerando los constructos mencionados en su título, así como que se persiguiera a través del análisis de resultados la predicción de alguna de las variables estudiadas, en forma preponderante respecto del resto de ellas. De cada una se describen las participantes, acciones, y resultados principales. Se discuten las derivaciones de cara a intervenciones psicosociales futuras. Los hallazgos de la presente revisión sugieren que las mujeres con cáncer de mama son vulnerables en tanto su CVRS puede verse afectada, o bien puedan presentar distrés psicológico, y desarrollar sintomatología depresiva. Ciertos estilos de afrontamiento, y ciertas variables sociodemográficas, clínicas, y psicosociales están asociados a un mejor ajuste a la enfermedad

Breast cancer is a malignant tumor that starts from cells of the breast. A malignant tumor is a group of cancer cells that develops, invading surrounding tissue, or expands as metastases towards remote areas of the body (American Cancer Society, 2009). The aim of the present study of systematic literature review was to identify among existing scientific bibliography, papers studying the effect of psychosocial factors (such as coping strategies or depressive symptomatology, which psychosocial interventions could improve) on HRQL outcomes in post-surgery women with breast cancer. The review portrayed several limitations in research, providing suggestions for future studies. The studies were organized bearing the following criteria in mind: either by the variables of interest included on their titles, or else by the expressed aim of associating any of the variables to HRQL.We describe for each study revised and included: its participants, main procedures, and most apparent results. Implications are discussed facing future prospects of psychosocial interventions. The findings of the present review suggest that women with breast cancer are vulnerable while their HRQL may be affected, they could suffer psychological distress, and/or develop depressive symptoms. Certain coping styles, as well as specific sociodemographic, clinical, and psychosocial factors are associated to a better adjustment to the desease

O presente estudo observou a existência de relações significativas entre sintomatologia psicopatológica (BSI), adesão ao tratamento (CEAT-VIH) e qualidade de vida (WHOQOL-Bref) em 125 pessoas HIV-positivo/AIDS em tratamento antirretroviral, atendidos em um hospital do Porto (Portugal). A sintomatologia psicopatológica correlacionou-se negativamente com adesão ao tratamento e qualidade de vida, e a adesão ao tratamento associou-se positivamente com a qualidade de vida. O modelo preditor de adesão ao tratamento, mediante análise de regressão múltipla, incluiu a ausência de sintomatologia psicopatológica, o comportamento de retirada dos medicamentos na farmácia hospitalar e a presença de efeitos colaterais do tratamento (R² =0,30). Ademais, observou-se um efeito mediador de sintomatologia psicopatológica entre a adesão ao tratamento e a qualidade de vida das pessoas com HIV/AIDS.

The study shows evidence of statistical association among psychopathological symptoms (BSI), treatment adherence (CEAT-VIH) and quality of life (WHOQOL-Bref) in 125 HIV-positive/AIDS patients followed at Porto Hospital (Portugal). The psychopathological symptoms present a negative correlation with treatment adherence and quality of life. On the other hand, adherence was positively correlated with quality of life. The model of adherence to the antiretroviral treatment using multiple regression analysis includes absence of psychopathological symptoms, an adherence behavior (i.e. to get the medication at the hospital's pharmacy) and the experience of side effects because of medication (R² = 0.30). Besides, psychopathological symptoms have a mediation effect between adherence and quality of life in people with HIV/AIDS.