Browsing by Author "Rubia Ortí, José Enrique de la"

Introducción: Los múltiples deterioros cognoscitivos de la demencia se suelen asociar a ansiedad, depresión y trastornos del sueño. El deterioro progresivo de las capacidades cognitivas e intelectuales desencadenados por la propia enfermedad, así como las modificaciones en el estado de ánimo y conductuales, repercuten no sólo en el propio individuo, sino también en el núcleo familiar. Objetivo: Conocer y describir la alteración y relación de los patrones funcionales de salud cognitivo – perceptual, rol – relaciones y adaptación – tolerancia al estrés, en los pacientes con DCL de nuestra muestra. Material y métodos: estudio descriptivo, transversal. Se procedió a la incorporación de sujetos mayores de 65 años con manifestaciones de demencia, pertenecientes al Centro de Salud Juan XXIII de Valencia y a los centros de día de la Asociación de Familiares de Alzheimer de Guadassuar, Algemesí y Benifaió. El reclutamiento inició en Julio de 2014. Las variables dependientes correspondieron a las funcionales (relativas a los instrumentos de medida), y las independientes a las variables sociodemográficas y clínicas. Resultados: Del total de una muestra de 54 pacientes, resultó estadísticamente significativa la correlación entre Apgar y Ansiedad – Depresión (p=0’006 β= -0,054); entre GHQ y Ansiedad – Depresión (p<0’001 β=0’634); entre Optimismo y Apgar (p<0’001 β= 0,382); GHQ y Pesimismo (p=0’007 β=0’254); CGHQ y Optimismo (p<0’001 β=-0’349); y entre el Optimismo, Apgar familiar (p=0’010 β= 0’419), y estado civil (p=0’007 β=2’480). Existe influencia de GHQ en el COS (p=0’035 β=0’758); Apgar grave disfunción y EVA (p=0’036 β= -16,589), y Ansiedad y EVA (p<0’001 β=- 5,449). Conclusión: Existe alteración de los patrones funcionales de salud cognitivo – perceptual, rol – relaciones y adaptación – tolerancia al estrés. Se demuestra que un estado de depresión influye en el nivel de DCL de los pacientes, y produce una alteración de los patrones funcionales de salud cognitivo – perceptual, rol - relaciones y adaptación – tolerancia al estrés. / Introduction: The multiple cognitive impairments of dementia are often associated with anxiety, depression and sleep disorders. The progressive deterioration of the cognitive and intellectual capacities, triggered by the disease itself, as well as mood and behavior changes, have repercussions not only on the individual, but also on the family. Objetive: To know and to describe the alteration and relation of the health functional patterns cognitive – perceptual, role – relations and adaptation – stress tolerance in the patients with DCL in our sample. Materials and Methods: Descriptive cross-sectional study. Individuals older than 65 with manifestations of dementia, belonging to the Healthcare Centre Juan XXIII, in Valencia, or to the Day Centres of the Alzheimer's Association of Guadassuar, Algemesí and Benifaió, were included in the sample. Recruitment began in July 2014. The dependent variables corresponded to the functional variables (relative to the instruments of measurement), and the independent variables to sociodemographic and clinical variables. Results: Of the total sample of 54 patients, the correlation between Apgar and Anxiety-Depression was found to be statistically significative (p=0.006 β= -0.054); between GHQ and Anxiety – Depression (p<0.001 β =0.634); between Optimism and Apgar (p<0.001 β = 0.382); GHQ y Pesimism (p=0.007 β =0.254); CGHQ and Optimism (p<0.001 β =-0.349); and between Optimism, family Apgar (p=0.010 β = 0.419), and marital status (p=0.007 β =2.480). There is an influence of GHQ on the COS (p=0.035 B=0.758); severe dysfunction Apgar and EVA (p=0.036 β = -16.589), and Anxiety and EVA (p<0.001 β =-5.449). Conclusion: There is an alteration of the health functional patterns cognitive - perceptual, role - relationships and adaptation - stress tolerance. It has been shown that a state of depression influences the patients' DCL level, and produces an alteration in the aforementioned health functional patterns.

Mindfulness-based interventions have shown some efficacy in decreasing stress levels and improving quality of life. However, so far, only a few studies have studied this type of intervention among patients with inflammatory bowel disease and none of them have studied their effects on inflammatory biomarkers. This current study was a two-armed, single-centre, randomised (2:1 ratio) controlled trial used to evaluate the effects of a mindfulness-based intervention (n = 37) compared to standard medical therapy (n = 20) in patients with Crohn’s disease or ulcerative colitis. The mindfulness intervention blended four internet-based therapy modules with four face-to-face support sessions. The outcomes we assessed were faecal calprotectin (primary outcome), C-reactive protein, and cortisol levels measured in hair samples at several timepoints. The between-group analysis highlighted significant decreases in faecal calprotectin and in C-reactive protein levels in the mindfulness-based intervention group compared to the standard medical therapy group at the six-month follow-up (faecal calprotectin: −367, [95% CI: −705, −29], P = 0.03; C-reactive protein: −2.82, [95% CI: −5.70, 0.08], P = 0.05), with moderate to large effect sizes (faecal calprotectin: ηp2 = 0.085; C-reactive protein: ηp2 = 0.066). We concluded that mindfulness-based therapy administered as part of standard clinical practice effectively improves inflammatory biomarkers in patients diagnosed with inflammatory bowel disease.