Browsing by Subject "Predictors"
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- PublicationOpen AccessDeterminants of quality of life in Alzheimer’s disease: perspective of patients, informal caregivers, and professional caregivers(Cambridge University Press, 2012-11) Gómez Amor, Jesús; Gómez García, Juan; Gómez Gallego, María; Atención SociosanitariaBackground: Alzheimer’s disease (AD) is a chronic medical condition with symptoms that compromise patients’ quality of life (QoL). The identification of the factor predicting QoL in AD is essential to develop more effective interventions. Recent research suggests that these factors could be different for the distinct informants. This study explores the QoL predictors considering three different sources of information: patients, caregivers, and healthcare staff. Methods: In this cross-sectional study, a sample of 102 patients, their primary caregivers, and 15 members of the healthcare staff evaluated patients’ QoL (QoL-AD Scale). Patients’ and caregivers’ demographic and clinical data (cognitive function, neuropsychiatric symptoms, depression, and caregivers’ burden) were considered as QoL predictors. Results: In multivariate-adjusted linear regression analyses, we observed that patients’ ratings were mainly affected by their mood whereas caregivers’ ratings were also negatively influenced by patients’ irritability and burden. According to staff ratings, both psychotic symptoms and neuroleptics were associated with lower QoL. Conclusions: Our findings suggest that depression is the main variable related to patients’ QoL and that more careful management of neuropsychiatric disorders is necessary. Both proxies’ ratings are not equivalent to patients’ reports in terms of predictors but they are complementary. Thus, a thorough QoL assessment should consider separately the perspective of the different informants.
- PublicationOpen AccessPredictors of Parental Accommodation and Response Treatment in Young Children With Obsessive-Compulsive Disorder(Frontiers, 2021) Rosa-Alcázar, Angel; Rosa-Alcázar, Ana Isabel; Parada-Navas, José Luis; Olivares-Olivares, Pablo; Rosa-Alcázar, Encarnación; Personalidad, Evaluación y Tratamiento PsicológicosBackground: Cognitive–behavioral family-based treatment (CBFT) is the treatment standard in very young children with obsessive–compulsive disorder (OCD), which includes the same core components of cognitive–behavioral therapy (CBT) with significant family involvement. Although the latter reports high rates of remission, some children do not improve with treatments. Therefore, it is necessary to identify possible moderating variables such as comorbidity, severity of disorder, years of onset, parental anxiety, and parental accommodation. This study has two main aims: (1) to propose a predictive model on family accommodation (father and mother), taking into account variables related to the children (severity of obsessive–compulsive responses, internalizing and externalizing symptoms, and comorbidity) and with the parents before intervention (worry, accommodation of one parental member over the other) and (2) to examine the mediating role of externalizing symptoms and mother’s accommodation in the relation between initial severity and improvement of severity of obsessive–compulsive responses in children aged 5–8 years. Methods: Participants comprised 56 children with OCD [mean = 6.61 (SD = 0.76)] and their parents; 79% of the sample was men. Treatment was implemented by two clinicians specialized in OCD (>15 years of experience). Clinicians were trained to administer CBT protocol in the same way. They were doctors of clinical psychology and researchers at the OCD. Results: Mother’s accommodation was associated with child variables (Child Behavior Checklist–Externalizing and Initial Severity, Children’s Yale–Brown Obsessive–Compulsive Scale). Father’s accommodation could be explained by parent variables (mother’s accommodation and worry). Simple mediation model tested using the SPSS macro PROCESS supported the relation of the initial severity of symptoms with that following intervention, through the simple indirect effect of externalizing symptoms of the child. Conclusions: Comorbidities with externalizing symptoms, father’s worry, and mother’s accommodation were variables that should be controlled in treatment of pediatric OCD.
- PublicationOpen AccessStability and predictors of poor 6-min walking test performance over 2 years in patients with COPD(MDPI, 2020-04-18) Sánchez Martínez, Mª Piedad; Bernabeu Mora, Roberto; Martínez González, Mariano; Gacto Sánchez, Mariano Luis; Martín San Agustín, Rodrigo; Medina i Mirapeix, Francesc; Fisioterapia; Facultad de MedicinaPoor performance in the 6-min walk test (6MWT < 350 m) is an important prognostic indicator of mortality and risk of exacerbations in patients with chronic obstructive pulmonary disease (COPD). Little is known about the stability of this state over time and what factors might predict a poor 6MWT performance. To determine the stability of 6MWT performance over a 2-year period in COPD patients participating in annual medical follow-up visits, and to assess the ability of several clinical, pulmonary, and non-pulmonary factors to predict poor 6MWT performance, we prospectively included 137 patients with stable COPD (mean age, 66.9 8.3 years). The 6MWT was scored at baseline and 2-year follow-up. To evaluate clinical, pulmonary, and non-pulmonary variables as potential predictors of poor 6MWT performance, we used multiple logistic regression models adjusted for age, sex, weight, height, and 6MWT performance at baseline. Poor 6MWT performance was stable over 2 years for 67.4% of patients. Predictors of poor 6MWT performance included a five-repetition sit-to-stand test score 2 (OR, 3.01; 95% CI, 1.22–7.42), the percentage of mobility activities with limitations (OR, 1.03; 95% CI, 1.00–1.07), and poor 6MWT performance at baseline (OR, 4.64; 95% CI, 1.88–11.43). Poor 6MWT performance status was stable for the majority of COPD patients. Lower scores on the five-repetition sit-to-stand test and a higher number of mobility activities with limitations were relevant predictors of poor 6MWT performance over 2 years. Prognostic models based on these non-pulmonary factors can provide non-inferior discriminative ability in comparison with prognostic models based on only pulmonary factors.