International Journal of Developmental and Educational Psychology (Revista INFAD de Psicología)
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Propuesta de intervención con terapias de tercera generación para cuidadores de personas con demencia en el ámbito rural
Full text linkFamily caregivers of people with dementia suffer a progressive overload in the task of caring, which makes them especially vulnerable to suffering psychological and health problems. In the case of caregivers who reside in rural areas, this challenge increases due to their high age, technological barriers and problems with access to specialized assistance resources. Third generation therapies offer us, in this context, new ways of understanding and doing psychotherapy, incorporating concepts such as acceptance, psychological flexibility or values, which can help prevent overload. Aim. To develop an intervention proposal with a hybrid design between the Acceptance and Commitment Therapy (ACT) models (Losada, 2015) and the Mindfulness and Self-Compassion (MSC) program. Methodology. A pre-post design is proposed, with two experimental groups (in-person and online) and a control group of caregivers of people with dementia. It is proposed to influence the variables: caregiver overload, anxiety, depression, quality of life, mindfulness, experiential avoidance and ambivalence. Results: The group program consists of ten sessions organized into five thematic blocks: knowing dementia, self-care, experiential avoidance, cognitive flexibility and values, interspersed with the practice of mindfulness techniques. A pre and post program evaluation is established, three monthly reinforcement sessions and finally three follow-up evaluations at 3, 6 and 12 months. Conclusions: Third generation psychological interventions may constitute a beneficial option to maintain the psychological well-being of family members who care for people with dementia. In our case, we propose a psychoeducational program adapted to the special characteristics of caregivers who live in rural environments.Introducción. Los cuidadores familiares de personas con demencia sufren una progresiva sobrecarga en la tarea de cuidar que les hace especialmente vulnerables a sufrir problemas psicológicos y de salud. En el caso de los cuidadores que residen en el medio rural, este desafío se incrementa debido a su elevada edad, a las barreras tecnológicas y a los problemas de acceso a recursos de asistencia especializada. Las terapias de tercera generación nos ofrecen, en este contexto, nuevas formas de entender y hacer psicoterapia, incorporando conceptos como la aceptación, la flexibilidad psicológica o los valores, que pueden ayudarles a prevenir su sobrecarga. Objetivo. Desarrollar una propuesta de intervención con un diseño híbrido entre los modelos de Terapia de Aceptación y Compromiso (ACT) (Losada, 2015) y el programa de Mindfulness y Autocompasión (MSC). Metodología. Se propone un diseño pre-post, con dos grupos experimentales (presencial y on line) y un grupo de control de cuidadores de personas con demencia. Se plantea incidir sobre las variables: sobrecarga del cuidador, ansiedad, depresión, calidad de vida, mindfulness, evitación experiencial y ambivalencia. Resultados: El programa grupal consta de diez sesiones organizadas en cinco bloques temáticos: conocer la demencia, autocuidado, evitación experiencial, flexibilidad cognitiva y valores, intercaladas con la práctica de técnicas de mindfulness. Se establece una evaluación pre y post programa, tres sesiones de refuerzo mensuales y finalmente tres evaluaciones de seguimiento a los 3, 6 y 12 meses. Conclusiones: Las intervenciones psicológicas de tercera generación pueden constituir una opción beneficiosa para mantener el bienestar psicológico de los familiares que cuidan a personas con demencia. En nuestro caso, proponemos un programa psicoeducativo adaptado a las especiales características de los cuidadores que viven en el entorno rural
Avaliação do sofrimento existencial na pessoa em situação paliativa: uma revisão narrativa
Full text linkTheoretical Framework: Existential suffering (ES) in palliative care patients addresses fundamental issues related to the meaning of life, fear of death and loss of purpose. Despite its importance, the adequate assessment of ES remains underexplored in clinical practice. The existing literature points to the need for robust methods and instruments for assessing ES in palliative contexts. This study aims to fill this gap by reviewing the methods and instruments used to assess ES in people in palliative care (PC). Objective: To identify the methods and instruments used to assess ES in palliative care patients. Methodology: A qualitative study was carried out through a narrative review in the PubMed, Cochrane Library and EBSCOhost databases. Eleven articles responding to the study’s objective were selected. Results and Discussion of Results: The review identifies the Existential Distress Scale (EDS), the Patient Dignity Inventory (PDI-IT) and the Demoralization Scale (DS-II) as effective tools for the comprehensive assessment of ES in PC. Additionally, the Care, Assistance/Help, Stress, Hopes/Fears (CASH) and Meaning and Existential Purpose (EMAP) are valued for their effectiveness in facilitating communication and complex decision making. However, it is imperative that these tools are continually developed and validated to maintain their relevance and effectiveness in varied cultural and clinical contexts, ensuring constant adaptations in the face of cultural diversity and different clinical practices. Conclusion: Accurate assessment of ES is essential for improving the quality of care. This study highlights the comprehensiveness of some instruments in simplifying the assessment of ES and in making complex decisions. However, it is crucial to continue developing and adapting these instruments to ensure their applicability and effectiveness in different cultural and clinical contexts.Enquadramento Teórico: O sofrimento existencial (SE) na pessoa em situação paliativa aborda questões fundamentais relacionadas ao sentido da vida, medo da morte e perda de propósito. Apesar da sua importância, a avaliação adequada do SE permanece subexplorada na prática clínica. A literatura existente aponta para a necessidade de métodos e instrumentos robustos para a avaliação do SE em contextos paliativos. Este estudo visa preencher esta lacuna, revisando os métodos e instrumentos utilizados na avaliação do SE na pessoa em cuidados paliativos (CP). Objetivo: Identificar métodos e instrumentos utilizados para avaliar o SE na pessoa em situação paliativa. Metodologia: Foi realizado um estudo qualitativo através de uma revisão narrativa nas bases de dados PubMed, Cochrane Library e EBSCOhost. Foram selecionados onze artigos que dão resposta ao objetivo do estudo. Resultados e Discussão de Resultados: A revisão identifica a Escala de Sofrimento Existencial (EDS), o Inventário de Dignidade do Paciente (PDI-IT) e a Escala de Desmoralização (DS-II) como ferramentas eficazes para a avaliação abrangente do SE em CP. Adicionalmente, a Cuidado, Assistência/Ajuda, Stress, Esperanças/Medos (CASH) e Significado e Propósito Existencial (EMAP) são valorizadas pela sua eficácia na facilitação da comunicação e na tomada de decisões complexas. No entanto, é imperativo que estas ferramentas sejam continuamente desenvolvidas e validadas para manter a sua relevância e eficácia em contextos culturais e clínicos variados, garantindo adaptações constantes face à diversidade cultural e práticas clínicas distintas. Conclusão: A avaliação precisa do SE é essencial para melhorar a qualidade dos cuidados. Este estudo sublinha a abrangência de alguns instrumentos na simplificação da avaliação do SE e na tomada de decisões complexas. Contudo, é crucial continuar a desenvolver e adaptar estes instrumentos para garantir a sua aplicabilidade e eficácia nos diversos contextos culturais e clínicos.
Viabilidad de un juego de mesa para abordar el miedo en la adultez temprana
No full textWereport theapplication ofa board game designed with a proposed methodology for the development of board games for clinical psychological use, with the aim of evidencing its viability in terms of utility, pertinence, adequacy and relevance in the identification, expression and regulation of fear in early adulthood. This is an exploratory-descriptive study with a non-experimental cross-sectional design, in which 102 Mexican adults selected through a non-probability sampling participated. A semistructured questionnaire developed for the purposes of this study was used. The analysis of the data through frequency distribution indicates that 87.3% of the participants considered that their experience with the game was good; In addition, 99% of the participants consider that the game was useful, mainly because it helped to identify and express the emotion of fear, as well as to listen to opinions and share ideas related to the action and regulation of fear, likewise 99% said that they would recommend the game to other people of their age. It should be noted that prior to the application of the game, it was validated by expert judges. Therefore, it is concluded that the board game designed to address fear is adequate, pertinent, relevant and useful in raising awareness of the naturalness of emotion and the importance of expressing it. In the design of the game, the need to adhere to a methodology based on scientific evidence that contributes to the design of this type of resources for psychological use is highlighted.Se reporta la aplicación de un juego de mesa diseñado con una metodología propuesta para la elaboración de juegos de mesa de uso clínico psicológico, con el objetivo de evidenciar su viabilidad en cuanto a utilidad, pertinencia, adecuación y relevancia en la identificación, expresión y regulación del miedo en la adultez temprana. Es un estudio exploratorio- descriptivo con un diseño no experimental transversal, en el que participaron 102 adultos mexicanos seleccionados mediante un muestreo no probabilístico. Se utilizó un cuestionario semiestructurado elaborado para los fines de este estudio. El análisis de los datos a través de distribución de frecuencias señala que el 87.3% de los participantes consideró que su experiencia con el juego fue buena; además el 99% de los participantes considera que el juego le fue de utilidad, principalmente porque ayudó a identificar y expresar la emoción del miedo, así como escuchar opiniones y compartir ideas relacionadas a la acción y la regulación del miedo, así mismo el 99% refirió que recomendaría el juego a otras personas de su edad. Se destaca que previo a la aplicación del juego, éste fue validado por jueces expertos. Por lo que se concluye que el juego de mesa diseñado para abordar el miedo es adecuado, pertinente, relevante y útil en la concientización de la naturalidad de la emoción y la importancia de expresarlo. En el diseño del juego se destaca la necesidad de apegarse a una metodología basada en evidencia científica que contribuya al diseño de este tipo de recursos de uso psicológico
Perceção de autoeficácia nos comportamentos de adesão ao papel de cuidador: relação com variaveis sociodemograficas
No full textIntroduction: In an integral and complex role of caring for a dependent family member, the family caregiver develops behaviours in the exercise of thisrole with variableself-efficacy. Self-efficacyistheability to implement these behaviours in new and stressful situations. It is, therefore, a relevant object of study. Objective: To analyse the relationship between the perception of self-efficacy in the behaviours of adherence to the role of family caregiver and some sociodemographic variables. Methodology: This is a descriptive-correlational, cross-sectional study with a quantitative approach in which 111 informal family carers, users of a Family Health Unit (USF) in the north of Portugal, participated. The data was collected using a form applied by telephone by the researchers and processed using SPSS 29.0 software, using descriptive and inferential statistics. Results: Of the total sample (n= 111), the majority of informal carers, members of a family, were female (82.9%), belonged to the 45-64 age group (52.3%), had the marital status of married/marital partnership (64.0%) and the largest group fell into the Middle class (33.3%). The majority of the family carers perceived themselves as incompetent in stimulating the family member’s independence (70.3%) but competent in assisting the dependent family member in their self- surveillance (78.4%). The perception of self-efficacy in the behaviours of adherence to the role of assisting the dependent family member in their self-monitoring differed between family carers with different marital status (Kruskal Wallis: p < 0.030), with divorced carers perceiving greater competence, followed by married carers(68.00 > 57.06 points). Single carers perceived themselves as having the lowest competence. Conclusions: The roles in which family carers perceived themselves to be less competent were identified, making it necessary for training to be made available to these carers to improve the health and well-being of the dependent member and even the family carer themselves.Introdução: O cuidador familiar num papel integral e complexo de cuidar do familiar dependente, desenvolve comportamentos no exercício desse papel, com autoeficácia variável. A autoeficácia assume-se pela capacidade de implementar estes comportamentos em situações novas e geradoras de stresse. É por isso um objeto relevante de estudo. Objetivo: Analisar a relação entre a perceção da autoeficácia nos comportamentos de adesão ao papel de cuidador familiar e algumas variáveis sociodemográficas. Metodologia: Trata-se de um estudo descritivo-correlacional, transversal e de abordagem quantitativa, no qual participaram 111 cuidadores informais familiares, utentes de uma Unidade de Saúde Familiar (USF), do Norte de Portugal. Na recolha de dados utilizámos um formulário, aplicado via telefone pelos investigadores, tendo sido tratados através do software SPSS 29.0, com recurso à estatística descritiva e inferencial. Resultados: Do total da amostra (n= 111) a maioria dos cuidadores informais, membros de uma família, era do sexo feminino (82,9%), pertencia ao grupo etário dos 45-64 anos (52,3%), detinha o estado civil de casado/união de facto (64,0%) e o maior grupo enquadrava-se na estimular a independência do familiar (70,3%), mas competentes na assistência ao familiar dependente na sua autovigilância (78,4%). A perceção da autoeficácia nos comportamentos de adesão ao papel de assistir ao familiar dependente na sua autovigilância difere entre os cuidadores familiares com diferente estado civil (Kruskal Wallis: p < 0,030), sendo que os cuidadores divorciados percecionaram maior competência, seguido pelos casados (68,00 > 57,06 pontos). Os solteiros percecionaram-se com a menor competência. Conclusões: Foram identificados os papéis em que os cuidadores familiares se percecionaram com menor competência, tornandose necessário que possa ser disponibilizada formação a estes cuidadores, a fim de melhorar a saúde e bem-estar do membro dependente e até do próprio cuidador familiar.
"Early numeracy skills" y rendimiento matemático: un estudio longitudinal de 7 años
No full textHaving good early numeracy skills seems to be important for success in this subject in later educational stages. However, most of the studies contemplate designs whose results cover up to the 1st cycle of Primary Education. The present longitudinal study aimed to explore the predictive value of certain early numeracy skills, such as counting skills, comparison magnitudes abilities, and logical operations, on mathematical performance and its components 6 years later. The sample included 91 children who were evaluated at two time points: Kindergarten (5-6 years) and 6th grade of Primary School (11-12 years). In Kindergarten, the TEDI-MATH (Gregóire et al., 2005) was used to assess the degree of acquisition of counting (conceptual and procedural), comparison of magnitudes (symbolic and non-symbolic), and logical operations (seriation, classification, conservation, and inclusion) early numeracy skills. In Primary School, the EVAMAT-6, version 3.0 (García et al., 2018) was administered to evaluate mathematical performance and its components (numbering, calculation, geometry, information and chance, and problem-solving). The results showed that procedural counting emerges as a prominent predictor of subsequent mathematical performance and its components. Likewise, although to a lesser extent, the influence of symbolic comparison skills and logical operations of seriation and conservation was also observed. The implications of thes findings for psychoeducational research and practice are discussed.Tener unas buenas competencias matemáticas básicas tempranas (“early numeracy skills”) parece ser de vital importancia para el éxito en dicha materia en etapas educativas posteriores. Sin embargo, la mayor parte de los estudios contemplan diseños cuyos resultados abarcan hasta el 1er ciclo de Educación Primaria. El presente estudio longitudinal se propuso explorar el poder predictivo de determinadas competencias matemáticas básicas evaluadas en etapas tempranas, tales como las habilidades de conteo, comparación de magnitudes y operaciones lógicas, sobre el rendimiento matemático y sus componentes seis años más tarde. La muestra contó con 91 niños y niñas que fueron evaluados en dos momentos temporales: Educación Infantil (5-6 años) y 6º de Educación Primaria (11-12 años). En Educación Infantil, se utilizó el TEDI-MATH (Gregóire et al., 2005) para evaluar el grado de adquisición de competencias matemáticas básicas de conteo (conceptual y procedimental), comparación de magnitudes (simbólicas y no-simbólicas) y operaciones lógicas (seriación, clasificación, conservación e inclusión). En Educación Primaria, se administró el EVAMAT-6, versión 3.0 (García et al., 2018) para evaluar el rendimiento matemático y sus componentes (numeración, cálculo, geometría, información y azar, y resolución de problemas). Los resultados mostraron que el conteo procedimental emergió como un predictor destacado sobre el rendimiento matemático posterior y sus componentes. Asimismo, y aunque en menor medida, se observó también la influencia de las habilidades de comparación simbólica y las operaciones lógicas de seriación y conservación. Se discuten las implicaciones de estos hallazgos para la investigación y la práctica psicoeducativa
Ansiedad escolar y rechazo escolar por evitación de situaciones negativas en adolescentes
No full textOne of the biggest challenges that the youth population faces today is demotivation due to academic results, which is closely reflected in stress, anxiety, and depression behaviors. Thus, among the most prominent disorders in thE adolescent population is Generalized Anxiety Disorder. Attending school favors the comprehensive development of students (academic, personal, and social), however, the school rejection rate continues to be alarming. Due to the complexity of the behavior, it has not been possible to reach a common agreement that justifies the behavior, since the reasons are heterogeneous (fear, anxiety, or defiant disorder). Emotionally based school avoidance is an important and persistent cause of school absenteeism. Considering, therefore, the close relationship between internalizing emotions (anxiety, depression, stress) and school rejection, the objective of the present study was toknow the relationship between school anxiety and school rejection based on the high and low scores in school refusal. The sample was made up of a total of 1920 high school students. The School Refusal BehaviorAssessment Scale-Revised for children (I. Avoidance of negative affectivity; II. Escape from social situations; III. Attention seeking; IV. Seeking tangible reinforcement) and the School Anxiety Inventory (IAES) were used. The results reflected that students with high scores in school rejection obtained higher scores in the different anxiety dimensions evaluated compared to the group with low scores in school rejection. The role of anxiety as a risk factor for school refusal behavior is discussedUno de los mayores desafíos a los que se enfrenta hoy día la población juvenil es a la desmotivación por los resultados académicos, lo que se ve estrechamente reflejado en conductas de estrés, ansiedad y depresión. Así, entre los trastornos más destacados en la población adolescente, se encuentra el Trastorno de Ansiedad Generalizada. Asistir a la escuela favorece el desarrollo integral de los estudiantes (académico, personal y social), no obstante, el índice de rechazo escolar continúa siendo alarmante. Debido a la complejidad del comportamiento, no se ha logrado llegar a un acuerdo común que justifique la conducta, pues las razones son heterogéneas (miedo, ansiedad o trastorno desafiante). La evitación escolar basada en las emociones es una importante causade absentismo escolar, además de persistente. Teniendo en cuenta por tanto la estrecha relación entre las emociones de tipo internalizante (ansiedad, depresión, estrés) y el rechazo escolar, el objetivo del presente estudio consistió en conocer la relación entre la ansiedad escolar y el rechazo escolar en función de las altas y bajas puntuaciones en rechazo escolar. La muestra estuvo compuesta por un total de 1920 estudiantes de bachillerato. La School Refusal Behavior Assessment Scale-Revised for children (I. Evitación de afectividad negativa; II. Escape de situaciones sociales; III. Búsqueda de atención; IV. Búsqueda del refuerzo tangible) y el Inventario de Ansiedad Escolar (IAES) fueron utilizados. Los resultados reflejaron que, los estudiantes con altas puntuaciones en rechazo escolar, obtuvieron puntuaciones superiores en las diferentes dimensiones de ansiedad evaluadas en comparación con el grupo con bajas puntuaciones en rechazo escolar. Se discute el papel de la ansiedad como factor de riesgo del comportamiento de rechazo escolar
Implicaciones de los problemas socioemocionales en escuelas primarias en desventaja de México
Full text linkA qualitative case study provides information about existing social and emotional problems in a primary school located in a highly vulnerable community in the coast of the Yucatan, Mexico. Throughout ethnographic techniques, participant observation, semi structured interviews and focus groups, we identified problems of family violence, aggressivity and bullying between students. School personnel attributed these cases to the context of poverty, neglect and addictions prevailing in families and in the whole community. We found limited psychological support, considering the infrequent visits of the designated psychologist. Although teachers expressed interest in addressing these problems, they complained about time and training constraints. Findings lead to the design and development of a first aid psychological workshop for participant teachers that was later evaluated to ponder itseffects. Theimportance ofaddressing socialand emotional problems in the school community that hinder its well-being, and the importance of training teachers to develop socioemotional intervention and support are discussed. Este artículo reporta los resultados de un estudio cualitativo de caso que explora las implicaciones de los problemas socioemocionales en una escuela primaria ubicada en una comunidad con alta vulnerabilidad social en la costa de Yucatán, México. A través de técnicas etnográficas, observación participante, entrevistas semiestructuradas y grupos de enfoque, se identificaron problemas de violencia familiar, agresividad y acoso verbal y físico entre estudiantes. El personal escolar atribuye estos casos a la pobreza, desinterés por los hijos y adicciones en las familias y la comunidad. Se evidenció que el apoyo de la psicóloga es limitado, ya que acude de manera infrecuente a la escuela. Por su parte, los docentes expresaron interés por abordar estos problemas, pero se quejaron de no tener tiempo ni capacidad para atenderlos. A raíz de estos hallazgos se impartió y evaluó el efecto de un curso de primeros auxilios psicológicos para los profesores. Se discute la importancia de la atención de factores socioemocionales que afectan la vida escolar y el bienestar de la comunidad, y la importancia de capacitar a los profesores para desarrollar acciones de intervención y apoyo en esta área
Intervenção da música na intervenção psicológica
Full text linkIn today’s world, the therapeutic role of music is well documented and has been the subject of countless studies. Music springs to life from the beating of the heart, from breathing through the lungs... these are two examples of its presence. Currently, as a resource for therapeutic purposes, it is often used in work with people diagnosed with the neurodegenerative disease Alzheimer’s (Moreira et al, 2018). However, its use is not limited to the context in which there is some form of injury, pathology or dementia; it can be used in various ways, for example: to encourage regular physical activity, as well as in the educational development of students, among others. The aim of this article was to investigate the diverse existing literature and, by analyzing the theoretical review, contribute to the planning of future projects, namely an educational project to be implemented during the professional internship in primary and secondary schools; in an attempt to intervene psychologically, where music will play a fundamental, proactive role in contributing to excellent learning!No mundo atual, o papel terapêutico da música encontra-se bem documentado, sendo objeto de estudo, vezes incontáveis. A música nasce da vida das batidas do coração, da respiração realizada pelos pulmões… são dois exemplos dessa presença. Atualmente, enquanto recurso para fins terapêuticos, é frequentemente utilizada no trabalho com pessoas que apresentam diagnóstico da doença neurodegenerativa Alzheimer (Moreira et al, 2018). Porém, a sua utilização não se cinge apenas ao âmbito em que exista alguna forma de lesão, patologia ou demência; sendo possível usá-la em diversos meios, como por exemplo: no incentivo à prática de uma atividade física regular, como também, no desenvolvimento educativo de alunos, entre outros. O objetivo do presente artigo foi investigar a diversa literatura existente e face à análise da revisão teórica contribuir para o planeamento de futuros projectos, nomeadamente num projecto educativo a ser implementado no estágio profissional na escola básicae secundária; numa procura de intervir psicologicamente ondea músicaterá um papel fundamental, proactivo e de contribuição para uma aprendizagem de excelência
Docencia compartida y motivación: hacia un modelo de colaboración emocional en el aula
Full text linkCo-teaching (CT) is a pedagogical model in which two or more teachers collaborate jointly in order to strengthen educational quality, interpersonal relationships and the professional development of teachers. The objectives of this study were: to analyze the relationship between CT and student learning motivation, to identify significant differences in the perception of CT according to demographic variables, and to examine the perception of student motivation in relation to the CT experience. The study participants were 758 Compulsory Secondary Education (ESO) students, 377 females (49.7%), 351 males (46.3%), and 30 students (4%) who did not specify their gender. Most of the students were between 12 and 15 years of age. A questionnaire was used to measure the Shared Teaching perspective, and the Motivational Evaluation of the Learning Process Scale. A descriptive and correlational analysis was performed. Among the most important results, a significant percentage of students have had CT experience. Women and younger students, as well as those in the first and fourth years of ESO, report greater satisfaction with shared teaching. Differences in inclusion are related only to the course. Students who have participated in CT show higher levels of intrinsic and extrinsic motivation. With the above, we conclude that CT is an effective pedagogical model for improving intrinsic and extrinsic motivation, school climate and students’ academic performance.La docencia compartida (DC) es un modelo pedagógico en donde colaboran de manera conjunta dos o más profesores, con el fin de fortalecer la calidad educativa, las relaciones interpersonales y el desarrollo profesional de los docentes. Los objetivos planteados en este estudio fueron: analizar la relación entre la DC y la motivación del aprendizaje de los estudiantes, identificar diferencias significativas en la percepción de la DC según variables demográficas y examinar la percepción de la motivación del alumnado en relación con la experiencia de DC. Los participantes del estudio fueron 758 estudiantes de Educación Secundaria Obligatoria (ESO), 377 mujeres (49.7%), 351 hombres (46.3%), y 30 estudiantes (4%) que no especificaron su género. La mayoría de los estudiantes tenía entre 12 y 15 años. Se utilizó un cuestionario para medir la perspectiva de la Docencia Compartida, y la Escala de Evaluación Motivacional del Proceso de Aprendizaje. Se realizó un análisis descriptivo y correlacional. Entre los resultados más importantes se destaca que, un porcentaje significativo de estudiantes ha tenido experiencia en DC. Las mujeres y los estudiantes más jóvenes, así como los de primero y cuarto de la ESO, reportan mayor satisfacción con la docencia compartida. Las diferencias en inclusión se relacionan solo con el curso. Los estudiantes que han participado en la DC muestran niveles más altos de motivación intrínseca y extrínseca. Con lo expuesto se concluye que la DC es un modelo pedagógico eficaz para mejorar la motivación intrínseca y extrínseca, el clima escolar y el rendimiento académico de los estudiantes
Modelo para predicción de resultado de la neurografía en el síndrome del túnel carpiano
Full text linkNeuropathy of the median nervecaused bytheentrapment of this nerveasit passesthrough the carpal tunnel is very common. Its symptoms and signs are known as carpal tunnel syndrome (CTS), whose diagnosticand therapeutic approach consumes important health resources as it is a highly prevalent pathology. Electroneurography (ENG) or neurographyisconsidered the gold standard in its evaluation, as it allows for quantifying the nerve injury degree, but the generalization of its use sometimes results in its performance even before a careful clinical evaluation and conservative treatment. A sensory and motor involvement of the nerve is usually a criterion for considering a surgical approach, leading to conservative treatment in the rest of the cases. We present a cohort of 816 patients referred to our service for ENG for suspected CTS. A clinical reassessment was carried out, classifying the symptoms as typical or atypical for CTS according to criteria, and ENG was performed in all cases. The correlation of a series of demographic and clinical characteristics of patients with a degree of sensory and motor involvement (≥ 3 on our scale) was studied and a statistical model was generated to predict the degree of neuropathy before ENG. Presenting typicalclinicalsymptoms, male gender,age over 50 years, bilateralsymptoms, or presenting them in the dominant hand, as well as positivity of Tinel’s sign and Phalen’s hand correlated with a higher degree of neuropathy.La neuropatía del nervio mediano ocasionada por el atrapamiento de este nervio a su paso por el túnel carpiano es muy frecuente. Sus síntomas y signos se conocen como síndrome del túnel carpiano (STC), cuyo abordaje diagnóstico y terapéutico consume importantes recursos sanitarios al tratarse de una patología muy prevalente. La electroneurografía (ENG) o neurografía se considera el patrón oro en su evaluación, pues permite cuantificar el grado de lesión del nervio, pero la generalización de su uso deriva, en ocasiones, a su realización previa, incluso, de una cuidadosa evaluación clínica y tratamiento conservador. Una afectación sensitiva y motora del nervio suele ser criterio para plantear abordaje quirúrgico, optando por el tratamiento conservador en el resto de los casos. Presentamos una cohorte de 816 pacientes remitidos a nuestro servicio para la realización de ENG por sospecha de STC. Se llevó a cabo una reevaluación clínica, clasificando los síntomas en típicos o atípicos para STC acorde a unos criterios, y se realizó ENG en todos los casos. Se estudió la correlación de una serie de características demográficas y clínicas de los pacientes con un grado de afectación sensitiva y motora (≥ 3 de nuestra escala) y se generó un modelo estadístico con la finalidad de poder predecir el resultado de la ENG antes de su realización. Presentar una sintomatología clínica típica, el género masculino, la edad superior a 50 años, la bilateralidad de los síntomas, o presentarlos en la mano dominante, así como la positividad del signo de Tinel y la manobra de Phalen, se correlacionaron con mayor grado de neuropatía