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      Autoestima y estilos de afrontamiento: predictores de la calidad de vida en personas con hemofilia Translated title: Self-esteem and coping skills: predictors of quality of life in patients with hemophilia

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          Abstract

          RESUMEN Introducción: La hemofilia es un trastorno hemorrágico que causa dolor y daños articulares graves. Las personas con esta condición de salud suelen presentar problemas psicosociales como baja autoestima y dificultad para enfrentar la enfermedad, lo cual puede impactar negativamente en su calidad de vida relacionada a la salud (CVRS). Objetivo: Analizar el efecto predictor de la autoestima y las estrategias de afrontamiento hacia la CVRS en personas con hemofilia. Métodos: Estudio cuantitativo, no experimental, de tipo correlacional, con muestra por conveniencia, realizado en 60 participantes con hemofilia, edades comprendidas entre 15 y 67 años (media = 27,43, desviación estándar = 11,32). Se utilizaron los cuestionarios: Calidad de Vida Específica para Hemofilia, Autoestima y Afrontamiento al Dolor Crónico. Se realizaron análisis descriptivos, correlación de Pearson y análisis de regresión lineal múltiple con el método por pasos. Resultados: Se obtuvo que el nivel de CVRS fue mayormente moderado; sin embargo, se observaron niveles bajos en las dimensiones Deporte y tiempo libre y Futuro. La dimensión Éxito de la escala de autoestima correlacionó positivamente con las dimensiones Deporte y tiempo libre (r(60)= 0,59), Salud física (r(60)=0,54) y Autopercepción (r(60)=0,48) de la escala calidad de vida; además de haber mostrado un nivel alto de predicción de la calidad de vida (R 2 = 0,35, p= 0,00). Conclusiones: Se comprobó que la autoestima resulta ser una variable predictora de la CVRS de los pacientes con hemofilia. Se requiere fortalecer la autoestima y la manera de enfrentarse ante el dolor crónico en personas con este padecimiento en pro de su calidad de vida y bienestar.

          Translated abstract

          ABSTRACT Introduction: Hemophilia is a bleeding disorder that causes severe pain and damage to the joints. People with this health condition often present psychosocial problems such as low self-esteem and difficulty facing their disease, which can negatively impact their health-related quality of life (HRQoL). Objective: To analyze the predictive effect of self-esteem and coping strategies towards HRQL in people with hemophilia. Methods: This was a quantitative, non-experimental, correlational study, with a convenience sample, carried out in 60 participants with hemophilia, ages between 15 and 67 years (mean = 27.43, standard deviation = 11.32). The Specific Quality of Life for Hemophilia, Self-esteem and Coping with Chronic Pain questionnaires were used. Descriptive analyzes. Pearson correlation and multiple linear regression analysis were performed with the stepwise method. Results: It was found that the level of HRQL was mostly moderate, however, low levels were observed in the Sports and free time and Future dimensions. The Success dimension of the self-esteem scale positively correlated with the Sports and free time dimensions (r(60) = 0.59). Physical health (r(60) = 0.54) and Self-perception (r(60) = 0.48) of the quality of life scale, in addition to having shown a high level of prediction of quality of life (R2 = 0.35, p = 0.00). Conclusions: It was found that self-esteem turns out to be a predictor variable of HRQL in patients with hemophilia. It is necessary to strengthen self-esteem and the way of coping with chronic pain in people with this condition in favor of their quality of life and well-being.

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          The impact of changing attitudes, norms, and self-efficacy on health-related intentions and behavior: A meta-analysis.

          Several health behavior theories converge on the hypothesis that attitudes, norms, and self-efficacy are important determinants of intentions and behavior. However, inferences regarding the relation between these cognitions and intention or behavior rest largely on correlational data that preclude causal inferences. To determine whether changing attitudes, norms, or self-efficacy leads to changes in intentions and behavior, investigators need to randomly assign participants to a treatment that significantly increases the respective cognition relative to a control condition, and test for differences in subsequent intentions or behavior. The present review analyzed findings from 204 experimental tests that met these criteria.
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            Joint disease in haemophilia: Pathophysiology, pain and imaging

            Haemarthroses cause major morbidity in patients with haemophilia. Blood has devastating effects on all joint components, resulting in synovitis, osteochondral degeneration and ultimately end-stage haemophilic arthropathy. Key players in this process are iron and inflammation. Preventing joint bleeds is of utmost importance to maintain joint health as targeted therapies directed against blood-induced inflammation and iron-mediated processes are lacking. Joint bleeds result in acute pain as well as chronic pain due to synovitis or arthropathy. Acute pain originates from nociceptors activated by tissue damage. In chronic inflammation, central and peripheral sensitization of nociceptors might occur resulting in chronic pain. This also triggers a series of brain disorders such as emotional fear, anxiety, mood depression and impairment of cognitive functions. Treatment of haemophilia-related pain not only consists of analgesics, but also of exercise, education and in selected cases antidepressants and anticonvulsants. For objective assessment of joint structural outcome and detecting earlier changes of haemophilic arthropathy, both ultrasound (US) and magnetic resonance (MR) imaging have shown valuable. Both can be considered equally able to reveal signs of disease activity. MR imaging is able to visualize haemosiderin deposition and is more comprehensive in depicting osteochondral changes. Disadvantages of MR imaging are the duration of the examination, evaluation of a single joint at a time, costs and may require sedation, and it may need intraarticular contrast injection to depict initial osteochondral changes with accuracy. As such, US is a more useful screening tool and can be used for repeated follow-up examinations.
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              Principles of Correlation Analysis.

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                Author and article information

                Journal
                hih
                Revista Cubana de Hematología, Inmunología y Hemoterapia
                Rev Cubana Hematol Inmunol Hemoter
                Editorial Ciencias Médicas (Ciudad de la Habana, , Cuba )
                0864-0289
                1561-2996
                June 2022
                : 38
                : 2
                : e1503
                Affiliations
                [2] orgnameUniversidad Autónoma del Estado de México Mexico
                [1] orgnameUniversidad Autónoma de Baja California Mexico
                [3] orgnameUniversidad Iberoamericana Mexico
                Article
                S0864-02892022000200006 S0864-0289(22)03800200006
                42f6e633-eb94-4ed3-a194-be2b816c68e1

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 11 June 2021
                : 30 September 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 25, Pages: 0
                Product

                SciELO Cuba

                Categories
                ARTÍCULOS ORIGINALES

                autoestima,hemophilia A,hemophilia B,quality of life,self-esteem,chronic pain,hemofilia A,hemofilia B,calidad de vida,dolor crónico

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