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Background: The highly stressful events we are currently experiencing require great cognitive and emotional effort and affect the mental health of the population. In this sense, coping with stress provides evidence of how people use their resources to cope with or avoid stressful events, which requires validated and reliable instruments to measure accurately. Objective: To determine the psychometric properties of reliability and validity of the BRIEF COPE 28, Spanish version. Method: The design used was instrumental; 530 people participated, 60% men and 40% women, between 18 and 60 years old, from different regions of Peru, selected by non-probability convenience sampling. Results: It is evident that the alpha coefficient of coping styles ranges from α ordinal = 0.74 to 0.82; while in strategies it was between α ordinal = 0.59 to 0.90. In terms of internal structure, the four-factor model obtained a good fit SB-χ²/gl=1.836; CFI=0.92; TLI=0.90, SRMS=0.09 and RMSEA=0.10. A good fit was found with the ten coping strategies model SB-χ²/gl=1.902; CFI=0.96; TLI=0.95, SRMS=0.056, RMSEA=0.069. Conclusion: COPE 28 has good internal consistency; and the model with the four coping styles is inconclusive, while the model with ten strategies has adequate goodness of fit.

Introducción: Los acontecimientos altamente estresantes que vivimos actualmente demandan gran esfuerzo cognitivo y emocional y afectan la salud mental de la población; en este sentido el afrontamiento al estrés proporciona evidencia de cómo las personas recurren a sus recursos para afrontar o evadir los eventos estresantes, lo cual necesita de instrumentos validados y confiables para medirlo con precisión. Objetivo: Determinar las propiedades psicométricas de confiabilidad y validez del BRIEF COPE 28, versión española. Método: El diseño usado fue instrumental; participaron 530 personas, 60% varones y 40% mujeres, entre 18 y 60 años, de distintas regiones del Perú, seleccionadas con el muestreo no probabilístico por conveniencia. Resultados: Se evidencia que el coeficiente alfa de los estilos de afrontamiento oscila entre α ordinal=0.74 a 0.82; mientras que en las estrategias fue entre α ordinal=0.59 a 0.90. En cuanto a la estructura interna, el modelo de cuatro factores obtuvo buen ajuste de bondad SB-χ²/gl=1.836; CFI=0.92; TLI=0.90, SRMS=0.09 y RMSEA=0.10. Asimismo, se encontró buen ajuste con el modelo de 10 estrategias de afrontamiento SB-χ²/gl=1.902; CFI=0.96; TLI=0.95, SRMS=0.056, RMSEA=0.069. Conclusión: El COPE 28 tiene buena consistencia interna; y que el modelo con los cuatro estilos de afrontamiento no es concluyente; mientras el modelo con 10 estrategias tiene adecuado ajuste de bondad.

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This is a mixed-methodology controlled clinical study that assessed the effect of the Health Lifestyle Deck of cards as a Cognitive-Behavioral Group Therapy tool for obese adults. Method The sample was divided into two groups: Intervention group and Intervention+Deck. The therapy was interdisciplinary handled by psychology, nutrition and physical education professionals, along 12 sessions. The following measures were performed: anthropometric assessment, indicators of binge eating, depression, anxiety and stress, quality of life, self-efficacy for eating habits, and physical activity at the beginning and the end of the intervention. Participants' written and verbal reports' content was analyzed. Results The results were: a reduction in body mass, binge eating, and improvement of self-efficacy to regulate eating habits in both groups. There was an improvement in the psychological domain of quality of life only in the Intervention+Deck group. Conclusion The study concluded that the intervention favored participants' cognitive and behavioral changes.

Este estudo clínico controlado de metodologia mista avaliou o efeito do Baralho do Estilo de Vida como ferramenta da Terapia Cognitivo-comportamental em grupo de adultos com obesidade. Método A amostra foi dividida em dois grupos: grupo Intervenção e grupo Intervenção+Baralho. A terapia foi interdisciplinar com profissionais da psicologia, nutrição e educação física e foram realizadas 12 sessões. As avaliações realizadas foram: avaliação antropométrica, indicadores de compulsão alimentar, depressão, ansiedade e estresse, qualidade de vida, autoeficácia para hábito alimentar e atividade física no início e no fim da intervenção. Foi realizada análise de conteúdo dos relatos verbais e por escrito dos participantes. Resultados Neste sentido, verificou-se redução da massa corporal, da compulsão alimentar e melhora da autoeficácia para regular o hábito alimentar nos dois grupos. Houve melhora no domínio psicológico da qualidade de vida apenas no grupo Intervenção+Baralho. Conclusão O estudo concluiu que a intervenção favoreceu mudanças cognitivas e comportamentais dos participantes.

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Chronic pelvic pain (CPP) in women is a highly prevalent condition worldwide and requires multimodal treatment. Adverse childhood experiences have been associated with CPP in women, while allodynia and poor outcomes have been linked to pain catastrophizing in these patients. Pain perception has been associated with parenting style during childhood. The objective of this study was to investigate the association between parenting style, pain catastrophizing, anxiety, depression and CPP in women. A case-control study was conducted between May 2018 and August 2021 with 123 women with CPP and 123 pain-free controls. Questionnaires were used to collect participants' data. The association between parenting style and CPP was assessed using multiple logistic regression, with odds ratios (OR) and 95% confidence intervals (CI) being calculated. The correlation between catastrophizing, pain intensity, pain duration, anxiety, depression, and parenting style in women with CPP was assessed using Spearman's rank correlation coefficient (r). A higher frequency of low maternal care (60.7% versus 45.2%; p = 0.026), anxiety (79.7% versus 56.9%; p < 0.001), depression (73.2% versus 56.1%; p = 0.008) and physical violence (31.7% versus 14.6%; p = 0.003) was found in the CPP group compared to the controls. There was no association between parenting style and CPP in the adjusted analysis. A positive correlation was found between catastrophizing and pain intensity (r = 0.342; p < 0.001), anxiety (r = 0.271; p = 0.002), depression (r = 0.272; p = 0.002), and maternal overprotection (r = 0.185; p = 0.046). A negative correlation was found between anxiety and maternal (r = -0.184; p = 0.047) and paternal (r = -0.286; p = 0.006) care and between depression and maternal (r = -0.219; p = 0.018) and paternal (r = -0.234; p = 0.026) care. The present results suggest a significant but weak association of parenting style with pain catastrophizing, the mental health of women with CPP, and the way in which they experience pain.

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Resumo: Introdução: A pandemia da Covid-19 trouxe diversos desafios para as instituições de ensino superior (IES) de todos os países. Nesse contexto, destacou-se a necessidade de reestruturação do processo de ensino-aprendizagem de forma a garantir a aquisição real de conhecimentos, bem como o desenvolvimento de métodos de estudo para que os discentes conseguissem conviver com o ensino remoto emergencial (ERE) e seus contratempos. Objetivo: Este estudo teve como objetivo investigar como ocorreu o estudo dirigido e a percepção dos discentes quanto aos ganhos de habilidades de autogestão durante o ERE. Método: Trata-se de um estudo transversal quantitativo e qualitativo, realizado com 93 estudantes de Medicina de diferentes IES brasileiras. Utilizou-se questionário semiestruturado para a coleta dos dados. Os dados foram processados no software Iramuteq, e utilizaram-se análise de similitude e nuvem de palavras, além de estatística descritiva. Resultado: Em relação ao tempo dedicado ao estudo dirigido, 59,1% dos estudantes relataram que o estabeleceram, e 57,0% afirmaram que traçaram estratégias para melhor geri-lo; 68,8% mencionaram que perceberam diferenças ao compararem os métodos de fixação de conteúdo utilizados antes e durante no ERE, e, desses, 70,3% consideraram que essas novas técnicas foram eficientes. Na análise qualitativa, analisaram-se seis corpora monotemáticos, relacionados à opinião sobre o que auxiliou e o que prejudicou a gestão das emoções e do tempo, quais estratégias de fixação de conteúdo foram utilizadas e quais habilidades de autogestão foram desenvolvidas no período do ERE. Conclusão: Evidenciou-se que, apesar das dificuldades encontradas, elas foram superadas com a adoção de estratégias centradas no desenvolvimento de habilidades de autogestão de tempo, emoções e fixação de conteúdo por parte dos estudantes, e, dessa forma, pode-se inferir que eles perceberam o desenvolvimento de algumas das habilidades essenciais para superar os novos e recentes desafios impostos pelas mudanças no planeta, como organização pessoal, dos estudos e do tempo, além das relacionadas às emoções e ao gerenciamento de recursos tecnológicos.

Abstract: Introduction: The Covid-19 pandemic presented several challenges to Higher Education Institutions (HEIs) in all countries. In this context, there is a prominent need to restructure the teaching-learning process in order to guarantee genuine knowledge acquisition, as well as the development of study methods to enable students to deal with the emergency remote teaching (ERT) and its setbacks. Objective: To investigate directed study was implemented and how students viewed the gains in self-management skills during ERT. Method: Quantitative and qualitative cross-sectional study, conducted with 93 medical students from different Brazilian HEIs. A semi-structured questionnaire was used for data collection. The data were processed using the IRAMUTEQ software, similarity analysis and word cloud, in addition to the use of descriptive statistics. Results: In relation to the time dedicated to directed study, 59.1% of the students reported having established it and 57.0% said they had outlined strategies to better manage this time; 68.8% reported having perceived differences when comparing the learning consolidation methods used before and during ERT and, of these, 70.3% considered that these new techniques were efficient. In the qualitative analysis, six monothematic corpora were analysed, relating to opinions on what helped and what hindered emotional and time management, which learning consolidation strategies were used and which self-management skills were developed during ERT. Conclusion: It was demonstrated that the difficulties encountered were overcome through the adoption of strategies to help students develop self-management skills in relation to time, emotions and learning consolidation. It can therefore be inferred that students successfully mastered some of the essential skills to overcome new and recent challenges imposed by changes in the world, such as their personal organization, studies and time, in addition to those related to emotions and management of technological resources.

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ABSTRACT Objective: To analyze normative acts on coping with COVID-19 in the teaching environment, sanctioned by the state and federal governments of Brazil. Methods: Documentary research, with a qualitative approach to documents published by federal and state education and health bodies between March/2020 and March/2021, analyzed according to Bardin's Document Analysis framework. Results: From 61 documents, four categories resulted: Acts and strategies to protect against COVID19 adopted by the federal government; Normative acts of state governments on suspension of classes; Strategies to protect against COVID-19 in the teaching environment common among Brazilian states; Strategies to protect against COVID-19 in the teaching environment specific to Brazilian states. Final considerations: The normative acts analyzed present weaknesses regarding the clarification on how to establish the systematization of COVID-19 surveillance actions in the teaching environment, as well as there is a lack of reflections on the importance of such actions.

RESUMEN Objetivo: Analizar actos normativos sobre enfrentamiento de la COVID-19 en instituciones académicas, sancionados por los gobiernos estatales y federal de Brasil. Métodos: Investigación documental, con abordaje cualitativo de documentos publicados por órganos federales y estatales de la educación y de la salud entre marzo/2020 y marzo/2021, analizados conforme el referencial de Bardin de Análisis Documental. Resultados: De 61 documentos, resultaron cuatro categorías: Actos y estrategias de protección contra la COVID-19 adoptadas por el gobierno federal; Actos normativos de gobiernos estatales sobre suspensión de clases; Estrategias de protección contra la COVID-19 en instituciones académicas comunes entre estados brasileños; Estrategias de protección contra la COVID-19 en instituciones académicas específicas de estados brasileños. Consideraciones finales: Los actos normativos analizados presentan fragilidades cuanto al esclarecimiento sobre como establecer la sistematización de las acciones de vigilancia de la COVID-19 en instituciones académicas, así como hay escasez de reflexiones acerca de la importancia de tales acciones.

RESUMO Objetivo: Analisar atos normativos sobre enfrentamento da COVID-19 no ambiente de ensino, sancionados pelos governos estaduais e federal do Brasil. Métodos: Pesquisa documental, com abordagem qualitativa de documentos publicados por órgãos federais e estaduais da educação e da saúde entre março/2020 e março/2021, analisados de acordo com o referencial de Bardin de Análise Documental. Resultados: De 61 documentos, resultaram quatro categorias: Atos e estratégias de proteção contra a COVID-19 adotadas pelo governo federal; Atos normativos de governos estaduais sobre suspensão de aulas; Estratégias de proteção contra a COVID-19 no ambiente de ensino comuns entre estados brasileiros; Estratégias de proteção contra a COVID-19 no ambiente de ensino específicas de estados brasileiros. Considerações finais: Os atos normativos analisados apresentam fragilidades quanto ao esclarecimento sobre como estabelecer a sistematização das ações de vigilância da COVID-19 no ambiente de ensino, bem como há escassez de reflexões acerca da importância de tais ações.

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Abstract Playing sports during youth has been considered one of the main tools for the development of life skills. Thus, this cross-sectional study investigated the association between the development of life skills and coping strategies in 134 young athletes of both sexes in the state of Pernambuco, Brazil. The instruments used were the Sports Life Skills Scale and Coping Skills Inventory-28 (ACSI-28BR). Data analysis was performed using Pearson's correlation and Multiple Regression (p<0.05). The results showed a significant (p<0.05) and positive correlation between the life skills subscales and coping strategies. Multiple regression analyses found that total life skills development (a summative score of all eight life skills scores) was positively related to coping skills-providing support for the "pile-up" effect. It was concluded that a range of life skills development is positively associated with the coping strategies of young athletes, possibly helping these young people to show more confidence and motivation to achieve better performances in training and competitions.

Resumo A prática de esportes durante a juventude tem sido considerada uma das principais ferramentas para o desenvolvimento de habilidades para a vida. Assim, esse estudo transversal investigou a associação entre o desenvolvimento de habilidades para vida e estratégias de coping em 134 jovens atletas de ambos os sexos do estado de Pernambuco, Brasil. Os instrumentos utilizados foram a Escala de Habilidades para a Vida Esportiva e Coping Skills Inventory-28 (ACSI-28BR). A análise dos dados foi realizada por meio da correlação de Pearson e Regressão Múltipla (p<0,05). Os resultados mostraram correlação significativa (p<0,05) e positiva entre as subescalas de habilidades para a vida e as estratégias de coping. Análises de regressão múltipla encontradas que o desenvolvimento total de habilidades para a vida (uma pontuação somativa de todas as oito pontuações de habilidades para a vida) foi positivamente relacionado as habilidades de coping- fornecendo suporte para o efeito de "empilhamento". Concluiu-se que uma gama de desenvolvimento de habilidades para vida está positivamente associada às estratégias de coping dos jovens atletas, possivelmente contribuindo para que esses jovens se mostrem mais confiantes e motivados a conseguirem melhores desempenhos nos treinos e competições.

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La declaración de la pandemia (Organización Mundial de la Salud, OMS, 2020) causada por el COVID-19 ha generado, a nivel global y en tiempo récord, investigaciones y publicaciones de evidencias preliminares. En este contexto, dentro de un diseño exploratorio, correlacional y comparativo, de corte transversal, se indaga comportamientos de riesgo y de protección (resiliencia, autoeficacia y afrontamiento) ante el COVID 19, percibidos individual y colectivamente, por los encuestados durante y post cuarentena. Participaron 1.134 encuestados, 31.48% hombres y 68.52% mujeres, con edad promedio de 30.18 años, el 94.4% residentes de Paraguay. Se destaca el acatamiento de normas de bioseguridad por parte de los participantes en el distanciamiento físico (62,17%), lavado regular de manos (89,8%), uso de tapabocas (81,13%). Existe acuerdo en la efectividad de la cuarentena para frenar el contagio (92,86%), pero una baja percepción de la capacidad para manejar el estrés individual en aislamiento (m=1.88; ds= .83), baja recurrencia a profesionales de la salud por ayuda (m= .86; s= 1.02), y un bajo nivel de afrontamiento en comparación a los otros factores preventivos (m= 10.61; ds=3.25). Importante seguir esta línea de investigación para las fases de confinamiento en proceso.

The declaration of the pandemic (WHO, 2020) caused by COVID-19 has generated, at a global level and in record time, investigations and publications of preliminary evidence. In this context, risk and protective behaviours (resilience, self-efficacy and coping) were investigated, perceived individually and collectively, by respondents during and after lockdown within an exploratory, correlational, and comparative, crosssectional design. The survey considered 1,134 respondents, with 31.48% men and 68.52% women, the average age was 30.18 years, and 94.4% were Paraguay residents. The study highlights the observance of biosafety regulations by the participants in terms of physical distance (62.17%), regular handwashing (89.8%) and use of face masks (81.13%). There is agreement on the effectiveness of lockdown to stop contagion (92.86%), but a low perception of the ability to handle individual stress in isolation (m = 1.88; ds = .83), low recurrence to health professionals for help (m = .86; s = 1.02), and a low level of coping compared to the other preventive factors (m = 10.61; ds = 3.25). It is important to follow this investigation line for the current lockdown phases.

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Resumen El incremento de riesgos hidrometereológicos causados por el cambio climático ha llevado consigo la necesidad de fortalecer las capacidades adaptativas de afrontamiento. Bajo este contexto, el objetivo del presente estudio fue esclarecer la relación entre la experiencia directa y las capacidades activas de afrontamiento, considerando tres posibles mediadores: la severidad subjetiva, la percepción del riesgo y la implicancia personal. Para esto, se obtuvo una muestra por conveniencia (n = 490) de una ciudad chilena afectada por aluviones. Como resultado, si bien todas las variables correlacionaron directamente con las capacidades activas (entre r = .13 y r = .49), la relación principal solo estuvo mediada por el temor al riesgo y la identificación y posibilidad de acción; por tanto, se concluye que la experiencia directa previa, el miedo y la autoeficacia percibida impulsarían comportamientos precautorios activos frente al riesgo aluvional.

Abstract The increase of hydro-meteorological risks, caused by climate change, has brought with it the need to strengthen adaptive coping capacities. In this context, the aim of the present study was to clarify the relationship between direct experience and active coping capacities, considering three possible mediators: subjective severity, risk perception and personal involvement. For this purpose, a convenience sample (n = 490) was obtained from a Chilean city affected by alluvium. Although all variables directly correlated with active capabilities (between r = .13 and r = .49), the main relationship was only mediated by i) fear for risk and ii) identification and possibility of action. Therefore, it is concluded that previous direct experience, fear and perceived self-efficacy, would drive active precautionary behaviors in the face of alluvial risk.

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Objective: to explore self-perception competence among Spanish nurses dealing with patient death and its relationship with work environment, evidence-based practice, and occupational stress. Method: a cross-sectional web-based survey collected information from a convenience sample of 534 nurses from professional Spanish Colleges who answered four validated questionnaires: Coping with Death Scale, Practice Environment Scale of the Nursing Work Index, Perception of Evidence-Based Practice (EBP) and Nursing Stress Scale. Results: a total of 79% of the participants were women, the average age was 40 years old, 38% had a postgraduate degree and 77% worked in public health settings. Many nurses evaluated their work environment as unfavorable (66%), reported high occupational stress (83.5±14.9), and had high scores on knowledge/skills in EBP (47.9±11.3). However, 61.2% of them perceived an optimal coping (>157 score). The multivariate logistic model indicated positive associations with work environment and EBP characteristics (OR: 1.30, p=0.054; OR: 1.04, p=0.007; OR: 1.13, p<0.001, respectively) but negative associations with occupational stress and short work experience (OR: 0.98, p=0.0043; OR: 0.74, p<0.002, respectively). These factors explained 23.1% of the coping variance (p<0.001). Conclusion: although most nurses perceived optimal coping, the situation could be enhanced by modifying several contextual factors. The identification of these factors would improve the quality of end-of-life care by facilitating nursing management.

Objetivo: explorar a capacidade de autopercepção entre enfermeiros espanhóis que lidam com a morte do paciente e sua relação com o ambiente de trabalho, a prática baseada em evidências e o estresse ocupacional. Método: pesquisa transversal pela internet coletou informações de uma amostra de conveniência de 534 enfermeiros das Faculdades Profissionais Espanholas que responderam a quatro questionários: Escala de Enfrentamento da Morte, Escala Ambiente de Trabalho da Prática de Enfermagem, Percepção da Prática Baseada em Evidências (EBP, acrônimo em inglês) e Escala de Estresse em Enfermagem. Resultados: 79% das participantes eram mulheres com média de 40 anos, 38% tinham pós-graduação e 77% trabalhavam em ambiente de saúde pública. Muitos enfermeiros avaliaram seu ambiente de trabalho como desfavorável (66%), relataram alto estresse ocupacional (83,5 ± 14,9) e altas pontuações em conhecimento/habilidades em EBP (47,9 ± 11,3). No entanto, 61,2% deles consideraram um enfrentamento ótimo (pontuação >157). O modelo logístico multivariado indicou associações positivas com o ambiente de trabalho e as características da EBP (OR: 1,30, p = 0,054; OR: 1,04, p = 0,007; OR: 1,13, p < 0,001, respectivamente), mas negativas com estresse ocupacional e curta experiência de trabalho (OR: 0,98, p = 0,0043; OR: 0,74, p < 0,002, respectivamente). Esses fatores explicaram 23,1% da variância de enfrentamento (p < 0,001). Conclusão: embora a maioria dos enfermeiros considerasse um enfrentamento ótimo, a situação poderia ser melhorada pela modificação de vários fatores contextuais. A identificação desses fatores melhoraria a qualidade da assistência no final da vida, facilitando a gestão da enfermagem.

Objetivo: explorar el afrontamiento autopercibido por los profesionales españoles de enfermería para trabajar con pacientes moribundos y su relación con el entorno laboral, la práctica clínica y el estrés ocupacional. Método: estudio observacional transversal vía internet de una muestra de conveniencia con 534 enfermeros reclutados a través de colegios profesionales españoles que respondieron a cuatro cuestionarios validados: Escala de Afrontamiento de la Muerte, Entorno de la Práctica Enfermera, Práctica Basada en la Evidencia en Enfermería (PBE) y Escala de Estrés para Enfermería. Resultados: la mayoría de los participantes fueron mujeres (79%), de 40 años de media, con estudios de posgrado (38%) y trabajando en el sistema público (77%). Gran parte evaluó su ambiente de trabajo como desfavorable (66%), mostrando estrés ocupacional (83,5 ± 14,9) y altas puntuaciones en conocimiento/habilidades-PBE (47,9 ± 11,3). Sin embargo, el 61,2% autopercibía un afrontamiento óptimo (> 157 puntos). El análisis de regresión logística multivariante mostró que el afrontamiento se asociaba positivamente con el entorno laboral y dos subescalas-PBE (OR: 1,30, p= 0,054; OR: 1,04, p= 0,007; OR: 1,13, p <0,001, respectivamente), pero negativamente con el estrés ocupacional y la poca experiencia laboral (OR: 0,98, p= 0,0043; OR: 0,74, p <0,002, respectivamente). Estos factores explicaban el 23,1% de la varianza (p <0.001). Conclusión: aunque la mayoría de los enfermeros percibían un afrontamiento óptimo, la situación podría mejorarse modificando algunos factores. La identificación de estos factores mejoraría la calidad de la atención de los pacientes al final de la vida, facilitando la gestión de enfermería.

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Resumen En este artículo se analiza la relación existente entre los recuerdos traumáticos y las posibles estrategias para hacerles frente. Los recuerdos traumáticos son difíciles de integrar en la biografía de las personas afectadas y pueden interferir de forma significativa en su funcionamiento social, académico y profesional. Se distingue psicopatológicamente entre los recuerdos normales y los recuerdos traumáticos. Asimismo se analizan las estrategias de afrontamiento adaptativas, tales como la evitación cognitiva, la exposición terapéutica a los recuerdos traumáticos o la capacidad de perdón. Pero también hay un afrontamiento inadaptativo (nostalgia, sentimientos de odio y de venganza o conductas autodestructivas) que puede dar cuenta de las dificultades de recuperación en algunos pacientes. Por último, se examinan las estrategias de regulación emocional cognitiva y el papel de la resiliencia y del crecimiento postraumático para afrontar los recuerdos traumáticos. Se comentan las implicaciones de este estudio para investigaciones futuras en esta área.

Abstract In this paper the relationship between traumatic memories and coping skills to deal with them is analyzed. Traumatic memories are difficult to be integrated into the survivor's life story and can significantly interfere with social, educational and occupational functioning. From a psychopathological point of view, a distinction between normal and traumatic memories is made. Adaptive coping skills to deal with traumatic memories, such as cognitive avoidance, therapeutic exposure to traumatic memories or forgiveness, are analyzed. But there is also maladaptive coping, such as nostalgia, hate and revenge feelings or self-destructive behaviors, which should be taken into account to explain the difficulties of recovery in some patients. Finally, the cognitive emotion regulation strategies and the role of resiliency and post-traumatic growth in some patients to cope with traumatic memories are examined. Implications of this study for future research in this field are commented upon.

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Introducción: La utilización el COPE en contextos clínicos permite conocer las estrategias que utilizan las personas para afrontar situaciones estresantes y por ende incidir sobre ellas mediante tratamiento psicológico. Objetivo: presentar a la comunidad científica de habla hispana la versión española del COPE-48 junto con las propiedades psicométricas obtenidas en una muestra de personas adultas con psicopatología. Métodos: la muestra estuvo formada por 301 participantes (62.5% mujeres). Resultados: la consistencia interna media de las escalas es de 0.81. Nuestros resultados muestran un patrón diferencial en la utilización de las estrategias según el género. Conclusiones: la administración del COPE-48 en contextos clínicos es de gran utilidad práctica, puesto que permite conocer de modo rápido, fácil y preciso las estrategias más frecuentemente utilizadas por los pacientes para afrontar situaciones altamente demandantes. Dicho conocimiento permite intervenir mediante tratamiento psicológico para instaurar, potenciar o minimizar las estrategias necesarias para afrontar una determinada situación comprometida.

Introduction: In clinical settings, the COPE questionnaire allows to assess the strategies people use to cope with stressful situations and therefore, if needed, to modify them through psychological treatment. Objective: The aim of this study is to offer to the Spanish-speaking scientific community the Spanish version of the COPE-48 along with the psychometric properties obtained in a sample of adults with psychopathology. Material and Methods: The sample consisted of 301 participants (62.5% women). Results: The average internal consistency of the scales was 0.81. Our results showed a gender pattern in the use of the coping strategies. Conclusions: In clinical settings, the administration of the COPE-48 allows a quick, easy and accurate assessment of the most frequently used strategies to cope with highly demanding situations. This knowledge makes possible to intervene with psychological treatment and whenever appropriate to establish, enhance or minimize the strategies needed to face difficult situations.

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RESUMEN Objetivo: Analizar la relación de la carga y las estrategias de afrontamiento con las características demográficas de los cuidadores de personas con esquizofrenia, así como las variables demográficas y clínicas de los pacientes. Métodos: Estudio transversal correlacional multicéntrico en el que se evaluó a 70 personas diagnosticadas de esquizofrenia o trastorno esquizoafectivo y 70 cuidadores informales primarios con la escala de sobrecarga del cuidador de Zarit, el cuestionario de estrategias familiares de afrontamiento, la escala para la evaluación de síntomas positivos, la escala para la evaluación de síntomas negativos y la escala breve de evaluación de la discapacidad. Resultados: En este estudio, la carga se correlacionó positivamente con el deterioro del funcionamiento ocupacional y social y presentó asociación negativa con la escolaridad de los pacientes. El escape, la coerción y la comunicación positiva presentaron correlaciones positivas con el deterioro del funcionamiento ocupacional y social de los pacientes. Asimismo, el interés social y las amistades mostraron asociación positiva con la escolaridad de los cuidadores. Además, la ayuda espiritual presentó correlaciones negativas con el deterioro del funcionamiento social y la edad de los pacientes, y la resignación se correlacionó negativamente con la duración del trastorno y la escolaridad de los pacientes. Conclusiones: La carga y la adopción de estrategias de afrontamiento disfuncionales, como el escape y la coerción, se asocian con el deterioro del funcionamiento de los pacientes. Estos hallazgos indican la necesidad de brindar a los cuidadores apoyos ajustados al nivel de funcionamiento del paciente que prevengan la carga del cuidado.

ABSTRACT Objective: To analyze of the relationship between burden of illness and coping strategies and the demographic variables of caregivers, and the demographic and clinical variables of people diagnosed with schizophrenia. Methods: Multicentre correlational cross-sectional study including 70 people diagnosed with schizophrenia, or a schizoaffective disorder, and 70 primary informal caregivers. They were evaluated using Zarit Caregiver Burden Inventory, Family Coping Strategies Questionnaire, Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, and the brief Disability Assessment Scale. Results: Burden of illness positively associated with patient impairment in occupational and social functioning, and negatively with education level. Avoidance, coercion and positive communication were positively associated with impairment in occupational and social functioning of patients. Social interest and friendships showed a positive association with the education level of caregivers. Spiritual assistance negatively correlated with impairment in social functioning and patient age, and resignation was negatively associated with length of the disorder and patient education level. Conclusions: Burden and dysfunctional coping strategies, such as avoidance and coercion, are associated with functional impairment of the patient. These findings suggest the need to provide support to caregivers, adjusted to the functional level of the patient, in order to prevent burden of care.

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BACKGROUND: Attention to the role of context in shaping individuals' coping strategies is necessary. This study used the Salutogenic Model (SM) as a framework to identify the coping strategies of oral health profession students from three countries. METHODS: Students from Australia, New Zealand and Chile were invited to participate in this cross-sectional study, and were given a questionnaire including socio-demographics, the Perceived Stress Scale, The SOC-13 and the Brief COPE. Descriptive analysis, correlation analysis and profile analysis were computed using SPSS v 20.0. RESULTS: Eight-hundred and ninety-seven valid questionnaires were returned, achieving a 44 % response rate. The coping dimension that the participants most commonly reported using was "Active Coping" with a mean value of 5.9 ± 1.5. Chilean respondents reported higher stress levels (19.8 vs. 17.7) and a lower Sense of Coherence (55.6 vs. 58.0) compared to Australian/New Zealand participants (p < 0.001). The SOC was positively correlated with active coping (p < 0.01) and positive reframing (p < 0.01). Profile analysis showed that when the differences in responses by sex were accounted for, there was no significant effect by country on the coping strategies used (p < 0.32). CONCLUSION: This initial investigation provides insights into the students' coping strategies and the validity of the SM. Students reporting high SOC scores where those who demonstrated the use of active coping and positive reframing as strategies to deal with stressful situations, which indicates the accuracy of the theoretical framework of the SM in health education environments. The results also suggest that a distinctive coping strategy pattern may apply to all participants, regardless of their country and sex.

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Objetivo Desarrollar un instrumento destinado a evaluar las estrategias de afrontamiento ante la enfermedad crónica en población adolescente. Sujetos y método Con base a una revisión teórica y entrevistas semiestructuradas a adolescentes, se construye un cuestionario que es finalmente evaluado por jueces expertos en tanto comprensión, pertinencia y viabilidad. Resultados Se propone una escala compuesta por 60 reactivos agrupados en 12 familias de afrontamiento. Conclusión La escala puede ser una herramienta útil para un clínico al entregar información clave sobre la vivencia y las formas de afrontar la enfermedad en un adolescente.

Objective To develop a tool to evaluate coping strategies for chronic illness in adolescents. Subjects and method Based on a theoretical review and semi-structured interviews with adolescents, a questionnaire was prepared that was finally evaluated by judges experienced in in understanding, relevance and viability. Results A scale is proposed that consists of 60 items grouped into 12 coping families. Conclusion The scale may be a useful clinical tool to provide key information about the experience and ways to cope with illness in adolescents.

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OBJECTIVE: To develop a tool to evaluate coping strategies for chronic illness in adolescents. SUBJECTS AND METHOD: Based on a theoretical review and semi-structured interviews with adolescents, a questionnaire was prepared that was finally evaluated by judges experienced in in understanding, relevance and viability. RESULTS: A scale is proposed that consists of 60 items grouped into 12 coping families. CONCLUSION: The scale may be a useful clinical tool to provide key information about the experience and ways to cope with illness in adolescents.

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El estrés y los trastornos emocionales en los estudiantesconstituyen unaproblemática importante a nivel mundial, sobre todo en las escuelas de medicina. Objetivos: Determinar los niveles de estrés, manifestaciones psicosomáticas y estrategias de afrontamiento en estudiantes de medicina de primero, cuarto y séptimo año de una Universidad Privada de Lima en el año 2012. Material y Métodos: Estudio descriptivo, de corte transversal, con una muestra de 187 alumnos formada por 52,9 % varones y 47,1 mujeres, con una media de edades de 23,34 ± 1,70 años. Se utilizó análisis de frecuencias y porcentajes por sexo y año de estudio. El Test Exacto de Fisher se empleó para evaluar las relaciones entre estrategias de afrontamiento, niveles de estrés y manifestaciones psicosomáticas. Resultados: La prevalencia de estrés académico alcanzó el 77,54 %; los estudiantes de séptimo año obtuvieron los mayores niveles, presentando los varones niveles de estrés más bajos respecto a las mujeres. El estresor más frecuente fue la sobrecarga de trabajos y evaluaciones de los profesores. La habilidad asertiva e implementación de un plan fueron las estrategias de afrontamiento más frecuentemente usadas por estudiantes con bajo nivel de estrés. Conclusiones: La frecuencia de recurrencia de manifestaciones psicosomáticas fue moderada a predominio de reacciones psicológicas en ambos sexos y en los tres años de estudio. Se sugiere la evaluación del estrés en estudiantes bajo terapia antidepresiva.

Stress and emotional disorders in students are a problem worldwide, especially in medical schools. Objectives: Determine the stress levels, psychosomatic manifestations and coping strategies in medical students from first, fourth and seventh year of a Private University in Lima, in 2012 academic year. Materials and Methods: A descriptive, cross-sectional study, with a sample of 187 students, that included 52.9% males and 47.1 % females, with a mean age of 23.34 ± 1.70 years. Analysis of frequencies and percentages by sex and year of study was used. The Fisher Exact test was performed to evaluate the relationships between coping strategies, levels of stress and psychosomatic manifestations. Results: The prevalence of academic stress reached 77.54%, the seventh grade students had the highest levels meanwhile males had lower stress levels as compared to women. The most common stressor was work overload and teacher evaluations. Assertive skills and implementation of a plan were the coping strategies most frequently used by students with low stress levels. Conclusions: The recurrence frequency of psychosomatic manifestations was moderate, with predominance of psychological reactions in both gender and in all three years of study. Further research is needed for the evaluation of medical students under antidepressant therapy.

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O objetivo desse estudo é apresentar o desenvolvimento do Role-Playing Game (RPG) Desafios por uma pesquisa qualitativa que adotou como estratégias: grupos focais, observação direta e questionários. Participaram adolescentes, de ambos os sexos: quatro internados para a dependência química e quatro estudantes do Ensino Médio. Os instrumentos foram: RPG Desafios, entrevista estruturada e escalas analógico-visuais. Após seu desenvolvimento, o jogo foi aplicado em estudo piloto, corrigido, avaliado por juízes e sua versão final foi testada. Conclui-se que o RPG Desafios é útil no tratamento e prevenção da dependência de drogas na adolescência pelo treinamento das habilidades para o enfrentamento de situações-problema e mudança da crença de que o uso de drogas é uma estratégia para resolução de conflitos.

The aim of this study is to present the development of the Role-Playing Game (RPG) Challenges by a qualitative study that adopted the following strategies: focus groups, direct observation and questionnaires. Adolescents of both sexes participated; four hospitalized for chemical dependency and four high school students. The instruments were: RPG Challenges, structured interviews and visual-analogies scales. After the development phase the game was used in a pilot study, was adjusted, and was evaluated by judges and the final version was tested. The results indicate that the RPG Challenges is useful in the treatment and prevention of drug dependence in adolescence through the training of skills dealing with problem situations and changing the belief that drug use is a strategy for conflict resolution.

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O objetivo desse estudo é apresentar o desenvolvimento do Role-Playing Game (RPG) Desafios por uma pesquisa qualitativa que adotou como estratégias: grupos focais, observação direta e questionários. Participaram adolescentes, de ambos os sexos: quatro internados para a dependência química e quatro estudantes do Ensino Médio. Os instrumentos foram: RPG Desafios, entrevista estruturada e escalas analógico-visuais. Após seu desenvolvimento, o jogo foi aplicado em estudo piloto, corrigido, avaliado por juízes e sua versão final foi testada. Conclui-se que o RPG Desafios é útil no tratamento e prevenção da dependência de drogas na adolescência pelo treinamento das habilidades para o enfrentamento de situações-problema e mudança da crença de que o uso de drogas é uma estratégia para resolução de conflitos.(AU)

The aim of this study is to present the development of the Role-Playing Game (RPG) Challenges by a qualitative study that adopted the following strategies: focus groups, direct observation and questionnaires. Adolescents of both sexes participated; four hospitalized for chemical dependency and four high school students. The instruments were: RPG Challenges, structured interviews and visual-analogies scales. After the development phase the game was used in a pilot study, was adjusted, and was evaluated by judges and the final version was tested. The results indicate that the RPG Challenges is useful in the treatment and prevention of drug dependence in adolescence through the training of skills dealing with problem situations and changing the belief that drug use is a strategy for conflict resolution.(AU)

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Bipolar disorder (BD) is a prevalent and highly disabling psychiatric condition. Despite the widely acknowledged importance of psychosocial interventions that involve a complex cognitive, behavioral, and biological process to help patients cope better with their illness, few studies have systematically evaluated coping in BD. Therefore, our objective was to examine recent developments in current research on coping in BD. Several studies have documented a strong association between BD and numerous neuroanatomical and neuropsychological abnormalities, particularly multiple episodes and longer durations of the disorder. The most marked effects of BD encompass brain areas involved in executive function, which may affect the mechanisms underlying an adequate selection of coping strategies. Thus, the ability of individuals to reduce their own stress burden is impaired, increasing vulnerability to stressful life events and negatively affecting the course of BD. Psychosocial interventions that focus on BD should be evaluated for their ability to improve coping abilities, and research on BD should consider neuropsychological impairment and cognitive-behavioral strategies for coping with stress

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Bipolar disorder (BD) is a prevalent and highly disabling psychiatric condition. Despite the widely acknowledged importance of psychosocial interventions that involve a complex cognitive, behavioral, and biological process to help patients cope better with their illness, few studies have systematically evaluated coping in BD. Therefore, our objective was to examine recent developments in current research on coping in BD. Several studies have documented a strong association between BD and numerous neuroanatomical and neuropsychological abnormalities, particularly multiple episodes and longer durations of the disorder. The most marked effects of BD encompass brain areas involved in executive function, which may affect the mechanisms underlying an adequate selection of coping strategies. Thus, the ability of individuals to reduce their own stress burden is impaired, increasing vulnerability to stressful life events and negatively affecting the course of BD. Psychosocial interventions that focus on BD should be evaluated for their ability to improve coping abilities, and research on BD should consider neuropsychological impairment and cognitive-behavioral strategies for coping with stress.(AU)

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