Carlos Alexis Chimpén-López

Background/Objectives: The 6 min walk test (6MWT) has been used to measure the level of walking capacity in people with Parkinson’s disease (PD). However, the use of a non-linear circuit has not yet been investigated deeply. Thus, the aim of this study was to evaluate the test–retest reliability of the 6 min walk test in a rectangular circuit in people with PD. Methods: Forty-two people with PD (men = 27, women = 15), mean age 66 ± 9.61 years, participated. All of them were in ON state. Each patient performed the 6MWT on 2 test days separated by 1 week, walking at a constant speed on a 20 m × 3.5 m circuit. Test–retest reliability was assessed using the intraclass correlation coefficient (ICC), minimal detectable change (MDC), and standard error of measurement (SEM), and Student’s t-test was applied to determine whether there were statistically significant differences between the test and the retest. Results: The ICC values for the total sample were excellent (>0.90) in both men and women. In addition, they had similar reliability, although slightly higher in women. The results showed that, for the total sample, a MDC < 17% can be considered as a true change for this procedure. The SEM percentage was 6.1%. Conclusions: The 6MWT, performed on a rectangular circuit, demonstrated excellent test–retest reliability in patients with Parkinson’s disease.

Background: The 6-minute walk test (6MWT) has been used to measure the level of functional capacity in people with Parkinson's disease (PD). However, the use of a non-linear circuit has not yet been investigated. Thus, the aim of this study was to evaluate the test-retest reliability of the 6-minute walk test in a rectangular circuit in people with PD. Methods: Forty-two people with PD (men=27, women=15), mean age 66±9.61 years, partici-pated. Each patient performed the 6MWT on 2 test days separated by 1 week, walking at a constant speed on a 20m x 3.5m circuit. Test-retest reliability was assessed using the intraclass correlation coefficient and the Student's t-test was applied to determine whether there were statistically significant differences between the test and the retest. Results: The ICC values for the total sample were excellent (< 0.90) in both men and women. In addition, they had similar reliability, although slightly higher in women. The results showed that, for the total sample, a smallest true difference (SRD) < 17% can be considered as a true change for this procedure. The standard error of measurement (SEM) percentage was 6.1. Conclusions: The 6-minute walk test (6MWT), performed on a rectangular circuit, is a reliable and valid tool for assessing functional capacity in PD patients.

Parkinson’s disease (PD) is a progressive disease characterised by motor and non-motor symptoms that affect patients’ daily activities. Square Stepping Exercise (SSE) is a training programme that requires physical and cognitive effort. The aim was to investigate whether the application of SSE is safe, applicable, can improve balance and is effective in preventing falls, improving cognitive and psychological aspects in people with PD. The randomised controlled study involved 22 people with PD, divided into 2 groups, SSE (n = 11) and control (n = 11). The results show that in the experimental group there were significant improvements in the variables related to physical condition: Balance: L-Test (p = 0.034), Time Up and Go 3 m test (p = 0.026), Time Up and Go 7 m test (p = 0.016). Speed: 6 mi walking test (p < 0.001). Strength: 30 s Sit to Stand test (p = 0.005) and 5 rep sit to stand (p = 0.003); except for the 30 m walking test (p = 0.947) and the functional reach test (p = 0.448). Similarly, the following cognitive tests showed post-intervention improvements: (SDMT) Symbol Digit Modalities Test (21 vs. 29, p = 0.003), (CVLT) The California Verbal Learning Test (55 vs. 69, p = 0.009), (BVMT) Brief Visuospatial Memory Test (5 vs. 8, p = 0.005) and the total score of the (Bicams) Brief International Cognitive Assessment (88 vs. 112, p < 0.001) and on psychosocial factors related to Perceived Social Support (p = 0.014). There was no significant effect on the frequency of falls, depression, anticipatory cognition and health-related quality of life. The SSE programme had a positive effect on physical condition, cognitive condition and psychosocial factors related to perceived social support.

Although couple identity has emerged as a relevant construct in clinical practice, there are few instruments to assess it, and none validated in Spanish. For this reason, we have designed and validated the EIPAR (Couple Identity Scale for its acronym in Spanish). It consists of 19 items scored on a five-interval Likert-type scale. The items were developed from published theory in the field and were organized into two subscales: (a) Relational Interaction (RI) and (b) Relational Life Project (RLP). A sample of 205 participants was selected by nonprobability snowball sampling; 69% of them were women. Participants completed the Dyadic Adjustment Scale (DAS) and the EIPAR. The two subscales obtained in the EIPAR scale showed adequate internal consistency indices, as well as in the assessment of the total scale. Furthermore, all items showed adequate item-total corrected item-total correlations. The convergent validity of the EIPAR scale with the DAS determined a high level of compatibility between the DAS dimensions and the EIPAR subscales, reinforcing the design and coherence of the latter. The EIPAR is confirmed as a valid and reliable instrument for the assessment of couple identity, both for research purposes and for intervention with couples.

Introduction: During the pandemic, nurses have undergone a high level of professional burnout, suffering emotional exhaustion, depersonalization, and lack of personal realization. Objective: The object of this study is to understand in depth, through a phenomenological study of Giorgi, the perceptions on commitment and professional development of frontline nurses during the first and second waves of the COVID-19 pandemic. Method: Qualitative study designed and analyzed using Giorgi’s phenomenological focus. For data collection, semi-structured interviews were utilized in a theoretical sample of frontline nurses who worked in public hospitals of Extremadura and Madrid, Spain, until saturation of data. The interviews were conducted between the months of May and December 2020 following an outline of topics. The analysis was based on the phenomenological focus of Giorgi and was supported by the software Atlas-Ti 8.0. Results: A total of 14 nurses participated in this study. Two main themes emerged to explain the perceptions of the nurses: (1) the professional commitment of the nurses during the pandemic and (2) the effects of the pandemic on professional development; seven subcategories were also identified. Conclusion: The social and professional development of nurses is important. If nurses feel that they are quality professionals, this will enable them to protect their psychosocial health and increase professional commitment toward their patients in difficult situations such as pandemics. The results of this study may serve as a guide for better understanding the problems and needs of nurses as healthcare providers. This may help administrators in the generation of solutions for the establishment of a safe and reliable work environment, which will in turn promote a healthcare system that can efficiently respond to future catastrophes.

The COVID-19 pandemic has caused ethical challenges and dilemmas in care decisions colliding with nurses’ ethical values. This study sought to understand the perceptions and ethical conflicts faced by nurses working on the frontline during the first and second waves of the COVID-19 pandemic and the main coping strategies. A qualitative phenomenological study was carried out following Giorgi’s descriptive phenomenological approach. Data were collected through semi-structured interviews until data saturation. The theoretical sample included 14 nurses from inpatient and intensive care units during the first and second waves of the pandemic. An interview script was used to guide the interviews. Data were analyzed following Giorgi’s phenomenological method using Atlas-Ti software. Two themes were identified: (1) ethical conflicts on a personal and professional level; and (2) coping strategies (active and autonomous learning, peer support and teamwork, catharsis, focusing on care, accepting the pandemic as just another work situation, forgetting the bad situations, valuing the positive reinforcement, and humanizing the situation). The strong professional commitment, teamwork, humanization of care, and continuous education have helped nurses to deal with ethical conflicts. It is necessary to address ethical conflicts and provide psychological and emotional support for nurses who have experienced personal and professional ethical conflicts during COVID-19.

Narration is a tool to organize experience into a coherent vision that explains our identity. According to Paul Ricoeur, fictional characters and real people’s identities are made out of the use of discourse. The tradition of narrative therapy states the importance of the use of letters, notes, and certificates to strengthen the alternative stories that are co-built with the person in the sessions. The digital format makes it easy not only to send but also to share such documents with a wider community. The so-called counter-documents are those writings that do not focus on problems but on the actions performed by people despite the problem and that contribute to the construction of so-called alternative stories. This article reflects on the use of these writings with literary merit for psychotherapy and also claims the need for psychotherapy to be updated and adapted to the current digital cultural context.

Aggressive behaviour is one of the most disruptive problems in children with autism. It generates anxiety in the parents and the child, who does not know what to do, and the family's quality of life is significantly reduced. In this scenario, using narrative practices may help promote the sense of agency in children with autism spectrum disorder (ASD) and help them find solutions based on self‐knowledge. This article explores different narrative practices to help deal with challenging behaviour in children with ASD. We discuss several examples using two techniques: a therapist's imaginary friend and using a magic coin as ways of externalising the problem and playing with metaphors. We present the procedures applied during the interventions with three children. These narrative practices can help to externalise the problem, think about possible solutions, and facilitate the development of imagination and abstract thinking in children with ASD.

We present The Couple’s Tree of Life (CTOL) as a new collective narrative methodology to strengthen couple relationships and prevent conflicts. The CTOL, based on the tree of life methodology (Ncube & Denborough, Tree of Life, mainstreaming psychosocial care and support: a manual for facilitators, REPSSI, 2007), aims to reinforce the identity and strengths of the couple. We explain the CTOL implementation process and illustrate it step by step with a group of 14 adult heterosexual Caucasian couples who belonged to Protestant churches in Madrid (Spain). As a way to assess its usefulness before applying the CTOL to other groups of couples, we conducted a pre‐post evaluation using the Dyadic Adjustment Scale of Spanier(1976). We found an improvement in dyadic adjustment, quality, understanding of, and satisfaction with, the relationship. The results, though not generalizable at this stage, suggest that the CTOL could reinforce the couple’s identity while maintaining individual identities. We also discuss the possible applications of couples therapy.

Background: The concern in the scientific community for the study of people with dementia and their families is comprehensible, especially the importance of knowing the effects that caring for the patient has on their family dynamic, paying special attention to the main caregiver. The objective of this study was to analyze the relationship of resilience and emotional intelligence with functional performance in the main caregivers of people with dementia in Spain according to the phase of the disease. Methods: A cross-sectional, descriptive, and analytical study was carried out. A total of 144 primary family caregivers of patients with dementia in Spain were included in the study. The following variables were measured: sociodemographic, psychosocial, and occupational, as well as resilience and emotional intelligence. Results: The caregivers obtained a low moderate resilience (mean = 64.01 ± 14.5), an emotional intelligence bordering between moderate and high (mean = 78.48 ± 14.82), and a 61.8% self-care categorized as somewhat and quite a bit. The presence of higher levels of resilience in family caregivers of people with dementia were positively related to the time spent on self-care (r = 0.227; p = 0.033) and leisure (r = 0.262; p = 0.014), especially in the moderate phase of the disease, while in the severe phase, this relationship appeared with productivity (r = 0.355; p = 0.034). The higher levels of emotional intelligence were positively related to a greater time dedicated to self-care (r = 0.233, p = 0.005), as well as the data observed in the moderate and severe phase (r = 0.214; p = 0.046 and r = 0.398; p = 0.016 respectively). Conclusions: The primary caregivers of relatives with dementia who have higher levels of resilience and emotional intelligence spend more time on self-care and leisure activities, especially in the moderate phase of the disease.