DSpace Repository :: Browsing by Author "Pérez Ewert, J. Carola"

Browsing by Author "Pérez Ewert, J. Carola"

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An Adjunctive Internet-Based Intervention to Enhance Treatment for Depression in Adults: Randomized Controlled Trial
(2021) Pérez Ewert, J. Carola; Fernández, Olga; Cáceres, Cristián; Carrasco, Álvaro E.; Moessner, Markus; Bauer, Stephanie; Espinosa-Duque, Daniel; Gloger, Sergio; Krause, Mariane
Background: Internet-based interventions promise to enhance the accessibility of mental health care for a greater number of people and in more remote places. Their effectiveness has been shown for the prevention and treatment of various mental disorders. However, their potential when delivered as add-on to conventional treatment (ie, blended care) is less clear. Objective: The aim of this study is to study the effectiveness of an internet intervention (ASCENSO) implemented in addition to face-to-face treatment as usual (TAU) for depression. Methods: A 2-arm, parallel-group, randomized controlled trial was conducted in an outpatient private mental health care center in Chile. In all, 167 adults, diagnosed with major depressive disorder, without severe comorbidities, and with internet access, were included. Eighty-four participants were assigned to the intervention group and received medical and psychological TAU from the mental health center plus access to the ASCENSO online platform. The control group (n=83) received only TAU. The ASCENSO platform includes psycho-educational information, depressive symptom monitoring and feedback, and managing emergencies based on the principles of cognitive behavioral therapy. Emergency management was mental health provider–assisted. TAU includes access to primary care physicians and psychiatrists, to a brief individual psychotherapy, and to medication when needed. The baseline questionnaires were administered in person, and 6- and 9-months assessments were conducted online. Depression symptoms and quality of life were measured by self-administered questionnaires, and treatment adherence was determined via the Mental Health Center’s internal records. The usage of ASCENSO was assessed by server logs. Reduction on depressive symptomatology was considered as the primary outcome of the intervention and quality of life as a secondary outcome. Results: Of the 84 participants in the intervention group, 5 participants (6%) never accessed the online platform. Of the remaining 79 participants who accessed ASCENSO, 1 (1%, 1/79) did not answer any of the symptom questionnaire, and most participants (72/79, 91%) answered the monitoring questionnaires irregularly. The ASCENSO intervention implemented in addition to face-to-face care did not improve the outcome of the usual care delivered at the mental health center, either in terms of reduction of depressive symptoms (F2,6087= 0.48; P=.62) or in the improvement of quality of life (EQ-5D-3L: F2,7678=0.24; P=.79 and EQ-VAS: F2,6670= 0.13; P=.88). In contrast, for the primary (F2,850=78.25; P<.001) and secondary outcomes (EQ-5D-3L: F2,1067=37.87; EQ-VAS: F2,4390= 51.69; P<.001) in both groups, there was an improvement from baseline to 6 months (P<.001), but there was no change at 9 months. In addition, no effects on adherence to or use of TAU were found. Finally, the dropout rate for the face-to-face treatment component was 54% (45/84) for the intervention group versus 39% (32/83) for the control group (P=.07). Conclusions: The fact that the adjunctive access to ASCENSO did not improve outcome could be due to both the rather high effectiveness of TAU and to patients’ limited use of the online platform. Trial Registration: ClinicalTrials.gov NCT03093467; https://clinicaltrials.gov/ct2/show/NCT03093467
Brief report: Agreement between parent and adolescent autonomy expectations and its relationship to adolescent adjustment
(2016) Pérez Ewert, J. Carola; Cumsille, Patricio; Martínez M., Loreto
While disagreement in autonomy expectations between parents and their adolescent children is normative, it may also compromise adolescent adjustment. This study examines the association between parents' and adolescents' agreement on autonomy expectations by cognitive social domains and adolescent adjustment. A sample of 211 Chilean dyads of adolescents (57% female, M-age = 15.29 years) and one of their parents (82% mothers, M-age = 44.36 years) reported their expectations for the age at which adolescents should decide on their own regarding different issues in their life. Indexes of parent adolescent agreement on autonomy expectations were estimated for issues of personal and prudential domains. Greater agreement in the prudential than in the personal domain was observed. For boys and girls, higher agreement in adolescent parent autonomy expectations in the personal domain was associated with lower substance use. A negative association between level of agreement in adolescent parent autonomy expectations in the prudential domain and externalizing behaviors and substance use was found. (C) 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
Caracterización de cyberbullying en el gran Santiago de Chile, en el año 2010
(2014) Varela, Jorge J.; Pérez Ewert, J. Carola; Schwaderer Z., Hermann; Astudillo, Javiera; Lecannelier A., Felipe
El estudio caracteriza el cyberbullying en estudiantes del gran Santiago de Chile (2010). Se aplicó una encuesta de autorreporte (Cuestionario de Experiencias de Internet) a 1.357 estudiantes entre 7º básico a IVº medio. El diseño de muestra fue no probabilístico por cuotas en 32 establecimientos educacionales, ponderados según género, curso y tipo de dependencia. El 50% fueron hombres, con un promedio de edad 15 años (DS= 1,82 años). Resultados: El 11,4% reportó haber sido víctima de algún tipo de cyberbullyingy el 12,5% victimario. No se encontraron diferencias significativas en las víctimas según sexo, curso y tipo de dependencia. Sólo los hombres reportan identificarse en forma más frecuente con los victimarios que las mujeres. Conclusiones: El cyberbullying es un fenómeno existente en la realidad chilena, siendo - mayormente - homogéneo en su presentación. Dado esto, se plantean nuevos desafíos y preguntas respecto a sus consecuencias tanto para los estudiantes como para todo el sistema escolar.
Discourse-voice regulatory strategies in the psychotherapeutic interaction: a state-space dynamics analysis
(2015) Tomicic, Alemka; Martínez, Claudio; Pérez Ewert, J. Carola; Hollenstein, Tom; Angulo, Salvador; Gerstmann, Adam; Barroux, Isabelle; Krause, Mariane
This study seeks to provide evidence of the dynamics associated with the configurations of discourse-voice regulatory strategies in patient–therapist interactions in relevant episodes within psychotherapeutic sessions. Its central assumption is that discourses manifest themselves differently in terms of their prosodic characteristics according to their regulatory functions in a system of interactions. The association between discourse and vocal quality in patients and therapists was analyzed in a sample of 153 relevant episodes taken from 164 sessions of five psychotherapies using the state space grid (SSG) method, a graphical tool based on the dynamic systems theory (DST). The results showed eight recurrent and stable discourse-voice regulatory strategies of the patients and three of the therapists. Also, four specific groups of these discourse-voice strategies were identified. The latter were interpreted as regulatory configurations, that is to say, as emergent self-organized groups of discourse-voice regulatory strategies constituting specific interactional systems. Both regulatory strategies and their configurations differed between two types of relevant episodes: Change Episodes and Rupture Episodes. As a whole, these results support the assumption that speaking and listening, as dimensions of the interaction that takes place during therapeutic conversation, occur at different levels. The study not only shows that these dimensions are dependent on each other, but also that they function as a complex and dynamic whole in therapeutic dialog, generating relational offers which allow the patient and the therapist to regulate each other and shape the psychotherapeutic process that characterizes each type of relevant episode.
Disentangling the change–alliance relationship: Observational assessment of the therapeutic alliance during change and stuck episodes
(2016) Mellado, Augusto; Suárez, Nicolás; Altimir, Carolina; Martínez, Claudio; Pérez Ewert, J. Carola; Krause, Mariane
The therapeutic alliance is considered the most robust process variable associated with positive therapeutic outcome in a variety of psychotherapeutic models [Alexander, L. B., & Luborsky, L. (1986). The Penn Helping Alliance Scales. In L. S. Greenberg & W. M. Pinsoff (Eds.), The psychotherapeutic process: A research handbook (pp. 325–356). New York: Guilford Press; Horvath, A. O., Gaston, L., & Luborsky, L. (1993). The alliance as predictor of benefits of counseling and therapy. In N. Miller, L. Luborsky, J. Barber, & J. P. Docherty (Eds.), Psychodynamic treatment research: A handbook for clinical practice (pp. 247–274). New York, NY: Basic Books; Horvath, A. O., Del Re, A. C., Flückiger, C., & Symonds, D. (2011). Alliance in individual psychotherapy. Psychotherapy, 48, 9–16; Orlinky, D., Grawe, K., & Parks, B. (1994). Process and outcome in psychotherapy: Noch einmal. In A. Bergin & J. S. Garfield (Eds.), Handbook of psychotherapy and behaviour change (4th ed., pp. 270–378). New York, NY: Wiley and Sons]. The relationship between alliance and outcome has traditionally been studied based on measures that assess these therapy factors at a global level. However, the specific variations of the alliance process and their association with therapy segments that are relevant for change have not yet been fully examined. The present study examines the variations in the therapeutic alliance in 73 significant in-session events: 35 change and 38 stuck episodes identified through the observation of 14 short-term therapies of different theoretical orientations. Variations in the alliance were assessed using the VTAS-SF [Shelef, K., & Diamond, G. (2008). Short form of the revised Vanderbilt Therapeutic Alliance Scale: Development, reliability, and validity. Psychotherapy Research, 18, 433–443]. Nested analyses (HLM) indicate a statistically significant better quality of the alliance during change episodes.
Efecto de una intervención multidimensional en personas mayores autovalentes para el manejo del riesgo de caídas
(2019) Bustamante-Troncoso, Claudia; Herrera-López, Luz María; Sánchez, Hugo; Pérez Ewert, J. Carola; Márquez-Doren, Francisca; Leiva, Sara
Objetivo: Evaluar el efecto de una intervención multidimensional en la percepción y el manejo de factores de riesgo intrínsecos y extrínsecos de caídas y en la frecuencia de caídas en personas mayores autovalentes que viven en la comunidad. Diseno: ̃ Ensayo clínico aleatorizado controlado. Emplazamiento: Centro público de salud familiar, nivel primario de atención. Participantes: Personas mayores autovalentes que viven en la comunidad. Intervención: Intervención educativa multidimensional de visita domiciliaria y seguimiento telefónico mensual por 5 meses para el grupo intervenido (GI, n = 77) y los asignados al grupo control (GC, n = 77) atención habitual en su centro de salud. Mediciones principales: Percepción de riesgo de caídas, número de factores de riesgo caídas y número de caídas en el periodo. Resultados: En ambos grupos aumenta la percepción de los factores de riesgo de caídas asociadas con la deambulación (GI: p ≤ 0,001 y GC: p ≤ 0,001). Pertenecer al GI se asocia significativamente con una disminución en los factores de riesgo asociados con las superficies (r = 0,25) y los zapatos (r = 0,24); un aumento en la percepción de riesgo de caídas asociadas a la deambulación (r = 0,21) y la presencia de objetos o muebles (r = 0,36). En GI, 5 participantes (7,9%) sufrieron al menos una caída en el periodo de 5 meses y en el GC 18 (27,7%) (p = 0,004). Conclusiones: La intervención multidimensional fue efectiva para reducir la frecuencia de caídas y para el manejo de factores de riesgo extrínsecos asociados con las superficies, la iluminación y los dispositivos de apoyo.
Episodios de Cambio y Estancamiento en Psicoterapia: Características de la comunicación verbal entre pacientes y terapeutas
(2012) Fernández, Olga; Herrera, Pablo; Krause, Mariane; Pérez Ewert, J. Carola; Valdés, Nelson; Vilches, Oriana; Tomicic, Alemka
Se presentan los resultados de un microanálisis de la conversación psicoterapéutica en Episodios de Cambio y de Estancamiento. Se realizó un análisis comparativo de la comunicación verbal en una muestra de 33 Episodios de Cambio y 34 de Estancamiento, correspondientes a 15 procesos terapéuticos, aplicando el Sistema de Codificación de la Actividad Terapéutica. Este sistema distingue cinco niveles de análisis: Formas Básicas, Intenciones Comunicacionales, Técnicas, Dominio y Referencia. Los resultados muestran que los Episodios de Cambio y Estancamiento se distinguen en cuanto a que, en los primeros, predomina un lenguaje más asertivo por parte del terapeuta y más receptivo en el paciente, estando ambos involucrados en la activa construcción de nuevos significados y el paciente centrado en sí mismo. En los segundos se rigidiza el lenguaje, se exacerban algunas técnicas por parte del terapeuta y se tiende a focalizar menos en el paciente como referente del diálogo terapéutico.
Evaluación de la efectividad del Programa Vínculos para la prevención e intervención del Bullying en Santiago de Chile
(2013) Pérez Ewert, J. Carola; Astudillo, Javiera; Varela, Jorge J.; Lecannelier A., Felipe
El Bullying, por sus características y consecuencias, se ha transformado en una preocupación central en los colegios, los cuales han desarrollado diferentes formas de afrontarlo. El objetivo principal de este artículo es evaluar la efectividad de un programa de prevención e intervención de Bullying y Ciberbullying, en una muestra de 320 alumnas en un colegio de Santiago de Chile, a través de un diseño pre-post. El programa utilizó estrategias preventivas e integrales orientadas a realizar intervenciones en los distintos niveles del sistema escolar: colegio, sala de clases, individuo y familia. Los resultados demostraron que el programa es efectivo en disminuir el reporte de ser testigos de Bullying y la victimización de manotaje a través de internet. La efectividad del programa se debería a que se respetaron los lineamientos de los programas que han demostrado ser efectivos.
Evaluación de las propiedades psicométricas de la Escala de Ansiedad Perinatal en una muestra de madres en Chile.
(2022) Coo, Soledad; Medina, Franco; García, María Ignacia; Pérez Ewert, J. Carola
Antecedentes y objetivo: Las dificultades de salud mental materna durante el periodo perinatal son prevalentes y tienen graves consecuencias para las madres y sus bebés. Las iniciativas de pesquisa temprana se han centrado en la sintomatología depresiva y han puesto menor atención a los síntomas de ansiedad, pese a su alta prevalencia. Uno de los factores que contribuye a la escasez de protocolos para la pesquisa de sintomatología ansiosa es la falta de instrumentos validados para tal fin. El objetivo de esta investigación fue evaluar la estructura factorial, validez concurrente y confiabilidad de la Escala de Ansiedad Perinatal, desarrollada para facilitar la pesquisa de sintomatología ansiosa en mujeres embarazadas y puérperas. Participantes y métodos: Las participantes fueron 265 mujeres, 138 de las cuales fueron evaluadas durante el tercer trimestre de gestación y 127, a los 3 meses postparto. La estructura factorial del instrumento fue analizada mediante un Análisis Factorial Exploratorio, el número de factores se definió con el test MAP de Velicer. Resultados: Se obtuvo una solución de cuatro factores con algunas diferencias en relación a la escala original. Se observó una alta consistencia interna para las subescalas del instrumento y para el puntaje global, además de una adecuada validez concurrente y confiabilidad test-retest. Conclusiones: Se concluye que la versión en español de la Escala de Ansiedad Perinatal posee características psicométricas adecuadas para su uso en Chile. Futuros estudios son requeridos para evaluar la validez de este instrumento en otros contextos latinoamericanos.
Factores Asociados al Autoestigma de la Depresión en Adolescentes en Santiago, Chile.
(2021) Suárez-Barba, Mariela Alexandra; Reyes, Pablo; Pérez Ewert, J. Carola; Martínez, Vania
Resumen. Objetivo: Determinar la asociación entre autoestigma de la depresión y factores sociodemográficos, historia personal y parental de depresión, sintomatología ansiosa y depresiva, y calidad de vida en adolescentes. Método: Estudio transversal correlacional, en una muestra de 192 adolescentes (8º básico a 3º medio) de tres colegios particulares subvencionados de Santiago, Chile, se aplicaron cuestionarios de factores sociodemográficos, autoestigma de la depresión, sintomatología ansiosa y depresiva, y calidad de vida. Los datos se analizaron con prueba t de Student, ANOVA, coeficiente de Pearson y Regresión Lineal. Resultados: No hubo diferencias en autoestigma de depresión entre hombres y mujeres. Fue mayor el autoestigma de la depresión en adolescentes que sospechaban que habían tenido o tenían depresión, referían que su madre o padre habían tenido depresión, tenían mayor sintomatología depresiva y/o ansiosa y menor calidad de vida. Conclusión: La presencia de depresión en los progenitores progenitores (madre y/o padre), así como el desconocimiento de los adolescentes respecto a si ellos presentan el cuadro clínico, se relaciona con mayor autoestigma de la depresión en los adolescentes, lo que inhibe la búsqueda de ayuda.
Fenómenos especiales y verbalizaciones desviadas en el test de Rorschach en una muestra de adolescentes chilenos
(Universidad del Desarrollo. Facultad de Psicología, 2017) Lecanda Gallego, María del Pilar; Apfelbeck Stegmann, Eve Marie; Pérez Ewert, J. Carola
Generic change indicators in therapeutic processes with different outcomes
(2015) Krause, Mariane; Altimir, Carolina; Pérez Ewert, J. Carola; Parra, Guillermo de la
Objectives: This paper analyzes the relationship between ongoing change and final outcome in therapies carried out in natural settings with 39 clients. Method: Ongoing change was assessed through generic change indicators (GCIs), an observational method designed to label the content of change moments by selecting one specific GCI from the sequence of 19 that covers from more rudimentary and low complexity to more elaborated and complex changes. These GCIs can also be grouped into three broad stages of change, according to their level of complexity. Productivity indicators were generated to account for the number of GCIs (total and grouped by stage) adjusted by the length of therapy and the respective individual production of GCIs. Outcome, in turn, is understood as the final result of therapy and was measured by Lambert's Outcome Questionnaire (OQ 45.2). Results: Using the Reliable Change Index of this measure, which qualifies the difference between initial and final scores, therapies were grouped into “good outcome” and “poor outcome” cases. Findings indicate that therapies with good final outcome show a greater presence of Stage III GCIs during the process. Furthermore, in these therapies there is a significant association between Stage I GCI productivity and the productivity of Stages II and III GCIs. This is not the case for poor outcome cases, where results show a greater productivity of initial stage GCIs, mostly in the second half of therapy and no relation of this productivity with Stage II and Stage III GCIs. Conclusions:Results support the relation of ongoing change and final outcome. Possibilities for the clinical use of GCIs, specifically for monitoring ongoing therapies, are discussed.
Mi hijo y sus hermanos: la experiencia de primera maternidad al interior de familias simultáneas chilenas
(2011) Pérez Ewert, J. Carola; Jaramillo Torrens, Andrea
This qualitative study shows the perception of a group of Chilean women aged between 29 and 39 years regarding their experience of having their first child when they are members of a simple stepfamily. Sixteen women, whose partners maintain active contact with their child(ren) born in previous relationships were interviewed. Results confirm the existence of a process of "becoming a mother" and its course depends on stepchildren's presence. In addition our more relevant findings show that the specific topics of fears and motivations of having a child depend on the particular stepfamily context, and women's experiences is that this process vary according to the perceived quality of stepmother/stepchildren relationships.
Online intervention to prevent postnatal depression and anxiety in Chilean new mothers: Protocol for a feasibility trial
(2022) Pérez Ewert, J. Carola; Aldoney, Daniela; García, María I.; Olhaberry, Marcia; Fernández, Olga; Alamo, Nicolle; Franco, Pamela; Pérez, Francisca; Fisher, Jane; Rowe, Heather; Coo, Soledad
Symptoms of postpartum depression and anxiety in new mothers are prevalent and negatively impact maternal emotional wellbeing and infant development. Barriers to accessing treatment prevent women from receiving mental health care, a situation that has worsened due to the COVID-19 pandemic. mHealth interventions hold the potential to support women during the transition to parenthood despite these barriers and to promote the use of preventive interventions. This study uses a mixed methods design to assess the feasibility and preliminary effectiveness of a psychoeducational, guided mHealth intervention to prevent postpartum mental health difficulties in women who receive care in primary health centers in Chile. The study will contribute to evidence-based research on the effectiveness of mHealth interventions for new mothers from an under-studied cultural background. The findings will also enable the development of a larger randomized controlled trial to assess the effectiveness of the intervention, which, if effective, could significantly contribute to the emotional wellbeing of women and their families.
Parental Psychological Control: Maternal, Adolescent, and Contextual Predictors
(2021) Pérez Ewert, J. Carola; Huerta, Paula; Rubio, Bernardita; Fernández, Olga
Parental psychological control (PC) hinders the development of autonomy, identity formation, and the attainment of self-determination and individuation of adolescents. The aim of this study was to deepen the understanding of which conditions increase the risk of the use of maternal PC by simultaneously considering the contribution of adolescent temperament, maternal separation anxiety, and adolescents’ perception of interparental conflict. A correlational study involving a sample of 106 Chilean adolescentmother dyads was done. Adolescents were, on average, 15.42 years old (SD = 1.09) and 77% male. Mothers were, on average, 45.46 years old (SD = 6.39). We administered self-report questionnaires to the adolescent measuring effortful control and frustration as temperamental dimensions, along with the perception of interparental conflict. Mothers reported on their separation anxiety. Both the adolescents and their mothers reported on the use of maternal PC. Adolescents reported higher levels of maternal PC than their mothers did. All predictors were associated with PC reports. Higher levels of maternal anxiety about adolescent distancing, inter-parental conflict, and adolescent frustration were associated with higher reported levels of PC. In contrast, higher levels of adolescent effortful control were associated with lower levels of maternal PC. Finally, when maternal separation anxiety and inter-parental conflict were high there was a higher use of maternal PC. The present findings inform on how adolescent’s selfregulatory skills could reduce the risk of being exposed to maternal PC. And highlight the importance of using a systemic and interactional conceptualization when trying to understand their use.
Plan piloto del sistema de comunicación y seguimiento móvil en salud para personas con diabetes
(2014) Alcayaga, Claudia; Pérez Ewert, J. Carola; Bustamante, Claudia; Campos, Solange; Lange, Ilta; Zuñiga, Francisca
mHealth is a practical, useful, and available tool for one-way or two-way communication between health professionals and patients. It is especially promising in countries such as Chile, with widespread and growing mobile telephone coverage that is very well accepted by the public. Our objective is to demonstrate the process for designing a mobile communication and monitoring model, aimed at providing communication between professionals in primary healthcare centers and their patients, to facilitate timely diagnosis and initiation of treatment for type 2 diabetes. This model's characteristics include use of mobile telephones as a communication tool, a one-way method (from health centers to patients), integration into in-person care delivered at health centers, use of different communication strategies (voice and written), and integrated functioning using open-source software. The system includes personalized communication, automated voice communication, and automated written communication using short message service (SMS). We describe the strategies and components of the system. The lessons learned include the contribution from successful implementation of COSMOS (consolidated online modulated operating systems), a technological innovation, to support the health care of people with suspected type 2 diabetes in primary healthcare centers. Working together with teams in the field is essential to this achievement.
Propiedades psicométricas del inventario de depresión de Beck IA para la población chilena
(2017) Valdés, Camila; Morales-Reyes, Irma; Pérez Ewert, J. Carola; Medellín, Adriana; Rojas, Graciela; Krause, Mariane
Background: According to the Chilean National Health Survey (2009- 2010), 17% of people aged 15 years or more have depressive symptoms. Thus, freely-available, easily-administered, and highly sensitive screening tests for depression are needed in clinical and research settings. Aim: To evaluate the psychometric properties of a Spanish version of the Beck Depression Inventory (BDI-IA) in adult Chilean population. Material and Methods: The inventory was applied to a sample of 1.105 adults aged between 18 to 73 years (94% women). Ninety nine participants were outpatients receiving treatment for affective disorders, 932 were parents and/or guardians of students enrolled in schools and 73 were university students (sample with no known depressive disorder). To perform data analysis, two groups from the random combination of both samples were generated. Results: The inventory showed an appropriate degree of internal consistency (Cronbach alpha = .92). An exploratory factor analysis suggested a one-factor solution. This solution was reinforced with a confirmatory factor analysis, which displayed an adequate goodness of fit. The cutoff score, based on the Youden Index, was 13/14 points. It was able to discriminate between depressed and non-depressed participants. Conclusions: These results indicate that the BDI-IA is an appropriate instrument to assess depressive symptoms in Chilean adults.
Psychosocial health of the adolescent mother in the relationship with her child and its development
(2017) Alamo, Nicolle; Krause, Mariane; Pérez Ewert, J. Carola; Aracena, Marcela
This study relates adolescent mothers' psychosocial health to the development of their child and to the mother-child relationship, in a sample of 99 mothers. The results show that 39.4% of mothers presented risk for mental health problems; 40.4% of children presented alterations in the language, and 7.1% in their socio-emotional development. We observed a direct association between the risk of developing mental health problems and the potential for abuse and neglect, and between psychosocial well-being and the quality of the relationship; also, we observed an inverse association between psychosocial well-being and potential abuse. It was confirmed that maternal mental health and the potential abuse predict the socioemotional development of the child, while the quality of the relationship predicts the development of language. These results may contribute to future generation of public policies.
Relevance of early changes in psychotherapy with adolescents
(2015) Fernández, Olga; Pérez Ewert, J. Carola; Gloger, Sergio; Krause, Mariane
This research is focused on the study Generic Change Indicators (GCI) in psychotherapies with adolescents conducted in natural settings. Specifically, it is centered on the evolution of GCI during the initial stage of therapy and their relation with treatment adherence. The participants were 19 adolescents with various diagnoses, who were receiving individual therapy with different theoretical approaches. Trained raters identified the CGI in the three initial sessions. The results reveal an evolution during the initial therapy stage, with hierarchically lower indicators dominating the first session and then decreasing in the second and third. In addition, the maximum CGI reached in the initial phase significantly predict the likelihood of completing the therapeutic process. Keywords
The CRIAA Program complex intervention in primary care to support women and their families in breastfeeding: Study protocol for a pilot trial
(2020-07) Lucchini-Raies, Camila; Marquez-Doren, Francisca; Beca, Paulina; Pérez Ewert, J. Carola; Campos, Solange; Lopez-Dicastillo, Olga
Aim: To report a pilot study protocol to assess the feasibility of a complex intervention, in the primary healthcare context, to support women and their families in breastfeeding. Design: A pilot/feasibility trial with control and intervention groups. Methods: The study will be conducted in two primary healthcare centres with 40 childbearing women (20 control group; 20 intervention group), with their partner/ meaningful person and their respective healthcare professionals. Intervention group participants will receive the intervention: (a) in a breastfeeding workshop during their third trimester of pregnancy; and (b) via virtual breastfeeding support for six months postpartum. Health professionals will be trained to deliver the intervention. The control group will receive standard care in the outpatient clinic. The pilot will help determine the intervention's feasibility. Data collected pre-intervention, 10-days postpartum and two-, four-, and six-months postpartum will provide estimates of the intervention's preliminary effects on self-efficacy and main outcomes. Research Ethics Committee approval was obtained in April 2019. Discussion: Breastfeeding support is a complex reality influenced by multiple factors. Therefore, approaches to breastfeeding are also, requiring interventions that address its multidimensional nature, including all actors involved. The proposed intervention will be applied by an interdisciplinary professional health team, allowing for its incorporation into standard practice and its perpetual maintenance. Impact: The study will produce an original, comprehensive, complex intervention addressing contextual, and organizational factors to promote breastfeeding support using an interdisciplinary and family-based approach; breastfeeding self-efficacy is the core concept. The program evaluation and feasibility study will permit exploration of the integration of the intervention's novel aspects into the daily work of professionals and reveal how to better use existing resources in a full-scale clinical trial. Trial registration: ClinicalTrials.gov ID: NCT03944642.

Browsing by Author "Pérez Ewert, J. Carola"

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