Artículos Psicología
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Browsing Artículos Psicología by Subject "Adherence"
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Item Relevance of early changes in psychotherapy with adolescents(2015) Fernández, Olga; Pérez Ewert, J. Carola; Gloger, Sergio; Krause, MarianeThis 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. KeywordsItem Treatment adherence during childhood in individuals with phenylketonuria: Early signs of treatment discontinuation(2017) García, María Ignacia; Araya, Gabriela; Coo, Soledad; Waisbren, Susan E.; de la Parra, AliciaIntroduction: Phenylketonuria (PKU) is an autosomal recessive disorder characterized by a deficiency in phenylalanine (Phe) hydroxylase activity. Early diagnosis and continuous treatment with a low Phe diet prevents severe neurological and cognitive impairment. Aims: 1. Analyze how treatment adherence evolves through infancy, childhood, and early adolescence in individuals with PKU. 2. Identify early signs of treatment discontinuation. Methodology: This longitudinal, retrospective study included 75 children diagnosed through newborn screening, ages 7 to 13 years. Data on blood Phe concentration, number of blood samples sent, proportion of samples with Phe concentrations over the recommended range, and number of visits to the metabolism clinic were recorded. Logistic regression analysis was used to identify the variables that predict treatment discontinuation before 13 years of age. Results: A progressive increase in mean blood Phe concentrations with age was identified. The greatest increase occurred between the first and second years of life. By age ten, mean Phe blood concentration of the group was above the recommended range. The proportion of samples with Phe concentrations over the recommended range also increased with age, from an average of 13% during the first year of life to 67% in early adolescence. Sixty-eight percent of the children attended the outpatient clinic and sent samples from birth to the time of the study. Individuals who discontinued follow-up showed significantly higher mean blood Phe concentrations (360 vs. 220.9 mu mol/L; p=0.004) and the proportion of samples over the recommended range (37% vs. 12% p=0.002) was significantly higher during the second year of life. Mean age for children who discontinued treatment was 5.5 years of age. Blood Phe concentration values at 12 to 23 months of age and at 6 to 8 years of age significantly predicted treatment discontinuation before 13 years of age. Conclusion: Treatment adherence in PKU diminishes with age. Early signs of treatment discontinuation can be identified during the second year of life, allowing preventive interventions in high risk groups.