Martínez, M. (Marina)
- Publications
- item.page.relationships.isContributorAdvisorOfPublication
- item.page.relationships.isContributorOfPublication
12 results
Search Results
Now showing 1 - 10 of 12
- Castillo, G. (2019). Cómo educar al niño para su futura adolescencia. Pamplona: EUNSA, 164 pp. [Reseña](Servicio de Publicaciones de la Universidad de Navarra, 2020) Martínez, M. (Marina)
- Spanish "fine tuning" of language to describe depression and anxiety(Mary Ann Liebert, 2009) Noguera, A. (Antonio); Portela, M.A. (María Angustias); Centeno, C. (Carlos); Urdiroz, J. (Julia); Carvajal, A. (Ana); Martínez, M. (Marina)On screening tools for emotional distress, the terms "depression" and "anxiety" are commonly used for patients with advanced cancer. However, these terms could have negative connotations in Spanish such that cultural and unexpected differences in perception may invalidate or skew the results of the screening if the best terms are not chosen. The goal of this study was to determine the best expression that can be used to explore anxiety and depression in Spanish. A prospective study of 100 Spanish-speaking patients was performed. Spanish patients with cancer completed the Hospital Anxiety and Depression Scale (HADS) and six Verbal Numerical Scales (VNS) exploring the level of anxiety using the terms ansioso (anxious), nervioso (nervous), or intranquilo (uneasy/disquiet), and the level of depression using the terms deprimido (depressed), desanimado (discouraged), or triste (sad). The correlation, sensitivity, and specificity for all the VNS and HADS (8 and 11 cutoff points) were analyzed. The correlation (Spearman rho) between HADS and the anxiety VNS was r = 0.557 using "anxious"; r = 0.603 using "nervous"; and r = 0.594 using "uneasy." The correlation for the depression VNS was r = 0.662 using "depression"; r = 0.759 using "discouraged" and r = 0.596 using "sad"; alpha < 0.001 was used in all VNS. A cutoff point of 4 of 10 for any term used to explore anxiety achieved the best levels for sensitivity (0.80) and specificity (0.70). The term "discouraged" with a cutoff point of 4 of 10 shows a sensitivity of 0.89, a specificity of 0.84, as well as a predictive positive value of 0.77 and a negative value of 0.93. In Spanish, the term desanimado seems to be more suitable in screening for depression. Alternate terms could be used to explore anxiety in Spanish. Exploring depression with simple questions in Spanish achieves greater accuracy than the same approach to exploring anxiety.
- Diseño e implantación de un proyecto docente para la formación de la identidad médica en estudiantes de Medicina(Elsevier, 2020) Arbea-Moreno, L. (Leire); Pozo, J.L. (José Luis) del; Centeno, C. (Carlos); Salvador, J. (Javier); Martínez, M. (Marina); Diaz-Gonzalez, J.A. (Juan Antonio); Soteras, M. (Marian); Pueyo, J. (Jesús)Se describen el diseño y la puesta en marcha de un proyecto docente en la Facultad de Medicina de la Universidad de Navarra dirigido a promover una fuerte identidad médica centrada en el paciente que armonice el desarrollo personal y el profesional de los futuros médicos. La acción educativa se lleva a cabo en 3 fases consecutivas. La primera consiste en unos talleres previos a las rotaciones clínicas en los que se reflexiona, de manera participativa, sobre un aspecto de identidad profesional seleccionado. En un segundo momento, el alumno identificará manifestaciones concretas de ese contenido en la práctica clínica: esa experiencia se recoge por escrito en un portafolio, no solo de manera descriptiva, sino también con una reflexión personal sobre lo que se ha vivido. Se cierra el proceso educativo con la evaluación razonada del portafolio y el contraste de su contenido con el tutor clínico.
- Héctor GHIRETTI (2004), Siniestra. En torno a la izquierda política en España, EUNSA, Pamplona [RECENSIÓN](Servicio de Publicaciones de la Universidad de Navarra, 2005) Martínez, M. (Marina)
- Sastre, R. y Nubiola, J. (2020). Las tesis de posgrado. Una guía novelada para quienes hacen y dirigen tesis. Pamplona, EUNSA, 143 pp. [RECENSIÓN](Servicio de Publicaciones de la Universidad de Navarra, 2021) Martínez, M. (Marina)
- ¿Cómo validar un instrumento de medida de la salud?(Gobierno de Navarra, 2011) Sanz-Rubiales, A. (Álvaro); Centeno, C. (Carlos); Watson, R. (R.); Carvajal, A. (Ana); Martínez, M. (Marina)It is increasingly necessary to have a measuring instrument available in the health field that can be used in clinical practice and research. In order to guarantee the quality of their measurements it is essential that the instruments should be subjected to a process of validation. This process consists in adapting the instrument culturally to the setting where its psychometric characteristics are to be administered and checked, such as: reliability, validity, sensitivity and feasibility. There are measuring instruments from the health field available in other languages but that have not been validated into Spanish. Besides, the methodology for validating an instrument is little understood by the health professionals, which explains the indiscriminate use of instruments that have only been adapted or validated in a way that is not very consistent. The aim of this review is to bring up to date the process of validating an instrument for measuring health, and what it involves, in a practical way. The accessibility of evaluation instruments that have been culturally adapted and validated in different languages will facilitate the comparison of results obtained with the same instrument and the development international studies in different cultures.
- Astenia en cáncer avanzado y uso de psicoestimulantes(Gobierno de Navarra. Departamento de Salud, 2011) Portela, M.A. (María Angustias); Sanz, A. (Álvaro); Centeno, C. (Carlos); Martínez, M. (Marina)Asthenia is the most frequent symptom in patients with advanced cancer and is probably what most affects the quality of life of oncology patients since it interferes in their physical and social activity. Treatment in the majority of cases is symptomatic. There is growing interest in the use of psychostimulants for treating asthenia. Methylphenidate and modafinil are two psychostimulants that have already been tested in controlled studies on asthenia of the patient with advanced cancer; they have proved to be efficient, particularly in patients in very advanced stages who are very tired.
- Multicenter Study of the Psychometric Properties of the New Demoralization Scale (DS-II) in Spanish-Speaking Advanced Cancer Patients(Elsevier, 2019) Santesteban, Y. (Yolanda); Centeno, C. (Carlos); Arantzamendi-Solabarrieta, M. (María); López-Fidalgo, J. (Jesús); Consigli, S. (Sara); Belar, A. (Alazne); Martínez, M. (Marina); Rodríguez-Núñez, A. (Alfredo)Context. Demoralization is a state of existential distress in patients with advanced illness, typically with coping difficulties, feelings of loss of sense, and purpose in life and despair, among other things. The New Demoralization Scale (DS-II) is an evaluation tool for this syndrome, which has recently been reformulated on a shorter scale. Objectives. The objective of this study was to obtain a Spanish version of the DS-II and to assess its psychometric properties in advanced cancer patients in Spain and a number of Latin American countries. Methods. Following a translationeback translation process, a validation study and a confirmatory analysis using structural equation models with their corresponding latent constructs were undertaken. Patients completed the DS-II in Spanish (DS-II (es)), the Hospital Anxiety and Depression Scale, and the Edmonton Symptom Assessment Systemerevised. Reliability was studied according to internal consistency; construct validity and concurrent validity with the Hospital Anxiety and Depression Scale and the Edmonton Symptom Assessment Systemerevised; discriminant validity using the Karnofsky Performance Status scale; and feasibility, with response ratio and required time. Cutoff points were established, and sensitivity and specificity were studied. Results. The DS-II (es) was obtained. One hundred fifty patients completed the validation study. The confirmatory analysis showed coherence, and all items correlated positively with their subscales and with the overall scale. Cronbach’s alpha for the DS-II (es) was 0.88, for the sense and purpose subscale 0.83, and for the coping ability 0.79. Demoralization correlated significantly with emotional distress (rho 1⁄4 0.73, P < 0.001). The tool distinguished between patients with diverse functional levels (rho 1⁄4 0.319, P 1⁄4 0.001). Cutoff points at 10 and 20 out of 32 were established. The scale showed high sensitivity (81.97%) and specificity (80.90%). The prevalence of demoralization was 33% in our sample. Conclusion. The Spanish version of the new Kissane DS-II demoralization scale has shown to be valid, reliable, and feasible with adequate psychometric properties. J Pain Symptom Manage 2019;57:627e634. 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.
- Proactive and systematic multidimensional needs assessment in patients with advanced cancer approaching palliative care: a study protocol(BMJ Publishing Group, 2020) Rocafort, J. (Javier); Noguera, A. (Antonio); Monforte-Royo, C. (Cristina); Pergolizzi, D. (Denise); Alonso-Babarro, A. (Alberto); Balaguer, A. (Albert); Goni-Fuste, B. (Blanca); Pérez-Bret, E. (Encarnación); Mateo-Ortega, D. (Dolors); Centeno, C. (Carlos); Nabal, M. (María); Arantzamendi-Solabarrieta, M. (María); May, L. (Luis); Rodríguez-Prat, A. (Andrea); Pascual, A. (Antonio); Moreno-Alonso, D. (Deborah); Belar, A. (Alazne); Julià-Torras, J. (Joaquim); Martínez, M. (Marina); Crespo, I. (Iris)Introduction The benefits of palliative care rely on how healthcare professionals assess patients’ needs in the initial encounter/s; crucial to the design of a personalised therapeutic plan. However, there is currently no evidence-based guideline to perform this needs assessment. We aim to design and evaluate a proactive and systematic method for the needs assessment using quality guidelines for developing complex interventions. This will involve patients, their relatives and healthcare professionals in all phases of the study and its communication to offer clinical practice a reliable approach to address the palliative needs of patients. Methods and analysis To design and assess the feasibility of an evidence-based, proactive and systematic Multidimensional needs Assessment in Palliative care (MAP) as a semistructured clinical interview guide for initial palliative care encounter/s in patients with advanced cancer. This is a two-phase multisite project conducted over 36 months between May 2019 and May 2022. Phase I includes a systematic review, discussions with stakeholders and Delphi consensus. The evidence gathered from phase I will be the basis for the initial versions of the MAP, then submitted to Delphi consensus to develop a preliminary guide of the MAP for the training of clinicians in the feasibility phase. Phase II is a mixed-methods multicenter feasibility study that will assess the MAP’s acceptability, participation, practicality, adaptation and implementation. A nested qualitative study will purposively sample a subset of participants to add preliminary clues about the benefits and barriers of the MAP. The evidence gathered from phase II will build a MAP user guide and educational programme for use in clinical practice.
- Cross-sectional survey of the wish to die among palliative patients in Spain: one phenomenon, different experiences(Cambridge University Press, 2020) Lama, M. (Marcos); Santesteban, Y. (Yolanda); Olza-Moreno, I. (Inés); Rullán, M. (María); Centeno, C. (Carlos); Arantzamendi-Solabarrieta, M. (María); López-Fidalgo, J. (Jesús); Belar, A. (Alazne); Martínez, M. (Marina); Breeze, R. (Ruth)Objective Cultural backgrounds and values have a decisive impact on the phenomenon of the wish to die (WTD), and examination of this in Mediterranean countries is in its early stages. The objectives of this study were to establish the prevalence of WTD and to characterise this phenomenon in our cultural context. Methods A cross-sectional study with consecutive advanced inpatients was conducted. Data about WTD (Assessing Frequency & Extent of Desire to Die (AFFED) interview) and anxiety and depression (Edmonton Symptom Assessment System-revised (ESAS-r)) were collected through two face-to-face clinical encounters. Data were analysed with descriptive statistics, χ2 and analysis of variance. Results 201 patients participated and 165 (82%) completed both interviews. Prevalence of WTD was 18% (36/201) in the first interview and 16% (26/165) in the second interview (p=0.25). After the first interview, no changes in depression (p=0.60) or anxiety (p=0.90) were detected. The AFFED shows different experiences within WTD: 11% of patients reported a sporadic experience, while 7% described a persistent experience. Thinking about hastening death (HD) appeared in 8 (22%) out of 36 patients with WTD: 5 (14%) out of 36 patients considered this hypothetically but would never take action, while 3 (8%) out of 36 patients had a more structured idea about HD. In this study, no relation was detected between HD and frequency of the appearance of WTD (p=0.12). Conclusions One in five patients had WTD. Our findings suggest the existence of different experiences within the same phenomenon, defined according to frequency of appearance and intention to hasten death. A linguistically grounded model is proposed, differentiating the experiences of the ‘wish’ or ‘desire’ to die, with or without HD ideation.