To describe the frequency of prognostic awareness (PA) in a population of advanced cancer patients in a Latino community and to explore the relationship between accurate PA with emotional distress and other covariates.

In this cross-sectional study performed in Puente Alto, Chile, advanced cancer patients in palliative care completed a survey that included a single question to assess PA (Do you believe your cancer is curable? yes/no). Patients reporting that their cancer was not curable were considered as having accurate PA. Demographics, emotional distress, quality of life, and patient perception of treatment goals were also assessed. Analyses to explore associations between PA and patient variables were adjusted.

A total of 201 patients were included in the analysis. Mean age was 65, 50% female. One hundred and three patients (51%) reported an accurate PA. In the univariate analysis, accurate PA was associated with not having a partner (p = 0.012), increased emotional distress (p = 0.013), depression (p = 0.003), and were less likely to report that the goal of the treatment was to get rid of the cancer (p < 0.001). In the multivariate analysis, patients with accurate PA had higher emotional distress or depression, were less likely to have a partner, and to report that the goal of the treatment was to get rid of the cancer.

Half of a population of Latino advanced cancer patients reported an accurate PA. Accurate PA was associated with increased emotional distress, which is similar to what has been reported in other countries. Weaknesses in prognostic disclosure by clinicians, local cultural factors, or higher motivation to seek prognostic information among distressed cancer patients could explain this association. Strategies to emotionally support patients when discussing prognostic information should be implemented.

Effective participation of individuals with disabilities in health technology assessment (HTA) processes is paramount. Aware of the reality of people with physical and organic disabilities, COGAMI (a not-for-profit umbrella organization of disability associations) conducted an internal study to gather perspectives on the participation of people with disabilities in HTA processes.

An ad hoc questionnaire of four open-ended questions was designed and distributed via email to COGAMI’s socio-health commission, representing 23 entities and 4,000 people in Galicia. A thematic analysis of the responses obtained was carried out.

Consensus underscores the fundamental role of individuals with disabilities and their representative organizations in HTA processes, though currently, only those with greater resources actively participate. The participants found that insufficient information reaching patient organizations hinders participation (e.g., lack of awareness in proposal submission), complicating their involvement. Additional challenges include accessibility and the digital divide. Proposed solutions involve enhancing communication channels and information accessibility, establishing collaborative frameworks nationally, and actively considering the disability condition to ensure a fair and equitable implementation.

This study suggests the need for concrete actions to enhance the participation of individuals with disabilities in HTA processes. Recommendations include improving communication channels, capacity building, and recognizing disability as a key element in HTA.

Mitral regurgitation (MR) is the most prevalent valvular heart disease worldwide and is frequently underdiagnosed and undertreated, resulting in a substantial healthcare burden. This project aimed to define an optimized patient journey, identifying specific unmet needs and pain points in the management of MR in Spain, and to propose a set of recommendations that can be implemented at a clinical level.

Using the Population, Intervention, Comparator, and Outcomes search strategy, a pragmatic literature review was conducted to contextualize the comprehensive management of patients with MR in Spain. Subsequently, a Delphi panel consisting of two rounds of questionnaires was implemented. Unmet needs detected for MR management along the patient journey were validated by a panel of clinical experts incorporating different profiles. A battery of actions to improve the MR patient journey was also gathered (first round), which were then systematically reviewed and prioritized by the experts using hierarchical point allocation methods (second round) based on their relevance and feasibility within the National Health System.

A set of actions was proposed for the following core phases: detection-diagnosis, treatment-decision, treatment, and follow up. Actions for detection-diagnosis should be prioritized since boosting patient referral to specialized centers was considered crucial. Within the treatment-decision stage, experts emphasized strengthening healthcare services communication and training on risk stratification. For treatment, early referral to specialized centers was prioritized. Optimizing follow up required educating patients and relatives on adherence and self-care. Finally, experts supported a common pathway for heart valve diseases such as MR, tricuspid regurgitation, and aortic stenosis. Specifically, they concluded that optimization of tricuspid regurgitation management aligned with the actions proposed for MR.

Altogether, unmet needs and critical aspects in each of the management steps of MR in Spain were detected and an array of potential actions was suggested by clinical experts. The evaluation of such actions resulted in a preliminary strategic plan that can help prioritize interventions and healthcare policies regarding the optimization of the healthcare journey for patients with MR (and other valvulopathies) in Spain.

Self-perceptions of aging seem to be a key variable to understand physical and mental health (see the systematic review conducted by Tully-Wilson et al., 2021). Following Levy’s (2003) stereotype embodiment theory, negative attitudes towards aging originate as aging stereotypes (e.g., “older people are frail”; Warmoth et al., 2016) during childhood. They are internalized and reinforced in adulthood, both consciously and below conscious awareness, becoming aging self-stereotypes in old age and affecting self-perceptions of aging (Levy, 2003). Kordnat et al. (2016) developed an implicit association test (IAT; Greenwald et al., 1998) to assess implicit age stereotypes for specific life domains (health and family domains) across the life span and found positive stereotypes towards older people for family domain and negative for health domain. However, the associations between implicit age stereotypes and adults’ psychological distress have been scarcely analyzed. The aims of this communication are: a) to present the preliminary data of the validation of the implicit association test (IAT, Greenwald et al., 1998) to measure implicit aging stereotypes and b) to explore the relationship between implicit aging stereotypes and older adults’ psychological distress (loneliness, guilt associated with self-perception as a burden, and anxiety and depressive symptoms).

The IAT used is an adaptation of the IAT developed by Kordnat et al. (2016). The IAT explores the relationship between the categories of sickness/health and old/young age. The task has a target category that consists of: a) a set of 6 words of physical and mental sickness (e.g., frail, weak, sad, lonely) and 6 words of physical and mental health (e.g., healthy, energetic, happy, in company); and b) 6 photos of old people and 6 photos of young people.

Preliminary results of the implicit aging stereotypes task associations with older adults’ psychological distress in 100 community dwelling older adults will be presented.

Findings will be discussed. The implicit (below awareness) assessment of the aging stereotypes with the IAT in older adults could provide a better understanding of the role of aging stereotypes in older adults’ psychological distress, avoiding the weaknesses of assessing the construct through self-report measures.

Anticipatory grief is frequently experienced by family caregivers of persons with dementia. It is defined as the feelings of pain and loss that appear in the caregiver prior to the death of the person cared for, and it is linked to negative consequences for the physical and psychological caregiver’s health. However, more research is needed about this construct. The purpose of this work was to explore the differences regarding gender and kinship in anticipatory grief in caregivers and to explore its associations with distress experienced by the caregivers.

The sample consisted of 70 caregivers. The anticipatory grief was measured with the Caregiver Grief Scale (CGS; Meichsner et al., 2016). Also, frequency of problematic behaviours in the person with dementia and caregiver reactions to them (RMPBC; Teri et al., 1992), depressive symptomatology (CES-D; Radloff, 1977), guilt (CGQ; Losada et al., 2010), anxiety (Tension Sub-scale of POMS’s Questionnaire; Fernández et al., 2000), emotional ambivalence (CAS; Losada et al., 2017) and the experiential avoidance in caregiving (EACQ; Losada et al., 2014) were measured.

Independent-samples T-tests were conducted to study if there were differences in anticipatory grief according to the gender of the caregiver and the kinship with the person with dementia. Secondly, Pearson correlations were conducted to study the associations between anticipatory grief and emotional distress variables.

The results showed no significative differences according to the gender of the caregiver in anticipatory grief. However, a longer caregiver ́s age and being a spouse caregiver was related to a greater anticipatory grief. Regarding the person cared for, behavioral problems and caregivers ́ reaction to them were associated with anticipatory grief. With regard to caregiver ́s emotional distress, significant and positive correlations were also obtained between anticipatory grief and its subscales with depressive symptomatology, guilt, anxiety, emotional ambivalence and experiential avoidance in caregiving.

The results suggest that anticipatory grief may have a relevant role in the well-being of dementia family caregivers. Therefore, it is necessary to consider this process in the assessment and intervention in this context with caregivers.

it has been shown that having negative-self perceptions of aging significantly predicts depressive symptomatology. Although the partner relationship may have an impact on the effects of perception of aging on distress, the number of studies assessing the effect of partner on negative self-perception of aging and mental health is limited. The stress of one partner may elicit dyadic coping (DC) responses in the other partner. The stress of one partner may elicit dyadic coping responses in the other partner. Depending on whether the responses are positive (supportive) or negative (hostile)a close relationship can go along with additional stress or resources and benefits. The present study analyzes the relationship between negative self-stereotypes and depressive symptomatology, considering the partner’s dyadic coping as a moderator variable in this association.

Participants were 365 individuals (59.3% women) 40 years or older (M= 60.86, SD=10.66) involved in a marital/partner relationship. Participants completed a questionnaire that included the variables: negative self-perception of aging, positive DC (e.g., “My partner shows empathy and understanding to me”), negative DC (e.g., “When I am stressed, my partner tends to withdraw”), and depressive symptomatology. Two moderation models were tested by linear regression: the first considered positive DC and the second negative DC as a moderator in the relationship between negative self-perception of aging and depressive symptoms.

The effect of negative self-perceptions of aging on depressive symptoms was smaller among those who perceived higher levels of positive DC and lower levels of negative DC by their partners than among those perceiving lower positive DC and higher negative DC. The influence of supportive dyadic coping was higher when the levels of negative self-perception of aging were higher. Gender was a determinant factor in the moderation.

Positive DC mitigates the negative effects of negative self-perception of aging on wellbeing (by the mechanism of moderation), while negative DC amplifies this association and goes along with lower well-being in persons who report negative self-perceptions of aging. Training couples in supportive dyadic coping may be a resource to buffer the negative effect of negative self-perceptions of aging on well-being.

Caring for a relative with dementia is a chronic stress situation related to negative consequences such as elevated depressive and anxiety symptoms. A possible mediator variable explored to explain pathways from chronic stress to emotional distress is emotional ambivalence towards the care-recipient (the simultaneous experience of positive and negative feelings towards the care-recipient). Emotional ambivalence, measured with questionnaires, presents significant associations with depression and anxiety in family carers of people with dementia. However, the self-report of emotional ambivalence is susceptible to being influenced by social desirability. The aim of this study is to present preliminary results that analyze implicit ambivalence and its association with emotional distress in family carers of people with dementia.

54 caregivers participated in the study (mean age = 61.2, SD = 12.92, 81.5% women). To explore implicit emotional ambivalence, we adapted a sequential priming paradigm developed to measure implicit ambivalence about significant others (Zayas & Shoda, 2015). Two priming stimuli were used: a) neutral (e.g., RRR) and b) valenced prime (i.e., the name of the care-recipient). The targets were positive and negative words that participants have to categorize as positive or negative.

A facilitation-inhibition indexes for positive and negative targets were calculated by subtracting the mean reaction time (RT) for valenced prime from the mean RT for neutral primes. Positive values show a facilitation effect of the valenced prime (i.e., the name of the care-recipient), and negative values inhibition. Participants were classified depending on their results of this indexes: a) positive (facilitation of positive information, inhibition of negative information), b) negative (facilitation of negative information, inhibition of positive information), c) flat (inhibition of positive and negative information), and d) ambivalence (facilitation of positive and negative information). ANOVAS were performed to explore differences between groups in emotional distress. The preliminary results showed that the ambivalence group might present more depressive symptoms compared with the positive group.

This is the first study that analyzed implicit ambivalence in family carers of people with dementia. The preliminary results show the relevance of exploring implicit processes to explain emotional distress in this population.

Research in informal dementia caregiving has focused on the negative outcomes it implies as a chronic stress situation, even though positive feelings derived from the caregiving experience are also reported. This co-occurrence of positive and negative experiences is a form of emotional complexity that has barely been explored in caregivers although it could be relevant for understanding caregivers' vulnerability to distress. To explore this emotional complexity, profiles of caregivers according to their levels of positive and negative affect were created and compared with regard to their reported anxiety, ambivalence feelings, experiential avoidance, quality of the actual relationship, thoughts of institutionalizing the person with dementia (PWD), and social support.

363 primary family caregivers were distributed in groups based on their reported depressive feelings and positive emotions related to caregiving and the PWD. Four groups were identified: (1) flat (low negative affect, low positive affect), (2) negative (high negative affect, low positive affect), (3) positive (low negative affect, high positive affect), (4) mixed (high negative affect, high positive affect). ANOVAS were performed to explore differences between groups.

Caregivers in the positive and mixed profiles reported better actual relationships with the PWD and higher experiential avoidance. Caregivers with both negative and mixed profile showed higher anxiety than the other profiles, and the negative profile also reported higher thoughts about institutionalizing the care-recipient and more ambivalence. Caregivers in the positive group reported the highest social support.

The obtained findings converge in the idea that caregivers ́ positive emotions towards the PWD are closely related to the quality of the relationship, and may be involved in a delayed decision to institutionalize her/him. The presence of negative affect (depressive feelings) is associated with anxiety symptoms, even when positive emotions are reported, supporting the high prevalence of anxiety-depressive comorbidity in this population. Finally, the negative profile (low positive and high negative affect) is the one that reports more ambivalence. Taken together, these findings suggest that caregiving for PWD should be considered an emotionally complex situation with positive affect derived from the caregiving being key in understanding caregivers’ well-being and distress.

Limited knowledge of the symptomatology of aortic stenosis (AS) among the general population may delay diagnosis and have a major impact on morbidity and resource use. Training programs have often been advocated by the scientific community. The present study reported the results of an assessment of a training program for the general population.

Patients who attended healthcare centers were asked to answer a questionnaire on their level of knowledge around AS. A cohort of patients without training (n=681) answered the questionnaire and a second cohort answered the questionnaire via phone 24 hours after training (n=197). Propensity score matching by sex and age was used to obtain a balanced sample between the two cohorts, giving a total study sample of 394 individuals (197 without training and 197 with training). A descriptive analysis was performed to compare differences in the level of knowledge between the two cohorts. Predictors of AS symptomatology were identified using multivariate logistic regression.

The trained cohort was more aware of AS disease than the untrained cohort (79% versus 31%, 95% confidence interval [CI]: 0.39, 0.56; p<0.001). They were also better at distinguishing the symptoms associated with AS (80% versus 43%, 95% CI: 0.28, 0.48, p<0.001) and were more aware of its severity (36% versus 12%; 95% CI: 0.16, 0.32, p<0.001). Moreover, the trained cohort were better at identifying symptoms that should make them consider visiting a doctor (76% versus 65%; 95% CI 0.02, 0.20, p<0.02). No differences were observed in level of concern regarding AS (8% versus 4%; 95% CI: -0.0046, 0.09, p=0.08).

The trained people who were aware of AS (p=0.04) correctly classified AS as a valvular disease (p=0.025), would seek medical consultation when AS symptoms occurred (p=0.04), and were more likely to correctly detect AS symptoms.

The training program significantly improved the knowledge and awareness of AS in the general population. This can improve the timeliness of AS diagnosis, reducing the health and economic burden of AS for the healthcare system.

Gambling disorder (GD) and bulimic spectrum eating disorders (BSDs) not only share numerous psychopathological, neurobiological, and comorbidity features but also are distinguished by the presence of inappropriate behaviours related to impulsivity and compulsivity. This study aimed to emphasise the differences and similarities in the main impulsivity and compulsivity features between GD and BSD patients, and to analyse the potential influence of sex in these domains.

Using self-reported and neurocognitive measures, we assessed different impulsive–compulsive components in a sample of 218 female and male patients (59 with BSD and 159 with GD) and 150 healthy controls.

We observed that GD and BSDs exhibited elevated levels of impulsivity and compulsivity in all the dimensions compared to healthy controls. Moreover, these disorders showed differences in several personality traits, such as high novelty seeking in GD, and low persistence and high harm avoidance in BSDs. In addition, patients with BSDs also displayed a trend towards greater impulsive choice than GD patients. Regarding sex effects, GD women presented higher overall impulsivity and compulsivity than GD men. Nevertheless, no sex differences were found in BSDs.

Clinical interventions should consider these deficits to enhance their effectiveness, including adjunctive treatment to target these difficulties. Our findings also provide support to the relevance of sex in GD, which should also be considered in clinical interventions.