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This study provides the results from the implementation of a highly structured therapist-guided iCBT program for people with work-related anxiety and depression, in terms of program efficacy, participants’ adherence and satisfaction. Seventy-seven national police-workers were randomly allocated to one of two groups: without additional videoconference sessions (web platform with guidance of therapist), and with additional videoconference sessions (same intervention as the previous group, plus two videoconference guidance sessions with a psychologist). The intervention was comprised of 12 sessions and took place for 17-20 weeks. We found an adherence rate of 36.4%, with no differences between groups. All participants endorsed lower depression [BDI-II F(1) = 36.98, ρ < .001; ATQ F(1) = 24.22, ρ < .001], and anxiety [STAI-State F(1) = 76.62, ρ < .001] after the program. As a variable related to anxiety and depression in workplace, participants also showed higher assertiveness levels [RAS F(1) = 8.96, ρ < .001]. A significant reduction of the mean level of anxiety perceived by participants as the intervention program progressed was observed in both groups (F(2)=7.44; p=.003). Participants were satisfied with the therapists’ intervention and with the program. No significant group effects were found for any of the measures. Reduction in depression levels was maintained in the 12 months follow-up, but levels of anxiety increased. This study is innovative, as it is the first controlled trial to analyze the effect of two added videoconference sessions, and it includes short and long term measures, which is not usual. The results are discussed to clarify the role of the contact with the therapist to improve treatment adherence. post-print 309 KB

Introduction Paternalism, assuming control of aged care, is a widespread orientation in older adults care. Paternalistic attitudes and practices are commonly understood as a threat to the freedom and autonomy of a person, making patients more dependent. Therefore, the reduction of these attitudes and behaviors is a primary goal for any older adult health and social care situation. The aim of this preliminary study is to develop a behavioral intervention to decrease paternalistic behaviors in formal caregivers and to increase those care behaviors which promote autonomy at post-intervention (1 week) and at follow-up (14 weeks). Methods A sample of 118 professional caregiver volunteers working in day care centers and nursing homes were assigned to quasi-experimental (N=47) and control (N=71) conditions. The intervention consisted of 3 weekly group sessions. Individual and contextual measures were collected: 1) the primary outcome variable was the type of care (paternalistic versus autonomist) measured through the self-report Paternalist/Autonomist Care Assessment (PACA); 2) A 10-item caregiver self-register of paternalistic behaviors was carried out, 3) Finally, in order to assess the potential effects on observed behavior both in caregiver and older adult functioning at a contextual level, the five institutions were assessed through the SERA-RS. Results Compared with the control group, caregivers in the behavioral intervention group displayed significantly lower paternalistic appraisals at posttest and follow-up. Regarding the intervention group, caregivers at posttest and follow-up showed significantly greater occurrence of autonomist behaviors being promoted and lower paternalistic appraisal. The results regarding the effect on the institutions showed better personnel performance and older adult functioning. Conclusion Caregivers who followed the intervention learned to better identify older adult needs; although we did not find significant differences in autonomy occurrence compared with the control group, a behavioral intervention may promote more autonomist environments and, therefore, better personnel and older adult functioning.

There is a need for a validated instrument to measure the type of care (paternalism or person-centred) provided for older adults. Since paternalism and person-centred care are the most important caregiving styles in the field of care and as they are usually opposed, the study aims to develop and establish psychometrics data of an instrument to identify paternalistic and autonomist behaviours in older adults care contexts, which can help to enhance care practice.Instrument development.After observing and standardizing behaviours in formal care contexts in 2016, an instrument was developed and proceeding to a first validation using standard validation techniques among caregivers in two care settings during 2016-2017: senior citizen centres and older adult day care centres.The Paternalist/Autonomist Care Assessment (PACA) is a 30-item, behaviour-based instrument which measures both the appraisal of caregivers on elements of care (Care Appraisal Scale- PACA-Appraisal) and the occurrence of behaviours (Occurrence of Care in Context- PACA-Occurrence). The Paternalist/Autonomist Care Assessment (PACA) was validated in 160 professional caregivers and was able to discriminate two factors: paternalistic or overprotective behaviours and autonomist behaviours. However, these factors were not fully dichotomous and were shown to coexist to some degree.The instrument displayed good psychometric properties to measure paternalism and autonomy in older adult care. Moreover, it showed that the two types of care are not antagonistic and can coexist, with overprotective behaviours being more frequent in contexts of care for more dependent persons.There are no validated instruments to measure paternalism and person-centred behaviour in care contexts. The two measures yielded by the PACA show good construct and concurrent empirical validity, internal consistency, and convergent and discriminant validity. Family caregiver, professional caregivers, nurses, older adults.目的: 我们需要一个衡量为老年人提供的护理类型(家长式或以人为本)的有效工具。家长制和以人为中心的护理是护理领域最重要的护理方式,而且这两种护理方式通常是对立的,因此本研究旨在开发和建立确定老年人护理环境中的家长制和自主行为范畴的心理测量数据,有助于加强护理实践。 设计: 量表开发。 方法: 以2016年对正规护理环境下的行为进行的观察和标准化为基础,建立量表。并在2016-2017年期间使用标准验证技术对两个护理环境:老年人中心和老年人日托中心中的护理人员进行了首次验证 。 结果: 家长式/自主式护理评估表(PACA)是一个30项、基于行为的量表,它衡量护理人员对护理要素的评估(护理评估量表-PACA-评估)和行为的发生(不同背景中护理的发生-PACA-护理)。家长式/自主式护理评估(PACA)在160名专业护理人员中进行验证,两个因素:家长式或过度保护行为和自主式行为能够被区分。然而,这些因素并不是完全相互区别的,在某种程度上显示出共存性。 结论: 该量表在衡量老年人护理中的家长式护理和自主性护理中显示出良好的心理计量特性。此外,研究表明,这两种类型的护理不是对立的,可以共存,在患者显示出更多依赖性时,过度保护行为出现更为频繁。 影响: 护理中没有有效工具来判定家长式护理和以人为本的护理的区别。PACA得出的两个测度具有良好的结构效度和并发经验效度、内部一致性、收敛和判别效度。适用于家庭护理人员,专业护理人员,护士,老年人。.

Rocío Fernández-Ballesteros,1 Macarena Sánchez-Izquierdo,2 Ricardo Olmos,3 Carmen Huici,4 Marta Santacreu,5 Rocío Schettini,6 María Ángeles Molina6 1Department of Psychobiology and Health, Autonomous University of Madrid, Madrid, Spain; 2Department of Psychology, Universidad Pontificia Comillas, Madrid, Spain; 3Department of Methodology, Autonomous University of Madrid, Madrid, Spain; 4Department of Social and Organizations Psychology, Universidad Nacional de Educación a Distancia, Madrid, Spain; 5Department of Psychology, Universidad Europea, Madrid, Spain; 6Department of Psychology, Universidad Francisco de Vitoria, Madrid, Spain Introduction: The main goal of the present study was to examine the stereotype content model (SCM) assumption for universality and to test whether the mediating role of cultural views about older adult caregivers is maintained in other health care contexts. Methods: One hundred and sixty professionals and volunteers who worked with older adults in day care centers (DCCs) and senior citizen centers (SCCs) and 1,151 participants from a representative sample of the Spanish population were examined using the SCM questionnaire; older adult and personnel functioning were assessed through an observation procedure with two subscales of the Evaluation Scale from the Sistema de Evaluación de Residencias de Ancianos. Results: The results showed that the context does not seem to influence the cultural views about older adults held by caregivers. All results support the cultural stereotype pattern in which members of the older adult group are viewed with high warmth (HW) and low competence (LC) as posited by the SCM model. With respect to the mediation of cultural stereotypes on caregivers/older adult functioning, this has not been supported in this study. Neither cultural views of warmth (predicted by the SCM) nor views of competence (from our previous studies) influence either caregiver functional behaviors or older adult functioning. Conclusion: Two post hoc hypotheses can be inferred: 1) there is more variability in competence and warmth in DCCs and SCCs and 2) although we did not find significant differences in the pattern of competence and warmth in perceived cultural stereotypes about older adults, more healthy environments could reduce the influence of cognitive views on behavior. Keywords: caregiving, prejudice, cultural stereotypes, caregiver functioning, older adult functioning

There is a broad semantic network of aging stereotypes; where different concepts and their measurement are confused: personal stereotypes, self-stereotypes and self-perception of aging.First, we analyze the translated version of the Image of Aging Scale (IAS) measurement model through exploratory and confirmatory factor analysis, with two representative sub-samples of the Spanish population aged over eighteen (N = 1,105) and in a sample of gerontologists and geriatricians (N = 325). Second, in an effort to disentangle the theoretical relationships between personal stereotypes, self-stereotypes and self-perception of aging, both the IAS (with different instructions) and Lawtonrsquo;s 5-item scale were administered to a representative sample of Spanish people over 50.Our results indicate that the Spanish version of the IAS has a similar psychometric structure to that proposed by the authors. Furthermore, the factorial structure (equal form and metric invariance) is replicated in both samples, but latent means and factor correlations were higher in the professional group.We discuss Levyrsquo;s theoretical assumptions about personal-stereotypes and the self-stereotype measured with IAS and their relationship to self-perception of ageing.

Among older adults, perceived age discrimination is highly associated with unhealthy outcomes and dissatisfaction. Active aging is a multidimensional concept described by a set of characteristics, particularly health, positive mood and control; most importantly, active aging is currently at the core of public policies. The aim of the present study was to test to what extent perceived discrimination influences active aging. Methods A total of 2005 older adults in three representative samples from regions of Germany, Mexico and Spain participated; they were tested on active aging and perceived discrimination. First, active aging was defined as high reported health, life satisfaction and self-perception of aging. Second, authors introduced the assumption that, in the total sample, structural equation modelling would confirm the hypothesis of a direct negative link between perceived age discrimination and active aging. Finally, multiple group comparison performed through structural equation modelling also provided support for the negative association between perceived discrimination and active aging proposed. In spite of the differences found among the three countries in both active aging variables and age discrimination perception, multiple group comparison indicates that regardless of the culture, perceived discrimination is a negative predictor of active aging. CASOENAC (2009-11), the project EVE MINECO PSI-2010- 14-1770 and ICESEN MINECO PSI2014-52464-P 2.241 JCR (2017) Q3, 34/53 Geriatrics and Gerontology UEM

Marta Santacreu, Rocío Fernández-BallesterosBiological and Health Psychology, Autonomous University of Madrid, Madrid, SpainAbstract: Urinary incontinence is a medical, psychological, social, economic, and hygienic problem. Although it is difficult to state its prevalence, all authors agree that it is related to age and gender. This study aimed to carry out a urinary incontinence behavioral treatment in order to reduce urine leakages in 14 participants recruited from a senior center. The program consists of daily training of the pelvic floor muscles with a weekly control by a supervisor during a2-month period and follow-up of results 2 months after the last control session. Urinary incontinence episodes were reduced by 75.67% after program completion. It appears that pelvic floor muscles training, carried out under controlled and constant supervision, significantly reduces urinary leakage. Moreover, maintaining this improvement after treatment depends on the continuation of the exercises as well as on the urinary leakage frequency baseline and the urinary leakage frequency during the last treatment session.Keywords: urinary incontinence, pelvic floor muscle training, quasi-experimental design