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It has been reported that the impact of the continuous ambulatory peritoneal dialysis (CAPD) procedure in the patient's quality of life has profound psychosocial consequences for him and his family. This replacement of renal function supports survival but not a complete physical, emotional and social development. These aspects may be crucial to the success of treatment with CAPD for its positive or negative influence on patient adherence to this procedure. This study evaluated the degree of psychological maladjustment in CAPD patients, psychosocial variables, coping strategies and the impact on their quality of life. We interviewed 83 patients on CAPD (43 women and 40 men, mean age, 53.5 years, SD, 15.3), chosen for availability in a dialysis unit of a general hospital. Quality of life was inversely and significantly associated with depression, anxiety and loneliness. Spirituality based on a full relationship with life is inversely associated with depression, hopelessness, suicidal ideation, loneliness and death anxiety. Depression, hopelessness and loneliness were associated with a cognitive-dysfunctional coping style. The loneliness and suicidal ideation are associated with a emotional-aggressive coping style the perceived ability of giving and spirituality based on life are associated with positive cognitive coping. When comparing subjects with a high degree of psychological maladjustment, against a norm group, the subjects showed higher mean depression and hopelessness. The results are consistent with findings reported in other latitudes, demonstrating the need to implement intervention strategies aimed at reducing the risk of suicide and to create a better psychological adjustment to the situation of CAPD. [ABSTRACT FROM AUTHOR]

The term «loss» in this article refers to the lack of a significant adaptive resource that is a central part of the affective world of the subject. The absence of such resource can generate psychological distress. Old age is seen as a time in which numerous changes occur that are associated with losses in important areas of life and which, as a whole, constitute a major source of stress. These losses involve a series of physical, social and psychological changes that affect and define old age and that require the subject to develop a process of adaptation to many intense stressors. Loss structure can be defined as a set of significant objects (that can be grouped under different loss categories), perceived as being under threat of being lost, effectively lost, or whose existence is uncertain or ambiguous (conceived of as types of loss), and whose influence continues to define cognitions, affection and behaviors. The unprecedented loss structure found in elderly adults could set up different routes of maladjustment. Maladjustment appear in three fundamental areas: psychological, physical and social. Hence, frustration can lead to depression. Successive losses seen as a series of failures can generate feelings of despair; losses related to sources of affection can produce loneliness, etc. The Loss Structure Scale (LSS), proposed here is an instrument for exploring losses that usually occur in old age. It also allows a systematic exploration of a wide range of losses previously validated in the Mexican context as a first approach to possible psychosocial causes of psychological maladjustment in old age. Method The project was divided into two phases. The first corresponded to the design of the LSS, and the second to a psychometric evaluation. Four samples were used with subjects chosen by availability in Mexico City. One model of the scale was explored that consisted of 60 items linked to experiences of loss with three reply options for each item: No loss, Ambiguous loss, and Definite loss in a final sample of 193 subjects (69.34% women, N = 134). The following instruments were used: The Center of Epidemiological Studies Depression Scale; Beck's Anxiety Inventory; Hunter Opinions and Personal Expectations Scale; the perceived disease subscale of WHOQoL- Brief; The World Health Organization Quality of Life Assessment, Brief; the Lack of Emotional Wellbeing subscale of the Multifaceted Loneliness Inventory and the Anxiety About Aging Scale. Results Factor structure. A factor analysis was carried out using the principal components method with varimax rotation and eigen values greater than one. The final factor structure showed nine well defined factors covering 36 items with an internal alpha consistence of .91 explaining 67.4% of the variance. Alpha values for the internal consistence of the 9 factors fluctuated between .74 and .83. Construct validity. 1) Moderately high correlations were obtained between total score on the Loss Structure Scale and all psychological maladjustment variables (between r=.50 and r=.66; p<.01), with the exception of aging anxiety, which seems to point to the important pathogenic role of losses suffered in most of the maladjustment variables, 2) a negative association was found between the frequency of no losses and the afore mentioned variables, with depression (r=-.70, p<.01) and loneliness (r=-.68, p<.01), 3) ambiguous loss frequency correlated positively with depression (r=.54, p<.01), loneliness (r=.47, p<.01), anxiety (r=.42, p<.01) and aging anxiety (r=.40, p<.01), 4) the frequency of definite losses correlated strongly with loneliness (r=.53, p<.01), depression (r=.50, p<.01) and perceived disease (r=.47, p<.01).… [ABSTRACT FROM AUTHOR]

Lifshitz has documented that conceptualization of old age is influenced by stereotypes. Milligan, Powell, Harley and Furchtgott, made evident that elderly people with poor health have a tendency to see themselves as the stereotype of an "old person", whereas those with better health tend to see themselves as younger people. Lasher and Faulkender have stressed the importance of anxiety in the process of getting old as an important factor adjusting to themselves. Lack of adjustment may manifest in four main dimensions: physical, psychological and social, and transpersonal or spiritual. These four dimensions are synthesized in three specific fears: 1. Fear of the process of aging, 2. fear of the state of being old, and 3. fear or anxiety facing old people. Based on this theoretical frame, the authors developed the Anxiety about Aging Scale, and Watkins, Coates and Ferroni pointed out the need to adapt it in order to apply it on elderly people. The objective of this paper is to evaluate the psychometric properties of the original Lasher and Faulkender scale, as well as presenting an adapted version for Mexican elderly people. Method Two independent samples of elder adults were used (n=234 and n=151) selected by availability within a government health clinic; on average, they were 63 years old. The original Lasher and Faulkender scale was translated into Spanish following a double blind procedure, using Likert type answer options with four alternatives. Two questionnaires were used, which included the original scale (EAE-O), in one, and the adapted scale (EAE-A) in the other, as well as the sub-scale of attitude facing one's own aging of the Philadelphia Geriatric Center Morale Scale, APE (2), and the Suicidal Ideational Scale (EIS), designed by Roberts (3). Additionally, interviewees were asked: «If you should have to set an age, forgetting a little about what doctors and people say, at what age would you consider that you really start to be "Old"?» and at what age do you think one would get "very old"? The scales were applied to subjects who agreed voluntarily to participate in an anonymous and informed way. Resulting data were analyzed with the system SPSS, v. 11.0. Factorial structure. A factorial analysis with varimax rotation and eigen values greater than 1 produced the following results: EAEO: The structure obtained was compounded by three factors that explained 53.1% of the variance with Cronbach's alpha of .74 (Fear facing one's own aging, Positive attitude towards old people and Optimism facing one's own aging). EAE-A: The analysis shed a factorial structure compounded by four factors that explained 60.8% of the variance with a general internal alpha consistency of .76 (Positive attitude towards old people, Fear of physical changes, Age and satisfaction with the self and life, and Age and dissatisfaction with the self and life). Concurrent validity. EAE-O. The correlation among the total punctuations of the EAE-O and APE was moderate and significant (r=.481, p<.000). The factors Fear facing one's own aging and Optimism facing one's own aging of the EAE-O, calculated here, obtained a moderate association with the total punctuation of the APE (r=.423, p<.000; r=.333, p<.000, respectively), and the factor of Positive attitude facing old people reported a very low association and no significant (r=.075, p=.252). As expected, the two factors of the APE that seem to evaluate positive and negative attitudes facing aging obtained moderate associations and significant with the two scales of the EAE-O that seem to evaluate the same attitudes (Optimism facing one's own aging, r=.415, p<.000; and Fear facing one's own aging, r=.424, p<.000, respectively). Consequently, a very low association was obtained when relating it with the opposite factor (v.gr. negative vs. positive). EAE-A.… [ABSTRACT FROM AUTHOR]

Spiritual life seems to play an important role in coping with stress in older adults. Spiritual life has been documented to have a positive effect on the sense of personal wellbeing in seniors and it has been inversely related to depression, to low levels of loneliness and psychopathology measured by MMPI-2. It has been documented that, when spirituality forms part of the subject's personality it tends to be expressed in his/her religious coping strategies and to have a positive impact on his/her health when these strategies are effectively used against stress during hospitalization and illness and against losses common in older age that are associated with depression. Two general approaches to the study of religious coping have been emphasized: a) the specific ways of coping, in which religious coping is a multidimensional phenomenon, which may include forgiveness, purification and confession, spiritual support, etc.; b) the study of coping patterns. The second approach includes religious coping methods and the patterns of interrelation they involve. Pargament et al. have distinguished between positive religious coping and negative religious coping; the former leads the individual towards productive and efficient spiritual coping associated with better health indicators than the negative coping strategy. According to the authors above mentioned, positive religious coping includes methods such as benevolent religious appraisal, collaborative religious coping and seeking spiritual support, seeking the support of clergy and church members, religious help and religious forgiveness. Negative religious coping includes methods such as punishing religious reappraisal, demonic religious appraisal, the reappraisal of the power of God, spiritual discontent, self directed religious coping, and interpersonal religious discontent. Pargament et al. have included these coping patterns in the Scale of Positive and Negative Patterns of Religious Coping Methods (Brief-RCOPE). Our research was aimed at identifying the validity and reliability of the religious coping scale (Brief-RCOPE) proposed by Pargament et al. in two samples of older adults living in Mexico City and selected according to availability in two health clinics. Additionally, with the objective of gaining greater knowledge of the characteristics of religious coping and the spiritual life of older Mexican adults, our research explored the possible existence of significant differences in the above mentioned variables regarding sex, age, education and religious denomination, marital and employment status. The subjects answered a questionnaire containing 37 questions with dichotomic multiple choice answers (likert type) which included: 1) demographic information; 2) the Positive and Negative Methods of Religious Coping Scale, Brief-RCOPE, with two subscales (positive religious coping and negative religious coping); 3) the subscale of Religious Coping when Confronting Loneliness, ARS, from the Loneliness Multiphase Inventory, IMSOL; and 4) the subscale of the Relationship with God from the Spiritual Wellbeing Scale, EBE. The results obtained allowed us to conclude that the tools that were used have adequate internal consistency which we obtained by calculating Cronbach's alpha coefficient; however, the negative religious coping subscale gave conservative results that may indicate the need for further investigation. A significant association between the positive Brief-RCOPE, Religious Coping when confronted with loneliness and the subscale of Relationship with God was found, which supports the convergent validity of the first subscale. On the contrary, and in a way consistent with the results of the authors negative Brief-RCOPE was not significantly associated with the other scales, but had a conservative association with regard to a measurement consisting of two items in the Relationship with God subscale.… [ABSTRACT FROM AUTHOR]

Given the importance of religious life in Mexican society, this piece of research poses the following question: Are older Mexican adults capable of benefiting from their spiritual life? Given that religiosity and spirituality show differential, even contrary, characteristics, this work is based on a vision of spirituality as an experience of the divine. Religiosity, in contrast, is conceived as an intermediate step in socialization during which believers are nourished by knowledge that will direct their behavior in the search for an experience of the divine. With the incorporation of such knowledge in the personality of the subject through the transformation of instrumental thoughts, emotions and behaviors, and with the concretion of the experience of the divine, as this experience is understood by the subject, the result can be spirituality. Spirituality is a construct that can be analyzed for its effects in the responses of a subject with respect to the conditions of his existence and in relation to the divine. This work adopts the term Spiritual Conviction with which to refer to spiritual and religious practices and beliefs, together with an integral criterion (that includes emotional, cognitive, behavioral and social aspects) in accordance with Holland, Kash, Passik, Gronert, Sison, ct al. [ABSTRACT FROM AUTHOR]