Examinando por Autor "Catalá, Patricia"

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Are Worries and Postpartum Depression Influenced by Early Depressive Symptoms and Mothers’ Lack of Confidence? A Prospective Study
(IMR Press, 2025-03-13) Écija, Carmen; Catalá, Patricia; Gutiérrez, Lorena; Peñacoba-Puente, Cecilia
Background: It is estimated that around 20% of women experience mental health problems during the perinatal period, including depression and anxiety, which negatively affect both the mother and the baby’s development. Although previous mental health problems have been identified as important predictors, it is relevant to further explore the role of other psychosocial variables of interest such as coping with worries or maternal confidence in caring for the baby, in order to design effective preventive actions to promote perinatal mental health. This study analyzed the effect of maternal lack of confidence in caring for her infant and depressive symptoms on pregnancy worries (PW) and postpartum depression (PPD) using a multifactorial and prospective approach. Methods: A prospective cohort study (with three points in time) was conducted with 120 pregnant women recruited from a public hospital in Madrid, Spain. Women were evaluated for pregnancy worries in the first trimester of pregnancy, for depressive symptoms in the third trimester, and for PPD and mothers’ lack of confidence 4 months after childbirth. Parallel and serial mediation analyses were conducted using PROCESS (SPSS tool for estimating regression models with mediation and/or moderation effects). According to the Enhancing the Quality and Transparency Of health Research (EQUATOR) checklist, the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) statement was chosen for this study. Results: A parallel multiple model showed that while depressive symptoms significantly mediated the relationship between pregnancy worries and postpartum depression (a1b1 = 1.4733, [95% confidence interval (95% CI) = 0.7105, 2.2309]), mothers’ lack of confidence did not (a2b2 = 0.2404, [95% CI = –0.0569, 0.5826]). However, when both mediators were analyzed together, a significant indirect effect of depressive symptoms on postpartum depression was found through the effect of depressive symptoms on mothers’ lack of confidence (d21 = 0.2144, [95% CI = 0.0595, 0.4562]). Conclusions: It is necessary to analyze factors related to postpartum depression from a multifactorial approach focused on the analysis of depression during pregnancy, but also including other variables such as mothers’ lack of confidence as possible risk factors of postpartum depression. The associations found between worries, depressive symptoms, and maternal insecurity with postpartum depression could allow professionals to develop preventive interventions of postpartum depression.
Is thought management a resource for functioning in women with fibromyalgia irrespective of pain levels?.
(Oxford University Press, 2021-02-17) Catalá, Patricia; Suso-Ribera, Carlos; Gutierrez, Lorena; Pérez, Soledad; López-Roig, Sofia; Peñacoba, Cecilia
Objective This study aimed to examine the relationship between cognitive factors (cognitive fusion and catastrophizing) and functional limitation experienced by patients with fibromyalgia across different levels of pain severity (i.e., moderation). Methods The sample comprised 226 women with fibromyalgia. Their mean age was 56.91 years (standard deviation = 8.94; range = 30 to 78 years). Results Pain severity, cognitive fusion, and all components of catastrophizing (i.e., rumination, magnification, and helplessness) contributed to greater fibromyalgia impact on functioning in the multivariate analyses (all P < 0.001). A moderation effect was also found in the relationship between cognitive fusion and fibromyalgia impact on functioning (B = –0.12, t = –2.42, P = 0.016, 95% confidence interval: –0.22 to –0.02) and between magnification and fibromyalgia impact (B = –0.37, t = –2.21, P = 0.028, 95% confidence interval: –0.69 to –0.04). This moderation was not observed for rumination and helplessness. Conclusions The results suggest that in interventions to improve functioning in people with fibromyalgia, some maladaptive forms of thought management (i.e., cognitive fusion and magnification) preferably should be challenged at milder levels of pain severity. According to our findings, cognitive fusion and magnification might have less room to impact functioning at higher levels of pain severity; therefore, rumination and helplessness, which had comparable associations with functioning irrespective of pain levels, would be preferable targets in psychological interventions in patients with fibromyalgia experiencing more severe pain levels.
Maternal Attachment and Perinatal Health in Refugee Women: A Systematic Review
(MDPI, 2025-02) Catalá, Patricia; Gutiérrez, Lorena; Écija, Carmen; Peñacoba, Cecilia
In the general population, a relationship between maternal mental health and maternal attachment has been identified, but it has not been studied in depth in vulnerable populations like refugee women. This review aims to analyze the relationship between maternal attachment and mental health in postpartum refugee women and to propose a conceptual framework for understanding these interactions. Methods: A systematic review was conducted following PRISMA guidelines, using search terms such as “attachment”, “bonding”, “mental health”, “post-traumatic stress”, “depression”, “anxiety”, and “refugee women”. The search was conducted between September and October 2023 in Scopus, MEDLINE, PsycINFO, and PubMed. Nine studies met the inclusion criteria, and their results were systematically synthesized to identify patterns and limitations. Results: Of the 455 studies identified, only 9 met the inclusion criteria. The analysis reveals a complex relationship between maternal mental health and maternal attachment. Although four studies (n = 4) found no significant relationships between maternal mental health and attachment styles, others identified negative correlations between secure attachment and symptoms of post-traumatic stress (n = 2) or depression (n = 2), highlighting the influence of maternal psychological well-being on the bond with the infant. Conclusions: The findings suggest that post-traumatic symptoms play a key role in shaping the relationship between maternal attachment and mental health. Consequently, psychosocial interventions focusing on maternal attachment could help prevent difficulties in mother–infant interactions and improve gestational health, thus supporting the development of the maternal role in refugee populations.
Percepción del paciente y ejecución real de la marcha como ejercicio físico: una mirada a la autoeficacia como variable clave en la adherencia en pacientes con fibromialgia
(MDPI, 2023) Gutiérrez, Lorena; Lavín Pérez, Ana Myriam; Catalá, Patricia; Écija, Carmen; Collado-Mateo, Daniel; Gil Arias, Alexander; Peñacoba, Cecilia
Adherence to physical exercise is especially low in patients with fibromyalgia, and there is a tendency to overestimate its performance. This study explores the relationship between perceived and actual walking behavior in patients with fibromyalgia, including self-efficacy as a mediating variable. A prospective study with two time points (with one week between them) was carried out on 132 women diagnosed with fibromyalgia. Self-efficacy towards exercise was assessed at the first time point, and perceived intensity of physical activity and “objective” walking amount (accelerometer) in relation to the previous week were assessed at the second point. Physical and emotional symptoms and the consumption of drugs were also evaluated as covariates. The results show that perception of vigorous-intensity exercise was related to walking (accelerometer) (effort greater than 6 METs). This relationship was explained by the mediating effect of self-efficacy and was not interfered with either by the symptoms or by the consumption of drugs. High self-efficacy regarding physical exercise was directly related to walking behavior despite patients’ interpretation of this activity as a vigorous physical exercise. In intervention and rehabilitation programs, it would be interesting to take into account and promote the self-efficacy of patients in relation to physical exercise in order to maintain adherence to walking.
Perspectives on Perinatal Support and Maternal Mental Health: A Qualitative Cross-Cultural Study in Spain and Brazil
(MDPI, 2025-06-06) Gomes Viana Meireles, Livia; Peñacoba, Cecilia; Écija, Carmen; Gutiérrez, Lorena; Catalá, Patricia
The perinatal period is a critical phase in a woman’s life, during which cultural and contextual factors significantly influence her physical and emotional well-being, as well as her transition to motherhood. Understanding cultural differences—such as those between Brazil and Spain—is essential for improving tailored perinatal care. Objective: This study explores and compares the perinatal experiences of women in Spain and Brazil, with a focus on their postpartum support needs and mental health implications. Method: A qualitative design was employed, using in-depth interviews with 22 postpartum women—11 from Spain and 11 from Brazil. Interviews were conducted using a semi-structured guide, and the data were analyzed through thematic analysis. Results: Common themes across both cultural contexts included the importance of preparation for childbirth, the need for emotional and psychological support, challenges related to breastfeeding, and adjustments to physical and psychological changes. Cultural differences were also identified: Brazilian women tended to engage in more detailed planning and valued the support of professionals such as doulas and midwives, whereas Spanish women emphasized the importance of having their choices respected during childbirth. Notably, both groups experienced significant emotional challenges, highlighting crucial considerations for maternal mental health. Conclusions: These findings emphasize the need for culturally sensitive perinatal support programs that address the emotional and psychological needs of postpartum women, aiming to improve mental health outcomes.
Positive Affect Moderates Walking's Impact on Depression in Fibromyalgia Patients
(Elsevier, 2025-02-12) Écija, Carmen; Catalá, Patricia; Gutiérrez, Lorena; Peñacoba, Cecilia
Background: Depression and pain have a dependent and complex relationship that increase pain-related barriers related to physical activity in patients with chronic pain. Moreover, positive affect and pain acceptance may also contribute to the development of lasting physical and cognitive resources that can support the maintenance of exercise behavior. Aim: The aim of this study was to examine the impact of psychosocial variables (commitment to physical activity (walking), positive affect) on depression and activity acceptance among patients with Fibromyalgia (FM). Design: Cross-sectional correlational study. Method: Commitment to physical activity (walking), positive affect, depression and activity acceptance were evaluated in 132 FM women. Two models were tested to analyze mediation and moderated mediation effects. Results: The mediating role of depression between walking and activity acceptance was corroborated regarding the subjective measure of walking. The moderated mediation model found that the effect of walking on activity acceptance was mediated by depression at medium (value: .19; ß = 2.50, [95% CI = 1.19/4.05]) and high levels (value: 9.87; ß =4.46, p < .001, [95% CI = 2.34/6.86]) of positive affect. The indirect effect of walking on activity acceptance via depression was stronger in individuals with higher positive affect. Conclusions: Different levels of positive affect played a contextual role when trying to prevent the effect of depression on activity acceptance in women that walked. Clinical implications: Positive affect is a key variable to prevent the effects of depression on activity acceptance in FM women that walk with the goal to exercise. Interventions from positive psychology, cognitive behavioural therapy and acceptance and commitment therapy can be very useful in this context.
Psychological Needs in Spanish Pregnant Women During the Transition to Motherhood: A Qualitative Study
(MDPI, 2025-02-18) Catalá, Patricia; Peñacoba, Cecilia; Écija, Carmen; Gutiérrez, Lorena; Gomes Viana Meireles, Livia
Motherhood involves significant identity transformation, encompassing physical, emotional, and social changes that can create tensions between a woman’s previous identity and her new maternal identity. In Spain, cultural expectations of motherhood can intensify this conflict, affecting the transition to the role of mother. This study explores the experiences and needs of Spanish women during the perinatal period, identifying common concerns and cultural particularities. Methods: A qualitative design using focus groups was employed. Thirty-three women from the Community of Madrid participated, with an average age of 28.42 years. Four focus groups were conducted: one with women in the third trimester of pregnancy, one with women in the early postpartum period (0–5 months), one with women in the late postpartum period (6–12 months), and one mixed group. Semi-structured questions guided the discussions, and thematic analysis was used to analyze the data. Findings: Nine main themes were identified: birth process, emotional management, acceptance of physical and mental changes, breastfeeding, sleep management, attachment and bonding, maternal identity, specialized resources, and setting limits. Key findings include the importance of mental and physical preparation for birth, managing emotions, and accepting bodily changes. Participants highlighted the need for emotional support, accurate information, and community resources. Conclusions: This study emphasizes the need for culturally sensitive perinatal support programs that provide tools for prenatal education, pain management, emotional support, and identity transition, integrating women’s prior identity to facilitate a harmonious transition to motherhood.
Resilience and Anxiety among Intensive Care Unit professionals during the COVID-19 pandemic
(Wiley, 2021) Gil, Fernanda; Carmona-Monge, Francisco Javier; Velasco, Lilian; García-Hedrera, Fernando Jose; Catalá, Patricia; Peñacoba, Cecilia
Background: The situation of the COVID-19 global pandemic has generated an unprecedented state of emergency worldwide that has had a psychological impact on health care workers working in the ICU and this has created the need to implement different psychological strategies. Aim: This study explores (a) the prevalence of symptoms associated with generalized anxiety disorder (GAD), (b) the relationship between GAD symptoms and resilience skills, and (c) which of the resilience skills were associated with a probable GAD among the ICU professionals during the COVID-19 pandemic. Study design: Cross-sectional survey design. Methods: We explored anxiety and resilience in 448 ICU health care workers using an online survey. Results: The participants showed high resilience levels and more than half of them presented symptoms consistent with a possible diagnosis of GAD. The GAD symptoms were more prevalent among women, nursing assistants, interns, staff who worked on rotation and health care workers who had to attend to more than 20 COVID patients. Significant negative correlations between resilience skills and GAD symptoms were found. The multiple regression analysis showed that resilience skills contribute to 14.4% of the variance for GAD symptoms. The binary logistic regression showed that the only skill that had a significant and negative predictive effect was “I usually take things in my stride” (OR = 0.774, 95% CI 0.67, 0.88; P = .000). This ability was the differentiating skill between professionals who equal or exceed the cut-off point established for the diagnosis of a probable GAD regarding those who do not. Conclusion: ICU professionals developed symptoms consistent with a possible diagnosis of GAD due to their exposure to extremely stressful circumstances. However, resilience skills acted as a protective factor. Relevance to clinical practice: The importance of incorporating programmes that mitigate these psychological effects and to promote adaptive coping styles during pandemics has become a need after what ICU professionals have gone through.
Revisiting the Mackey Childbirth Satisfaction Rating Scale: Spanish adaptation, factor analysis, and sources of construct validity
(Wiley, 2023) Suso-Ribera, Carlos; Catalá, Patricia; Carmona, Javier; Peñacoba-Puente, Cecilia
Background: Women's dissatisfaction with perinatal health care services is asso-ciated with poor postpartum outcomes for the mother and the baby. The Mackey Childbirth Satisfaction Rating Scale is a frequently used measure of women's childbirth satisfaction. However, its factor structure has been inconsistent across investigations. The goal of this study was to evaluate the psychometric properties of the scale (i.e., factor structure and sources of validity evidence).Methods: This study is a descriptive prospective investigation. Participants in-cluded 106 pregnant women (mean age = 31.86, SD =4.12) recruited from a pub-lic university hospital situated in South Madrid. Sources of construct validity of the Mackey were explored with the Women's View of Birth Labor Satisfaction Questionnaire. Sources of criterion validity were investigated with measures of pain (labor, delivery, and just after birth) and post-traumatic stress symptoms.Results: Minor adaptations in item distribution resulted in an adequate fit of the original six-factor solution of the Mackey scale (i.e., oneself, the partner, the baby, the nurse, the physician, and overall satisfaction). Sources of validity evidence supported the construct and criterion validity of the scale.Conclusions: Obtaining a psychometrically and conceptually sound factor solu-tion is fundamental when validating a scale. With the present study, researchers and clinicians (e.g., midwives) will be able to measure women's childbirth satis-faction in a more robust manner. Both antecedents and consequences of satisfac-tion were found to correlate with several satisfaction subscales, which might help guide prevention programs in mother care in a more efficient way.
Sedentary Behavior and Pain after Physical Activity in Women with Fibromyalgia-The Influence of Pain-Avoidance Goals and Catastrophizing.
(MDPI, 2023-01-07) Gutiérrez, Lorena; Écija, Carmen; Catalá, Patricia; Peñacoba, Cecilia
Background: Fibromyalgia is characterized by chronic pain and fatigue that triggers a functional disability caused by the lack of activity. Pain catastrophizing may contribute to avoiding activity with the intention of managing pain levels. Based on the sedentary behavior with fibromyalgia, the present study assessed the preference of pain-avoidance goals and pain catastrophizing as mediator and moderator variables, respectively, that influence pain perception after a 6-min-walking test. Methods: The sample was composed of 76 women with fibromyalgia (mean age = 55.05, SD = 7.70). Previous sedentary behavior, preference for pain-avoidance goals, and pain catastrophizing were evaluated before starting the walking-test. Subsequently, pain perception was evaluated. Results: A significant moderated-mediation model was found in which pain-avoidance goals mediated the relationship between sedentarism and pain after a walking-test, and pain catastrophizing moderated the relationship between the preference for pain-avoidance goals and pain perception. Specifically, high levels of pain catastrophizing contributed to increased pain perceptions after completing the test (B = 0.570, p = 0.03, CI 95% (0.09, 0.11)]. Conclusions: The results suggest that motivational interventions can improve the symptoms because their objectives are focused on managing conflict goals. These interventions should focus on catastrophic cognitions considering that pain catastrophizing is deemed to be one of the major inhibitors of physical activity in fibromyalgia.
Symptoms in women with fibromyalgia after performing physical activity: the role of pain catastrophizing and disease impact
(Springer, 2022) López-Gómez, Irene; Velasco, Lilian; Gutiérrez, Lorena; Écija, Carmen; Catalá, Patricia; Peñacoba-Puente, Cecilia
Introduction Walking is an efective treatment for symptoms’ management in patients with fbromyalgia. However, despite its benefts, fbromyalgia patients face a variety of obstacles that result in reduced ability to sustain physical exercise. The main goal of the study was to analyze the role of pain catastrophizing and fbromyalgia impact in the relationship between regular walking behavior and pain and fatigue experienced after a laboratory walking test. Method The study has an observational analytical laboratory design. A total of 100 women were contacted by the research team. Seventy-six women diagnosed with fbromyalgia aged 18 years and older (mean age=55.05, SD=7.69) participated. Results Signifcant correlations were found among regular walking behavior, pain catastrophizing, impact of fbromyalgia, pain intensity after walking, and fatigue intensity after walking. The serial multiple mediation analyses confrmed that pain catastrophizing and impact of fbromyalgia mediated the relationship between regular walking behavior and the level of pain (beta B=0.044, 95% CI=[0.01–0.012]) and fatigue (beta B=0.028, 95% CI=[0.01–0.08]) after the laboratory walking test. Also, the participants that walked less regularly experienced more pain and fatigue after the 6-Minute Walk Test. Conclusions Considering cognitive variables alongside the impact of fbromyalgia will help understand the inhibitors of engaging in physical activity. Therapeutic walking programs must be tailored to patients with fbromyalgia to reduce pain and fatigue related to physical activity and to promote better functioning and quality of life.