A chronic illness in childhood has a negative impact on the paediatric patient and on family functioning. Psychological stress in parents influences the level of adjustment to the illness of their children. The Pediatric Inventory for Parents (PIP) was designed to measure stress in parents whose child has a chronic illness or requires prolonged medical monitoring. The main objective of this study is to provide a brief version of the Spanish translation of the PIP, across a sample consisting of 465 main familial caregivers (85.2% female, n = 396) between 27 and 67 years old ( = 44.13; SD = 5.35) of paediatric patients between 9 and 18 years old ( = 12.10, SD = 2.20; 56.8% men, n = 264) diagnosed with diabetes mellitus type I (20.9% of the sample; n = 97), short stature (32.5% of the sample; n = 151), or a chronic respiratory disease (asthma, cystic fibrosis, bronchiolitis obliterans and bronchiectasis) (46.6% of the sample; n = 217). After performing several EFAs (Exploratory Factor Analyses) and CFAs (Confirmatory Factorial Analyses), it was decided that 30 items need to be removed. Reliability and validity results suggest that the new 12-item version possesses appropriate psychometric properties. Cronbach’s alpha value ranging between α = .42 and α = .81 and fit values obtained indicate a good fit: χ2/df (88.393/48) = 1.84 (α < .01); S-B χ2(df) = 88.393 (48); CFI = .95; IFI = .95; RMSEA = .05 (.033 - .074) for the frequency scales and χ2/df (72.002/48) = 1.5 (α < .01); S-Bχ2(df) = 72.002 (48); CFI = .97; IFI = .97; RMSEA = .04 (.011 - .063) for the difficulty scales. The PIP also showed predictive ability in regards to anxiety and depression, a positive relationship between the instrument's own scales and a negative relationship with the caregiver's age. Finally, depending on the paediatric patient's diagnosis, differences in stress levels were found.

Objective: the objective of the study was to assess the psychometric properties of the Brief Illness Perception Questionnaire in a sample of adolescents with chronic endocrine or pneumological conditions and to analyze the dimensionality and reduce the scale elaborating scales by sex and medical diagnosis. Method: we evaluated 510 patients aged 9-16 years using the Brief Illness Perception Questionnaire and the Hospital Anxiety and Depression Scale. We carried out tests of reliability, construct and criterion validity and a comparison of means based on the diagnosis and socio-demographic variables. The reliability and validity analyses showed adequate psychometric properties for this scale, with better results obtained for a single dimension after eliminating 3 items. Results: adolescents with type 1 diabetes and girls were found to have an increased threat perception of their illness. Anxiety/depression was positively associated with the perception of illness. Conclusion: this questionnaire is a useful and practical tool for evaluating adjustment to illness in pediatric patients.

Introduction. The Hospital Anxiety and Depression Scale (HADS) is a screening instrument that assesses emotional symptoms in different populations and medical conditions. This study analyzes the psychometric properties and factor structure of the HADS in adolescents with chronic disease and the differences based on their medical condition. Method. The HADS was administered to a sample of 302 adolescents with chronic disease. Exploratory factor analyses were done in a subsample of 100 adolescents, while confirmatory factor analyses were performed in the rest of participants (202) to examine the validity and reliability of the HADS (14 items); an analysis of variance for a single factor was also done to study differences among diseases. Results. Patients were aged 12-16 years, with a similar sex ratio; 43 % had respiratory diseases and 47 %, endocrine disorders. The original twofactor structure (anxiety and depression) showed adequate fit indices and incorporated a secondorder factor (emotional distress). Three of the original items were removed, thus obtaining a new 11-item version. This showed adequate psychometric properties, and differences were observed between patients with type 1 diabetes mellitus and those with respiratory disease, but not in terms of short stature, in the depression factor. Conclusions. The HADS displays an adequate reliability and validity in pediatric patients with chronic disease and is useful for the early detection of anxiety and depression in the health care setting. Key words: factor structure, patient health questionnaire in the anxiety and depression scale, type 1 diabetes mellitus, chronic respiratory diseases, short stature.

Los adolescentes con una enfermedad crónica (EC), tales como son el asma bronquial, la Diabetes Mellitus Tipo 1 o la Talla Baja, deben adaptarse al desafío que supone este diagnóstico en esta etapa vital de grandes cambios, lo que puede contribuir a la aparición de dificultades emocionales y repercutir en su autoestima. Los objetivos del presente estudio fueron analizar los niveles de sintomatología ansiosa-depresiva y autoestima de la muestra total y de cada una de las enfermedades estudiadas, observar las relaciones existentes entre las variables analizadas y establecer diferencias en función del diagnóstico. La muestra estuvo constituida por 248 pacientes pediátricos con EC. Se utilizaron instrumentos específicos para evaluar la clínica psicológica emocional (Hamilton Anxiety and Depression Scale, HADS) y el nivel de autoestima (Rosenberg Self-Esteem Scale, RSES). Los resultados mostraron que un tercio de los pacientes pediátricos presentaron sintomatología ansiosa y un 27% bajos niveles de autoestima. Los pacientes asmáticos fueron quienes tuvieron menor autoestima, además en la muestra total son los chicos los que presentaron mejor autoestima. La sintomatología emocional se relaciona negativa y significativamente con la autoestima. La edad del paciente se asoció negativamente con los niveles de ansiedad y autoestima mostrados por estos pacientes. De esta manera, se concluye que la enfermedad en sí misma no conlleva presencia de malestar emocional y la autoestima funciona como factor de protección. Es necesario realizar un abordaje físico y psicológico de la enfermedad para detectar aquellos casos que presenten un mal ajuste y poder proporcionarles una intervención psicológica temprana.

Short stature (SS) is one of the main diagnoses in Pediatric Endocrinology. SS can have a negative impact on family dynamics, causing stress and psychopathology. Poor adaptation by the family caregiver negatively affects the pediatric patient. Our objective was therefore to study the adjustment of the main family caregivers of pediatric patients with SS, analyzing the factors influencing it. One hundred and ten primary family caregivers of pediatric SS patients from hospitals in Valencia, Spain, participated. Parental stress (Pediatric Inventory for Parents), anxious and depressive symptoms (Hospital Anxiety and Depression Scale), family functioning (Family Cohesion and Adaptation Scale), and adult attachment (Adult Attachment Questionnaire) were evaluated. Fuzzy set qualitative comparative analysis (fsQCA) was performed. The caregiver's age, anxiety, and attachment variables are significant when predicting the main family caregiver's adaptation to the stress caused by the diagnosis. These results will help improve adaptation to the diagnosis, since healthcare personnel will be able to establish that caregivers and/or families present a greater risk of mismatch more quickly and apply the necessary intervention.