DEPARTAMENT PERSONALITAT, AVALUACIÓ I TRACTAMENTS PSICOLÒGICS

Transcripción

1 DEPARTAMENT PERSONALITAT, AVALUACIÓ I TRACTAMENTS PSICOLÒGICS ESTUDIO PSICOLÓGICO DEL PACIENTE CON OBESIDAD MÓRBIDA SOMETIDO A INTERVENCIÓN QUIRÚRGICA: ANÁLISIS DE LAS DIFERENTES VARIABLES QUE PUEDEN AFECTAR A LA PÉRDIDA DE PESO REGINA FERNÁNDEZ CANET UNIVERSITAT DE VALENCIA Servei de Publicacions 2009

2 Aquesta Tesi Doctoral va ser presentada a València el dia 14 de novembre de 2008 davant un tribunal format per: - Dª. Adelia de Miguel Negredo - D. Abilio Reig Ferrer - D. Antonio José Torres García - Dª. Amelia Díaz Martínez - Dª. Angela Beleña Mateo Va ser dirigida per: Dª. Mª José Báguena Puigcerver D. Joaquín Ortega Serrano Copyright: Servei de Publicacions Regina Fernández Canet Depòsit legal: I.S.B.N.: D.L.:V Edita: Universitat de València Servei de Publicacions C/ Artes Gráficas, 13 bajo València Spain Telèfon:

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67 345 $!!(G+) +4--' U)F:;;;H'"/?>AA & 2!!' ) - 2 % 2 "! 2#&4"-!' )0("2+()# 0("#0(D2(- [!G\) 2" - [\)2 2!#!+ ( + $) / " " =< - 2 2! "!! # )#&2 2'( (!'!#) "-0'&0'G ) F=BBBH - #!" 2% " # 0(") :3!"') -(1(/(? $7=**+& ""&#*@!" # 2" 0! +) -!" (G" F( ) =BB<HL # 2! '! (1! ) 0 F:;;;H!" 30! (!" )!" (2" ("(02 #--0 #! 0 ( 0# 2! # 2( 2 (") (D- ((&2 # ( - # 2 '!" - 0 '%,/.+ %7 082" # 2 2 ),/24)F=B<AH#("4 0 ) F=BB@H)"'2"! '%("4 (2!" 57

68 345 $ 2" (!F>?H#2")2( 0-- (!"F2(0; BC#; BAH),/!!' $ + %! 7 F$,/H # ( 2" "4 & FHF0) =BB@],) :;;: :;;>H) >? 2 -!D 2 F=K :K >K!?K -(>?G :;?)2-!D%2" $ (1#F,) :;;: :;;>H) " 4 ' (1 2!% 2" "# ") >3!"') -(1(0(*+& "#& $* *+&,$* +*")*#. ( & ' " ( ) ( F=B@CH!" # ' ##"E) &!#!) D"8 F=K# :K >K?K H) " =; #?;) 3! - # +!F(=B@C (] =B@C]U]8#=B@BH) 0 ' " ' 0(D F=BBCH -2"1(+) '!?3) -(1(1(>/39*=#2*7?&$$$*&$@ +! 0 2! 2 # "()(2(!!2#(! 2#+") D 4 # - 0 " 0 +!FH 58

69 345 $ (!" () (!%2 (" 2 )F,1 ) =BB<H)!" ' (& % +F"2H#2F4 H) (0# ))# ) ( D 4 0 +#!F,1) =BB<H) + (! " (!"#!2(2 2" ( )# &I. $,!0 G>@%&#.%)$,!08 2!' & - ' ' 2""&2F$ =BB<H) '!"! 0 G>@) G>@ %& 4 ->@0+( -2!! 2 # F$ =BB<H)2! 9 ", $0 $+.( $%9 (%08+-2#( (")ID!!FH("#(2 #! 2 (2 2#!!) ( + - 0! &?;; ##' -"!# F) :;;CH) 3" (1 ) G>@ & >@ FH -!!!!+< - &2 &2#) %"2 2 " # ) G>@ # " - ((4) 59

70 345 $ ' & 2" D (((4!" G>@) 0 FH (F$ =BB<H% &,*"+&'" 2 "%&'" 4+&% 4+&% # % # # $.*"*# &&$$ "%&'" + %& *, %& " $,*" 7-2! 2! ( #'2') 7-22(1#!! - ' 2) $ # 2 (1 0(#!0) " -#"#!2#2) #! 2#&) 7-(2!2 2!0() 7 - ( 2 (1 #! " "#(1) " " #() I#:!%d&eF? H#deF=H)&f=?4 # 2 ( - (+ ( "! # 2") " 2 #!) 60

71 345 $ G>@&2-#"1 ) " 2 # 2-;F "H0=;;F1H)-22" 0 C;O -+) F& C;O H " 0 () &&: 2 FH # F$H (" ") ; =;; G>@ 0 ' # ' " &3 # 1#()( G>@( #!1- ( (" 2) 2 C; 1! -("2) 2( # 2 g (0 "! Fg (0 K ; AH 3 2")2 2"2#(!1 2( # #! ; B;!) ( ( + (# ) G>@ # 4 2"! 2" 2 2" 3)! )(+ 0( " # 0' F! 1-1(H)!" 4 0 ( " (!') -2((! '"! (F) :;;CH)( - 0! - 0 D 2-0#1) C3!"'G>@) 61

72 345 $ -(1(3(>FG>?&",. +&% '.&%*"*#@ GB;G.%$ ):;< &0!!" F=B<>H#7'&'!F=B<BH -!!"#&(" -F) :;;;H) %$ $ ): 2 4 $! *0 I8, 2!" ( " - ' -& (" + 9!" ( & )(C=# )%$ $):FIH)F=BA>H!" B;FGB;H -=BAA(:#2 A "GB;G)-0'# - - " 7'&'! F=B<BH) - 0 ( & (#!') GB;G D B; ( F;K 0 ( #?K 0 3H) 3 =; 2 "% =) '"% =:!! 2"!!! #) :).("G"%=;-( - 1 ( - #-2!) >) (%B-' #!h' 2& 0( #1# 0(" )?) "% => - #! #!!2" 0 ' # 2! # 2! # &!) C) % =; 2 2 ' [&\ # - #! ( ( # ) A) "(% A -!! 3 2"( # 62

73 345 $ (1 "!" 0 #2(#2(- 2() <) " 2 " - # 2 " 0 + # ) B) % =; - 2 " - 3 -'! 0 2 # - (" & " -2) =;) %A&-#2 "")F7() :;;CH "GB;G2!2"%( #) H7., >%7 -(1277 FJ7!7(H -21B; L F!H D 3 L # FJ $!H 2!),H$. =;"&) H J.$. 0 2 ( )!" 0!( =; #E77&') ' 2!"!" 4 # & ( )2 (1! ) 2 & - 2 " - -(1(6(. F! ] 0 =B<CH => 2) " - 63

74 345 $ - 2! 2 ( & - " 2 - & ( " + ' # G"! ] 0 F! ) =B<= =B<C # =B<BH # 0 ]! F=B<<H) 0! (! " # ) 0 L >KI( 0 (L #?KI( 0 0) 1 - " - & 1 " &'+) "4#"=C2- =) 2 (% # 2" 2!#(2' ") :) 2! (% - # " 0"!#22) >)!%" " #!")?) 2%# #0 #(D-#) 0 % # #22) F#' =BBAH) 'A3) -(1(:( - #$).)) 0( ) F=BB=H) (! #!!FH!F#H)!"3!D) $.#!1#( %=H2!F"4#HL:H"! F( HL >H F( # +HL #?H E2 F( 1 2"H):;L! 64

75 345 $ D#2-!)D2 8 =FHCFHF0() =BB=L! ) =BB= =BB?]') :;;?H) '!# <3) -(3(*+%#&%&'"$*,*+#!"0@;-2 &) "2!) #;4&%!( #%*"8*+$*,*+#$*+8* ++*.B"*= +&$ "$*+**+= #*&<$ &"*#2*"%&'"$*)7>++.;+#&%?D3G@( 37% 63% CLÍNICO QUIRÓN! F K><H! 0 D( FI H # >AO F K::H 0!F/"H) #;4&% -($$,*$&$* ++8* +A*4 #,",*+#?D3G@( , ,86 MEDIA DESVIACIÓN TÍPICA 0!0?? ;C 4)!" 0 =; <@) (-0#(1"!- # ( " " # 2 - ) 65

76 23% 345 $ #;4&% /( #%*"8*$*=,)#*+7,8*#*+$*"# $*,*+#?D3G@( 77% MUJERES HOMBRES 3 AAO!-!(&1FK?@H#:>OFK=?H0()D "! ( # 1-0( -() #;4&% 0(+$ %&2&$* +%&*"*+$*,*+#+*.B"+*"+ *# +N%+$ + 2&2&*"$ *"#*8N+*#$ + $&2 #%&$ +72&$ +?D3G@( 5% 12% CASADOS/AS 22% 61% SOLTEROS/AS VIUDOS/AS SEPARADOS/AS AO F K >AH E!!1L:= AOFK=>HELCO!E FK>H#== AOFKAHE!E) #;4&% 1(&2*+ %& *% "',&% $* +%&*"*+$*,*+#+*.B" +2 #*+$* )8 N,*$& 7?D3G@( 3% 17% 80% BAJO MEDIO ALTO! " - <; O 1 (0 "" >O4 " " # =AO 0( " "(1) 66

77 345 $ #;4&% 3( &2* $**+$& +#*&<$ +*",*+# $* %&*"*+ +*.B" + %*. #+ $* #&,#& +N +*%"$#& +N "&2*#+&#& +,*$& + 7 "&2*#+&#& + +*#& #*+?D3G@( 33% 8% 7% 52% PRIMARIOS SECUNDARIOS EST.UNIV.MEDIOS EST.UNIV.SUPERIOR 2! >=! FC:OH :; F>>OH F+,)) )) (0 2 & 1!H # " C F<OH #? FAOH 1 2! #!) - ( ( & "0(#!( (1!") #;4&% 6(+$ $* %%&'") #+*.B"+&#)8" " *"*+ +,,*" +?D3G@( 52% 48% TRABAJA NO TRABAJA " (?< >O F:BH! 4(1 2C= AOF>=H-(1) 0#D1(E#-01(1 " #-(1+)# -(1-&&2& # 1 ) 2 - ( "( 0' (+&(#2& "&) -(6( # %*$&,&*" +*.&$ & 2 ( "( 0!#0D( -!+ 67

78 345 $ &) " #! 0 ' "0! #" 0 D( ( - ( 2" -!!" # 0! 1 # #')!"0 " 0 0! # 0(" G 0D() " 0 ) "E ("(#!"-!' '(!GF!,(&H#3( " ( - 2!E)!' # # (!G --(( +! 2 ") 0! # ' ) 0 D( #! '( #!& ) & 0D( 0#D( G!2 0 #2 D1 3=;-!" # - #! - # &)5: '2") 4""2) "2" 0 0!)(( - - " 2 8! ' &3!") & '((+%! )-+(00) ""2(0) 0!0!""#(1 #! " ( 0 D( 0 (""#- " +) IFID(H '" #0( " G' 0!) (1 0! # - ( -! 0 68

79 345 $ (")-&' /" (1!!" " " 0&( 0&( #!04 ")! # +" D! ( "! " # +)@(1"#& ) 2" (!( 2( F) :;;CH)3#(1('+ -#-) -#0#"% G G!-4#" G0 0+4# G0[-(\#-( G - 0#&3 C) G G!0! G G G. # - (1 "!12)0&( 1 2 2) - 1 ( 0&( ( # (#') #!# -0&-0# ("#)(+ (1!-! ( ('" # - 0! ( 2 ).&#!"" #!"(# (-!4+")I# --(1(1!! ) - 3--"# (22!!(&) (1!#!( 0&( (! 2 # ( !!G ( F$'+ :;;@H) I( ) F=BB<H (!

80 345 $ #! &--- 2) ( # 7 F=BB>H! ) (& '"#!" - ) -(!2+ - ( 1 2 ( ( 0&('22&#2&!2) # 0(--(# ' &--0F.0) :;;<H) 0( 0 D(! -2"2%!,#(12 /,/ ( G>@ GB;. $. -0@"% /,/ ( G>@ GB; -04"% /,/ ( G>@ GB; 70

81 345 $ -(:(";&+&+*+$+&% +#*&<$ + 0 ' - (! (1! )? # A &(!&!) (1!!"( - &[!\-&!((!(-!1 #!! -() & (! & 2 " ( 0(0 ((!( FH)&!0'"& 2!( ' 2 #+) C (1! # ) ' ( '!( - 2! # =: "H) & (! " & # ( 2 F H '!(!"F= :#>H) 3!!(-2!!"-DF=H"!#("-(" 3 + (F3(1!H)0'& #(2-0++2" D ) - 2 &! "'"&= :#> 2&!(&-2 0(#1() D A(+(1!-2) (40 FD(!!H) & ' 1 ) 71

82 345 $ &2'=C);) 72

83 = /( 9M OP 0&(! # 1 2 -!! 0 # "(!, &! 1 2 # 0&( (!)! 2!!-D) 0(FK@;H # -D!!1!" # -!, 2 '(0!"-D) /(!(";&+&+$*+%#&&2 $* +$ + )*"&$ +$**"#*2&+&"&%& #*> *# #&?"#*2&+ + "@ /(!(!(9&+ #&$**+ 7"#&%&'" #;4&% :( #*+A*#*#*+*""*&"&%& $*# )*,$* )*+&$$*",*+# $*%&*"*+?D3G@( 25% 12% 5% 58% INFANCIA ADOLESCENCIA EDAD ADULTA ESTRESOR #! C<OF>CH 2( -'2 -!!# $#!)=:OFAH4' )-2 :COF=CH 2('" 1 ( ('!2)1 73

84 = & (1 CO F>H 2 - ( ( - ( (!!") #;4&% F(*$&7$*+2&%&'"&%$**+,;+)8 %"<$ #,*+#$* +8* +*"+=&+ #&$* )*+&$$?D3G@( KILOS MEDIA DESVIACIÓN TÍPICA RESULTADOS 86,97 17,74-2!F!,H2 &(1(F2'H-()!D<@ BA8) #;4&%!G(*$&7$*+2&%&'"&%$*&*, $*,"*"&,&*" $* +%&*"*+ $*,*+#*"**+,;+)8?D3G@( ,25 MEDIA 1684,28 DESVIACIÓN TÍPICA b &! c D A>@ :C : (1 -( 2&) =C D 2 - & (1 0 - = ( &3 4 ( 2 4 =C 4) 74

85 = #;4&%!!(*$&7$*+2&%&'"&%$*&*, $*,"*"&,&*" $*,*+#$* +8* +*"+* , , MEDIA DESVIACIÓN TÍPICA b0( & c D < 4) 2- #- # -!2#G# # "D!) /(!(-("*" +#*#$*#*+ %,*"*7*"*+$! 2 + ' E 2)0'#+3-0 ) #;4&%!-( #%*"8*$*,*+#A*+&.*"$&* #+,&+, *" %&$$?D3G@( 10% SIN ÉXITO CON ÉXITO 90%?>OFK:@H-0 B;OFK:>H #=;OFK>H+30+3) 75

86 = #;4&%!/( #%*"8*$*,*+#A*+&.&'"$&* #+,&+, 20% 80% SIN ÉXITO CON ÉXITO <;OFK?<H- <;O2 +3+3FK?>H #:;OFKCH+30+3) #;4&%!0( #%*"8* $*,*+# A* +&.* " $&*,C$&% +&"#*%**" 10% SIN ÉXITO CON ÉXITO 90% >:OFK=BH-0 B;OFK=AH #=;OFK:H+30+3) #;4&%!1( #%*"8*$*,*+#A*+&.&'"$&*,C$&%+&"#*%**"* 28% SIN ÉXITO CON ÉXITO 72% ABO FK?AH - A:O FK>?H #:<OFK=>H+30+3) 76

87 = #;4&%!3( #%*"8*$*,*+#A*+&.*"$&* ##*+%#&%&'",C$&% 22% SIN ÉXITO CON ÉXITO AO FK>AH - 0 A<O FK:BH #::OFK<H+30+3) #;4&%!6( #%*"8*$*,*+#A*+&.&'"$&* ##*+%#&%&'",C$&% *"*+$?D3G@( 35% 65% SIN ÉXITO CON ÉXITO B@ AO FKC<H FK><H # >CO FK:;H ) #;4&%!:( #%*"8*$*,*+#A*+&.*"$&*,&.# +*"%&$$?D3G@( 2% SIN ÉXITO CON ÉXITO 98% 77

88 = COFK>H20(' #-0+3) #;4&%!F( #%*"8*$*,*+#A*+&.&'"$&*,&.# 19% 81% SIN ÉXITO CON AO FK:<H - <=O FK::H #=BOFK@H+30+3) #;4&% -G( #%*"8* $*,*+# A* +&.* " $&*)8*"% #+ $#"* $,&+&'"= +&#&*"%&$$?D3G@( 5% SIN ÉXITO CON ÉXITO 95% == AOFKAH-0 BCOFK@H #COFK=H+30+3) #;4&% -!( #%*"8*$*,*+#A*+&.&'"$&*)8*"% #+$#"* $,&+&'"= +&#&*"*+$?D3G@( 12% SIN ÉXITO CON ÉXITO 88% 78

89 = >CO FK:=H - <<O FK=AH #=:OFK?H+30+3) #;4&% --( #%*"8*$*,*+#A*+&.*"$&**"#C.&,*",) #& *"%&$$?D3G@( 9% SIN ÉXITO CON ÉXITO 91% =< >O FK==H - 0 B=O FK=;H #BOFK=H+30+3) #;4&% -/( #%*"8*$*,*+#A*+&.&'"$&*)8*"#C.&,*",) #& *"*+$?D3G@( 13% SIN ÉXITO CON ÉXITO 87% C= AO FK>=H - <AO FK:CH #=>OFK@H+30+3) #;4&% -0( #%*"8*$*,*+#A*=#*&<$ +&% *#&*"#C.&,*",) #& %*"#$*"C#$&$$**+ *"*+$?D3G@( 8% SIN ÉXITO CON ÉXITO 92% 79

90 = == AOFKAH #<OFK=H+30+3) ":F> >OH0(+ +3) #;4&% -1( #%*"8*$*,*+#A*=#*&<$ #.#,+$**8*#%&%& + %*"#$ +*"C#$&$$**+ *"*+$?D3G@( 7% SIN ÉXITO CON ÉXITO 93% =@ AO FK=;H - B>O FKBH #AOFK=H+30+3) ">FCOH0(+ +3) #;4&% -3( #%*"8*$*,*+#A*=#*&<$.B"& $*&"*#2*"%&'" A&#B#.&%*"*+$ & & +%%&'"?D3G@( 7% SIN ÉXITO CON ÉXITO 93% =;OFK@H- B>OFKCH #AOFK=H+30+3) D &!" -D") #;4&% -6( #%*"8*$*,*+#A*+*=#.$,*$&"*2',& +NE"*+ $&#C&% +?D3G@( 80

91 = 4% SIN ÉXITO CON ÉXITO 96% AO FK=;H - B@O FKBH #?OFK=H+30 +3) " > FCOH 0( 0(! 0( ' # -4). ( + # F#H'"! -F#H11 ) + " = F= AOH 2" + #">FCOH20() = 0 #?F@ AOH) #;4&% -:( #%*"8*$*,*+#A*=#*&<$ # & $**#&+# *#$*#*+ & %"#?D3G@( 15% SIN ÉXITO CON ÉXITO 85%?;O FK:?H - <CO FK=BH #=COFKCH+30+3) COFK>H4+ +3) /(!(/( "$%+$*&,*"%&'"! 2 " 20D"F D$GG"% 81

92 = ))"' % =) 2! - # # (1) :) " + ( F)1) " - -+ & & H),)"&% =)0&&) :)0() >)0()?)!) C) " ( + ") (++"- 0#) :< >O FK=AH 2 0( # 0( ' 2 > &! -,!) /(!(0(#+% "$%+$*&,*"%&'" #;4&% -F( #%*"8*$*,*+#A*&% *7%,**"% %&",&*"#+*+; $*&C?D3G@( 82

93 = 58% 42% POCA FRECUENCIA MUCHA F K >BH 2! )?:O FK=@H0!' #C<OFK:>H!!) #;4&% /G( #%*"8*$*,*+#A*%,*,&*"#+% %&" #*#.B" &,*"?D3G@( 47% POCA FRECUENCIA 53% MUCHA FRECUENCIA C@ AO FK>?H 2! ) C>O FK=<H0!' #?AOFK=@H!!) #;4&% /!( #%*"8*$*,*+#A*%,*#;&$?,;+#;&$ A*,7 # #*$*+*#+ "+@?D3G@( 83

94 = 58% 42% POCA FRECUENCIA MUCHA AO FK>AH 2! )?:O #C<OFK:=H!!) #;4&% /-( #%*"8*$*,*+#A*%,*%"$ " 35% 65% POCA FRECUENCIA MUCHA FRECUENCIA?= AO FK:CH 2! FK=@H0!' #>COFKBH!!) #;4&% //( #%*"8*$*,*+#A*)*)*)*)&$+%#) "$+?D3G@( 45% POCA FRECUENCIA 55% MUCHA FRECUENCIA C> >O FK>:H 2! ) CCO FK=<H0!' #?COFK=?H 84

95 ) " ( 0 =;O FK@H 2 ' C02#=20() #;4&% /0( #%*"8* $*,*+# A*)*)*.#"$*+%"&$$*+ $* A&$ + %'#&% +? #$*N)&$ +N+ $<%#$@?D3G@( 25% POCA FRECUENCIA MUCHA FRECUENCIA 75% >CO FK:=H 2! ) ACO FK=@H0!' #:COFKCH!!) #;4&% /1( #%*"8*$*,*+#A*)*)*,*" +:2+ +$*.%$$?D3G@( 14% POCA FRECUENCIA MUCHA FRECUENCIA 86% B> >O FKC@H 2! ) =?O FK<H0!' #<@OFK?<H!!) "! "CF< >OH') 85

96 = /(-(%&2&$$4+&% #;4&% /3(*$&7$*+2&%&'"#*+*% += #+$*+*5 A*$*#,*" + %&*"*+$*,*+#?D3G@( HORAS ,85 MEDIA 1,67 DESVIACIÓN TÍPICA 0-DA0) #;4&% /6(*$&7$*+2&%&'"&%+ )#* +#*+$ +$*#*."I* *2"$*+%"+$ J?D3G@( 57% 43% SI NO?>OFK:@H!2! #CAO FK>?H-) #;4&% /:(*$&7$*+2&%&'"&%+ )#* +#*+$ +$*#*."I;" &*, +$$*"*$*" #$*"$ #NN2&$* % "+ Q J?D3G@( 12% 27% 61% DE 1 A 3 HORAS DE 4 A 6 HORAS MÁS DE 6 HORAS 86

97 0! 0 #;4&% /F( #%*"8*$*#*+$ ++ )#**$* #*.&,"+&A* +%&*"*+ 8% 8% 5% 2% NINGÚN DEPORTE MENOS DE 1 HORA DE 1 A 3 HORAS DE 4 A 6 HORAS 77% DE 10 A 12 HORAS AAOFK?@H0D <OFKCH D = 0 <O FKCH 0 = # > 0 COFK>H'?@0 #= 4'=;0) #;4&% 0G( #%*"8*$*#*+$ ++ )#*,*$&A*%,&""$ + %&*"*+$*,*+#"*+$*+*#&"*#2*"&$ +?D3G@( 18% 2% 5% 30% NO CAM INAN NADA ENTRE 30 M IN. Y 1 HORA ENTRE 1 Y 2 HORAS 45% ENTRE 2 Y 3 HORAS M ÁS DE 3 HORAS 87

98 = >;OFK=<H?COFK:AH >;#=0 =<OFK==H=#:0 :O FK=H : # > 0 # CO FK>H & > 0 ) -# - 0# >;O - 2 ( 2' - (3) #;4&% 0!( #%*"8*$*#*+$ ++ )#*,*$&$*&+ +A*+)*"$ + %&*"*+?D3G@( 10% 17% 15% NINGÚN PISO 35% 1 PISO 2 PISOS 3 PISOS 23% MÁS DE 4 PISOS >CO FK:=H ( D # - ' :>O FK=?H ( = =AO FK=;H ( : =;O FK@H ( > # =CO FKBH(&?)2-(# #-0-")$#-!(01 D ) #;4&% 0-( #%*"8*$*#*+$ ++ )#*,*$&$*= #+A**#,"*%*" +*"$ +$ +%&*"*+$*,*+#?D3G@( 18% 12% 7% 3% 25% ENTRE 2 Y 3 HORAS ENTRE 3 Y 5 HORAS ENTRE 5 Y 7 HORAS ENTRE 7 Y 10 HORAS ENTRE 10 Y 15 HORAS 35% MÁS DE 15 HORAS 88

99 = :CO FK=CH :# > 0 >COFK:=H>#C0 =:OFKAHC#A0 =<OFK==HA# =; 0 AO FK?H =; # =C 0 # >O FK:H & =C 0) - &=C0 -(1 - -D2(+&0-2'+F^ H) /(/( "%+& "*+$*% 2(!! -D ( ( - '2 &(1'<A8 0:4) < 4 2 =;;O # +3 ) & 0! 7&2 0!#-00) 2 0( # 0( ' -0(,! F2H( -2) 2 & + # & & - #)?;O - 0( 0!4- (')5 C;O((( =;;O2(( :) 0&( 1 2 <;O 4'D #@=O=>0 0 #!2>O -&=C0(() 89

100 > 0( P! ( F2(H!(!") 2 &! ( - + 0(!-D) 0(!(&)&&$$$*+2#&)*+&&<$+*"&"2*+&.%&'" 7#$#F=BBCH 2(00 - " '!' - # ) 2( -+#-0 ( ) (1 ( ( 2( )) --!22'!(-1) " 0 2! FgH (0) 2 ' "!(&-0)!;#= - (+!! F- - 0# - H)&-2 #&! -3 '(-& 2()D7#$#F=BBCH!(0(1; A;!+(L ; A;#; <; 0 2! (L!; <;G; B; 2!( #!; B;3) 2" -!(+&(1 -!(&! 2! ) (=22(FH- 0 (!!") - 2( 2&! '(-() 90

101 > )!("$&%$ #*+$*% "+&+*"%&&"*#"?R$*# ##*+ "$&*"*+ %"%&,&*" #*2& $* *#%&'",*$&$ +% ""#*2&+ + ""*+$* &"*#2*"%&'"?D3G@( ENTREVISTA BOSTON ANTES SEIS MESES UN AÑO COMPRENSIÓN DEL PROCEDIMIENTO.96 - / - - / - CUIDADOS NECESARIOS.97 - / - - / - RESTRICCIONES POSTOPERATORIAS.97 - / - - / - PUNTUACIÓN TOTAL EN CONOCIMIENTO.96 - / - - / - MOTIVACIÓN.80 - / - - / - EXPECTATIVAS DE RESULTADOS.81 - / - - / - (!-(= -(-!D - ( " - & # 2( 3) 2(!"!" # 3! ( 3 ) (: (2((.#$. --!, 2 D") 2( 2(22 ('!()-(- 2 0 (0 # (1 FgK ;?AH!!(&-&) 2 ( # ( 3"! -'!3FgK; B?H) )-( "$&%$ #*+ $*% "+&+*"%&&"*#"?R $* # ")%=@ # +*+%+ %##*+ "$&*"*+ 7"*+$* *#%&'"(?D3G@( C.O.P.E. NºÍTEMS ANTES SEIS MESES UN AÑO AFRONTAMIENTO CONDUCTUAL CENTRADO EN EL PROBLEMA / - - / - AFRONTAMIENTO COGNITIVO DEL PROBLEMA / - - / - ESCAPE COGNITIVO / - - / - AFRONTAMIENTO CENTRADO EN LAS EMOCIONES / - - / - ESCAPE CONDUCTUAL / - - / - CONSUMO DE DROGAS / - - / - 91

102 > M.O.S. NºÍTEMS ANTES SEIS MESES UN AÑO APOYO EMOCIONAL- INFORMACIONAL / - - / - APOYO AFECTIVO / - - / - APOYO INSTRUMENTAL / - - / - PUNTUACIÓN TOTAL EN APOYO EMOCIONAL / - - / - 2 # " # 2'(#3) (>!(-2!!") )/( "$&%$ #*+ $*% "+&+*"%&&"*#"?R $* # ")%=@ # +*+%+ %##*+ "$&*"*+ +%*+& "#& +N7>/3"*+$* *#%&'"N +3,*+*+75 (?D3G@( T.F.E.Q. NºÍTEMS ANTES SEIS MESES UN AÑO RESTRICCIÓN DESINHIBICIÓN B.S.Q. NºÍTEMS ANTES SEIS MESES UN AÑO INSATISFACCIÓN CORPORAL PREOCUPACIÓN POR EL PESO PUNTUACIÓN TOTAL S.F.-36 NºÍTEMS ANTES SEIS MESES UN AÑO FUNCIONAMIENTO FÍSICO ROL FÍSICO DOLOR SALUD GENERAL VITALIDAD FUNCIONAMIENTO SOCIAL ROL EMOCIONAL SALUD MENTAL SALUD FÍSICA (funcionamiento físico+rol físico+dolor+salud general+vitalidad) SALUD MENTAL (salud general+vitalidad+funcionamiento social+rol emocional+salud mental)

103 > ( > /) 2 2( 2 -!D ( (" - ") - 2,/) - ( 4 2(3 2#" () G>@ (#(22 3 ( - $ # )!(! (22 2(3) (?22(!- 2!) ( ((#3) (!-J7!7(F77H-02B; ( 2(3) ) 0( "$&%$ #*+ $*% "+&+*"%&&"*#"?R $* # ")%=@ # +*+%+ %##*+ "$&*"*+>FG"*+$* *#%&'"N +3,*+*+75 (? D 3G@( S.C.L.-90 NºÍTEMS ANTES SEIS MESES UN AÑO SOMATIZACIÓN OBSESIÓN-COMPULSIÓN SENSIBILIDAD INTERPERSONAL DEPRESIÓN ANSIEDAD HOSTILIDAD ANSIEDAD FÓBICA IDEACIÓN PARANOIDE PSICOTICISMO DEPRESIÓN MELANCÓLICA ÍNDICE DE GRAVEDAD GLOBAL AUTOESTIMA DE ROSENBERG NºÍTEMS ANTES SEIS MESES UN AÑO AUTOESTIMA

104 > (2(2 (? ( 2" 7#$#F=BBCH) 0(-(";&+&+*+#%# 3! - 2!(() &2"FH ) # 2 2 )!(-2! -2!"-D) 0(-(!(";&+&+)&2#&$ " (G # 2 2"()3&!2(") 0(-(!(!("#*2&+ + " A <#B!(!,F!:H!) )1)#&<$*% ##*%& "*+$*"#*2&+ + "% "+&.,&+,?D3G@( Comprensión procedimiento Cuidados necesarios.68*** Restricciones.64***.71*** Comprensión puntuación total.84***.89***.92*** Motivación ,05 Expectativas.46***.44***.44***.52***.18 94

105 )3)#&<$*% ##*%& "*+$*"#*2&+ + "% " #+2#&)*+?NN7 *+&,@?D3G@(! Comprensión procedimiento Cuidados necesarios Restricciones Comprensión puntuación total Motivación.02.36**.30*.51***.49*** -.35** Expectativas **.37** -.14 )6)#&<$*% ##*%& "*+$*"#*2&+ + "% "**+& "#& >FG?D3G@( "#$% & "#$%'# "#$% # "#$% ( "#$%! "#$% ) "#$%! "#$% "#$% "#$%( Comprensión procedimiento Cuidados necesarios Restricciones Comprensión puntuación total Motivación.39**.45***.37**.42**.43**.22.34**.35**.37**.49*** Expectativas BC

106 > ):)#&<$*% ##*%& "*+$*"#*2&+ + "% "+2#&)*+$* + *+& "#& + 7?D3G@(!! * *! *!+!+!+ Comprensión procedimiento Cuidados necesarios Restricciones Comprensión puntuación total Motivación * Expectativas )F)#&<$*% ##*%& "*+$*"#*2&+ + "% "**+& "#& >/3?D3G@(,, ( * - Comprensión procedimiento Cuidados necesarios Restricciones Comprensión puntuación total Motivación -.36** -.30* ** -.30* ** Expectativas &!% FH!(! F" -D #+G H!! 2" i);;= -&" 96

107 > ' (! )!' "!(!)!! 2 #! 3!! ( " F2! i);;=h F(H!!F1 )H "!2#!F!i);;=H " (!!# "")(+2! -& F2!i);=H "#!GB;)!& "3(&12!!") 2! #! -!(!!! 1 ) #!" "! 2#2!# 2! G>@)(+!"&2 FKG; >CH)! "#(# 2 +) D D 2!-+(2!FK; :A i);ch) FH 3"2!! " & ( 3! (!(!) 0(-(!(-*+& "#& $*&,*"%&'"$*"S#$7*++&%S?@ (=; == =:#=>22- ""#!(!) )!G)#&<$*% ##*%& "*+$*%*+& "#& % " #+2#&)*+?N + "NN *+&,7% TFQ Restricción TFEQ Desinhibición ( ***.47*** *.33** -.46***! 97

108 > )!!)#&<$*% ##*%& "*+$*%*+& "#& % "**+& "#& >FG?D3G@( "#$% & "#$%'# "#$%# "#$%( "#$%! "#$%) "#$%! "#$% "#$% "#$%( TFEQ Restricción.37**.40**.28*.29*.40**.18.36**.45***.26*.45*** TFEQ Desinhibición.49***.48***.50***.50***.44**.41**.42**.44**.47***.42** )!-)#&<$*% ##*%& "*+$*%*+& "#& % " #+2#&)*+? 7@?D3G@(!! * *! *!+!+!+ TFEQ Restricción TFEQ Desinhibición * ** -.30*

109 > )!/)#&<$*% ##*%& "*+$*%*+& "#& % " #+2#&)*+?>/3 7@?D3G@(,, ( * - TFEQ Restricción TFEQ Desinhibición FH F(H -.26* -.40** * * *** -.37** -.38** -.42** -.32* -.43** ** -2( % 2 "! / "! # 2! 2,/ 2" # "!2" i);;=)20("(+! - 2F!i);=H2,/)" 2!( "! # 2!)4-#0(" ) "(2"#(1#!) ( == 2 "! # 2! Fi);;=H!(GB;-02" #"" (+0 -" Fi);=H '" # ("G") # " # # # (" ) 2 0(" " # #! 2 '" ("G " ( " # - (+!( GB; 2 & ) 4! F"H#("0( ) ( =: (! -!( 2 # # ( 2! - "! # 2!i);=!(#2 0(") FH "! # 2! Fi);;=H 3 2 0(" # G>@ - # 0(" " 2 2 &!!" -D) (+! 2 99

110 > ##)42! - 0(" (! 1!-D) 2!! #!(2!(0(2") 0(-(!(/(*+& "#& $*,.*" # #?@ (=? =C =@#=A(!,/!( -!0'( ") )!0)#&<$*% ##*%& "*+$*%*+& "#&,*$&$ % " #+2#&)*+?N *+&,7% BSQ Insatisfacción corporal ***.95*** BSQ Preocupación por el peso ***.95*** )!1)#&<$*% ##*%& "*+$*%*+& "#& % "**+& "#& >FG?D3G@( BSQ Insatis facción BSQ Preocupa ción por el peso "#$% & "#$%'# "#$%# "#$%( "#$%! "#$%)! "#$%! "#$% "#$% "#$%(.61***.64***.65***.65***.66***.52***.57***.70***.61***.61***.60***.64***.64***.61***.66***.54***.57***.68***.60***.56*** 100

111 > )!3)#&<$*% ##*%& "*+$*%*+& "#& % " #+2#&)*+? * *! *!+!+!+ BSQ Insatisfacción * -.31* -.29* BSQ Preocupación * * * por el peso )!6) #&< $*% ##*%& "*+ $*%*+& "#& % "* *+& "#& $* &$$$*&$>/3?D3G@(,, ( * - BSQ Insatisfacción BSQ Preocupación por el peso ** -.36** -.43** -.39** -.55*** -.39** -.49*** ** -.33* -.40** -.40** -.49*** -.35** -.50*** (=? =C =@#=A&!% FH F(H!(,/ "2" 2!#2!FK)BCH ( 2! ( " -!" -D)" 21-#" #2")!( " 2! #!"(2 FKG; ><H-# "2" ) ( " 2! #! - 3,/ #GB;) (2,/ 2" i);;c '" ("G" ( " 0 2"( " # " ") -!( 2! " "

112 > FH 2" # " # ( "() 2"! +( #! Fi);CH!( # ( ") "(+2!( ###) 2 2. D +(!(! ") "-3,/#!(! "! # 2! Fi);;=H 2" # " 2 #)(-# # 2" # " 2 #! ( )!(2"#"(+! 2! -Fi);=H!(2! #) 0(-(!(0(*+& "#& $* *+&,$* +*")*#. ( =< =B # :; 2 "#!(!) )!:)#&<$*% ##*%& "*+$*%*+& "#& $* *+&,$* +*")*#.,*$&$ % "*7**+& "#& >FG?D3G@( "#$% & "#$%'# "#$%# "#$%( "#$%! "#$%) "#$%! "#$% "#$% "#$%( Autoestima *** -.52*** -.64*** -.63*** -.52*** -.46*** -.48*** -.57*** -.58*** -.54*** )!F)#&<$*% ##*%& "*+$*%*+& "#& $* *+&,$* +*")*#.% " **+& "#& 7?D3G@(!! * *! *!+!+!+ Autoestima * ***

113 > )-G)#&<$*% ##*%& "*+$*%*+& "#& $* *+&,$* +*")*#.% " **+& "#& ( * - Autoestima.35**.27*.14.38**.44***.41**.19.47*** -3(% FH GB; ( =< 4 "! # 2!Fi);;=H-3!( # 2 - " ) "!&42(-" 4 #-!(1 &(! 1) 0#"2!$#) F(H FH "-3##2 2! #!) $0 4 - ( # 2! # 1 ) 2! " 3 " +( #!Fi);CH#!!(.0#"2!) (:; -!(! # G>@"#!!() 2 2#!! 2'Fi);=H#!(20+() 103

114 > 0(-(!(1(*+& "#& $*&",. +&% )-!)#&<$*% ##*%& "*+$*%*+& "#& >FG,*$&$ % "+&.,&+, 7% "*?D3G@( "#$% & "#$%'# "#$%# "#$%( "#$%! "#$%) "#$%! "#$% "#$% "#$%( SCL-90 Somatización SCL-90 Obsesióncompulsión SCL-90 Suscep. Interpersonal SCL-90 Depresión SCL-90 Ansiedad SCL-90 Hostilidad SCL-90 Ansiedad fóbica SCL-90 Ideación paranoide SCL-90 Psicoticismo SCL-90 Depresión melancólica *** ***.84*** ***.86***.93*** ***.88***.84***.85*** ***.78***.79***.79***.80*** ***.74***.78***.76***.84***.74*** ***.85***.87***.81***.80***.73***.81*** ***.83***.85***.81***.85***.85***.79***.83*** ***.80***.80***.84***.83***.75***.68***.73***.70*** 104

115 > )--)#&<$*% ##*%& "*+$*%*+& "#& >FG% "+2#&)*+$**+& "#& * *! *!+!+!+ SCL-90 Somatización SCL-90 Obsesióncompulsión SCL-90 Suscep. Interpersonal SCL-90 Depresión SCL-90 Ansiedad SCL-90 Hostilidad SCL-90 Ansiedad fóbica SCL-90 Ideación paranoide SCL-90 Psicoticismo SCL-90 Depresión melancólica * ** -.34** -.35** **.01.27* -.42** -.36** -.34** * *** -.42** -.32* * *** -.43** -.35** *** * -.44** -.36** -.39** * ** -.49*** -.41** ** * -.43** -.41** -.36** * ** -.42** -.33** -.26* * * -.51*** -.55*** -.33* *.36** ** -.32* -.30* 105

116 > )-/)#&<$*% ##*%& "*+$*%*+& "#& >FG% "**+& "#& ( * - SCL-90 Somatización -.48*** -.65*** -.68*** -.74*** -.73*** -.71*** -.63*** -.71*** SCL-90 Obsesión-compulsión -.39*** -.56*** -.49*** -.57*** -.66*** -.65*** -.55*** -.72*** SCL-90 Suscep. Interpersonal -.34** -.54*** -.46*** -.61*** -.65*** -.65*** -.54*** -.75*** SCL-90 Depresión -.44*** -.63*** -.52*** -.63*** -.73*** -.77*** -.66*** -.77*** SCL-90 Ansiedad -.32* -.51*** -.38** -.54*** -.59*** -.59*** -.58*** -.86*** SCL-90 Hostilidad ** -.35** -.43** -.50*** -.47*** -.53*** -.71*** SCL-90 Ansiedad fóbica -.27* -.31* *** -.46*** -.56*** -.46*** -.74*** SCL-90 Ideación paranoide -.36** -.51*** -.44*** -.56*** -.52*** -.61*** -.51*** -.66*** SCL-90 Psicoticismo -.27* -.39** -.36** -.48*** -.50*** -.52*** -.50*** -.71*** SCL-90 Depresión melancólica -.37** -.63*** -.44*** -.53*** -.60*** -.60*** -.53*** -.71*** 106