MARTA SANTACREU
@universidadeuropea.es
Psychology
Universidad Europea de Madrid
RESEARCH INTERESTS
Ageing, aging, active aging, online clinical internvention, pyschology
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Rocío Fernández‐Ballesteros, Macarena Sánchez‐Izquierdo, Ricardo Olmos, Carmen Huici, María Giovanna Caprara, Marta Santacreu, José Manuel Ribera Casado, and Alfonso Cruz‐Jentoft
Wiley
AIM
There is a need for a validated instrument to measure the type of care (paternalism or person-centered) provided for older adults. Since paternalism and person-centered 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 behaviors in older adults care contexts, which can help to enhance care practice.
DESIGN
Instrument development.
METHODS
After observing and standardizing behaviors 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 centers and older adult day care centers.
RESULTS
The Paternalist/Autonomist Care Assessment (PACA) is a 30-item, behavior-based instrument which measures both the appraisal of caregivers on elements of care (Care Appraisal Scale- PACA-Appraisal) and the occurrence of behaviors (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 behaviors and autonomist behaviors. However, these factors were not fully dichotomous and were shown to coexist to some degree.
CONCLUSION
The instrument displayed good psychometric properties as an instrument 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 behaviors being more frequent in contexts of care for more dependent persons. This article is protected by copyright. All rights reserved.
Marta Santacreu, Marcos Alonso Rodríguez, and María Ángeles Molina
Cambridge University Press
M. Sánchez-Izquierdo, M Santacreu, R. Olmos, and R. Fernández-Ballesteros
Informa UK Limited
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.
Rocío Fernández-Ballesteros, Macarena Sánchez‐Izquierdo, Ricardo Olmos, Carmen Huici, Marta Santacreu, Rocío Schettini, and María Ángeles Molina
Informa UK Limited
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.
Rocio Fernandez-Ballesteros, Ricardo Olmos, Marta Santacreu, Antonio Bustillos, and Maria Angeles Molina
Elsevier BV
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.
R. Fernández-Ballesteros, R. Olmos, M. Santacreu, A. Bustillos, Rocío Schettini, C. Huici and J. M. Rivera
Abstract Background: 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. Method: 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 Lawton's 5‐item scale were administered to a representative sample of Spanish people over 50. Results: 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. Conclusions: We discuss Levy's theoretical assumptions about personal‐stereotypes and the self‐stereotype measured with IAS and their relationship to self‐perception of ageing. Resumen Evaluando estereotipos del envejecimiento: estereotipos personales, autoestereotipos y auto‐percepción del envejecimiento. Antecedentes: existe una amplia red semántica sobre los estereotipos del envejecimiento; donde se confunden diferentes términos como: los estereotipos personales, autoestereotipos y la auto‐percepción del envejecimiento; así como la manera en que se evalúan. Método: con el objetivo de clarificar esta red semántica, se analiza la versión traducida del modelo de medición Image of Aging Scale (IAS) a través del análisis factorial exploratorio y confirmatorio, en dos sub‐muestras representativas de la población española mayor de 18 (N = 1.105) y en una muestra de gerontólogos y geriatras (N = 325). También se administran el IAS (con diferentes instrucciones) y la escala de 5 ítems de Lawton a una muestra representativa de españoles mayores de 50 años. Resultados: nuestros resultados indican que la versión española de la IAS tiene una estructura psicométrica similar a la propuesta por los autores. La estructura factorial se replica en ambas muestras, las medias latentes y las correlaciones de los factores fueron mayores en el grupo profesional. Conclusiones: se discuten los supuestos teóricos de Levy sobre los estereotipos personales y el auto‐estereotipo medidos con el IAS y su relación con la auto‐percepción del envejecimiento. Palabras clave: estereotipos del envejecimiento, estereotipos personales, auto‐estereotipos y la auto‐percepción del envejecimiento.
Rocio Fernandez-Ballesteros, Antonio Bustillos, Rocio Schettini, Pura Diaz-Veiga, Carmen Huici, and Marta Santacreu
Informa UK Limited
Purpose The purpose of this study is to examine, from the stereotype content model (SCM) perspective, the role of the competence and warmth stereotypes of older adults held by professional caregivers. Methods A quasi-experimental design, ex post facto with observational analyses, was used in this study. The cultural view on competence and warmth was assessed in 100 caregivers working in a set of six residential geriatric care units (three of them organized following a person-centered care approach and the other three providing standard geriatric care). In order to assess caregivers’ cultural stereotypical views, the SCM questionnaire was administered. To evaluate the role of caregivers’ cultural stereotypes in their professional performance as well as in older adult functioning, two observational scales from the Sistema de Evaluación de Residencias de Ancianos (assessment system for older adults residences)-RS (staff functioning and residents’ functioning) were applied. Results Caregivers’ cultural views of older adults (compared to young people) are characterized by low competence and high warmth, replicating the data obtained elsewhere from the SCM. Most importantly, the person-centered units predict better staff performance and better resident functioning than standard units. Moreover, cultural stereotyping of older adult competence moderates the effects of staff performance on resident functioning, in line with the findings of previous research. Conclusion Our results underline the influence of caregivers’ cultural stereotypes on the type of care, as well as on their professional behaviors and on older adult functioning. Caregivers’ cultural stereotypes could be considered as a central issue in older adult care since they mediate the triangle of care: caregivers/older adults/type of care; therefore, much more attention should be paid to this psychosocial care component.
Marta Santacreu, Antonio Bustillos, and Rocio Fernandez-Ballesteros
Springer Science and Business Media LLC
The aim of this study is to provide cross-cultural empirical support that endorses the scientific nature of Quality of Life (QoL), which a review of definitions reveals as a nomothetic and multidimensional concept (personal and environmental circumstances), made up of a set of subjective and objective indicators. Although this is commonly accepted, many instruments and authors reduce it to subjective and personal conditions. Bearing in mind the aim described, multi-group Structural Equation Modelling analysis was applied to two representative samples made up of 1217 participants aged over 60 from Mexico and Spain, recruited both at random (through the random route procedure), who completed the CUBRECAVI (Brief Questionnaire of Quality of Life). In this model two third-order latent variables are considered for QoL: personal and external factors, both made up of objective and subjective indicators. As predicted, the results permit us to state that the structural model is invariant across the two countries—that is, although the QoL construct has the same structure in the two countries, the importance of the indicators (factor loadings) and the relationships between them are not equivalent.
Mariagiovanna Caprara, María Ángeles Molina, Rocío Schettini, Marta Santacreu, Teresa Orosa, Víctor Manuel Mendoza-Núñez, Macarena Rojas, and Rocío Fernández-Ballesteros
Hindawi Limited
Active aging is one of the terms in the semantic network of aging well, together with others such as successful, productive, competent aging. All allude to the new paradigm in gerontology, whereby aging is considered from a positive perspective. Most authors in the field agree active aging is a multidimensional concept, embracing health, physical and cognitive fitness, positive affect and control, social relationships and engagement. This paper describesVital Aging, an individual active aging promotion program implemented through three modalities: Life, Multimedia, and e-Learning. The program was developed on the basis of extensive evidence about individual determinants of active aging. The different versions ofVital Agingare described, and four evaluation studies (both formative and summative) are reported. Formative evaluation reflected participants’ satisfaction and expected changes; summative evaluations yielded some quite encouraging results using quasi-experimental designs: those who took part in the programs increased their physical exercise, significantly improved their diet, reported better memory, had better emotional balance, and enjoyed more cultural, intellectual, affective, and social activities than they did before the course, thus increasing their social relationships. These results are discussed in the context of the common literature within the field and, also, taking into account the limitations of the evaluations accomplished.
Rocío Fernández-Ballesteros, Mariagiovanna Caprara, Rocío Schettini, Antonio Bustillos, Víctor Mendoza-Nunez, Teresa Orosa, Rosita Kornfeld, Macarena Rojas, María Dolores López, Lda. Marta Santacreu,et al.
Informa UK Limited
University Programs for Older Adults (Programas Universitarios para Adultos Mayores or PUMAs) have been developed throughout the world as an outcome of two worldwide policies: Life Long Learning (LLL) and Active Aging as a priority direction (UN, 2002). According to these policies, older persons should become full participants in the development process of a society, sharing in its benefits, while policies and actions should promote a positive view of aging. The present paper sets out to report some of the results from the evaluation of four PUMAs offered in 2009–2010 at four Universities: Autónoma University of Madrid (Spain), Autónoma University of Mexico (Mexico), Catholic University (Chile), and La Habana University (Cuba). With this purpose, a study with quasiexperimental design and nonequivalent control group was carried out. In total, 313 students (75% women, age range 50–87) on these four PUMAs and 190 controls (77% female, age range 50–91) participated in this evaluation study. Pre- and postexperimental and control comparisons results yielded significant differences in the expected direction: those people attending PUMAs significantly improved their self-perception of aging and group stereotypes, as well as significantly reduced their negative affect, and improving their emotional balance. At the same time, their perception of cultural age stereotypes became more negative. The results are discussed from the point of view of the II International Plan of Action on Aging objectives: the reduction of negative stereotypes and the promotion of the role of PUMAs in active aging.
Rocío Fernández-Ballesteros, Rocío Schettini, Marta Santacreu, and María Angeles Molina
Wiley
Conflict of Interest: The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this paper. This study was supported by a grant from the Ministry of Health, Labour and Welfare, Japan (H19–025, No. 21A-9 and No. 23–4; principal investigator, Dr. Yumiko Arai). Author Contributions: All of the authors contributed to the study concept, design, data analysis, and preparation of the letter. Sponsor’s Role: The funding resource played no role in this study.
Marta Santacreu
Hogrefe Publishing Group
Spain, like other developed countries, has witnessed exponential growth in the number of older persons, and it has made great efforts to address this new social situation, gradually developing an extensive network for supporting not only dependent persons, but also healthy retired people with new demands. In order to better understand the situation with respect to aging, this chapter provides some demographic indicators illustrating the current structure of Spain’s aging population. The second and third sections outline the main research areas in Spain and the resources available for older adults. With regard to research on aging, there has been a considerable increase in the number of both research projects and publications in the Spanish context, particularly from the 1980s to the present. Most of the studies are aimed at assessing the different characteristics and conditions of senior citizens. This is a good first step with a view toward identifying their demands, though more research is necessary for making crucial changes. On the subject of resources and services, Spain has developed a wide variety of resources designed to meet the needs of both independent and dependent older adults. Finally, it should always be borne in mind that social needs change over time, so that they must be continuously studied and reappraised – and our respective responses updated – in order to maintain standards of excellence.
Santacreu
Informa UK Limited
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 a 2-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.