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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">La hidrosadenitis supurativa es una enfermedad dermatol&#243;gica cr&#243;nica del fol&#237;culo piloseb&#225;ceo&#44; con una gran afectaci&#243;n en la calidad de vida de los pacientes y con una elevada comorbilidad biopsicosocial<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">La psicodermatolog&#237;a&#44; que tiene como objetivo favorecer la valoraci&#243;n y tratamiento psicol&#243;gico de la atenci&#243;n m&#233;dica de los pacientes de dermatolog&#237;a&#44; ha cobrado una relevancia mayor en los &#250;ltimos a&#241;os en Europa&#46; Por ello&#44; conscientes de la alta prevalencia de la morbilidad ps&#237;quica en los pacientes con enfermedades m&#233;dico-quir&#250;rgicas&#44; el Grupo Europeo de Psiquiatr&#237;a de Consulta y Enlace cre&#243; el m&#233;todo INTERMED<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a>&#44; validado en castellano&#44; y recientemente reformulado en su versi&#243;n autoadministrada &#40;IM-SA&#41;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a>&#44; con el objetivo de identificar y clasificar a los pacientes complejos biopsicosocialmente&#44; realizar una valoraci&#243;n multidimensional r&#225;pida y as&#237; mejorar la eficiencia del abordaje de los pacientes que precisan un mayor cuidado m&#233;dico y&#44; por lo tanto&#44; recursos econ&#243;micos&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Para evaluar la utilidad del m&#233;todo IMSA en el estudio de los pacientes con una hidrosadenitis supurativa&#44; se realiz&#243; un estudio piloto de tipo transversal sobre una muestra de pacientes &#40;n &#61; 23&#41;&#44; mayores de edad y en pleno uso de sus facultades mentales&#44; que acudieron de forma consecutiva a la consulta monogr&#225;fica de hidrosadenitis supurativa &#40;HS&#41; del servicio de Dermatolog&#237;a del Hospital Cl&#237;nico Universitario Lozano Blesa de Zaragoza&#44; entre los meses de marzo y mayo de 2021&#46; El estudio fue aprobado por el Comit&#233; de &#201;tica de Investigaci&#243;n de la Comunidad de Arag&#243;n &#40;CEICA&#41;&#46; Se recopilaron las siguientes variables&#58; los datos sociodemogr&#225;ficos de los pacientes&#44; la gravedad de la HS &#40;seg&#250;n la escala de Hurley&#41; y el instrumento autoadministrado IM-SA en su versi&#243;n en espa&#241;ol&#44; el cual cataloga a los pacientes mediante cuatro dominios&#58; biol&#243;gico&#44; psicol&#243;gico&#44; social y asistencia sanitaria&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los datos se procesaron en el programa Jamovi 1&#46;8&#46;2 obteni&#233;ndose las medidas descriptivas y anal&#237;ticas de contraste de hip&#243;tesis&#44; utilizando para estas &#250;ltimas pruebas no param&#233;tricas al tener un tama&#241;o muestral peque&#241;o &#40;n &#61; 23&#41;&#46; La significaci&#243;n estad&#237;stica se estableci&#243; para valores de p &#60; 0&#44;05&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Las mujeres &#40;16&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>8&#44;8&#41; presentaron una puntuaci&#243;n global en IM-SA mayor que los hombres &#40;11&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>6&#44;5&#41;&#44; aunque las diferencias no fueron significativas &#40;p &#61; 0&#44;14&#41;&#46; El an&#225;lisis por dominios mostr&#243; unas diferencias estad&#237;sticamente significativas en el &#225;rea psicol&#243;gica &#40;tanto en antecedentes&#44; historia actual y pron&#243;stico&#41;&#44; en los que las mujeres mostraron unas puntuaciones mayores que los hombres &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">La escala IM-SA permite clasificar a los pacientes seg&#250;n su complejidad biopsicosocial en &#171;No complejos&#187; &#40;n &#61; 19&#41; si punt&#250;an menos de 19 puntos o en &#171;Complejos&#187; &#40;n &#61; 4&#41; si obtienen una puntuaci&#243;n mayor o igual a 19&#46; Al analizar la puntuaci&#243;n total IM-SA se observa que &#233;sta es mayor en los pacientes complejos &#40;28<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;7&#41; que los no complejos &#40;10&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;1&#41; &#40;p &#61; 0&#44;002&#41;&#46; Las diferencias de las medias de las puntuaciones obtenidas en los diferentes dominios del IM-SA se detallan en la <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#46; Seg&#250;n los resultados del estudio&#44; solo 17&#44;3&#37; de los pacientes resultaron complejos&#46; La puntuaci&#243;n media de IM-SA de los 19 pacientes no complejos fue de 10&#44;6 &#40;SD&#58;4&#44;1&#41; mientras que la de los cuatro pacientes complejos fue de 28 &#40;SD&#58;4&#44;7&#41;&#46; Este resultado indica que los pacientes con una hidradenitis supurativa son m&#225;s complejos que otras entidades estudiadas previamente con el instrumento INTERMED&#44; como la esclerosis m&#250;ltiple &#40;media de 14&#41;&#44; la artritis reumatoide &#40;media de 17&#44;2&#41; o el trasplante hep&#225;tico &#40;media de 20&#41;<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a>&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0035" class="elsevierStylePara elsevierViewall">Como era esperado&#44; unas puntuaciones mayores de IM-SA se asociaron con unas puntuaciones mayores en los dominios psicol&#243;gicos y sociales&#44; p &#61; 0&#44;005 &#40;dominios de&#58; estado psicol&#243;gico pasado&#44; estado social pasado&#44; asistencia sanitaria pasada&#44; estado biol&#243;gico actual&#44; estado psicol&#243;gico actual&#44; estado social actual y pron&#243;stico social y sanitario&#41;&#46; Esta asociaci&#243;n concuerda con la bibliograf&#237;a disponible&#44; como en un estudio de Kouris et al&#46;&#44; que demuestran que los pacientes con hidradenitis supurativa sufren estad&#237;sticamente significativa mayor ansiedad que el grupo control &#40;6&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;3 vs&#46; 5&#46;0<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;6&#44; p &#60; 0&#44;001&#41;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">El estudio piloto llevado a cabo demuestra que el instrumento IM-SA es capaz de detectar y se&#241;alar pacientes complejos&#44; demostrando que los pacientes con hidradenitis supurativa poseen mayor complejidad que poblaciones estudiadas previamente con el instrumento INTERMED&#46; Dado que se trata de un estudio piloto&#44; ser&#237;a interesante continuar la investigaci&#243;n para poder mejorar la calidad asistencial y proporcionar una atenci&#243;n y cuidados personalizados&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Financiaci&#243;n</span><p id="par0045" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n no ha recibido ninguna beca espec&#237;fica de agencias de los sectores p&#250;blico&#44; comercial o sin &#225;nimo de lucro&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicto de intereses</span><p id="par0050" class="elsevierStylePara elsevierViewall">Los autores declaran que no existe ning&#250;n conflicto de inter&#233;s en la realizaci&#243;n de este trabajo&#46;</p></span></span>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Dominios IM-SA&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sexo&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Antecedentes psicol&#243;gicos&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HombreMujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;53&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Historia actual psicol&#243;gica&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pron&#243;stico psicol&#243;gico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
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        "descripcion" => array:1 [
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                  \t\t\t\t">Estado biol&#243;gico&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;43&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;33&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">Asistencia sanitaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;64&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;048&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Estado social&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">0&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;42&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>2&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#44;009&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Asistencia sanitaria&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#44;51&#44;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44;0&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;143&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " rowspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">No complejoComplejo&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Estado psicol&#243;gico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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