An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials
Las morbilidades psicológicas son comunes en pacientes con cáncer de mama. Condiciones clínicas como depresión, alteraciones cognitivas, ansiedad, angustia, miedo al cáncer, trastornos del sueño y fatiga pueden persistir en sobrevivientes de cáncer. Por ello, las intervenciones psicológicas son rele...
- Autores:
-
Bonilla Santos, Jasmin
González Montealegre, Rodrigo Alberto
González Hernández, Alfredis
- Tipo de recurso:
- Article of investigation
- Fecha de publicación:
- 2022
- Institución:
- Universidad Cooperativa de Colombia
- Repositorio:
- Repositorio UCC
- Idioma:
- OAI Identifier:
- oai:repository.ucc.edu.co:20.500.12494/52588
- Palabra clave:
- Intervención psicológica
Psicoterapia
Cáncer de mama
Neoplasia de mama
Revisión sistemática
Psychological intervention
Psychotherapy
Breast cancer
Breast neoplasma
Systematic review
- Rights
- closedAccess
- License
- Atribución – No comercial – Sin Derivar
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An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| title |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| spellingShingle |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials Intervención psicológica Psicoterapia Cáncer de mama Neoplasia de mama Revisión sistemática Psychological intervention Psychotherapy Breast cancer Breast neoplasma Systematic review |
| title_short |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| title_full |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| title_fullStr |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| title_full_unstemmed |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| title_sort |
An Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled Trials |
| dc.creator.fl_str_mv |
Bonilla Santos, Jasmin González Montealegre, Rodrigo Alberto González Hernández, Alfredis |
| dc.contributor.author.none.fl_str_mv |
Bonilla Santos, Jasmin González Montealegre, Rodrigo Alberto González Hernández, Alfredis |
| dc.subject.none.fl_str_mv |
Intervención psicológica Psicoterapia Cáncer de mama Neoplasia de mama Revisión sistemática |
| topic |
Intervención psicológica Psicoterapia Cáncer de mama Neoplasia de mama Revisión sistemática Psychological intervention Psychotherapy Breast cancer Breast neoplasma Systematic review |
| dc.subject.other.none.fl_str_mv |
Psychological intervention Psychotherapy Breast cancer Breast neoplasma Systematic review |
| description |
Las morbilidades psicológicas son comunes en pacientes con cáncer de mama. Condiciones clínicas como depresión, alteraciones cognitivas, ansiedad, angustia, miedo al cáncer, trastornos del sueño y fatiga pueden persistir en sobrevivientes de cáncer. Por ello, las intervenciones psicológicas son relevantes durante el tratamiento en el cáncer de mama. Objetivo: Identificar intervenciones y resultados psicológicos para mujeres con cáncer de mama. Se buscaron en cinco bases de datos: EMBASE, ScienceDirect, MEDLINE (Ovid), CENTRAL (Ovid) y PsycINFO (APA PsyNET), de enero de 2014 al 4 de junio de 2018. Dos autores revisaron todos los artículos en bases de datos y seleccionaron estudios potencialmente elegibles. Se utilizó una síntesis narrativa de los resultados debido a la heterogeneidad en ensayos controlados aleatorios, características de la población, psicoterapias aplicadas, resultados y tiempo de las evaluaciones. Este resumen incluyó 14 ensayos controlados aleatorios que comprometen a 1914 participantes (incluidos no metastásicos y metastásicos) en 21 artículos. Las intervenciones psicológicas más comunes fueron basadas en el comportamiento cognitivo. Los principales resultados psicológicos evaluados fueron la depresión, la calidad de vida, la fatiga y la ansiedad. Conclusión: Los resultados de esta revisión son útiles para aclarar una visión general de la intervención en morbilidades psicológicas en el cáncer de mama. Las comorbilidades varían, contribuyen con costos a los pacientes y no hay suficiente evidencia empírica sobre psicoterapias para resolver todas las morbilidades psicológicas en la mujer con cáncer de mama. |
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2022 |
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2022-05-03 |
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2023-08-30T17:10:53Z |
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2023-08-30T17:10:53Z |
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Artículos Científicos |
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info:eu-repo/semantics/publishedVersion |
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20117531 |
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https://doi.org/10.14482/sun.38.1.616.89 https://hdl.handle.net/20.500.12494/52588 |
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Bonilla Santos, J., González Montealegre, R. A., & González Hernández, A. (2022). Una descripción general de la psicoterapia para pacientes con cáncer de mama: revisión sistemática de ensayos controlados aleatorios. Revista Científica Salud Uninorte, 38(1), 278–298. https://doi.org/10.14482/sun.38.1.616.89 |
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20117531 Bonilla Santos, J., González Montealegre, R. A., & González Hernández, A. (2022). Una descripción general de la psicoterapia para pacientes con cáncer de mama: revisión sistemática de ensayos controlados aleatorios. Revista Científica Salud Uninorte, 38(1), 278–298. https://doi.org/10.14482/sun.38.1.616.89 |
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https://doi.org/10.14482/sun.38.1.616.89 https://hdl.handle.net/20.500.12494/52588 |
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https://rcientificas.uninorte.edu.co/index.php/salud/article/view/14037 |
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Revista Científica Salud Uninorte |
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World Health Organization. World Health Statistics 2018- Monitoring Health for the SDG’s (Sustainable development goals). 2018. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin 2016;66:271–89. doi:10.3322/caac.21349. De Moor JS, Mariotto AB, Parry C, Alfano CM, Padgett L, Kent EE, et al. Cancer Survivors in the United States: Prevalence across the Survivorship Trajectory and Implications for Care 2013. Doi:10.1158/1055-9965.EPI-12-1356. Mens MG, Helgeson VS, Lembersky BC, Baum A, Scheier MF, Mens MG Lembersky BC, Baum A, Scheier MF HVS. Randomized psychosocial interventions for breast cancer: impact on life purpose. Psychooncology 2016;25:618–25. doi:https://dx.doi.org/10.1002/pon.3891. Ho RTH, Fong TCT, Yip PSF. Perceived stress moderates the effects of a randomized trial of dance movement therapy on diurnal cortisol slopes in breast cancer patients. Psychoneuroendocrinology 2018;87:119–26. Doi:10.1016/j.psyneuen.2017.10.012. Vitali M, Ripamonti CI, Roila F, Proto C, Signorelli D, Imbimbo M, et al. Cognitive impairment and chemotherapy: a brief overview. Crit Rev Oncol Hematol 2017;118:7–14. Doi:10.1016/j.critrevonc.2017.08.001. Carvalho AF, Hyphantis T, Sales PMG, Soeiro-de-Souza MG, Macêdo DS, Cha DS, et al. Major depressive disorder in breast cancer: A critical systematic review of pharmacological and psychotherapeutic clinical trials. Cancer Treat Rev 2014;40:349–55. Doi:10.1016/j.ctrv.2013.09.009. Yang Y-L, Sui G-Y, Liu G-C, Huang D-S, Wang S-M, Wang L. The effects of psychological interventions on depression and anxiety among Chinese adults with cancer: A meta-analysis of randomized controlled studies. BMC Cancer 2014;14. Doi:10.1186/1471-2407-14-956. Hopko DR, Cannity K, McIndoo CC, File AA, Ryba MM, Clark CG, et al. Behavior therapy for depressed breast cancer patients: Predictors of treatment outcome. J Consult Clin Psychol 2015;83:225–31. Doi:10.1037/a0037704. Weißflog G, Brähler E, Leuteritz K, Barthel Y, Kuhnt S, Wiltink J, et al. Does psychodynamic shortterm psychotherapy for depressed breast cancer patients also improve fatigue? Results from a randomized controlled trial. Breast Cancer Res Treat 2015;152:581–8. Doi:10.1007/s10549-015-3494-0. Hosseini SH, Rafiei A, Janbabai G, Tirgari A, Zakavi A, Yazdani J, et al. comparison of religious cognitive behavioral therapy, cognitive behavioral therapy, and citalopram on depression and anxiety among women with breast cancer: A study protocol for a randomized controlled trial. Asian J Pharm Res Heal Care 2016;8:55–62. Doi:10.18311/ajprhc/2016/8364. Andryszak P, Wiłkość M, Izdebski P, Żurawski B. A systemic literature review of neuroimaging studies in women with breast cancer treated with adjuvant chemotherapy. Contemp Oncol (Pozn) 2017;21:6– 15. Doi:10.5114/wo.2017.66652. Bernstein LJ, McCreath GA, Komeylian Z, Rich JB. Cognitive impairment in breast cancer survivors treated with chemotherapy depends on control group type and cognitive domains assessed: A multilevel meta-analysis. Neurosci Biobehav Rev 2017;83:417–28. Doi:10.1016/j.neubiorev.2017.10.028. Chan RJ, McCarthy AL, Devenish J, Sullivan KA, Chan A, R.J. C, et al. Systematic review of pharmacologic and non-pharmacologic interventions to manage cognitive alterations after chemotherapy for breast cancer. Eur J Cancer 2015;51:437–50. Doi: 10.1016/j.ejca.2014.12.017. Bonilla Santos J, Rodríguez Orjuela R, Trujillo Sánchez PA, González Rojas A del P, Gonzalez Hernandez A. Desempeño cognitivo en pacientes con cáncer de mama tratadas con quimioterapia. Gac Mex Oncol 2016;15:199–206. Doi:10.1016/J.GAMO.2016.07.004. Merckaert I, Lewis F, Delevallez F, Herman S, Caillier M, Delvaux N, et al. Improving anxiety regulation in patients with breast cancer at the beginning of the survivorship period: a randomized clinical trial comparing the benefits of single-component and multiple-component group interventions. Psychooncology 2017;26:1147–54. Doi:10.1002/pon.4294. Ross S, Bossis A, Guss J, Agin-Liebes G, Malone T, Cohen B, et al. Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: A randomized controlled trial. J Psychopharmacol 2016;30:1165–80. Doi:10.1177/0269881116675512. Ludwig G, Krenz S, Zdrojewski C, Bot M, Rousselle I, Stagno D, et al. Psychodynamic interventions in cancer care I: Psychometric results of a randomized controlled trial. Psychooncology 2014;23:65–74. Doi:10.1002/pon.3374. Cobeanu O, David D. Alleviation of Side Effects and Distress in Breast Cancer Patients by Cognitive-Behavioral Interventions: A Systematic Review and Meta-analysis. J Clin Psychol Med Settings 2018;0:1–21. Doi:10.1007/s10880-017-9526-7. Baniasadi H, Kashani FL, Jamshidifar Z. Effectiveness of Mindfulness Training on Reduction of Distress of Patients Infected by Breast Cancer. Procedia - Soc Behav Sci 2014;114:944–8. Doi:https://doi. org/10.1016/j.sbspro.2013.12.812 Beatty L Wade T, Yip D, Katris P, Turner J, Yates P, Wootten A, Lambert S, Butow P, Koczwara B KE, Beatty L Wade T, Yip D, Katris P, Turner J, Yates P, Wootten A, Lambert S, Butow P, Koczwara B KE. Finding my way: Uptake and satisfaction with an Internet self-help program for cancer-related distress. Psychooncology 2015;24:36 Savard J, Savard MH, Caplette-Gingras A, Casault L, Camateros C. Development and Feasibility of a Group Cognitive-Behavioral Therapy for Fear of Cancer Recurrence. Cogn Behav Pract 2018;25:275– 85. Doi:10.1016/j.cbpra.2017.08.001. Butow PN, Turner J, Gilchrist J, Sharpe L, Smith A Ben, Fardell JE, et al. Randomized Trial of ConquerFear: a Novel, Theoretically Based Psychosocial Intervention for Fear of Cancer Recurrence. J Clin Oncol 2017;35:4066–77. Doi:https://dx.doi.org/10.1200/JCO.2017.73.1257. Trockel M, Karlin BE, Taylor CB, Manber R. Cognitive Behavioral Therapy for insomnia with veterans: Evaluation of effectiveness and correlates of treatment outcomes. Behav Res Ther 2014;53:41–6. Doi:https://doi.org/10.1016/j.brat.2013.11.006. Casault L, Savard J, Ivers H, Savard M-H. A randomized-controlled trial of an early minimal cognitive-behavioural therapy for insomnia comorbid with cancer. Behav Res Ther 2015;67:45–54. Doi:https://doi.org/10.1016/j.brat.2015.02.003. Savard J, Ivers H, Savard M-H, Morin CM. Long-Term Effects of Two Formats of Cognitive Behavioral Therapy for Insomnia Comorbid with Breast Cancer. Sleep 2015. Rissanen R, Arving C, Ahlgren J, Nordin K, Rissanen R Ahlgren J, Nordin K AC, Rissanen R, et al. Group versus individual stress management intervention in breast cancer patients for fatigue and emotional reactivity: A randomised intervention study. Acta Oncol (Madr) 2014;53:1221–9. Doi:10.3 109/0284186X.2014.923935. Oberguggenberger A, Meraner V, Sztankay M, Hilbert A, Hubalek M, Holzner B, et al. Health Behavior and Quality of Life Outcome in Breast Cancer Survivors: Prevalence Rates and Predictors. Clin Breast Cancer 2018;18:38–44. Doi:10.1016/j.clbc.2017.09.008. De La Torre-Luque A, Gambara H, López E, Cruzado JA. International Journal of Clinical and Health Psychology Psychological treatments to improve quality of life in cancer contexts: A meta-analysis. Int J Clin Heal Psychol 2016;16:211–9. doi:10.1016/j.ijchp.2015.07.005. Kirshbaum MN, Dent J, Stephenson J, Topping AE, Allinson V, McCoy M, et al. Open access follow-up care for early breast cancer: a randomised controlled quality of life analysis. Eur J Cancer Care (Engl) 2017;26. Doi:https://dx.doi.org/10.1111/ecc.12577. Norcross JC, VandenBos GR, Freedheim DK, Olatunji BO, editors. APA handbook of clinical psychology: Theory and research (Vol. 2). Washington: American Psychological Association; 2016. Doi:10.1037/14773-000. Jassim GA, Whitford DL, Hickey A, Carter B. Psychological interventions for women with non-metastatic breast cancer. Cochrane Database Syst Rev 2015. doi:10.1002/14651858.CD008729.pub2. Mustafa M, Carson-Stevens A, Gillespie D, Edwards AG. Psychological interventions for women with metastatic breast cancer. Cochrane Database Syst Rev 2013. doi:10.1002/14651858.CD004253. pub4. Beatty L, Kemp E, Butow P, Girgis A, Schofield P, Turner J, et al. A systematic review of psychotherapeutic interventions for women with metastatic breast cancer: Context matters. Psychooncology 2018;27:34–42. doi:10.1002/pon.4445. Higgins J, Green S, editors. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration; n.d. Moher D, Liberati A, Tetzlaff J, Altman DG, Group TP. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 2009;6:e1000097. doi:10.1371/journal.pmed.1000097. Öster I, Svensk A-C, Magnusson E, Thyme KE, Sjõdin M, Åström S, et al. Art therapy improves coping resources: a randomized, controlled study among women with breast cancer. Palliat Support Care 2006;4:57–64. doi:10.10170S147895150606007X. Rissanen R, Nordin K, Ahlgren J, Arving C. A stepped care stress management intervention on cancer-related traumatic stress symptoms among breast cancer patients-a randomized study in group vs. individual setting. Psychooncology 2015;24:1028–35. doi:https://dx.doi.org/10.1002/pon.3763. Beutel ME, Weißflog G, Leuteritz K, Wiltink J, Haselbacher A, Ruckes C, et al. Efficacy of shortterm psychodynamic psychotherapy (STPP) with depressed breast cancer patients: Results of a randomized controlled multicenter trial. Ann Oncol 2014;25:378–84. doi:10.1093/annonc/mdt526. Gudenkauf LM, Antoni MH, Stagl JM, Lechner SC, Jutagir DR, Bouchard LC, et al. Brief cognitive– behavioral and relaxation training interventions for breast cancer: A randomized controlled trial. J Consult Clin Psychol 2015;83:677–88. doi:10.1037/ccp0000020. Hopko DR, Armento MEA, Robertson SMC, Ryba MM, Carvalho JP, Colman LK, et al. Brief behavioral activation and problem-solving therapy for depressed breast cancer patients: Randomized trial. J Consult Clin Psychol 2011;79:834–49. doi:10.1037/a0025450. Manne SL, Siegel SD, Heckman CJ, Kashy DA. A randomized clinical trial of a supportive versus a skill-based couple-focused group intervention for breast cancer patients. J Consult Clin Psychol 2016;84:668–81. doi:10.1037/ccp0000110 Desautels C, Savard J, Ivers H, Savard M-H, Caplette-Gingras A. Treatment of depressive symptoms in patients with breast cancer: A randomized controlled trial comparing cognitive therapy and bright light therapy. Heal Psychol 2018;37:1–13. Doi:10.1037/hea0000539. Vargas S, Antoni M, Carver C, Lechner S, Wohlgemuth W, Llabre M. Sleep quality and fatigue after a stress management intervention for women with early-starge breast cancer in southern Florida. Int J Behav Med 2014;21:971–81. Doi:10.1007/s12529-013-9374-2.Sleep Savard J, Ivers H, Savard M-H, Morin CM. Is a video-based cognitive behavioral therapy for insomnia as efficacious as a professionally administered treatment in breast cancer? Results of a randomized controlled trial. Sleep 2014;37:1305–14. Doi:10.5665/sleep.3918. Rahmani S, Talepasand S, Ghanbary-Motlagh A. Comparison of effectiveness of the metacognition treatment and the mindfulness-based stress reduction treatment on global and specific life quality of women with breast cancer. Iran J Cancer Prev 2014;7:184–96 Pintado S, Andrade S. Randomized controlled trial of mindfulness program to enhance body image in patients with breast cancer. Eur J Integr Med 2017;12:147–52. Doi:10.1016/j.eujim.2017.05.009. Hopko DR, Clark CG, Cannity K, Bell JL. Pretreatment depression severity in breast cancer patients and its relation to treatment response to behavior therapy. Heal Psychol 2016;35:10–8. Doi:10.1037/ hea0000252 Stagl JM, Antoni MH, Lechner SC, Bouchard LC, Blomberg BB, Glück S, et al. Randomized controlled trial of cognitive behavioral stress management in breast cancer: A brief report of effects on 5-year depressive symptoms. Heal Psychol 2015;34:176–80. Doi:10.1037/hea0000125. psychological benefits of cognitive-behavioral stress management for women with breast cancer: 11-year follow-up of a randomized controlled trial. Cancer 2015;121:1873–81. Doi:https://dx.doi. org/10.1002/cncr.29076. Öster I, Tavelin B, Thyme KE, Magnusson E, Isaksson U, Lindh J, et al. Art therapy during radiotherapy - A five-year follow-up study with women diagnosed with breast cancer. Arts Psychother 2014;41:36– 40. Doi:10.1016/j.aip.2013.10.003. Parikh PB. Breast Cancer Survivorship and Clinical Depression in Women: A Mental Health Perspective. Alliant International University, 2014. Jeffery D, Russo CA, Hopkins L, Burke HB. Mental health comorbidity costs and healthcare utilization in a nonelderly population with breast cancer. Psychooncology 2017;26:36. Doi:10.1002/pon.4353. Drageset S, Austrheim G, Ellingsen S. Quality of life of women living with metastatic breast cancer and receiving palliative care: A systematic review. Https://NebulosaIcesiEduCo:2144/101080/0739933220211876063 2021. Doi:10.1080/07399332.2021.1876063. Beauplet B, Soulie O, Niemier J-Y, Pons-Peyneau C, Belhadi D, Couffignal C, et al. Dealing with the lack of evidence to treat depression in older patients with cancer: French Societies of Geriatric Oncology (SOFOG) and PsychoOncology (SFFPO) position paper based on a systematic review. Support Care Cancer 2021;29:563–71. Doi:10.1007/s00520-020-05682-9 |
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Bonilla Santos, JasminGonzález Montealegre, Rodrigo AlbertoGonzález Hernández, Alfredis38 (1)2023-08-30T17:10:53Z2023-08-30T17:10:53Z2022-05-0320117531https://doi.org/10.14482/sun.38.1.616.89https://hdl.handle.net/20.500.12494/52588Bonilla Santos, J., González Montealegre, R. A., & González Hernández, A. (2022). Una descripción general de la psicoterapia para pacientes con cáncer de mama: revisión sistemática de ensayos controlados aleatorios. Revista Científica Salud Uninorte, 38(1), 278–298. https://doi.org/10.14482/sun.38.1.616.89Las morbilidades psicológicas son comunes en pacientes con cáncer de mama. Condiciones clínicas como depresión, alteraciones cognitivas, ansiedad, angustia, miedo al cáncer, trastornos del sueño y fatiga pueden persistir en sobrevivientes de cáncer. Por ello, las intervenciones psicológicas son relevantes durante el tratamiento en el cáncer de mama. Objetivo: Identificar intervenciones y resultados psicológicos para mujeres con cáncer de mama. Se buscaron en cinco bases de datos: EMBASE, ScienceDirect, MEDLINE (Ovid), CENTRAL (Ovid) y PsycINFO (APA PsyNET), de enero de 2014 al 4 de junio de 2018. Dos autores revisaron todos los artículos en bases de datos y seleccionaron estudios potencialmente elegibles. Se utilizó una síntesis narrativa de los resultados debido a la heterogeneidad en ensayos controlados aleatorios, características de la población, psicoterapias aplicadas, resultados y tiempo de las evaluaciones. Este resumen incluyó 14 ensayos controlados aleatorios que comprometen a 1914 participantes (incluidos no metastásicos y metastásicos) en 21 artículos. Las intervenciones psicológicas más comunes fueron basadas en el comportamiento cognitivo. Los principales resultados psicológicos evaluados fueron la depresión, la calidad de vida, la fatiga y la ansiedad. Conclusión: Los resultados de esta revisión son útiles para aclarar una visión general de la intervención en morbilidades psicológicas en el cáncer de mama. Las comorbilidades varían, contribuyen con costos a los pacientes y no hay suficiente evidencia empírica sobre psicoterapias para resolver todas las morbilidades psicológicas en la mujer con cáncer de mama.Psychological morbidities are common in breast cancer patients. Clinical conditions like depression, cognitive alterations, anxiety, distress, fear of cancer, sleep disorders, and fatigue may persist in cancer survivors. Therefore, psychological interventions are an essential treatment for breast cancer. To identify psychological interventions and psychological outcomes for women with breast cancer. Methods: Five databases were searched: EMBASE, ScienceDirect, MEDLINE (Ovid), CENTRAL (Ovid) y PsycINFO (APA PsyNET), from Jan 2014 to Jun 4th, 2018. Two authors reviewed all title articles and abstracts in databases and selected potentially eligible studies. A narrative synthesis of results was used due to the heterogeneity in randomized controlled trials, population characteristics, psychotherapies applied, outcomes, and timing of assessments. This overview included 14 randomized controlled trials which comprise 1914 participants (included non-metastatic and metastatic), across 21 articles. The most common psychological interventions were cognitive-behavioral based. The principal psychological outcomes assessed were depression, quality of life, fatigue, and anxiety. Conclusion: Results from this review are useful to clarify an overview of intervention in psychological morbidities in breast cancer. 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Doi:10.1007/s00520-020-05682-9Intervención psicológicaPsicoterapiaCáncer de mamaNeoplasia de mamaRevisión sistemáticaPsychological interventionPsychotherapyBreast cancerBreast neoplasmaSystematic reviewAn Overview of Psychological Interventions on Breast Cancer Patients: Systematic Review of Randomized Controlled TrialsArtículos Científicosinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/resource_type/c_2df8fbb1http://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleAtribución – No comercial – Sin Derivarinfo:eu-repo/semantics/closedAccesshttp://purl.org/coar/access_right/c_14cbPublicationLICENSElicense.txtlicense.txttext/plain; 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