[Optimism, family cohesion and treatment as predictors of quality of life in blood cancer diseases]. / Optimismo, cohesión familiar y tratamiento como predictores de la calidad de vida en padecimientos oncohematológicos.

BACKGROUND: Quality of life must be a part of the goals of care given to blood cancer patients and it must be used to assess the effectiveness of their treatment. The objective was to evaluate the quality of life of patients with leukemia and its relationship with psychological, familial and disease-related aspects. METHODS: An analytic cross-sectional study was carried out in patients with acute leukemia at different stages of treatment. We used SF-36, Optimism and Family Cohesion scales. RESULTS: Quality of life was affected physically and mentally in the treatment phases aimed to mitigate the active, and the advanced stage of this disease (50.6 ± 25.6, 62 ± 14.3; 46 ± 23.2, 53.8 ± 23.4, respectively), regardless of gender, age, level of optimism and family cohesion. Patients could carry out basic functions of self-care (bathing, feeding, etcetera), but not activities of daily living (shopping, household chores, etcetera), which require a greater effort. Although the patients perceived having been affected in the emotional health area-by the presence of anxiety and depression-they did not consider that these alterations limited their ability to carry out work and everyday activities. CONCLUSIONS: Quality of life was most affected at mental dimension and physical dimension, mainly in patients at induction and palliative treatment. The results showed that the objectives of care aimed to reduce symptoms and maintain patient comfort are not achieved.

Introducción: la calidad de vida debe ser parte de los objetivos de la atención a pacientes oncohematológicos y ser utilizada para evaluar la eficacia del tratamiento que se les brinda. El objetivo fue evaluar la calidad de vida en pacientes con leucemia y su relación con aspectos del padecimiento, psicológicos y familiares. Métodos: se realizó un estudio transversal analítico en pacientes con leucemia aguda en diferentes etapas de tratamiento. Se aplicaron las escalas SF-36, Optimismo y Cohesión Familiar. Resultados: la calidad de vida se vio afectada física y mentalmente en las fases del tratamiento dirigidas a combatir la enfermedad activa (50.6 ± 25.6; 62 ± 14.3) y avanzada (46 ± 23.2; 53.8 ± 23.4), independientemente del género, la edad, el nivel de optimismo y la cohesión familiar. Los pacientes podían llevar a cabo funciones básicas de autocuidado, no así actividades de la vida diaria y laborales que requieren mayor esfuerzo. Si bien los pacientes percibieron afectación en el área de salud emocional (por la presencia de ansiedad y depresión), no consideraron que estas alteraciones limitaban su capacidad para llevar a cabo actividades laborales y cotidianas. Conclusiones: la calidad de vida estuvo más afectada en la dimensión mental (Salud emocional) y física (Rol físico), principalmente en los pacientes en tratamiento paliativo y de inducción. Los resultados muestran que no se cubren los objetivos de los esfuerzos asistenciales dirigidos a aminorar los síntomas y mantener el confort del paciente.

[Health care satisfaction. From the perspective of patients]. / Satisfacción con la atención a la salud. La perspectiva del usuario.

BACKGROUND: patient's health care satisfaction is the most important element in the evaluation of the health care quality. Nevertheless, there is still no agreement regarding which aspects from this phenomenon should be measured. OBJECTIVE: to describe which aspects integrate health care satisfaction from the patient perspective. METHODS: a descriptive study was held with a qualitative technique. The cultural aspects were determined in the patients first medical examination in Mexico's General Hospital trough two structured interviews. Multidimensional Scaling and the Smith's Index was used for the data analysis. RESULTS: 95 patients were been interviewed, 71.4 % were women, and according to the statistic method used, the 52 concepts mentioned by the patients were integrated in two dimensions. The dimension "the Process" included patients expectations regarding the physician's commitment to their healing and constant training process. The dimension "the Structure" was concerned with the administrative management of the hospital. Patients also pointed out the need to improve their interaction with the nurse personnel. CONCLUSIONS: health care satisfaction from the patients perspective is based upon attitude, and the physician's commitment and his/her developmental skills in benefit of the patient's healing.