Do we really know if they are in pain? A cross-sectional study in hospitalised adult patients in Spain.

AIMS: To describe the prevalence and characteristics of pain in adult hospitalised patients, as well as to analyse the concordance between patient-reported and recorded pain and its impact on analgesic management. DESIGN: A cross sectional study. METHODS: The study was performed on a sample of 611 patients, from October to December 2017. Data were obtained from patient interviews, review of medical and nursing records and review of electronic prescribing. RESULTS: The prevalence of pain at the time of the interview was 36.7%. The median VAS score was 4. 90% of the patients had their pain assessed within the last 24 h; however, concordance between patient-reported pain and recorded pain in the nursing record was slight. CONCLUSION: Pain is still often documented inadequately. Despite the wide use of analgesics, half of the patients with moderate to severe pain do not have adequate pain management. A systematic assessment and recording of pain promotes appropriate analgesic prescription. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE: The findings of our study provide insight into the main gaps in the correct management of pain in hospitalised patients. A systematic assessment and recording of the pain suffered by the patient facilitates its control and allows a better management of the analgesic prescription by the physician. This information could help hospital managers to develop training programmes on pain assessment and on the importance of doctor-nurse collaboration to improve pain management, increasing the quality of care and reducing hospital costs. REPORTING METHOD: The study has adhered to the relevant EQUATOR guidelines, according to The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

Fear and Attitude towards SARS-CoV-2 (COVID-19) Infection in Spanish Population during the Period of Confinement.

In January 2020, the WHO classified SARS-CoV-2 infection as a public health emergency and it was declared a pandemic on 11 March 2020. The media warned about the danger of infection, fuelling the population's fear of the new situation and increasing the perception of risk. This fear can cause behaviour that will determine the course of the pandemic and, therefore, the purpose of this study was to analyse the fear of infection from COVID-19 among the Spanish population during the state of emergency. A cross-sectional, descriptive observational study was conducted with 16,372 participants. Data on sociodemographic factors, health factors, risk perception and fear were collected through an online survey. Level of fear is associated with older age, a lower level of education, having a person infected with SARS-CoV-2 in the immediate surroundings and living with and belonging to the most socioeconomically vulnerable group of people. Risk perception is associated with increased preventive behaviour. This paper provides relevant information for the public health sector since it contributes first-hand knowledge of population data that is highly useful in terms of prevention. Understanding the experiences of people in this pandemic helps to create more effective future intervention strategies in terms of planning and management for crisis situations.

Risk Perception of COVID-19 Community Transmission among the Spanish Population.

On 11 March 2020 the SARS-CoV-2 virus was officially declared a pandemic and measures were set up in various countries to avoid its spread among the population. This paper aims to analyse the perception of risk of COVID-19 infection in the Spanish population. A cross-sectional, descriptive observational study was conducted with a total of 16,372 Spanish participants. An online survey was used to gather data for 5 consecutive days over the compulsory lockdown period which was established after the state of emergency was declared. There is an association between socio-demographic variables and risk perception, and a very strong relationship between this perception and contact and direct experience with the virus in a family, social or professional setting. We also found that compared to working from home, working outside the home increased the perception of risk of infection and the perception of worsening health. Understanding the public perception of the risk of COVID-19 infection is fundamental for establishing effective prevention measures.

Guía de práctica clínica sobre tratamiento de la insuficiencia cardiaca crónica / Clinical practice guide on chronic heart failure treatment

El objetivo general de la Guía de Práctica Clínica es proporcionar a los agentes encargados de la asistencia y cuidados de este tipo de pacientes, una herramienta que les permita tomar las mejores decisiones sobre algunos de los problemas que ocasionan su atención y que no han sido resueltos. Esta Guía ha sido desarrollada para generar recomendaciones sobre el tratamiento de la insuficiencia cardiaca crónica (ICC). Abarca los siguientes aspectos: TRATAMIENTO FARMACOLÓGICO: - Inhibidores de la enzima convertidora de la angiotensina ( o antagonistas de los receptores de la angiotensina), Betabloqueantes y antagonistas de la aldosterona en pacientes mayores de 65 años con disfunción sistólica. En pacientes con con fracción de eyección preservada o ligeramente deprimida. - Efectividad de la eplerona frente a espironolactona. - Eficacia del sacubitrilo/valsartán sustituyendo a un inhibidor de la enzima convertidora de la angiotensina (o a un antagonista del receptor de la angiotensina II), junto a betabloqueante y antagonistas de la aldosterona. TRATAMIENTO NO FARMACOLÓGICO: -Control temprano tras el alta hospitalaria. -Eficacia de las medidas higiénico-dietéticas. -Monitorización mediante péptidos natriuréticos para control del tratamiento farmacológico. -Eficacia de los programas de telemedicina. -Eficacia de las rehabilitación cardiaca basada en el ejercicio. -Eficacia de los desfibriladores automáticos implantables en mayores de 65 años.