[Heart failure in primary care: Attitudes, knowledge and self-care]. / Insuficiencia cardiaca en atención primaria: actitudes, conocimientos y autocuidado.

OBJECTIVE: To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care. DESIGN: Cross-sectional and multicentre study. SETTING: Primary Care. PARTICIPANTS: Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona. MAIN MEASUREMENTS: Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care. RESULTS: A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n=282; R2 conditional=0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: -1.37; -1.85 to -0.90), and coronary heart disease diagnosis (-2.41; -4.36: -0.46). CONCLUSION: Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care.

[Knowledge and attitudes on pain management by nurses in surgery and oncology in level III hospitals]. / Conocimientos y actitudes sobre el manejo del dolor por parte de las enfermeras de unidades de cirugía y oncología de hospitales de nivel iii.

OBJECTIVE: Identify the knowledge and attitudes on pain by nurses in general surgery and oncology units in Level III hospitals, and to find out if there are any differences between groups. METHOD: A multicentre, observational, analytical and cross-sectional study conducted in the general surgery and oncology units in 5 Spanish level III hospitals. Study subjects were all nurses working in these units. We collected demographic variables, as well as employment and training on the level of pain. To assess the knowledge and attitudes the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire was used. RESULTS: Of the 236 questionnaires delivered, 170 were successfully completed (72%). A total of 96 nurses (58%) indicated that they had received specific training on pain. A large majority, 85% (145) felt that patients should not have pain, and 14.7% (25) said it was normal that they should have moderate or intense pain. A total of 93.8% (152) were in agreement that the person to assess the intensity of pain more accurately is the patient, 46% (74) considered that 10% of patients exaggerated the intensity of pain. The majority, 61.9% (52), did not know the equivalence between oral and intravenous morphine. The overall median of correct answers, of which there was 37 in the questionnaire, was 18 (min=0, max=28), categorized as a score of 0 to 10, the median was 5 (min=0, max=8). CONCLUSIONS: The level of knowledge that the nurses studied had on pain was not very high. Specific training is required and its impact evaluated.