[Prevalence of pain in Andalusian public hospitals]. / Estudio epidemiológico del dolor en los hospitales públicos andaluces.

OBJECTIVE: To determine the prevalence of pain in medical and surgical patients admitted to reference hospitals in Andalusia, as well as their features and the most population groups most affected. MATERIAL AND METHODS: A cross-sectional, multicenter epidemiological study was conducted simultaneously on the population admitted to 5 hospitals. Using a structured questionnaire the demographics, hospital area, presence of pain at the time of the interview, and pre- and post-variables related to the intensity of pain and its treatment at 24h were investigated. All patients over 18 years old were included, except those patients with difficulty in understanding the questionnaire, and psychiatric and obstetric patients. Pain intensity was assessed by simple verbal scale. RESULTS: Of the 1,236 patients included, 54.2% were male, with 51.1% of patients aged 65 years, and 69.17% were admitted to medical areas. Pain was observed in 52.9% of patients admitted to the surgical area compared to 29.4% in the medical area. Of the 19.4% who reported having had pain in the last 24h prior to the questionnaire, 57.7% of them were surgical patients and 32% were medical, P<.005), and of the 42.2% who had pain at the time of study, 52.7% were female. The incidence of pain on movement was higher than that observed at rest. The mean resting pain was 1.8 and 1.4 for the surgical and medical patients, respectively (P<.01). The mean pain on movement was 2.2 and 1.6 for the surgical and medical patients, respectively (P<.01). More than one quarter (25.8%) of surgical patients and 16.5% of medical patients had difficulty sleeping (P<.005). Some 12.8% of all patients had no analgesic regimen, and 66.2% and 85.6% of surgical and medical patients, respectively, did not request analgesics (P<.005). The main drugs were prescribed paracetamol analgesic and metamizole, and in 54.4% of patients. CONCLUSIONS: We believe that the presence of pain in patients admitted to our study population is high and it is essential to encourage an improvement in the pain management of both acute and chronic pain processes.

[The objective structured clinical evaluation of teaching in anaesthesiology and resuscitation]. / La evaluación clínica objetiva estructurada en la docencia en Anestesiología y Reanimación.

OBJECTIVES: To find out the acquirement of professional competencies of Anaesthesiology and Resuscitation medical residents at the end of their training period using the Objective Structured Clinical Evaluation (OCSE) tool. MATERIAL AND METHODS: Six competency components to evalúate were defined as follows: clinical interview (communication), technical ability and relationship abilities (leadership, decision making, work in a team), diagnostic assessment, therapeutic management, and medical records. Different methodologies were determined depending on the knowledge and skills to evaluate. Twelve clinical cases were developed that were performed in 12 stations. A total of 107 Ítems, specified within the stations, evaluated the competency components. A total of 43 residents were invited to participate in the last 4 months of their training in hospitals in Andalusia and Extremadura. RESULTS: A total of 33 residents participated. The overall mean of the classifications obtained in the 12 stations was 64.2 out of a maximum of 100. The medical residents demonstrated higher competency in obstetrics, paediatric anaesthesia, and that associated with difficult airway. The main competency gaps were detected in the area of one-day surgery, chronic pain, and literature management, in which approximately half passed the test. CONCLUSIONS: We believe that training evaluations, such as the OCSE, help in determining the skill levels of the medical resident, making it easier to continually improve the training of the future anaesthesiologist.