[Perception of the professional nursing environment in Primary Care in the Valencian Community, in departments with public and private management]. / Percepción del entorno de práctica enfermera de Atención Primaria de la Comunidad Valenciana, en departamentos con gestión pública y privada.

BACKGROUND: Nursing practice environments (NPE) improve the quality of care, satisfaction and heath results; there are no studies that compare the Primary Health Care (PHC) environments according to their management model. Our aim is to estimate and compare the perception of the quality of the NPE in the PHC in Health Departments (HD) of the Valencian Community (Spain) with management model public or indirect-private (Administrative concession). METHOD: Transversal study on PHC nurses from three HD, one with direct public management and two with indirect-private management. The Practice Environment Scale-Nursing Work Index questionnaire, validated in Spain, was administered. Sociodemographic and professional variables were recorded. Variables related to test score were analyzed by multiple linear regression. RESULTS: Two hundred and sixty-nine answers (80.3%). All HD perceived NPE quality in a positive way, both globally and for the different dimensions (except D4). Indirect private management model HD obtained higher global scores, the same tendency was observed for D1 and D2, and the opposite for D4. Global score was related to age, professional experience, being a coordinator and management model; only the age of the nurses and being a coordinator showed a significant relationship with the score in the multivariate regression model. CONCLUSIONS: The NPE of the PHC of the Valencian Community are of good quality, without significant differences according to different management models of the HD. Being a coordinator and, particularly, the age of the nurses are variables that are independently related to the global score obtained.

Investigating self-care in a sample of patients with decompensated heart failure: A cross-sectional study. / Investigando el autocuidado en una muestra de pacientes con insuficiencia cardiaca descompensada: un estudio transversal.

BACKGROUND: There is scarce evidence relating to self-care of heart failure (HF) in Spain. In particular, there is a need to establish patients' level of understanding of HF, as well as their ability to recognise signs and symptoms of decompensation. PATIENTS AND METHODS: Cross-sectional study to determine the level of self-care in a population of Spanish patients admitted to hospital with a primary diagnosis of decompensated HF. A convenience sample of 108 patients (50 women and 58 men) aged 83±8 were recruited to participate in this study. RESULTS: The Self-Care of Heart Failure Index version 6.2 was used to quantify self-care in our sample. Mean and standard deviation from the Self-Care of Heart Failure Index self-care maintenance subscale were: a) "exercise for 30 minutes", 1±1; b) "forget to take one of your medicines", 2±2; c) "ask for low-salt items when eating out or visiting others", 2±1. A percentage of 67.6 had experienced shortness of breath or ankle swelling in the past month. However, the vast majority of our patients were unlikely to independently implement a remedy: a) reduce salt, 2±1; b) reduce fluid intake, 1±1; c) take an extra diuretic, 1±1. Over 50% of our sample felt confident or very confident at following professional advice (3±1), keeping themselves free of symptoms (3±1), recognizing changes in their condition (3±1) and evaluating the significance of such changes (3±1). CONCLUSIONS: HF patients have a significantly low level of self-care when compared with HF patients from other countries, especially when it comes to managing their condition. Self-care promotion should be a priority for all healthcare professionals involved in the care and management of HF patients.