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INTRODUCTION: Subjective memory complaints (SMC) might be an early sign of further deterioration in cognitive functions. However, no population studies have been published covering all Spain to determine the SMC prevalence. The objective of the present study was to determine the SMC prevalence in the general population residing in Spain >50 years of age and also which related actions were done. MATERIALS AND METHODS: Interviews were conducted with a nationally representative sample >50 years of age using an online/computer assisted web interview (CAWI) questionnaire. The survey consisted of 34 items divided into two blocks. Presence of SMC was considered when in question 1 the subject answered that "Yes" he had some memory problem. RESULTS: Two thousand three hundred people (53.7% women; 23.9% ≥75 years old) were interviewed. 31% answered that they considered they had a memory problem (no differences between sexes, mean time with memory problems of 3.0 years). A higher prevalence of SMC was observed in ≥75 years old (44%). 90% did not include any specific foods in their diet for their memory problems, neither were taking any pharmaceuticals, diet supplements or nutritional supplements (92%). 78% of those interviewed with SMC have not consulted health professionals for their memory problems. CONCLUSIONS: SMC are considerably prevalent in our environment affecting almost a third of people ≥50 years of age. Most of the interviewees with SMC did not go to health professionals to manage their SMC.
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Transtornos da Memória , Projetos de Pesquisa , Masculino , Humanos , Feminino , Idoso , Espanha/epidemiologia , Prevalência , Transtornos da Memória/epidemiologia , Transtornos da Memória/diagnóstico , Transtornos da Memória/psicologia , Cognição , Testes NeuropsicológicosRESUMO
BACKGROUND: Nausea and vomiting is a very prevalent condition during pregnancy. Combination of doxylamine and pyridoxine is placed as first-line pharmacological option for its treatment in most clinical guidelines. Among different release forms available, Cariban® is a fixed-dose combination of doxylamine/pyridoxine 10/10 mg, formulated as modified-release capsules. OBJECTIVES: In the present study, we aimed to characterize the bioavailability performance of Cariban® in vitro and in vivo. METHODS: An in vitro dissolution test was performed to evaluate the release profile of Cariban®, together with immediate- and delayed-release formulations available on the market. A single-center, single-dose, open-label bioavailability study following Cariban® administration in 12 healthy adult female patients was carried out to explore the drug behavior in vivo (protocol NBR-002-13; EUDRA-CT 2013-005422-35). These data were additionally used to perform a computational pharmacokinetic simulation of the posology approved for this drug. RESULTS: Cariban® capsules demonstrate a prolonged-release performance, with an early, gradual, and progressive release of both actives until reaching a complete dissolution after 4-5 h in solution. The pharmacokinetic features of these capsules show that doxylamine and pyridoxine metabolites are early absorbed, being all detectable in plasma within 1 h following oral administration. Computational pharmacokinetic simulation predicts that different posology provides distinct profiles of metabolites in plasma, with 1-1-2 (morning-midafternoon-night) being the one that concentrates higher plasma levels but lower dose dumping for 24 h. CONCLUSION: Cariban® behaves as a prolonged-release formulation, which correlates with rapid absorption and arising of the actives in the plasma, but also long-lasting and sustained bioavailability, especially when administered following the complete posology. These results would underlie its demonstrated efficacy to relieve nausea and vomiting of pregnancy (NVP) under clinical settings.
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Antieméticos , Complicações na Gravidez , Adulto , Feminino , Humanos , Gravidez , Antieméticos/farmacocinética , Antieméticos/uso terapêutico , Disponibilidade Biológica , Cápsulas , Preparações de Ação Retardada , Doxilamina/farmacocinética , Combinação de Medicamentos , Náusea , Complicações na Gravidez/tratamento farmacológico , Piridoxina/farmacocinética , Piridoxina/uso terapêutico , Vômito/tratamento farmacológicoRESUMO
AIMS AND OBJECTIVES: To identify the autonomous competences and quality of professional life of paediatric nurses in primary care, their relationship and possible associated factors. BACKGROUND: The autonomous competences of paediatric nurses vary among healthcare providers in Catalonia, Spain. Autonomy is related to quality of professional life, but little is known about autonomous competences and other factors contributing to paediatric nurses' quality of professional life. DESIGN: A cross-sectional study following the STROBE statement. METHODS: Data from 206 paediatric primary care nurses were analysed. A self-administered survey consisting of an ad hoc questionnaire and a validated instrument to measure quality of professional life (QPL-35 questionnaire) was conducted. Descriptive, bivariate and general multivariate regression analyses were used to identify the relationship between autonomous competences and quality of professional life, and its predicting factors. RESULTS: 47.6% nurses reported a medium level of autonomous competences, 46.6% a high level, and 5.8% a low level. Quality of professional life was medium-high for the domains perception of managerial support and global perception of workload and for the item disconnect from work after work shift, and very high and high values for the domain intrinsic motivation and for the item quality of work life, respectively. Autonomous competences and perceived autonomy were factors associated with quality of professional life. Other associated factors were academic background, specific training and being a paediatric nurse specialist. CONCLUSIONS: Paediatric nurses in primary care have a medium-high level of autonomous competences and they perceive a high level of autonomy. Autonomous competences and level of perceived autonomy are predictors of quality of professional life. RELEVANCE TO CLINICAL PRACTICE: Enhancing paediatric nurses' autonomous competences and academic background, receiving specific training and being paediatric nurse specialists might improve their quality of professional life, healthcare quality and outcomes for the child population.
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Enfermeiros Pediátricos , Enfermeiras e Enfermeiros , Recursos Humanos de Enfermagem Hospitalar , Humanos , Criança , Estudos Transversais , Inquéritos e Questionários , Satisfação no Emprego , Atenção Primária à SaúdeRESUMO
BACKGROUND: Melatonin is an endogenous substance which plays a key role in sleep induction by reducing sleep onset latency; it has been approved by the European Food Safety Authority as a food supplement for exogenous administration. Oniria® is a food supplement formulated as 1.98 mg of prolonged-release melatonin tablets; it displays a dual dissolution profile in vitro. OBJECTIVES: The main objective of the present study was to evaluate the relative oral bioavailability of Oniria®, in comparison with immediate-release tablets (IRT) with a similar melatonin content as a reference. We also attempted to characterize the circadian rhythm of endogenous melatonin. METHODS: We performed an open-label, cross-over, randomized, phase I clinical study with two sequences and three periods involving 14 healthy volunteers. We characterized the endogenous melatonin circadian profile (period 1) and pharmacokinetics (PK) of both Oniria® and the reference melatonin (periods 2 and 3). RESULTS: Two phases were clearly differentiated in the PK profile of Oniria®. An initial one, from dosing up to 2 h, and a delayed one from 2 to 11 h post-administration. During the initial phase, both melatonin formulations were equivalent, with a Cmax value close to 4000 pg/mL. However, in the delayed phase, Oniria® showed significantly higher melatonin concentrations than the IRT (three times higher at 4-6 h post-administration). Moreover, Oniria® exhibited concentrations above the endogenous melatonin peak of 80 pg/mL for up to 2.5 h versus the reference formulation, potentially suggesting an effect of Oniria®, not only in the induction of sleep, but also in the maintenance. CONCLUSION: Oniria® could be a highly promising food supplement, not only for sleep induction but also for the maintenance of sleep.
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Melatonina , Disponibilidade Biológica , Estudos Cross-Over , Preparações de Ação Retardada , Voluntários Saudáveis , Humanos , ComprimidosRESUMO
BACKGROUND: Heterogeneity in cognitive functioning among major depressive disorder (MDD) patients could have been the reason for the small-to-moderate differences reported so far when it is compared to other psychiatric conditions or to healthy controls. Additionally, most of these studies did not take into account clinical and sociodemographic characteristics that could have played a relevant role in cognitive variability. This study aims to identify empirical clusters based on cognitive, clinical and sociodemographic variables in a sample of acute MDD patients. METHODS: In a sample of 174 patients with an acute depressive episode, a two-step clustering analysis was applied considering potentially relevant cognitive, clinical and sociodemographic variables as indicators for grouping. RESULTS: Treatment resistance was the most important factor for clustering, closely followed by cognitive performance. Three empirical subgroups were obtained: cluster 1 was characterized by a sample of non-resistant patients with preserved cognitive functioning (n = 68, 39%); cluster 2 was formed by treatment-resistant patients with selective cognitive deficits (n = 66, 38%) and cluster 3 consisted of resistant (n = 23, 58%) and non-resistant (n = 17, 42%) acute patients with significant deficits in all neurocognitive domains (n = 40, 23%). CONCLUSIONS: The findings provide evidence upon the existence of cognitive heterogeneity across patients in an acute depressive episode. Therefore, assessing cognition becomes an evident necessity for all patients diagnosed with MDD, and although treatment resistant is associated with greater cognitive dysfunction, non-resistant patients can also show significant cognitive deficits. By targeting not only mood but also cognition, patients are more likely to achieve full recovery and prevent new relapses.
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Transtornos Cognitivos , Disfunção Cognitiva , Transtorno Depressivo Maior , Humanos , Transtorno Depressivo Maior/psicologia , Depressão , Disfunção Cognitiva/complicações , Transtornos Cognitivos/psicologia , Cognição , Análise por Conglomerados , Testes NeuropsicológicosRESUMO
AIM: To evaluate nursing governance in intermediate care in Catalonia Spain and propose improvements. BACKGROUND: Drawing on two existing models, the Magnet model and the corporate governance model, we propose that good nursing governance requires nursing leaders to apply the following dimensions: transformational leadership, transformational culture, commitment and sustainability, authority, scientific evidence, transparency and communication, and teamwork. METHOD: A qualitative, exploratory study conducted in two phases. First, we asked nursing leaders in intermediate care to describe their opinions and experiences in each of the dimensions. Next, we observed governance practices at two intermediate care centres and conducted interviews with their nursing leaders. Content analysis was used. RESULTS: Our participants' behaviour corresponded closely to the model in the dimensions of transformational culture and commitment and sustainability but failed to meet the model in the dimensions of scientific evidence and transparency and communication. CONCLUSIONS: Participants had a leadership style focused on transforming their surroundings. According to the model, the leaders in our sample should draw more on scientific evidence and improve their internal communication about outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: Establishing committees of nurses to address areas in which governance does not adhere to the model would create sustainable benefits for patients and nurses in intermediate care.
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Comunicação , Liderança , Humanos , Pesquisa Qualitativa , EspanhaRESUMO
BACKGROUND: This study aimed to identify clinical and cognitive factors associated with increased risk for difficult-to-treat depression (DTD) or treatment-resistant depression (TRD). METHODS: A total of 229 adult outpatients with major depression were recruited from the mental health unit at a public hospital. Participants were subdivided into resistant and nonresistant groups according to their Maudsley Staging Model score. Sociodemographic, clinical, and cognitive (objective and subjective measures) variables were compared between groups, and a logistic regression model was used to identify the factors most associated with TRD risk. RESULTS: TRD group patients present higher verbal memory impairment than the nonresistant group irrespective of pharmacological treatment or depressive symptom severity. Logistic regression analysis showed that low verbal memory scores (odds ratio [OR]: 2.02; 95% confidence interval [CI]: 1.38-2.95) together with high depressive symptom severity (OR: 1.29; CI95%: 1.01-1.65) were associated with TRD risk. CONCLUSIONS: Our findings align with neuroprogression models of depression, in which more severe patients, defined by greater verbal memory impairment and depressive symptoms, develop a more resistant profile as a result of increasingly detrimental neuronal changes. Moreover, our results support a more comprehensive approach in the evaluation and treatment of DTD in order to improve illness course. Longitudinal studies are warranted to confirm the predictive value of verbal memory and depression severity in the development of TRD.
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Cognição , Disfunção Cognitiva/fisiopatologia , Disfunção Cognitiva/psicologia , Transtorno Depressivo Maior/fisiopatologia , Transtorno Depressivo Maior/psicologia , Transtorno Depressivo Resistente a Tratamento/fisiopatologia , Transtorno Depressivo Resistente a Tratamento/psicologia , Adulto , Transtorno Depressivo Maior/terapia , Feminino , Humanos , Masculino , Memória , Pessoa de Meia-Idade , Razão de Chances , Pacientes Ambulatoriais/psicologiaRESUMO
OBJECTIVES: The guidelines and recommendation sof good clinical practice have been disrupted by new and urgent policies, marked by the COVID-19 pandemic. Urothelial carcinoma has a significant prevalence in Spain, whose population has been greatly affected by COVID-19, directly by the disease and indirectly by the confinement. The objective of this work is to offer recommendations on protocols and guidelines adjusted to different phases of the pandemic. MATERIAL AND METHODS: This document on the management of bladder carcinoma is based on few evidence on urological oncological practice during the first months of the pandemic and on the authors' experience in this pathology during the crisis of COVID-19. Hospital experts in infectious disseases and radiology have participated to design a common strategy to reorganize the activity. RESULTS: Different proposals for treatment and follow-up of patients diagnosed with bladder cancer adjusted for oncological risk and the different phases of the pandemic are presented. CONCLUSIONS: The pandemic's spread was unimaginable just a few months ago. Health systems have been shaken by the disease in the most critical phases. It is necessary, at this time, to make an additional effort to develop tools that can facilitate the care of bladder carcinoma and minimize the impact and risks for patients and health professionals in the future.
OBJETIVOS: Las directrices y recomendaciones de la buena práctica clínica se han visto trastocadas por las nuevas y urgentes prioridades, marcadas po rla pandemia COVID-19. El carcinoma urotelial es una enfermedad de prevalencia significativa en España, cuya población se ha visto muy afectada por la COVID-19, directamente por la enfermedad e indirectamente por el confinamiento. El objetivo de este trabajo es ofrecer recomendaciones sobre protocolos y circuitos asistenciales ajustados a diferentes fases de la pandemia. MATERIAL Y MÉTODOS: El presente documento sobre el manejo del carcinoma vesical, se basa en la escasa evidencia sobre la práctica oncológica urológica durante los primeros meses de la pandemia y en la experiencia de los autores en esta patología durante la crisis del COVID-19. En ella, han participado expertos hospitalarios en patología infecciosa y radiodiagnóstico para diseñar una estrategia común y reorganizar así la actividad. RESULTADOS: Se presentan distintas propuestas de tratamiento y seguimiento de los pacientes diagnosticados de cáncer vesical ajustados al riesgo oncológico en las diferentes fases de la pandemia. CONCLUSIONES: La velocidad de expansión de la pandemia era inimaginable hace solo unos meses. Los sistemas sanitarios se han visto sacudidos por la enfermedad en las fases más críticas. Es necesario, en estos momentos, realizar un esfuerzo más para desarrollar herramientas que puedan facilitar la asistencia del carcinoma vesical y minimizar el impacto y los riesgos para los pacientes y los profesionales de la salud en el futuro.
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Infecções por Coronavirus , Pandemias , Pneumonia Viral , Neoplasias da Bexiga Urinária , Betacoronavirus , COVID-19 , Infecções por Coronavirus/epidemiologia , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional , Pneumonia Viral/epidemiologia , SARS-CoV-2 , Espanha , Neoplasias da Bexiga Urinária/diagnóstico , Neoplasias da Bexiga Urinária/terapiaRESUMO
Background: Childhood maltreatment increases the risk of suicide attempts in the general population, possibly having similar effects among patients with major depressive disorder (MDD). The few studies that have addressed this association have been restricted to specific populations (e.g. treatment-resistant depression, personality disorders) and have rarely taken sex into account. Objective: To examine the impact of childhood maltreatment on suicide attempts among MDD patients above and beyond other risk factors and potential confounders, while considering potential sex-specific effects. Methods: The study assessed 165 patients with a principal diagnosis of MDD. Neurological alterations, psychiatric comorbidities, and drug abuse were reasons for exclusion. Logistic regressions using the whole sample, and divided by sex, were run to test the association between childhood maltreatment and history of suicide attempts, controlling for symptom severity, comorbidities, and treatment-resistant depression. Results: There was a significant and clinically relevant association between childhood maltreatment and history of suicide attempts in the total sample. Patients with childhood maltreatment were 3.01 times more likely to present a history of suicide attempts than patients without childhood maltreatment. A family history of psychiatric disorders also contributed to the variance of attempted suicide, but its interaction with childhood maltreatment was not statistically significant. When testing the model separately, the effect of childhood maltreatment on suicide attempts remained for females, whereas for males, age of MDD onset and Childhood Trauma Questionnaire minimization-denial scale were predictive variables. Conclusions: Childhood maltreatment is a clear predictor of suicidal behaviour among MDD patients, and this effect remains significant after controlling for potential confounders. Also, the sex of patients emerges as a relevant factor that may model the mechanisms underlying the prediction of suicide attempts. Since suicide is the main cause of premature death among MDD patients, interventions targeting childhood maltreatment should be included in preventive and clinical strategies.
Planteamiento: el maltrato infantil aumenta el riesgo de intentos de suicidio en la población general, y podría tener efectos similares en pacientes con trastorno depresivo mayor (TDM). Los escasos estudios que han abordado este tema se han restringido a poblaciones específicas (p.ej. depresión resistente al tratamiento, trastornos de personalidad) y rara vez tienen en cuenta el sexo.Objetivo: evaluar el impacto del maltrato infantil en las tentativas de suicidio en pacientes con TDM, considerando potenciales factores de riesgo y de confusión, al tiempo que se estudian los posibles efectos del sexo.Método: se evaluó una muestra de 165 pacientes con diagnóstico principal de TDM. Las alteraciones neurológicas, las comorbilidades psiquiátricas y el abuso de drogas fueron motivos de exclusión. Para explorar la asociación entre el maltrato infantil y el historial de intentos de suicidio (controlando por la gravedad de los síntomas, la comorbilidad y la resistencia al tratamiento), se realizaron regresiones logísticas con la muestra completa, así como en hombres y mujeres por separado.Resultados: existe una asociación significativa y clínicamente relevante entre el maltrato infantil y la historia de intentos de suicidio en el total de la muestra. Las personas con maltrato infantil tenían 3,01 veces más probabilidades de presentar historia de tentativas de suicidio que aquellas sin maltrato infantil. Los antecedentes familiares de trastorno psiquiátrico también contribuyeron a la varianza de los intentos de suicidio, pero su interacción con el maltrato infantil no resultó estadísticamente significativa. Al analizar el modelo por separado, el efecto del maltrato infantil en las tentativas suicidas se mantuvo en las pacientes mujeres, mientras que en los pacientes hombres la edad de inicio del TDM y la escala de minimización-negación del CTQ fueron las variables explicativas.Conclusiones: el maltrato infantil predice el comportamiento suicida en pacientes con TDM, persistiendo este efecto después de controlar posibles factores de confusión. Además, el sexo de las personas modelaría los mecanismos subyacentes en cuanto a predecir las tentativas de suicidio. Dado que el suicidio es la principal causa de muerte prematura entre pacientes con TDM, las intervenciones dirigidas al maltrato infantil deberían incluirse dentro de las estrategias tanto preventivas como terapéuticas.
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Objective and subjective cognitive measures are altered in major depressive disorder (MDD), but there is a poor correlation between them. This study aims to explore such discrepancy and the characteristics explaining this phenomenon. 229 patients with MDD subdivided into remitted (nâ¯=â¯57), partially remitted (nâ¯=â¯90) and acute (nâ¯=â¯82) underwent a clinical interview, completed self-report questionnaires and a neuropsychological assessment. The association between objective and subjective cognition was evaluated in the areas of attention and memory. Also, dependent measures of concordance and self-appraisal were calculated for each patient. Potential predictors of these outcomes were evaluated through regression analysis. Depressive symptoms correlated negatively with objective but especially with subjective cognition. Patients in an acute episode showed a significant correlation between objective and subjective attention/memory measures, but also the greatest underestimation of their cognitive performance. In those with fewer depressive symptoms, objective and subjective cognition showed poor correspondence between them. In the regression analyses with the full MDD sample, higher scores on depressive symptoms, intelligence quotient and executive functions predicted lower self-appraisal. Objective and subjective cognition show poor concordance in MDD patients, especially in those with residual mood symptoms. Higher executive functions also explain this discrepancy. Assessments of both subjective cognitive complaints and objective performance seem necessary as they may be measuring different aspects of cognitive functioning.
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Cognição , Transtorno Depressivo Maior/psicologia , Adolescente , Adulto , Idoso , Atenção , Transtorno Depressivo Maior/diagnóstico , Autoavaliação Diagnóstica , Função Executiva , Feminino , Humanos , Testes de Inteligência , Masculino , Memória , Pessoa de Meia-Idade , Testes Neuropsicológicos , Indução de Remissão , Adulto JovemRESUMO
Introducción: los países con mayor presencia indígena tienen niveles más altos de mortalidad materna en la región. Por lo que resulta necesario tomar medidas para reducir la mortalidad materna y neonatal. Para evaluar la satisfacción de las mujeres atendidas el Estado creó guías de atención al parto culturalmente adecuado. Objetivos: analizar el nivel de satisfacción de las mujeres atendidas en el Centro de Salud de Loreto con el parto culturalmente adecuado y su relación con la percepción del dolor. Métodos: se realizó un estudio cuantitativo, descriptivo, prospectivo, de corte longitudinal desde marzo hasta mayo de 2016. La muestra estuvo constituida por 62 mujeres atendidas en dicho período. Resultados: en el grupo estudiado predominaron las adolescentes con 53 por ciento y las mujeres con edades comprendidas entre 20 y 35 años (39 por ciento). Del total de mujeres, 38 de ellas se sintieron satisfechas con la atención durante el parto y el 54,8 por ciento refirieron dolor muy intenso durante este. Conclusiones: el nivel de satisfacción fue alto y la percepción del dolor durante el trabajo de parto fue muy elevado. Hubo una relación significativa entre el dolor y el nivel de satisfacción(AU)
Introduction: The countries with the largest indigenous populations have higher levels of maternal mortality in the region. It is necessary to take measures to reduce maternal and neonatal death. To this end, the State prepared guidelines for the culturally appropriate childbirth care and the evaluation of satisfaction. Objectives: To analyze the level of satisfaction of women with culturally appropriate childbirth and its relation with labor pain perception in the health center of Loreto. Methods: A prospective, longitudinal, descriptive and quantitative study was conducted in the period from March to May 2016 in a sample of 62 women seen during that period. Results: In the study group, adolescents (53 percent) and women aged between 20 and 35 years (39 percent) predominated. Thirty eight women were satisfied with care during childbirth and 54.8 percent reported very intense labor pain. Conclusions: The levels of satisfaction and of perception of pain during labor were high and very high, respectively. There was significant association between pain and level of satisfaction(AU)
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Humanos , Feminino , Gravidez , Adolescente , Adulto , Mortalidade Materna , Parto Humanizado , Saúde de Populações Indígenas , Morte Perinatal , Estudos de Avaliação como Assunto , Epidemiologia Descritiva , Estudos Prospectivos , Estudos Longitudinais , Satisfação do PacienteRESUMO
OBJECTIVE: To analyze the nurses make use of electronic health records (EHR) and assess their perception of it. METHOD: A descriptive cross-sectional observational study was conducted in 2010 analyzing the nurses' perceptions of adult and pediatric consultations of primary health care teams in Baix Llobregat (Catalonia) in which the EHR is used. The study variables were: registration of care, continuity of care, training, usability and sociodemographic composition of the sample. The statistical analysis was descriptive. RESULTS: Nurses agree that EHR provides "continuity of care" in relation to nursing care (mean 2.03, Sd.0.83) and overall (mean 2.19, 5d.0.83). Show indifference to the "usability" of the EHR (mean 3.26, Sd.0.5), to facilitate the "record information" (mean 2.69, Sd.0.68) and the need for "training" in the use of EHR (mean 2.6, 5d.0.59). It has been found that with increasing age of the nurse, it shows more agreement that the EHR provides greater continuity of care overall. The average ratings of the continuum of care nurse, recording of information, continuity of care in general are greater the lead time using the EHR. CONCLUSIONS: The nurses' perceptions regarding the EHR are positive in that it provides continuity of care and to exchange information on patient health data.
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Atitude do Pessoal de Saúde , Sistemas Computadorizados de Registros Médicos , Enfermagem , Atenção Primária à Saúde , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Patients with schizophrenia have a shorter life expectancy and their risk of dying from a cardiovascular disease is higher than the general population. Both facts have been attributed to the raised presence of metabolic syndrome. There is a big amount of scientific publications that deals with the relationship between schizophrenia, antipsychotic treatment, and the development of metabolic syndrome. There is also information about recommendations and clinical guides to achieve an adequate prevention, screening, and treatment of the disease. The aim of this review is to update the current information about this issue and to understand related etiologic factors, differences between antipsychotic drugs, and the current recommendations for patient's care.
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Antipsicóticos/efeitos adversos , Síndrome Metabólica/induzido quimicamente , Esquizofrenia/tratamento farmacológico , Antipsicóticos/uso terapêutico , Benzodiazepinas/efeitos adversos , Benzodiazepinas/uso terapêutico , Glicemia/análise , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/mortalidade , Clozapina/efeitos adversos , Clozapina/uso terapêutico , Comorbidade , Seguimentos , Humanos , Hipotálamo/efeitos dos fármacos , Hipotálamo/fisiopatologia , Incidência , Expectativa de Vida , Metabolismo dos Lipídeos/efeitos dos fármacos , Síndrome Metabólica/tratamento farmacológico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/fisiopatologia , Síndrome Metabólica/prevenção & controle , Obesidade Abdominal/induzido quimicamente , Obesidade Abdominal/epidemiologia , Olanzapina , Guias de Prática Clínica como Assunto , Esquizofrenia/epidemiologia , Aumento de PesoRESUMO
This study was aimed to analyze and assess the use and perception of electronic health records (EHRs) by nurses. The study sample included 113 nurses from different shifts of primary health facilities in Catalonia, Spain, devoted to adult as well as pediatric outpatients using EHRs throughout the year 2010. A majority of the sample (87.5%) were women and 12.5% were men. The average age was 44.27 years and the average time working in primary healthcare was 47.15 months. A majority (80.4%) received specific training on the use of the EHR and 19.6% did not. The use of the application required side technical support (mean: 3.42) and it is considered necessary to learn more about the performance of the application (mean: 3.50). The relationship between the average ratings that nurses have about the EHR and age shows that there is no statistically significant linear relationship (r=-0.002, p-value=0.984). As to how long they have used the EHRs, there are significant differences (r=-0.304, p-value=0.00), so the more time the nurse takes using the EHR, the greater degree of satisfaction is shown. In addition, there are significant differences between nurses' perceptions regarding the EHR and gender (t=-0.421, p-value=0.675). Nurses assessed as positive the contribution of the EHRs in their nursing care day work (average score: 2.55/5). Considering that the usability of the EHR device is assessed as satisfactory, the results of the perception of nurses show that we must also take into account the training and emphasize the need for a side technical support in the implementation process of the EHR. Doing so, the positive perception that nurses have in regard to information and communication technology in general and with respect to the EHR in particular may be increased.
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Atitude do Pessoal de Saúde , Registros Eletrônicos de Saúde/normas , Enfermagem de Atenção Primária/psicologia , Atenção Primária à Saúde/tendências , Adulto , Registros Eletrônicos de Saúde/organização & administração , Feminino , Humanos , Masculino , Enfermagem de Atenção Primária/métodos , Atenção Primária à Saúde/organização & administração , Psicometria , Espanha , Recursos HumanosRESUMO
OBJECTIVE: The aim of the study is to determine the incidence of adverse reactions to iodinated contrast media and to characterise them in a group of outpatients, inpatients and emergency patients in a private hospital in Barcelona. METHOD: A retrospective cohort study was carried out over a 60 months period, from February 2002 to February 2007, analysing the patients who underwent to iodinated contrast radiological examinations. Adverse reactions were evaluated from the manual record format developed following the requirements of the Quality Assurance Program in Radiology. Study variables were, administration route, contrast media dose, adverse reaction type, and signs and symptoms. Statistical analysis was descriptive. RESULTS: A total of 68 (0.3 %) of adverse reaction were registered of which 64 were mild (94.1%), 4 moderate (5.9%) and none severe. On the basis of the administration route (intravenous or oral) adverse reaction were 67 (94%) and 1 (6%) respectively. With a 40-80ml contrast media dose by injection, mild adverse reactions were 87.5%, moderate 12.5% and severe 0%. With a 90-150ml contrast media dose by injection, mild adverse reaction were 94.9% and moderate 5.1%. CONCLUSIONS: The number of adverse reaction using iodinated contrast media is low and are they are generally mild; however the nurse must be ready to recognise and treat them.