[The NADYA-SENPE Home Enteral Nutrition Registry in Spain: years 2018 and 2019]. / Registro del Grupo NADYA-SENPE de Nutrición Enteral Domiciliaria en España: años 2018 y 2019.

INTRODUCTION: Aim: to present the results of the Spanish home enteral nutrition (HEN) registry of the NADYA-SENPE group for the years 2018 and 2019. Material and methods: from January 1, 2018 to December 31, 2019 the home enteral nutrition registry was recorded, and afterwards a further descriptive and analytical analysis was done. Results: in 2018, 4756 active patients were registered and the prevalence was 101.79 patients per one million inhabitants; in 2019 there were 4633 patients with a prevalence of 98.51 patients per one million inhabitants. They originated in 46 hospitals: 51.3 % were male, and median age was 71.0 years in both periods. The most frequent diagnosis was a neurological disorder that presents with aphagia or severe dysphagia - 58.7 % and 58.2 %, respectively. The main cause of episode termination was death. A total of 116 pediatric patients were registered in 2018 and 115 in 2019. Females represented 57.8 % and 59.1 %, respectively, in each of the periods. Median age at the beginning of HEN was 5 and 7 months. The most commonly recordered diagnostic group (42.2 % and 42.6 %) was included within the other pathologies group, followed by neurological disorders that present with aphagia or severe dysphagia in 41.4 % and 41.7 % of children. The route of administration was gastrostomy in 46.6 % and 46.1 %, respectively, in each of the periods. Conclusions: the NED registry of the NADYA-SENPE group continues to operate uninterruptedly since its inception. The number of registered patients and the number of participating hospitals remained stable in the last biennium analyzed.

INTRODUCCIÓN: Objetivo: exponer los resultados del registro de nutrición enteral domiciliaria (NED) de los años 2018 y 2019 del Grupo NADYA-SENPE. Material y métodos: se recopilaron los pacientes introducidos en el registro desde el 1 de enero al 31 de diciembre de 2018 y en las mismas fechas para 2019, procediendo al análisis descriptivo y analítico de los datos. Resultados: en el año 2018 se registraron 4756 pacientes activos con una tasa de prevalencia de 101,79 pacientes/millón de habitantes; en 2019 fueron 4633 con una tasa de prevalencia de 98,51 pacientes/millón de habitantes. Procedían de 46 hospitales. Fueron el 51,3 % los varones registrados y la edad mediana fue de 71,0 años en ambos periodos. El diagnóstico más frecuente fue el de enfermedad neurológica que cursa con afagia o disfagia severa (58,7 % y 58,2 %), respectivamente. La causa principal de finalización de los episodios fue el fallecimiento. Los pacientes pediátricos registrados fueron 116 en 2018 y 115 en 2019. Las niñas representaron el 57,8 % y 59,1 %, respectivamente, en cada uno de los periodos. La edad mediana de inicio de la NED fue de 5 y 7 meses. El grupo diagnóstico más registrado (42,2 % y 42,6 %) se englobó dentro del grupo de otras patologías, seguido de la enfermedad neurológica que cursa con afagia o disfagia severa de los niños (41,4 % y 41,7 %). Se alimentaban a través de gastrostomía el 46,6 % y 46,1 %, respectivamente, en cada uno de los periodos. Conclusiones: el registro de NED del grupo NADYA-SENPE sigue operativo de forma ininterrumpida desde sus inicios. El número de pacientes registrados y el de hospitales participantes permanece estable en el último bienio analizado.

[Home and Ambulatory Artificial Nutrition (NADYA) Group report: home parenteral nutrition in Spain, 2019]. / Nutrición parenteral domiciliaria en España, 2019: informe del Grupo de Nutrición Artificial Domiciliaria y Ambulatoria NADYA.

INTRODUCTION: Aim: to communicate the home parenteral nutrition (HPN) data obtained from the HPN registry of the NADYA-SENPE group (www.nadya-senpe.com) for the year 2019. Material and methods: a descriptive analysis of the data collected from adult and pediatric patients with HPN in the NADYA-SENPE group registry from January 1 to December 31, 2019. Results: a total of 283 patients (51.9 % women), 31 children, and 252 adults from 47 Spanish hospitals were registered, which represents a prevalence rate of 6.01 patients per million inhabitants for year 2019. The most frequent diagnosis in adults was "palliative oncological" and "others" (21.0 %). In children, it was Hirschsprung's disease together with necrotizing enterocolitis, alterations in intestinal motility, and chronic intestinal pseudo-obstruction, with 4 cases each (12.9 %). The first reason for the indication was short-bowel syndrome in both children (51.6 %) and adults (37.3 %). The most used type of catheter was tunnelled both in children (75.9 %) and in adults (40.8 %). Sixty-eight episodes ended, all in adults, and the most frequent cause was death (54.4 %); 38.2 % were switched to oral. Conclusions: the number of collaborating centers and professionals in the NADYA registry is increasing. The main indications and reasons for HPN termination remain stable.

INTRODUCCIÓN: Objetivo: comunicar los datos de nutrición parenteral domiciliaria (NPD) obtenidos del registro del grupo NADYA-SENPE (www.nadya-senpe.com) del año 2019. Material y métodos: análisis descriptivo de los datos recogidos de pacientes adultos y pediátricos con NPD en el registro NADYA-SENPE desde el 1 de enero al 31 de diciembre de 2019. Resultados: se registraron 283 pacientes (51,9 %, mujeres), 31 niños y 252 adultos procedentes de 47 hospitales españoles, lo que representa una tasa de prevalencia de 6,01 pacientes/millón de habitantes/año 2019. El diagnóstico más frecuente en los adultos fue "oncológico paliativo" y "otros" (21,0 %). En los niños fue la enfermedad de Hirschsprung junto a la enterocolitis necrotizante, las alteraciones de la motilidad intestinal y la pseudoobstrucción intestinal crónica, con 4 casos cada uno (12,9 %). El primer motivo de indicación fue el síndrome del intestino corto tanto en los niños (51,6 %) como en los adultos (37,3 %). El tipo de catéter más utilizado fue el tunelizado tanto en los niños (75,9 %) como en los adultos (40,8 %). Finalizaron 68 episodios, todos en adultos: la causa más frecuente fue el fallecimiento (54,4 %). Pasaron a la vía oral el 38,2 %. Conclusiones: el número de centros y profesionales colaboradores con el registro NADYA va incrementándose. Se mantienen estables las principales indicaciones y los motivos de finalización de la NPD.

Effectiveness of a respiratory rehabilitation programme in patients with chronic obstructive pulmonary disease. / Efectividad de un programa de rehabilitación respiratoria en pacientes con enfermedad pulmonar obstructiva crónica.

OBJECTIVE: To evaluate the effectiveness of the multidisciplinary respiratory rehabilitation (RR) programme in patients with severe or very severe chronic obstructive pulmonary disease pre the RR programme, at the end of the programme and one year after the RR, measuring changes in ability to exercise (walking test), effort tolerance(forced expiratory volume (FEV1)) and health-related quality of life. METHOD: Quasi-experimental single group design. We included patients diagnosed with severe or very severe chronic obstructive pulmonary disease (stages III and IV of the GOLD classification) who entered the rehabilitation programme for the years 2011 and 2012. Demographic data, questionnaires on general health-related quality of life (SF-36) and specific to respiratory patients (St George's Respiratory Questionnaire), FEV1% and exercise capacity test (running test 6minutes) were collected. Data were collected before the RR programme, at the end of the RR programme and a year after completing the program. RESULTS: No significant differences in FEV1% values were observed. Regarding exercise capacity, an increase in distance walked in the walking test was noted, which changed significantly after training, 377±59.7 to 415±79 m after one year (P<.01). A statistically significant improvement in mean scores of HRQoL was observed, except for the emotional role dimension of the SF-36 questionnaire. CONCLUSION: A pulmonary rehabilitation programme for 8 weeks improved the exercise capacity, dyspnoea and quality of life of patients with severe and very severe chronic obstructive pulmonary disease.

[Effects of a pre-transplant educational program on the improvement of knowledge at hospital discharge after a liver transplant]. / Efectividad de un programa educativo en pretrasplante sobre la mejora de conocimientos al alta hospitalaria postrasplante hepático.

OBJECTIVE: To determine the effect of an educational program implemented before liver transplant on improving understanding at hospital discharge after the transplant and examine the contribution of different demographic and clinical variables on the level of knowledge. METHODS: A quasi-experimental study with a non-equivalent control group undertaken at the Hepato-Biliary-Pancreatic and Transplant Unit of Carlos Haya Regional University Hospital, Malaga, Spain. Sampling was consecutive (non-probabilistic), with a sample size of 31 patients for each group. An educational program was designed, encompassing the following Nurse Intervention Classification (NIC): Teaching: disease process; Teaching: prescribed diet; Education: prescription drugs; Protection against infection; Management of Hyperglycaemia; Management of Hypoglycaemia. For the outcome variable, a knowledge questionnaire was designed, with a total score range between 5-30 points, structured according to 6 indicators for Nurse Outcomes Classification (NOC): Description of the disease process, Description of the medication prescribed, Description of the prescribed diet, Description of self-care responsibilities, Description of practices that reduce transmission, Identification of actions to take in relation to blood glucose. RESULTS: The study included 61 patients, 33 for the control group and 28 for the intervention group. The mean score on the questionnaire of the intervention group was 20.25 ± 2.8 and that of the control group 13.06 ± 3.51 points. The difference between the two groups was 7.19 (95% CI: 5.73-8.64; P<.01). The analysis of the indicators showed that there were significant differences between the study groups, except for the indicator identification of actions to take in relation to blood glucose. No demographic or clinical variable (sex, education level, primary caregiver, waiting list time, time in hospital unit, hospital stay and days since the last talk before the transplant (only in intervention group)) was significantly associated with level of knowledge. CONCLUSION: This educational program conducted at Carlos Haya hospital in patients on the liver transplant waiting list improved their knowledge after their transplant.

[The tympanic thermometer in pediatrics as an alternative to the mercury-in-glass thermometer]. / Termometría timpánica en pediatría como alternativa al termómetro de mercurio.

OBJECTIVES: To determine the behavior of a new and smaller model of infrared thermometer cone and to assess whether it is an appropriate alternative to determine fever in children under 14-years-old. METHOD: We performed a cross-sectional, descriptive study comparing the temperatures taken with a mercury thermometer with those taken by an infrared thermometer in children under 14-years-old. The researchers followed the manufacturer's instructions for use for each thermometer. The overall sample of 400 children was divided into two age groups. Group I consisted of children aged less than 2 years and group II of 2-14-years-old. In group I the rectal mercury thermometer was placed in the rectum for 3 minutes and the tympanic thermometer was used in rectal mode and placed in the right ear. In group II, the axillary mercury thermometer was placed for 8 minutes in the right axilla and the tympanic thermometer was used in the axillary mode. To analyze intraobserver bias, 50 patients were selected from the sample and their temperatures were simultaneously taken by two nurses from the team. The intraclass correlation coefficient (ICC) was used both to measure the reliability of the tympanic thermometer and to analyze intraobserver bias. RESULTS: Temperature measurements with both instruments showed an ICC of 0.91 (95% confidence interval [CI], 0.88-0.94) for group I and 0.90 (95% CI, 0.87-0.92) for group II. The reproducibility of the measurements taken by the two nurses in 50 patients showed an ICC of 0.97 (95% CI, 0.95-0.98) for the tympanic thermometer. CONCLUSIONS: The infrared thermometer is an appropriate device for rapidly measuring temperature in the emergency department. However, the measurements taken should be confirmed by another method when clinical decisions are based on temperature values.

Patient satisfaction with nursing care in a regional university hospital in southern Spain.

Patient satisfaction is a valid indicator for measurement of service quality. Patients' opinions are important because dissatisfaction suggests opportunities for improvement. We evaluated the satisfaction of patients with nursing care in a regional university hospital in southern Spain and determined the relevant sociodemographic and attendance characteristics. A cross-sectional descriptive study was undertaken using the SERVQUAL questionnaire. Reliability and validity of the SERVQUAL instrument were established. The only interaction considered was gender and education level. Analysis of covariance showed that the only factors significantly associated with lower patient satisfaction were female gender, higher educational level, lower overall satisfaction with the hospital, and not knowing the name of the nurse.