[Research in action. How to assist the integration of residents of family and community medicine in health centers]. / Investigación en la acción. Cómo facilitar la incorporación de los residentes de MFyC al centro de salud.

OBJECTIVES: To find the causes of worry in second-year family and community medicine (FCM) residents on their arrival at health centres. DESIGN: A descriptive study. A survey with 4 questions on difficulties found in the on-demand clinic, in consultations by appointment, other causes of anxiety and problems foreseen a priori. SETTING: Health centres in the Murcia Region with second-year FCM residents. PARTICIPANTS: All the second-year FCM residents (28) on their arrival at health centres in November, 1995. RESULTS: The three points of most concern to residents were: 1. On-demand clinic: unfinishable consultations, lack of time and clinical problems. 2. Consultations by appointment: clinical problems, over-long consultations and difficulties in resolving the consultations. 3. Other causes of anxiety: not having the day off after being on call, research work and emergencies. 4. Problems foreseen a priori: a lot of patients in a short time, not creating problems for the tutor and unemployment at the end of the residency. CONCLUSIONS: The short time to attend each patient and clinical problems are what cause most difficulty. This was the first time the difficulties residents had to integrate into Health Centres were surveyed. The initiative was greatly appreciated by them.

[Reasons for anxiety in primary care professionals. A resident-tutor comparison]. / Motivos de ansiedad en los profesionales de atención primaria. Comparación residentes-tutores.

OBJECTIVES: 1) To find the reasons for PC professionals' anxiety when going about their normal work. 2) To check whether training and experience affect the assessment of the reasons of Family Doctors for anxiety. DESIGN: A descriptive study using a questionnaire. SETTING: PC health centres with second-year family and community medicine (FCM) residents from the Murcia Teaching Unit. PARTICIPANTS: All second-year FCM residents from the Teaching Unit (28) in December 1995 and their tutors. MEASUREMENTS: Open questionnaire based on three points: Causes of anxiety in on-demand consultations; causes of anxiety in scheduled consultations; other reasons for anxiety connected with the Health Centre. RESULTS: The three most anxiety-producing causes in relation to each question were: a) on-demand consultation: residents (R)--unfinishable consultations, lack of time, clinical problems; tutors (T)--unfinishable consultations, a lot of patients waiting outside, manipulative patients. b) Scheduled consultation: R--clinical problems, consultation too long, difficulties in reaching a solution; T--consultation too long, patients without an appointment and interruptions in the middle of the consultation. c) Other reasons for anxiety: R--not being off the day after being on call, having to do research work, and emergency calls; T--emergency calls, research work and temperature problems. CONCLUSIONS: Clinical problems are the causes of anxiety with the greatest difference between tutors and residents. Regulated training in the health centre and professional experience seem to act positively on some of the causes of anxiety.

[Decile distribution of risk of mortality from ischemic cardiopathy in the male population registered at a health care center]. / Distribución según deciles de riesgos de mortalidad por cardiopatía isquémica de la población masculina adscrita a un centro de salud.

OBJECTIVE: To distribute the male population registered at our health centre into deciles of risk of death from ischaemic heart disease, using only the data in the clinical history. DESIGN: A crossover, retrospective and observational study, without random distribution. SETTING: Urban health centre. PATIENTS AND OTHER PARTICIPANTS: The work material was 2848 clinical histories of men aged between 25 and 55 1420 of these were histories with up-to-date data because the men had had a consultation during the preceding year. MEASUREMENTS AND MAIN RESULTS: The method proposed by Shaper to evaluate cardiovascular risk was used. The most prevalent risk factor was tobacco dependency, at 50.1% (CI 95%, 47.5-52.7), whereas hypertension and diabetes did not exceed 14.1% (CI, 12.3-15.9) and 2.5% (CI, 0.016-3.31), respectively, 90% of those under 35 were in the 10-30 deciles, while about half the over-45s were in the 40-90 deciles. CONCLUSIONS: Use of the Shaper method enabled us to distribute our male patients according to risk and identify 4% (2.56-5.37) as being at high risk of ischaemic heart disease.