[The adaptation and validation to Spanish of the questionnaire Aid to Capacity Evaluation (ACE), for the assessment of the ability of patients in medical decision-making]. / Adaptación y validación al español del cuestionario Aid to Capacity Evaluation (ACE) , para la valoración de la capacidad del paciente en la toma de decisiones médicas.

OBJECTIVE: To adapt and validate the Spanish version of the Aid to Capacity Evaluation scale, designed to assess the capacity of the adult in medical decision-making, both in diagnosis and treatment processes. DESIGN: Observational study of prospective validation. SETTING: Primary and hospital care of the basic health area of Jaen. PARTICIPANTS: One hundred twenty-nine patients. MAIN MEASUREMENTS: Questionnaire which included sociodemographic variables, concerning the decision (scope, type of decision, the need for written informed consent), assessment of the capacity to the Aid to Capacity Evaluation scale and other related comorbidity (hearing loss, alcoholism, cognitive level variables with the Mini-Mental State Examination and depression by Goldberg or Yesavage test). RESULTS: The tool is considered viable. The conclusions of the expert panel were favorable. The result of the criteria' validity, comparing the results with the assessment of the experts (forensic and psychiatrist) was very satisfying (P<.001). The intra-observer reliability was low (kappa=0,135). Interobserver reliability remained high (kappa=0.74). The internal consistency was awarded an alpha of Cronbach's 0,645 for the reduced model of 6 items. CONCLUSIONS: The Aid to Capacity Evaluation scale was adapted to Spanish, demonstrating adequate internal consistency and construct validity. Its use in clinical practice could contribute to the identification of patients unable to make a particular medical decision and/or to give an informed consent.

[Drugs consumption among Intern Specialists in Jaén (Spain) and their relationship to clinical counseling]. / Consumo de drogas entre los Especialistas Internos Residentes de Jaén (España) y su relación con el consejo clínico.

There are few studies on the prevalence of alcohol, tobacco and illegal drugs consumption among Specialist Interns (EIR) and their counseling to the patients. A multicenter cross-sectional study is carried out, consisting in a self-administered validated questionnaire to describe the consumption of the EIR of 17 health centers in Jaen (Andalusia) (4 hospitals, 13 primary care) and their relationship with their counseling. 215 EIR participate with 81% of valid questionnaires: mean age 31.2 years (± 0.7), 70% women, 13% foreigners, only 6% nursing. Of them 78% consumed alcohol (onset age 16.8 years ± 0.3), 81% occasionally and 17% weekend. The alcohol average weekly intake was 5.9 (± 5.8) UBE, especially beer and cocktails; 17% show a binge-drinking pattern (more frequent in men, p = .001 x 2). 19% smoke. A total of 71% smoke on a daily bases (mean of 8.9 ± 1.6 cigarettes/day); the nicotine dependence is low (68%) and two thirds have tried to quit. Only 3% use cannabis. A fifth part of EIR does not usually advise against smoking use (21%), a third part does not advise against alcohol (34%) and almost half of them neither advises against drugs (44%) (p = .001 x 2). Logistic regression shows greater clinical advice from older EIR. Advice against drinking alcohol provided by EIR women is more frequent (OR 2.93) and, probably, even more in EIR that binge drink (OR 2.32). Late smoking onset is related to less clinical advice against illegal drugs (OR 0.76).

[Psychosocial nature of chronic illnesses in the dependent elderly]. / Tipología psicosocial de las enfermedades crónicas en los mayores dependientes.

OBJECTIVE: To find the psychosocial nature of chronic diseases in elderly dependent persons. DESIGN: Transversal, observational study. SETTING: Two urban health districts in Granada and Jaén, Spain. PARTICIPANTS: One hundred five patients included in the Family and Home Care programme for elderly dependent persons. MAIN MEASUREMENTS: The type of chronic illness was analysed through the modified Rolland classification. Types of incapacity, demographic variables and the presence of multi-pathologies were recorded. RESULTS: 47.6% of the 105 participants were between 70 and 79 years old. On their psychosocial nature, 94.2% had some kind of disability, 78% had a gradual start, 61% had a progressive course of disease, and 63.8% had a possibly fatal prognosis. Psychosocial type B -- incapacitating, gradual start, progressive and possibly fatal -- was the most common (44.7%). CONCLUSION: The study of psychosocial type in elderly dependent persons is an important instrument for the analysis of families with chronic illnesses within them. Questions relating to its progressive course and the fatal prognosis may have a more determining prognostic weight.