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Introduction: Stress inherent to health care, which is characterized by work overload and shortage of specialized staff, is associated with decreased quality of life and suboptimal patient care. Mindfulness-based programs have proved to be effective in reducing stress in healthcare providers. This study aims to assess the feasibility of an 8-week mindfulness program to reduce the burnout levels of the staff of a pain clinic in a tertiary public hospital. Materials and methods: A longitudinal study with a within subject pre/post-intervention design, consisting of daily face-to-face 10-min sessions and the creation of a virtual group using a social media platform. Variables measured: burnout, mindfulness, empathy, self-compassion, and demographic characteristics. Results: Program feasibility (i.e., reach, adherence, acceptability, and preliminary effectiveness) was evaluated in 10 participants (6 physicians, 2 nurse practitioners, 1 nursing assistant, and 1 administrative). The results revealed a high reach (i.e., participation rate of 90%), excellent adherence to the program (daily practice 95% of times), and very good acceptability of the group format and satisfaction with most treatment components. Regarding potential effectiveness, we report the results of the Wilcoxon signed-rank tests and its associated effect size (r). We observed improvements in mindfulness and all its subscales (-2.077 ≤ Z ≤ -2.703, 0.69 ≤ r ≤ 0.90, all p < 0.05) except for non-reactivity and all subcomponents of self-compassion (-2.501 ≤ Z ≤ -2.611, 0.83 ≤ r ≤ 0.87, all p < 0.05) but not on its global self-compassion score. Empathy and burnout did not change. In an exploratory manner, however, we found significant reductions in the burnout component of emotional exhaustion, but only in physicians (Z = -2.201, p = 0.028, r = 0.73). Discussion: We believe that the 8-week mindfulness-based program described in the present investigation might be a feasible and potentially effective method that can be easily implemented to reduce burnout and promote mindfulness in specialized pain clinics.
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IntroducciónEn un escenario de circulación comunitaria del virus, el impacto de la pandemia sobre el sistema sanitario y en las unidades de cuidados intensivos (UCI) se preveía devastador. El Hospital Universitario Vall dHebron (HUVH) ha desplegado un dispositivo de atención a pacientes críticos sin precedentes.MétodosSe describen las previsiones realizadas, las medidas tomadas y los principales resultados en una cohorte de pacientes críticos durante los primeros dos meses (3 de marzo al 2 de mayo del 2020) de la pandemia por COVID-19 en el HUVH de Barcelona.ResultadosEn el periodo de estudio, ingresaron en las Unidades de Críticos del HUVH 333 pacientes. El porcentaje de los pacientes en VMI o VMI y ECMO se mantuvo constantemente por encima del 78%. La mayoría de pacientes han sido hombres (65%); el grupo de edad más frecuente entre 60 y 70 años. Veintitrés pacientes recibieron ECMO, 18 de los cuales fueron canulados en otro centro y trasladados al HUVH. A fecha de cierre del estudio, 14 pacientes se decanularon satisfactoriamente, tres pacientes fallecieron y el resto siguen en soporte con ECMO. Han sido atendidas en UCI ocho gestantes, con una supervivencia del 100%. La mortalidad en UCI de los pacientes menores de 60 años fue el 3,2%. La estancia media en UCI de las altas y los fallecimientos ha sido de 14 días.ConclusionesLas estrategias de organización de la expansión de recursos para la atención de pacientes críticos, sus principales retos y los resultados obtenidos, pueden servir de clave para futuros escenarios similares.
IntroductionIn the context of community transmission of the virus, the impact of the pandemic on health-care systems, mainly on intensive care units (ICU), was expected to be devastating. Vall d́Hebron University Hospital (HUVH) implemented an unprecedented critical patient-care planning and management of resources.MethodsWe describe a cohort of critically ill patients during the first two months of the pandemic (from March 3, 2020, to May 2, 2020) in HUVH, Barcelona.In this manuscript, we report our previsions, strategies implemented, and the outcomes obtained.ResultsThree-thousand and thirty-three patients were admitted to the HUVH Critical Care Units. Throughout the study period, the proportion of patients on IMV or IMV and ECMO remained above 78%. Most patients were men (65%); the most common age group was 60-70 years. Twenty-three patients received ECMO, and eighteen were cannulated at another center and transferred to HUVH. At the end of the study, fourteen patients were successfully decannulated, three patients died, and the rest of the patients were still on ECMO. Eight pregnant women have been treated in the ICU, with a survival rate of 100%. The ICU mortality of patients younger than 60 years was 3.2%. The mean ICU stay of both survivors and nonsurvivors was 14 days.ConclusionThe adequate preparation for resource expansion for critically ill patients care, main challenges, and overall positive results can serve as a precedent for similar future scenarios.
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Humanos , Ciencias de la Salud , Atención Ambulatoria , Pandemias , Hospitales , Coronavirus Relacionado al Síndrome Respiratorio Agudo Severo , Coronavirus , Neumonía , Sistemas de Salud , España , Unidades de Cuidados Intensivos , Enfermedades Transmisibles , MicrobiologíaRESUMEN
INTRODUCTION: In the context of community transmission of the virus, the impact of the pandemic on health-care systems, mainly on intensive care units (ICU), was expected to be devastating. Vall d'Hebron University Hospital (HUVH) implemented an unprecedented critical patient-care planning and management of resources. METHODS: We describe a cohort of critically ill patients during the first two months of the pandemic (from March 3, 2020, to May 2, 2020) in HUVH, Barcelona. In this manuscript, we report our previsions, strategies implemented, and the outcomes obtained. RESULTS: Three-thousand and thirty-three patients were admitted to the HUVH Critical Care Units. Throughout the study period, the proportion of patients on IMV or IMV and ECMO remained above 78%. Most patients were men (65%); the most common age group was 60-70 years. Twenty-three patients received ECMO, and eighteen were cannulated at another center and transferred to HUVH. At the end of the study, fourteen patients were successfully decannulated, three patients died, and the rest of the patients were still on ECMO. Eight pregnant women have been treated in the ICU, with a survival rate of 100%. The ICU mortality of patients younger than 60 years was 3.2%. The mean ICU stay of both survivors and nonsurvivors was 14 days. CONCLUSION: The adequate preparation for resource expansion for critically ill patients care, main challenges, and overall positive results can serve as a precedent for similar future scenarios.
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COVID-19 , Pandemias , Anciano , Enfermedad Crítica , Femenino , Hospitales Universitarios , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , EmbarazoRESUMEN
INTRODUCTION: In the context of community transmission of the virus, the impact of the pandemic on health-care systems, mainly on intensive care units (ICU), was expected to be devastating. Vall dÌHebron University Hospital (HUVH) implemented an unprecedented critical patient-care planning and management of resources. METHODS: We describe a cohort of critically ill patients during the first two months of the pandemic (from March 3, 2020, to May 2, 2020) in HUVH, Barcelona. In this manuscript, we report our previsions, strategies implemented, and the outcomes obtained. RESULTS: Three-thousand and thirty-three patients were admitted to the HUVH Critical Care Units. Throughout the study period, the proportion of patients on IMV or IMV and ECMO remained above 78%. Most patients were men (65%); the most common age group was 60-70 years. Twenty-three patients received ECMO, and eighteen were cannulated at another center and transferred to HUVH. At the end of the study, fourteen patients were successfully decannulated, three patients died, and the rest of the patients were still on ECMO. Eight pregnant women have been treated in the ICU, with a survival rate of 100%. The ICU mortality of patients younger than 60 years was 3.2%. The mean ICU stay of both survivors and nonsurvivors was 14 days. CONCLUSION: The adequate preparation for resource expansion for critically ill patients care, main challenges, and overall positive results can serve as a precedent for similar future scenarios.
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INTRODUCCIÓN: En un escenario de circulación comunitaria del virus, el impacto de la pandemia sobre el sistema sanitario y en las unidades de cuidados intensivos (UCI) se preveía devastador. El Hospital Universitario Vall d'Hebron (HUVH) ha desplegado un dispositivo de atención a pacientes críticos sin precedentes. MÉTODOS: Se describen las previsiones realizadas, las medidas tomadas y los principales resultados en una cohorte de pacientes críticos durante los primeros dos meses (3 de marzo al 2 de mayo del 2020) de la pandemia por COVID-19 en el HUVH de Barcelona. RESULTADOS: En el periodo de estudio, ingresaron en las Unidades de Críticos del HUVH 333 pacientes. El porcentaje de los pacientes en VMI o VMI y ECMO se mantuvo constantemente por encima del 78%. La mayoría de pacientes han sido hombres (65%); el grupo de edad más frecuente entre 60 y 70 años. Veintitrés pacientes recibieron ECMO, 18 de los cuales fueron canulados en otro centro y trasladados al HUVH. A fecha de cierre del estudio, 14 pacientes se decanularon satisfactoriamente, tres pacientes fallecieron y el resto siguen en soporte con ECMO. Han sido atendidas en UCI ocho gestantes, con una supervivencia del 100%. La mortalidad en UCI de los pacientes menores de 60 años fue el 3,2%. La estancia media en UCI de las altas y los fallecimientos ha sido de 14 días. CONCLUSIONES: Las estrategias de organización de la expansión de recursos para la atención de pacientes críticos, sus principales retos y los resultados obtenidos, pueden servir de clave para futuros escenarios similares
INTRODUCTION: In the context of community transmission of the virus, the impact of the pandemic on health-care systems, mainly on intensive care units (ICU), was expected to be devastating. Vall d'Hebron University Hospital (HUVH) implemented an unprecedented critical patient-care planning and management of resources. METHODS: We describe a cohort of critically ill patients during the first two months of the pandemic (from March 3, 2020, to May 2, 2020) in HUVH, Barcelona. In this manuscript, we report our previsions, strategies implemented, and the outcomes obtained. RESULTS: Three-thousand and thirty-three patients were admitted to the HUVH Critical Care Units. Throughout the study period, the proportion of patients on IMV or IMV and ECMO remained above 78%. Most patients were men (65%); the most common age group was 60-70 years. Twenty-three patients received ECMO, and eighteen were cannulated at another center and transferred to HUVH. At the end of the study, fourteen patients were successfully decannulated, three patients died, and the rest of the patients were still on ECMO. Eight pregnant women have been treated in the ICU, with a survival rate of 100%. The ICU mortality of patients younger than 60 years was 3.2%. The mean ICU stay of both survivors and nonsurvivors was 14 days. CONCLUSION: The adequate preparation for resource expansion for critically ill patients care, main challenges, and overall positive results can serve as a precedent for similar future scenarios
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Humanos , Masculino , Femenino , Recién Nacido , Niño , Adulto , Persona de Mediana Edad , Anciano , Infecciones por Coronavirus/epidemiología , Neumonía Viral/epidemiología , Pandemias , Enfermedad Crítica/terapia , Unidades de Cuidados Intensivos/organización & administración , Cuidados Críticos/organización & administración , Unidades de Cuidados Intensivos/provisión & distribución , Infecciones por Coronavirus/terapia , Neumonía Viral/terapia , EspañaRESUMEN
El presente trabajo abordó la figura de Reynold García García, revolucionario que fue el alma y guía del asalto al cuartel Domingo Goicuría, en la cubana ciudad de Matanzas, hecho combativo más importante que tuvo lugar en esta urbe durante la República Neocolonial (1902-1958). Varias instituciones matanceras llevan su nombre, entre ellas el Policlínico Universitario de la barriada de Versalles(AU)
The current work approached the figure of Reynold García García, revolutionary fighter who was the soul and leader of the assault of Domingo Goicuría garrison, in the Cuban city of Matanzas, the most important struggling fact that took place in this city during the Neo-colonial Republic (1902-1958). Several Matanzasan institutions are named after him, among them the Teaching Policlinic of Versalles neighbourhood(AU)