Relatos sobre COVID-19 de profesionales de la salud en un hospital / Stories about covid-19 from health professionals in a hospital

Introducción: la pandemia de COVID-19 impone a los profesionales de la salud: altas exigencias y modificaciones en el modo de vincularse con pacientes, pares y familiares. Estos cambios implican consecuencias emocionales tales como el incremento del nivel de estrés y síntomas de ansiedad y de depresión. Objetivo: describir un proyecto interdisciplinario creado bajo el modelo de la Medicina Narrativa dirigido a habilitar el relato de la experiencia de profesionales de la salud pertenecientes a un hospital general privado de alta complejidad de la ciudad de Buenos Aires durante la pandemia de COVID-19. Metodología: se creó una lista de correo y se convocó a profesionales del hospital a realizar una producción escrita, oral o gráfica que represente su experiencia durante la pandemia. Luego, el material recibido se envió a la misma lista de distribución con frecuencia semanal. En cada correo se renovó la invitación a narrar lo vivido o comentar los relatos de otros. Resultados: en el transcurso de siete semanas se recibieron diez producciones individuales: ocho textos, un audio y un gráfico. Los principales temas tratados pudieron agruparse en tres ejes: sala COVID, comunidad y telemedicina. Los autores fueron profesionales de Medicina, Enfermería, Psicología y de Puericultura. Conclusión: desarrollamos un proyecto bajo el modelo de la Medicina Narrativa que permitió a profesionales narrar su experiencia durante la pandemia de COVID-19, habilitando la posibilidad de poner en palabras lo vivido, reflexionar sobre modelos de actuación y elaborar el desgaste emocional generado por el contacto permanente con el dolor y el sufrimiento. (AU)

Introduction: the COVID-19 pandemic imposes high demands on health professionals and changes in the way they relate to patients, peers and family members. These changes involve emotional consequences such as increased stress levels, symptoms of anxiety and depression. Objective: to describe an interdisciplinary project created under the Narrative Medicine model aimed at enabling the reporting of the experience of health professionals belonging to a highly complex private general hospital in the city of Buenos Aires during the COVID-19 pandemic. Methodology: a mailing list was created and hospital professionals were invited to make a written, oral or graphic production that represents their experience during the pandemic. Then, the received material was sent to the same distribution list on a weekly basis. In each email, the invitation to narrate what was experienced or to comment on the stories of others was renewed. Results: over the course of seven weeks, ten individual productions were received: eight texts, one audio and one graphic. The main topics discussed could be grouped into three axes: COVID room, community and telemedicine. The authors were professionals from Medicine, Nursing, Psychology and Childcare. Conclusion: we developed a project under the Narrative Medicine model that allowed professionals to tell their experience during the covid 19 pandemic, enabling the possibility of putting into words what was experienced, reflecting on models of action and elaborating on the emotional exhaustion generated by permanent contact with pain and suffering. (AU)

[Seating, postural support, safety and satisfaction of users of wheelchairs in a CABA Rehabilitation Institute. Descriptive study]. / Calce, apoyo postural, seguridad y satisfacción de usuarios de sillas de ruedas en un Instituto de Rehabilitación de CABA. Estudio descriptivo.

Introduction: In the world, 75 million people require a wheelchair (W/C) but only between 5% and 15% of them have one. The WHO defines a W/C as adequate if it meets the needs of the user and their environment, offers appropriate seating and postural support and if it is safe and durable. Objective: The primary objective is to describe the seating, postural support and safety of W/Cs users who attend the I.Re.P kinesiology service. The secondary objective is to learn about their satisfaction with their W/Cs and related services. Subjects and method: The subjects were W/C users who attend the I.Re.P. kinesiology service. The W/Cs were evaluated following the WHO guidelines, and the satisfaction using the QUEST 2.0 questionnaire. Results: Within 30 patients, 21 were men aged around 48.17 years. Only 1 subject had all the correct measures of safety, seating and posture adjustment. 6 had all the correct measures for an adequate seating and 5 had all the safety measures. Regarding satisfaction, high scores have been found with respect to W/C and low scores with respect to related services. All in all, the total satisfaction got mostly medium and high scores. Conclusion: Only 1 subject out of the 30 evaluated complied with all the seating, postural adjustment and safety requirements necessary to consider an adequate W/C. Most subjects reported being more satisfied with their W/C than with the related services.

Introducción: En el mundo, 75 millones de personas requieren una silla de ruedas (SDR) pero entre el 5% y el 15% de ellas disponen de una. La OMS define SDR adecuada como aquella satisface las necesidades del usuario y su entorno, ofrece calce y apoyo postural apropiados, es segura y duradera. Objetivo: El objetivo primario es describir el calce, apoyo postural y seguridad de los usuarios de SDR que concurren al servicio de kinesiología del I.Re.P. El objetivo secundario es conocer la satisfacción respecto a su SDR y los servicios relacionados. Sujetos y método: Se incluyeron usuarios de SDR que concurran al servicio de kinesiología del I.Re.P. Las SDR fueron evaluadas siguiendo los lineamientos de la OMS, y la satisfacción utilizando el cuestionario QUEST 2.0. Resultados: De 30 sujetos incluidos, 21 fueron hombres con una edad media de 48,17 años. Sólo 1 sujeto contó con todas las medidas correctas de seguridad, calce y ajuste postural, 6 sujetos contaban con todas las medidas correctas para un calce adecuado y 5 con todas las medidas de seguridad. En cuanto a la satisfacción, se han encontrado puntajes elevados respecto a las SDR y puntajes bajos respecto a los servicios relacionados. La Satisfacción total recibió en su mayoría puntajes medios y altos. Conclusión: Sólo 1 sujeto de los 30 evaluados cumplió con todos los requisitos de calce, ajuste postural y seguridad necesarios para considerar una SDR adecuada. La mayoría de los sujetos reportaron estar más satisfechos con su SDR que con los servicios relacionados.

[Risk factors for the development and recurrence of pressure ulcers in patients with spinal cord injury: A systematic review.] / Factores de riesgo para la aparición y/o recurrencia de úlceras por presión en sujetos con lesión medular: revisión sistemática.

Introduction: A spinal cord injury refers to the damage suffered in the spinal cord as a result of trauma, disease or degeneration. Every person with spinal cord injury is at risk of developing pressure ulcers, and almost everyone will develop at least one ulcer due to severe pressure during his or her life. Objective: To identify the studies that detected risk factors for the development and recurrence of pressure ulcers in patients with spinal cord injury; and, if possible, synthesize the evidence to determine whether an association exists between them. Methods: A systematic search was conducted in Medline, LILACS, SciELO and Cochrane until December 4, 2018. The following studies were included: observational studies, case-control studies, and prospective or retrospective cohort studies, which provided an adjusted analysis of the risk factors associated with the development and recurrence of pressure ulcers in patients with spinal cord injury. Results: 25 articles met the eligibility criteria and were included for analysis. A total of 30 risk factors were identified: 4 were demographic factors, 8 were related to the injury, 5 belonged to medical comorbidities, 3 to nutritional factors, 9 were psychological, cognitive, contextual and social factors and 1 was related to support surface. As regards the factors, 56.67 percent of them were classified as non-modifiable. Conclusion: 30 risk factors were identified for the development and recurrence of pressure ulcers in patients with spinal cord injury. However, we were not able to synthesize the evidence due to the heterogeneity of the articles included in this review.

Introducción: Una lesión medular hace referencia a los daños sufridos en la médula espinal a consecuencia de un traumatismo, enfermedad o degeneración. Todas las personas con lesión medular corren riesgo de desarrollar úlceras por presión y casi todas desarrollarán al menos una úlcera por presión grave durante su vida. Objetivo: Identificar los estudios que detectaron factores de riesgo para la aparición y/o recurrencia de úlceras por presión en sujetos con lesión medular. Y de ser posible, sintetizar la evidencia para detectar asociación entre los mismos. Método: Se realizó una búsqueda sistemática en Medline, LILACS, SciELO y Cochrane hasta el 4 de diciembre del año 2018. Se incluyeron estudios observacionales, casos-controles y de cohorte, retrospectivos o prospectivos, que realizaron un análisis ajustado de los factores de riesgo para el desarrollo y/o recurrencia de úlceras por presión en sujetos con lesión medular. Resultados: 25 artículos cumplieron los criterios de elegibilidad y fueron incluidos para el análisis. Se identificaron un total de 30 factores de riesgo, de los cuales 4 fueron factores demográficos, 8 relacionados con la lesión, 5 pertenecieron a comorbilidades médicas, 3 a factores nutricionales, 9 fueron factores psicológicos, cognitivos, contextuales y sociales y 1 estuvo relacionado con la superficie de apoyo. El 56,67% se clasificaron como no modificables. Conclusión: Se identificaron 30 factores de riesgo para la aparición y/o recurrencia de úlceras por presión en sujetos con lesión medular. No fue posible sintetizar la evidencia debido a la heterogeneidad presentada por los artículos incluidos en la presente revisión.

[Elder abuse: Twenty years later]. / Maltrato y abuso en la vejez: veinte años después.

This article analyzes various aspects of elder abuse. Subtypes of abuse, neglect and self-neglect are defned. The phenomenon is analyzed in the context of geriatric institutions, people with dementia, and among the gay, lesbian and trans people. The narrative model is used to exemplify various situations, using authors such as Irving, Ford and Lodge.

[From Ulysses to Paris: Journey to the medicalization of ageing]. / De Ulises a Paris: viaje hacia la medicalización del envejecimiento.

In the following study we will be introducing the Paris Syndrome, taking as a departure stand the Ulises Syndrome described by Mercer Rang back in 1972. This syndrome is analyzed within the current context of medicalization that old people within Western societies are currently undergoing. We decided to present this topic by looking at the medical trajectories of four paradigmatic patients with the intention of capturing how they themselves experience this process. Through these cases, we would also like to further understand current medical practices toward the elderly.

[FROM ULYSSES TO PARIS: JOURNEY TO THE MEDICALIZATION OF AGEING]. / De Ulises a Paris: viaje hacia la medicalización del envejecimiento.

In the following study we will be introducing the Paris Syndrome, taking as a departure stand the Ulises Syndrome described by Mercer Rang back in 1972. This syndrome is analyzed within the current context of medicalization that old people within Western societies are currently undergoing. We decided to present this topic by looking at the medical trajectories of four paradigmatic patients with the intention of capturing how they themselves experience this process. Through these cases, we would also like to further understand current medical practices toward the elderly.

[Psychogeriatric unit within a General Hospital. Descriptive analysis of outpatient assessment, diagnosis and treatment]. / Unidad de Psicogeriatría de un Hospital General. Análisis descriptivo de la evaluación, diagnóstico y tratamiento de las consultas ambulatorias.

OBJECTIVE: To assess the frequency of some epidemiological variables in 200 patients over 65 years old that came to admission as outpatients in the psychogeriatric area in the psychiatric unit at the Hospital Italiano in Buenos Aires, Argentina. METHOD: A specific questionnaire was completed by both patient (or relative) and the physician. RESULTS: 83% were female and 17% male. The most important diagnosis were depressive disorder (34%), adaptive upheavals (28%) and dementia (16%), within this group, major depressive disorder and Alzheimer dementia. Only a 31% patients went under a neuropsychological assessment psychotherapy was indicated to 18% of the patients, pharmacology for 39%, memory improvement group for 18% and combined treatment for 25%. CONCLUSION: This paper brings data regarding outpatients over 65 years old with psychogeriatric treatment. This may improve the health system in psychogeriatric area taking into account socio-cultural and economic factors.