ABSTRACT
Introduction: The global aging population poses challenges for society such as health inequalities among older persons and between genders. Objectives: To determine how Social Determinants of Health (SDH) influence the quality of life (QoL) of individuals over 50 years old in various European countries, taking a gender perspective in a longitudinal study. Materials and methods: Sample of 11,493 individuals from 13 European countries from Waves 5 (2013), 6 (2015), and 7 (2017) of the SHARE study. Instruments: CASP-12 (QoL), EURO-D (depression), SDH: gender, age, educational level, socioeconomic status, ethnicity, place of residence, and European region. Sociodemographic and clinical variables. Statistical analysis: Bivariate and multivariate mixed linear models. Results: The bivariate analysis showed higher economic hardship and lower education in women compared to men. The CASP-12 score was higher in men than in women. In the multivariate analysis, the variables associated with lower QoL scores among men and women from Wave 5 to Wave 7 were: (ß:-0.196, 95% CI: -0.345; -0.047) vs (ß:0.038, 95% CI: -0.122; 0.197); economic hardship; and the European region between South and North (ß: 2.709, 95% CI: 2.403; 3.015) vs men (ß: 2.224, 95% CI: 1.896; 2.551). Conclusions: The main SDH associated with poorer QoL were female gender, advanced age, economic hardship, educational level, and geographic location within Europe. Depression in women and in Southern Europe were associated with a decrease in QoL scores.
ABSTRACT
BACKGROUND: Health Literacy (HL) is the knowledge and competence to access, understand, appraise, and apply health information for health judgment. We analyze for the first time HL level of Catalonia's population. Our objective was to assess HL of population in our area and to identify social determinants of HL in order to improve the strategies of the Healthcare Plan, aimed at establishing a person-centered system and reducing social inequalities in health. METHODS: This was a cross-sectional study based on the Health Survey for Catalonia (ESCA, Enquesta de Salut de Catalunya), which included the 16 items of the European Health Literacy Survey Questionnaire (HLS-EU-Q16). The statements in the questionnaire cover three different health literacy domains: Health Care, Disease Prevention, and Health Promotion. HL was categorized in three levels: Sufficient, Problematic and Inadequate. Chi-square tests were performed to compare the percentages of subjects with adequate or inadequate HL across sociodemographic and health-related variables. Variables showing significant differences were included in a stepwise logistic regression to predict inadequate HL level. RESULTS: The questionnaire was administered to 2433 subjects aged between 15 and 98 years old (mean of 45.9 years, SD 18.0). Overall, 2059 subjects (84.6%) showed sufficient HL, 250 (10.3%) inadequate HL, and 124 (5.1%) problematic HL, with no significant differences between men and women (p = 0.070). A logistic regression analysis showed that low health literacy is associated with a lower level of education (OR 2.08, CI 95% 1.32-3.28, p = 0.002), low socioeconomic status (OR 2.11, CI 95% 1.42-3.15, p < 0.001) and a physical limitation to perform everyday activities (OR 2.50, CI 95% 1.34-4.66, p = 0.004). We also found a more modest association with low physical activity, having a self-perceived chronic disorder and performing preventive activities. CONCLUSIONS: Catalonia has a high percentage of subjects with sufficient HL. Education level, socioeconomic status and physical limitations were the factors with the strongest contribution to inadequate or problematic health literacy. Although these results are likely to be country-specific, the factors identified will allow policymakers of areas with similar socioeconomic profiles to identify groups with high risk of problematic or inadequate HL, which is essential for a successful patient-centered model of care.
Subject(s)
Health Literacy/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Health Surveys , Humans , Male , Middle Aged , Socioeconomic Factors , Spain , Young AdultABSTRACT
AIM: This paper is a report of a study conducted to evaluate, from the patients' perspective, a Liaison and Continuity of Care Programme coordinating care provision between a hospital and primary care centres. BACKGROUND: Promoting continuity of care between hospitals and primary care improves quality of care, patient satisfaction and decreases further hospitalizations. However, inadequate pain management is common after discharge. METHOD: A sample of patients from the Liaison and Continuity of Care Programme were included in a longitudinal study in 2007. We conducted standardized telephone interviews at 24 hours, 7 days, 1 and 3 months after discharge. Outcome measures included readmission, time between hospital discharge and readmission, information level at discharge, patient satisfaction, queries about care and information related to perceived state of health and pain. RESULTS: Eighty-three adult patients (average age 69.3, 50.6% males) who needed continued care at discharge were followed. Ten participants died during follow-up, and seven required readmission. A total of 49.4% of patients stated that they had understood the information given at discharge very well or perfectly. At 24 hours after discharge, 30% already had doubts about their state of health and the management of their condition. In relation to perceived health, only 25.3% stated that this was good or very good. Prevalence of pain 24-hours after discharge was 58.3% in surgical patients and 17.1% in other patients. CONCLUSION: The preparation and education of patients and family members should be improved before discharge, and appropriate written information must be given, especially if a patient has pain or requires complex care.
Subject(s)
Continuity of Patient Care/standards , Pain Management , Pain Measurement/standards , Patient Satisfaction , Adult , Aged , Female , Health Knowledge, Attitudes, Practice , Health Status , Humans , Longitudinal Studies , Male , Middle Aged , Outcome Assessment, Health Care , Pain/psychology , Patient Discharge , Patient Education as Topic/standards , Patient Readmission , Program Evaluation , Time FactorsABSTRACT
Este estudio describe la incidencia de las caídas en el Hospital Universitario Dr. Josep Trueta de Girona durante el período de un año, y se identifican los factores intrínsecos y extrínsecos al paciente en relación con las caídas acontencidas. Entre los factores intrínsecos se destacan, de parte de los pacientes, la confusión, alteración de la comunicación, desorientación temporo-espacial, inestabilidad en la marcha, agitación, tratamiento con psicofármacos e hipotensores. Casi el 40 por ciento de los pacientes tenían medidas de protección en el momento de la caída. Se protegió de forma significativa a los pacientes más dependientes. En relación con los factores extrínsecos se identificaron suelos resbaladizos, calzado inseguro y ausencia de barandillas en la cama. Se concluye que es necesario un mayor reconocimiento de los factores desencadenantes y una mejor utilización de las medidas de protección en los hospitales
Subject(s)
Humans , Male , Female , Accidental Falls , Hospitalization , Accidental Falls/mortality , Incidence , Precipitating FactorsABSTRACT
Este estudio describe la incidencia de las caídas en el Hospital Universitario Dr. Josep Trueta de Girona durante el período de un año, y se identifican los factores intrínsecos y extrínsecos al paciente en relación con las caídas acontencidas. Entre los factores intrínsecos se destacan, de parte de los pacientes, la confusión, alteración de la comunicación, desorientación temporo-espacial, inestabilidad en la marcha, agitación, tratamiento con psicofármacos e hipotensores. Casi el 40 por ciento de los pacientes tenían medidas de protección en el momento de la caída. Se protegió de forma significativa a los pacientes más dependientes. En relación con los factores extrínsecos se identificaron suelos resbaladizos, calzado inseguro y ausencia de barandillas en la cama. Se concluye que es necesario un mayor reconocimiento de los factores desencadenantes y una mejor utilización de las medidas de protección en los hospitales
Subject(s)
Humans , Male , Female , Accidental Falls , Hospitalization , Precipitating Factors , Incidence , Accidental Falls/mortalityABSTRACT
Los compromisos de atención sanitaria actual hacen que los hospitales estén inmersos en un constante cambio. Las direcciones de enfermería tienen, ante esta situación, un reto importante en la gestión de los recursos y su adecuación a las necesidades de los usuarios. Este estudio de doble ciego aplicado a 3208 procesos de cuidados pretende evidenciar la validez del instrumento PRN en al ámbito de la gestión hospitalaria
Subject(s)
Humans , Male , Female , Primary Nursing/classification , Clinical Nursing Research/methods , Workload , Hospital Units , Nursing Staff , SpainABSTRACT
Los compromisos de atención sanitaria actual hacen que los hospitales estén inmersos en un constante cambio. Las direcciones de enfermería tienen, ante esta situación, un reto importante en la gestión de los recursos y su adecuación a las necesidades de los usuarios. Este estudio de doble ciego aplicado a 3208 procesos de cuidados pretende evidenciar la validez del instrumento PRN en al ámbito de la gestión hospitalaria
