ABSTRACT
OBJECTIVE: To evaluate the degree of inter-observer concordance in the blood pressure figures taken by a nurse and a doctor with a mercury sphygmomanometer and by the patient with a semi-automatic device. DESIGN: Observational, crossover study. SETTING: A rural health centre. PATIENTS: 318 people selected by systematic sampling. INTERVENTIONS: Pressure was taken in different ways by 3 different "observers" (0): the patient with a semi-automatic device (01), a nurse (02) and a family doctor (03). Inter-observer concordance was assessed through the Intra-class Correlation Coefficient (ICC) and the kappa index. MEASUREMENTS AND MAIN RESULTS: 42.1%, 41.8% and 44.3% of patients had high blood pressure (> or = 140/90 mmHg) according to 01, 02 and 03, respectively. 33% were known to be hypertense. The ICC for systolic pressure was 0.81 (95% CI, 0.75-0.87) between 01 and 02; 0.84 (CI, 0.78-0.90) between 01 and 03; and 0.87 (CI, 0.82-0.92) between 02 and 03. The ICC for diastolic pressure was 0.67 (CI, 0.59-0.75), 0.72 (CI, 0.64-0.79) and 0.79 (CI, 0.72-0.86) for 01-02, 01-03 and 02-03, respectively. The kappa index was 0.53 (CI, 0.43-0.62) for 01-02; 0.60 (CI, 0.51-0.68) for 01-03; and 0.67 (CI, 0.58-0.75) for 02-03. CONCLUSIONS: Inter-observer concordance was good, with no substantial differences between the measurements made by the different observers. As the figures determined by the semi-automatic device were reliable, this is a good option for the follow-up and monitoring of hypertense patients.
Subject(s)
Blood Pressure Determination/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Blood Pressure Monitors , Child , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Observer Variation , Primary Health Care , Reproducibility of ResultsABSTRACT
Objetivo. Valorar el grado de concordancia interobservador en las cifras de presión arterial tomadas por un enfermero y un médico con esfigmomanómetro de mercurio y el paciente con un aparato semiautomático. Diseño. Observacional transversal. Emplazamiento. Un centro de salud rural. Pacientes. Trescientos dieciocho sujetos seleccionados por muestreo sistemático. Intervenciones. Se realizaron 3 tomas tensionales de forma alternativa por 3 observadores (O) distintos: el paciente con aparato semiautomático (O1), un enfermero (O2) y un médico de familia (O3). Valoración de la concordancia interobservador mediante el coeficiente de correlación intraclase (CCI) y el índice kappa. Mediciones y resultados principales. Presentaron cifras elevadas de presión arterial (>= 140/90 mmHg) un 42,1, 41,8 y 44,3 por ciento de los sujetos, según O1, O2 y O3, respectivamente; un 33 por ciento era hipertenso conocido. El CCI para la presión arterial sistólica fue de 0,81 (IC del 95 por ciento, 0,75-0,87) entre O1-O2, de 0,84 (IC del 95 por ciento, 0,78-0,90) entre O1-O3 y de 0,87 (IC del 95 por ciento, 0,82-0,92) entre O2-O3. Para la presión arterial diastólica el CCI fue de 0,67 (IC del 95 por ciento, 0,59-0,75), 0,72 (IC del 95 por ciento, 0,64-0,79) y 0,79 (IC del 95 por ciento, 0,72-0,86) para O1-O2, O1-O3 y O2-O3, respectivamente. El índice kappa fue de 0,53 (IC del 95 por ciento, 0,43-0,62) para O1-O2; 0,60 (IC del 95 por ciento, 0,51-0,68) para O1-O3 y 0,67 (IC del 95 por ciento, 0,58-0,75) para O2-O3. Conclusiones. El grado de acuerdo interobservador fue bueno, no apreciándose diferencias sustanciales entre las mediciones efectuadas por los distintos observadores. Las determinaciones obtenidas por el aparato semiautomático son fiables, constituyendo una buena opción para el seguimiento y control de los pacientes hipertensos (AU)
Subject(s)
Middle Aged , Child , Adult , Adolescent , Aged , Aged, 80 and over , Male , Female , Humans , Reproducibility of Results , Observer Variation , Blood Pressure Monitors , Primary Health Care , Blood Pressure Determination , Cross-Sectional StudiesABSTRACT
OBJECTIVES: to study the evolution of the smoking prevalence and the personal attitudes about smoking among doctors of a university hospital. MATERIAL & METHODS: cross-sectional study. A survey. Study population was all physicians working in "Reina Sofía" University Hospital of Cordoba (N=738). By systematic sampling we select a random sample of 250 especialist physicians. We designed a self-administered questionnaire with items measuring the prevalence of smoking, the brand they used, the degree of smoking dependence, and their opinion about the new anti-smoking law. We also study the measures for smoking cessation that doctors considered most useful. We compared our data with other similar study carried out in 1987. RESULTS: the prevalence of tobacco use was 42% (CI:95%: 35.5-48.9), below the figure we obtained in 1987 (56.3%; p < 0.001). Doctors between 36-45 years had the highest rates of tobacco consumption (p < 0.01). 86.9% of smokers thought that smoking was unhealthy and among these 83.3% accepted the risk derived of smoking. 86.7% of smokers used to smoke inside the hospital. 86.8% of doctors thought that the new public places restrictive smoking law must be implemented. Doctors smoke more often (68.5%) when they are on call and 26.4% of them recognize to smoke when they inform the patient's family. CONCLUSIONS: we highlight a reduction of the prevalence of smoking among this kind of physicians. We still consider important the high number of physicians which smoke inside the hospital, although this figure have significantly decreased.
