ABSTRACT
Objetivo: Analizar las características de la consulta enfermera en Atención Primaria e identificar los factores asociados a los diferentes tipos de actividad. Método: Estudio observacional multicéntrico transversal sobre 662 consultas de 164 enfermeras diferentes (23 centros de salud, Comunidad de Madrid). La consulta se clasificó según una propuesta de consenso en: «actividades de prevención» (AdP), «déficit de autocuidados» (DA), «afrontamiento y adaptación» (AyA) y «procedimientos diagnósticos y terapéuticos» (PDyT). Se recogieron características sociodemográficas, de necesidad en salud y relativas a la consulta. Se hizo un análisis inferencial bivariante y se construyeron modelos multivariantes explicativos. Resultados: El 63,6% (IC del 95%: 59,9-67,3%) de las consultas fueron PDyT. En el 24,3% (IC del 95%: 21,0- 27,7%) de los casos la consulta era a demanda. No hubo diferencias en el tipo de consultas por género (p = 0,858), ni para inmigrantes (p = 0,428). Los sujetos de clases sociales superiores ocuparon con más frecuencia consultas de AdP (p = 0,007). No había otras diferencias en accesibilidad. Las consultas de PDyT se relacionaron con la existencia de hospitalizaciones previas (OR: 1,191; IC del 95%: 1,088-1,304), o el uso previo de servicios (consulta enfermera OR: 1,002, IC del 95%: 1,000-1,003; consulta médica OR: 1,003, IC del 95%: 1,000-1,006). Conclusiones: La consulta enfermera en nuestro medio se dirige preferentemente a la realización de procedimientos y predomina la consulta autoconcertada respecto a la demanda. No se detectan inequidades en la accesibilidad, pero el tipo de atención para diferentes grupos sociales no fue homogéneo
Objective: to analyse the characteristics of primary care nurse consultation and to identify the factors associated with different types of activity. Method: A cross-sectional multicentre observational study in 23 health centres (Community of Madrid), on 164 different nurses. The consultation was classified according to a consensus proposal in: "preventive activities" (PA), "self-care deficit" (SD), "coping and adaptation" (CA) and "diagnostic and therapeutic procedures" (DTP). Sociodemographic characteristics, health needs, and consultation characteristics were collected. A bivariate inferential analysis was made, and explanatory multivariate models were constructed. Results: Of the total consultations 63.6% (95% CI: 59.9-67.3%) were classified as DTP. The consultation was directly requested by the patient in 24.3% (95% CI: 21.0- 27.7%) of the cases. There were no differences in the type of consultations by gender (P=.858), or for immigrants (P=.428). Subjects from higher social classes more frequently attended PA consultations (P=.007). There were no other differences in accessibility. The DTP consultations related to previous hospitalizations (OR: 1.191, 95% CI: 1.088-1.304), or the previous use of services (nurse consultation OR: 1.002, 95% CI: 1.000-1.003, medical consultation OR: 1.003, 95% CI: 1.000-1.006). Conclusions: The nurse consultation is mainly aimed at carrying out procedures and previously arranged consultation prevails over patient demanded consultation. No inequities in accessibility were detected, but the type of care for different social groups was not homogeneous
Subject(s)
Humans , Middle Aged , Office Nursing/organization & administration , Primary Health Care , Nurse's Role , Cross-Sectional Studies , Multivariate Analysis , Spain/epidemiology , Primary Prevention , Nursing Care/classification , Analysis of Variance , Confidence Intervals , Adaptation, Psychological , Self Care/trendsABSTRACT
OBJECTIVE: to analyse the characteristics of primary care nurse consultation and to identify the factors associated with different types of activity. METHOD: A cross-sectional multicentre observational study in 23 health centres (Community of Madrid), on 164 different nurses. The consultation was classified according to a consensus proposal in: "preventive activities" (PA), "self-care deficit" (SD), "coping and adaptation" (CA) and "diagnostic and therapeutic procedures" (DTP). Sociodemographic characteristics, health needs, and consultation characteristics were collected. A bivariate inferential analysis was made, and explanatory multivariate models were constructed. RESULTS: Of the total consultations 63.6% (95% CI: 59.9-67.3%) were classified as DTP. The consultation was directly requested by the patient in 24.3% (95% CI: 21.0- 27.7%) of the cases. There were no differences in the type of consultations by gender (P=.858), or for immigrants (P=.428). Subjects from higher social classes more frequently attended PA consultations (P=.007). There were no other differences in accessibility. The DTP consultations related to previous hospitalizations (OR: 1.191, 95% CI: 1.088-1.304), or the previous use of services (nurse consultation OR: 1.002, 95% CI: 1.000-1.003, medical consultation OR: 1.003, 95% CI: 1.000-1.006). CONCLUSIONS: The nurse consultation is mainly aimed at carrying out procedures and previously arranged consultation prevails over patient demanded consultation. No inequities in accessibility were detected, but the type of care for different social groups was not homogeneous.
Subject(s)
Primary Care Nursing , Referral and Consultation , Aged , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Nurse's Role , Spain , Urban PopulationABSTRACT
El carcinoma basocelular es la neoplasia maligna de piel de mayor frecuencia que afecta mayoritariamente a las personas de la raza blanca. Se relaciona etiológicamente el potencial efecto carcinogénico a la explosión acumulativa de los rayos ultravioletas y con el deterioro de la capa de ozono este fenómeno tiende a aumentar en los últimos años, por tanto, la búsquedas de alternativas de tratamiento eficaces y seguros constituye una prioridad para los sistemas de salud como respuesta a este creciente problema de salud. Los interferones son productos biotecnológicos considerados modificadores de la respuesta biológica que por sus propiedades antiproliferativas y antiantigénicas se emplean en la terapéutica moderna del basotelioma. Se realizó una revisión en las principales base de datos, se seleccionaron 46 artículos que actualizan los aspectos, moleculares y estudios clínicos que justifican el empleo de la inmunoterapia y esencialmente los interferones como una estrategia eficaz y segura en el tratamiento de este tipo de neoplasia.
Basocellular carcinoma is a skin malignant neoplasia that primarily affects white race people. Potential carcinogenic effect is etiologically related to the accumulative explosion of ultraviolet rays, with the deterioration of the ozone layer this phenomenon tends to increase in the last few years, thus the search of efficacious and safe alternative treatments constitutes a health system priority. Interferons are biotechnological products known to modify the biological response that, due to its antiproliferative and antiantigenic properties, are employed in modern therapy of basothelioma. A revision was carried out in the main databases, choosing 46 articles that update the molecular aspects and the clinical trials that justify the use of immune therapy, and essentially, the interferons, as a safe and efficacious strategy in the treatment of this type of neoplasia.
ABSTRACT
El carcinoma basocelular es la neoplasia maligna de piel de mayor frecuencia que afecta mayoritariamente a las personas de la raza blanca. Se relaciona etiológicamente el potencial efecto carcinogénico a la explosión acumulativa de los rayos ultravioletas y con el deterioro de la capa de ozono este fenómeno tiende a aumentar en los últimos años, por tanto, la búsquedas de alternativas de tratamiento eficaces y seguros constituye una prioridad para los sistemas de salud como respuesta a este creciente problema de salud. Los interferones son productos biotecnológicos considerados modificadores de la respuesta biológica que por sus propiedades antiproliferativas y antiantigénicas se emplean en la terapéutica moderna del basotelioma. Se realizó una revisión en las principales base de datos, se seleccionaron 46 artículos que actualizan los aspectos, moleculares y estudios clínicos que justifican el empleo de la inmunoterapia y esencialmente los interferones como una estrategia eficaz y segura en el tratamiento de este tipo de neoplasia(AU)
Basocellular carcinoma is a skin malignant neoplasia that primarily affects white race people. Potential carcinogenic effect is etiologically related to the accumulative explosion of ultraviolet rays, with the deterioration of the ozone layer this phenomenon tends to increase in the last few years, thus the search of efficacious and safe alternative treatments constitutes a health system priority. Interferons are biotechnological products known to modify the biological response that, due to its antiproliferative and antiantigenic properties, are employed in modern therapy of basothelioma. A revision was carried out in the main databases, choosing 46 articles that update the molecular aspects and the clinical trials that justify the use of immune therapy, and essentially, the interferons, as a safe and efficacious strategy in the treatment of this type of neoplasia(AU)
