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1.
Rev. esp. salud pública ; 98: e202403018, Mar. 2024. tab
Article in Spanish | IBECS | ID: ibc-231921

ABSTRACT

Fundamentos: diferentes estudios identifican la alfabetización en salud y/o salud mental (asm) como factores protectores contra el desarrollo de un problema de salud mental. El objetivo de este trabajo fue determinar el grado de alfabetización en salud mental de la población adolescente de barcelona, así como su relación con variables sociodemográficas y educativas.métodos: se realizó un estudio transversal en barcelona durante el curso 2017-2018. Participaron 1.032 jóvenes entre trece y diecisiete años. Se recogieron las siguientes variables: sexo; edad; nacionalidad; nivel socioeconómico (rdhpc); y nota media escolar. La asm se midió mediante los test de conocimientos emhl (reconocimiento de problemas mentales y conocimientos en salud mental; rango 0-10 cada parte), estigma (cami: rango 10-50, y ribs: rango 4-20) y búsqueda de ayuda (ghsq: rango de 1 a 7). Se realizó análisis de regresión lineal múltiple ajustando el efecto de variables sociodemográficas sobre la puntuación de cada escala.resultados: la puntuación media (desviación típica) del emhl test fue de 7,28 (1,27) y 4,24 (1,14), respectivamente, obteniendo mayor pun-tuación las chicas, rdhpc altas, nota excelente y con nacionalidad española. La mayor diferencia de puntuación en emhl, ajustando por el resto de variables, correspondió a los adolescentes con nota media excelente y con índice rdhpc elevado (respecto a la categoría basal, beta=0,72 y 0,52, respectivamente). La puntuación media del estigma fue 27,6 (4,47) para cami y 8,83 (3,36) para ribs. Las variables relacionadas con una mayor diferencia de puntuación respecto a la categoría basal y ajustado por el resto de variables fueron: sexo (chico=1,54) y nota académica (excelente=-2,38) para cami, y nacionalidad (extranjera=0,82) y nota académica (excelente=-1,30) para ribs. La puntuación media de ribs fue 8,83 (3,36), siendo la mayor diferencia de puntuación respecto a la categoría basal la nacionalidad extranjera (beta=0,82) y tener una nota de excelente (1,30). La búsqueda de ayuda fue mayor en padres/madres y amigos, con diferencias según sexo y nacionalidad.conclusiones: el nivel de alfabetización de salud mental es medio-bajo. Mientras que género, nacionalidad y resultados académicos son los factores que se relacionan con conocimientos y estigma, el nivel socioeconómico se relaciona únicamente con conocimientos en salud mental.(AU)


Background: different studies identify mental health literacy as a protective factor for developing a mental health problem. The aim of this paper was to determine the degree of mental health literacy of the adolescent population of barcelona, and its relationship with socio-de-mographic and educational variables.methods: a cross-sectional study was carried out in barcelona during the 2017-2018 academic year. A total of 1,032 young people between thirteen and seventeen years of age participated. The following variables were collected: sex, age, nationality, socioeconomic status (rdhpc) and average school grade. The aim was to determine the degree of mental health literacy (knowledge, stigma and help-seeking) of the adolescent population of barcelona, and its relationship with socio-demographic and educational variables. Multiple linear regression analysis was performed adjusting for the effect of sociodemographic variables on the score of each scale.results: the mean score (standard deviation) of the emhl test was 7.28 (1.27) and 4.24 (1.14) respectively, with higher scores obtained by girls, high rdhpc, excellent score and spanish nationality. The greatest difference in emhl scores, adjusting for the rest of the variables, corresponded to adolescents with an excellent mean score and a high rdhpc index (with respect to the baseline category, beta=0.72 and 0.52 respectively). The mean stigma score was 27.6 (4.47) for cami and 8.83 (3.36) for ribs. The variables related to a greater difference in score with respect to the baseline category and adjusted for the rest of the variables were: gender (boy=1.54) and academic grade (excellent=-2.38) for cami, and nationality (foreign=0.82) and academic grade (excellent=-1.30) for ribs. The mean ribs score was 8.83 (3.36) with the largest difference in score from baseline being foreign nationality (beta=0.82) and having a grade of excellent (1.30). Help-seeking was higher in parents and friends, with differences according to gender and nationality.conclusions: the level of mental health literacy is medium-low. While gender, nationality and educational attainment are the factors that are related to knowledge and stigma, socio-economic status is only related to mental health literacy.(AU)


Subject(s)
Humans , Male , Female , Adolescent , Stereotyping , Education , Mental Health , Student Health , Public Health , Spain , Cross-Sectional Studies
2.
Aten. prim. (Barc., Ed. impr.) ; 54(2): 102171, feb.2022. tab, graf
Article in Spanish | IBECS | ID: ibc-203314

ABSTRACT

Objetivo: Evaluar la incidencia de fractura de cadera en pacientes con tratamiento antipsicótico, comparándola con la de individuos que no han sido tratados con antipsicóticos.Diseño: Estudio de cohortes históricas de pacientes tratados con fármacos antipsicóticos (TAP) y pacientes sin tratamiento conocido (no TAP). El periodo de observación fue 2006-2014.Emplazamiento: Todos los equipos de atención primaria de Cataluña del Instituto Catalán de la Salud (ICS).Participantes: Pacientes mayores de 44 años con TAP de al menos 3 meses de duración. Cohorte control: selección aleatoria de pacientes no TAP emparejando por comorbilidades basales, sexo, edad y prescripción de fármacos (excluyendo psicofármacos). Se analiza un total de 22.010 pacientes.Mediciones principales Tasa de incidencia (×1.000 personas-año [PY]) de fractura de cadera en cada grupo (TAP y no TAP). Modelos de regresión de Cox para estimar riesgos ajustados (hazard ratio [HR]) añadiendo los psicofármacos como covariables. Resultados: La tasa de incidencia de fractura de cadera fue mayor en los pacientes TAP (5,83 frente a 3,58 fracturas por 1.000 PY), y es mayor en todos los estratos según sexo, edad y tipo de diagnóstico. El riesgo de sufrir una fractura de cadera fue un 60% mayor (HR: 1,60; IC95%: 1,34-1,92) en el grupo TAP que en el grupo no TAP. El riesgo fue mayor en el grupo con esquizofrenia (HR: 3,57; IC95%: 1,75-7,30), seguido del trastorno bipolar (HR: 2,61; IC95%: 1,39-4,92) y depresión (HR: 1,51; IC95%: 1,21-1,88). Conclusiones: Los pacientes con tratamiento antipsicótico presentan más riesgo de fractura de cadera que los que no han sido tratados con antipsicóticos.


ObjectiveTo evaluate the incidence of hip fracture in patients with antipsychotic treatment, comparing it with that of individuals who have not been treated with antipsychotics.DesignRetrospective cohort study of patients treated with antipsychotic drugs (TAP) and patients without known treatment (non-TAP). The observation period was 2006–2014.SiteAll primary care teams in Catalonia of the Catalan Health Institute (ICS).ParticipantsPatients older than 44 years with TAP lasting at least 3 months. Control cohort: random selection of non-TAP patients matching for baseline comorbidities and other variables. A total of 22,010 are analyzed.Main measurements Incidence rate (1000× person-years: PY) of hip fracture in each group (TAP and non-TAP). Cox regression models to estimate adjusted risks (hazard ratio: HR).ResultsThe hip fracture incidence rate was higher in TAP patients (5.83 vs 3.58 fractures per 1000 PY), and is higher in all strata according to sex, age and type of diagnosis. The risk of suffering a hip fracture was 60% higher (HR: 1.60 95% CI: 1.34–1.92) in the TAP group than in the non-TAP group. The risk was higher in the group with schizophrenia (HR: 3.57 95% CI: 1.75–7.30), followed by bipolar disorder (HR: 2.61; 95% CI: 1.39–4.92) and depression (HR: 1.51; 95% CI: 1.21–1.88).ConclusionsPatients with antipsychotic treatment have a higher risk of hip fracture than those who have not been treated with antipsychotics.


Subject(s)
Humans , Middle Aged , Health Sciences , Primary Health Care , Antipsychotic Agents/pharmacology , Hip Fractures/therapy , Osteoporotic Fractures
3.
Aten Primaria ; 54(2): 102171, 2022 02.
Article in Spanish | MEDLINE | ID: mdl-34798403

ABSTRACT

OBJECTIVE: To evaluate the incidence of hip fracture in patients with antipsychotic treatment, comparing it with that of individuals who have not been treated with antipsychotics. DESIGN: Retrospective cohort study of patients treated with antipsychotic drugs (TAP) and patients without known treatment (non-TAP). The observation period was 2006-2014. SITE: All primary care teams in Catalonia of the Catalan Health Institute (ICS). PARTICIPANTS: Patients older than 44 years with TAP lasting at least 3 months. Control cohort: random selection of non-TAP patients matching for baseline comorbidities and other variables. A total of 22,010 are analyzed. Main measurements Incidence rate (1000× person-years: PY) of hip fracture in each group (TAP and non-TAP). Cox regression models to estimate adjusted risks (hazard ratio: HR). RESULTS: The hip fracture incidence rate was higher in TAP patients (5.83 vs 3.58 fractures per 1000 PY), and is higher in all strata according to sex, age and type of diagnosis. The risk of suffering a hip fracture was 60% higher (HR: 1.60 95% CI: 1.34-1.92) in the TAP group than in the non-TAP group. The risk was higher in the group with schizophrenia (HR: 3.57 95% CI: 1.75-7.30), followed by bipolar disorder (HR: 2.61; 95% CI: 1.39-4.92) and depression (HR: 1.51; 95% CI: 1.21-1.88). CONCLUSIONS: Patients with antipsychotic treatment have a higher risk of hip fracture than those who have not been treated with antipsychotics.


Subject(s)
Antipsychotic Agents , Hip Fractures , Antipsychotic Agents/adverse effects , Hip Fractures/epidemiology , Humans , Incidence , Retrospective Studies , Risk Factors , Spain/epidemiology
4.
Blood Press Monit ; 24(5): 259-263, 2019 Oct.
Article in English | MEDLINE | ID: mdl-31425157

ABSTRACT

OBJECTIVE: The arm with the higher blood pressure (BP) is assigned as the follow up arm for hypertensive patients (reference-arm). We evaluated the reproducibility of this assignment. METHODS: BP was measured simultaneously on both arms with a double cuff validated device in two visits separated <10 days (two sets of three readings per visit). Two reference-arms were assigned in each visit (the arm with higher BP, at least ≥1 mmHg). The intravisit and intervisit agreements of this assignment were evaluated. RESULTS: We included 313 hypertensive patients. First visit mean right arm BP was 131.6 (16.6)/75.3 (9.4) mmHg and left arm BP was 132.4 (16.9)/75.7 (9.7) mmHg (P = 0.002). Intravisit concordance at the first and second visits were κ = 0.60 [95% confidence interval (CI), 0.516-0.696] and κ = 0.45 [95% CI, 0.356-0.555], respectively. Therefore, 21.8% of patients (at the first visit) and 29.1% (at the second visit) with the right arm as the reference-arm in the first round of readings changed to the left arm in the same visit in the second round of readings. The intervisit κ index was 0.25 [95% CI, 0.147-0.365]. After that, 36.8% of patients with the right arm as the reference-arm at the first visit changed to the left arm at the second visit. The subgroup (9.5%) with an interarm systolic BP difference ≥10 mmHg at the first visit did not differ significantly from the rest of patients. CONCLUSION: The reference-arm assignment agreement is weak to moderate. The assignment of the reference-arm should be individualized and not considered as definitive.


Subject(s)
Blood Pressure Determination/methods , Blood Pressure Determination/standards , Blood Pressure , Hypertension/physiopathology , Aged , Arm , Female , Humans , Male , Middle Aged , Practice Guidelines as Topic/standards , Reference Standards , Reproducibility of Results , Systole
5.
Metas enferm ; 22(1): 5-13, feb. 2019. tab
Article in Spanish | IBECS | ID: ibc-183458

ABSTRACT

Objetivo: evaluar el impacto de una intervención acerca de los conocimientos relacionados con las infecciones de transmisión sexual (ITS) y los servicios sanitarios disponibles en adolescentes escolarizados en el barrio del Raval Nord (Barcelona). Método: estudio cuasi-experimental pre-post intervención en adolescentes mayores de 14 años escolarizados en 3º y 4º de Educación Secundaria Obligatoria y 1º y 2º de Bachillerato de tres centros. Variables: sociodemográficas, conductas de riesgo (11 ítems con respuesta escala Likert 0-10), uso de preservativo, inicio de relaciones sexuales, consumo de alcohol y otras drogas, conocimiento de servicios sanitarios y de las ITS. Intervención con tres unidades didácticas: conductas de riesgo y formas de contagio; síntomas, conocimiento y tratamiento de las ITS; uso de servicios sanitarios.Tratamiento y análisis de los datos: Chi cuadrado y U de Mann Whitney para analisis bivariante con variables sociodemográficas. Se calcularon intervalos de confianza al 95% de seguridad (IC95%). Resultados: se estudiaron 211 adolescentes, 56,8% mujeres, media de edad: 15,4 años. El 79,6% procedía de fuera de Europa. El 30,3% había iniciado relaciones sexuales y el 32,4% utilizaba siempre preservativo. El 61,9% no asoció nunca alcohol ni otras drogas en la relación. El VIH es la ITS más conocida (59,8%). Los hombres tienen una percepción de riesgo menor que las mujeres. Post-intervención la percepción de riesgo global aumenta, así como el conocimiento de los servicios sanitarios y de las ITS. Conclusiones: existe déficit de conocimientos de los adolescentes acerca de las ITS. Los conocimientos sobre las ITS, la percepción de riesgo y los recursos sanitarios mejoraron tras la intervención


Objective: to evaluate the impact of an intervention on the knowledge about sexually transmitted infections (STIs) and the healthcare services available among adolescents attending school in the Raval Nord neighborhood (Barcelona). Method: a quasi-experimental study before and after the intervention in adolescents >14-year-old attending 3rd and 4th term of Secondary School and 1st and 2nd term of High School in three centres. Variables: sociodemographical, risk behaviours (11 items with answer through the 0-10 Likert Scale), use of condoms, initiation of sexual relationships, use of alcohol and other drugs, knowledge of healthcare services and of STIs. An intervention with three educational units: risk behaviours and ways of infection; symptoms, knowledge and treatment of STIs; use of healthcare services. Data treatment and analysis: Chi Square and Mann Whitney's U for bivariate analysis with sociodemographical variables. Confidence intervals were calculated at 95% safety (CI95%). Results: the study included 211 adolescents: 56.8% were female, with 15.4 years as mean age. Of these, 79.6% came from outside Europe, 30.3% had initiated sexual relationships, and 32.4% always used condoms; 61.0% of them never associated alcohol or other drugs with their relationship. HIV was the most widely known STI (59.8%). Men had a lower perception of risk than women. After the intervention, there was an increase in their overall perception of risk, as well as in their knowledge of healthcare services and STIs. Conclusions: there is lack of knowledge among adolescents about STIs. After the intervention, there was an improvement in their knowledge of STIs and healthcare services, as well as in their perception of risk


Subject(s)
Humans , Male , Female , Adolescent , Health Knowledge, Attitudes, Practice , Sexually Transmitted Diseases/epidemiology , Health Services , Primary Health Care , Risk-Taking , Confidence Intervals , Health Education , Surveys and Questionnaires
6.
Rev. neurol. (Ed. impr.) ; 57(11): 495-503, 1 dic., 2013. tab
Article in Spanish | IBECS | ID: ibc-117579

ABSTRACT

Objetivo. Comparar la prevalencia de factores de riesgo cardiovascular (FRCV) y eventos vasculares en pacientes tratados con antipsicoticos, comparandolos con los no tratados. Sujetos y métodos. Estudio descriptivo transversal de pacientes atendidos en atencion primaria de la ciudad de Barcelona y tratados con antipsicoticos entre el 2008 y el 2010, comparandolos con una poblacion no tratada. Se registraron las variables antropometricas y clinicas y los FRCV. Se estudio por separado a pacientes adultos y ancianos, y a los tratados con antipsicoticos tipicos y atipicos. Resultados. Un total de 14.087 pacientes habian sido tratados con antipsicoticos (63,4% atipicos). El mas prescrito fue la risperidona. Se aparejaron 13.724 pacientes de la misma edad y genero, pero no tratados (n total = 27.811). Los tratados con antipsicoticos presentaron una prevalencia superior de obesidad (16,9% frente a 10,6%), tabaquismo (22,2% frente a 11,1%), diabetes mellitus (16% frente a 11,9%) y dislipemia (32,8% frente a 25,8%) (p < 0,001). La prevalencia de accidente vascular cerebral fue significativamente superior entre los tratados, tanto en los adultos (odds ratio = 2,33) como en los ancianos (odds ratio = 1,64). La prevalencia de cardiopatia isquemica fue similar en ambos grupos (odds ratio = 0,97). No se observaron diferencias significativas entre los tratados con un antipsicotico tipico o atipico. Conclusiones. Los pacientes tratados con antipsicoticos presentaron una mayor prevalencia de FRCV (diabetes, obesidad y tabaquismo). La presencia de ictus fue superior entre los tratados con antipsicoticos. No se detectaron diferencias importantes entre los pacientes tratados con antipsicoticos tipicos y atípicos (AU)


Cardiovascular risk factors in chronic treatment with antipsychotic agents used in primary care (AU)


Subject(s)
Humans , Antipsychotic Agents/adverse effects , Cardiovascular Diseases/epidemiology , Cerebrovascular Disorders/drug therapy , Risk Factors , Primary Health Care , Time/analysis , Diabetes Mellitus/epidemiology , Obesity/epidemiology , Smoking/epidemiology
7.
Rev Neurol ; 57(11): 495-503, 2013 Dec 01.
Article in English, Spanish | MEDLINE | ID: mdl-24265143

ABSTRACT

AIM: To compare the prevalence of cardiovascular risk factors (CVRF) and vascular events, between patients treated and untreated with antipsychotic drugs. SUBJECTS AND METHODS: A cross-sectional study was done in Barcelona. We compared patients attended in Primary Health Care Centres, treated with or without antipsychotics between 2008 and 2010. Anthropometric measurements, clinical variables, and CVRF were assessed. Adult and elderly patients, typical and atypical antipsychotics, were studied separately. RESULTS: 14,087 patients had been prescribed antipsychotics (63.4% atypical), the most common being risperidone. We selected 13,724 patients with the same age and gender but not treated (total of 27,811 patients). Patients receiving antipsychotic had higher prevalence of obesity (16.9% vs. 11.9%), smoking (22.2% vs. 11.1%), diabetes mellitus (16% vs. 11.9%), and dyslipidemia (32.8% vs. 25.8%) (p < 0.001). The prevalence of stroke was significantly higher in the treated patients, both in adults (odds ratio = 2.33) and the elderly (odds ratio = 1.64). The prevalence of coronary heart disease was similar in both groups (odds ratio = 0.97). Among patients treated with antipsychotic, differences were not observed depending typical or atypical ones. CONCLUSIONS: Patients treated with antipsychotic drugs had a greater prevalence of several CVRF (diabetes mellitus, obesity, and smoking). The presence of stroke was higher in those treated with antipsychotics. No relevant differences were observed between patients receiving typical or atypical antipsychotics.


TITLE: Factores de riesgo cardiovascular en el tratamiento cronico con antipsicoticos en atencion primaria.Objetivo. Comparar la prevalencia de factores de riesgo cardiovascular (FRCV) y eventos vasculares en pacientes tratados con antipsicoticos, comparandolos con los no tratados. Sujetos y metodos. Estudio descriptivo transversal de pacientes atendidos en atencion primaria de la ciudad de Barcelona y tratados con antipsicoticos entre el 2008 y el 2010, comparandolos con una poblacion no tratada. Se registraron las variables antropometricas y clinicas y los FRCV. Se estudio por separado a pacientes adultos y ancianos, y a los tratados con antipsicoticos tipicos y atipicos. Resultados. Un total de 14.087 pacientes habian sido tratados con antipsicoticos (63,4% atipicos). El mas prescrito fue la risperidona. Se aparejaron 13.724 pacientes de la misma edad y genero, pero no tratados (n total = 27.811). Los tratados con antipsicoticos presentaron una prevalencia superior de obesidad (16,9% frente a 10,6%), tabaquismo (22,2% frente a 11,1%), diabetes mellitus (16% frente a 11,9%) y dislipemia (32,8% frente a 25,8%) (p < 0,001). La prevalencia de accidente vascular cerebral fue significativamente superior entre los tratados, tanto en los adultos (odds ratio = 2,33) como en los ancianos (odds ratio = 1,64). La prevalencia de cardiopatia isquemica fue similar en ambos grupos (odds ratio = 0,97). No se observaron diferencias significativas entre los tratados con un antipsicotico tipico o atipico. Conclusiones. Los pacientes tratados con antipsicoticos presentaron una mayor prevalencia de FRCV (diabetes, obesidad y tabaquismo). La presencia de ictus fue superior entre los tratados con antipsicoticos. No se detectaron diferencias importantes entre los pacientes tratados con antipsicoticos tipicos y atipicos.


Subject(s)
Antipsychotic Agents/therapeutic use , Cardiovascular Diseases/epidemiology , Adolescent , Adult , Age Factors , Aged , Anthropometry , Antipsychotic Agents/adverse effects , Chronic Disease , Comorbidity , Cross-Sectional Studies , Databases, Factual , Diabetes Mellitus/epidemiology , Drug Utilization , Dyslipidemias/chemically induced , Dyslipidemias/epidemiology , Female , Humans , Male , Mental Disorders/drug therapy , Mental Disorders/epidemiology , Middle Aged , Nervous System Diseases/drug therapy , Nervous System Diseases/epidemiology , Obesity/chemically induced , Obesity/epidemiology , Risk Factors , Smoking/epidemiology , Spain/epidemiology , Young Adult
8.
Actas esp. psiquiatr ; 41(4): 242-252, jul.-ago. 2013. ilus, tab
Article in Spanish | IBECS | ID: ibc-115236

ABSTRACT

Introducción: Durante los últimos 20 años, varios estudios han establecido la eficacia de diferentes formas de psicoterapia para el trastorno límite de la personalidad (TLP).Sin embargo, la investigación existente ha utilizado una amplia gama de medidas de resultado que hace difícil cuantificarlos datos y comparar las intervenciones. Esta revisión ha sido diseñada para analizar la evidencia procedente de los estudios controlados con asignación aleatoria (ECA) mediante un abordaje cualitativo. Metodología: Se ha llevado a cabo una revisión sistemática de los ECA publicados sobre las psicoterapias específicas del TLP para encontrar la literatura relevante recogida en las bases de datos online PsycINFO, ISI Web of Knowledge y Medline. Se ha realizado un análisis de la variabilidad en las variables principales de resultado, los pacientes que abandonan y aquellos que no entran en tratamiento para evaluar si un rango de variación amplio podría indicar algún sesgo potencial. Resultados: Hay una substancial variación entre los estudios en las variables principales de resultado, como los intentos de suicidio (7,4-33,9%), y especialmente en los pacientes que abandonan (6,7-47,4%) y en aquellos que no entran en tratamiento (17,6-63,6%). Globalmente, la psicoterapia específica para el TLP, al menos en un 40% de los pacientes que demandan tratamiento, no sería eficaz. Conclusiones: La eficacia global de las psicoterapias específicas para el TLP es prometedora. Sin embargo, la variabilidad de los resultados, plantea interrogantes sobre potenciales sesgos. Los estudios futuros deberían investigar nuevos abordajes terapéuticos que permitan el manejo de los pacientes más severos y refractarios (AU)


Introduction: Over the past 20 years, several studies have established the efficacy of different forms of psychotherapy for borderline personality disorders (BPD). However, existing research has used a wide range of outcomes measures which makes it difficult to quantify data and to compare interventions. This review has been designed to analyse the evidence from randomized controlled trials (RCT) through a qualitative approach. Methods: A systematic review of published RCT on specific psychotherapies for BPD has been undertaken to find relevant literature from online PsycINFO, ISI Web of Knowledge and Medline databases. An analysis of variability in primary outcomes, dropout patients and those who do not enter treatment has been conducted to assess if a wide range of variation could show any potential bias. Results: There is a substantial variation between the studies in primary outcomes, such as suicide attempts (7.4-33.9%), and specially in dropout patients (6.7-47.4%) and those who do not enter treatment (17.6-63.6%). Globally, specific psychotherapy for BPD, at least in a 40% of patients who demand treatment, would not be efficacious. Conclusions: The overall efficacy of specific therapies for BPD is promising. However, the variability of results raise questions about potential bias. Future studies should investigate new therapeutic approaches to allow the management of more severe and refractory patients (AU)


Subject(s)
Humans , Psychotherapy/methods , Borderline Personality Disorder/drug therapy , Random Allocation , Severity of Illness Index , Treatment Outcome
9.
Blood Press ; 21(6): 352-9, 2012 Dec.
Article in English | MEDLINE | ID: mdl-22587668

ABSTRACT

AIM: To assess the variability and concordance of left ventricular hypertrophy electrocardiographic (LVH-ECG) criteria. METHODS AND RESULTS: Convenience sampling of hypertensive subjects without coronary disease or bundle branch blocks. Two electrocardiograms (ECGs) were performed on each patient. Two investigators carried out two blind-readings of each ECG (Cornell and Sokolow-Lyon criteria). The between-rater and within-rater reliability were assessed (intraclass correlation coefficient, ICC). Poor concordance was defined: mean voltage difference between both ECGs >2 mm; 824 ECG readings were performed in 103 subjects (58.3% females), aged 66.8±8.8 years, mean blood pressure 141±15.10/78±9.0 mmHg. The between-rater ICCs of the baseline ECG were 0.97(95% CI 0.96-0.98) and 0.98 (95% CI 0.97-0.99) for Cornell and Sokolow-Lyon criteria, respectively. Poor concordance was found in 39.8% and in 41.7% of the cases for Cornell and Sokolow-Lyon criteria, respectively. Systolic blood pressure was found to be significant and positively associated with both criteria. Elderly hypertensive subjects, with higher ECG voltages and lower pulse pressure presented poor concordance of Cornell criteria. CONCLUSIONS: The between-rater and within-rater reliability of Cornell and Sokolow-Lyon criteria is minimal. Approximately 40% of hypertensive subjects presented poor concordance in a second ECG. Older patients with lower pulse pressure and higher baseline voltages presented poorer reproducibility of LVH-ECG criteria.


Subject(s)
Electrocardiography/standards , Hypertension/physiopathology , Hypertrophy, Left Ventricular/physiopathology , Aged , Electrocardiography/methods , Female , Humans , Hypertension/diagnosis , Hypertrophy, Left Ventricular/diagnosis , Male , Survival Analysis , Treatment Outcome
10.
Metas enferm ; 15(3): 53-56, abr. 2012. tab
Article in Spanish | IBECS | ID: ibc-98775

ABSTRACT

Objetivo: identificar el perfil del usuario que acude a la consulta de acogida de Enfermería, el motivo de la visita, la resolución de la misma y la satisfacción por parte del paciente. Como objetivo secundario se planteó analizar el cambio experimentando en las visitas espontáneas que lleva a cabo la enfermera de guardia, tras la implantación de la consulta de Enfermería de acogida. Material y método: estudio descriptivo transversal. La población objeto de estudio fueron los usuarios que acudían al centro de Raval Nord. Se eligió sistemáticamente una de cada tres visitas de lunes a viernes, a las que se aplicaba los criterios de inclusión y exclusión, durante los meses de abril a octubre de 2009. Variables de estudio: sexo, edad, país de procedencia, número de visitas previas del paciente, motivo de consulta (patología aguda, agudización patología crónica, otros), duración de la visita, intervención enfermera, satisfacción del usuario. También se cuantificó el número de visitas espontáneas que llevó a cabo la enfermera de guardia durante los meses de abril a octubre de 2008 y las realizadas por la enfermera de acogida con el nuevo rol durante el período de estudio. Resultados: 85 visitas analizadas, 47,1% hombres y 52,9% mujeres, media de edad 53,4 años. El 64,9% autóctonos y el 34,1% extranjeros. 47,6% no ha sido visitado por la enfermera en el último año. El motivo de visita: 60,7%patología aguda. Tiempo medio de la visita: 14 minutos. La resolución por parte de la enfermera es superior al 60%. Incremento relativo del 61% de visitas realizadas por la enfermera a partir de la nueva organización. Conclusiones: la resolución por parte de la enfermera es alta y la satisfacción del usuario también. Cambiar el acceso de la población a la consulta, para gestionar la demanda, optimiza la función de la enfermera (AU)


Objective: to identify the profile of the user who presents to the Host Nursing consultation office, the reason for the visit, the resolution of it and the satisfaction of the patient. A secondary objective was to analyze the change in the number of spontaneous visits undertaken by the nurse on duty, following the introduction of Host Nursing consultation. Material and methods: cross sectional descriptive study. The study population were users who presented to the health center of Raval Nord , one out of three visits from Monday to Friday was chosen systematically to which inclusion and exclusion criteria were applied during the months from April to October 2009. Study variables: sex, age, national origin, number of previous visits of the patient, reason for visit (acute disease, chronic disease exacerbations, others), duration of visit, nursing intervention, user satisfaction. We also measured the number of spontaneous visits conducted by the nurse on duty during the months of april to october 2008 and those made by the host nurse in her new role during the study period. Results: 85 visits analyzed, 47,1% men and 52,9% female, mean age 53,4years. 64,9% nationals and 34,1% foreigners. 47.6% has not been visited by the nurse in the last year. The reason for visit: 60,7% acute pathology. Average time of visit 14 minutes. Resolution by the nurse is over 60%. Relative increase of 61% of visits by the nurse as of the date of the new organisation. Conclusions: resolution of the visit by the nurse is high and so is customer satisfaction. Changing the population's access to consultation, to manage demand, optimizes the role of the nurse (AU)


Subject(s)
Humans , Nursing Care/trends , Nursing Service, Hospital/statistics & numerical data , Nursing Diagnosis/organization & administration , Patient Satisfaction/statistics & numerical data , Nurse's Role , Epidemiology, Descriptive
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