Sesiones docentes en Atención Primaria. Experiencia en los centros de un Área de Madrid / Teaching sessions in primary care. Experience in health centres in an area of Madrid

Existe la percepción por parte de los responsables de docencia de los diferentesequipos de Atención Primaria del Área 7 de Madrid de una importante disparidad en la organizaciónde las sesiones docentes. Por esta razón, la Comisión de Docencia e Investigación delÁrea 7 de Madrid organizó una jornada de puesta en común. Este artículo pretende mostrar lasdiferentes formas organizativas, modelos de sesiones, ventajas de las sesiones docentes, problemaspercibidos y propuestas de mejora. Finalmente, se plantea un decálogo que pueda servircomo guía para la organización de las sesiones docentes en los centros de Atención Primaria(AU)

Those responsible for teaching of primary care teams of Area 7 of Madrid have noteda significant disparity in the organisation of teaching sessions. Therefore, the Madrid Area 7Commission for Teaching and Research organised an idea-sharing day. This article aims to showthe different organisational forms, model sessions, the benefits of education sessions, perceivedproblems and suggestions for improvement. Finally there is a decalogue, which can serve as aguide for organising teaching sessions in primary care(AU)

[Teaching sessions in primary care. Experience in health centres in an area of Madrid]. / Sesiones docentes en Atención Primaria. Experiencia en los centros de un Área de Madrid.

Those responsible for teaching of primary care teams of Area 7 of Madrid have noted a significant disparity in the organisation of teaching sessions. Therefore, the Madrid Area 7 Commission for Teaching and Research organised an idea-sharing day. This article aims to show the different organisational forms, model sessions, the benefits of education sessions, perceived problems and suggestions for improvement. Finally there is a decalogue, which can serve as a guide for organising teaching sessions in primary care.

[Do our patients know what a family medicine resident is?]. / Saben nuestros pacientes qué es un residente de medicina de familia?

OBJECTIVES: To find patients' view of the idea of family and community medicine (FCM) residents and of what they do and patients' satisfaction with their work. DESIGN: Cross-sectional, descriptive study using a questionnaire. SETTING: FCM teaching health centres. Area 7, Madrid, Spain. PARTICIPANTS: Twenty-one tutors' lists, with 220 people. MAIN MEASUREMENTS: Social and demographic variables, concept of FCM resident, satisfaction with resident, comparisons between resident and tutor, changes observed by patients in their doctor. RESULTS: Women patients numbered 146 (66.4%); average age, 56.2 (18.95); 138 (62.7%) did not know exactly what a resident was, although 132 (60%) said he/she was a doctor. Knowledge increased with greater educational level (P< .001) and younger age (P=.04). Eighty-five (38.6%) demanded more from the tutor and tolerated errors of both equally; 196 (89.1%) were calm on being seen by a resident; 203 (92.3%) said they had the same trust in both. They noted no changes in the tutor when the resident was present (206; 93.6%). They wanted to change the same things in both (kappa=0.518). Patients were satisfied or very satisfied: 212 (96.4%), with the time that the doctor devoted to him/her with the resident present; 194 (88.2%), with having 2 doctors; and 214 (97.3%), with the attention and listening of the resident. Finally, 163 (74.1%) would recommend the resident as a doctor. CONCLUSIONS: Most patients do not know exactly what a FCM resident is or does. They believe that the presence of the resident does not affect the consultation with the tutor. Trust and tolerance is similar. Satisfaction with the care received is high.

Saben nuestros pacientes qué es un residente de medicina de familia? / Do our patients know what a family medicine resident is?

Objetivos. Conocer la percepción que tienen los pacientes del concepto de residente de medicina de familia y comunitaria (MFyC), de su labor y la satisfacción con su trabajo. Diseño. Estudio descriptivo, transversal, mediante cuestionario. Emplazamiento. Centros de salud docentes de MFyC. Área 7. Madrid. Participantes. En total, 220 personas pertenecientes a 21 cupos de tutores. Mediciones principales. Variables sociodemográficas, concepto de residente de MFyC, satisfacción con el residente, comparaciones entre residente y tutor, cambios observados por los pacientes en su médico. Resultados. Había 146 (66,4%) mujeres, con una media de edad de 56,2 ± 18,95 años. El 62,7% (138) no sabe exactamente qué es un residente, aunque el 60% (132) dice que es un médico, el conocimiento aumenta a mayor nivel educativo (p < 0,001) y menor edad (p = 0,04). El 38,6% (85) exige más al tutor y toleran por igual los errores a ambos. El 89,1% (196) está tranquilo cuando le atiende el residente, el 92,3% (203) manifiesta igual confianza. El 93,6% (206) no nota cambios en el tutor cuando está el residente. Desean cambiar los mismos aspectos en ambos (kappa = 0,518). Están satisfechos o muy satisfechos: el 96,4% (212) con el tiempo que el médico le dedica cuando está el residente, el 88,2% (194) por tener 2 médicos, el 97,3% (214) con la atención y escucha del residente. El 74,1% (163) recomendaría al residente como médico. Conclusiones. La mayoría de los pacientes no saben con exactitud lo que es y la labor de un residente de MFyC. Opinan que la presencia del residente no influye en la consulta del tutor. La confianza y la tolerancia son similares. La satisfacción es alta con la atención recibida

Objectives. To find patients' view of the idea of family and community medicine (FCM) residents and of what they do and patients' satisfaction with their work. Design. Cross-sectional, descriptive study using a questionnaire. Setting. FCM teaching health centres. Area 7, Madrid, Spain. Participants. Twenty-one tutors' lists, with 220 people. Main measurements. Social and demographic variables, concept of FCM resident, satisfaction with resident, comparisons between resident and tutor, changes observed by patients in their doctor. Results. Women patients numbered 146 (66.4%); average age, 56.2 (18.95); 138 (62.7%) did not know exactly what a resident was, although 132 (60%) said he/she was a doctor. Knowledge increased with greater educational level (P<.001) and younger age (P=.04). Eighty-five (38.6%) demanded more from the tutor and tolerated errors of both equally; 196 (89.1%) were calm on being seen by a resident; 203 (92.3%) said they had the same trust in both. They noted no changes in the tutor when the resident was present (206; 93.6%). They wanted to change the same things in both (kappa=0.518). Patients were satisfied or very satisfied: 212 (96.4%), with the time that the doctor devoted to him/her with the resident present; 194 (88.2%), with having 2 doctors; and 214 (97.3%), with the attention and listening of the resident. Finally, 163 (74.1%) would recommend the resident as a doctor. Conclusions. Most patients do not know exactly what a FCM resident is or does. They believe that the presence of the resident does not affect the consultation with the tutor. Trust and tolerance is similar. Satisfaction with the care received is high (AU)

[Sexuality in older women]. / Sexualidad en las mujeres mayores.

OBJECTIVES: To determine the prevalence of sexual relations in women >or=65 years. To determine factors that affect their activity and interest in sex. To evaluate the impact on their quality of life. DESIGN. Descriptive, cross-sectional study by means of survey. SETTING: Palacio de Segovia Health Centre, Madrid, Spain. Primary care. PARTICIPANTS: Women >or=65 years old. Criteria of exclusion: bed-ridden women, with psychiatric disease and/or moderate-severe cognitive deterioration. Sequential selection from 10 medical lists. MAIN MEASUREMENTS: Social and demographic, medical, geriatric (Katz and Lawton-Brody index), quality of life (WONCA sheets), variables on sexuality. RESULTS: One hundred and sixty two women. Mean age, 74.7 (7.8). Sixty one women with a stable partner (37.7%). Thirty four maintained sexual relations (20.98%), 61.8% (21) of them with coitus: these were satisfactory for 29 women (85.3%). For 50 (30.8%), communication was the most important aspect of sexuality. The lower their age, the more sexual relations they had (P<.022; odds ratio [OR]=0.85; 0.74-0.97). Of 115 women satisfied with the relations of their youth, 28.7% maintained sexual relations now (P<.003; OR=17; 1.7-178.8). The 23.9% maintained their sexual desire, though their partners had more interest in sex (50.9%). Women with stable partners and high self-esteem had more sexual relations than those who had neither, with a significant difference in both cases (P<.001). Maintaining sexual relations is a dependent factor on the Katz index (P<.007). The 32.2% of women thought that their sex life had changed for the worse, while 30.12% (20.54+19.17) thought their sex life had not changed or had improved. CONCLUSIONS: One of every 4 women >64 years old maintain sexual relations. Factors that determine sexual activity are: self-esteem, having a partner, sexual desire, previous sexual history, and the Katz index. Sexual relations are independent of quality of life.

Sexualidad en las mujeres mayores / Sexuality in older women

Objetivos. Determinar la prevalencia de relaciones sexuales en mujeres mayores de 64 años, los factores que condicionan su actividad e interés sexual y valorar el impacto en su calidad de vida. Diseño. Estudio descriptivo, transversal, mediante encuesta. Emplazamiento. Centro de salud Palacio de Segovia (Madrid). Atención primaria. Participantes. Mujeres mayores de 64 años. Criterios de exclusión: mujeres encamadas, con enfermedad psiquiátrica y/o deterioro cognitivo moderado-severo. Selección secuencial en 10 cupos médicos. Mediciones principales. Variables sociodemográficas, médicas, geriátricas (índice de Katz, Lawton-Brody), calidad de vida (láminas WONCA), variables sobre sexualidad. Resultados. Se incluyó a 162 mujeres. Edad media de 74,7 ± 7,8 años. En total, 61 mujeres tenían pareja estable (37,7%). Mantienen relaciones sexuales 34 (20,98%), el 61,8% (21) de ellas, coitales, que son satisfactorias para 29 (85,3%). Para 50 (30,8%) establecer una comunicación es el elemento más importante de la sexualidad. A menor edad, más relaciones (p < 0,022; odds ratio [OR] = 0,85; 0,74-0,97). De las 115 mujeres satisfechas con las relaciones de su juventud, un 28,7% mantiene relaciones en la actualidad (p < 0,003; OR = 17; 1,7-178,8). El 23,9% mantiene el deseo sexual, aunque presentan más interés sexual sus parejas (50,9%). Las mujeres con pareja estable y autoestima elevada mantienen más relaciones sexuales (p < 0,001). Mantener relaciones sexuales es un factor dependiente del índice de Katz (p < 0,007). El 32,2% de las mujeres piensa que su vida sexual ha cambiado a peor, mientras que para el 30,12% de las mujeres del estudio (20,54 + 19,17) su vida sexual no ha cambiado o lo ha hecho para mejorar. Conclusiones. Mantiene relaciones sexuales una de cada 4 mujeres mayores de 64 años. Los factores que condicionan la actividad sexual son la autoestima, tener pareja, el deseo sexual, la historia sexual previa y el índice de Katz. Las relaciones sexuales son independientes de la calidad de vida

Objectives. To determine the prevalence of sexual relations in women é65 years. To determine factors that affect their activity and interest in sex. To evaluate the impact on their quality of life. Design. Descriptive, cross-sectional study by means of survey. Setting. Palacio de Segovia Health Centre, Madrid, Spain. Primary care. Participants. Women é65 years old. Criteria of exclusion: bed-ridden women, with psychiatric disease and/or moderate-severe cognitive deterioration. Sequential selection from 10 medical lists. Main measurements. Social and demographic, medical, geriatric (Katz and Lawton-Brody index), quality of life (WONCA sheets), variables on sexuality. Results. One hundred and sixty two women. Mean age, 74.7 (7.8). Sixty one women with a stable partner (37.7%). Thirty four maintained sexual relations (20.98%), 61.8% (21) of them with coitus: these were satisfactory for 29 women (85.3%). For 50 (30.8%), communication was the most important aspect of sexuality. The lower their age, the more sexual relations they had (P64 years old maintain sexual relations. Factors that determine sexual activity are: self-esteem, having a partner, sexual desire, previous sexual history, and the Katz index. Sexual relations are independent of quality of life