RESUMO
Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the workplace, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.
Assuntos
Poluentes Atmosféricos , Poluição do Ar , Poluentes Atmosféricos/análise , Poluição do Ar/análise , Poluição do Ar/prevenção & controle , Causalidade , Exposição Ambiental/análise , Humanos , PandemiasRESUMO
Para proporcionar un cuidado individualizado e integral a los pacientes que conviven con un proceso crónico se aboga en la actualidad por el uso de nuevas tecnologías, como la tele-enfermería. El objetivo es identificar las principales características de la tele-enfermería, así como las barreras y facilitadores para su implantación. Revisión sistemática de las bases de datos PubMed, Cochrane Library, Cinhal, Psycinfo, Cuiden, Dialnet y Scielo entre 2008 y 2019. Los 34 artículos seleccionados identificaron el soporte virtual, el seguimiento telefónico y los dispositivos electrónicos como principales características de la tele-enfermería, el perfil del paciente (no joven, con nivel socioeconómico y educativo bajo) y la resistencia de los profesionales de enfermería fueron las barreras identificadas, mientras que la nueva era tecnológica se identificó como un facilitador para su implementación. Proporcionar una mayor formación entre los profesionales de enfermería para dar a conocer las principales características de la tele-enfermería es fundamental para su aceptación e integración y, consecuentemente, su implantación en la práctica clínica diaria
At present there is a strong case for using new technologies, such as tele-nursing, to provide individualised and integral care to patients who live with a chronic process. The aim is to identify the main characteristics of tele-nursing and the factors that facilitate and hinder its implantation. Systematic review of the following databases: PubMed, Cochrane Library, Cinhal, Psycinfo, Cuiden, Dialnet and Scielo during the 2008-2019 period. The 34 articles selected identified virtual support, telephone monitoring and electronic devices as the main characteristics of tele-nursing; the patient's profile (not young, with a low socio-economic and educational level) and the resistance of the nursing professionals were the barriers identified; while the new technological age was identified as a factor facilitating its implementation. The provision of greater training for nursing professionals to make them aware of the main characteristics of tele-nursing is essential for its acceptance and integration and consequent implantation in daily clinical practice
Assuntos
Humanos , Doença Crônica/terapia , Enfermeiras e Enfermeiros/organização & administração , Telenfermagem/organização & administração , Fatores Socioeconômicos , EscolaridadeRESUMO
At present there is a strong case for using new technologies, such as tele-nursing, to provide individualised and integral care to patients who live with a chronic process. The aim is to identify the main characteristics of tele-nursing and the factors that facilitate and hinder its implantation. Systematic review of the following databases: PubMed, Cochrane Library, Cinhal, Psycinfo, Cuiden, Dialnet and Scielo during the 2008-2019 period. The 34 articles selected identified virtual support, telephone monitoring and electronic devices as the main characteristics of tele-nursing; the patient's profile (not young, with a low socio-economic and educational level) and the resistance of the nursing professionals were the barriers identified; while the new technological age was identified as a factor facilitating its implementation. The provision of greater training for nursing professionals to make them aware of the main characteristics of tele-nursing is essential for its acceptance and integration and consequent implantation in daily clinical practice.
Assuntos
Doença Crônica/terapia , Enfermeiras e Enfermeiros/organização & administração , Telenfermagem/organização & administração , Escolaridade , Humanos , Fatores SocioeconômicosRESUMO
INTRODUCCIÓN: El objetivo de nuestro estudio es conocer la implantación de las guías GOLD y GesEPOC en pacientes EPOC en las consultas de Neumología de Andalucía y Extremadura, para evaluar su variabilidad y los posibles factores determinantes. MÉTODOS: EPOCONSUL es un estudio en el que se realiza una auditoría de historias clínicas de pacientes con diagnóstico de EPOC. Se hace un estudio observacional en 62 centros de España. Se han extraído los datos de los centros del ámbito de NEUMOSUR para su análisis. Se analiza el grado de implantación de las guías GOLD y GesEPOC, así como la variabilidad en los distintos grados de enfermedad y fenotipos clínicos. RESULTADOS: Se ha analizado la historia clínica de 926 pacientes. El 32,8% estaban clasificados siguiendo la guía GOLD. De estos pacientes, el 36,2% estaban clasificados como grado A, 9,9% grado B, 22,3% grado C y el 31,6% como grado D. El 49,5% estaban clasificados siguiendo los criterios de GesEPOC. El 44,5% eran clasificados como fenotipo no agudizador, 14,9% fenotipo mixto EPOC-asma, 15,7% fenotipo agudizador con predomino de enfisema y 24,9% fenotipo agudizador con predominio de bronquitis crónica. CONCLUSIONES: En las consultas de neumología del ámbito de NEUMOSUR hay un mayor uso de los criterios de la guía GesEPOC que de la guía GOLD. Los grados más frecuentes son los de bajo riesgo y poco sintomáticos (A) seguidos de los de alto riesgo y muy sintomáticos (D). El fenotipo que con mayor frecuencia se atiende en la consulta es el no agudizado
INTRODUCTION: The objective of our study is to learn the implementation of the GOLD and Ges EPOC guidelines among patients with COPD at Pneumology departments in the regions of Andalusia and Extremadura (Spain) to assess variability and possible determining factors. METHOD: EPOCONSUL is a study that audits the clinical histories of patients who have been diagnosed with COPD. An observational study in 62 centers in Spain is carried out. Data has been extracted from centers within the scope of NEUMOSUR (Pneumology Departments in Andalusia and Extremadura) for analysis. The degree to which the GOLD and GesEPOC guidelines are implemented were analyzed, as well as variability in the various degrees of the disease and clinical phenotypes. RESULTS: The clinical histories of 926 patients were analyzed. 32.8% were classified according to GOLD guidelines. Of these patients, 36.2% were classified as grade A, 9.9% as grade B, 22.3% as grade C and 31.6% as grade D. 49.5% of the cases were classified following GesEPOC criteria. 44.5% were classified as non-acute phenotype, 14.9% as mixed phenotype COPD-asthma, 15.7% as acute phenotype with a predominance of emphysema and 24.9% as acute phenotype with a predominance of chronic bronchitis. CONCLUSIONS: Within the scope of NEUMOSUR medical practices, there is a majority use of GesEPOC guidelines over GOLD guidelines. The most frequent degrees are those of low risk and barely symptomatic (A) followed by high risk and very symptomatic (D). The phenotype seen most frequently at practices is the non-acute type
