Self-Care Practices of Primary Health Care Patients Diagnosed with Chronic Heart Failure: A Cross-Sectional Survey.

Chronic heart failure patients require self-care behaviors and active monitoring of signs and symptoms to prevent worsening. Most patients with this condition are attended in primary healthcare centers. This study aimed to evaluate the endorsement of and adherence to self-care behaviors in primary health care patients with chronic heart failure. We conducted a multicenter cross-sectional study. We randomly included chronic heart failure patients from 10 primary healthcare centers in the Barcelona metropolitan area (Spain). Patients completed the European Heart Failure Self-Care Behaviour Scale, a health literacy questionnaire. Differences between groups were studied using ANOVA tests. We included 318 patients with a mean age of 77.9 years, mild limitations in functional activity New York Heart Association scale (NYHA) II = 51.25%), and a low health literacy index of 79.6%. The endorsement of self-care behaviors was low in daily weighing (10.66%), contacting clinicians if the body weight increased (22.57%), and doing physical exercise regularly (35.58%). Patients with lower educational levels and a worse health literacy had a lower endorsement. The screening of individual self-care practices in heart failure patients might improve the clinician follow-up. We suggest that primary healthcare clinicians should routinely screen self-care behaviors to identify patients requiring a closer follow-up and to design and adapt rehabilitation programs to improve self-care.

Alfabetización en salud en pacientes con insuficiencia cardiaca atendidos en atención primaria / Health literacy in patients with heart failure treated in primary care

OBJETIVOS: Examinar el nivel de alfabetización en salud y los factores que la condicionan en pacientes con insuficiencia cardiaca visitados en atención primaria. DISEÑO: Estudio transversal multicéntrico. Emplazamiento. Diez centros de atención primaria del área metropolitana de Barcelona. PARTICIPANTES: Pacientes con diagnóstico de insuficiencia cardiaca. CRITERIOS DE INCLUSIÓN: visita al centro de salud en el último año, desplazarse al centro de manera autónoma y acceder a participar voluntariamente. Mediciones principales. Cuestionarios Health Literacy Survey - European Union (HLS-EU-Q) y versión española de la Escala Europea de Autocuidado en Insuficiencia Cardiaca (EHFScBS). Se analizó la relación entre ambas escalas y variables sociodemográficas y clínicas mediante el test de ANOVA y un modelo de regresión lineal múltiple. RESULTADOS: Se incluyeron 318 pacientes (51,2% mujeres), con una media de edad de 77,9±8,7 años. El índice de alfabetización en salud del 79,6% (n=253) de los participantes fue de competencia insuficiente para comprender la información de salud. Los factores que explicaron la alfabetización en salud fueron el nivel académico (p < 0,001), la clasificación funcional de insuficiencia cardiaca (p = 0,032), los autocuidados y la edad (p < 0,04). El nivel académico explicaba el 61,6% del nivel de alfabetización (IC 95% bootstrap: 44,58%; 46,75%). CONCLUSIONES: La alfabetización en salud permite explicar la actitud de los pacientes hacia el régimen terapéutico que requiere la insuficiencia cardiaca. En los pacientes con insuficiencia cardiaca, los médicos y enfermeras de atención primaria han de tener en cuenta los factores que facilitan la comprensión de la información de salud

OBJECTIVES: The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. DESIGN: A multicentre cross-sectional study. SETTING: 10 Primary care centres from the metropolitan area of Barcelona. Participants. Patients diagnosed with heart failure. Inclusion criteria: to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. Main measurements. Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. RESULTS: The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). CONCLUSIONS: In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failur

[Health literacy in patients with heart failure treated in primary care]. / Alfabetización en salud en pacientes con insuficiencia cardiaca atendidos en atención primaria.

OBJECTIVES: The level of health literacy is examined, as well as its conditioning factors in patients with heart failure who are seen routinely in a Primary Health Care Area. DESIGN: A multicentre cross-sectional study. SETTING: 10 Primary care centres from the metropolitan area of Barcelona. PARTICIPANTS: Patients diagnosed with heart failure. INCLUSION CRITERIA: to have visited the Primary Health Care centre in the last year, being able to arrive at the primary care setting independently, and voluntarily participation. MAIN MEASUREMENTS: Health Literacy Survey-European Union - Questionnaire (HLS-EU-Q) and Spanish version of the European Heart Failure Self-care Behaviour Scale. An analysis was made of the relationships between health literacy, self-care practices, sociodemographic, and clinical variables using ANOVA test and a multiple linear regression model. RESULTS: The study included 318 patients (51.2% women) with a mean age of 77.9±8.7 years. The index of health literacy of 79.6% (n=253) of the participants indicated problems in understanding healthcare information. Health literacy level was explained by academic level (P<.001), the extent of heart failure (P=.032), self-care, and age (P<.04).The academic level explained 61.6% of the health of literacy (95% bootstrap: 44.58%; 46.75%). CONCLUSIONS: In patients with stable heart failure, it is important to consider all factors that help patients to understand the healthcare information. Health literacy explains patient self-care attitude in heart failure.

[Listening to the voice of the patient: an imperative. 2008 SESPAS Report]. / La voz de los pacientes ha de ser escuchada. Informe SESPAS 2008.

To democratize health services, citizen participation should be free, informed and involve choice. To achieve this, a formal and public system of health services' evaluation is required. The present article aims to argue the need to promote the participation of patients and persons affected by disease to achieve greater democratization of health services and improve the effectiveness of healthcare. Qualitative studies and population surveys can be used to assess the extent to which greater participation is being achieved. To this end, the present article uses information extracted from distinct qualitative studies performed in Spanish patients by the team of the Josep Laporte Foundation Library since 2000. The "paradoxes" found in diagnosis allow some recommendations to be made on health policy. There is a substantial chasm between the working of the health system and citizens' perceptions, indicating the need for a communication strategy that would help the majority of citizens - and especially patients as direct users - to identify basic elements of the system. Despite state and regional legislation on patients' rights, a large proportion of patients remain unaware of these rights. This situation reveals the possible discrepancy between legislative and executive settings. The laws shaping health policy should be evaluated to consolidate democratic processes. Providing credibility and publicizing patient rights could legitimize the introduction of the need for dialogue on patients' responsibilities.

La voz de los pacientes ha de ser escuchada. Informe SESPAS 2008 / Listening to the voice of the patient: an imperative. 2008 SESPAS Report

La participación ciudadana, para la democratización de los servicios de salud, debe ser libre, informada y con capacidad de elección. Para ello se requiere un sistema formal y público de «rendición de cuentas», o evaluación de los servicios de salud. El objetivo de este artículo es defender la necesidad de promover la participación de los pacientes y de las personas afectadas por la enfermedad para conseguir una mayor democratización de la sanidad e intentar mejorar la efectividad de la atención sanitaria. Algo que puede avalarse mediante la observación de un cambio de tendencias hacia un nuevo modelo de paciente con estudios cualitativos y con encuestas a la población. Para ello, se utiliza la información extraída de diferentes estudios cualitativos realizados en pacientes españoles por el equipo de profesionales de la Fundació Biblioteca Josep Laporte desde el año 2000. Las «paradojas» encontradas en el diagnóstico permiten realizar algunas recomendaciones de política sanitaria. Hay una desconexión importante entre el funcionamiento del sistema sanitario y la percepción de los ciudadanos, lo que permite identificar la necesidad de realizar una estrategia de comunicación que ayude a conocer elementos básicos del sistema a la mayor parte de los ciudadanos, y especialmente a los pacientes como usuarios directos. También destacamos el elevado desconocimiento que tienen los ciudadanos de sus derechos formales como pacientes, a pesar de la existencia de legislación estatal y autonómica sobre dichos derechos. Esta situación refleja la posible discrepancia entre los ámbitos legislativo y ejecutivo. Las leyes que conforman la política sanitaria deberían evaluarse con el propósito de consolidar los procesos democráticos. Este hecho es importante, ya que dar credibilidad y publicidad a los derechos de los pacientes puede legitimar la necesaria introducción del necesario diálogo sobre sus obligaciones

To democratize health services, citizen participation should be free, informed and involve choice. To achieve this, a formal and public system of health services¿ evaluation is required. The present article aims to argue the need to promote the participation of patients and persons affected by disease to achieve greater democratization of health services and improve the effectiveness of healthcare. Qualitative studies and population surveys can be used to assess the extent to which greater participation is being achieved. To this end, the present article uses information extracted from distinct qualitative studies performed in Spanish patients by the team of the Josep Laporte Foundation Library since 2000. The ¿paradoxes¿ found in diagnosis allow some recommendations to be made on health policy. There is a substantial chasm between the working of the health system and citizens¿ perceptions, indicating the need for a communication strategy that would help the majority of citizens ¿ and especially patients as direct users ¿ to identify basic elements of the system. Despite state and regional legislation on patients¿ rights, a large proportion of patients remain unaware of these rights. This situation reveals the possible discrepancy between legislative and executive settings. The laws shaping health policy should be evaluated to consolidate democratic processes. Providing credibility and publicizing patient rights could legitimize the introduction of the need for dialogue on patients' responsibilities (AU)

La voz de los pacientes ha de ser escuchada. Informe SESPAS 2008 / Listening to the voice of the patient: an imperative. 2008 SESPAS Report

La participación ciudadana, para la democratización de losservicios de salud, debe ser libre, informada y con capacidadde elección. Para ello se requiere un sistema formal y públicode ®rendición de cuentas», o evaluación de los servicios de salud.El objetivo de este artículo es defender la necesidad de promoverla participación de los pacientes y de las personas afectadaspor la enfermedad para conseguir una mayor democratizaciónde la sanidad e intentar mejorar la efectividad de laatención sanitaria. Algo que puede avalarse mediante la observaciónde un cambio de tendencias hacia un nuevo modelode paciente con estudios cualitativos y con encuestas a lapoblación. Para ello, se utiliza la información extraída de diferentesestudios cualitativos realizados en pacientes españolespor el equipo de profesionales de la Fundació Biblioteca JosepLaporte desde el año 2000.Las ®paradojas» encontradas en el diagnóstico permiten realizaralgunas recomendaciones de política sanitaria. Hay una desconexiónimportante entre el funcionamiento del sistema sanitarioy la percepción de los ciudadanos, lo que permiteidentificar la necesidad de realizar una estrategia de comunicaciónque ayude a conocer elementos básicos del sistema ala mayor parte de los ciudadanos, y especialmente a los pacientescomo usuarios directos. También destacamos el elevado desconocimientoque tienen los ciudadanos de sus derechos formalescomo pacientes, a pesar de la existencia de legislaciónestatal y autonómica sobre dichos derechos. Esta situación reflejala posible discrepancia entre los ámbitos legislativo y ejecutivo.Las leyes que conforman la política sanitaria deberíanevaluarse con el propósito de consolidar los procesos democráticos.Este hecho es importante, ya que dar credibilidad y publicidada los derechos de los pacientes puede legitimar la necesariaintroducción del necesario diálogo sobre sus obligaciones(AU)

To democratize health services, citizen participation shouldbe free, informed and involve choice. To achieve this, a formaland public system of health services’ evaluation is required.The present article aims to argue the need to promotethe participation of patients and persons affected bydisease to achieve greater democratization of health servicesand improve the effectiveness of healthcare. Qualitativestudies and population surveys can be used to assessthe extent to which greater participation is being achieved.To this end, the present article uses information extractedfrom distinct qualitative studies performed in Spanish patientsby the team of the Josep Laporte Foundation Librarysince 2000.The “paradoxes” found in diagnosis allow some recommendationsto be made on health policy. There is a substantialchasm between the working of the health system andcitizens’ perceptions, indicating the need for a communicationstrategy that would help the majority of citizens – andespecially patients as direct users – to identify basic elementsof the system. Despite state and regional legislation on patients’rights, a large proportion of patients remain unawareof these rights. This situation reveals the possible discrepancybetween legislative and executive settings. The laws shapinghealth policy should be evaluated to consolidate democraticprocesses. Providing credibility and publicizing patient rightscould legitimize the introduction of the need for dialogue onpatients’ responsibilities(AU)

Participación del Paciente: Nuevo rol del paciente en el sistema sanitario / Involvement of the patient: the new role of patients in the health system

No disponible

No disponible