Validation and cross-cultural adaptation of the quality of Recovery-15 questionnaire in a Spanish-speaking population in Colombia.

Background: The quality of recovery is an important component in the evaluation of perioperative care. To measure this, the Quality of Recovery-15 (QoR-15) scale has been validated previously. The aim of this study was to culturally, linguistically, and psychometrically adapt this scale to the Colombian Spanish language. Methods: After linguistic adaptation, a validation study of the psychometric properties was carried out. These included validity, reliability, and responsiveness. The scale was administered after the administration of general anaesthesia. Validity was determined by correlating with the general recovery VAS, surgical risk, surgical duration, and length of hospital stay. Structural validity was assessed using factor analysis. Test-retest and internal consistency were used to measure reliability. Results: Interviews were conducted with 161 adults. A positive correlation was found between the Spanish version of the QoR-15 scale (QoR-15C) and VAS scores (r=0.51), and a negative correlation between the QoR-15C score and the duration of surgery (r=-0.47) and hospital stay (r=-0.62). The reliability of the scale was adequate. Cronbach's alpha was 0.74, and Lin's correlation concordance coefficient was 0.99. Confirmatory factor analysis indicated that the scale in the Colombian Spanish version does not have a single domain, whilst exploratory factor analysis indicated that the scale may measure an additional factor. Conclusions: The QoR-15C scale for assessing the quality of recovery after general anaesthesia showed psychometric properties comparable with those of the English scale. This allows the scale to be considered for use in research and clinical practice.

Economic Evaluation of Exercise-Based Cardiac Rehabilitation Programs for Chronic Heart Failure Patients in Colombia.

PURPOSE: Cardiac rehabilitation (CR) in patients with chronic heart failure (CHF) has met with resistance from third-party payers in low- and middle-income countries because of lack of evidence regarding its cost-effectiveness. We aimed to provide information to help better inform this decision-making process. METHODS: Costs associated with a 12-week exercise-based rehabilitation program in Colombia for patients with CHF were estimated. We collected data on all medical resources used in ambulatory care and data on hospital costs incurred for treating patients with uncompensated CHF. A literature search to establish the hospitalization rates because of uncompensated CHF, death because of CHF, and potential decreases in these data because of the utilization of CR was conducted. We modeled incremental costs and effectiveness over a period of 5 years from the perspective of the third-party payer. RESULTS: All costs were converted from Colombian pesos to US dollars. For an exercise-based CR program of 12-week duration (36 sessions), costs ranged from US$265 to US$369 per patient. Monthly costs associated with ambulatory care of CHF averaged US$128 ± US$321 per patient, and hospitalization costs were US$3621 ± US$5 444 per event. Yearly hospitalization incidence rates with and without CR were 0.154 and 0.216, respectively. The incremental cost of CR would be US$998 per additional quality-adjusted life-year. Sensitivity analysis did not significantly change these results. CONCLUSIONS: Cardiac rehabilitation in patients with CHF in settings such as Colombia can be a cost-effective strategy, with minimal incremental costs and better quality of life, mainly because of decreased rates of hospitalization.

El docente, su entorno y el síndrome de agotamiento profesional (SAP) en colegios públicos en Bogotá (Colombia) / Teachers, their environment and burnout syndrome (PBS) in public schools in Bogota (Colombia)

Introducción: El síndrome de agotamiento profesional (SAP) o burnout es de gran importancia y prevalencia entre los docentes; no obstante, en Colombia se ha estudiado poco. Objetivos: (1) Describir algunas características de los docentes respecto a su entorno laboral, bienestar y satisfacción personal, dificultades laborales, relación con estudiantes con dificultades y autoconocimiento, y (2) analizar su relación con el SAP en tres colegios públicos de Bogotá. Método: Se evaluó el SAP en docentes con un estudio de corte transversal, tipo encuesta, en tres colegios públicos de Bogotá, Colombia, mediante el Inventario de Maslach para Burnout y un cuestionario diseñado para indagar sobre factores socieodemográficos, personales y laborales. Resultados: Se realizaron 343 encuestas, de 367 previstas, para un índice de respuesta del 93,4%. El SAP tiene una prevalencia del 15,6%. El análisis factorial del cuestionario diseñado para docentes encontró que evaluaba cinco dimensiones y dentro de estas son evidentes las quejas sobre el ambiente laboral y las dificultades en los colegios, así como que más de un 70% de los docentes no se sienten preparados para manejar estudiantes con discapacidad física, mental y sensorial. Se establecieron relaciones entre algunos de estos factores y la presencia o no de SAP. Conclusión: El SAP es frecuente en docentes, existen quejas en múltiples esferas y se requieren intervenciones de salud mental que lleven a mejorar la interacción docente-alumno, en aras de mejorar la calidad de la educación...

Introduction: Despite the high prevalence and importance of burnout syndrome among teachers, it has rarely been studied in Colombia. Objective: To document and describe the following as they relate to burnout syndrome in three public schools in Bogotá: characteristics of the typical teaching environment, characteristics of student-teacher relations, the degree of well-being and personal satisfaction felt by teachers, as well as the difficulties they face on the job. Methods: A cross-sectional study was employed at three public schools in Bogotá. Teachers were evaluated via the Maslach Inventory for Burnout and a questionnaire encompassing sociodemographic, personal, and professional factors. Results: 343 out of 367 possible teachers completed the questionnaire resulting in a 93.4% response rate. The prevalence of burnout among this population was 15.6%. A factorial analysis of the questionnaire defined 5 categories of influence: work environment, personal satisfaction, work difficulties, working with problem students, and self-knowledge. Complaints related to work environment and work difficulties were the most common and more than 70% of survey-takers did not feel prepared to work with students possessing physical, mental or sensory handicaps. Some associations between these issues and the presence or absence of burnout syndrome were established. Conclusion: Burnout syndrome is a common occurrence among teachers in Bogotá stemming from a number of factors. Mental health interventions aimed at improving student-teacher interactions are required to enhance the overall quality of our educational system...