Validación de encuesta a pacientes con insuficiencia cardíaca crónica en cuidados paliativos para el trabajo de enfermería / Validation of a Survey for Nursing Work with Patients with Chronic Heart Failure in Palliative Care

Introducción: En Cuba, las enfermedades del corazón son primera causa de muerte. En etapas avanzadas de la insuficiencia cardiaca, la terapia curativa pierde eficacia y los cuidados paliativos constituyen una opción válida, pero su uso no está aún generalizado. Objetivo: Validar una encuesta para caracterizar la situación psicosocial educativa y de salud y la opinión sobre la atención a pacientes con insuficiencia cardíaca crónica en cuidados paliativos. Métodos: Estudio instrumental en el área de salud del Policlínico "XX Aniversario", del municipio Remedios, Villa Clara, Cuba, entre enero-diciembre de 2018. Basado en el método Delphi para determinar la validez, a través del criterio de expertos, de una encuesta para aplicar a pacientes con insuficiencia cardiaca crónica. La investigación se desarrolló en tres etapas: adecuación del cuestionario, validación de contenido y prueba piloto. Se seleccionó una muestra de 35 pacientes. La validación de la funcionabilidad del cuestionario se determinó a través del cálculo del coeficiente Alfa de Cronbach. Resultados: La encuesta elaborada para la investigación, validada y enriquecida por el criterio de expertos, permite caracterizar la situación psicosocial educativa y de salud de pacientes con insuficiencia cardíaca crónica que reciben cuidados paliativos y ayuda a conocer sus criterios sobre la atención que reciben. Conclusiones: El instrumento construido es pertinente para su empleo efectivo en su contexto de aplicación y es posible su generalización a otros escenarios(AU)

Introduction: In Cuba, heart diseases are the leading cause of death. In advanced stages of heart failure, the curative therapy loses efficacy and palliative care is a valid option; however, its use is not yet widespread. Objective: To validate a survey for characterizing the educative psychosocial and health situation, as well as the opinion about the care of patients with chronic heart failure in palliative care. Methods: Instrumental study carried out, between January and December 2018, in the health area of XX Aniversario Polyclinic of Remedios Municipality, Villa Clara Province, Cuba. The study was based on the Delphi method to determine the validity, through expert judgment, of a survey to apply with patients with chronic heart failure. The research was developed in three stages: adaptation of the questionnaire, content validation, and pilot test. A sample of 35 patients was selected. The validation of the questionnaire's functionality was determined through calculation of Cronbach's alpha coefficient. Results: The survey prepared for the research, validated and enriched by expert judgement, allows to characterize the educative psychosocial and health situation of patients with chronic heart failure who receive palliative care and helps to know their criteria about the care they receive. Conclusions: The obtained instrument is appropriate for its effective use in its application context, while its generalization to other settings is possible(AU)

Distribution and status of living colonies of Acropora spp. in the reef crests of a protected marine area of the Caribbean (Jardines de la Reina National Park, Cuba).

The reef crests of the Jardines de la Reina National Park (JRNP) are largely formed by Acropora palmata, but colonies of A. cervicornis and the hybrid A. prolifera are also present. This study shows spatial distribution of colonies, thickets and live fragments of these species in the fore reefs. Snorkeling was used to perform the direct observations. The maximum diameter of 4,399 colonies of A. palmata was measured and the health of 3,546 colonies was evaluated. The same was done to 168 colonies of A. cervicornis and 104 colonies of A. prolifera. The influence of the location and marine currents on a number of living colonies of A. palmata was analyzed. For such purpose, reef crests were divided into segments of 500 m. The marine park was divided into two sectors: East and West. The Caballones Channel was used as the reference dividing line. The park was also divided into five reserve zones. We counted 7,276 live colonies of Acropora spp. 1.4% was A. prolifera, 3.5% A. cervicornis and 95.1% A. palmata. There were 104 thickets of A. palmata, ranging from eight to 12 colonies, and 3,495 fragments; 0.6% was A. cervicornis and the rest A. palmata (99.4%). In the East sector, 263 colonies (3.8% of the total), six thickets (5.8%) and 32 fragments (1%) of A. palmate were recorded. In the same sector, there were 11 fragments (50%) of A.cervicornis and two (2%) colonies of A. prolifera. Health of A. palmata was evaluated as good and not so good in the study area. Health of A. cervicornis was critical and health of A. prolifera was good in all five reserve zones. There was a significant increase in the number of colonies from east to west (Χ2 = 11.5, gl = 3.0, p = 0.009). This corroborates the existence of an important abundance differences between the eastern and the western region of the JRNP. A negative relationship was observed between the number of colonies and the distance from the channel (Χ2 = 65.0, df = 3.0, p < 0.001). The influence of the channel, for the live colonies of A. palmata is greater within the first 2,000 m. It then decreases until approximately 6,000 m, and no significant increase beyond. The orientation of the reef crests significantly influenced the abundance of the colonies (Χ2 = 15.5, df = 2.9, p = 0.001). The results presented here provide a baseline for future research on the status of the populations of Acropora spp., considering that there has been a certain recovery of the species A. palmata during the last 10-16 years. Given the current status of the populations of Acropora spp., conservation actions focusing A. cervicornis should be prioritized.