Insuficiencia cardiaca en atención primaria: actitudes, conocimientos y autocuidado / Heart failure in primary care: Attitudes, knowledge and self-care

OBJETIVO: Conocer actitudes, conocimientos y prácticas en autocuidado en pacientes con insuficiencia cardiaca (IC) atendidos en atención primaria, e identificar factores asociados a mayor autocuidado. DISEÑO: Estudio transversal multicéntrico. Emplazamiento: Atención primaria. PARTICIPANTES: Individuos mayores de 18 años con diagnóstico activo de IC a 1 de diciembre de 2011 en 10 centros de salud del Área Metropolitana de Barcelona. Medidas principales: Se realizó entrevista y revisión de historia clínica para obtención de datos sociodemográficos, clínicos y tests de actitudes (Self-efficacy Managing Chronic Disease Scale), conocimientos (Patient Knowledge Questionnaire), autocuidado (European Heart Failure Self-care Behaviour Scale), grado autonomía (Barthel) y cribado ansiedad-depresión (test Goldberg). Se analizaron las variables asociadas a autocuidado mediante modelo de regresión lineal múltiple de efectos mixtos jerarquizado por centros. RESULTADOS: n = 295 individuos (77,6%), edad media 75,6años (DE: 11), 56,6% mujeres, 62% sin estudios primarios. Se obtuvo una media global de autocuidado de 28,65 (DE: 8,22) puntos. Un 25% de los pacientes presentaron puntuaciones inferiores a 21 puntos. En el modelo multivariante final (n = 282; R2 condicional = 0,3382), un mayor autocuidado se relacionó con mejores conocimientos sobre la IC (coeficiente -1,37; intervalo de confianza 95%: -1,85 a -0,90) y el diagnóstico de cardiopatía isquémica (-2,41; -4,36: -0,46). CONCLUSIONES: El grado de prácticas en autocuidado es moderado. La asociación de mejor autocuidado y mayor nivel de conocimientos sobre la IC, potencialmente modificables, subraya la oportunidad de implementar estrategias para su mejora adaptadas a las características diferenciales de los pacientes con IC atendidos de atención primaria

OBJECTIVE: To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care. DESIGN: Cross-sectional and multicentre study. SETTING: Primary Care. PARTICIPANTS: Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona. MAIN MEASUREMENTS: Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care. RESULTS: A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n = 282; R2 conditional = 0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: -1.37; -1.85 to -0.90), and coronary heart disease diagnosis (-2.41; -4.36: -0.46). CONCLUSION: Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care

[Heart failure in primary care: Attitudes, knowledge and self-care]. / Insuficiencia cardiaca en atención primaria: actitudes, conocimientos y autocuidado.

OBJECTIVE: To determine the attitudes, knowledge, and self-care practices in patients with heart failure (HF) in Primary Care, as well as to identify factors associated with better self-care. DESIGN: Cross-sectional and multicentre study. SETTING: Primary Care. PARTICIPANTS: Subjects over 18 years old with HF diagnosis, attended in 10 Primary Health Care Centres in the Metropolitan Area of Barcelona. MAIN MEASUREMENTS: Self-care was measured using the European Heart Failure Self-Care Behaviour Scale. Sociodemographic and clinical characteristics, tests on attitudes (Self-efficacy Managing Chronic Disease Scale), knowledge (Patient Knowledge Questionnaire), level of autonomy (Barthel), and anxiety and depression screening (Goldberg Test), were also gathered in an interview. A multivariate mixed model stratified by centre was used to analyse the adjusted association of covariates with self-care. RESULTS: A total of 295 subjects (77.6%) agreed to participate, with a mean age of 75.6 years (SD: 11), 56.6% women, and 62% with no primary education. The mean self-care score was 28.65 (SD: 8.22), with 25% of patients scoring lower than 21 points. In the final stratified multivariate model (n=282; R2 conditional=0.3382), better self-care was associated with higher knowledge (coefficient, 95% confidence interval: -1.37; -1.85 to -0.90), and coronary heart disease diagnosis (-2.41; -4.36: -0.46). CONCLUSION: Self-care was moderate. The correlation of better self-care with higher knowledge highlights the opportunity to implement strategies to improve self-care, which should consider the characteristics of heart failure patients attended in Primary Care.

Ser residente de enfermería familiar y comunitaria ¿Cómo informarme para elegir unidad docente? / Finding information to choose a training unit to become a Family and Community Nursing Resident?

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Conocimientos y actitudes sobre el manejo del dolor por parte de las enfermeras de unidades de cirugía y oncología de hospitales de nivel iii / Knowledge and attitudes on pain management by nurses in surgery and oncology in level III hospitals

Objetivos. Identificar los conocimientos y actitudes que sobre el dolor tienen las enfermeras de las unidades de cirugía general y oncología de hospitales de nivel iii, y conocer si existen diferencias entre ambos grupos. Método. Estudio multicéntrico, observacional, analítico y transversal, que se realizó en las unidades de cirugía general y oncología de 5 hospitales españoles de nivel iii. Los sujetos de estudios fueron todas las enfermeras que trabajaban en las unidades mencionadas. Se recogieron variables demográficas, laborales y el nivel de formación sobre el dolor. Para valorar los conocimentos y las actitudes se utilizó el cuestionario validado Nurses’ Knowledge and Attitudes Survey Regarding Pain. Resultados. De los 236 cuestionarios entregados, se recogieron correctamente cumplimentados 170 (72%). Indicaron haber realizado formación específica sobre el dolor 96 enfermeras (58%). El 85% (145) opinó que los pacientes no debían tener dolor, y el 14,7% (25) respondió que era normal que éstos tuvieran dolor moderado o intenso. El 93,8 % (152) estaba de acuerdo en que el juez más exacto para valorar la intensidad del dolor es el paciente; el 46% (74) consideraba que el 10% de los pacientes exageraba la intensidad del dolor. El 61,9% (52) desconocía la equivalencia entre morfina oral e intravenosa. La mediana global de respuestas correctas, de las 37 que recoge el cuestionario, es de 18 respuestas correctas (min = 0, máx = 28), categorizadas en una puntuación de 0 a 10; la mediana obtenida fue de 5 (min = 0, máx = 8). Conclusiones. El nivel de conocimientos que sobre el dolor tienen las enfermeras estudiadas no es demasiado elevado. Sería necesario impartir formación específica y evaluar su impacto(AU)

Objective. Identify the knowledge and attitudes on pain by nurses in general surgery and oncology units in Level III hospitals, and to find out if there are any differences between groups. Method. A multicentre, observational, analytical and cross-sectional study conducted in the general surgery and oncology units in 5 Spanish level III hospitals. Study subjects were all nurses working in these units. We collected demographic variables, as well as employment and training on the level of pain. To assess the knowledge and attitudes the Nurses’ Knowledge and Attitudes Survey Regarding Pain questionnaire was used. Results. Of the 236 questionnaires delivered, 170 were successfully completed (72%). A total of 96 nurses (58%) indicated that they had received specific training on pain. A large majority, 85% (145) felt that patients should not have pain, and 14.7% (25) said it was normal that they should have moderate or intense pain. A total of 93.8% (152) were in agreement that the person to assess the intensity of pain more accurately is the patient, 46% (74) considered that 10% of patients exaggerated the intensity of pain. The majority, 61.9% (52), did not know the equivalence between oral and intravenous morphine. The overall median of correct answers, of which there was 37 in the questionnaire, was 18 (min=0, max=28), categorized as a score of 0 to 10, the median was 5 (min=0, max=8). Conclusions. The level of knowledge that the nurses studied had on pain was not very high. Specific training is required and its impact evaluated(AU)

[Knowledge and attitudes on pain management by nurses in surgery and oncology in level III hospitals]. / Conocimientos y actitudes sobre el manejo del dolor por parte de las enfermeras de unidades de cirugía y oncología de hospitales de nivel iii.

OBJECTIVE: Identify the knowledge and attitudes on pain by nurses in general surgery and oncology units in Level III hospitals, and to find out if there are any differences between groups. METHOD: A multicentre, observational, analytical and cross-sectional study conducted in the general surgery and oncology units in 5 Spanish level III hospitals. Study subjects were all nurses working in these units. We collected demographic variables, as well as employment and training on the level of pain. To assess the knowledge and attitudes the Nurses' Knowledge and Attitudes Survey Regarding Pain questionnaire was used. RESULTS: Of the 236 questionnaires delivered, 170 were successfully completed (72%). A total of 96 nurses (58%) indicated that they had received specific training on pain. A large majority, 85% (145) felt that patients should not have pain, and 14.7% (25) said it was normal that they should have moderate or intense pain. A total of 93.8% (152) were in agreement that the person to assess the intensity of pain more accurately is the patient, 46% (74) considered that 10% of patients exaggerated the intensity of pain. The majority, 61.9% (52), did not know the equivalence between oral and intravenous morphine. The overall median of correct answers, of which there was 37 in the questionnaire, was 18 (min=0, max=28), categorized as a score of 0 to 10, the median was 5 (min=0, max=8). CONCLUSIONS: The level of knowledge that the nurses studied had on pain was not very high. Specific training is required and its impact evaluated.