Socioeconomic Factors and Quality of Life Perceived by Parents and Children with Complex Chronic Conditions in Spain.

Health-related quality of life of children with complex chronic conditions could be affected by sociodemographic factors. Most studies focus exclusively on the parents' perceptions of quality of life. This study aimed to determine the health-related quality of life of these children, according to their parents and the children themselves. A cross-sectional study was developed on children aged over five years with complex chronic conditions. Health-related quality of life, educational attainment, and social status were evaluated. A total of 101 children were included with a mean age of 10.48 years, and 35.6% were female. The most frequent disease was oncological (28.7%). Children perceived a better health-related quality of life, compared to their parents' assessment: median difference -8.4 (95%CI: -9.2 to -3.8). Moreover, differences were observed by socioeconomic factors. Parents and children with complex chronic conditions perceive differently the health-related quality of life. Social determinants associate with an uneven perceived quality of life.

Sesiones clínicas de cuidados para profundizar en el pensamiento enfermero / Clinical sessions on patient care in order to probe into what nurses think

Desde 2009 el Hospital Universitario Virgen de las Nieves (HUVN), en Granada, viene realizando sesiones clínicas de cuidados con el objetivo de profundizar en el uso de la metodología enfermera, y crear el hábito de la reflexión continua sobre la calidad de los cuidados que se aplican. Con este trabajo se pretende dar a conocer la experiencia desarrollada durante los años 2011-2012 en la realización de sesiones clínicas de cuidados. Durante el periodo estudiado se han desarrollado un total de 35 sesiones clínicas de este tipo, distribuidas en los centros asistenciales del complejo hospitalario, de las cuales 19 han sido casos clínicos, 12 actualizaciones en cuidados, tres revisiones de guías de práctica clínica y una revisión de proceso asistencial integrado. La media de asistencia a las sesiones ha sido de 16 profesionales por sesión. Los temas tratados incluyen situaciones de salud específicas de interés en las unidades asistenciales, la indagación en diagnósticos diferénciales y la incorporación de la evidencia científica. Como mejora se propone la incorporación de criterios para la evaluación del proceso enfermero y de la estructura de las sesiones clínicas de cuidados

Since 2009, the Hospital Universitario Virgen de las Nieves (HUVN) has been conducting clinical sessions on patient care, with the objective of achieving a deep understanding about the use of nursing methodology, and creating the habit of continuous reflection about the quality of careapplied. This paper intends to make public the experience developed during the years 2011-2012 in terms of clinical sessions on patient care. During the period studied, 35 clinical sessions on patient care have been conducted, distributed among the healthcare centres of the hospital complex; 19 of these have been clinical cases, 12 have been patient care updates, three reviews of clinical practice guidelines, and one review of integrated healthcare system. The average attendance to these sessions was of 16 professionals per session. The topics covered included specific health situations of interest for patient care units, investigation into differential diagnoses, and the incorporation of scientific evidence. As an improvement, it has been suggested to incorporate criteria forthe assessment of the nursing process, and of the structure of clinical sessions on patient care

Evaluación del plan funcional dirigido a personas cuidadoras en hospitalización / Evaluation of a functional plan for caregivers in hospital

Fundamentos: El cuidado de personas dependientes se ha incrementado, por lo que las reformas del sistema sanitario están visibilizando a las personas cuidadoras. Se desarrolló un plan funcional para personas cuidadoras en hospitalización, y esta investigación pretende indagar cómo ha sido su implementación, identificando puntos fuertes y débiles que promuevan cambios entre el sistema formal e informal. Métodos Se diseñó un estudio cualitativo, considerando como sujetos de estudio a los profesionales de enfermería y personas cuidadoras identificadas en el Hospital. Se utilizó la técnica de grupo focal seleccionando 8 personas en cada segmento. Se elaboraron 2 guiones de preguntas con los criterios de evaluación recogidos en las líneas estratégicas del plan: identificación/captación, acogida, descanso, dieta, atención sanitaria, información/educación sanitaria, gestión e implementación y otras propuestas. Los datos se recogieron durante mayo de 2011.ResultadosSe encontraron dificultades en la identificación y captación de las personas cuidadoras, por no realizar su valoración inicial. En cuanto a la acogida, en algunos casos no se entregaba folleto informativo. El descanso no es posible por la renuncia a alejarse de su familiar. La dieta es la principal causa del conflicto y destaca la falta de educación sanitaria para continuar con los cuidados domiciliarios. Se valoran positivamente los circuitos de atención preferente en urgencias. Los profesionales de enfermería consideran que el desarrollo del plan supone una sobrecarga de trabajo. Conclusiones Los puntos fuertes y débiles identificados permitirán establecer mejoras en la implementación del plan para conseguir el cambio en aspectos específicos como la información/educación, atención, descanso y dieta de la persona cuidadora. Destacamos la necesidad de potenciar el cambio de modelo (AU)

BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011.RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change (AU)

[Evaluation of a functional plan for caregivers in hospital]. / Evaluación del plan funcional dirigido a personas cuidadoras en hospitalización.

BACKGROUND: The care of dependent persons has increased, as such that healthcare reforms are taking caregivers into account. A functional plan in hospitalization was developed for caregivers, and his study aims to investigate its implementation, identifying the strengths and weaknesses that promote changes between the formal and informal system. METHODS: A qualitative study was designed, using nursing professionals and caregivers identified in the hospital as subjects. A focus group technique was used with 8 people selected for each segment. Two scripts were developed with questions on the evaluation criteria included in the plan: identification/recruitment, reception, rest, diet, health care, information/health education, management and implementation of the plan and other proposals. The data were collected during May 2011. RESULTS: Difficulties were encountered in identifying caregivers, as an initial evaluation was not made. As regards the reception, in some cases the information brochure was not given. Rest was not possible as the caregivers did not want to move away from the patient. Diet was the main cause of the conflict, highlighting the lack of health education to continue in home care. Circuits of preferential care in emergency were positively valuated. Nurses consider the plan as an extra task. CONCLUSIONS: The strengths and weaknesses identified should enable improvements to be made in the implementation of the plan, in order to achieve changes in specific aspects such as information/education, health, rest and diet of the caregivers. We emphasize the need to enhance the model change.