[Knowledge and attitudes of health care professionals in advance healthcare directives]. / Conocimientos y actitudes sobre voluntades anticipadas en profesionales sanitarios.

BACKGROUND AND OBJECTIVE: The advanced healthcare directive is a new style of health care relationship, based on the respect of the patients autonomous decisions: as well as a valuable tool that enables a proper management of the decisions made at the end of life. The objective of this study was to explore the knowledge and attitudes of the health care professionals regarding the advance directives, as well as the resources for advanced care planning in a municipality of Madrid during 2016-2017. MATERIAL AND METHODS: A cross-sectional descriptive study was carried out on a population of Health care professionals of Primary and Specialised Care. The knowledge and attitudes questionnaire about the advance directives was used. Sociodemographic and knowledge variables related to resources for the advanced care planning. Statistical-descriptive analysis was performed. RESULTS: A total of 431 professionals were included, with a mean age of 44.55 years (SD: 11.1). As regards knowledge about advance directives, the mean score was 5.08 (SD 2.4), with statistically significant differences being found between professional groups. A small percentage (4.6%) of the professionals had their document of Advance directives ready, and 42% of professionals did not know if they were regulated by the Community of Madrid. Less than half (41.5%) of the professionals knew the palliative resources of their institution. CONCLUSIONS: The health care professional's knowledge about advance directives, as well as the resources for the advanced care planning, show deficiencies at training and information level. Almost half of the professionals did not know if these are regulated in the Community of Madrid. They also believe that it would be useful to plan, and very useful to have the Advance directives document ready.

Estudio descriptivo de los pacientes atendidos en una Unidad de Tabaquismo / No disponible

Objetivo: Conocer las características de los pacientes atendidos en nuestra Unidad de tabaquismo así como los resultados obtenidos en términos de abstinencia. Pacientes y métodos: Se revisan los datos recogidos de los pacientes atendidos durante 7 años en nuestra consulta, y realizamos un estudio descriptivo. Se analizan los datos antropométricos, los relativos al consumo de tabaco, el tratamiento prescrito y la abstinencia en las distintas visitas de seguimiento hasta el año de seguimiento. Análisis estadístico con SPSS 15.0. Resultados: De los 518 pacientes revisados atendidos en nuestra Unidad hay un predominio de mujeres (56,4%), con una edad media de 47,11 años, y un consumo tabáquico de 26,6 cigarrillos al día. El tratamiento pautado con más frecuencia ha sido la terapia sustitutiva con nicotina (TSN). La abstinencia a los 6 meses de seguimiento obtenida fue del 63,8%, y al año del 55,8%. Conclusiones: Atendemos a una población de mediana edad con un consumo de tabaco elevado. El tratamiento farmacológico prescrito con mayor frecuencia es la TSN, logrando la abstinencia a los 6 meses más de la mitad de los pacientes atendidos

Purpose: To know the data of patients attending our Smoking Cessation Unit and their abstinence rate. Patients and methods: Review of the data collected along 7 years and descriptive analysis. We studied anthropometric data, smoking habits, treatment prescribed for smoking cessation and abstinence in each visit until one year of follow-up. Statistical analysis with SPSS 15.0. Results: 518 patients studied, 56.4% females, mean age 47.11 years old, smoked 26.6 cigarettes per day. The pharmacological treatment more frequently prescribed was nicotine replacement therapy (NRT). Six-month abstinence was 63.8% and at one year 55.8%. Conclusions: Our patients are middle-aged and have a high rate of smoking consumption. NRT is the treatment more frequently used, with abstinence in more than half of the patients

Edad pulmonar espirométrica: antes y después del abandono del tabaco / Spirometry lung age: before and after quitting smoking

Resumen. Objetivos: Calcular la edad pulmonar espirométrica del fumador. Conocer las diferencias entre la edad cronológica y la edad pulmonar espirométrica antes y un año tras el abandono del tabaco. Averiguar si los datos de consumo de tabaco influyen en dichas diferencias. Analizar estos datos en el subgrupo de pacientes EPOC. Material y métodos: Pacientes que acuden a nuestra consulta de deshabituación tabáquica; se les realiza una espirometría antes y un año tras dejar de fumar. Cálculo de la edad pulmonar espirométrica basal y al año del abandono. Análisis estadístico con SPSS 11.0. Resultados: 117 pacientes, 58,10% mujeres; edad media 47,10 años, edad inicio consumo 16,45 años, consumo medio diario 26,40 cigarrillos. Las cifras de consumo de tabaco no mostraban diferencias significativas entre ambos sexos. La edad media pulmonar del fumador era superior a la cronológica, tanto en varones como en mujeres (12,58 y 1,13 años, respectivamente). Tras un año de abstinencia, el pulmón de los varones tenía 10,97 años más que el propio paciente, mientras que en mujeres la edad pulmonar estaba por debajo de la edad cronológica en 3,67 años. Los datos de consumo de tabaco mostraban correlación con la edad pulmonar antes y después del abandono en ambos sexos. Los fumadores que tenían valores de función pulmonar de EPOC eran 18 (55,6% varones). Estos pacientes presentaban mayores diferencias entre las edades pulmonares final e inicial en ambos sexos frente a la serie global. Conclusión: el pulmón del fumador está “envejecido”. Tras el abandono del tabaco se consigue un rejuvenecimiento del pulmón del fumador. Los pulmones femeninos se benefician más del abandono. La carga tabáquica tiene clara influencia sobre la edad pulmonar inicial y sobre el beneficio tras el abandono. Los pulmones de pacientes EPOC se benefician más del abandono del tabaco (AU)

Abstract. Objectives: To calculate the spirometry lung age of the smoker. To know the differences between chronological age and spirometric lung age before and at one year of quitting smoking. To find out if the tobacco consumption data influence in these differences. To analyze these data in the COPD patient subgroup. Material and methods: Patients who come to our smoking cessation clinic: a spirometry is performed before and one year after they quit smoking. The baseline spirometric lung age and age at one year of smoking cessation is calculated. Statistical analysis is performed with the SPSS 11.0. Results: 117 patients, 58.10% women; mean age 47.10 years, age of onset consumption 16.45 years, mean daily consumption 26.40 cigarettes. There were no significant differences between both genders for tobacco consumption levels. Mean lung age of the smoker is greater than the chronological one, both in men and women (12.58 and 1.13 years, respectively). After one year of abstinence, the lung of the men had 10.97 years more than the real age of the patient, while the lung age in the woman was 3.67 years below the chronological age. The tobacco consumption data showed a correlation with the lung age before and after cessation in both genders. Eighteen (55.6% men) of the smokers had lung function levels of COPD. These patients showed greater differences between the final and initial lung ages in both genders compared to the global series. Conclusion: The lung of the smoker is "aged." After smoking cessation, the smoker's lung was rejuvenated. Female lungs benefit more from the cessation. The tobacco load has a clear influence on the initial lung age and on benefit after cessation. The lungs of COPD patients benefit more from smoking cessation (AU)