Validación del cuestionario CTM-3-modificado sobre satisfacción con la continuidad de cuidados: un estudio de cohortes / Validation of the CTM-3-Modified Questionnaire on Satisfaction with Continuity of Care: A Cohort Study / Validação do questionário CTM-3-modificado sobre a satisfação com a continuidade de cuidados: um estudo de coortes

RESUMEN Objetivos: validar el contenido y constructo de la encuesta CTM-3 (Care Transitions Measure- 3 preguntas) modificada. Determinar el nivel de satisfacción de los usuarios con la continuidad de cuidados de enfermería interniveles y relacionarlo con la presencia de Informe de Cuidados de Enfermería tras su última hospitalización. Material y método: estudio de cohortes retrospectivo, con 131 pacientes hospitalizados en el Complejo Hospitalario de Cartagena (España).La satisfacción con la continuidad de cuidados se valoró con el cuestionario CTM-3-modificado, resultado de un proceso de validación realizado sobre el mismo. Resultados: un 94% de los encuestados presenta una satisfacción aceptable con el proceso de continuidad de cuidados. Los pacientes con Informe de Cuidados tienen un nivel alto de satisfacción con la continuidad de cuidados, RR= 0,90 (IC 95%: 0,831-0,990). Conclusiones: La validez de contenido y constructo realizadas, han permitido medir la satisfacción de los usuarios con la continuidad y su correlación con la presencia de informe, obteniendo como resultado que la realización de Informe de Cuidados influye ligeramente en la satisfacción con el proceso de continuidad de cuidados. Sin embargo, el hecho de que el informe se entregue en mano y/o se explique no parece afectar a la misma.

ABSTRACT Objectives: validate the content and construction of the modified CTM-3 survey (Care Transitions Measure - 3 questions). Determine the level of user satisfaction with the continuity of intermediate-level nursing care and relate it to the presence of a nursing care report after the most recent hospitalization. Material and method: A retrospective cohort study was conducted with 131 patients hospitalized at the Cartagena Hospital Complex (Spain). Satisfaction with the continuity of care was assessed with the CTM-3-modified questionnaire, which is the result of an earlier validation process. Results: Ninety-four percent (94%) of those who responded to the questionnaire indicated acceptable satisfaction with the continuity-of-care process. Patients with a care report have a high level of satisfaction with the continuity of care: RR = 0.90 (95% CI: 0.831-0.990). Conclusions: The content and construct validity of the questionnaire make it possible to measure user satisfaction with the continuity of care and its correlation to the presence of a care report, the result being that preparation of a care report slightly influences the level of satisfaction with the continuity-of-care process. On the other hand, the fact that the report is delivered by hand and/or explained appears to have no effect.

RESUMO Objetivos: validar o conteúdo e constructo do questionário CTM-3 (Care Transitions Measure - três perguntas) modificado. Determinar o nível de satisfação dos usuários com a continuidade de cuidados de enfermagem interníveis e relacioná-lo com a presença de relatório de cuidados de enfermagem após sua última hospitalização. Material e método: estudo de coortes retrospectivo, com 131 pacientes hospitalizados no Complexo Hospitalar de Cartagena (Espanha). A satisfação com a continuidade de cuidados foi avaliada com o questionário CTM-3-modificado, resultado de um processo de validação realizado sobre este. Resultados: 94 % dos entrevistados apresentam satisfação aceitável com o processo de continuidade de cuidados. Os pacientes com relatório de cuidados têm nível alto de satisfação com a continuidade de cuidados, RR= 0,90 (IC 95 %: 0,831-0,990). Conclusões: a validade de conteúdo e constructo realizada permite medir a satisfação dos usuários com a continuidade e sua correlação com a presença de relatório, obtendo como resultado que a realização de relatório de cuidados influencia levemente na satisfação com o processo de continuidade de cuidados. Contudo, o fato de que o relatório seja entregue em mãos e/ou seja explicado não parece afetá-la.

Características de la escala Downton en la valoración del riesgo de caídas en pacientes hospitalizados / Characteristics of the Downton fall risk assessment scale in hospitalised patients

Objetivo: Describir las características de las valoraciones del riesgo de caídas y el perfil de los pacientes que sufrieron caídas en un hospital público del Sistema Nacional de Salud y determinar si existió asociación entre la «presencia de caídas» y la puntuación previa en la escala Downton, con el objeto de calcular algunas de las características de esta herramienta: sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo, odss ratio y razón de verosimilitud. Metodología: diseño descriptivo retrospectivo sobre la incidencia de caídas registradas en el Complejo Hospitalario de Cartagena, realizando un análisis de las posibles causas y consecuencias de las mismas durante el período 2010-2015 (marzo). Un total de 576 pacientes sufrieron caídas durante el periodo analizado, de los cuales 107 no tenían ningún registro de «riesgo de caídas». La muestra final de pacientes fue de 469. El análisis estadístico de datos se realizó con el programa SPSSv.19. Resultados: En el contexto en el que se utiliza, la escala de Downton tiene una sensibilidad del 0,58; una especificidad de 0,62; una razón de verosimilitudes positiva del 1,55 y una razón de verosimilitudes negativa del 0,67. La odss ratio calculada fue de 2,31. Conclusiones: Los datos sobre incidencia de caídas (0,51%) son parecidos a los encontrados en otros trabajos. Los pobres resultados obtenidos en las características de la Escala Downton deberían ser una llamada de atención para las Instituciones Sanitarias. Una herramienta de valoración que clasifique a un paciente de riesgo debe ser incluida en los protocolos de seguridad del paciente si tiene una validez adecuada, y si permite evaluaciones rápidas y fiables que capten los cambios en la situación del paciente, con mejor criterio que el propio profesional de Enfermería (AU)

Objective: To describe the risk of falls assessments properties and profiles of the patients who fell in a public hospital of the National Health System, and to determine the relationship between the «presence of a fall» and the previous score using the Downton scale, in order to calculate some of the features of this tool: sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, and odss ratio. Materials and methods: a study with a descriptive retrospective design was conducted on the incidence of falls recorded in Cartagena Hospital. An analysis was made of possible causes and effects of falls during the period from March 2010 to March 2015. A total of 576 patients fell during the period of the study, of whom 107 were recorded in the no «fall risk» registry, leaving a sample of 469 patients in the study. Data analysis was performed using the SPSSv.19 Statistics Package. Results: In the context in which the assessment was made, the Downton scale had a sensitivity of 0.58, specificity 0.62, a positive likelihood ratio of 1.55, and negative likelihood ratio of 0.67. The odds ratio calculated was 2.31. Conclusions: The data on the incidence of falls (0.51%) are similar to those found in other studies. Poor scores obtained on the Downton Index should serve as a wakeup call for the healthcare institutions. An assessment tool that classifies the at-risk patient should be included in patient safety profiles, provided it is of relevant validity to cover any changes in the patient’s situation, and acts as a better yardstick than the nurses' own assessment (AU)

Characteristics of the Downton fall risk assessment scale in hospitalised patients. / Características de la escala Downton en la valoración del riesgo de caídas en pacientes hospitalizados.

OBJECTIVE: To describe the risk of falls assessments properties and profiles of the patients who fell in a public hospital of the National Health System, and to determine the relationship between the "presence of a fall" and the previous score using the Downton scale, in order to calculate some of the features of this tool: Sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio, and odss ratio. MATERIALS AND METHODS: A study with a descriptive retrospective design was conducted on the incidence of falls recorded in Cartagena Hospital. An analysis was made of possible causes and effects of falls during the period from March 2010 to March 2015. A total of 576 patients fell during the period of the study, of whom 107 were recorded in the no "fall risk" registry, leaving a sample of 469 patients in the study. Data analysis was performed using the SPSSv.19 Statistics Package. RESULTS: In the context in which the assessment was made, the Downton scale had a sensitivity of 0.58, specificity 0.62, a positive likelihood ratio of 1.55, and negative likelihood ratio of 0.67. The odds ratio calculated was 2.31. CONCLUSIONS: The data on the incidence of falls (0.51%) are similar to those found in other studies. Poor scores obtained on the Downton Index should serve as a wakeup call for the healthcare institutions. An assessment tool that classifies the at-risk patient should be included in patient safety profiles, provided it is of relevant validity to cover any changes in the patient's situation, and acts as a better yardstick than the nurses' own assessment.