La formación y la autopercepción de conocimientos teóricos y habilidades prácticas de los enfermeros de Atención Primaria de Salud del Principado de Asturias en procedimientos de urgencia / Formation and self-peception of theoretical knowledge and practical skills by Primary Health Care nurses in Asturias in emergency procedures

OBJETIVO: Estimar la formación recibida y el grado de conocimiento teórico y de habilidad práctica autopercibidos por los enfermeros de Atención Primaria de Salud (APS) de Asturias sobre 40 procedimientos de urgencia, así como sus características. MÉTODO: Estudio transversal en una muestra aleatoria y representativa de 236 enfermeros obtenida sobre el total de enfermeros de APS de Asturias (nivel de confianza del 99%) mediante una encuesta estructurada y autoadministrada, elaborada ad hoc y previamente evaluada. RESULTADOS: Los enfermeros perciben tener un conocimiento teórico general de los procedimientos de urgencia de nivel medio (6,39 sobre 10; desviación estándar = 1,56), así como una habilidad práctica general también de nivel medio (6,50 sobre 10; desviación estándar = 1,46) con diferencias significativas (p < 0,05) entre los distintos procedimientos y áreas de salud. Algunos procedimientos muy relevantes en urgencia como la canalización de vías venosas, soporte vital básico o uso de desfibriladores tenían tanto un nivel de conocimiento teórico como de habilidad práctica significativamente bajos (p < 0,05). DISCUSIÓN: Existen diferencias significativas, tanto a nivel teórico como práctico, en los conocimientos específicos de cada uno de los procedimientos. Mayoritariamente, se percibe tener un mejor grado de conocimiento teórico que de habilidad práctica para atender situaciones de urgencia. Es por ello necesario que la administración sanitaria asegure una homogeneidad adecuada en los niveles de conocimiento teórico y de habilidad práctica de su personal de enfermería

OBJECTIVE: To estimate the formation and the self-perceived level of theoretical knowledge and practical skills of Primary Health Care (APS) of Asturias in 40 procedures of Emergency Medicine, as well as its characteristics. METHOD: Cross-sectional study of a randomized and representative sample of 236 nurses (n) on the total of 730 APS nurses (N) of Asturias on MUE procedures using a structured questionnaire in 2 dimensions, ad hoc and previously evaluated. RESULTS: The nurses perceive to have a general theoretical knowledge of the procedures of urgency and emergency of average level (6,39 on 10; standard deviation = 1,56), as well as a general practical skill also of average level (6,50 on 10; standard deviation = 1,46) with significant differences (p < 0,05) between the different procedures and areas of health. Some highly excellent procedures in urgency and emergency like the canalization of venous routes, basic vital support or use of defibrillators had so much a level of theoretical knowledge as of practical skill significantly low (p < 0,05). DISCUSSION: Significant differences exist, both at theoretical and practical level, in the specific knowledge of each of the procedures. For the most part it is perceived to have a better grade of theoretical knowledge than of practical skill to attend to situations of urgency and emergency. It is for it necessarily that the Sanitary Administration assures a homogeneity adapted in the levels of theoretical knowledge and of practical skill of nurses

Self-Perception of Theoretical Knowledge and Practical Skills by Primary Health Care Physicians in Life-Threatening Emergencies.

OBJECTIVES: The goal of this study was to find out the training received in Urgent and Emergency Medicine (UEM) by the Primary Health Care (PHC) physicians of Asturias (Spain), as well as their perception of their own theoretical knowledge and practical skills in a series of procedures employed in life-threatening emergencies (LTEs), and also to analyze the differences according to the geographical area of their work. METHODS: This was a cross-sectional survey of PHC physicians using an ad hoc survey of a sample of 213 physicians in Asturias regarding their self-perception of theoretical knowledge and practical skills in techniques used in LTEs by areas of work (rural, suburban, and urban). The interview was conducted by mail from April through May 2017. The data processing has used absolute and relative frequencies, as well as central tendency parameters and dispersion parameters. The estimates for the entire population have been made using confidence intervals for the mean of 95%. In the comparison of parameters, the differences between parameters with a probability of error less than five percent (P<.05) have been considered significant. For the comparison of means between the different techniques in the different areas of work, ANOVA was used. RESULTS: With respect to the training of physicians, in general, for managing emergencies, both at the regional level and by areas of work (rural, suburban, and urban), none of the sets analyzed attained five points. By areas of work, it was the suburban region where there was a greater average general level of knowledge. There were significant differences in the average theoretical knowledge and the average practical skills in the procedures studied according to the different areas of work. The greater number of significant differences was between the urban and suburban regions and within the urban area. CONCLUSIONS: It's necessary to ensure an adequate homogeneity of the levels of theoretical knowledge and practical skills of PHC physicians in order to guarantee the equity of provision of health care in emergencies in different geographical areas. Cernuda MartínezJA, Castro DelgadoR, Ferrero FernándezE, Arcos GonzálezP. Self-perception of theoretical knowledges and practical skills by primary health care physicians in life-threatening emergencies. Prehosp Disaster Med. 2018;33(5):508-518.

Conocimientos teóricos y habilidades prácticas autopercibidas en medicina de urgencia y emergencia de los médicos de Atención Primaria de Salud de Asturias / Self- perceived theoretical knowledges and practice skills in Emergency Medicine by physicians of Asturias Primary Health Care

OBJETIVO: Conocer la formación recibida por los médicos de atención primaria de salud (APS) de Asturias y estimar su grado de conocimiento teórico y habilidad práctica autopercibida en 49 procedimientos de medicina de urgencia y emergencia (MUE). MÉTODO: Estudio observacional de corte transversal de una muestra aleatoria y representativa de 213 médicos (n) sobre los 851 médicos (N) de la plantilla de APS de Asturias acerca de procedimientos de MUE mediante un cuestionario estructurado en 2 dimensiones. RESULTADOS: La formación recibida en MUE se percibe de nivel medio (6 sobre 10), el conocimiento teórico general es de nivel medio (5,9 sobre 10), con diferencias significativas según el procedimiento estudiado (rango de 2 a 9 sobre 10). También se percibe como de nivel medio la habilidad práctica general en MUE (media de 5,5 sobre 10). Se percibe tener un mejor grado de conocimiento teórico que de habilidad práctica para actuar en situaciones de urgencia y emergencia. En Asturias el porcentaje medio de adquisición de las competencias en los procedimientos estudiados es bajo (24,87% para conocimientos teóricos y 21,93% en habilidades prácticas) y disminuye con los años trabajados. CONCLUSIONES: La formación en MUE de los médicos de APS en Asturias es heterogénea y percibida como de nivel medio, con deficiencias en procedimientos relevantes. Es necesario que las administraciones sanitarias evalúen adecuada y periódicamente estos conocimientos y habilidades en los médicos para ser capaces de garantizar un nivel de calidad asistencial adecuado a la urgencia y emergencia

OBJECTIVE: To determine the training received by the physicians of Primary Health Care (APS) of Asturias and estimate their self-perceived level of theoretical knowledge and practical skills in 49 procedures Emergency Medicine procedures (MUE). METHOD: A cross-sectional study was conducted on a randomised and representative sample of 213 physicians (n) from the total of 851 APS physicians (N) of Asturias on MUE procedures using a structured questionnaire in two dimensions. RESULTS: Training received in MUE is perceived as medium level (6 out of 10), general theoretical knowledge as intermediate level (5.9 out of 10), with significant differences according to the procedure studied (range 2 to 9 out of 10). General practical skills in MUE are also perceived as average level (mean of 5.5 out of 10). It is perceived to have a better level of theoretical knowledge than practical ability to face emergency situations. In Asturias the mean percentage of acquisition of competences in the procedures studied is low, (24.87% for theoretical knowledge and 21.93% for practical skills) and decreases with the years employed. CONCLUSIONS: Education in MUE of APS physicians in Asturias is heterogeneous, and is perceived as average level, with deficiencies in relevant procedures. Health administrations need to adequately and periodically evaluate this knowledge and skills in physicians to be able to guarantee the level of quality emergency healthcare

La mortalidad por desastres en España: Un análisis del periodo 1950-2012 / Disaster mortality in Spain: An analysis of the period 1950-2012

Objetivo principal: Estimar el impacto en mortalidad de los desastres en España y sus tendencias epidemiológicas entre 1950 y 2012. Metodología: Estudio observacional retrospectivo con análisis de tendencias mediante análisis de regresión y suavizado exponencial. Resultados principales: Se estudiaron 284 desastres ocurridos en España entre 1950 y 2012. 57% fueron desastres tecnológicos, 39% desastres naturales (64% biológicos) y 4% deliberados (atentados terroristas). Aumentaron significativamente (p<0,05) la frecuencia total de desastres, los naturales, los tecnológicos y los subgrupos de desastres biológicos, climatológicos y de transporte. Disminuyó significativamente (p<0,05) la mortalidad total por desastres y la más alta por episodio fue por tecnológicos. Conclusión principal: España tiene un patrón mixto de desastres, con predominio de los tecnológicos. Aumentaron la frecuencia de episodios, específicamente biológicos, climatológicos y de transporte. La mortalidad está condicionada por los eventos de alto impacto

Objective: To estimate the impact on mortality due to disasters in Spain since1950 to 2012 and its epidemiological trends. Methods: Retrospective observational study with trend analysis by regression analysis and exponential smoothing. Results: We studied 284 events during the period. 57% were technological disasters (81% transport accidents), 39% were natural disasters (64% biological disasters) and 4% deliberated events. We found a significant (p<0,05) increasing trend in the total number of disasters, as well in natural and technological disaster groups, and also in the biological, climatological and transport accident subgroups. Technological disasters show highest average mortality per episode. Decreasing mortality trend was found significant (p<0,05). Conclusions: Spain showed a mixed pattern of disaster type although technological ones are the most frequent. There is an upward trend of disaster frequency, especially in biological, climatological and transport accident subgroups. Mortality is determined by high-impact events

Uso de Internet por parte de los adolescentes de Gijón (Asturias) como fuente de información sobre salud / Internet use by teenagers from Gijón (Asturias) as a source of health information

ObjetivosValorar el uso de Internet como fuente de información sobre salud por parte de los adolescentes y la fiabilidad que otorgan a ésta, así como la aceptabilidad de un servicio de correo electrónico para resolver sus dudas.DiseñoEstudio descriptivo transversal.EmplazamientoCentros de enseñanza secundaria. Gijón (Asturias).ParticipantesCuatrocientos setenta y cinco alumnos (1.o y 4.o de ESO, y 1.o de Bachillerato) seleccionados por muestreo por conglomerados bietápico.Mediciones principalesCuestionario autocumplimentado de 10 preguntas.VariablesEdad, sexo, disponibilidad de Internet en casa, tiempo diario de uso, temas consultados, fuente de consulta de salud, fiabilidad de la información obtenida, disposición para utilizar un correo electrónico de consultas de salud.ResultadosCuatrocientos sesenta y ocho cuestionarios válidos. El 88,5% tiene Internet en casa; el 42,5% lo usa más de una hora diaria entre semana, y el 74% lo usa durante el fin de semana. Los temas más consultados fueron ejercicio físico (29,5%), imagen personal (23,3%) y piercing-tatuajes (18,4%). Internet es el cuarto recurso utilizado para dudas de salud (13,9%), por detrás de la familia, el médico y los amigos. El 56% otorga escasa fiabilidad a la información sobre salud obtenida en Internet. El 70,5% utilizaría una dirección de correo electrónico en la que se ofreciesen respuestas a dudas de salud.ConclusionesDisponibilidad de Internet en domicilio por encima de la media nacional. Alta utilización pero escasa para información de salud, a la que se otorga baja credibilidad. Sería recomendable la puesta en marcha de un servicio de correo electrónico para adolescentes atendido por un equipo multidisciplinario desde Atención Primaria(AU)

ObjectivesTo evaluate the use of Internet as a source of health information by adolescents, its reliability and the acceptability of an email service for their questions.DesignCross-sectional study.SettingSecondary schools. Gijón (Asturias).Participants475 students (1st and 4th Secondary, and 1st High School) selected by two-stage cluster sampling.Main outcome measuresSelf-administered questionnaire of ten items.VariablesAge, sex, availability of Internet at home, daily time use, subjects consulted, source health consultation, information obtained reliability, willingness to use e-mail health consultations.ResultsA total of 468 valid questionnaires, of which 88.5% had Internet at home, 42.5% use more than one hour daily on weekdays and 74% during the weekend. The most accessed topics were physical exercise (29.5%), self-image (23.3%) and piercing, and tattoos (18.4%). Internet is the fourth resource used for health concerns (13.9%), behind family, doctor and friends. The majority, 56%, gave a very low reliability to health information obtained on Internet. A total of 70.5% would use an email address that provided answers to health questions.ConclusionsAvailability of Internet at home is above the national average. High usage but low for health information, which gives low credibility. It would be advisable to start a mail service for adolescents treated by a multidisciplinary team from Primary Care(AU)

[Internet use by teenagers from Gijón (Asturias) as a source of health information]. / Uso de Internet por parte de los adolescentes de Gijón (Asturias) como fuente de información sobre salud.

OBJECTIVES: To evaluate the use of Internet as a source of health information by adolescents, its reliability and the acceptability of an email service for their questions. DESIGN: Cross-sectional study. SETTING: Secondary schools. Gijón (Asturias). PARTICIPANTS: 475 students (1st and 4th Secondary, and 1st High School) selected by two-stage cluster sampling. MAIN OUTCOME MEASURES: Self-administered questionnaire of ten items. VARIABLES: Age, sex, availability of Internet at home, daily time use, subjects consulted, source health consultation, information obtained reliability, willingness to use e-mail health consultations. RESULTS: A total of 468 valid questionnaires, of which 88.5% had Internet at home, 42.5% use more than one hour daily on weekdays and 74% during the weekend. The most accessed topics were physical exercise (29.5%), self-image (23.3%) and piercing, and tattoos (18.4%). Internet is the fourth resource used for health concerns (13.9%), behind family, doctor and friends. The majority, 56%, gave a very low reliability to health information obtained on Internet. A total of 70.5% would use an email address that provided answers to health questions. CONCLUSIONS: Availability of Internet at home is above the national average. High usage but low for health information, which gives low credibility. It would be advisable to start a mail service for adolescents treated by a multidisciplinary team from Primary Care.