Estudio observacional de pacientes de una Unidad de Lípidos en tratamiento hipolipemiante para prevención primaria y secundaria: Estudio ULFI / Observational study of patients from a Lipid Unit on lipid-modifying therapy for primary and secondary prevention: ULFI Study

Objetivos: Evaluar la consecución de los objetivos de colesterol unido a lipoproteínas de baja densidad (cLDL) establecidos por las guías europeas de manejo de las dislipemias de 2019 y de prevención cardiovascular de 2021, describir el tratamiento hipolipemiante realizado, analizar el logro de los objetivos según el tratamiento hipolipemiante recibido y estudiar los factores asociados al éxito terapéutico. Diseño: Estudio observacional con 185 pacientes de ambos sexos de 18 años o más en tratamiento hipolipemiante para prevención primaria o secundaria, atendidos en la Unidad de Lípidos. Resultados: El 62,1% de los pacientes presentó un riesgo cardiovascular (RCV) muy alto según la guía de 2019, y el 60,5% según la de 2021. Del total de casos, el 22,7% logró un control adecuado del cLDL según la guía de 2019 y el 20% lo hizo de acuerdo con la de 2021. El 47,6% de los pacientes recibió tratamiento hipolipemiante de muy alta intensidad y el 14,1% lo recibió de extremadamente alta intensidad. El 76% de los sujetos con muy alto RCV en tratamiento hipolipemiante de extremadamente alta intensidad logró los objetivos terapéuticos de ambas guías. En el análisis multivariante, los factores asociados al éxito terapéutico fueron la presencia de enfermedad cardiovascular arteriosclerótica, la intensidad del tratamiento hipolipemiante, la diabetes mellitus y el consumo bajo o moderado de alcohol. Conclusiones: El control de la dislipemia es mejorable. Los tratamientos hipolipemiantes de alta o extremadamente alta intensidad pueden contribuir a optimizar el control de los pacientes con mayor RCV. (AU)

Objectives: To evaluate the achievement of low-density lipoprotein cholesterol (LDLc) goals established by the 2019 European Guidelines for the Management of Dyslipidemias and 2021 Cardiovascular Disease Prevention Guidelines, describe the lipid-lowering treatment received, analyze the achievement of goals according to the lipid-lowering treatment received and study the factors associated with therapeutic success. Design: Observational study that included 185 patients of both sexes aged 18 or over undergoing lipid-lowering treatment for primary or secondary prevention, attended at the Lipid Unit. Results: 62.1% of the patients had a very high cardiovascular risk (CVR) according to the 2019 guidelines, and 60.5% according to the 2021 guidelines. Of the total cases, 22.7% achieved adequate control of LDLc according to the 2019 guidelines and 20% according to the 2021 guidelines. 47.6% of the patients received very high intensity lipid-lowering treatment, and 14.1% received extremely high intensity lipid-lowering treatment. 76% of subjects with very high CVR on extremely high intensity lipid-lowering treatment achieved the therapeutic objectives of both guides. In the multivariate analysis, factors associated with therapeutic success were the presence of arteriosclerotic cardiovascular disease, the intensity of lipid-lowering treatment, diabetes mellitus, and low to moderate alcohol consumption. Conclusions: Dyslipidemia control is improvable. High or extremely high intensity lipid-lowering treatments can contribute to optimizing control of patients with higher CVR. (AU)

Observational study of patients from a Lipid Unit on lipid-modifying therapy for primary and secondary prevention: ULFI Study. / Estudio observacional de pacientes de una Unidad de Lípidos en tratamiento hipolipemiante para prevención primaria y secundaria: Estudio ULFI.

OBJECTIVES: To evaluate the achievement of low-density lipoprotein cholesterol (LDLc) goals established by the 2019 European Guidelines for the Management of Dyslipidemias and 2021 Cardiovascular Disease Prevention Guidelines, describe the lipid-lowering treatment received, analyze the achievement of goals according to the lipid-lowering treatment received and study the factors associated with therapeutic success. DESIGN: Observational study that included 185 patients of both sexes aged 18 or over undergoing lipid-lowering treatment for primary or secondary prevention, attended at the Lipid Unit. RESULTS: 62.1% of the patients had a very high cardiovascular risk (CVR) according to the 2019 guidelines, and 60.5% according to the 2021 guidelines. Of the total cases, 22.7% achieved adequate control of LDLc according to the 2019 guidelines and 20% according to the 2021 guidelines. 47.6% of the patients received very high intensity lipid-lowering treatment, and 14.1% received extremely high intensity lipid-lowering treatment. 76% of subjects with very high CVR on extremely high intensity lipid-lowering treatment achieved the therapeutic objectives of both guides. In the multivariate analysis, factors associated with therapeutic success were the presence of arteriosclerotic cardiovascular disease, the intensity of lipid-lowering treatment, diabetes mellitus, and low to moderate alcohol consumption. CONCLUSIONS: Dyslipidemia control is improvable. High or extremely high intensity lipid-lowering treatments can contribute to optimizing control of patients with higher CVR.

Evaluación de la empatía en estudiantes de Medicina / Empathy assessment in medical students

INTRODUCCIÓN Y OBJETIVOS: La empatía es la capacidad de transmitir comprensión hacia las emociones de otros individuos. La empatía de los profesionales sanitarios se ha asociado a mejores resultados clínicos y de relación con el paciente. El objetivo del estudio era conocer el nivel de empatía de los estudiantes de Medicina, y su evolución después de recibir un curso sobre Entrevista Clínica y Comunicación. MÉTODOS: Estudio longitudinal prospectivo con intervención (módulo de Comunicación y Entrevista Clínica de un mes de duración) y sin grupo control. La empatía se midió con el cuestionario Índice de Reactividad Interpersonal (IRI) que tiene 2 dimensiones cognitivas (toma de perspectiva y fantasía) y 2 emocionales (preocupación empática y distrés personal). La empatía percibida se obtuvo mediante autoevaluación del 0 al 10. RESULTADOS: Participaron 136 alumnos, un 72% eran mujeres, con una edad media de 20,3 años. La empatía percibida correlacionó con las dimensiones del IRI, excepto con distrés personal. Después de la intervención educativa se observaron incrementos en los hombres en toma de perspectiva (de 16,5 a 17,8; p = 0,005) y en las mujeres en fantasía (de 15,5 a 16,7; p = 0,001), con aumento en ambos sexos de la empatía percibida autoevaluada (de 6,9 a 7,4 en hombres; p = 0,009 y de 7,4 a 7,8 en mujeres; p < 0,001). No se modificaron las dimensiones emocionales de empatía. CONCLUSIONES: Los estudiantes de Medicina no perciben dentro de la empatía el componente de distrés personal, y después de la formación se incrementaron los niveles de empatía cognitiva y percibida

INTRODUCTION AND OBJECTIVES: Empathy is the capacity to place oneself in another's position and understand his/her emotions. Empathy of health professionals has been associated with better clinical outcomes and relationship with the patients. The aim of the study is to define the level of empathy of Medical students and how does it evolve after following a one-month Clinical Interview and Communication training module. METHODS: The study is a non-control prospective longitudinal study. Second year Medical students have followed Clinical interview and Communication training module during one month. Empathy has been measured through the Interpersonal Reactivity Index (IRI) questionnaire that has 2 cognitive (perspective taking and fantasy) and 2 emotional (empathic concern and personal distress) dimensions. The perceived empathy was self-assessed using a 1-10 points scale. RESULTS: A sample of 136 students participated on this study (72% women, mean age 20.3 years). The perceived empathy correlates with the size of IRI, except personal distress. Post training intervention scores showed a significant increase in perspective taking dimension among men (from 16.5 to 17.8; P=.005) and fantasy among women (from15.5 to 16.7; P=.001), while self-assessed empathy increased in both sexes (from 6.9 to 7.4 in men; P=.009 and from 7.4 to 7.8 in women; P<.001). CONCLUSIONS: Medical students don't perceive personal distress as an empathy component. After receiving clinical interview and training module, cognitive and perceived empathy were significantly increased

Influencia de factores personales, profesionales y transnacionales en el Síndrome de Burnout en personal sanitario hispanoamericano y español (2007) / Influence of personal, professional and cross-national factors in Burnout Syndrome in Hispanic Americans and Spanish health workers (2007)

Fundamento: La aparición del síndrome de burnout se relaciona con factores ambientales, culturales y personales. Los objetivos de este estudio son comparar la prevalencia de burnout entre profesionales sanitarios de países de habla hispana y explorar su asociación con las características sociodemográficas y profesionales de los trabajadores y con sus percepciones. Métodos: Se ha estudiado el síndrome de burnout en 11.530 profesionales de la salud de habla hispana (51% varones, edad media de 41,7 años). Se utilizó el Maslach Burnout Inventory y un cuestionario de elaboración propia vía online desde el portal sanitario Intramed El período de estudio fue desde diciembre del 2006 hasta septiembre del 2007. Las asociaciones entre variables se estudiaron mediante pruebas de regresión logística. Resultados: La prevalencia de burnout en los profesionales residentes en España fue de 14,9%, del 14,4% en Argentina, y del 7,9% en Uruguay. Los profesionales de México, Ecuador, Perú, Colombia, Guatemala y El Salvador presentaron prevalencias entre 2,5% y 5,9%. Por profesiones, Medicina tuvo una pre- valencia del 12,1%, Enfermería del 7,2%, y Odontología, Psicología y Nutrición tuvieron cifras inferiores al 6%. Entre los médicos el burnout predominaba en los que trabajaban en urgencias (17%) e internistas (15,5%), mientras que anestesistas y dermatólogos tuvieron las prevalencias más bajas (5% y 5,3% respectivamente). Fueron variables protectoras la mayor edad (OR=0,96), tener hijos (OR=0,93), la percepción de sentirse valorado (OR=0,53), el optimismo (OR=0,80), la satisfacción profesional (OR=0,80) y la valoración económica (OR=0,91). Conclusiones: La prevalencia del burnout es mayor en España y Argentina y los profesionales que más lo padecen son los médicos. La edad, tener hijos, la percepción de sentirse valorado, el optimismo, la satisfacción laboral y la valoración económica, son variables protectoras de burnout (AU)

Background: Burnout syndrome is related to cultural and individual factors. The aim of this study was to compare the frequency of burnout and the scores for its three components with the perceptions and the demographic and professional characteristics of the workers. Methods: Burnout syndrome was studied in 11,530 Hispanic Americans and Spanish healthcare professionals (51% male, mean age 41.7 years). The Maslach Burnout Inventory and a previously drawn up questionnaire were administered online from the Intramed website from December 2006 to September 2007. Associations were tested using multiple logistic regression. Results: The frequency of burnout in professionals resident in Spain was 14.9%, in Argentina 14.4%, and in Uruguay 7.9% whereas professionals in Mexico, Ecuador, Peru, Columbia, Uruguay, Guatemala and El Salvador presented frequencies of burnout of between 2.5% and 5.9%. By professions, doctors had a prevalence of burnout of 12.1%, nurses 7.2%, and dentists, psychologists and nutritionists of <6%. Amongst doctors, burnout predominated amongst doctors working in emergency departments (17%) and internal medicine departments (15.5%) whereas anaesthetists and dermatologists had the lowest prevalence (5% and 5.3%, respectively). Older age (OR=0.96), having children (OR=0.93), the perception of feeling valued (OR=0.53), optimism (OR=0.80), job satisfaction (OR=0.80), and satisfaction with salary (OR=0.91) are variables which protect against burnout. Conclusions The expression of burnout varies among nations and professions. Age (older age), having children, the perception of feeling valued, optimism, job satisfaction and satisfaction with salary are protective variables of burnout (AU)

Calidad de vida relacionada con la salud y consumo de tabaco / Health related quality of life and tobacco consumption

La calidad de vida relacionada con la salud se ha descrito como un concepto multidimensionalque incluye la identificación de síntomas, el estado funcional, la percepción debienestar psicológico y la percepción general de salud. En el caso de la adicción al consumode tabaco, la preocupación por la salud actual o futura es uno de los motivos másinformados para dejar de fumar. En el presente estudio se analiza la relación entre la percepciónde la calidad de vida relacionada con la salud y la etapa de cambio en el abandonodel consumo de tabaco propuesta desde el modelo transteórico a fin de mejorar lasestrategias de intervención comunitaria y clínica para la cesación tabáquica. Se ha administradoel cuestionario SF-36 a una muestra formada por 201 fumadores y exfumadores.Los datos obtenidos indican peor salud física percibida en las etapas de cambio más próximasal abandono de tabaco y una peor salud mental percibida en las etapas con tabaquismoactivo. Se comparan los resultados con los observados en otras poblaciones y sediscuten las implicaciones a nivel de tratamiento y prevención del tabaquismo

Health-related quality of life (HRQL) has been described as a multidimensional conceptthat includes symptoms identification, functional condition, psychological wellbeing perceptionand general health perception. In the case of nicotine addiction, the concern aboutcurrent or future health is one of the most reported reasons for smoking cessation. Themain goal of this research is to investigate the relationship between HRQL perception andtobacco cessation stage formulated by the Tran theoretical model, with the aim to improvecommunity and clinical interventions. SF-36 questionnaire has been administered to asample of 201 smokers and ex-smokers. Results show worse perceived physical health instages of change closer to smoking cessation and worse perceived mental health in stagesof change with active tobacco habit. Results are compared with previous studies, whileimplications for tobacco consumption and prevention are discussed

El optimismo de los profesionales sanitarios y su relación con la calidad de vida, el burnout y el clima organizacional / Optimism in health workers and its relationship with quality of life, burnout syndrome, and organizational environment

Objetivo: Conocer la autoevaluación del grado de optimismo de los trabajadores sanitarios hospitalarios, y su relación con la calidad de vida relacionada con la salud, el síndrome del desgaste profesional y el clima organizacional de la empresa. Pacientes y método: Estudio observacional transversal descriptivo en una muestra de 1.086 trabajadores sanitarios hospitalarios. Se cuantificó el grado de optimismo mediante una escala analógica visual de 0 (nada optimista) a 10 (totalmente optimista) con las respuestas a la pregunta "¿se considera una persona optimista?". La puntuación de optimismo se codificó como nivel de optimismo inferior (NoI) para valores de 0 a 5; nivel de optimismo medio (NoM), entre 6 y 8, y nivel superior (NoS), para los valores 9 y 10. Se estudió el clima organizacional de la empresa, el desgaste profesional (Maslach Burnout Inventory) y la calidad de vida relacionada con la salud (SF-36). Resultados: La mediana de optimismo fue 7 con un percentil 25 de 6 y un percentil 75 de 8. Un 19,2% se clasificó como NoI y un 18%, como NoS. Las personas con un mayor nivel de optimismo tuvieron mayores puntuaciones en calidad de vida en todas las dimensiones del SF-36, menor desgaste profesional y una mejor percepción del clima organizacional. Conclusiones: La autovaloración de los trabajadores sanitarios tuvo una tendencia hacia los valores altos de optimismo. Se observaron mejores resultados en las tres escalas medidas a mayor nivel de optimismo. El optimismo debe ser una variable a controlar en los estudios de valoración de la salud percibida y de desgaste profesional

Objectives: To identify self-reported levels of optimism in hospital health workers and to study its relationship with health-related quality of life, burnout syndrome, and the hospital's organizational environment. Patients and method: We performed an observational, descriptive, cross-sectional study in a sample of 1,086 hospital health workers. The level of optimism was quantified through a visual analog scale from 0 (not at all optimistic) to 10 (totally optimistic) in which the workers responded to the question "Do you consider yourself to be an optimistic person?" The optimism score was codified so that levels from 0 to 5 were considered to indicate a low level of optimism, values from 6 to 8 to indicate medium levels of optimism, and scores of 9 and 10 to indicate a high level of optimism. The relationship between optimism and the hospital's organizational environment, burnout syndrome (Maslach Burnout Inventory), and health-related quality of life (SF-36 health questionnaire) was studied. Results: The median level of optimism was 7 with a 25th percentile of 6 and 75th percentile of 8. A total of 19.2% were classified as having a low level of optimism and 18% as having a high level of optimism. High levels of optimism corresponded to better quality of life in all aspects of the SF-36, lower levels of occupational burnout and a more favorable perception of the organizational environment. Conclusions: The health workers' self-evaluation tended toward high scores for optimism. Better results were found in the three scales measured when optimism was higher. Optimism is a factor that should be taken into account in studies evaluating perceived health and occupational burnout

Desgaste profesional en el personal sanitario y su relación con los factores personales y ambientales / Burnout syndrome in health workers and relationship with personal and environmental factors

Objetivos: Entre los profesionales sanitarios se han hallado altos índices de desgaste profesional. Nuestro objetivo fue estudiar la prevalencia del síndrome de desgaste profesional en los trabajadores sanitarios hospitalarios, y valorar su relación con los factores personales y ambientales. Métodos: Un total de 2.290 trabajadores sanitarios de 5 hospitales de Girona fueron invitados a participar. Se les administró un cuestionario de elaboración propia, una encuesta del clima organizacional, y el Maslach Burnout Inventory, que incluye tres dimensiones: cansancio emocional, despersonalización y baja realización personal. Resultados: Contestaron la encuesta 1.095 trabajadores (con un 47,8% de participación). Un 41,6% presentó un alto nivel de cansancio emocional, sobre todo los médicos y el personal de enfermería; un 23% tuvo un alto nivel de despersonalización, sobre todo los médicos, y un 27,9% tuvo una baja realización personal, en especial los técnicos y los médicos. Mediante un análisis de regresión logística múltiple, se asoció un alto nivel de cansancio emocional al consumo de tranquilizantes o antidepresivos con asiduidad, mientras que el optimismo y la satisfacción profesional mostraron una asociación inversa. Los años de profesión, el optimismo, valorar como útil el trabajo y percibir que se es valorado por los demás se asociaron inversamente con un alto nivel de despersonalización. La baja realización personal se asoció inversamente con el optimismo, la valoración de la utilidad del trabajo y el equipo de trabajo. Conclusiones: A partir de los resultados obtenidos, recomendamos mejorar el clima organizacional y potenciar el optimismo y la autoestima individual, para disminuir el desgaste profesional en los hospitales

Objectives: High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health workers and to determine its relationship with personal and environmental factors. Methods: A total of 2290 health workers from five hospitals in the province of Girona (Spain) were invited to participate. Interviewees were given a specifically designed questionnaire, a questionnaire on organizational climate, and the Spanish version of the Maslach Burnout Inventory, which includes three scales: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: Responses were received from 1095 health workers (a response rate of 47.8%). A high level of emotional exhaustion was found in 41.6% of staff members, especially among doctors and nurses; a high level of depersonalization was found in 23%, mainly among doctors, and reduced personal accomplishment was found in 27.9%, mainly among technicians and doctors. Multiple logistic regression revealed that a high level of emotional exhaustion was associated with frequent consumption of tranquilizers or antidepressants, whereas optimism and job satisfaction showed an inverse association. The variables that were inversely associated with a high level of depersonalization were the number of years in the profession, optimism, evaluation of work as being useful and the perception of being valued by others. Reduced personal accomplishment was also inversely associated with optimism, satisfaction with the usefulness of one's work, and satisfaction with teamwork. Conclusions: In view of the results obtained, to reduce professional burnout in hospitals, optimism and a sense of self-worth among individuals should be encouraged and the organizational environment should be improved

[Burnout syndrome in health workers and relationship with personal and environmental factors]. / Desgaste profesional en el personal sanitario y su relación con los factores personales y ambientales.

OBJECTIVES: High rates of professional burnout syndrome have been found among health service professionals. Our objective was to study the prevalence of burnout syndrome in hospital health workers and to determine its relationship with personal and environmental factors. METHODS: A total of 2290 health workers from five hospitals in the province of Girona (Spain) were invited to participate. Interviewees were given a specifically designed questionnaire, a questionnaire on organizational climate, and the Spanish version of the Maslach Burnout Inventory, which includes three scales: emotional exhaustion, depersonalization, and reduced personal accomplishment. RESULTS: Responses were received from 1095 health workers (a response rate of 47.8%). A high level of emotional exhaustion was found in 41.6% of staff members, especially among doctors and nurses; a high level of depersonalization was found in 23%, mainly among doctors, and reduced personal accomplishment was found in 27.9%, mainly among technicians and doctors. Multiple logistic regression revealed that a high level of emotional exhaustion was associated with frequent consumption of tranquilizers or antidepressants, whereas optimism and job satisfaction showed an inverse association. The variables that were inversely associated with a high level of depersonalization were the number of years in the profession, optimism, evaluation of work as being useful and the perception of being valued by others. Reduced personal accomplishment was also inversely associated with optimism, satisfaction with the usefulness of one's work, and satisfaction with teamwork. CONCLUSIONS: In view of the results obtained, to reduce professional burnout in hospitals, optimism and a sense of self-worth among individuals should be encouraged and the organizational environment should be improved.