Evaluation of Nutritional Interventions in the Care Plan for Cancer Patients: The NOA Project.

The NOA (Oncological Nutrition in Andalusia) project analyses the degree of integration and areas of improvement in implementing nutritional support in the care plans of cancer patients in Andalusia. The aim was to analyse nutritional interventions for better care of cancer patients and for the improvement of the management of malnutrition in cancer. A prospective evaluation of the implementation of two areas of improvement in nutrition was conducted in three hospitals. Data were collected from each hospital over a six-month period using an online platform. A standardised care plan was designed for hospitals in Andalusia, in which proposed improvements were devised and prioritised, selecting nutritional screening in oncology services and the participation of the Nutrition Support Team (NST) on the tumour boards, as well as the assessment of the patients presented at these sessions. Our results indicated an increase in the number of medical records with nutritional evaluation results six months later, regardless of the type of tumour or hospitalisation; and there was greater participation of the NST on the tumour boards, mainly for head and neck and oesophagogastric cases. Solutions for improvement have been pinpointed and implemented that have positively impacted the nutritional care plan in the course of oncological disease.

Significant Decrease in Annual Cancer Diagnoses in Spain during the COVID-19 Pandemic: A Real-Data Study.

The COVID-19 pandemic has caused a profound change in health organizations at both the primary and hospital care levels. This cross-sectional study aims to investigate the impact of the COVID-19 pandemic in the annual rate of new cancer diagnosis in two university-affiliated hospitals. This study includes all the patients with a pathological diagnosis of cancer attended in two hospitals in Málaga (Spain) during the first year of pandemic. This study population was compared with the patients diagnosed during the previous year 2019. To analyze whether the possible differences in the annual rate of diagnoses were due to the pandemic or to other causes, the patients diagnosed during 2018 and 2017 were also compared. There were 2340 new cancer diagnosis compared to 2825 patients in 2019 which represented a decrease of -17.2% (p = 0.0001). Differences in the number of cancer patients diagnosed between 2018 and 2019 (2840 new cases; 0.5% increase) or 2017 and 2019 (2909 new cases; 3% increase) were not statistically significant. The highest number of patients lost from diagnosis in 2020 was in breast cancer (-26.1%), colorectal neoplasms (-16.9%), and head and neck tumors (-19.8%). The study of incidence rates throughout the first year of the COVID-19 pandemic shows that the diagnosis of new cancer patients has been significantly impaired. Health systems must take the necessary measures to restore pre-pandemic diagnostic procedures and to recover lost patients who have not been diagnosed.

[Perceived self-efficacy in patients after a cardiac rehabilitation programme in primary care: A new model of attention.] / Autoeficacia percibida en pacientes tras programa de rehabilitación cardíaca en Atención Primaria: un nuevo modelo de atención.

OBJECTIVE: The literature points to the possibility of carrying out an intervention, from primary prevention to rehabilitation after a cardiac event, towards decreasing the incidence of such cardiac events and facilitating the return to daily life. The objective was to determine the effect of a cardiac rehabilitation intervention over perceived selfefficacy for patients who have suffered a cardiac event. METHODS: A community clinical trial, open, controlled, and randomised, was designed, and performed in primary care. To determine the sample size, the research team used the General Self-Efficacy Scale by Baessler and Schwarzer. The mean difference between groups considered of clinical relevance was of at least 6 points in the aforementioned General Self-Efficacy Scale. A precision of 95% and a test power of 80% were accepted. The result proposed a sample of 44 subjects in each group. Over 12 months, all subjects of legal age (N = 104), both sexes, that had concluded phase II in the cardiac rehabilitation unit of the university Hospital Puerta del Mar (Cadiz) were offered to participate in the study. The patients were informed about the study development, asking for their participation and providing them with a written informed consent. The subjects were randomly assigned to the intervention or control group through blind allocation (in a sealed envelope to the researcher), on a pre-set 2:1 ratio (two patients assigned to the intervention group to one assigned to the control group). A non-response or rejection to participate in the study record was made for the non-response analysis. RESULTS: A total of 89 subjects were included in the statistical analysis (response rate of 85.57%), with an average age of 63.01 years (SD: 8.75). The main dependent variable was the scores difference between groups, comparing means before and after the intervention, through the General Self-Efficacy Scale by Baessler & Schwarner. A mean difference of 6.0972 points was obtained between the intervention and the control groups (p<0.0053; 95% CI -4.1950 to -10.29), as a result of a 3.3750 mean points increase (standard deviation: 7.01) in the intervention group and a 3.3750 mean points decrease (standard deviation: 7.19) in the control group. In relation to the possible changes to be detected through the Hamilton anxiety scale and the Beck's depression inventory, after finishing the intervention, an estimate and contrast of population means was made between groups for the scores difference in the Hamilton scale, determined on the final visit, with no significant differences found (t-student 0.1211; p <0.9 43). Similarly, no significant differences were found between the groups for the means obtained in the variable "Beck's depression inventory scores difference" (t-student -0.1281; p<0.8987). CONCLUSIONS: The inclusion in cardiac rehabilitation programmes carried out in primary care improves the general perceived self-efficacy of patients who have suffered cardiac events.

OBJETIVO: La literatura evidencia la posibilidad de intervención, desde la prevención primaria hasta la rehabilitación tras un evento cardiaco, y así disminuir su incidencia y facilitar la reincorporación a la vida cotidiana. El objetivo de este trabajo fue determinar el efecto sobre la autoeficacia percibida de una intervención en rehabilitación cardiaca a pacientes que han sufrido evento cardíaco. METODOS: Se diseñó un ensayo comunitario abierto, controlado y aleatorizado, realizado en atención primaria de salud. Para determinar el tamaño de muestra, el equipo de investigación utilizó la Escala General de Autoeficacia de Baessler y Schwarzer. La diferencia de medias entre grupos considerada como clínicamente relevante fue de al menos 6 puntos en la puntuación de la Escala General de Autoeficacia. Se aceptó una precisión del 95% y un poder del test del 80%. El resultado propuso una muestra de 44 sujetos en cada grupo. Se propuso participar, a lo largo de 12 meses, a todos los sujetos, mayores de edad (N= 104), de ambos sexos, que concluyeron la fase II en la unidad de RHC del Hospital Universitario Puerta del Mar (Cádiz). Se informó a los pacientes de la realización del estudio pidiéndoles su participación y ofreciendo consentimiento informado por escrito. De forma aleatoria, los sujetos fueron asignados aleatoriamente, siendo esta asignación de forma ciega (en sobre cerrado al investigador), al grupo de intervención o de control, mediante una proporción preestablecida 2:1 (dos pacientes a asignados a grupo intervención por uno a grupo control. Se realizó un registro de la no respuesta o rechazo a participar en el estudio para el análisis de la no respuesta. RESULTADOS: Un total de 89 sujetos fueron incluidos en el análisis estadístico (tasa de respuesta de 85, 57%), con una edad media de 63, 01 años, (DE 8, 75). La variable dependiente principal fue la diferencia de puntuación entre grupos, comparando medias, antes y después de la intervención, en la escala general de autoeficacia de Baessler & Schwarner. Se obtuvo diferencia de medias de 6.0972 puntos entre los grupos de intervención y de control (p<0.0053, IC 95% -4.1950 a -10.29), resultado de un aumento de 3.3750 puntos de media en el grupo de intervención (desviación estándar 7.01), y un descenso de 2.7222 puntos de media (desviación estándar 7.19), en el grupo de control. En relación a los posibles cambios a detectar en las escalas de ansiedad de Hamilton e inventario de depresión de Beck, tras finalizar la intervención, se realizó una estimación y contraste de medias poblacionales entre grupos para la diferencia de puntuaciones en la escala de Hamilton, determinadas en la visita final, no encontrándose diferencias significativas (t student 0.1211; p<0.9 43). De igual forma, no se encontraron diferencias significativas entre grupos para las medias obtenidas en la variable "diferencia de puntuación en inventario de Beck en depresión" (t student -0.1281; p<0.8987). CONCLUSIONES: La inclusión en los programas de rehabilitación cardiaca realizados en atención primaria mejora la autoeficacia general percibida de pacientes que han sufrido eventos cardíacos.

Cardiac Rehabilitation in Primary Care. Impact of an Intervention on Perceived Self-Efficacy.

Cardiac rehabilitation is cost-effective and should be considered a part of the care system provided to patients who have suffered a myocardial infarction or another heart disease. The main variable to study was the scoring, prior to and after the intervention in the General Scale of Self-Efficacy by Baessler & Schwarzer. A clinical community trial that was open controlled and randomised was used. All adult subjects of both sexes who had completed a cardiac rehabilitation program for 12 months at the reference hospital were selected and offered to participate. The psychometric variables registered were the Salamanca screening questionnaire, the Hamilton Anxiety Rating Scale, and the Beck Depression Inventory. Eighty-nine subjects accepted to participate in the study (93.89% response rate), with an average age of 63.01 years (SD 8.75). Once the study was concluded, the main outcome was a difference in means of 6.09 points in the General Scale of Self-Efficacy (p < 0.0053, 96% confidence interval-4.1950-10.29), showing that the group exposed to the intervention reached a higher score in the above-mentioned scale. However, there were no significant differences (t-student 0.1211; p = 0.943) after the estimation and contrast of population means for score differences between the groups regarding the Hamilton scale. Similarly, there were no significant differences between the groups regarding the means obtained in the variable score difference in the Beck Depression Inventory (t-student -0.1281; p = 0.8987). The results showed an increase in those scores related to general self-efficacy among the population that completed the intervention program, as compared to the control group.

Autoeficacia percibida en pacientes tras programa de rehabilitación cardíaca en Atención Primaria: un nuevo modelo de atención / Perceived self-efficacy in patients after a cardiac rehabilitation programme in primary care: a new model of attention

OBJETIVO: La literatura evidencia la posibilidad de intervención, desde la prevención primaria hasta la rehabilitación tras un evento cardiaco, y así disminuir su incidencia y facilitar la reincorporación a la vida cotidiana. El objetivo de este trabajo fue determinar el efecto sobre la autoeficacia percibida de una intervención en rehabilitación cardiaca a pacientes que han sufrido evento cardíaco. MÉTODOS: Se diseñó un ensayo comunitario abierto, controlado y aleatorizado, realizado en atención primaria de salud. Para determinar el tamaño de muestra, el equipo de investigación utilizó la Escala General de Autoeficacia de Baessler y Schwarzer. La diferencia de medias entre grupos considerada como clínicamente relevante fue de al menos 6 puntos en la puntuación de la Escala General de Autoeficacia. Se aceptó una precisión del 95% y un poder del test del 80%. El resultado propuso una muestra de 44 sujetos en cada grupo. Se propuso participar, a lo largo de 12 meses, a todos los sujetos, mayores de edad (N= 104), de ambos sexos, que concluyeron la fase II en la unidad de RHC del Hospital Universitario Puerta del Mar (Cádiz). Se informó a los pacientes de la realización del estudio pidiéndoles su participación y ofreciendo consentimiento informado por escrito. De forma aleatoria, los sujetos fueron asignados aleatoriamente, siendo esta asignación de forma ciega (en sobre cerrado al investigador), al grupo de intervención o de control, mediante una proporción preestablecida 2:1 (dos pacientes a asignados a grupo intervención por uno a grupo control. Se realizó un registro de la no respuesta o rechazo a participar en el estudio para el análisis de la no respuesta. RESULTADOS: Un total de 89 sujetos fueron incluidos en el análisis estadístico (tasa de respuesta de 85, 57%), con una edad media de 63, 01 años, (DE 8, 75). La variable dependiente principal fue la diferencia de puntuación entre grupos, comparando medias, antes y después de la intervención, en la escala general de autoeficacia de Baessler & Schwarner. Se obtuvo diferencia de medias de 6.0972 puntos entre los grupos de intervención y de control (p<0.0053, IC 95% -4.1950 a -10.29), resultado de un aumento de 3.3750 puntos de media en el grupo de intervención (desviación estándar 7.01), y un descenso de 2.7222 puntos de media (desviación estándar 7.19), en el grupo de control. En relación a los posibles cambios a detectar en las escalas de ansiedad de Hamilton e inventario de depresión de Beck, tras finalizar la intervención, se realizó una estimación y contraste de medias poblacionales entre grupos para la diferencia de puntuaciones en la escala de Hamilton, determinadas en la visita final, no encontrándose diferencias significativas (t student 0.1211; p<0.9 43). De igual forma, no se encontraron diferencias significativas entre grupos para las medias obtenidas en la variable "diferencia de puntuación en inventario de Beck en depresión" (t student -0.1281; p<0.8987). CONCLUSIONES: La inclusión en los programas de rehabilitación cardiaca realizados en atención primaria mejora la autoeficacia general percibida de pacientes que han sufrido eventos cardíacos

OBJECTIVE: The literature points to the possibility of carrying out an intervention, from primary prevention to rehabilitation after a cardiac event, towards decreasing the incidence of such cardiac events and facilitating the return to daily life. The objective was to determine the effect of a cardiac rehabilitation intervention over perceived selfefficacy for patients who have suffered a cardiac event. METHODS: A community clinical trial, open, controlled, and randomised, was designed, and performed in primary care. To determine the sample size, the research team used the General Self-Efficacy Scale by Baessler and Schwarzer. The mean difference between groups considered of clinical relevance was of at least 6 points in the aforementioned General Self-Efficacy Scale. A precision of 95% and a test power of 80% were accepted. The result proposed a sample of 44 subjects in each group. Over 12 months, all subjects of legal age (N = 104), both sexes, that had concluded phase II in the cardiac rehabilitation unit of the university Hospital Puerta del Mar (Cadiz) were offered to participate in the study. The patients were informed about the study development, asking for their participation and providing them with a written informed consent. The subjects were randomly assigned to the intervention or control group through blind allocation (in a sealed envelope to the researcher), on a pre-set 2:1 ratio (two patients assigned to the intervention group to one assigned to the control group). A non-response or rejection to participate in the study record was made for the non-response analysis. RESULTS: A total of 89 subjects were included in the statistical analysis (response rate of 85.57%), with an average age of 63.01 years (SD: 8.75). The main dependent variable was the scores difference between groups, comparing means before and after the intervention, through the General Self-Efficacy Scale by Baessler & Schwarner. A mean difference of 6.0972 points was obtained between the intervention and the control groups (p<0.0053; 95% CI -4.1950 to -10.29), as a result of a 3.3750 mean points increase (standard deviation: 7.01) in the intervention group and a 3.3750 mean points decrease (standard deviation: 7.19) in the control group. In relation to the possible changes to be detected through the Hamilton anxiety scale and the Beck's depression inventory, after finishing the intervention, an estimate and contrast of population means was made between groups for the scores difference in the Hamilton scale, determined on the final visit, with no significant differences found (t-student 0.1211; p <0.9 43). Similarly, no significant differences were found between the groups for the means obtained in the variable "Beck's depression inventory scores difference" (t-student -0.1281; p<0.8987). CONCLUSIONS: The inclusion in cardiac rehabilitation programmes carried out in primary care improves the general perceived self-efficacy of patients who have suffered cardiac events

Autoeficacia percibida, rasgos de personalidad y biotipos previos a programa de rehabilitación cardíaca en atención primaria de salud / Perceived self-efficacy, personality and bioethics before a heart rehabilitation programme in primary health care

Objetivos: Existe evidencia del beneficio de la rehabilitación cardíaca tras evento cardiovascular sobre el estado de ánimo y la autoeficacia percibida por el paciente para con el cuidado de su salud. Se quiere conocer la correlación entre variables relacionadas con el estado anímico, biotipo y autoeficacia de esta población. Diseño: Estudio descriptivo. Emplazamiento, participantes: Sobre toda la población de pacientes dados de alta en unidad de rehabilitación cardíaca hospitalaria a lo largo de 12 meses. Mediciones principales: Se determinan variables universales, psicométricas (escala general de autoeficacia, cuestionario de personalidad Salamanca, Hamilton ansiedad e índice de depresión de Beck) y antropométricas. Se realiza estadística descriptiva y correlaciones de Pearson entre la variable dependiente principal y variables asociadas. Resultados: Se incluyó a 88 pacientes, tasa de respuesta 92%. La edad media fue 53 años, con el 80,23% varones. De forma significativa, la autoeficacia correlacionó negativamente con la ansiedad (r= -0,4009) y la depresión (r= -0,4152), así como con el rasgo dependiente de la personalidad (r= -03175) e impulsivo (r= -0,4243). El biotipo endomorfo correlaciona de forma positiva con niveles más altos de ansiedad (r= 0,3304) y síntomas relacionados con depresión (r= 0,2563). No hay diferencias según edad y sexo con la autoeficacia percibida. Conclusiones: Existe correlación entre rasgos de personalidad, estado anímico y biotipo corporal con la autoeficacia percibida en la población a estudio (AU)

Objectives: There is a clear evidence of the benefit of cardiac rehabilitation after a cardiovascular event on patients' mood and perceived self-efficacy in terms of their own health care. Our aim is to define the correlation between mood-related variables, biotype and self-efficacy in this population. Design: Descriptive study. Background, participants: The entire population of patients discharged from the cardiac rehabilitation unit over 12 months. Main measurements: Universal anthropometric and psychometric (general self-efficacy scale, Salamanca personality traits questionnaire, Hamilton anxiety scale and Beck depression inventory) variables are determined. Descriptive statistics and association between variables (correlation) is determined. Results: This study involved 88 patients, response rate 92%. The average age was 53 years old, 80.23% were males. Descriptive statistics and Pearson correlations for the main dependent variable and associated variables is performed. Significant evidence is shown, self-efficacy is negatively correlated with anxiety (r=-0.4009) and depression (r=-0.4152), as well as dependent(r=-03 175) and impulsive (r=-0.4243) personality traits. Higher levels of anxiety positively correlate with endomorph biotype (r=0.3304), and depression-associated symptoms (r=0.2563). Age and gender do not correlate with self-perceived efficacy. Conclusions: Self-efficacy in the study population is correlated with personality traits, mood and body biotype (AU)

Perceived self-efficacy, personality and bioethics before a heart rehabilitation programme in primary health care. / Autoeficacia percibida, rasgos de personalidad y biotipos previos a programa de rehabilitación cardíaca en atención primaria de salud.

OBJECTIVES: There is a clear evidence of the benefit of cardiac rehabilitation after a cardiovascular event on patients' mood and perceived self-efficacy in terms of their own health care. Our aim is to define the correlation between mood-related variables, biotype and self-efficacy in this population. DESIGN: Descriptive study. BACKGROUND, PARTICIPANTS: The entire population of patients discharged from thecardiac rehabilitation unit over 12 months. MAIN MEASUREMENTS: Universal anthropometric and psychometric (general self-efficacy scale, Salamanca personality traits questionnaire, Hamilton anxiety scale and Beck depression inventory) variables are determined. Descriptive statistics and association between variables (correlation) is determined. RESULTS: This study involved 88 patients, response rate 92%. The average age was 53 years old, 80.23% were males. Descriptive statistics and Pearson correlations for the main dependent variable and associated variables is performed. Significant evidence is shown, self-efficacy is negatively correlated with anxiety (r=-0.4009) and depression (r=-0.4152), as well as dependent(r=-03 175) and impulsive (r=-0.4243) personality traits. Higher levels of anxiety positively correlate with endomorph biotype (r=0.3304), and depression-associated symptoms (r=0.2563). Age and gender do not correlate with self-perceived efficacy. CONCLUSIONS: Self-efficacy in the study population is correlated with personality traits, mood and body biotype.