Identificación de necesidades de los cuidadores informales: estudio exploratorio / Identification of the needs of informal caregivers: an exploratory study

Introducción: El envejecimiento de la población es uno de los principales retos de la salud pública en los países desarrollados. Los cuidadores informales emergen como uno de los principales actores en este escenario, y esto puede afectarlos de forma negativa. Objetivo: El presente estudio tiene como objetivo identificar las necesidades de los cuidadores informales relacionadas con el cuidado de una persona dependiente de una zona básica de salud. Método: Estudio cualitativo y fenomenológico. Participaron en él cuatro cuidadores informales de pacientes no institucionalizados, a quienes se le realizó una entrevista semiestructurada. Posteriormente se realizó un análisis deductivo del discurso. Resultados: El análisis mostró tres temas clave: efecto del cuidar (cuidar tiene efectos negativos en la salud global de los cuidadores), dificultades relacionadas con el cuidado (relacionadas con las adaptaciones en el domicilio, la prevención de heridas, accidentes y movilizaciones) y estrategias de aprendizaje del cuidar (por lógica, observación y formación) Conclusiones: Cuidar tiene un efecto negativo sobre la salud global de los cuidadores. Estos presentan dificultades a la hora de cuidar, y manifiestan utilizar diferentes metodologías para el aprendizaje de los cuidados. Las intervenciones dirigidas a los cuidadores informales deberían incluir aspectos relacionados con la mejoría de su salud y su formación en cuidados. (AU)

Introduction: Population aging is one of the main issues in public health within developed countries. Informal caregivers play a central role in this scenario, which can affect them negatively. Objective: The aim of this study is to identify the needs of informal caregivers related to the care of dependent persons of a Basic Health Area. Method: Qualitative and phenomenological study. Four informal caregivers in charge of non-institutionalized patients took part. These patients expressed their opinions in a semi-structured interview, that was deductively analyzed afterwards. Results: The analysis showed three key subjects: the effects of caregiving (how this task negatively affects the global health of the caregivers); difficulties related to care (related to the process of adaptation once at home, prevention of wounds, accidents and mobility issues), and caregiving learning strategies (by deductive reasoning, observation and formation). Conclusions: Caregiving has a negative effect on the caregivers’ global health. They show some difficulties in the execution of their tasks, and they declare that they are using various caregiving learning methods. Interventions directed at informal caregivers should include aspects related to health improvement and caregiving training. (AU)

Experiences and coping strategies of preterm infants' parents and parental competences after early physiotherapy intervention: qualitative study.

BACKGROUND: Birth before term is a stressful experience for parents because of the unexpected delivery or admission to the neonatal intensive care unit. OBJECTIVE: This research aimed to evaluate the impact of the early PT intervention on preterm infants' parents' experiences, and also to obtain knowledge about parents' experiences and perceived difficulties during preterm infants' care. METHODS: This qualitative study is based on the methods of phenomenology. In the first phase, open interviews were developed to allow researchers to immerse themselves in the context of the study and refine the questions for the semi-structured interviews. Data collected from the semi-structured interviews were analyzed through content analysis. RESULTS: The results were summarized around three themes: 1) parental competence; 2) difficulties during preterm infants' care; and 3) coping strategies. Each theme was divided into two sub-themes. CONCLUSION: Mothers and fathers of preterm infants experienced difficulties when caring for their babies. Parents that received the early physiotherapy intervention felt empowered to take care of their babies and to enhance infants' development. These parents were more capable of developing coping strategies after the intervention. Parents that did not receive the early physiotherapy intervention expressed difficulties when caring for their preterm babies.

The Impact of a Peer Social Support Network from the Perspective of Women with Fibromyalgia: A Qualitative Study.

BACKGROUND: Fibromyalgia is a chronic and complex disease whose management by patients requires a high level of commitment. Patient empowerment therefore represents an important milestone in chronic disease treatment and control. We explored the impact of a peer social support network from the perspective of women with fibromyalgia. METHODS: A generic qualitative design was proposed for the study, for which women who had been diagnosed with fibromyalgia were purposefully selected. Six semi-structured interviews were conducted, and the collected data were thematically analysed. RESULTS: Three key themes emerged regarding the peer social support network: (1) empowerment (facilitating acceptance of the diagnosis and acting as a source of information); (2) effects on well-being and quality of life (attenuated the stigma, improved physical well-being, provided emotional support and was a socialization medium); and (3), valuable aspects (transmitted feelings of being understood and listened to and increased personal feelings of satisfaction). CONCLUSIONS: A peer social support network for women with fibromyalgia exerts positive effects on their physical, mental, and social well-being and empowers them to better manage their disease. Healthcare for women with fibromyalgia should include strategies that connect them through peer social support networks.

Assessment of frailty in elderly patients attending a multidisciplinary wound care centre: a cohort study.

BACKGROUND: The incidence of frailty and non-healing wounds increases with patients' age. Knowledge of the relationship between frailty and wound healing progress is greatly lacking. METHODS: The aim of this study is to characterize the degree of frailty in elderly patients attending a multidisciplinary wound care centres (MWCC). Additionally, we seek to assess the impact of frailty on the wound healing rate and wound healing time. An open cohort study was conducted on 51 consecutive patients aged > 70 years treated for wounds at an MWCC of an intermediate care hospital. The frailty score was determined according to the Frail-VIG index. Data were collected through patient questionnaires at the beginning of the study, and at 6 months or upon wound healing. Wounds were followed up every 2 weeks. To analyse the relationship between two variables was used the Chi-square test and Student's or the ANOVA model. The t-test for paired data was used to analyse the evolution of the frailty index during follow-up. RESULTS: A total of 51 consecutive patients were included (aged 81.1 ± 6.1 years). Frailty prevalence was 74.5% according to the Frail-VIG index (47.1% mildly frail, 19.6% moderately frail, and 7.8% severely frail). Wounds healed in 69.6% of cases at 6 months. The frailty index (FI) was higher in patients with non-healing wounds in comparison with patients with healing wounds (IF 0.31 ± 0.15 vs IF 0.24 ± 0.11, p = 0.043). A strong correlation between FI and wound healing results was observed in patients with non-venous ulcers (FI 0.37 ± 0.13 vs FI 0.27 ± 0.10, p = 0.015). However, no correlation was observed in patients with venous ulcers (FI 0.17 ± 0.09 vs FI 0.19 ± 0.09, p = 0.637). Wound healing rate is statically significantly higher in non-frail patients (8.9% wound reduction/day, P25-P75 3.34-18.3%/day;AQ6 p = 0.044) in comparison with frail patients (3.26% wound reduction/day, P25-P75 0.8-8.8%/day). CONCLUSION: Frailty is prevalent in elderly patients treated at an MWCC. Frailty degree is correlated with wound healing results and wound healing time.