RENEB Inter-Laboratory Comparison 2021: The FISH-Based Translocation Assay.

Translocation analysis using fluorescence in situ hybridization (FISH) is the method of choice for dose assessment in case of chronic or past exposures to ionizing radiation. Although it is a widespread technique, unlike dicentrics, the number of FISH-based inter-laboratory comparisons is small. For this reason, although the current Running the European Network of Biological and Physical retrospective Dosimetry (RENEB) inter-laboratory comparison 2021 was designed as a fast response to a real emergency scenario, it was considered a good opportunity to perform an inter-laboratory comparison using the FISH technique to gain further experience. The Bundeswehr Institute of Radiobiology provided peripheral blood samples from one healthy human volunteer. Three test samples were irradiated with blinded doses of 0, 1.2, and 3.5 Gy, respectively. Samples were then sent to the seven participating laboratories. The FISH technique was applied according to the standard procedure of each laboratory. Both, the frequency of translocations and the estimated dose for each sample were sent to the coordinator using a special scoring sheet for FISH. All participants sent their results in due time. However, although it was initially requested to send the results based on the full analysis, evaluating 500 equivalent cells, most laboratories only sent the results based on triage, with a smaller number of analyzed cells. In the triage analysis, there was great heterogeneity in the number of equivalent cells scored. On the contrary, for the full analysis, this number was more homogeneous. For all three samples, one laboratory showed outlier yields compared to the other laboratories. Excluding these results, in the triage analysis, the frequency of translocations in sample no. 1 ranged from 0 to 0.013 translocations per cell, and for samples no. 2 and no. 3 the genomic mean frequency were 0.27 ± 0.03 and 1.47 ± 0.14, with a coefficient of variation of 0.29 and 0.23 respectively. Considering only results obtained in the triage analysis for sample no. 1, all laboratories, except one, classified this sample as the non-irradiated one. For sample no. 2, excluding the outlier value, the mean reported dose was 1.74 ± 0.16 Gy indicating a mean deviation of about 0.5 Gy to the delivered dose of 1.2 Gy. For sample no. 3 the mean dose estimated was 4.21 ± 0.21 Gy indicating a mean deviation of about 0.7 Gy to the delivered dose of 3.5 Gy. In the frame of RENEB, this is the second FISH-based inter-laboratory comparison. The whole exercise was planned as a response to an emergency, therefore, a triage analysis was requested for all the biomarkers except for FISH. Although a full analysis was initially requested for FISH, most of the laboratories reported only a triage-based result. The main reason is that it was not clearly stated what was required before starting the exercise. Results show that most of the laboratories successfully discriminated unexposed and irradiated samples from each other without any overlap. A good agreement in the observed frequencies of translocations was observed but there was a tendency to overestimate the delivered doses. Efforts to improve the harmonization of this technique and subsequent exercises to elucidate the reason for this trend should be promoted.

Repercusiones del confinamiento por COVID-19 en pacientes crónicos de Andalucía / Consequences of the COVID-19 lockdown in patients with chronic diseases in Andalusia

Objetivo: Conocer las repercusiones del confinamiento por la pandemia de COVID-19 en los autocuidados de personas con enfermedades crónicas y en su salud percibida, e identificar factores para el manejo y la gestión de su enfermedad en situaciones de emergencia. Método: Estudio cualitativo realizado en marzo-abril de 2020, durante el confinamiento por la pandemia de COVID-19, en Andalucía (España), mediante grupos focales virtuales usando la herramienta telemática Zoom. Se realizaron tres grupos con 34 pacientes (17 hombres y 17 mujeres) con enfermedades crónicas: artritis, diabetes, enfermedad cardiovascular, enfermedad inflamatoria intestinal, cáncer de mama y fibromialgia. Resultados: Las personas con enfermedades crónicas refirieron repercusiones del confinamiento en relación con su vivencia emocional, sus recursos de afrontamiento, la información recibida, las dificultades para el autocuidado y el contacto/acceso a los servicios sanitarios, además de sugerir aprendizajes para el futuro. Más y mejor información, formación de pacientes, colaboración directa con asociaciones de pacientes por parte de los gestores y una mejora de la accesibilidad telemática a los servicios sanitarios destacan como las principales líneas de mejora para minimizar el impacto de futuros confinamientos en el autocuidado y en la salud de las personas con enfermedades crónicas. Conclusiones: Durante el confinamiento, las personas con enfermedades crónicas experimentaron dificultades más allá del riesgo de contagio: interferencias en el cuidado y en la atención sanitaria recibida. Es necesaria mayor información y más formación a los/las pacientes y mejoras en la accesibilidad a los servicios sanitarios en situaciones de crisis sanitaria. (AU)

Objective: To understand the consequences of the COVID-19 pandemic lockdown on the self-care of people living with chronic diseases and on their self-perceived health, and to identify factors that may influence the management of their disease in emergency situations. Method: A qualitative study conducted in 2020 (March and April) in Andalusia (Spain) during the COVID-19 pandemic lockdown, through virtual focus groups, using the Zoom telematics tool. Three virtual focus groups were conducted, including 34 patients from Andalusia with different chronic conditions such as arthritis, diabetes, cardiovascular disease, inflammatory bowel disease, breast cancer and fibromyalgia. Results: People with chronic diseases reported effects of the lockdown in relation to their emotional experience, their coping resources, the information they received, the difficulties to manage self-care, and the contact or access to health services. They also suggested some lessons learned for the future. The need for more and better information, patient training, involving patient associations, and improving telematics access to health services are the main areas for improvement to minimize the impact of future quarantines on the self-care and the health of people with chronic diseases. Conclusions: Besides the risk of contracting COVID-19, the difficulties encountered by people with chronic diseases during the lockdown include interferences in the self-care and the health care received. Health crisis situations demand more information, training for patients and improvements in the health services accessibility for patients with chronic conditions. (AU)

[Consequences of the COVID-19 lockdown in patients with chronic diseases in Andalusia]. / Repercusiones del confinamiento por COVID-19 en pacientes crónicos de Andalucía.

OBJECTIVE: To understand the consequences of the COVID-19 pandemic lockdown on the self-care of people living with chronic diseases and on their self-perceived health, and to identify factors that may influence the management of their disease in emergency situations. METHOD: A qualitative study conducted in 2020 (March and April) in Andalusia (Spain) during the COVID-19 pandemic lockdown, through virtual focus groups, using the Zoom telematics tool. Three virtual focus groups were conducted, including 34 patients from Andalusia with different chronic conditions such as arthritis, diabetes, cardiovascular disease, inflammatory bowel disease, breast cancer and fibromyalgia. RESULTS: People with chronic diseases reported effects of the lockdown in relation to their emotional experience, their coping resources, the information they received, the difficulties to manage self-care, and the contact or access to health services. They also suggested some lessons learned for the future. The need for more and better information, patient training, involving patient associations, and improving telematics access to health services are the main areas for improvement to minimize the impact of future quarantines on the self-care and the health of people with chronic diseases. CONCLUSIONS: Besides the risk of contracting COVID-19, the difficulties encountered by people with chronic diseases during the lockdown include interferences in the self-care and the health care received. Health crisis situations demand more information, training for patients and improvements in the health services accessibility for patients with chronic conditions.

Repercusiones del confinamiento por COVID-19 en pacientes crónicos de Andalucía / Consequences of the COVID-19 lockdown in patients with chronic diseases in Andalusia

OBJETIVO: Conocer las repercusiones del confinamiento por la pandemia de COVID-19 en los autocuidados de personas con enfermedades crónicas y en su salud percibida, e identificar factores para el manejo y la gestión de su enfermedad en situaciones de emergencia. MÉTODO: Estudio cualitativo realizado en marzo-abril de 2020, durante el confinamiento por la pandemia de COVID-19, en Andalucía (España), mediante grupos focales virtuales usando la herramienta telemática Zoom. Se realizaron tres grupos con 34 pacientes (17 hombres y 17 mujeres) con enfermedades crónicas: artritis, diabetes, enfermedad cardiovascular, enfermedad inflamatoria intestinal, cáncer de mama y fibromialgia. RESULTADOS: Las personas con enfermedades crónicas refirieron repercusiones del confinamiento en relación con su vivencia emocional, sus recursos de afrontamiento, la información recibida, las dificultades para el autocuidado y el contacto/acceso a los servicios sanitarios, además de sugerir aprendizajes para el futuro. Más y mejor información, formación de pacientes, colaboración directa con asociaciones de pacientes por parte de los gestores y una mejora de la accesibilidad telemática a los servicios sanitarios destacan como las principales líneas de mejora para minimizar el impacto de futuros confinamientos en el autocuidado y en la salud de las personas con enfermedades crónicas. CONCLUSIONES: Durante el confinamiento, las personas con enfermedades crónicas experimentaron dificultades más allá del riesgo de contagio: interferencias en el cuidado y en la atención sanitaria recibida. Es necesaria mayor información y más formación a los/las pacientes y mejoras en la accesibilidad a los servicios sanitarios en situaciones de crisis sanitaria

OBJECTIVE: To understand the consequences of the COVID-19 pandemic lockdown on the self-care of people living with chronic diseases and on their self-perceived health, and to identify factors that may influence the management of their disease in emergency situations. METHOD: A qualitative study conducted in 2020 (March and April) in Andalusia (Spain) during the COVID-19 pandemic lockdown, through virtual focus groups, using the Zoom telematics tool. Three virtual focus groups were conducted, including 34 patients from Andalusia with different chronic conditions such as arthritis, diabetes, cardiovascular disease, inflammatory bowel disease, breast cancer and fibromyalgia. RESULTS: People with chronic diseases reported effects of the lockdown in relation to their emotional experience, their coping resources, the information they received, the difficulties to manage self-care, and the contact or access to health services. They also suggested some lessons learned for the future. The need for more and better information, patient training, involving patient associations, and improving telematics access to health services are the main areas for improvement to minimize the impact of future quarantines on the self-care and the health of people with chronic diseases. CONCLUSIONS: Besides the risk of contracting COVID-19, the difficulties encountered by people with chronic diseases during the lockdown include interferences in the self-care and the health care received. Health crisis situations demand more information, training for patients and improvements in the health services accessibility for patients with chronic conditions

[Chronic patient activation and their relationship with health professionals in Andalusia]. / La activación de pacientes crónicos y su relación con el personal sanitario en Andalucía.

BACKGROUND: To evaluate the (inter)relation between chronic patient activation and its relationship with health professionals in Andalusia. METHODS: Descriptive and quantitative study involving 258 chronic patients from the School of Patients, contacted by email. One hundred and forty-two answered the Patient Activation Measurement (PAM) and the chronic patient's experience (IEXPAC) questionnaires. Statistical analyses included correlation study and comparison of means. RESULTS: The mean of Patient Activation Measurement was 87 points (scale from 0 to 100) and IEXPAC scale was 5.3 (scale from 0 to 10), with a directly proportional relation between variables. Males and participants belonging to patients' associations had higher levels of activation. The relationship with health professionals was better among patients with primary education and with <10 years of chronic disease. In general, medical staff received better evaluation, yet nurses were considered more prone to encouraging relationships among patients. The dimensions with higher impact on patient activation were inter-professional coordination and the attention paid to treatment and medication. Feeling confident to communicate one's concerns had more impact on IEXPAC scale. CONCLUSIONS: The correlation observed between patient activation and its relationship with health professionals leads to the need to improve the involvement and self-management of chronic patients, as well as to strengthen improved professional coordination and patient-staff communication.

Presentación de 2 casos clínicos-patológicos de neoplasias papilares intraductales pancreáticas con diferentes fenotipos y evolución / Report of two clinical-pathological cases of pancreatic intraductal papillary neoplasms with distinct phenotype and outcome

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[Elaboration and validation of an informative document on adenoamigdalectomy for patients]. / Elaboración y validación de un documento informativo sobre adeno-amigdalectomía para pacientes.

BACKGROUND: Access to up-to-date and understandable health information is a growing citizen demand, as well as an ethical duty and a legal regulation. Written information reinforces information transmitted orally during the consultation and improves recall capacity. Adenoamigdalectomy is an intervention that affects a high number of patients, the majority from the child population that has a high emotional sensitivity, and it is experienced by parents with considerable anxiety. An informative guide on adenoamigdalectomy was elaborated and validated. The aim of this article is to describe the process of elaborating the document, emphasizing its validation and results. MATERIAL AND METHODS: The document was validated in three phases: A) Clinical content validated by professionals with a checklist and a consensus meeting; B) Analysis of grammatical legibility according to the Flesch index; C) Validation of lexical legibility with citizens by means of a validation guide and interviews. RESULTS: The validation by professionals and citizens was highly positive. The professionals stressed the accuracy of the content and corrected some imprecisions. They made suggestions concerning format, writing style and length. The citizens stressed understandable language, resolution of doubts, respectful tone and their satisfaction with the initiative. They also differed on aspects such as their opinion of the document's length. CONCLUSIONS: The validation of informative documents by both professionals and patients is a process of great interest. Lack of agreement in their analyses makes it clear why it is important to include both sectors. The document was improved by their contributions.

Definición de competencia médica según pacientes crónicos del sistema sanitario público de Andalucía / Definition of medical competence. The point of view of chronically-ill patients in the Andalusian public healthcare system (Spain)

Objetivo Identificar los atributos con los cuales los/las pacientes crónicos/as atendidos/as en el Sistema Sanitario Público de Andalucía (SSPA) describen la competencia profesional del personal facultativo que les atiende a lo largo de su proceso asistencial. Métodos 147 pacientes crónicos de diferentes procesos asistenciales y sus familiares. Investigación cualitativa con grupos focales y entrevistas en profundidad, realizadas en centros de salud y consultas externas de Granada, Málaga, Sevilla, Cádiz y Córdoba, entre 2007 y 2008. Análisis de contenido con Nudist Vivo. Resultados Las personas participantes definen la competencia médica enlazando elementos de habilidad y conocimientos técnicos (tener conocimientos e interés por la enfermedad, mantener una continuidad en la atención mediante seguimientos correctos o solicitar las pruebas precisas) con otros relacionales, tanto sobre comunicación e información (informar, escuchar, confiar, estimular las preguntas) como sobre trato (humanidad, amabilidad, respeto, interés, cercanía). En la valoración de la asistencia en atención primaria, las expectativas incluyen relación cercana, trato personalizado, información, gestión de recetas y baja laboral, y derivación al/a la especialista. Sobre las consultas de especialidad destaca acertar diagnóstico y tratamiento, informar y hacer un seguimiento del/de la paciente. En el servicio de urgencias se valoran especialmente el alivio de los síntomas, acertar el diagnóstico, ser derivado al/a la especialista y recibir un trato humano. Conclusiones Las necesidades y las expectativas de los/as pacientes crónicos/as hacia la competencia médica se organizan en torno a habilidades técnicas y relacionales (AU)

Objective To identify the attributes used by chronically-ill patients to describe physicians’ competence in the public healthcare system in Andalucia. Methods A total of 147 chronically-ill patients and their relatives were included in this qualitative study. Focal groups and in-depth interviews were performed in health centers and outpatient centers in Granada, Malaga, Seville, Cadiz and Cordoba between 2007 and 2008. Content analysis was carried out using Nudist Vivo. Results The participants defined medical competence as combining elements of technical ability and knowledge (awareness of and interest in the disease, continuity of follow-up and requesting specific tests) with interpersonal skills related to communication, information (informing, listening, trust, prompting questions) and attention (courtesy, cordiality, respect, interest and approachability). Primary care was expected to provide a close relationship, personalized treatment, information, drug prescription, and referral to specialized care. Specialized care was expected to provide an accurate diagnosis and appropriate treatment, information and follow-up. Highly valued aspects of emergency care were symptom relief, accurate diagnosis, referral to specialists and courtesy. Conclusions Chronically-ill patients based their evaluation of medical competence on technical and interpersonal skills (AU)

[Definition of medical competence. The point of view of chronically-ill patients in the Andalusian public healthcare system (Spain)]. / Definición de competencia médica según pacientes crónicos del sistema sanitario público de Andalucía.

OBJECTIVE: To identify the attributes used by chronically-ill patients to describe physicians' competence in the public healthcare system in Andalucia. METHODS: A total of 147 chronically-ill patients and their relatives were included in this qualitative study. Focal groups and in-depth interviews were performed in health centers and outpatient centers in Granada, Malaga, Seville, Cadiz and Cordoba between 2007 and 2008. Content analysis was carried out using Nudist Vivo. RESULTS: The participants defined medical competence as combining elements of technical ability and knowledge (awareness of and interest in the disease, continuity of follow-up and requesting specific tests) with interpersonal skills related to communication, information (informing, listening, trust, prompting questions) and attention (courtesy, cordiality, respect, interest and approachability). Primary care was expected to provide a close relationship, personalized treatment, information, drug prescription, and referral to specialized care. Specialized care was expected to provide an accurate diagnosis and appropriate treatment, information and follow-up. Highly valued aspects of emergency care were symptom relief, accurate diagnosis, referral to specialists and courtesy. CONCLUSIONS: Chronically-ill patients based their evaluation of medical competence on technical and interpersonal skills.

[Evaluation of a child health prevention and promotion telephone service before its introduction]. / Evaluación de un servicio telefónico de prevención y promoción de salud infantil antes de su puesta en funcionamiento.

OBJECTIVES: To evaluate a telephone-information service on health issues for children before its implementation. To determine the overall assessment of the service and quality of the information available from the perspective of a potential user population. DESIGN: Simulation of a telephone call to the telephone service and further evaluation using qualitative techniques. SETTING: Primary and special care in the city of Granada. PARTICIPANTS: Parents, who were not health professionals, of children between 0 and 14 years old, resident in Andalusia and recruited from both primary care and hospitals throughout the city of Granada. A comprehensive assessment of service and quality of information offered through interviews and focus groups. The number of participants was established on two criteria: evaluation of the whole range of information provided by the telephone service; response saturation. RESULTS: The overall service assessment was positive, emphasising the quick and easy access to information, time saving and confidence building. The information received was described as clear, easily understood and expressed in a respectful tone. To improve the service it has been suggested that the calls be free and that the range of information topics available should be extended. CONCLUSIONS: The methodology used is novel, as most telephone services are evaluated after they have been put in place and without the participation of the future users.

[Emotional climate in health professional teams in Andalusia]. / Clima emocional en equipos de profesionales sanitarios de Andalucía.

OBJECTIVE: The emotional climate in the health care environment is one of the main factors that affect professional duties and quality of care. The aim of this research is to analyse the emotional climate in health work teams, relating it with the number of members in each group. METHOD: A cross-sectional, descriptive, and observational study with 212 professionals from 17 health centres. They were given a Likert scale questionnaire and the results were analysed using SPSS program, comparing the mean, standard deviation and Anova test. RESULTS: There was no linear relationship between group size and emotional climate. Using "group size" as a qualitative variable, significant results appear: Small groups (<8 persons) scored 18.3 points on the Emotional Climate Scale (-50,+50 scale). Personal recognition received 5.3 points (-15,+15 scale), interpersonal relationships 6.0 points (-15,+15 scale) and shared projects 6.9 points (-15,+15 scale). Medium groups (8-12 persons) had a better evaluation (23.7 points for the general scale and 7.9, 6.4 and 9.3 for the scale dimensions). Large groups (>12 persons) registered the best results (26.4 points for the general scale and 9.0, 9.2 and 11.5 points for the scale dimensions). CONCLUSIONS: Team size directly influences emotional climate: larger groups lead to better emotional climate.

Mejora de la información sanitaria contenida en los prospectos de los medicamentos: expectativas de pacientes y de profesionales sanitarios / Quality improvement of health information included in drug information leaflets. Patient and health professional expectations

ObjetivoAnalizar la opinión y las expectativas de los pacientes y de los profesionales sobre la información contenida en los prospectos de los medicamentos y conocer la legibilidad lingüística formal de los medicamentos más consumidos durante el año 2003.DiseñoEstudio cualitativo y cuantitativo.EmplazamientoCentros de Atención Primaria y Especializada de Andalucía, Cataluña, País Vasco, Navarra, Aragón y Extremadura.ParticipantesPacientes de centros de salud, profesionales expertos, médicos especialistas y farmacéuticos, representantes de asociaciones de usuarios(as), elegidos por muestreo intencional.Las mediciones y resultados principales se basan en entrevistas semiestructuradas y grupos focales. Estudio de legibilidad mediante el test de Flesch.Mediciones y resultados principalesEntre profesionales y pacientes hay diferentes grados de satisfacción respecto a la cantidad y a la calidad del prospecto. Destacan las deficiencias de usar un lenguaje técnico y con un tamaño de letra demasiado pequeño. Los profesionales otorgan al prospecto gran importancia divulgativa, mientras que los pacientes lo usan como fuente de información complementaria. Los expertos y los usuarios coinciden en considerar más difíciles de entender los apartados referidos a la posología, a los efectos secundarios y a las contraindicaciones. Los prospectos tienen un grado de legibilidad insuficiente(AU)

ConclusionesEs deseable que la información sanitaria se centre en los aspectos prácticos del proceso de salud, enfermedad y atención, mediante la adaptación del contenido y la forma de los prospectos a los usuarios y a los profesionales que manifiestan estas necesidades. El personal facultativo es el principal referente de la información en salud, por lo que es aconsejable su formación en habilidades de comunicación. Además, se recomienda reforzar cauces alternativos que ofrezcan a la ciudadanía información sanitaria de calidad(AU)

ObjectiveTo report on patient and professional opinions and expectations concerning the information included in drug package leaflets and to determine their readability.DesignQualitative and quantitative study.PlacementPrimary Care and Specialized Centres from Andalusia, Catalonia, Basque Country, Navarra, Aragon and Extremadura.ParticipantsPatients from Primary Care Health Centers, physicians, pharmacists and citizen associations, using intentional sampling.MethodQualitative interviews. Flesch Readability Test is used to determine the leaflet readability.ResultsThere are different degrees of satisfaction between professionals and patients, concerning both quality and quantity of information leaflets. The use of technical language and a small lettering size was observed. The leaflet is considered an important source of information among professionals, but not among patients who prefer information from their physicians. The greatest comprehension difficulties appear in paragraphs on posology, secondary and adverse effects.ConclusionsHealth information must centre on practical aspects of the health-illness-care process. Leaflets must be adapted to the needs of the patients and professionals. Physicians are commonly consulted by patients, so it is important to ensure they have high communication skills. Patients have the need for constant information; therefore new information channels must be created(AU)

[Quality improvement of health information included in drug information leaflets. Patient and health professional expectations]. / Mejora de la información sanitaria contenida en los prospectos de los medicamentos: expectativas de pacientes y de profesionales sanitarios.

OBJECTIVE: To report on patient and professional opinions and expectations concerning the information included in drug package leaflets and to determine their readability. DESIGN: Qualitative and quantitative study. PLACEMENT: Primary Care and Specialized Centres from Andalusia, Catalonia, Basque Country, Navarra, Aragon and Extremadura. PARTICIPANTS: Patients from Primary Care Health Centers, physicians, pharmacists and citizen associations, using intentional sampling. METHOD: Qualitative interviews. Flesch Readability Test is used to determine the leaflet readability. RESULTS: There are different degrees of satisfaction between professionals and patients, concerning both quality and quantity of information leaflets. The use of technical language and a small lettering size was observed. The leaflet is considered an important source of information among professionals, but not among patients who prefer information from their physicians. The greatest comprehension difficulties appear in paragraphs on posology, secondary and adverse effects. CONCLUSIONS: Health information must centre on practical aspects of the health-illness-care process. Leaflets must be adapted to the needs of the patients and professionals. Physicians are commonly consulted by patients, so it is important to ensure they have high communication skills. Patients have the need for constant information; therefore new information channels must be created.

[Grammatical readability of the package leaflets of the medicinal products most widely consumed and generating the highest expense in Spain during 2005]. / Legibilidad gramatical de los prospectos de los medicamentos de más consumo y facturación en España en 2005.

BACKGROUND: The manufacturers of medicinal products are responsible for providing consumers proper information on the use of such products. This information is set out in the package leaflets which, according to current legislation, must be easy for patients to read and understand. The purpose of this study is to analyse the linguistic/grammatical readability of the package leaflets of medicinal products through application of the Flesch formula. METHODS: The 30 medicinal products most widely consumed and the 30 which generated the highest expenditure during 2005 in Spain were selected. In line with the recommendations of the relevant literature, documents with a Flesch Index value of > or = 10 were considered readable. The grammatical readability was calculated by using the Flesch Index accessible through the Microsoft Office 2000 programme. RESULTS: Only 5 documents obtained an acceptable Flesch Index score (= 10), while 18 scored 0. Half of the values were under 2; 25% were 0 and 25% scored 6 or more. CONCLUSIONS: The data obtained reveal a low level of linguistic and grammatical readability in the package leaflets analysed. The syntax used on drafting the texts tends to use long words.

Legibilidad gramatical de los prospectos de los medicamentos de más consumo y facturación en España en 2005 / Grammatical readability of the package leaflets of the medicinal products most widely consumed and generating the highest expense in Spain during 2005

Fundamento. Los fabricantes de medicamentos tienen el deber de proporcionar a los consumidores información correcta sobre su uso. Esta información está recogida en el prospecto que, según la normativa vigente, debe ser legible y comprensible para el paciente. El objetivo de este estudio es analizar la legibilidad lingüística gramatical de los prospectos de medicamentos mediante la aplicación de la fórmula de Flesch. Métodos. Se seleccionan las 30 medicamentos más consumidos y los 30 que más gasto han generado durante el año 2005 en España. Siguiendo las recomendaciones de la literatura, se han considerado legibles aquellos documentos cuyo Índice de Flesch fuese ≥ 10. Se ha calculado la legibilidad gramatical a través del Índice de Flesch accesible en el programa Microsoft Office 2000. Resultados. Sólo 5 documentos alcanzan un índice de Flesch aceptable (= 10) y 18 tienen una puntuación de 0. La mitad de los valores si sitúan por debajo de 2; 25% de los valores tienen valor 0 y 25% tiene valores de 6 ó más. Conclusiones. Los datos obtenidos revelan una baja legibilidad lingüística y gramatical de los prospectos analizados. La sintaxis empleada al redactarlos tiende a usar frases y palabras largas, lo que incumple claramente las indicaciones de la normativa vigente (AU)

Background. The manufacturers of medicinal products are responsible for providing consumers proper information on the use of such products. This information is set out in the package leaflets which, according to current legislation, must be easy for patients to read and understand. The purpose of this study is to analyse the linguistic/grammatical readability of the package leaflets of medicinal products through application of the Flesch formula. Methods. The 30 medicinal products most widely consumed and the 30 which generated the highest expenditure during 2005 in Spain were selected. In line with the recommendations of the relevant literature, documents with a Flesch Index value of ≥ 10 were considered readable. The grammatical readability was calculated by using the Flesch Index accessible through the Microsoft Office 2000 programme. Results. Only 5 documents obtained an acceptable Flesch Index score (= 10), while 18 scored 0. Half of the values were under 2; 25% were 0 and 25% scored 6 or more. Conclusions. The data obtained reveal a low level of linguistic and grammatical readability in the package leaflets analysed. The syntax used on drafting the texts tends to use long words (AU)

Perspectivas de la ciudadanía sobre necesidades y expectativas de información sanitaria / Health information needs and expectations from the user’s perspective

Fundamento: La necesidad de información en salud está ampliamente reconocida. El objetivo de este estudio es conocer cómo se recibe y cómo se valora la información sanitaria que se obtiene actualmente, y explorar en la identificación de necesidades y expectativasde la ciudadanía andaluza sobre este tema.Material y método: Metodología cualitativa basada en entrevistas semiestructuradas realizadas por teléfono. Se realizaron 48 entrevistas con personas que responden a diferentes perfiles teóricos sociosanitariosa partir de una muestra estructural. La selección finalde las personas a entrevistar se formalizó siguiendo el muestreo de “bola de nieve”. Se realizó un análisis de contenido apoyado del programa informático NUDIST Vivo versión 1.1.Resultados: Las personas entrevistadas manifiestan recibir información sanitaria principalmente del personal sanitario. También señalan hacer uso de otras fuentes de información de manera complementaria,como internet, publicaciones y asociaciones. Haydiferentes grados de satisfacción respecto de la información sanitaria recibida según el grado de comprensión y profundidad que ésta aporte. Se pretende recibir toda la información posible relacionadacon el proceso de salud-enfermedad-atención, así como que esta información sea transmitida principalmente por profesionales de la medicina.Conclusiones: Es deseable que la información sanitaria se centre enlos aspectos prácticos del proceso salud-enfermedad-atención. El personal facultativo es el principal referente de información en salud, por lo que es aconsejable la promoción de actividades formativasen habilidades de comunicación en este grupo profesional. Además, se recomienda reforzar cauces alternativos que ofrezcan a la ciudadanía información sanitaria de calidad (AU)

Background: Patients' need for health information is widely recognized. The aim of this study was to determine how patients currently receive and rate this information. Additionally, we aimed to identifythe needs and expectations of citizens of the autonomous region of Andalusia in this regard. Material and method: We performed a qualitative research study involving semi-structured telephone interviews with participants. A total of 48 interviews were performed in people with different social and health profiles from a structural sample. The final selection of persons to be interviewed was made using the snow-ball sampling method. Interview material was analyzed by means of NUDIST vivo 1.1 software-aided content analysis.Results: The interviewees reported receiving health information mainly from healthcare personnel. Supplementary information sources were the internet, associations and publications. The intervieweesexpressed different degrees of satisfaction with the health information received, depending on its understandability and the amount of detail provided. The persons interviewed reported that they would like to receive all the information possible on their health-illness-care process and would prefer this information to come mainly from physicians.Conclusions: Information about the health-illness-care process should center on practical issues. Physicians are the first and principal source of medical information and consequently communicationskills should be promoted in this collective through training courses. Additionally, alternative sources of information used by citizens should be strengthened to provide high-quality health information (AU)

[Patient perceptions on healthcare safety]. / Percepción de los pacientes sobre la seguridad de la asistencia sanitaria.

BACKGROUND AND OBJECTIVE: Patient Safety is an issue of growing interest in healthcare politics and specialized bibliography, but there are limited studies that include the perspective of the public on healthcare safety. MATERIAL AND METHOD: Qualitative research performed in 4 Spanish Autonomous Regions, using focus groups and semi-structured interviews with patients and representatives of associations. Discourse analysis and result triangulation. RESULTS: For the patients interviewed, the concept of safety is not limited to absence of error, but includes aspects such as confidence, communication, information and participation. In the process of resolving of adverse events, an apologetic attitude by the professionals is considered a key element. Existing interventions such as protocols and notification systems are positively valued, at same time pointing out difficulties in the implementation process. As regards information, the patients demand that the professional is trained in communication skills. More participation in their own healthcare process and clinical management is considered appropriate, at same time, it was stated that few members of the public have the opportunity to participate in current safety policies. CONCLUSIONS: Regarding healthcare safety, patients and key agents indicate the importance of moving from a blame culture to a confidence culture.

[Not Available]. / Perspectivas de la ciudadanía sobre necesidades y expectativas de información sanitaria.

BACKGROUND: Patients' need for health information is widely recognized. The aim of this study was to determine how patients currently receive and rate this information. Additionally, we aimed to identify the needs and expectations of citizens of the autonomous region of Andalusia in this regard. MATERIAL AND METHOD: We performed a qualitative research study involving semi-structured telephone interviews with participants. A total of 48 interviews were performed in people with different social and health profiles from a structural sample. The final selection of persons to be interviewed was made using the snow-ball sampling method. Interview material was analyzed by means of NUDIST vivo 1.1 software-aided content analysis. RESULTS: The interviewees reported receiving health information mainly from healthcare personnel. Supplementary information sources were the internet, associations and publications. The interviewees expressed different degrees of satisfaction with the health information received, depending on its understandability and the amount of detail provided. The persons interviewed reported that they would like to receive all the information possible on their health-illness-care process and would prefer this information to come mainly from physicians. CONCLUSIONS: Information about the health-illness-care process should center on practical issues. Physicians are the first and principal source of medical information and consequently communication skills should be promoted in this collective through training courses. Additionally, alternative sources of information used by citizens should be strengthened to provide high-quality health information.