Cost-effectiveness and cost-utility study of a psychoeducational group intervention for people with depression and physical comorbidity in primary care.

OBJECTIVE: To evaluate the cost-effectiveness and cost-utility of a psychoeducational group intervention led by primary care (PC) nurses in relation to customary care to prevent the depression and improve quality of life in patients with physical comorbidity. DESIGN: Economic evaluation based on data from randomized, multicenter clinical trial with blind response variables and a one-year follow-up, carried in the context of the PSICODEP study. LOCATION: 27 PC teams from Catalonia. PARTICIPANTS: >50 year-old patients with depression and some physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. INTERVENTION: 12 psychoeducational group sessions, 1 per week, led by 2 PC nurses with prior training. MEASUREMENTS: Effectiveness: depression-free days (DFD) calculated from the BDI-II and quality-adjusted life years (QALYs) from the Euroqol-5D. Direct costs: PC visits, mental health, emergencies and hospitalizations, drugs. Indirect costs: days of temporary disability (TD). The incremental cost-effectiveness ratios (ICER), cost-effectiveness (ΔCost/ΔDLD) and cost-utility (ΔCost/ΔQALY) were estimated. RESULTS: The study includes 380 patients (intervention group [IG] = 204; control group [CG] = 176). 81.6% women; mean age 68.4 (SD = 8.8). The IG had a higher mean cost of visits, less of hospitalizations and less TD than the CG. The difference in costs between the IG and the CG was -357.95€ (95% CI: -2026.96 to 1311.06) at one year of follow-up. There was a mean of 11.95 (95% CI: -15.98 to 39.88) more DFD in the IG than in the CG. QALYs were similar (difference -0.01, 95% CI -0.04 to 0.05). The ICERs were 29.95€/DLD and 35,795€/QALY. CONCLUSIONS: Psychoeducational intervention is associated with an improvement in DFD, as well as a reduction in costs at 12 months, although not significantly. QALYs were very similar between groups.

A primary care psychoeducational group intervention for patients with depression and physical comorbidity: A qualitative study with a gender perspective.

OBJECTIVE: To explore the experiences and emotions of individuals with depression and physical comorbidity within the context of psychoeducational group interventions led by primary care nurses in Catalunya (Spain). METHOD: A psychoeducational group intervention was conducted in the first semester of 2019 with 13 primary care teams (rural/urban) and 95 participants with depression and physical comorbidity. The qualitative research and phenomenological perspective were based on 13 field diaries and 7 semi-structured interviews carried out with the observer nurses. The interviews were recorded and transcribed. Codes were identified by segmenting the text into citations/verbatim accounts and emerging categories/subcategories by regrouping the codes. The results were triangulated among the researchers to identify and compare similarities and differences. RESULTS: Four major themes were found: (a) gender differences; (b) coping strategies and changes observed during the intervention; (c) functions of the group as a therapeutic element; and (d) the nurses' perceptions of the group experience. Gender differences were identified in relation to experiences and emotions. CONCLUSIONS: As some patients acquired skills/behaviours during the intervention that helped them initiate changes and the nurses were satisfied with the intervention, it is important to include this information when planning effective interventions for patients with this profile.

The effectiveness of a "EspaiJove.net"- a school-based intervention programme in increasing mental health knowledge, help seeking and reducing stigma attitudes in the adolescent population: a cluster randomised controlled trial.

BACKGROUND: The aim of this study is to evaluate the short- and long-term effects of the universal mental health literacy intervention "EspaiJove.net" in increasing mental health knowledge, help seeking and reducing stigma attitudes in the adolescent population. We also examine whether these effects depend on the intervention intensity.  METHODS: A clustered school-based randomised controlled trial (cRCT) design. SUBJECTS: 1,298 secondary pupils aged 13 and 14 were recruited from 18 schools in Barcelona (Spain) between September 2016 and January 2018. INTERVENTION: Three programmes were assessed: 1) Sensitivity Programme (SP; 1 h); 2) Mental Health Literacy (MHL; 6 h); 3) MHL plus a first-person Stigma Reduction Programme (MHL + SR; 7 h); 4) Control group (CG): waiting list. OUTCOME MEASURES: 1) MHL: EspaiJove.net EMHL Test (First part and Second Part); 2) Stigma: RIBS and CAMI; 3) Help-seeking and use of treatment: GHSQ. ANALYSIS: The data was collected at baseline, post-intervention and 6 and 12 months later. An intention-to-treat analysis and imputation method was used to analyse the missing data. Intervention effects were analysed using multilevel modelling. RESULTS: One thousand thirty-two students were included (SP = 225; MHL = 261; MHL + SR = 295 and CG = 251). The MHL and MHL + SR interventions showed short- and long-term an increase in knowledge compared to SP and CG, but no significant change post-intervention or over time (First part p = 0.52 and Second part p = 0.62) between intervention groups and CG. No significant changes were found in stigma scores post-intervention or over time (CAMI p = 0.61 and RIBS p = 0.98) or in help-seeking scores (parent p = 0.69; teacher p = 0.23 and healthcare professional p = 0.75). The MHL + SR intervention was the best valued and recommended (p < 0.005). CONCLUSIONS: The three interventions of the EspaiJove.net programme (SP, MHL and MHL + SR) seem not to be effective in terms MHL, Stigma and help-seeking behaviours. The contact with a person who has experimented mental illness first-hand did not reduce stigma attitudes. Further research should deal with the heterogeneity of MHL interventions (concept, duration and measures) and identify which components of stigma interventions are effective. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03215654 (registration date 12 July 2017).

Experiencia de Atención Comunitaria en residencias de ancianos durante la primera ola de la pandemia COVID-19 / Experience in Community Care in nursing homes during the first wave of the COVID-19 pandemic

La COVID-19 ha producido muchas muertes en las residencias geriátricas. El compromiso de las enfermeras/os y médicos de Atención Primaria (AP) con la población que atienden hacía indispensable realizar acciones comunitarias para mejorar la atención de estas personas.El objetivo general fue implementar el “Plan de Acción para la Gestión de Personas en el Ámbito Residencial y la Asistencia Sanitaria en Situación de Pandemia por COVID-19” de la Generalitat de Cataluña y adecuarlo a las necesidades concretas en los centros atendidos. La intervención fue realizada por enfermeras y médicas de AP en dos residencias de ancianos de un núcleo urbano de Barcelona entre marzo y mayo de 2020. Constó de tres etapas: 1) Valoración: las dos residencias atendían 41 residentes (78,6% mujeres; edad media 84,5 años). El 100% tenía patología crónica, el 41,5% presentaba dependencia total, un 21,9% dependencia grave y el 26,8% tenía deterioro cognitivo. Un 63,4% estaba asintomático. Se identificaron carencias de material, infraestructuras y conocimientos. 2) Acciones de coordinación: desinfección de residencias por el servicio de bomberos y toma de muestras PCR que fueron negativas en el 100% de residentes y positivas en cuatro cuidadoras. 3) Taller de educación sanitaria para personal con trato directo a las personas residentes.Las residencias se mantuvieron libres de COVID-19 hasta el momento del inicio de la desescalada a finales de mayo de 2020. Se mantuvo la relación posterior con las residencias. La intervención comunitaria puede haber contribuido a la falta de casos de contagio de trabajadoras y personas residentes.(AU)

COVID-19 has caused many deaths in geriatric homes. The commitment by female Primary Care doctors and nurses with the population they manage made it essential to conduct community actions in order to improve the care for these persons.The general objective was to implement the “Plan of Action for Managing Persons in the Nursing Home Setting and Healthcare during the COVID-19 Pandemic” of the Government of Catalonia, and to adapt it to the specific needs in the centres managed. The intervention was conducted by female Primary Care nurses and doctors, in two nursing homes from an urban area of Barcelona between March and May, 2020. It consisted of three stages: 1) Assessment: Both nursing homes cared for 41 persons (78.6% were female; mean age: 84.5 years). Of these, 100% had a chronic condition, 41.5% presented total dependence, 21.9% presented severe dependence, and 26.8% suffered cognitive deterioration; 63.4% of them were asymptomatic. Lack of materials, infrastructures, and knowledge were detected. 2) Coordination actions: Disinfection of nursing homes by the Fire Department, and extraction of PCR samples, which tested negative in 100% of patients and positive in four caregivers. 3) Health Education Workshop for staff in direct contact with the persons living in the nursing home.Nursing homes stayed free of COVID-19 until the start of de-escalation by the end of May, 2020. Subsequent contact was maintained with nursing homes. Community intervention might have contributed to the lack of infection cases among workers and persons living in the nursing homes.(AU)

Effectiveness of a Psychoeducational Group Intervention Carried Out by Nurses for Patients with Depression and Physical Comorbidity in Primary Care: Randomized Clinical Trial.

The association between physical illness and depression implies a poorer management of chronic disease and a lower response to antidepressant treatments. Our study evaluates the effectiveness of a psychoeducational group intervention led by Primary Care (PC) nurses, aimed at patients of this kind. It is a randomized, multicenter clinical trial with intervention (IG) and control groups (CG), blind response variables, and a one year follow-up. The study included 380 patients ≥50 years of age from 18 PC teams. The participants presented depression (BDI-II > 12) and a physical comorbidity: diabetes mellitus type 2, ischemic heart disease, chronic obstructive pulmonary disease, and/or asthma. The IG (n = 204) received the psychoeducational intervention (12 weekly sessions of 90 min), and the CG (n = 176) had standard care. The patients were evaluated at baseline, and at 4 and 12 months. The main outcome measures were clinical remission of depressive symptoms (BDI-II ≤ 13) and therapeutic response (reduction of depressive symptoms by 50%). Remission was not significant at four months. At 12 months it was 53.9% in the IG and 41.5% in the CG. (OR = 0.61, 95% CI, 0.49-0.76). At 4 months the response in the IG (OR = 0.59, 95% CI, 0.44-0.78) was significant, but not at 12 months. The psychoeducational group intervention led by PC nurses for individuals with depression and physical comorbidity has been shown to be effective for remission at long-term and for therapeutic response at short-term.

Calidad de vida en personas con depresión y comorbilidad física desde una perspectiva de género / Quality of life in people with depression and physical comorbidity from a gender perspective

OBJETIVO: El objetivo del estudio es describir la percepción de la calidad de vida relacionada con la salud de personas con depresión y comorbilidad física bajo una perspectiva de género. Se incluyeron 380 individuos mayores de 49 años con, al menos, una patología de las siguientes: diabetes, enfermedad obstructiva pulmonar crónica y cardiopatía isquémica, reclutadas en 31 equipos de atención primaria de Cataluña. La calidad de vida se midió con la escala EuroQol (EQ-5D). Además, se recogieron variables sociodemográficas, gravedad de depresión, índice de privación económica y ámbito de residencia. Se evaluó la relación ajustada entre el sexo y las dimensiones de calidad de vida, mediante una regresión logística multivariante. RESULTADOS: El 81,3% fueron mujeres; la media de edad fue de 68,4 años (DE: 8,8), La media de la escala visual analógica fue de 57,8 (DE: 17,4) en hombres y 55,8 (DE: 18,6) en mujeres. La media del EQ-Health Index fue de 0,74 (DE: 0,17) en hombres y 0,65 (DE: 0,21) en mujeres (p = 0,001). La probabilidad de presentar problemas en las dimensiones del EQ-5D mostró el sexo como factor de más peso (mujer = 1/hombre = 0) en: autocuidado OR: 2,29 (IC 95% 1,04 a 5,07) y actividades cotidianas OR: 3,09 (IC 95% 1,67 a 5,71). La movilidad se asoció con la edad OR: 1,87 (IC 95% 1,22 a 2,86), el ámbito de residencia con el dolor OR: 2,51 (IC 95% 1,18 a 5,34) y el Beck Depression Inventory (BDI) con la ansiedad/depresión OR: 4,77 (IC 95% 1,77 a 12,88). CONCLUSIÓN: La percepción en la calidad de vida de las mujeres con depresión y comorbilidad física es inferior a la de los hombres, siendo en ambos casos inferior a la de población general

OBJECTIVE: The aim of the study is to describe from a gender perspective how people with depression and physical comorbidity perceive their quality of life. The study included 380 people over 49 years of age with at least one of the following pathologies: diabetes, chronic obstructive pulmonary disease and ischemic heart disease. Participants were recruited from 31 teams the primary care of in Catalonia. Quality of life was measured using the EuroQol Scale. In addition, sociodemographic variables were collected, as well as the severity of depression, the index of economic deprivation and area of residence. The adjusted relationship between sex and dimensions of quality of life was assessed by means of multivariate logistic regression. RESULTS: 81.3% were women; the mean age was 68.4 years (SD: 8.8). The mean on the Visual Analogue Scale was 57.8 (SD: 17.4) in men and 55.8 (SD: 18.6) in women. The mean of the EQ-Health Index was 0.74 (SD: 0.17) in men and 0.65 (SD: 0.2) in women (p = 0.001). The probability of having problems of the EQ-5D showed sex as the most important factor (woman = 1/man = 0) in: self-care OR: 2.29 (95% CI 1.04-5.07) and daily activities OR: 3.09 (95% CI 1.67-5.71). Mobility was associated with age OR: 1.87 (95% CI 1.22-2.86), pain with area of residence OR: 2.51 (95% CI 1.18-5,34) and the BDI with anxiety/depression OR: 4,77 (95% CI 1.77-12,88). CONCLUSION: The perception quality of life of women with depression and physical comorbidity is lower than that of men and, in both cases, it is lower than that of the general population

[Quality of life in people with depression and physical comorbidity from a gender perspective]. / Calidad de vida en personas con depresión y comorbilidad física desde una perspectiva de género.

OBJECTIVE: The aim of the study is to describe from a gender perspective how people with depression and physical comorbidity perceive their quality of life. The study included 380 people over 49 years of age with at least one of the following pathologies: diabetes, chronic obstructive pulmonary disease and ischemic heart disease. Participants were recruited from 31 teams the primary care of in Catalonia. Quality of life was measured using the EuroQol Scale. In addition, sociodemographic variables were collected, as well as the severity of depression, the index of economic deprivation and area of residence. The adjusted relationship between sex and dimensions of quality of life was assessed by means of multivariate logistic regression. RESULTS: 81.3% were women; the mean age was 68.4 years (SD: 8.8). The mean on the Visual Analogue Scale was 57.8 (SD: 17.4) in men and 55.8 (SD: 18.6) in women. The mean of the EQ-Health Index was 0.74 (SD: 0.17) in men and 0.65 (SD: 0.2) in women (p = 0.001). The probability of having problems of the EQ-5D showed sex as the most important factor (woman = 1/man = 0) in: self-care OR: 2.29 (95% CI 1.04-5.07) and daily activities OR: 3.09 (95% CI 1.67-5.71). Mobility was associated with age OR: 1.87 (95% CI 1.22-2.86), pain with area of residence OR: 2.51 (95% CI 1.18-5,34) and the BDI with anxiety/depression OR: 4,77 (95% CI 1.77-12,88). CONCLUSION: The perception quality of life of women with depression and physical comorbidity is lower than that of men and, in both cases, it is lower than that of the general population.

Análisis crítico de la prescripción enfermera en la Atención Primaria: experiencia de uso en Cataluña / Critical analysis of nurse prescribing in primary care: Experience of its use in Catalonia

No disponible

Conocimientos de los adolescentes sobre infecciones de transmisión sexual: necesidad de intervenciones eficaces / Knowledge of adolescents about sexually transmitted infections: The need for effective interventions

No disponible

Effectiveness of a psychoeducation group intervention conducted by primary healthcare nurses in patients with depression and physical comorbidity: study protocol for a randomized, controlled trial.

BACKGROUND: Depressive disorders are the third leading cause of consultation in primary care, mainly in patients with chronic physical illnesses. Studies have shown the effectiveness of group psychoeducation in reducing symptoms in depressive individuals. Our primary aim is to evaluate the effectiveness of an intervention based on a psychoeducational program, carried out by primary care nurses, to improve the remission/response rate of depression in patients with chronic physical illness. Secondarily, to assess the cost-effectiveness of the intervention, its impact on improving control of the physical pathology and quality of life, and intervention feasibility. METHODS/DESIGN: A multicenter, randomized, clinical trial, with two groups and one-year follow-up evaluation. Economic evaluation study. SUBJECTS: We will assess 504 patients (252 in each group) aged > 50 years assigned to 25 primary healthcare centers (PHC) from Catalonia (urban, semi-urban, and rural). Participants suffer from major depression (Beck depression inventory: BDI-II 13-28) and at least one of the following: type 2 diabetes mellitus, chronic obstructive pulmonary disease, asthma, and/or ischemic cardiopathy. Patients with moderate/severe suicide risk or severe mental disorders are excluded. Participants will be distributed randomly into the intervention group (IG) and control (CG). INTERVENTION: The IG will participate in the psychoeducational intervention: 12 sessions of 90 min, once a week led by two Primary Care (PC) nurses. The sessions will consist of health education regarding chronic physical illness and depressive symptoms. MAIN MEASUREMENTS: Clinical remission of depression and/or response to intervention (BDI-II). SECONDARY MEASUREMENTS: Improvement in control of chronic diseases (blood test and physical parameters), drug compliance (Morinsky-Green test and number of containers returned), quality of life (EQ-5D), medical service utilization (appointments and hospital admissions due to complications), and feasibility of the intervention (satisfaction and compliance). Evaluations will be blinded, and conducted at baseline, post-intervention, and 12 months follow-up. DISCUSSION: Results could be informative for efforts to prevent depression in patients with a chronic physical illness. TRIAL REGISTRATION: NCT03243799 (registration date August 9, 2017).

Percepción de la salud ante la crisis política asociada al proceso de independencia de Cataluña (España) / Health's Perception in the Face of the Political Crisis Associated with the Catalonia's (Spain) Independence Process

Objetivo principal: Conocer la percepción de las personas sobre la repercusión del contexto político en su salud. Metodología: Se realizó un estudio cualitativo. Participaron cinco usuarios del Centro de Atención Primaria Raval Nord en Barcelona que verbalizaron en consulta malestar físico y emocional relacionado con el contexto político. Se realizaron entrevistas semiestructuradas, preservando el rigor científico mediante la triangulación del investigador. Resultados principales: Todos los participantes manifestaron malestar emocional y físico que relacionaron con incertidumbre y desconfianza hacia las instituciones políticas. Refirieron diferentes tipos de afrontamiento; la evitación fue el más utilizado entre otros como la resignación, la socialización o la implicación. Conclusión principal: Los participantes perciben su salud biopsicosocial afectada por la crisis política. Identifican el contexto político como principal estresor. La integración en la práctica profesional de la dimensión social y la percepción de salud de la persona debe ser una realidad, y es esencial para un cuidado holístico y de calidad

Objective: Get to know people's perception about the consequences of the political context on their own health. Methods: A qualitative study was conducted. Five users of the Raval Nord Primary Care Center in Barcelona city, who during consultation verbalized physical and emotional discomfort related to the political context. Semi-structured interviews were carried out, preserving scientific rigor through the triangulation of the researcher. Results: All participants expressed emotional and physical discomfort related to uncertainty and distrust towards political institutions. They manifested different types coping strategies; avoidance was the most used among others as resignation, socialization and involvement were also described. Conclusions: Participants perceive their biopsychosocial health as affected by the political crisis. They identify the political context as the main stressor. The social dimension and the person health's perception must be integrated into the professional practice, and it is essential for a holistic quality care

Evaluación pre-post intervención de los conocimientos de infecciones de transmisión sexual en adolescentes / Evaluation before and after the intervention on the knowledge by adolescents about sexually transmitted infections

Objetivo: evaluar el impacto de una intervención acerca de los conocimientos relacionados con las infecciones de transmisión sexual (ITS) y los servicios sanitarios disponibles en adolescentes escolarizados en el barrio del Raval Nord (Barcelona). Método: estudio cuasi-experimental pre-post intervención en adolescentes mayores de 14 años escolarizados en 3º y 4º de Educación Secundaria Obligatoria y 1º y 2º de Bachillerato de tres centros. Variables: sociodemográficas, conductas de riesgo (11 ítems con respuesta escala Likert 0-10), uso de preservativo, inicio de relaciones sexuales, consumo de alcohol y otras drogas, conocimiento de servicios sanitarios y de las ITS. Intervención con tres unidades didácticas: conductas de riesgo y formas de contagio; síntomas, conocimiento y tratamiento de las ITS; uso de servicios sanitarios.Tratamiento y análisis de los datos: Chi cuadrado y U de Mann Whitney para analisis bivariante con variables sociodemográficas. Se calcularon intervalos de confianza al 95% de seguridad (IC95%). Resultados: se estudiaron 211 adolescentes, 56,8% mujeres, media de edad: 15,4 años. El 79,6% procedía de fuera de Europa. El 30,3% había iniciado relaciones sexuales y el 32,4% utilizaba siempre preservativo. El 61,9% no asoció nunca alcohol ni otras drogas en la relación. El VIH es la ITS más conocida (59,8%). Los hombres tienen una percepción de riesgo menor que las mujeres. Post-intervención la percepción de riesgo global aumenta, así como el conocimiento de los servicios sanitarios y de las ITS. Conclusiones: existe déficit de conocimientos de los adolescentes acerca de las ITS. Los conocimientos sobre las ITS, la percepción de riesgo y los recursos sanitarios mejoraron tras la intervención

Objective: to evaluate the impact of an intervention on the knowledge about sexually transmitted infections (STIs) and the healthcare services available among adolescents attending school in the Raval Nord neighborhood (Barcelona). Method: a quasi-experimental study before and after the intervention in adolescents >14-year-old attending 3rd and 4th term of Secondary School and 1st and 2nd term of High School in three centres. Variables: sociodemographical, risk behaviours (11 items with answer through the 0-10 Likert Scale), use of condoms, initiation of sexual relationships, use of alcohol and other drugs, knowledge of healthcare services and of STIs. An intervention with three educational units: risk behaviours and ways of infection; symptoms, knowledge and treatment of STIs; use of healthcare services. Data treatment and analysis: Chi Square and Mann Whitney's U for bivariate analysis with sociodemographical variables. Confidence intervals were calculated at 95% safety (CI95%). Results: the study included 211 adolescents: 56.8% were female, with 15.4 years as mean age. Of these, 79.6% came from outside Europe, 30.3% had initiated sexual relationships, and 32.4% always used condoms; 61.0% of them never associated alcohol or other drugs with their relationship. HIV was the most widely known STI (59.8%). Men had a lower perception of risk than women. After the intervention, there was an increase in their overall perception of risk, as well as in their knowledge of healthcare services and STIs. Conclusions: there is lack of knowledge among adolescents about STIs. After the intervention, there was an improvement in their knowledge of STIs and healthcare services, as well as in their perception of risk

[IMPACT OF A PSYCHOEDUCATIONAL GROUP INTERVENTION FOR PATIENTS WITH MILD/MODERATE DEPRESSION IN PRIMARY CARE CONSULTATIONS]. / Impacto de una intervención grupal psicoeducativa: PARA PACIENTES CON DEPRESIÓN LEVE/MODERADA EN LAS CONSULTAS DE ATENCIÓN PRIMARIA.

OBJECTIVE: To analyze the impact of psycho-educational groups for patients with mild/moderate depression in relation to attendance in primary care consultations, the consumption of anxiolytics and antidepressants and the number of days of temporary disability of patients who performed the intervention group versus those not performed. METHOD: Controlled, longitudinal, prospective cohorts in 13 primary care teams of Barcelona city randomized trial. 232 patients, 120 intervention group and 112 in the control group. The study variables were: sex, age, marital status, nationality, education level, employment status, consumption of anxiolytics and/or antidepressants, number of working days, depressive symptoms, quality of life, co-morbidity and attendance in consulting physician and primary care nurse. RESULTS: 69.7% of the total sample were healthy persons frequenting the control group and intervention in the nursing represented a reduction of 2 points in the average number of visits made during the pre-intervention year and the year after the intervention. This was not affected attendance in the control group and in visits to the family doctor. A reduction was observed in the number of casualties of those who have made thegroup intervention. CONCLUSIONS: The psychoeducational group intervention for patients with mild/moderate depression makes decrease the assistance frequency of the patients to nurse consultory. Patients who have assisted to psychoeducational group intervention tend to apply less for the medical leave.

Impacto de una intervención grupal psicoeducativa para pacientes con depresión leve/moderada en las consultas de atención primaria / Impact of a psychoeducational group intervention for patients with mild/moderate depression in primary care

Objetivo. Analizar el impacto de los grupos psicoeducativos para pacientes con depresión leve/moderada en relación con la frecuentación de las consultas de Atención Primaria, el consumo de ansiolíticos y antidepresivos y el número de días de incapacidad temporal de los pacientes que realizaron la intervención grupal frente a aquellos que no la realizaron. Método. Ensayo aleatorio controlado, longitudinal, prospectivo de dos cohortes en 13 Equipos de Atención Primaria de Barcelona ciudad. 232 pacientes: 120 del grupo intervención y 112 del grupo control. Las variables del estudio fueron: sexo, edad, estado civil, nacionalidad, nivel de estudios, situación laboral, consumo de ansiolíticos y/o antidepresivos, número de días de baja laboral, sintomatología depresiva, calidad de vida, comorbilidad asociada y frecuentación de las consultas de médico y enfermera de Atención Primaria. Resultados. El 69.7 % de la muestra total eran personas sanas. La frecuentación del grupo control y del grupo intervención en las consultas de enfermería representó una reducción de 2 puntos en la media de visitas realizadas durante el año previo a la intervención y el año posterior a la intervención. Esta frecuentación no quedó afectada en el grupo control ni en las visitas al médico de familia. Se observó una reducción en el número de bajas de aquellas personas que han realizado la intervención grupal. Conclusiones. La intervención grupal psicoeducativa para pacientes con depresión leve/moderada disminuye la frecuentación de los pacientes en las consultas de enfermería y reduce el número de personas que solicita una baja laboral después de la intervención (AU)

Objective. To analyze the impact of psycho-educational groups for patients with mild/moderate depression in relation to attendance in primary care consultations, the consumption of anxiolytics and antidepressants and the number of days of temporary disability of patients who performed the intervention group versus those not performed. Method. Controlled, longitudinal, prospective cohorts in 13 primary care teams of Barcelona city randomized trial. 232 patients, 120 intervention group and 112 in the control group. The study variables were: sex, age, marital status, nationality, education level, employment status, consumption of anxiolytics and/or antidepressants, number of working days, depressive symptoms, quality of life, co-morbidity and attendance in consulting physician and primary care nurse . Results. 69.7 % of the total sample were healthy persons frequenting the control group and intervention in the nursing represented a reduction of 2 points in the average number of visits made during the pre-intervention year and the year after the intervention. This was not affected attendance in the control group and in visits to the family doctor. A reduction was observed in the number of casualties of those who have made the group intervention. Conclusions. The psychoeducational group intervention for patients with mild/moderate depression makes decrease the assistance frequency of the patients to nurse consultory. Patients who have assisted to psychoeducational group intervention tend to apply less for the medical leave (AU)

Gestión de la demanda desde la consulta de acogida de Enfermería / Management of the demand for care from the host Nursing consultation

Objetivo: identificar el perfil del usuario que acude a la consulta de acogida de Enfermería, el motivo de la visita, la resolución de la misma y la satisfacción por parte del paciente. Como objetivo secundario se planteó analizar el cambio experimentando en las visitas espontáneas que lleva a cabo la enfermera de guardia, tras la implantación de la consulta de Enfermería de acogida. Material y método: estudio descriptivo transversal. La población objeto de estudio fueron los usuarios que acudían al centro de Raval Nord. Se eligió sistemáticamente una de cada tres visitas de lunes a viernes, a las que se aplicaba los criterios de inclusión y exclusión, durante los meses de abril a octubre de 2009. Variables de estudio: sexo, edad, país de procedencia, número de visitas previas del paciente, motivo de consulta (patología aguda, agudización patología crónica, otros), duración de la visita, intervención enfermera, satisfacción del usuario. También se cuantificó el número de visitas espontáneas que llevó a cabo la enfermera de guardia durante los meses de abril a octubre de 2008 y las realizadas por la enfermera de acogida con el nuevo rol durante el período de estudio. Resultados: 85 visitas analizadas, 47,1% hombres y 52,9% mujeres, media de edad 53,4 años. El 64,9% autóctonos y el 34,1% extranjeros. 47,6% no ha sido visitado por la enfermera en el último año. El motivo de visita: 60,7%patología aguda. Tiempo medio de la visita: 14 minutos. La resolución por parte de la enfermera es superior al 60%. Incremento relativo del 61% de visitas realizadas por la enfermera a partir de la nueva organización. Conclusiones: la resolución por parte de la enfermera es alta y la satisfacción del usuario también. Cambiar el acceso de la población a la consulta, para gestionar la demanda, optimiza la función de la enfermera (AU)

Objective: to identify the profile of the user who presents to the Host Nursing consultation office, the reason for the visit, the resolution of it and the satisfaction of the patient. A secondary objective was to analyze the change in the number of spontaneous visits undertaken by the nurse on duty, following the introduction of Host Nursing consultation. Material and methods: cross sectional descriptive study. The study population were users who presented to the health center of Raval Nord , one out of three visits from Monday to Friday was chosen systematically to which inclusion and exclusion criteria were applied during the months from April to October 2009. Study variables: sex, age, national origin, number of previous visits of the patient, reason for visit (acute disease, chronic disease exacerbations, others), duration of visit, nursing intervention, user satisfaction. We also measured the number of spontaneous visits conducted by the nurse on duty during the months of april to october 2008 and those made by the host nurse in her new role during the study period. Results: 85 visits analyzed, 47,1% men and 52,9% female, mean age 53,4years. 64,9% nationals and 34,1% foreigners. 47.6% has not been visited by the nurse in the last year. The reason for visit: 60,7% acute pathology. Average time of visit 14 minutes. Resolution by the nurse is over 60%. Relative increase of 61% of visits by the nurse as of the date of the new organisation. Conclusions: resolution of the visit by the nurse is high and so is customer satisfaction. Changing the population's access to consultation, to manage demand, optimizes the role of the nurse (AU)