Spanish translation, cultural adaptation and validation of the SarQoL®: a specific health-related quality of life questionnaire for sarcopenia.

BACKGROUND: In 2015, a specific health-related quality of life questionnaire for sarcopenia, SarQoL®, was developed and validated in French. Since then, SarQoL® has been adapted and validated in different languages. We prepared a translation, cultural adaptation and validation of the psychometric properties of the SarQoL® into Spanish. METHODS: A cross-sectional study with 86 participants. The translation and adaptation followed international guidelines with two direct translations, a synthesized version of the direct translations, two reverse translations, consensus by an expert committee of a pre-final version, pre-test by end users and final version. The discriminative power (logistic regression analyses), construct validity (Pearson and Spearman´s correlation), internal consistency (Cronbach´s alpha coefficient), test-retest reliability (intraclass correlation coefficient) and ceiling and floor effects were analyzed. RESULTS: The Spanish version showed good construct validity (high correlation with comparable domains of the SF-36), high internal consistency (Cronbach's alpha coefficient: 0.84) and excellent test-retest reliability (ICC: 0.967, 95%, CI 0.917 - 0.989). However, it had no discriminative power between sarcopenic and non-sarcopenic participants defined with the EWGSOP and FNIH diagnostic criteria of sarcopenia. It did show discriminative power between patients with decreased vs normal muscle strength (54.9 vs. 62.6, p 0.009) and low vs. normal physical performance (57.3 vs. 70.2; p 0.005). No ceiling or floor effect was found. CONCLUSIONS: The Spanish version of SarQoL® has similar psychometric properties to those of the original version of the instrument. It did not discriminate between sarcopenic and non-sarcopenic patients diagnosed according to the EWGSOP or FNIH criteria, but it did with those with low muscle strength and low physical performance.

Factors Associated with Non-Adherence to Drugs in Patients with Chronic Diseases Who Go to Pharmacies in Spain.

BACKGROUND: Pharmacological non-adherence in chronic diseases is 40-65%. No predictive profile of non-adherence exists in patients with multiple chronic diseases. Our study aimed to quantify the prevalence of non-adherence to pharmacological treatment and its associated factors in patients who visit pharmacies in Spain. METHODS: This observational cross-sectional study included patients with one or more chronic diseases. The variables analyzed were demographics, diseases involved, self-medication, information about disease, and lifestyle. The main variable was adherence using the Morisky-Green test. A total of 132 pharmacies collaborated, providing 6327 patients representing all Spain regions (April-December 2016). Bivariate and multivariate analyses were performed and the area under the receiver operating characteristic (ROC) curve was calculated. RESULTS: Non-adherence was 48.4% (95% confidence interval (CI): 47.2-49.7%). The variables that reached significance in the multivariate model were: difficulty in taking medication, self-medication, desire for more information, smoking, lower physical activity, younger age and number of chronic treatments. Discrimination was satisfactory (area under the ROC curve = 70%). Our study found that 50% patients was non-adherent and we obtained a profile of variables associated with therapeutic non-adherence. CONCLUSIONS: It is cause for concern that in patients with multiple diseases and taking multiple medications, there is an association between non-adherence, self-medication and worse lifestyle.

Envejecimiento positivo en las noticias: toda generalización lleva a error / Positive ageing in the news: all generalisations carry an error

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The situation of infection in the elderly in Spain: a multidisciplinary opinion document / Situación de la infección en el anciano: un documento multidisciplinar de opinión

Infection in the elderly is a huge issue whose treatment usually has partial and specific approaches. It is, moreover, one of the areas where intervention can have the most success in improving the quality of life of older patients. In an attempt to give the widest possible focus to this issue, the Health Sciences Foundation has convened experts from different areas to produce this position paper on Infection in the Elderly, so as to compare the opinions of expert doctors and nurses, pharmacists, journalists, representatives of elderly associations and concluding with the ethical aspects raised by the issue. The format is that of discussion of a series of pre-formulated questions that were discussed by all those present. We begin by discussing the concept of the elderly, the reasons for their predisposition to infection, the most frequent infections and their causes, and the workload and economic burden they place on society. We also considered whether we had the data to estimate the proportion of these infections that could be reduced by specific programmes, including vaccination programmes. In this context, the limited presence of this issue in the media, the position of scientific societies and patient associations on the issue and the ethical aspects raised by all this were discussed

La infección en los ancianos es un tema enorme que suele recibir enfoques muy específicos pero parciales. Además, es una de las áreas en las que la intervención podría tener más éxito para mejorar la calidad de vida de los pacientes mayores. En un intento de dar el mayor enfoque posible a este tema, la Fundación de Ciencias de la Salud ha convocado a expertos de diferentes áreas para elaborar este documento de opinión sobre la situación de la infección en los ancianos, tratando de comparar las opiniones de médicos expertos, enfermeras, farmacéuticos, periodistas, representantes de asociaciones de ancianos y terminando con los aspectos éticos que plantea el problema. El formato es el de la discusión de una serie de preguntas preformuladas que fueron discutidas entre todos los presentes. Empezamos discutiendo el concepto de "anciano", las razones de la predisposición a la infección, las infecciones más frecuentes y sus causas, y la carga laboral y económica que suponen para la sociedad. También preguntamos si teníamos datos para estimar la proporción de estas infecciones que podrían ser reducidas por programas específicos, incluyendo programas de vacunación. En este contexto, se discutió la baja presencia de este problema en los medios de comunicación, la posición de las asociaciones científicas y de pacientes sobre el problema y los aspectos éticos que todo esto plantea

Edad y responsabilidades políticas / Age and political responsabilities

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Geriatría en España 2020. Retos principales / Geriatrics in Spain 2020: main challenges

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Diez recomendaciones para mejorar la enseñanza de la Geriatría en el pregrado / Ten recommendations to improve undergraduate training in Geriatric Medicine

Introducción: El envejecimiento de la población y los avances científicos hacen imprescindible una formación específica en Geriatría para todos los estudiantes de Medicina. Existen distintas recomendaciones internacionales sobre la docencia de Geriatría en el pregrado, que aún está lejos de ofrecerse de forma generalizada. El objetivo de este trabajo fue desarrollar un listado nacional de recomendaciones sobre la docencia de la medicina geriátrica en el pregrado. Material y métodos: Se elaboró un decálogo considerando la situación de la docencia de Geriatría en España en el 2016/2017 y las recomendaciones internacionales. Se alcanzó un consenso global entre los miembros del Grupo de Trabajo de la SEGG «Enseñanza de la Geriatría en el pregrado» mediante 2reuniones presenciales y discusiones a través de correo electrónico. Resultados: Se propone un decálogo de recomendaciones sobre la docencia de Geriatría en las facultades de Medicina españolas, incluyendo las características recomendables con relación a su estado, duración, contenidos, prácticas, profesorado, métodos docentes e innovación. Conclusiones: Estas recomendaciones tienen la finalidad de ayudar a mejorar la enseñanza de Geriatría. Pueden ser empleadas por las distintas facultades de Medicina, ya sea para adaptar la docencia de la Geriatría ya sea para incorporarla

Introduction: Population ageing and scientific progress have made specific training in Geriatrics essential for any medical students. There are different international recommendations on the teaching of Geriatric Medicine at undergraduate level, but they are still far from being offered systematically. The aim of this work was to develop a National list of recommendations in order to improve training in Geriatric Medicine at the undergraduate level. Material and methods: A list of 10 recommendations was produced by reflecting on the Geriatric training situation in Spain in 2016/2017 and international recommendations. Consensus was reached among the members of the Spanish Society of Geriatrics and Gerontology (SEGG) working group on «Geriatric training at undergraduate level» through 2meetings and online discussions. Results: A list of 10 of recommendations on Geriatric training in Spanish Medical Schools is proposed, including areas such as, the status of the discipline in the curriculum, length, contents, practical training, lecturers, teaching methods, and innovation. Conclusions: These recommendations are intended to improve Geriatrics training. They can be used by different Medical Schools either to adapt their programs or to start training in Geriatric Medicine

Development and validation of a paternalism and autonomist care assessment.

AIM: There is a need for a validated instrument to measure the type of care (paternalism or person-centred) provided for older adults. Since paternalism and person-centred care are the most important caregiving styles in the field of care and as they are usually opposed, the study aims to develop and establish psychometrics data of an instrument to identify paternalistic and autonomist behaviours in older adults care contexts, which can help to enhance care practice. DESIGN: Instrument development. METHODS: After observing and standardizing behaviours in formal care contexts in 2016, an instrument was developed and proceeding to a first validation using standard validation techniques among caregivers in two care settings during 2016-2017: senior citizen centres and older adult day care centres. RESULTS: The Paternalist/Autonomist Care Assessment (PACA) is a 30-item, behaviour-based instrument which measures both the appraisal of caregivers on elements of care (Care Appraisal Scale- PACA-Appraisal) and the occurrence of behaviours (Occurrence of Care in Context- PACA-Occurrence). The Paternalist/Autonomist Care Assessment (PACA) was validated in 160 professional caregivers and was able to discriminate two factors: paternalistic or overprotective behaviours and autonomist behaviours. However, these factors were not fully dichotomous and were shown to coexist to some degree. CONCLUSION: The instrument displayed good psychometric properties to measure paternalism and autonomy in older adult care. Moreover, it showed that the two types of care are not antagonistic and can coexist, with overprotective behaviours being more frequent in contexts of care for more dependent persons. IMPACT: There are no validated instruments to measure paternalism and person-centred behaviour in care contexts. The two measures yielded by the PACA show good construct and concurrent empirical validity, internal consistency, and convergent and discriminant validity. Family caregiver, professional caregivers, nurses, older adults.

Gregorio Marañón y el nacimiento de la especialidad de geriatría en España / Gregorio Marañón and the birth of the specialty of geriatrics in Spain

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[Ten recommendations to improve undergraduate training in Geriatric Medicine]. / Diez recomendaciones para mejorar la enseñanza de la Geriatría en el pregrado.

INTRODUCTION: Population ageing and scientific progress have made specific training in Geriatrics essential for any medical students. There are different international recommendations on the teaching of Geriatric Medicine at undergraduate level, but they are still far from being offered systematically. The aim of this work was to develop a National list of recommendations in order to improve training in Geriatric Medicine at the undergraduate level. MATERIAL AND METHODS: A list of 10 recommendations was produced by reflecting on the Geriatric training situation in Spain in 2016/2017 and international recommendations. Consensus was reached among the members of the Spanish Society of Geriatrics and Gerontology (SEGG) working group on «Geriatric training at undergraduate level¼ through 2meetings and online discussions. RESULTS: A list of 10 of recommendations on Geriatric training in Spanish Medical Schools is proposed, including areas such as, the status of the discipline in the curriculum, length, contents, practical training, lecturers, teaching methods, and innovation. CONCLUSIONS: These recommendations are intended to improve Geriatrics training. They can be used by different Medical Schools either to adapt their programs or to start training in Geriatric Medicine.

Evolución de la enseñanza de Geriatría en las facultades de Medicina españolas / Evolution of Geriatric teaching at Spanish Medical schools

OBJETIVO: Determinar la evolución reciente de la enseñanza de la Geriatría en el pregrado en España tras el aumento de facultades de Medicina y el cambio del plan de estudios. METODOLOGÍA: Se compararon las características de la enseñanza de la Geriatría en las facultades de Medicina españolas mediante dos encuestas nacionales realizadas en 2008 y 2015. En ambos casos se analizaron la inclusión de contenidos de Geriatría, el año y la materia en la que se imparte, las características del profesorado responsable y la duración de la misma. RESULTADOS: La prevalencia de docencia de Geriatría en las facultades de Medicina de las universidades españolas era del 75% en el 2008 y 77,5% en el 2015. Esta docencia se ha ido haciendo con mayor frecuencia obligatoria (66,7 vs. 96,8%, p < 0,005) pero se ha reducido su carácter de asignatura independiente (71,4 vs. 35,5%, p < 0,01). En ambos años aproximadamente el 50% de las facultades contemplaban aspectos teóricos y prácticos y en el 90% las prácticas tenían un carácter obligatorio. Se ha observado un incremento de la participación de los Servicios de Geriatría (27,3 vs. 47,1%) y de los propios geriatras como docentes directos (38,1 vs. 74,2%, p = 0,03). El tiempo medio programado para esta enseñanza era de 36 y 32 h respectivamente. No se han producido cambios significativos en más de la mitad de las facultades existentes en lo que respecta a inclusión de la Geriatría en el plan de estudios de pregrado, docencia independiente, incorporación de contenidos prácticos, estatus de las prácticas y participación de geriatras. CONCLUSIONES: La docencia de Geriatría ha presentado una evolución ligeramente positiva en muchas características, sin lograr una incorporación universal o los niveles alcanzados en otros países de nuestro entorno

OBJECTIVE: To analyse the recent evolution of Geriatric teaching at undergaduate level in Spain after the recent increase in the number of medical schools and the introductions of changes in the offical curricula. METHODOLOGY: A comparison of several characteristics of Geriatrics teaching at Spanish medical schools was done through two national surveys carried out in 2008 and 2015. The inclusion of Geriatric contents, the year when they are taught, faculty in charge and teaching hours were compared at both time points. RESULTS: The prevalence of Geriatric training was 75% in 2008 and 77.5% in 2015. This training has become compulsory more frequently (66.7 vs. 96.8%, p < .005) but the independence of Geriatrics related to other matters has decreased (71.4 vs. 35.5%, p < .01). In both surveys 50% of medical schools included theoretical and practical contents and in 90% of practices were compulsory. We found an increased of Geriatrics departments (27.3 vs. 47.1%) and geriatricians (38.1 vs. 74.2%, p= .03) in teaching. The mean duration of this training was 36 and 32hours respectively. In more than half of the medical schools existing in both years there were no significant changes in any of the characteristics surveyed. CONCLUSIONS: The teaching of Geriatrics at pregraduate level shows some positive changes, but universal teaching with standards approaching close countries has not yet been achieved

Setenta años de la Sociedad Española de Geriatría y Gerontología / Seventy years of the Spanish Society of Geriatrics and Gerontology

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Financial fraud and health: the case of Spain / Fraudes financieros y salud: el caso de España

Objective: To examine whether financial fraud is associated with poor health sleeping problems and poor quality of life. Methods: Pilot study (n=188) conducted in 2015-2016 in Madrid and León (Spain) by recruiting subjects affected by two types of fraud (preferred shares and foreign currency mortgages) using venue-based sampling. Information on the monetary value of each case of fraud; the dates when subjects became aware of being swindled, lodged legal claim and received financial compensation were collected. Inter-group comparisons of the prevalence of poor physical and mental health, sleep and quality of life were carried according to type of fraud and the 2011-2012 National Health Survey. Results: In this conventional sample, victims of financial fraud had poorer health, more mental health and sleeping problems, and poorer quality of life than comparable populations of a similar age. Those who had received financial compensation for preferred share losses had better health and quality of life than those who had not been compensated and those who had taken out foreign currency mortgages. Conclusion: The results suggest that financial fraud is detrimental to health. Further research should examine the mechanisms through which financial fraud impacts health. If our results are confirmed psychological and medical care should be provided, in addition to financial compensation (AU)

Objetivo: Explorar si los fraudes financieros se asocian a la mala salud, problemas de sueño y mala calidad de vida. Métodos: Estudio piloto (n=188) realizado en 2015-2016 en Madrid y León reclutando personas afectadas por dos tipos de fraudes (preferentes e hipotecas multidivisas), por el método venue-sampling. Se recogió información sobre el valor monetario del fraude, las fechas en que la persona conocía que había sido estafada, había iniciado una demanda y había recibido una compensación económica. Se compararon las prevalencias de mala salud física y mental, sueño y calidad de vida entre grupos según tipo de fraude y con la Encuesta Nacional de Salud de 2011-2012. Resultados: En esta muestra convencional, las víctimas de fraude financiero presentaron peor salud, más problemas de salud mental y de sueño, y peor calidad de vida que las poblaciones comparables de la misma edad. Aquellos que habían recibido una compensación económica por las pérdidas en preferentes tuvieron mejor salud y calidad de vida que los que no habían recibido compensación y que aquellos que habían contratado hipotecas multidivisas. Conclusión: Los resultados sugieren que los fraudes financieros causan daños a la salud. Deberían investigarse los mecanismos por los que los fraudes financieros causan daños de salud. Si los resultados se confirman, debe proveerse asistencia psicológica y médica, además de las compensaciones económicas (AU)