Comparison between attention and experiences of chronic complex patients: A multicentric study.

The aim of this research is to explore and analyse the functional status and experiences of complex patients located at levels 3-4 of the risk pyramid of the chronic care model in primary care, within the hospital system of two regions in Spain. The design was a mixed design (COREQ). The participants were enrolled in programs for chronic complex patients and their caregivers. Sociodemographic variables were gathered, together with the following measures: the Barthel test, the Mini mental test, the Zarit questionnaire, the IEXPAC scale and the Braden scale. A semi-structured interview was conducted individually with patients in order to explore their experiences and narrative on the process of their illness and the support they had received. The sample comprised 206 chronic pluripathological patients, of whom 103 were from Cantabria and a further 103 were from Mallorca. The patient profile in both regions was very similar. There was an equal distribution across both gender and the patients were over 78 years old. They all had a basic (primary) education, an average income and required moderate physical dependence, receiving assistance primarily from their children. The qualitative analysis highlighted patients' awareness of the illness and their concern for the future, noting that, overall, patients were satisfied with the care provided by their caregivers and the health system. We can conclude that is the first multicentric study of these characteristics conducted in Spain, despite it being the country with the second largest ageing population in the world. It is important to test new organisational models with differentiating areas of advanced clinical practice in primary care, whereby both patients and their caregivers can be co-responsible within the care process.

Incontinencia urinaria en mujeres de Mallorca: prevalencia y calidad de vida / Urinary Incontinence in Mallorcan Women: Prevalence and Quality of Life

Objetivos: Estimar la prevalencia poblacional de incontinencia urinaria (IU) en mujeres mayores de 30 años de Mallorca, su distribución por edad y tipo de incontinencia y su repercusión en la calidad de vida. Material y métodos: Estudio descriptivo transversal, poblacional, en muestra aleatoria de 673 mujeres de la población adscrita al Hospital Son Llàtzer y a los 14 centros de salud de su sector de influencia. Tras invitación a participar en el estudio, fueron entrevistadas telefónicamente y en consulta por sus enfermeras de atención primaria, cumplimentando un cuestionario con las versiones españolas del ICIQ-SF y EuroQol-5D. Se estimó la prevalencia, los tipos de IU y su severidad (ICIQ-SF de 0 a 21 puntos), los antecedentes y la calidad de vida de mujeres con y sin incontinencia. Resultados: Un 24% (IC 95% = 20,9-27,5%) sufría incontinencia, y la prevalencia aumentaba de manera significativa con la edad. El tipo de IU más frecuente fue de esfuerzo (45%), seguido de mixta (29%), de urgencia (19,4%) y continua (6,5%). En las mujeres incontinentes la puntuación total media del ICIQ-SF fue de 9,2; un 25,2% correspondía a IU moderada-severa. La mayor puntuación del ICIQ-SF fue en la IU mixta y continua. Las mujeres incontinentes presentaron peor calidad de vida en todas las dimensiones del EuroQol-5D, observando una mayor afectación en aquellas mujeres con IU mixta y continua. Conclusiones: Una de cada 4 mujeres sufre IU y tienen peor calidad de vida. La prevalencia aumenta con la edad, la mitad es de esfuerzo y una cuarta parte moderada-grave (AU)

Goals: To estimate the prevalence, age distribution, impact on quality of life and type of urinary incontinence (UI) in women over 30 years in Mallorca (Spain). Material and methods: Cross-sectional descriptive study on a randomized sample of 673 women in the health district affiliated to Son Llàtzer Hospital and the 14 Community Health Centres on its area of influence. Following an invitation to participate in the study, women were interviewed twice by their Community Nurse, through the phone and face-to-face. Every interview comprised the completion of the Spanish versions of the ICIQ-SF and EuroQol-5D questionnaires. Prevalence, type and severity (ICIQ-SF) of UI, previous health history and quality of life of women suffering from and free from UI were all estimated. Results: 24% (CI 95% = 20.9-27.5%) of women suffered from UI and prevalence increased significantly with age. Most frequently identified type of UI was stress incontinence (45%) followed by mixed incontinence (29%), urge incontinence (19.4%) and continuous incontinence (6.5%). For women suffering from UI, ICIQ-SF mean total score was 9.2, 25.2% of these suffering from moderate to severe UI. Women suffering from mixed or continuous UI scored highest at ICIQ-SF. Women suffering from UI showed worse quality of life in every dimension of EuroQol-5D. Quality of life was especially poor for women suffering from mixed or continuous UI .Conclusions: One in four women suffers from UI. UI prevalence increases with age. Half of identified women suffered from stress UI. A fourth of identified incontinences were described as moderate to severe. Women suffering from UI showed worse quality of life (AU)

Urinary incontinence in Mallorcan women: prevalence and quality of life.

GOALS: To estimate the prevalence, age distribution, impact on quality of life and type of urinary incontinence (UI) in women over 30 years in Mallorca (Spain). MATERIAL AND METHODS: Cross-sectional descriptive study on a randomized sample of 673 women in the health district affiliated to Son Llàtzer Hospital and the 14 Community Health Centres on its area of influence. Following an invitation to participate in the study, women were interviewed twice by their Community Nurse, through the phone and face-to-face. Every interview comprised the completion of the Spanish versions of the ICIQ-SF and EuroQol-5D questionnaires. Prevalence, type and severity (ICIQ-SF) of UI, previous health history and quality of life of women suffering from and free from UI were all estimated. RESULTS: 24% (CI 95%=20.9-27.5%) of women suffered from UI and prevalence increased significantly with age. Most frequently identified type of UI was stress incontinence (45%) followed by mixed incontinence (29%), urge incontinence (19.4%) and continuous incontinence (6.5%). For women suffering from UI, ICIQ-SF mean total score was 9.2, 25.2% of these suffering from moderate to severe UI. Women suffering from mixed or continuous UI scored highest at ICIQ-SF. Women suffering from UI showed worse quality of life in every dimension of EuroQol-5D. Quality of life was especially poor for women suffering from mixed or continuous UI. CONCLUSIONS: One in four women suffers from UI. UI prevalence increases with age. Half of identified women suffered from stress UI. A fourth of identified incontinences were described as moderate to severe. Women suffering from UI showed worse quality of life.