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1.
Aten Primaria ; 57(2): 103083, 2024 Sep 12.
Artigo em Espanhol | MEDLINE | ID: mdl-39270582

RESUMO

AIM: To determine the proportion of people who undergo discharge follow-up when indicated. DESIGN: Retrospective longitudinal observational study, with an analytical approach. POPULATION: persons discharged from the Hospital Universitario de la Princesa of any age and sex, with any reason for admission and with an indication for discharge follow-up in Primary Care. Users who did not have an assigned Autonomous Personal Identification Code (CIPA) were excluded. Random sample (n=289). VARIABLES: Discharge follow-up and readmissions (<30 days). Sociodemographic, clinical and discharge follow-up variables were included from the electronic medical records of Primary and Hospital Care. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was conducted. To analyze the association between discharge follow-up and readmissions, a logistic regression model was used. RESULTS: Age 72.4 years (RIQ 60-87). 55.2% of the population were women. Follow-up was conducted in 61.2% of those indicated. According to the logistic regression model performed between early readmission and discharge follow-up, adjusted for all other factors, the group with discharge follow-up had a 66% lower likelihood of hospital readmission (OR 0.34, 95% CI (0.18-0.67)). CONCLUSIONS: These findings suggest that nursing discharge follow-up conducted in primary care reduces the risk of early readmission.

2.
Aten Primaria ; 54(1): 102232, 2022 01.
Artigo em Espanhol | MEDLINE | ID: mdl-34800871

RESUMO

OBJECTIVES: To know the perspective of professionals on aspects and dimensions that should be an indispensable part of Person-Centered Care (PCA). DESIGN: Delphi Technique. LOCATION: Primary Care. PARTICIPANTS: 74 medical experts specializing in family and community medicine (FM), teaching tutors, psychologists and sociologists distributed throughout the national territory (January-June 2015). METHODS: They responded to three questionnaires: first, on aspects that a FP should take into account to carry out PCA in all its dimensions. In the second, they asked about the degree of agreement with each item and dimension in which it was classified. The responses were prioritized in a third questionnaire (Likert scale, score range 1-10). RESULTS: The response rate (RR) to the 1st questionnaire was 54.05%, obtaining 84 items, the most frequent Respect and Comprehensive Attention. The 2nd questionnaire with RR = 48.6%, obtained 52 items with a degree of agreement greater than 75%. The RR of the 3rd questionnaire was 52.7%, obtaining 21 items with a score> 9. The highest values corresponded to essential aspects of PCA: respect, comprehensive care, biopsychosocial approach, patient autonomy, and participation in decision-making. CONCLUSIONS: New dimensions were identified: Prevention and health promotion, Resource Management and Clinical Competence, added to those previously described: Biopsychosocial perspective, Doctor as a person, Patient as a person, Doctor-patient relationship and Shared Power and Responsibility. Respect, comprehensive care, the biopsychosocial approach, the patient's autonomy and their participation in decision-making, are the most valued aspects among those selected by the participating professionals.


Assuntos
Relações Médico-Paciente , Autocuidado , Técnica Delphi , Humanos , Assistência Centrada no Paciente , Inquéritos e Questionários
3.
Aten Primaria ; 52(10): 738-749, 2020 12.
Artigo em Espanhol | MEDLINE | ID: mdl-31883783

RESUMO

OBJECTIVE: Despite the acknowledged importance of 'Person Centered Care' (PCC), there are obvious limitations for its determination and measurement due to the difficulty of its exact definition. The objective of our review is to identify valid tools that measure the PCC or some of its aspects in the field of Primary Health Care. DESIGN: Systematic review DATA SOURCES: MEDLINE, Embase, Cochrane, PSYCinfo, IME-Biomedicine, LILACS and TESEO until May 31, 2018. SELECTION OF STUDIES: The inclusion criteria were: validation studies of questionnaires, systematic reviews of validation or other descriptive studies, all of which were carried out in the context of the Primary Health Care and that measured aspects of the PCC in professionals and/or patients. Two investigators independently reviewed the articles and their discrepancies were resolved by a third investigator. DATA EXTRACTION: Data were collected on the measured ACP aspects, target population, type of questionnaire, and data on validity and reliability. RESULTS: 1,415 articles were located, to which 54 additional references were subsequently added via cross references. Finally, there were 75 articles that fulfilled all the criteria and there were 39 which had the tools identified and classified according to the dimensions analyzed. CONCLUSIONS: Due to the difficulty of measuring PCC as a whole, most of the articles refer only to one of its aspects or dimensions, with the patient's perspective prevailing over that of the professional. All these tools are, nevertheless, an important starting point for future questionnaires that attempt an integral approach to the PCC.


Assuntos
Atenção Primária à Saúde , Autocuidado , Humanos , Assistência Centrada no Paciente , Reprodutibilidade dos Testes , Inquéritos e Questionários
4.
J Healthc Qual Res ; 2024 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-38991921

RESUMO

BACKGROUND AND OBJECTIVE: Hospitalization significantly interferes with the individual's well-being and it occurs both during and after the hospitalization period. Different approaches to minimize morbidity related to hospitalization and the post-discharge period have been proposed, especially to those aimed at reducing readmission rates. The aim of this study is to evaluate the effect of multicomponent intervention (MI) on operational indicators and continuity of care outcomes. MATERIALS AND METHODS: A quasi-experimental study conducted in a Brazilian university hospital in order to compare the impact of the intervention with usual care. The MI was the implementation of multidisciplinary rounds, the inclusion of the role of the navigator nurse, and care transition actions with half of the Internal Medicine teams in a clinical unit of a general hospital. Adult patients hospitalized were included in 2 periods and divided in 3 groups - Group A: before the intervention; Group B: after and with MI; Group C after and without MI. RESULTS: A total of 2333 hospitalizations were evaluated. There was a reduction in the rate of intensive care transfers to intensive care unit (ICU) and in the length of stay (LOS). LOS, discharge before noon, and transfers to ICU improved when comparing before and after the intervention, but were not different in post-intervention groups with and without MI. CONCLUSION: These results reflect the improvement of care provided by MI, an effect that could be due to cross contamination also to teams without the intervention.

5.
Semergen ; 50(5): 102192, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38306821

RESUMO

COPD is a disease with a high prevalence that diminishes the quality of life of many patients. Despite this, there are still high rates of under-diagnosis in Spain, partly due to a lack of recognition of the pathology by patients. In this context, the role played by primary care teams becomes fundamental, as they are one of the first lines of entry into the health system. In this paper we explain the different COPD profiles that may be present, and update the tools for diagnosis and treatment, which, together with an attitude of active suspicion of the disease, can help in the correct management of patients, whether they are undiagnosed or have subsequent complications.


Assuntos
Atenção Primária à Saúde , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Encaminhamento e Consulta , Humanos , Atenção Primária à Saúde/normas , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Espanha , Prevalência
6.
Farm Hosp ; 48(4): 180-184, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38458852

RESUMO

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, "Guía de entrevista telemática en atención farmacéutica," as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care.


Assuntos
Serviço de Farmácia Hospitalar , Telemedicina , Humanos , Serviço de Farmácia Hospitalar/organização & administração , Entrevistas como Assunto , Consenso , Monitoramento de Medicamentos/métodos , Sistemas de Liberação de Medicamentos , Farmacêuticos
7.
Enferm Clin (Engl Ed) ; 34(4): 330-342, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39032784

RESUMO

Case report is a narrative description of the problem of one or several patients. The CARE checklist (CAse REport) is the consensus document for reporting clinical case reports and through adaptations to the different CARE disciplines is used to define standards for authors in scientific journals; however, the specificity of the nursing process makes it difficult to adjust nursing case reports to CARE. The aim was to analyze the publications of clinical cases with a nursing perspective in scientific journals, as well as the quality standards and evaluation systems used. Few journals reviewed agreed to publish nursing case reports or stated standards for authors to adjust to CARE. Preliminary results indicated average or poor adherence to CARE, with the most reported elements being: Keywords, patient information and introduction. Adherence was lower for the elements: Timeline, therapeutic intervention, follow-up and outcomes, and patient perspective. The characteristics of the nursing process implies a low adherence to CARE, so it is necessary to unify criteria to guide researchers, authors, reviewers and editors of scientific journals, as well as to improve the rigor and quality of the reports. Currently, there are no specific guidelines for reporting clinical case reports with a nursing perspective available. These normative gaps could be solved by developing a CARE extension adapted to the methodological characteristics of the nursing process.


Assuntos
Lista de Checagem , Humanos , Editoração/normas , Processo de Enfermagem/normas
8.
Farm Hosp ; 48(4): T180-T184, 2024.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-38777651

RESUMO

Telepharmacy is defined as the practice of remote pharmaceutical care, using information and communication technologies. Given its growing importance in outpatient pharmaceutical care, the Spanish Society of Hospital Pharmacy developed a consensus document, Guía de entrevista telemática en atención farmacéutica, as part of its strategy for the development and expansion of telepharmacy, with key recommendations for effective pharmacotherapeutic monitoring and informed dispensing and delivery of medications through telematic interviews. The document was developed by a working group of hospital pharmacists with experience in the field. It highlights the benefits of telematic interviewing for patients, hospital pharmacy professionals, and the healthcare system as a whole, reviews the various tools for conducting telematic interviews, and provides recommendations for each phase of the interview. These recommendations cover aspects such as tool/platform selection, patient selection, obtaining authorization and consent, assessing technological skills, defining objectives and structure, scheduling appointments, reviewing medical records, and ensuring humane treatment. Telematic interview is a valuable complement to face-to-face consultations but its novelty requires a strategic and formal framework that this consensus document aims to cover. The use of appropriate communication tools and compliance with recommended procedures ensure patient safety and satisfaction. By implementing telematic interviews, healthcare institutions can improve patient care, optimize the use of resources and promote continuity of care.


Assuntos
Serviço de Farmácia Hospitalar , Telemedicina , Humanos , Serviço de Farmácia Hospitalar/organização & administração , Entrevistas como Assunto , Sistemas de Liberação de Medicamentos , Farmacêuticos
9.
Rev Esp Cardiol (Engl Ed) ; 76(10): 803-812, 2023 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-36963612

RESUMO

INTRODUCTION AND OBJECTIVES: Low socioeconomic status (SES) is associated with poor outcomes in patients with heart failure (HF). We aimed to examine the influence of SES on health outcomes after a quality of care improvement intervention for the management of HF integrating hospital and primary care resources in a health care area of 209 255 inhabitants. METHODS: We conducted a population-based pragmatic evaluation of the implementation of an integrated HF program by conducting a natural experiment using health care data. We included all individuals consecutively admitted to hospital with at least one ICD-9-CM code for HF as the primary diagnosis and discharged alive in Catalonia between January 1, 2015 and December 31, 2019. We compared outcomes between patients exposed to the new HF program and those in the remaining health care areas, globally and stratified by SES. RESULTS: A total of 77 554 patients were included in the study. Death occurred in 37 469 (48.3%), clinically-related hospitalization in 41 709 (53.8%) and HF readmission in 29 755 (38.4%). On multivariate analysis, low or very low SES was associated with an increased risk of all-cause death and clinically-related hospitalization (all Ps <.05). The multivariate models showed a significant reduction in the risk of all-cause death (HR, 0.812; 95%CI, 0.723-0.912), clinically-related hospitalization (HR, 0.886; 95%CI, 0.805-0.976) and HF hospitalization (HR, 0.838; 95%CI, 0.745-0.944) in patients exposed to the new HF program compared with patients exposed to the remaining health care areas and this effect was independent of SES. CONCLUSIONS: An intensive transitional HF management program improved clinical outcomes, both overall and across SES strata.


Assuntos
Prestação Integrada de Cuidados de Saúde , Insuficiência Cardíaca , Humanos , Hospitalização , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/terapia , Classe Social , Estudos Retrospectivos
10.
Enferm Clin (Engl Ed) ; 33(3): 184-194, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37023962

RESUMO

OBJECTIVE: To explore the elements involved in the process of paediatric palliative home care in the Spanish context according to the opinion of professionals. METHOD: Qualitative study based on Grounded Theory, adjusted to COREQ standards, using theoretical sampling with in-depth interviews (June 2021-February 2022) with paediatricians, paediatric nurses and social workers from paediatric palliative care units in Spain, excluding professionals with less than 1 years' experience. Interviews were recorded and transcribed literally for coding and categorisation through a constant comparative process of code co-occurrence until data saturation using Atlas-Ti®. The anonymity of the informants has been guaranteed by using pseudonyms after approval by the Research Ethics Committee of the Hospital Universitario de Gran Canaria Doctor Negrín (Las Palmas, Canary Islands) with registration number 2021-403-1. RESULTS: 18 interviews were conducted and 990 quotes were grouped into 22 categories of analysis and structured into four thematic groups (care, environment, patient and family, and professionals). The findings showed a holistic view emphasising the need to organise and integrate the factors involved in the home-based approach to paediatric palliative home care. CONCLUSIONS: In our context, the home environment meets appropriate conditions for the development of paediatric palliative care. The categories of analysis identified establish a starting point for further deepening the approach from the thematic areas involved: care, the environment, the patient and family, and professionals.


Assuntos
Serviços de Assistência Domiciliar , Humanos , Criança , Teoria Fundamentada , Cuidados Paliativos , Pesquisa Qualitativa , Hospitais
11.
J Healthc Qual Res ; 38(3): 144-151, 2023.
Artigo em Espanhol | MEDLINE | ID: mdl-36372730

RESUMO

INTRODUCTION AND OBJECTIVES: The Galician Health Service designed a system to improve demand management in primary care known as "XIDE". In it, all professionals participate in an interdisciplinary manner and within their competence framework, to respond to a reason for consultation in a certain time and manner. This article evaluates the pilot phase of implementation of XIDE in primary care of the Galician Health Service. MATERIALS AND METHODS: Cross-sectional descriptive study carried out in 45 primary care centers selected opportunistically at the discretion of the management of the Galician Health Service. For each center, were included all on-demand appointments requested by the adult population in the administrative units in person or by telephone, between 11/2021-05/2022. The XIDE integrates an intelligent search engine that, through algorithms, guides the administrative staff to make an appointment on demand. It performed a descriptive analysis of all the variables, as well as a bivariate analysis with chi-square to identify the causes of the population's rejection of XIDE. RESULTS: The three most frequent reasons for consultation were: knowing the results of the analysis (11.2%), performing blood tests (11.2%) and prescriptions for drugs (10.9%). Family medicine and nursing professionals are the ones who received the most citations. 22.1% of the appointments required to be scheduled on the same day or immediately. The acceptance of the population to the XIDE system was 85.0%. The reason for consultation, response time, mode of care and the recipient professional had a significant influence (p<0.0001) on the rejection of the appointment. CONCLUSIONS: The XIDE adapts globally well to the appointment systems and the organization of primary care of the Galician Health Service, which could facilitate its extension to all health centers in Galicia. However, it is necessary to delve deeper into the causes of rejection in order to introduce improvements that guarantee its viability in the medium-long term.


Assuntos
Serviços de Saúde , Encaminhamento e Consulta , Adulto , Humanos , Estudos Transversais , Atenção Primária à Saúde
12.
Rev Esp Anestesiol Reanim (Engl Ed) ; 69(4): 203-207, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35534385

RESUMO

BACKGROUND AND OBJECTIVE: Scientific and technological advances are changing medical practice and transforming hospitals, and both the age and comorbidities of hospitalized patients are rapidly increasing. The increasing complexity of these patients and the scant clinical differences between medical and surgical inpatients calls for changes in the organization and delivery of in-hospital care. Our objective has been to assess differences in age and comorbidity between surgical and medical inpatients. MATERIALS AND METHODS: Retrospective, observational, descriptive study in patients aged ≥16 years discharged from all medical and surgical services during 2019, except for obstetrics and intensive care. All data were obtained from the hospital's minimum basic data set and analyzed using univariate analysis. RESULTS: The study included 31,264 patients: 16,397 from the medical area and 14,867 from the surgical area. Those in the surgical area were 8 years younger (62.69 years [95% CI 62.4-62.98]), with a slightly higher proportion of women (OR 1.12 [95% CI 1.07-1.17]) compared to the medical area, and fewer non-scheduled admissions (OR 0.11 [95% CI 0.10-0.12]). There were no significant differences in comorbidity burden between study groups. CONCLUSIONS: Patients in the surgical area have a high burden of medical comorbidity, similar to those in the medical area. This information is important for surgeons and anesthetists, and should compel hospitals to change the current organizational model.


Assuntos
Pacientes Internados , Alta do Paciente , Comorbidade , Feminino , Hospitalização , Humanos , Estudos Retrospectivos
13.
Bol Med Hosp Infant Mex ; 79(4): 259-262, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36100215

RESUMO

Healthcare-associated infections are a significant cause of morbidity and mortality. Hand hygiene is considered an effective method of prevention. This article summarizes the results of a Cochrane systematic review evaluating methods for improving hand hygiene compliance in patient care.


Las infecciones asociadas con la atención médica son una causa importante de morbilidad y mortalidad. La higiene de las manos se considera un método eficaz de prevención. Este documento resume los resultados de una revisión sistemática Cochrane que evalúa los métodos para mejorar el cumplimiento de la higiene de manos en la atención al paciente.


Assuntos
Infecção Hospitalar , Higiene das Mãos , Infecção Hospitalar/prevenção & controle , Humanos , Assistência ao Paciente , Cooperação do Paciente
14.
Med Clin (Barc) ; 158(8): 361-365, 2022 04 22.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34311974

RESUMO

BACKGROUND AND OBJECTIVES: The miniaturisation and portability of ultrasound devices allow the family doctor to apply them in areas such as the patient's home. The present study aims to prove that performing an abdominal ultrasound in the home of frail patients is feasible, decreases the delay in care, and reduces diagnostic uncertainty. PATIENTS AND METHODS: Case-control study. A sample of 59 patients was studied: 30 cases and 29 controls. A descriptive analysis of the case group was carried out and the delay variable was compared between both groups. RESULTS: A relevant and significant reduction, up to 10 times lower, was observed in the delay between the ultrasound performed in homecare compared those performed in the hospital. Of the patients, 73.4% only required clinical follow-up by their physician. In those patients who required other complementary tests or referrals, the definitive diagnosis was in complete agreement with the results of the ultrasound performed in homecare. CONCLUSIONS: The implementation of ultrasound in homecare services is feasible and provides relevant clinical benefits for the patient and increases the resolution capacity of the professional.


Assuntos
Serviços de Assistência Domiciliar , Médicos , Estudos de Casos e Controles , Estudos de Viabilidade , Humanos , Ultrassonografia
15.
Nutr Hosp ; 38(Spec No1): 41-45, 2021 Apr 12.
Artigo em Inglês | MEDLINE | ID: mdl-33525886

RESUMO

INTRODUCTION: The debate from the course preceding the SENPE (Spanish Society of Clinical Nutrition and Metabolism) 2020 Conference gathered together well-known professionals who form part of nutritional support teams (NSTs), as well as other specialists from departments whose patients benefit from the services offered by these NSTs. In this article, relevant points from the round table, including strengths and weaknesses detected in the implementation of nutrition support teams, are summarized.


INTRODUCCIÓN: El debate del curso previo al congreso de la Sociedad Española de Nutrición Clínica y Metabolismo (SENPE) 2020 reunió en una mesa redonda a profesionales de prestigio que forman parte de unidades de nutrición y dietética, y a otros especialistas de servicios cuyos pacientes se benefician de los servicios de estas unidades. En este artículo se muestran los puntos relevantes que se trataron en el mismo y se muestran algunas fortalezas y debilidades que se han detectado en la implementación de las unidades de nutrición.


Assuntos
Serviço Hospitalar de Nutrição , Pessoal de Saúde/organização & administração , Apoio Nutricional , Equipe de Assistência ao Paciente/organização & administração , COVID-19/epidemiologia , Humanos , Pandemias
16.
Rev Esp Anestesiol Reanim (Engl Ed) ; 68(9): 523-530, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34801469

RESUMO

INTRODUCTION: Non-technical skills are related to morbi-mortality in medicine; it has been proposed that 46% of fatal outcomes are explained to limitations in non-technical skills and only 5% to technical skills deficiencies, however, there is no validated instrument or scale in spanish that allows its evaluation in the management of medical crisis. OBJECTIVE: To evaluate the psychometric properties of a Spanish-adapted version of the "Ottawa crisis resource management (CRM) global rating scale (GRS)" in medical staff involved in critical decision-making based in high-fidelity simulation, which could be beneficial to impact patient safety and improve clinical outcomes. METHODS: Transversal cultural instrument validation and adaptation study, included 91 participants who simulated a medical crisis between 2018 and 2019, and to whom the Spanish version of the CRM-GRS was applied in order to evaluate its psychometric properties. RESULTS: A cultural adaptation with translation into Spanish of the CRM-GRS was made. Subsequently, the scale was applied to 91 participants. An internal consistency (Cronbach's alpha) greater than 0.9 was found in each dimension. The level of inter-rater reliability, evaluated by the interclass coefficient was 0.59 to 0.69, and test-retest reliability with an interclass coefficient greater than 0.7. The validity of the convergent construct was moderate (interclass coefficient between 0.6 and 0.7 for all domains) and the validity of the divergent construct between 0.4 and 0.5 was found adequate. CONCLUSION: The translated and adapted Spanish version of the CRM-GRS in crisis had adequate internal consistency, reliability, and construct validity.


Assuntos
Tradução , Traduções , Pessoal de Saúde , Humanos , Psicometria , Reprodutibilidade dos Testes
17.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-34538662

RESUMO

INTRODUCTION: Non-technical skills are related to morbi-mortality in medicine; it has been proposed that 46% of fatal outcomes are explained to limitations in non-technical skills and only 5% to technical skills deficiencies, however, there is no validated instrument or scale in spanish that allows its evaluation in the management of medical crisis. OBJECTIVE: To evaluate the psychometric properties of a Spanish-adapted version of the "Ottawa crisis resource management (CRM) global rating scale (GRS)" in medical staff involved in critical decision-making based in high-fidelity simulation, which could be beneficial to impact patient safety and improve clinical outcomes. METHODS: Transversal cultural instrument validation and adaptation study, included 91 participants who simulated a medical crisis between 2018 and 2019, and to whom the Spanish version of the CRM-GRS was applied in order to evaluate its psychometric properties. RESULTS: A cultural adaptation with translation into Spanish of the CRM-GRS was made. Subsequently, the scale was applied to 91 participants. An internal consistency (Cronbach's alpha) greater than 0.9 was found in each dimension. The level of inter-rater reliability, evaluated by the interclass coefficient was 0.59 to 0.69, and test-retest reliability with an interclass coefficient greater than 0.7. The validity of the convergent construct was moderate (interclass coefficient between 0.6 and 0.7 for all domains) and the validity of the divergent construct between 0.4 and 0.5 was found adequate. CONCLUSION: The translated and adapted Spanish version of the CRM-GRS in crisis had adequate internal consistency, reliability, and construct validity.

18.
Endocrinol Diabetes Nutr (Engl Ed) ; 67(10): 665-671, 2020 Dec.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32499203

RESUMO

INTRODUCTION: The activity of an Endocrinology and Nutrition (E&N) department consists of inpatient care both by those attached to the department and through consultations with specialists from other departments. The inpatient care activity of all the E&N departments of a public health system has not been studied in Spain. MATERIAL AND METHODS: This was a retrospective study of hospital ward activity during 2018 of the E&N departments of the Castilla-La Mancha Public Health Service. It was undertaken in order to ascertain the characteristics of the patients attended to, both by those in charge of the E&N departments and through interconsultation with other departments, as well as the case-mix of the pathology of these patients. All patients admitted to E&N and a 10% sample of those treated through interconsultation were analysed. RESULTS: 261 admissions were recorded for Castilla-La Mancha Public Health Service E&N departments. 82.8% were urgent and 53.7% were due to type 1 diabetes mellitus. A total of 5955 patients were seen on an interconsultation basis, 591 of whom were analysed. The most frequent reason for interconsultation was diabetes mellitus/hyperglucemia (28.8%), requiring 6.1±6.7 days per patient. However, interconsultations for artificial nutrition required more days of attendance per patient and accounted for a higher percentage of the total number of days of interconsultation (60.4%). CONCLUSIONS: The inpatient care activity of the E&N departments of Castilla-La Mancha Public Health Service mainly consists of attending to patients with chronic pathologies of high hospital prevalence such as diabetes mellitus/hyperglucemia and, especially, clinical nutrition.

19.
Enferm Clin (Engl Ed) ; 30(1): 31-36, 2020.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30711427

RESUMO

OBJECTIVE: To determine associations between respiratory nursing diagnoses and nursing interventions in patients submitted to thoracic or upper abdominal surgery. METHOD: Cross sectional quantitative study. Participants were 312 adult patients within the first 48 hours after thoracic or upper abdominal surgery. Patients were examined by the research team using an instrument with variables related to the respiratory function. The research team established the presence/absence of three nursing diagnoses and proposed interventions using the NANDA-I classification and the Nursing Interventions Classification. Correlations were tested using the chi-square or Fisher's test. RESULTS: From the total 312 examinations, ineffective airway clearance was present in 185 (59.3%) assessments, ineffective breathing pattern in 123 (39.4%), and impaired gas exchange in 141 (45.4%). Significant correlations showed that patients with ineffective airway clearance were more likely to require pain management (or: 2.27), chest physiotherapy (or: 2.96), and positioning (or:1.8), while patients with impaired gas exchange were less likely to require airway management (or: 0.13) and chest physiotherapy (or: 0.28). CONCLUSIONS: Patients with ineffective airway clearance had more chances of requiring pain management, chest physiotherapy, and positioning, while the nursing diagnosis impaired gas exchange was related with airway management and chest physiotherapy. The findings provide basis for nurses to develop effective care plans and to minimize postoperative respiratory complications.


Assuntos
Diagnóstico de Enfermagem , Transtornos Respiratórios , Adulto , Estudos Transversais , Humanos , Transtornos Respiratórios/terapia
20.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1563615

RESUMO

Introducción: las competencias bioéticas permiten abordar colectiva y críticamente, aspectos éticos involucrados en la práctica clínica. Pero, la deliberación ética simultánea de médico/as con enfermero/as, en pacientes no críticos, es inhabitual. Objetivo: constatar la percepción de médico/as y enfermero/as de un hospital de alta complejidad, sobre sus competencias bioéticas y deliberación sincrónica, en hospitalizados pediátricos sin riesgo vital. Métodos: se realizó un estudio descriptivo y transversal mediante encuesta, a médico/as y enfermero/as del servicio médico-quirúrgico infantil, sobre presencia, modalidad de enseñanza de bioética en pregrado, percepción de tener conocimiento bioético suficiente para aplicarlo clínicamente y si hubo análisis ético-clínico conjunto, en pacientes hospitalizados. Resultados: la mayoría de los encuestados 47/54 (87%) recibió formación teórica obligatoria en bioética durante el pregrado. De ellos, 19/29 (65,5%) médico/as y 11/18 (61,1%) enfermero/as reconocieron que esta formación fue insuficiente para aplicarla en el trabajo. 25/35 (71,4%) médicos, afirmó participar en deliberación ética antes de enviar un caso al comité de ética asistencial, pero esta deliberación ocasionalmente incluyó a enfermero/as ya que, sólo 2/19 (10,5%) de los enfermero/as señalaron intervenir en este tipo de deliberación. Conclusiones: médico/as y enfermero/as que trabajan en pediatría y cirugía infantil, perciben insuficiencias de formación en pregrado en bioética e impericia para aplicar contenidos a la práctica cotidiana. La deliberación ética sobre casos clínicos pediátricos de enfermero/as es esporádica respecto de médico/as en hospitalización médico-quirúrgica básica.


Introduction: Bioethical skills are essential for addressing, both collectively and critically, ethical issues that arise in clinical practice. However, joint ethical deliberation between physicians and nurses with non-critical patients is uncommon Objective: To study the perception of physicians and nurses regarding their bioethical skills in a high-complexity hospital and whether they engage in collective deliberation in units of pediatric inpatients not at vital risk. Methods: A descriptive, cross-sectional study was conducted via a survey targeting physicians and nurses in the pediatric medical-surgical service. The survey inquired about the presence and modality of bioethics teaching during undergraduate education, the perception of having sufficient bioethical knowledge for clinical application, and whether joint ethical-clinical analysis was performed regarding hospitalized patients. Results: Most respondents, 47/54 (87%), had received mandatory theoretical training in bioethics during their undergraduate education. 19/29 (65.5%) physicians and 11/18 (61.1%) nurses acknowledged that this training was insufficient for application in their work. A high percentage of physicians, 19/29 (65.5%), claimed to carry out ethical analysis of cases before referring them to the healthcare ethics committee, occasionally including nurses since only 2/18 (11.1%) of the nurses indicated participation in such analysis. Conclusions: Medical and nursing professionals who work in pediatrics and children's surgery perceive insufficiencies in undergraduate training in bioethics issues and an inability to apply content to daily practice. Ethical deliberation on pediatric clinical cases by nurses is sporadic compared to doctors in basic medical-surgical hospitalization.

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