1
|
Jiménez-Puente A, Martín-Escalante MD, Martos-Pérez F, García-Alegría J. Increase in hospital care at the end of life: Retrospective analysis of the last 20 years of life of a cohort of patients. Rev Esp Geriatr Gerontol 2024; 59:101484. [PMID: 38552406 DOI: 10.1016/j.regg.2024.101484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND There is an increasing need for end-of-life care due to society's progressive aging. This study aimed to describe how hospitalizations evolve long-term and in the last months life of a cohort of deceased patients. METHODS The study population were those who died in one year who lived in a district in southern Spain. The number of hospital stays over the previous 20 years and number of contacts with the emergency department, hospitalization, outpatient clinics, and medical day hospital in the last three months of life were determined. The analyses were stratified by age, sex, and pattern of functional decline. RESULTS The study population included 1773 patients (82.5% of all who died in the district). The hospital stays during the last 20 years of life were concentrated in the last five years (66%) and specially in the last six months (32%). Eighty percent had contact with the hospital during their last three months of life. The older group had the minimun of stays over the last 20 years and contacts with the hospital in the last months of life. CONCLUSIONS The majority of hospitalizations occur at the end of life and these admissions represent a significant part of an acute-care hospital's activity. The progressive prolongation of life does not have to go necessarily along with a proportional increase in hospital stays.
Collapse
Affiliation(s)
- Alberto Jiménez-Puente
- Hospital Costa del Sol, Unidad de Evaluación, Marbella, Málaga, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Marbella, Málaga, Spain; IBIMA Plataforma BIONAND, Marbella, Málaga, Spain.
| | | | | | - Javier García-Alegría
- Hospital Costa del Sol, Área de Medicina Interna, Marbella, Málaga, Spain; Red de Investigación en Cronicidad, Atención Primaria y Promoción de la Salud (RICAPPS), Marbella, Málaga, Spain; IBIMA Plataforma BIONAND, Marbella, Málaga, Spain
| |
Collapse
|
2
|
Martínez-Sanz J, Losa-García JE, Orozco N, Alastrué I, Mascort J, Pérez-Elías MJ. Executive summary of the consensus document on the shared care of patients with HIV infection between primary and hospital care. Enferm Infecc Microbiol Clin (Engl Ed) 2024; 42:102-107. [PMID: 37919199 DOI: 10.1016/j.eimce.2023.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 11/04/2023]
Abstract
The current reality of the diagnosis and treatment of HIV infection justifies a multidisciplinary and coordinated approach between Primary Care and Hospital Care, contemplating bidirectionality and communication between the two care settings. The consensus document, coordinated by the AIDS Study Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC-GeSIDA) and the Spanish Society of Family and Community Medicine (semFYC), was born out of this need. Here, the recommendations of the four sections that comprise it are summarized: the first deals with aspects of prevention and diagnosis of HIV infection; the second contemplates the clinical care of people living with HIV; the third deals with social factors, including legal and confidentiality issues, quality of life, and the role of NGOs; finally, the fourth block addresses bidirectional and shared training/teaching and research.
Collapse
Affiliation(s)
- Javier Martínez-Sanz
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFEC, Madrid, Spain.
| | - Juan E Losa-García
- Unidad de Enfermedades Infecciosas, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain
| | | | - Ignacio Alastrué
- Centro de Información y Prevención del Sida y otras ITS, Valencia, Spain
| | - Juanjo Mascort
- Centro de Salud La Florida Sud, ICS, L'Hospitalet de Llobregat, Barcelona, Spain
| | - María Jesús Pérez-Elías
- Servicio de Enfermedades Infecciosas, Hospital Universitario Ramón y Cajal, IRYCIS, CIBERINFEC, Madrid, Spain
| |
Collapse
|
3
|
Suárez Álvarez Ó, Ruiz-Cantero MT. [Morbidity due to chronic diseases and their health care in Asturias: a gender analysis]. Gac Sanit 2023; 37:102334. [PMID: 37988970 DOI: 10.1016/j.gaceta.2023.102334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/18/2023] [Accepted: 09/18/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To determine gender differences in the magnitude and complexity of chronic diseases and gender inequalities in health care in the adult population of Asturias in 2022. METHOD A cross-sectional population study in people (>14 years) with at least one diagnosis of chronic disease (780,566 inhabitants). SOURCES OF INFORMATION computer program for morbidity groups (Ministry of Health), Electronic medical record of primary care and hospital. Comparative analysis by sex and age, the mean values of chronic diseases and complexity index (Student's t test and one-way ANOVA), and probability (odds ratio and 95% CI) of suffering from specific chronic diseases, making one or more visits to the hospital emergency department or one or more admissions to hospital. RESULTS 89.9% of women and 82.1% of men were registered with at least one chronic disease. The mean was higher in women (4.36) than in men (3.22) (p<0.001). Complexity index: men 4.56 and women 5.85 (p<0.001). Results show that women are more likely to attend the hospital emergency department, with an attendance rate of 50% for the diseases cited, compared with men at 29%. The rate of hospital admission is higher in men in 13 of the 14 diseases studied (85%). CONCLUSIONS Gender analysis can also be applied to secondary sources of the National Health System. Despite the greater magnitude and complexity of chronic diseases in women, there is a higher frequency of hospital admissions in men compared to women with the same diseases. This implies an unequal care profile in the field of hospital admissions that the scientific literature associates with gender biases in health care.
Collapse
Affiliation(s)
- Óscar Suárez Álvarez
- Programa de Doctorado en Ciencias de la Salud, Universidad de Alicante, Alicante, España.
| | - María Teresa Ruiz-Cantero
- Grupo de Investigación en Salud Pública, Universidad de Alicante, Alicante, España; CIBER de Epidemiología y Salud Pública (CIBERESP), España
| |
Collapse
|
4
|
Mateo-Gavira I, Carrasco-García S, Larran L, Fierro MJ, Zarallo A, Mayoral Sánchez E, Aguilar-Diosdado M. Specific model for the coordination of primary and hospital care for patients with diabetes mellitus. Evaluation of two-year results (2015-2017). ENDOCRINOL DIAB NUTR 2021; 68:175-183. [PMID: 34167697 DOI: 10.1016/j.endien.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Accepted: 12/24/2019] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Diabetes mellitus (DM) is one of the most prevalent chronicdiseases and has a significant health and social impact. Strict control of blood glucose levels and other risk factors for vascular disease (VD) reduces complications and mortality and is related to the quality of care received. Although care should be interdisciplinary, based on the coordination of primary care (PC) and hospital care (HC), little information is available on the effectiveness of the different existing intervention models. OBJECTIVE To assess, in a population with DM from a healthcare area, the impact on health, quality of care, and effectiveness in the use of resources of a specific model of shared management of patients with DM (Instrument for Evaluation of Models of Chronic Care in Diabetes Mellitus; IEMAC-DM). PATIENTS AND METHODS A quasi-experimental before-after intervention study in patients with DM in the Cádiz-San Fernando Healthcare Area (Andalusia, Spain) that allows for identifying the capacity of the program to improve the quality indicators both in the whole population with DM and in that referred to HC. For this, a working group consisting of healthcare professionals of different profiles and care levels was set up. An initial self-assessment was done using the IEMAC-DM tool and, after analysis of the preliminary results, improvement strategies were established and implemented. Finally, the clinical and resource management results were assessed before and two years after the implementation of the model. RESULTS During the study period, no significant changes were seen in process indicators related to laboratory practices or examinations in the health area. The proportion of patients with acceptable metabolic control [glycosylated hemoglobin (HbA1c) level < 8%] was 49% in 2015 and 45% in 2017. The number of admissions related to acute myocardial infarction (AMI) and stroke remained constant, but there was an increase in the standardized ratio of major lower limb amputations (1.5 vs. 1.9). Of the 295 patients referred from PC to HC, the proportion of adequate referrals increased from 40% in 2015 to 76% in 2017 (P = .001). In the referred patients, a significant improvement was seen in the mean difference in glycosylated hemoglobin levels (HbA1c; 1.14 ± 1.73%; 95% CI: 0.73-1.55; P = .0001) and cholesterol (11.28 ± 40 mg/dL; 95% CI: 2.07-20.48; P = .012). CONCLUSIONS This study shows that an intervention based on a chronicity care model adapted to patients with DM improves certain aspects related to the quality of care and the degree of metabolic control. Improving health outcomes will require long-term evaluation and, probably, other additional interventions.
Collapse
Affiliation(s)
- Isabel Mateo-Gavira
- Servicio de Endocrinología y Nutrición, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - Laura Larran
- Servicio de Endocrinología y Nutrición, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Hospital Universitario Puerta del Mar, Cádiz, Spain
| | | | - Antonio Zarallo
- Centro de Salud Dr. Cayetano Roldán, San Fernando, Cádiz, Spain
| | | | - Manuel Aguilar-Diosdado
- Servicio de Endocrinología y Nutrición, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA), Hospital Universitario Puerta del Mar, Cádiz, Spain; Departamento de Medicina, Facultad de Medicina, Universidad de Cádiz, Cádiz, Spain.
| | | |
Collapse
|
5
|
Sánchez Chaparro MÁ, Pascual Fuster V. Relationship beetween Primary and Hospital Care in cardiovascular prevention and treatment of dyslipidemias. Derivation algorithm. Discharge criteria. Clin Investig Arterioscler 2021; 33 Suppl 1:65-70. [PMID: 33966816 DOI: 10.1016/j.arteri.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/19/2021] [Accepted: 01/19/2021] [Indexed: 11/22/2022]
Abstract
Effective cardiovascular prevention requires taking advantage of all opportunities for patient contact with the Health Services in order to detect risk factors (CVRF) and global cardiovascular risk stratification (CVR). This particularly involves the Primary Care (PC) services, which must be coordinated with the Hospital Care (HC) in order to make all health resources available to the population. In addition, it is necessary to take into account the contribution of Occupational Health and Pharmacy services. There are hopeful signs as regards the possibility of overcoming the barriers that limit the necessary exchange of information between PC and HC professionals, as a basis for adequate coordination between both levels of care. This includes the implementation of referral and discharge algorithms (in this review this means those related to dyslipidaemias) accepted by professionals at both levels, and currently facilitated by the availability of new corporate tools (mobile, email, virtual consultations). The challenge lies in seizing the opportunity they offer to make their implementation effective.
Collapse
|
6
|
Carrillo Alcalá ME, Minaya Saiz J. [Attending COVID-19 patients during the first wave of the pandemic in a Medium Stay Hospital: Variables associated with mortality in hospitalized patients in an acute situation]. Rev Esp Geriatr Gerontol 2021; 56:334-342. [PMID: 34330544 PMCID: PMC8139233 DOI: 10.1016/j.regg.2021.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 05/01/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND OBJECTIVE Spain has been one of the countries most affected by the SARS-CoV-2 pandemic. The objective of this study is to describe the characteristics of the patients treated for COVID-19 at Guadarrama Hospital and to identify the associated mortality factors in those admitted in an acute situation. MATERIAL AND METHODS Retrospective observational study of COVID-19 patients admitted from 3/15 to 5/15/2020. Sociodemographic, mental, functional, analytical, clinical, radiological and therapeutic variables were collected. Factors associated with mortality were analysed using a bivariate and multivariate study. RESULTS Two hundred eleven patients were included: 102 (48.3%) in an acute situation and 109 (51.7%) in the convalescent phase, the median (interquartile range) age was 82 (72, 85) years. The most frequent symptoms were fever, cough and respiratory failure. The 89.9% had pneumonia. An acute mortality rate of 26.5% (27/102) was detected and the associated factors were: respiratory failure (P 0.002), Charlson index (ChI)≥3 (P<0.001), CURB≥2 (P 0.011), low SatO2/FiO2 ratio (<0.001), elevated urea (P<0.001) and creatinine (P 0.036), hypoproteinemia (P 0.037) and age (P<0.018). The deceased had a worse functional situation than the survivors (P 0.025). In the multivariate analysis, SatO2/FiO2 ratio (OR: 2.23; 95% CI: 1.07-4.63; P 0.031) and ChI≥3 (OR: 4.25; 95% CI: 1.06-17.04; P 0.041) were independent factors of mortality. CONCLUSIONS The COVID-19 patients treated were mostly severe cases. The variables associated with mortality were age, respiratory failure, comorbidity, kidney failure, and malnutrition. Respiratory failure and comorbidity outweigh age as independent risk factors for mortality.
Collapse
|
7
|
Mateo-Gavira I, Carrasco-García S, Larran L, Fierro MJ, Zarallo A, Mayoral Sánchez E, Aguilar-Diosdado M. Specific model for the coordination of primary and hospital care for patients with diabetes mellitus. Evaluation of two-year results (2015-2017). ACTA ACUST UNITED AC 2020; 68:175-183. [PMID: 32505436 DOI: 10.1016/j.endinu.2019.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 12/23/2019] [Accepted: 12/24/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Diabetes mellitus (DM) is one of the most prevalent chronic diseases and has a significant health and social impact. Strict control of blood glucose levels and other risk factors for vascular disease reduces complications and mortality and is related to the quality of care received. Although care should be interdisciplinary, based on the coordination of primary care (PC) and hospital care (HC), little information is available on the effectiveness of the different existing intervention models. OBJECTIVE To assess, in a population with DM from a healthcare area, the impact on health, quality of care, and effectiveness in the use of resources of a specific model of shared management of patients with DM (Instrument for Evaluation of Models of Chronic Care in Diabetes Mellitus; IEMAC-DM). PATIENTS AND METHODS A quasi-experimental before-after intervention study in patients with DM in the Cádiz-San Fernando Healthcare Area (Andalusia, Spain) that allows for identifying the capacity of the program to improve the quality indicators both in the whole population with DM and in that referred to HC. For this, a working group consisting of healthcare professionals of different profiles and care levels was set up. An initial self-assessment was done using the IEMAC-DM tool and, after analysis of the preliminary results, improvement strategies were established and implemented. Finally, the clinical and resource management results were assessed before and two years after the implementation of the model. RESULTS During the study period, no significant changes were seen in process indicators related to laboratory practices or examinations in the health area. The proportion of patients with acceptable metabolic control [glycosylated hemoglobin (HbA1c) level<8%] was 49% in 2015 and 45% in 2017. The number of admissions related to acute myocardial infarction and stroke remained constant, but there was an increase in the standardized ratio of major lower limb amputations (1.5 vs. 1.9). Of the 295 patients referred from PC to HC, the proportion of adequate referrals increased from 40% in 2015 to 76% in 2017 (p=0.001). In the referred patients, a significant improvement was seen in the mean difference in glycosylated hemoglobin levels (HbA1c; 1.14±1.73%; 95% CI: 0.73-1.55; p=0.0001) and cholesterol (11.28±40mg/dL; 95% CI: 2.07-20.48; p=0.012). CONCLUSIONS This study shows that an intervention based on a chronicity care model adapted to patients with DM improves certain aspects related to the quality of care and the degree of metabolic control. Improving health outcomes will require long-term evaluation and, probably, other additional interventions.
Collapse
Affiliation(s)
- Isabel Mateo-Gavira
- Servicio de Endocrinología y Nutrición, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA). Hospital Universitario Puerta del Mar, Cádiz, España
| | | | - Laura Larran
- Servicio de Endocrinología y Nutrición, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA). Hospital Universitario Puerta del Mar, Cádiz, España
| | | | - Antonio Zarallo
- Centro de Salud Dr. Cayetano Roldán, San Fernando, Cádiz, España
| | | | - Manuel Aguilar-Diosdado
- Servicio de Endocrinología y Nutrición, Instituto de Investigación e Innovación Biomédica de Cádiz (INIBICA). Hospital Universitario Puerta del Mar, Cádiz, España; Departamento de Medicina, Facultad de Medicina, Universidad de Cádiz, Cádiz, España.
| | | | | |
Collapse
|
8
|
Conesa González A, Pastor Duran X, Lozano-Rubí R. [Effectiveness of an assessment of computerised medical records in a university hospital]. ACTA ACUST UNITED AC 2017; 32:328-334. [PMID: 29169963 DOI: 10.1016/j.cali.2017.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 09/14/2017] [Accepted: 09/26/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate a sample of electronic medical records (EMR) that was sufficiently representative of the different areas of care in a university hospital, as well as to verify the effectiveness of an initial intervention through a second evaluation. METHODS Medical records audits were performed in 2012 and 2013 by a blind peer review of random samples of care episodes, proportional to the activity of each clinical department, and with the same evaluation method being applied to all of them. RESULTS More than 1,000 episodes of care were reviewed in the 2audits. A significant improvement was found in hospital admissions (P=.000) in all the sections of the EMR analysed (P=.002), and was especially significant for the reason for consultation, for which its completion increased by 8.5% (p<.05), and also in the sections of the current process record (7.1%), physical examination (4.7%), allergies (3.9%), and clinical course (3.6%). The assessment of the discharge report, as a whole, showed an improvement (P=.001). In outpatient follow-up visits, a significant positive improvement was observed in the 4sections evaluated (P<.05), and also overall (P=.000). CONCLUSIONS According to study conditions, the dissemination of the results was effective in improving the quality of the EMR. The results have made it possible to implement actions to review the work processes in certain departments, and also the partial redesign of the interface on being a reproducible methodology accepted by the organisation.
Collapse
Affiliation(s)
- A Conesa González
- Unidad de Informática Médica, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España.
| | - X Pastor Duran
- Unidad de Informática Médica, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| | - R Lozano-Rubí
- Unidad de Informática Médica, Hospital Clínic de Barcelona, Universidad de Barcelona, Barcelona, España
| |
Collapse
|
9
|
Cidoncha-Moreno MÁ, Ruíz de Alegría-Fernandez de Retana B. Barriers to the implementation of research perceived by nurses from Osakidetza. Enferm Clin 2017; 27:286-293. [PMID: 28456492 DOI: 10.1016/j.enfcli.2017.03.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 03/16/2017] [Accepted: 03/28/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To understand the barriers to implementing nursing research findings into practice, as perceived by the nurses working in Osakidetza and to analyze if the workplace factor and time worked affect the perception of these barriers. METHODS Cross-sectional study. BARRIERS Scale questionnaire was given to a representative sample of 1,572 Basque Health Service nurses, stratified and randomized, according to scope of work and job responsibility (response rate: 43.76%). RESULTS According to the research results, the first important barrier was "insufficient time on the job to implement new ideas". Nurses have perceived the organizational factor as the most important barrier in their practice. Nurses in "Special hospital departments" perceived more barriers in the "quality of research" factor than those working in "Primary Care". Years of service showed a slight influence. CONCLUSIONS The nurses stated that external factors related to the organization principally interfered in implementing results into clinical practice. They placed lack of critical reading training second. Working environment and seniority mark differences in the perception of barriers. This study may help to develop strategies for planning training programs to facilitate the use of research in clinical practice, in order to provide quality care.
Collapse
|
10
|
Jiménez Ruiz CA, de Granda Orive JI, Solano Reina S, Riesco Miranda JA, de Higes Martinez E, Pascual Lledó JF, Garcia Rueda M, Lorza Blasco JJ, Signes Costa-Miñana J, Valencia Azcona B, Villar Laguna C, Cristóbal Fernández M. Guidelines for the Treatment of Smoking in Hospitalized Patients. Arch Bronconeumol 2016; 53:387-394. [PMID: 28017455 DOI: 10.1016/j.arbres.2016.11.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 10/23/2016] [Accepted: 11/03/2016] [Indexed: 01/15/2023]
Abstract
Between 15 and 27% of patients admitted to Spanish hospitals are smokers. Hospitalization is an ideal time for a smoker to decide to quit. We performed a MEDLINE search of controlled, randomized or observational studies associated with helping hospitalized patients quit smoking, published between January 1, 2002 and September 30, 2015. On the basis of the results of those studies, we have issued some recommendations for the treatment of smoking in hospitalized patients. The recommendations were drawn up according to the GRADE system. Offering the smoker psychological counselling and prolonging follow-up for at least 4 weeks after discharge is the most effective recommendation for helping hospitalized patients to quit.
Collapse
Affiliation(s)
- Carlos A Jiménez Ruiz
- PII Tabaquismo, Unidad Especializada en Tabaquismo, Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Madrid, España.
| | - Jose Ignacio de Granda Orive
- Área de Tabaquismo, Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Servicio de Neumología, Hospital Universitario 12 de Octubre, Madrid, España
| | | | - Juan Antonio Riesco Miranda
- Sociedad Española de Neumología y Cirugía Torácica (SEPAR) EPOC y Tabaco, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Servicio de Neumología, Hospital San Pedro de Alcántara, Cáceres, España
| | - Eva de Higes Martinez
- Grupo Emergente Tabaquismo, Servicio de Neumología, Hospital Fundación Alcorcón, Alcorcón, Madrid, España
| | | | - Marcos Garcia Rueda
- Unidad de Tabaquismo, Servicio de Neumología, Hospital Carlos Haya, Málaga, España
| | | | - Jaime Signes Costa-Miñana
- PII de Tabaquismo, Sociedad Española de Neumología y Cirugía Torácica (SEPAR), Servicio de Neumología, Hospital Clínico de Valencia, Valencia, España
| | | | | | | |
Collapse
|
11
|
Jerez C, Lázaro JJ, Ullán AM. [Evaluation of the scales used to measure anxiety and child behaviour during the induction of anaesthesia. Literature review]. Rev Esp Anestesiol Reanim 2016; 63:101-107. [PMID: 26162900 DOI: 10.1016/j.redar.2015.05.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 05/26/2015] [Accepted: 05/27/2015] [Indexed: 06/04/2023]
Abstract
The assessment of children's anxiety during anaesthetic induction is useful to determine if pre-operative strategies have been effective in reducing anxiety. The aim of this study is to review the different tools used to evaluate child anxiety or behaviour during the induction of anaesthesia. The electronic databases with no date limits were reviewed in December 2013, with a second review repeated in September 2014. A data extraction template was applied to find the scales used in the articles. Eight observational scales were found. Six of them can only be used during induction of anaesthesia, and two of those could be applied at various perioperative times, before surgery and during induction of anaesthesia.
Collapse
Affiliation(s)
- C Jerez
- Departamento de Anestesiología y Reanimación, Hospital Materno-Infantil Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España.
| | - J J Lázaro
- Departamento de Anestesiología y Reanimación, Hospital Materno-Infantil Sant Joan de Déu, Esplugues de Llobregat, Barcelona, España
| | - A M Ullán
- Facultad de Ciencias Sociales, Universidad de Salamanca, Campus Miguel de Unamuno, Salamanca, España
| |
Collapse
|
12
|
Revilla-López C, Calderón-Larrañaga A, Enríquez-Martín N, Prados-Torres A. [Low concordance between primary care and hospital clinical information]. Aten Primaria 2015; 48:244-50. [PMID: 26300324 PMCID: PMC6877834 DOI: 10.1016/j.aprim.2015.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 06/19/2015] [Accepted: 06/22/2015] [Indexed: 11/25/2022] Open
Abstract
Objetivos Medir la concordancia respecto a las enfermedades crónicas registradas en atención primaria (AP) y hospitalaria, y valorar la utilidad de sus registros asistenciales con fines de investigación. Emplazamiento Estudio transversal retrospectivo integrando información diagnóstica de AP y hospitalaria de la población de Aragón ingresada en 2010. Participantes Se analizó a 75.176 pacientes Intervenciones Se analizaron coincidencias, divergencias e índice kappa de los diagnósticos registrados en AP y hospital, estratificando por grupos de edad y sexo. Mediciones principales Enfermedades estudiadas: EPOC, diabetes, hipertensión, enfermedad cerebrovascular, cardiopatía isquémica, asma, epilepsia e insuficiencia cardiaca. Resultados La concordancia fue mayor en hombres y entre los 45-64 años. Diabetes fue el diagnóstico más concordante (índice kappa: 0,75) mientras que asma obtuvo los valores más bajos (índice kappa: 0,34). Conclusiones La baja concordancia de la información diagnóstica contenida en AP y hospital obliga a adoptar medidas que permitan a los profesionales sanitarios a conocer el conjunto de problemas de salud que presenta un paciente.
Collapse
Affiliation(s)
- Concha Revilla-López
- Unidad Docente de Medicina Preventiva y Salud Pública, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España.
| | - Amaia Calderón-Larrañaga
- Unidad Docente de Medicina Preventiva y Salud Pública, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España; Grupo EpiChron de Investigación en Enfermedades Crónicas, Instituto Aragonés de Ciencias de la Salud (IACS), IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, España; Universidad de Zaragoza, Zaragoza, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Instituto de Salud Carlos III, Madrid, España; Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto Aragonés de Ciencias de la Salud (IACS), IIS Aragón, Zaragoza, España
| | - Natalia Enríquez-Martín
- Unidad Docente de Medicina Preventiva y Salud Pública, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España; Universidad de Zaragoza, Zaragoza, España; Departamento de Sanidad, Bienestar Social y Familia, D.G. de Planificación y Aseguramiento, Gobierno de Aragón, Zaragoza, España
| | - Alexandra Prados-Torres
- Unidad Docente de Medicina Preventiva y Salud Pública, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España; Grupo EpiChron de Investigación en Enfermedades Crónicas, Instituto Aragonés de Ciencias de la Salud (IACS), IIS Aragón, Hospital Universitario Miguel Servet, Zaragoza, España; Universidad de Zaragoza, Zaragoza, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Instituto de Salud Carlos III, Madrid, España; Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto Aragonés de Ciencias de la Salud (IACS), IIS Aragón, Zaragoza, España
| |
Collapse
|