Valls-Ibanez V.,Atencion Primaria |
Fernandez-Obispo M.,Hospital Materno Infantil Vall dHebron |
Torralbas-Ortega J.,Institute Universitari Parc Tauli |
Bernal-Jimenez M.,Atencion Primaria
Enfermeria Clinica | Year: 2016
Spain is one of the countries where most solid organ transplants are performed each year, in the year 2014 a 2.7% of them were given in childhood. Given the complexity and severity of this disease it is necessary to establish a care plan that covers both pre-transplant and post-transplant, with close cooperation between different levels of care, to approach the several problems that can appear and assure continuum of care. In the following example, a Gambian teen with risk of social exclusion fostered a collaboration between the primary care nurse and transplant nurse that was the key to continuum care. Multiple strategies were used in the care plan to ensure better adherence and compliance of the treatment. However, the knowledge of the culture of origin must be deepened to establish more individualized care plans and thus improve results. The care plan included problems according to the NANDA, NOC, NIC taxonomy. © 2016.
PubMed | Atencion Primaria, University of Vigo and Altamira
Type: | Journal: Atencion primaria | Year: 2016
To describe the burden of informal carers of dependent people and to identify related variables.Descriptive observational cross-sectional study.Primary Health Care in the southern area of Pontevedra.97 caregivers of dependent persons.We collected socioeconomic data and health conditions from caregivers and dependent persons, time spent on the daily care and caregiver burden (Zarit abbreviate) through a personal interview. Besides the description of the sample-including their burden level-, a contrast mean was used to identify characteristics that influenced in punctuation of Zarit scale. A logistic regression was used to analyse characteristics that increase the likelihood to experiment burden.61.9% of caregivers are subject to intense burden. The item on the scale which contributes most to the caregiver burden is the lack of time for oneself, followed by the negative effects of interpersonal relationships. Contrast means shows that degree of relationship, number of care hours, caregiver health and aggressiveness of dependent persons produce significant differences in Zarit scale. Physic and psychological health of caregivers and aggressiveness of dependent persons is associated with the likelihood of developing caregiver burden.Informal caregivers of dependent persons show a high level of burden, both related to their characteristics and those of the dependent persons. Caregiver burden rethinks the need for public policies focused on dependence to adopt an integrative caregiver-dependent vision.
Utility and validity of indicators from the Nursing Outcomes Classification as a support tool for diagnosing Ineffective Self Health Management in patients with chronic conditions in Primary Health Care [Utilidad y validez de un instrumento basado en indicadores de la Nursing Outcomes Classification como ayuda al diagnóstico de pacientes crónicos de Atención Primaria con gestión ineficiente de la salud propia]
Morilla-Herrera J.C.,Atencion Primaria de Malaga |
Morales-Asencio J.M.,University of Malaga |
Fernandez-Gallego M.C.,Atencion Primaria |
Berrobianco Cobos E.,Atencion Primaria de Malaga |
Delgado Romero A.,Atencion Primaria Cadiz Bahia La Janda
Anales del Sistema Sanitario de Navarra | Year: 2011
Background. Self-care and management of therapeutic regime (drugs adherence, preventive behaviours and development of healthy life-styles) are key components for managing chronic diseases. Nursing has standardized languages which describe many of these situations, such as the diagnosis "Ineffective Self Health Management" (ISHM) or many of the Nursing Outcomes Classification (NOC) indicators. The aims of this study were to determine the interobserver reliability of a NOC-based instrument for assessment and aid in diagnosis of the ISHM in patients with chronic conditions in Primary Health Care, to determine its diagnostic validity and to describe the prevalence of patients with this problem. Methods. Cross-sectional validation study developed in the provinces of Málaga, Cádiz and Almería from 2006 to 2009. Each patient was assessed by 3 independent observers: the first two observers evaluated scoring of the NOC indicators and the third one acted as the "gold-standard". Results. Two hundred and twenty-eight patients were included, 37.7% of them with more than one chronic condition. NOC indicators showed a high interobserver reliability (ICC>0,70) and a consistency (Cronbach's alpha: 0.81). With a cut-point of 10.5, sensitivity was 61% and specificity 85%, and the area under the curve was 0.81 (CI95%: 0.77 to 0.85). The prevalence of patients with ISHM was 36% (CI 95%: 34 to 40). Conclusions. The use of NOC indicators allows evaluation of management of the therapeutic regime in people with chronic conditions with a satisfactory validity and it provides new approaches for dealing with this problem.
PubMed | Atencion Primaria, Hospital Materno Infantil Vall dHebron and Institute Universitari Parc Tauli
Type: | Journal: Enfermeria clinica | Year: 2017
Spain is one of the countries where most solid organ transplants are performed each year, in the year 2014 a 2.7% of them were given in childhood. Given the complexity and severity of this disease it is necessary to establish a care plan that covers both pre-transplant and post-transplant, with close cooperation between different levels of care, to approach the several problems that can appear and assure continuum of care. In the following example, a Gambian teen with risk of social exclusion fostered a collaboration between the primary care nurse and transplant nurse that was the key to continuum care. Multiple strategies were used in the care plan to ensure better adherence and compliance of the treatment. However, the knowledge of the culture of origin must be deepened to establish more individualized care plans and thus improve results. The care plan included problems according to the NANDA, NOC, NIC taxonomy.
Torralba A.,Coordinador Nacional de Artritis ConArtritis |
Miquel A.,Atencion Primaria |
Darba J.,University of Barcelona
Revista de la Sociedad Espanola del Dolor | Year: 2014
One in five Europeans (19 %) is estimated to suffer from chronic pain. The Pain Proposal initiative represents perspectives from a range of stakeholders from across 15 European countries concerning chronic pain, including people with chronic pain, clinicians from different medical specialties, policy experts, industry members and health economists. This article sets forth the recommendations and opinions of the Pain Proposal in reference to the present chronic pain care model in Spain. The data presented in this report have highlighted a number of inadequacies in the way chronic pain is currently managed in Spain. Patients have reported long waiting times for referral and persisting pain despite treatment, with consequences for their ability to work and their relationships with partners and family. Healthcare professionals have also reported dissatisfaction with aspects of chronic pain management and a desire for greater support. Improving pain management will bring substantial economic benefits: More efficient use of existing resources for pain management, less absenteeism, greater productivity, and a reduced burden on social security budgets. Everyone involved in the chronic pain area, from healthcare professionals to government departments, needs to work together to improve pain management across Spain.
Impact of comprehensive and intensive treatment of risk factors concerning cardiovascular mortality in secondary prevention: MIRVAS Study [Impacto de un tratamiento integral e intensivo de factores de riesgo sobre la mortalidad cardiovascular en prevención secundaria: estudio MIRVAS]
Moreno-Palanco M.A.,Hospital Universitario Of La Princesa |
Ibanez-Sanz P.,Hospital Universitario Of La Princesa |
Pablo C.C.-D.,Atencion Primaria |
Pizarro-Portillo A.,Hospital Universitario Of La Princesa |
And 2 more authors.
Revista Espanola de Cardiologia | Year: 2011
Introduction and objectives: The aim was to determine whether secondary prevention involving the comprehensive and intensive treatment of cardiovascular risk factors reduces cardiovascular events and cardiovascular mortality at 3-year follow up. Methods: The study design comprised a randomized, controlled, open trial in a routine clinical practice setting. In total, 247 patients who presented with acute coronary syndrome or stroke were selected. They were randomized to comprehensive and intensive treatment of cardiovascular risk factors (n=121) or to follow-up based on usual care (n=126). The main study outcomes were the number of cardiovascular events and cardiovascular mortality at 3-year follow-up. The percentage of patients in whom each risk factor was successfully controlled was a secondary outcome. Results: Overall, 88.8% of patients assigned to the intensive treatment group had a low-density lipoprotein cholesterol level <100 mg/dl compared with 56.4% of the usual-care group (relative risk [RR]=1.57; 95% confidence interval [CI], 1.28-1.93), and 75.7% of diabetics had a hemoglobin A1c <7% compared with 28.6% of the usual-care group (RR=2.65; 95% CI, 1.13-6.19). There were four deaths due to cardiovascular causes and 26 nonfatal events in the intensive treatment group versus 17 deaths and 54 nonfatal events in the usual-care group. The cumulative survival rate at 3 years was 97.4% in the intervention group and 85.5% in the control group (p=.003). Conclusions: Secondary prevention involving comprehensive and intensive treatment of cardiovascular risk factors reduced both morbidity and mortality at 3-year follow up. © 2010 Sociedad Española de Cardiología. Published by Elsevier España, S.L. All rights reserved.
Martinez Perez R.,Atencion Primaria
Farmaceuticos de Atencion Primaria | Year: 2012
Renal lithiasis or urolithiasis is a disease caused by stones in the kidneys or urinary tract. It is very prevalent and the purpose of medical treatment is to prevent its recurrence. Abundant intake of fluids and correction of the possible excess of calcium, phosphate, oxalate and purine contribution are recommended. The medicinal product of choice for the treatment of nephritic colic is diclofenac, 75 mg IM. It can be associated to metamizol magnesium 1 or 2 g IV applied in 20 minutes. For the prevention of the recurrence of the nephritic colic, 50 mg/8 h of diclofenac during seven days is recommended. The medical expulsive therapy for minor lithiases of 10 mm should be done with oral tamsulosin 0.4 mg/daily or oral alfuzosine 10 mg/daily for 30 days. © 2011 SEFAP. Published by Elsevier España, S.L. All rights reserved.
Garcia Prim J.M.,University of Santiago de Compostela |
Moldes Rodriguez M.,University of Santiago de Compostela |
Alvarez Fernandez J.,Atencion Primaria |
Rey Rey M.J.,Atencion Primaria |
And 2 more authors.
Medical Oncology | Year: 2010
Lung cancer (LC) is now the leading cause of cancer mortality in the world, therefore it would be useful to identify prognostic factors to determine patient outcome.The objective of this study is to evaluate the usefulness of platelet counts at the time of diagnosis as a prognostic factor. A retrospective study of patients with histological diagnostic evidence of LC was carried in our catchment area over a 3-year period. Survival adjusted for other factors was assessed according to the platelet count at the time of diagnosis. Patients with platelet levels within the reference range (RR) (135000-381000/ll) were divided into two groups, between 135000-258000/ll and 258000-381000/ll. A third group was made up of patients with platelet counts over 381000/ll. Adjusted survival was analysed using Cox regression models. Patients with high platelets have a 37% worse survival than those with a platelet level within the RR, but lower than 258000/ll. When tumour stage is included in the covariates, platelet levels are no longer an independent survival factor. In conclusion, platelet levels at the time of diagnosis could be a useful prognostic factor in LC. © 2009 Humana Press Inc.
Identification of some characteristics of Primary Health Care physicians that influence pharmaceutical costs [Identificación de algunas características del médico de atención primaria que influyen en el gasto farmacéutico]
Segura-Benito M.J.,Atencion Primaria |
Moya-Martinez P.,University of Castilla - La Mancha |
Escribano-Sotos F.,University of Castilla - La Mancha
Revista de Calidad Asistencial | Year: 2012
Objective: Aging and medicalisation are leading to a progressive growth in pharmaceutical expenditure, which is difficult to measure. It is important to develop social studies of this drug spending in order to support the policies of containment. The aim of this study is to identify elements that influence pharmaceutical expenditure of Primary Care physicians in the Health Area of Cuenca (Spain). Material and methods: A retrospective observational study using multilevel models of pharmaceutical expenditures by physicians between 2006 and 2009. It took into account the particular characteristics of each doctor and their patients. Results: The average pharmaceutical expenditure by doctor and patient was * euro 277.13 year. In addition, a one-point of increase in the rate of referrals to specialised care increases pharmaceutical expenditure by 2.97 * euro per year and an increase in the percentage of generic drugs prescribed reduced in 2.54 * euro per year. These two variables and the percentage of retired patients (pensioners) are the most important factors to explain the variability in pharmaceutical expenditure. In contrast, the characteristics of physicians such as education, tenure, seniority, or age does not influence pharmaceutical costs. Conclusions: This study supports the importance of developing interventions in prescription policies. It will be of particular interest to those physicians with higher quotas of elderly patients. It also shows a significant relationship in pharmaceutical expenditures between primary and specialist physicians, which needs to be clarified by future studies. © 2011 SECA. Publicado por Elsevier Espana, S.L. Todos los derechos reservados.
PubMed | Atencion Primaria and University of Santiago de Compostela
Type: | Journal: Semergen | Year: 2016
About 85-94% of the Spanish adults older than 35 experience gum problems, and about 15-30% suffer from periodontitis, being severe in up to 5-11% of them. Unlike other inflammatory conditions, periodontal disease rarely causes discomfort, or limits life or causes functional limitations until its advanced stages, when clinical signs and symptoms arise (gingival recession, pathological teeth migration, or mobility). Lack of knowledge about the disease, together with the idea that tooth loss is linked to ageing, frequently results in a late diagnosis, requiring extensive treatments with a worse prognosis. At Primary Care level, there is series of drugs have been related to periodontal disease (anticonvulsants, immunosuppressive drugs, and calcium channel blockers) as secondary effects, which vary as regards their frequency and severity depending of the amount of accumulated plaque. Stress and depression have also been reported to alter the immune response and to increase the inflammatory response as well as periodontal susceptibility. Certain systemic conditions, such as diabetes mellitus, cardiovascular disorders, respiratory diseases, as well as low-weight pre-term birth, have also been linked to periodontitis.