Assessing satisfaction with the care given by peritoneal dialysis patients during the pandemic

Introduction: The COVID-19 pandemic forced our unit to alternate in-person consultations with telephone consultations, without this increasing urgent visits. Therefore, it seemed necessary to know the patient's opinion regarding this matter. Objective: To assess the satisfaction of patients receiving peritoneal dialysis with the quality of care received through a mixed model of in-person and teleconsultations. Material and Method: PA descriptive cross-sectional study was conducted between February and March 2021, using an anonymous telephone survey conducted by an independent interviewer. Inclusion criteria: aged over 18, receiving peritoneal dialysis, and giving their consent. Variables collected: age, sex, primary caregiver, provider (Baxter® / Fresenius® ), hospital admission (Yes/No). Satisfaction questionnaire (9 questions): 2 open-ended, 1 semi-closed with a dichotomous response and free text, and 6 closed with Likert-type response from 0-10. Results: Of the 78 peritoneal dialysis patients, 71 participants were included. 59.1% (n=42) were men, with an average age of 66.1 years (23.33-91.23 years). The average score for healthcare received through the mixed model of visits was 9.5 ±1.13. Regarding aspects to improve in phone consultations, 61.2% (n=41) considered it unnecessary to assign a specific time, 11.2% (n=8) stated the need to receive changes in writing, 4.5% (n=3) requested an improvement in the request for laboratory analysis at the healthcare center, and none considered video calls necessary. Conclusions: The patient's satisfaction with our mixed model of visits seems to reflect a good quality of care, subject to improvement and individualization. © 2023, Sociedad Espanola de Enfermeria Nefrologica. All rights reserved.

[Identification and review of health promotion at work programs in Spain.]

OBJECTIVE: Health promotion at work (HPW) is an essential component of social and economic policies. METHODS: Regional HPW programs were identified through occupational health committee. Their webs were reviewed, and we interviewed by videoconference the persons in charge of each program. We used a data collection notebook to collect descriptive as well as quality variables, according to health promotion and equity models. RESULTS: 6 regions have a HPW program: Andalucia, Aragon, Cataluna, Comunidad Valenciana, Extremadura and Galicia, developed by health administration or work administration, but only in 1 case by both. 4 programs have regulations and 3 have created a network. The participation of occupational risk prevention services is key, while participation of workers and management teams is variable. Only 2 regions have incorporated information and materials related to COVID-19. Measures to promote equality and work-life balance, but not to promote equity. CONCLUSIONS: HPW in Spain is a reality in 6 regions, with differences between them related to the requisites and what the administration offers to them.

Ischaemic stroke and SARS-CoV-2 infection: A causal or incidental association? / Ictus isquémico e infección por SARS-CoV-2, ¿asociación casual o causal?

INTRODUCTION: Ischaemic stroke has been reported in patients with COVID-19, particularly in more severe cases. However, it is unclear to what extent this is linked to systemic inflammation and hypercoagulability secondary to the infection. METHODS: We describe the cases of 4 patients with ischaemic stroke and COVID-19 who were attended at our hospital. Patients are classified according to the likelihood of a causal relationship between the hypercoagulable state and ischaemic stroke. We also conducted a review of studies addressing the possible mechanisms involved in the aetiopathogenesis of ischaemic stroke in these patients. RESULTS: The association between COVID-19 and stroke was probably causal in 2 patients, who presented cortical infarcts and had no relevant arterial or cardioembolic disease, but did show signs of hypercoagulability and systemic inflammation in laboratory analyses. The other 2 patients were of advanced age and presented cardioembolic ischaemic stroke; the association in these patients was probably incidental. CONCLUSIONS: Systemic inflammation and the potential direct action of the virus may cause endothelial dysfunction, resulting in a hypercoagulable state that could be considered a potential cause of ischaemic stroke. However, stroke involves multiple pathophysiological mechanisms; studies with larger samples are therefore needed to confirm our hypothesis. The management protocol for patients with stroke and COVID-19 should include a complete aetiological study, with the appropriate safety precautions always being observed.