Psychological distress in relatives of critically ill patients: Risk and protective factors.

The admission to an intensive care unit can result in a significant burden of emotional distress in the family. This study analyzes the psychological distress of 89 relatives of intensive care unit patients and the potential risk/protective factors for such distress. Families show high levels of anxiety, depression, and stress. Regarding risk factors, having steady partner, being a woman, and being a mother are associated with increased risk of anxiety, depression, and stress. Contrarily, being younger and having higher educational level are associated with reduced anxiety and stress. Influencing these trends could change positively the suffering course experienced by relatives and intensive care unit patients indirectly.

[Knowledge of the Assistance Bioethics Committee (ABC) between the general hospital health professionals]. / Conocimiento del Comité de Ética Asistencial (CEA) entre profesionales sanitarios de un hospital general.

To show hospital health professionals' knowledge on ABC. Observational, descriptive, transversal and analytical research using questionnaires designed ad hoc. Comparative statistical analysis applying Ji-square by Pearson and Fisher tests. Binary logistic regression model to determine the odd ratios (O.R) having education level and sex as independent variables. A 4% accuracy was accepted, as well as a confidence Interval of 95% and a p value inferior to 0.05. The data was processed by IBM SPSS Statistics v.20 software. Required sample of 351 professionals (108 doctors and other related graduate; 144 nurses and 99 clinical assistants (TCAE)). 276 participants (78,6%; IC95%: 74,0-82,2); of which 84 doctors (77,8%; IC95%: 68,8-85,2); 120 nurses (83,3%; IC95%: 76,2-89,0) y 71 TCAE (71,7%; IC95%: 61,7-80,3), predominantly women (194, 70,3%). 228 (82,6%) were aware of the existence of ABC. Both doctors and nurses had more knowledge of ABC than clinical assistants (p 0,0001 for both), however there was not significative difference between doctors and nurses (p=0,836; OR:0,901; IC95%: 0,334-2,228). 124 (45,1%) knew the functions of ABC, with doctors displaying more knownledge than both nurses and clinical assistants (p=0,002 and p 0,0001 respectively) and nurses showing more familiarity than clinical assistants (p=0,008). 129(47,6%) communicated ethical conflicts, showing no significative difference between doctors and nurses (p=0,119). However, clinical assistants displayed different behabiour than the other two groups in this regard (p 0,0001 and p=0,001 respectively). Of all, 47 (22,4%) communicated they had ethical conflicts regarding the beginning and end of life. The knowledge on the existence of the ABC is high, however there is poor knowledge around its functions. Among health professionals, doctors and nurses know him better than TCAE. Matters related with the beginning and end of life cause most of ethical conflicts.

Conocimiento del Comité de Ética Asistencial (CEA) entre profesionales sanitarios de un hospital general / Knowledge of the Assistance Bioethics Committee (ABC) between the general hospital health professionals

Mostrar el conocimiento del CEA entre los profesionales sanitarios de un hospital. Estudio observacional, descriptivo, transversal y analítico Se cumplimentó un cuestionario diseñado ad hoc. Análisis comparativo mediante el test de Ji-cuadrado de Pearson y test de Fisher. Modelos de regresión logística binaria para determinar los odd ratios (O.R), siendo variables independientes titulación y sexo. Se aceptaron una precisión del 4%, intervalo de confianza del 95% y p valor inferior a 0,05. Se utilizó el programa IBM SPSS Statistics V.20. Muestra requerida: 351 profesionales (108 médicos y otros licenciados; 144 enfermeros y 99 auxiliares de clínica (TCAE)). Contestaron 276 (78,6%; IC95%: 74,0-82,2); 84 médicos (77,8%; IC95%: 68,8-85,2); 120 enfermeros (83,3%; IC95%: 76,2-89,0) y 71 TCAE (71,7%; IC95%: 61,7-80,3), predominantemente mujeres (194, 70,3%). 28 (82,6%) conocían la existencia del CEA, más los médicos y enfermeros que auxilia-res (p < 0,0001 en ambos), pero sin diferencia entre médicos y enfermeros (p = 0,836; OR:0,901; IC95%: 0,334-2,228). 124 (45,1%) conocían sus funciones, más médicos que enfermeros y auxiliares (p = 0,002 y p < 0,0001) y más enfermeros que TCAE (p = 0,008). 129(47,6%) referían conflictos éticos, sin diferencias entre médicos y enfermeros (p = 0,119) pero sí entre estos y los TCAE (p < 0,0001 y p = 0,001). De todos, 47 (22,4%) refirieron haber tenido conflictos éticos relacionados con el inicio y final de la vida. El conocimiento de la existencia del CEA es elevado, pero pobre el de sus funciones. Médicos y enfermeros lo conocen mejor que TCAE. El inicio y el final de la vida son las situaciones que más conflictos éticos plantean

To show hospital health professionals' knowledge on ABC. Observational, descriptive, transversal and analytical research using questionnaires designed ad hoc. Comparative statistical analysis applying Ji-square by Pearson and Fisher tests. Binary logistic regression model to determine the odd ratios (O.R) having education level and sex as independent variables. A 4% accuracy was accepted, as well as a confidence Interval of 95% and a p value inferior to 0.05. The data was processed by IBM SPSS Statis-tics V.20 software. Required sample of 351 professionals (108 doctors and other related graduate; 144 nurses and 99 clinical assistants (TCAE)). 276 participants (78,6%; IC95%: 74,0-82,2); of which 84 doctors (77,8%; IC95%: 68,8-85,2); 120 nurses (83,3%; IC95%: 76,2-89,0) y 71 TCAE (71,7%; IC95%: 61,7-80,3), predominantly women (194, 70,3%). 228 (82,6%) were aware of the existence of ABC. Both doctors and nurses had more knowledge of ABC than clinical assistants (p < 0,0001 for both), however there was not significative difference between doctors and nurses (p = 0,836; OR:0,901; IC95%: 0,334-2,228). 124 (45,1%) knew the functions of ABC, with doctors displaying more knownledge than both nurses and clinical assistants (p = 0,002 and p < 0,0001 respectively) and nurses showing more familiarity than clinical assistants (p = 0,008). 129(47,6%) communicated ethical conflicts, showing no significative difference bet-ween doctors and nurses (p = 0,119). However, clinical assistants displayed different behabiour than the other two groups in this regard (p < 0,0001 and p = 0,001 respectively). Of all, 47 (22,4%) communicated they had ethical conflicts regarding the beginning and end of life. The knowledge on the existence of the ABC is high, however there is poor knowledge around its functions. Among health professionals, doctors and nurses know him better than TCAE. Matters related with the beginning and end of life cause most of ethical conflicts

[Assessment of the ICU stay from the point of view of patients and their relatives]. / Valoración de la estancia en UCI desde el punto de vista de pacientes y familiares.

OBJECTIVE: The quality of care is a key aspect in the gene- ral hospital setting and particularly in ICU. The objective of this study was to analyze the assessment of ICU stay by patients and relatives, as well as the influence of socio-demographic/psychological variables on this assessment. METHODS: 71 critically ill patients and 89 relatives answered the Questionnaire of the ICU stay assessment and the Hospital Anxiety-Depression Scale. Descriptive and frequency analyzes were performed. Likewise, correlation coefficients (Pearson/ Spearman), Student's t test, ANOVA analysis and multiple regression equations were used. RESULTS: Results show a positive evaluation in patients, both globally (Mean=4,06; SD=1,25) and in relation to different and inherent to ICU aspects, highlighting the attention/care of professionals (Mean=4,73; SD=0,68). As unpleasant/annoying aspects, they show the scarce possibilities of distraction (Mean=2,41; SD=1,38), lack of silence (Mean=3,15; SD=1,19) and visits policy (Mean=3,66; SD=1,04). Families evaluate globally the patient stay in ICU as "something" pleasant (Mean=3,31; SD=1,76). They also assess most aspects of the unit positively and underline the care/attention of professionals and the attention to psycho- logical needs. The valuation of the ICU stay shows differences in some aspects on the basis of socio-demographic variables. Likewise, family assesses more negatively the patient stay in ICU than patients do. CONCLUSIONS: The general evaluation of the ICU stay was positive, although with aspects susceptible to be improved. To know this reality is the prior step to the implementation of those measures that reinforce the well-valued issues and improve the worst- valued aspects in order to optimize the quality of the offered care.

OBJETIVO: La calidad asistencial es un aspecto primordial en el ámbito hospitalario general y particularmente en UCI. Nuestro objetivo fue analizar la valoración de pacientes y familiares sobre la estancia en UCI, y la influencia en dicha valoración de variables sociodemográficas y psicológicas. METODOS: 71 pacientes críticos y 89 familiares de una UCI polivalente de la Comunidad Valenciana respondieron el Cuestionario de Valoración de la Estancia en UCI y la Escala de ansiedad-depresión hospitalaria durante 2014-2015. Se realizaron análisis descriptivos y de frecuencias. Asimismo, se utilizaron coeficientes de correlación (Pearson/Spearman), Prueba t de Stu- dent, análisis ANOVA y ecuaciones de regresión múltiple. RESULTADOS: Los resultados mostraron una valoración positiva en los pacientes tanto a nivel global (Media=4,06; DE=1,25) como en relación con distintos aspectos inherentes a UCI, destacando las atenciones/cuidados de los profesionales (Media=4,73; DE=0,68). Como aspectos más desagradables/molestos señalaron las escasas posibilidades de distraerse (Media=2,41; DE=1,38), la falta de silencio (Media=3,15; DE=1,19) y el régimen de visitas (Media=3,66; DE=1,04). Los familiares, evaluaron globalmente la estancia del paciente en UCI como "algo" agradable (Media=3,31; DE=1,76), y valoraron positivamente la mayoría de aspectos propios de la unidad. La valoración de la estancia en UCI mostró diferencias en algunos aspectos en función de variables sociodemográficas. Asimismo, la familia valoró más negativamente que el paciente su estancia en UCI. CONCLUSIONES: La valoración de la estancia en UCI en líneas generales fue positiva aunque con aspectos susceptibles de mejora. Conocer esta realidad es el paso previo a la puesta en marcha de medidas que refuercen lo bien valorado y mejoren los aspectos peor valorados para poder optimizar la calidad asistencial ofrecida.

Valoración de la estancia en UCI desde el punto de vista de pacientes y familiares / Assessment of the ICU stay from the point of view of patients and their relatives

Fundamentos: La calidad asistencial es un aspecto primordial en el ámbito hospitalario general y particularmente en UCI. Nuestro objetivo fue analizar la valoración de pacientes y familiares sobre la estancia en UCI, y la influencia en dicha valoración de variables sociodemográficas y psicológicas. Métodos: 71 pacientes críticos y 89 familiares de una UCI polivalente de la Comunidad Valenciana respondieron el Cuestionario de Valoración de la Estancia en UCI y la Escala de ansiedad-depresión hospitalaria durante 2014-2015. Se realizaron análisis descriptivos y de frecuencias. Asimismo, se utilizaron coeficientes de correlación (Pearson/Spearman), Prueba t de Student, análisis ANOVA y ecuaciones de regresión múltiple. Resultados:Los resultados mostraron una valoración positiva en los pacientes tanto a nivel global (Media=4,06; DE=1,25) como en relación con distintos aspectos inherentes a UCI, destacando las atenciones/cuidados de los profesionales (Media=4,73; DE=0,68). Como aspectos más desagradables/molestos señalaron las escasas posibilidades de distraerse (Media=2,41; DE=1,38), la falta de silencio (Media=3,15; DE=1,19) y el régimen de visitas (Media=3,66; DE=1,04). Los familiares, evaluaron globalmente la estancia del paciente en UCI como "algo " agradable (Media=3,31; DE=1,76), y valoraron positivamente la mayoría de aspectos propios de la unidad. La valoración de la estancia en UCI mostró diferencias en algunos aspectos en función de variables sociodemográficas. Asimismo, la familia valoró más negativamente que el paciente su estancia en UCI. Conclusiones: La valoración de la estancia en UCI en líneas generales fue positiva aunque con aspectos susceptibles de mejora. Conocer esta realidad es el paso previo a la puesta en marcha de medidas que refuercen lo bien valorado y mejoren los aspectos peor valorados para poder optimizar la calidad asistencial ofrecida

Background: The quality of care is a key aspect in the general hospital setting and particularly in ICU. The objective of this study was to analyze the assessment of ICU stay by patients and relatives, as well as the influence of socio-demographic/psychological variables on this assessment. Methods: 71 critically ill patients and 89 relatives answered the Questionnaire of the ICU stay assessment and the Hospital Anxiety-Depression Scale. Descriptive and frequency analyzes were performed. Likewise, correlation coefficients (Pearson/Spearman), Student's t test, ANOVA analysis and multiple regression equations were used. Results: Results show a positive evaluation in patients, both globally (Mean=4,06; SD=1,25) and in relation to different and inherent to ICU aspects, highlighting the attention/care of professionals (Mean=4,73; SD=0,68). As unpleasant/annoying aspects, they show the scarce possibilities of distraction (Mean=2,41; SD=1,38), lack of silence (Mean=3,15; SD=1,19) and visits policy (Mean=3,66; SD=1,04). Families evaluate globally the patient stay in ICU as "something " pleasant (Mean=3,31; SD=1,76). They also assess most aspects of the unit positively and underline the care/attention of professionals and the attention to psychological needs. The valuation of the ICU stay shows differences in some aspects on the basis of socio-demographic variables. Likewise, family assesses more negatively the patient stay in ICU than patients do. Conclusion: The general evaluation of the ICU stay was positive, although with aspects susceptible to be improved. To know this reality is the prior step to the implementation of those measures that reinforce the well-valued issues and improve the worst-valued aspects in order to optimize the quality of the offered care

El trabajo diario determina el prestigio de una sociedad científica / Daily work determines the prestige of a scientific society

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