Evolución del patrón de actividad física en el embarazo y puerperio. análisis de una cohorte de 133 mujeres en Zaragoza (España) / Evolution of physical activity patterns in pregnancy and pospartum. A cohort study of 133 women in Zaragoza (Spain)

Introducción. El objetivo de este estudio ha sido describir las características y evolución de la actividad física a lo largo del embarazo y hasta tres meses después del parto. Metodología. Se realizó un estudio descriptivo longitudinal para evaluar la naturaleza, la frecuencia, la duración y la intensidad de la actividad física llevada a cabo por una cohorte de 133 mujeres en las semanas 11 a 13, 20 a 22 y 32 a 34 del embarazo y a las 12 semanas tras el parto. Resultados. La actividad física global disminuyó a lo largo del embarazo y también en la época del puerperio (p<0.05). La contribución de las actividades lúdicas al total de la actividad física realizada aumentó en cada uno de los momentos de medición. Por el contrario, la actividad física en el hogar, en el trabajo y para desplazarse disminuyó progresivamente a lo largo del embarazo y el puerperio (p < 0.05). El tiempo dedicado a actividades vigorosas fue prácticamente nulo, y el dedicado a actividades de intensidad moderada disminuyó a lo largo del seguimiento (p < 0.05). Conclusiones. Los profesionales de la salud deberían poner en marcha estrategias encaminadas al mantenimiento de los niveles previos de actividad física en las épocas del embarazo y el puerperio (AU)

Introduction. The aim of this study was to describe the characteristics and evolution of physical activity throughout pregnancy and puerperium. Method. We performed a descriptive longitudinal study to assess the nature, frequency, duration and intensity of physical activity undertaken by a cohort of 133 women at weeks 11-13, 20-22 and 32-34 of pregnancy and 12 weeks after birth. Results. Physical activity declined throughout pregnancy and in the postpartum period (p < 0.05). The contribution of leisure physical activity increased on each of the measures. By contrast, physical activity at home, at work and to be transported progressively decreased throughout pregnancy and postpartum (p < 0.05). Time spent in vigorous activity was near zero, and time spent in moderate-intensity activities decreased along the protocol (p<0.05). Conclusions. Health care professionals are encouraged to perform strategies in order to maintain previous levels of physical activity during pregnancy and the postpartum periods (AU)

Encuesta de satisfacción de un proyecto de mejora de calidad del servicio aragonés de salud / Satisfaction survey of a quality improvement program of the aragonese health service

Introducción: Según el informe de 2008 del Sistema Nacional de Salud, existe un 4,7% de los usuarios que opina que el sistema sanitario debería rehacerse por completo y casi un 27%, que es necesario introducir cambios importantes para su mejora. Hipótesis: El desarrollo de un programa específico de control de peso para pacientes obesos en Atención Primaria mejora la calidad de la actuación percibida por el paciente de Atención Primaria. Objetivos: Valorar la influencia de un proyecto de mejora de calidad de Atención Primaria en los resultados globales de una encuesta de satisfacción de los usuarios de dicha Zona Básica de Salud. Material y Métodos: Estudio prospectivo de intervención cuasiexperimental centrado en el tratamiento de la obesidad en Atención Primaria realizado desde Enero de 2012 a Diciembre 2013, en cuya evaluación final se realizó una encuesta autoadministrada de Satisfacción de los usuarios y se comparó con los resultados obtenidos con el mismo cuestionario por el Servicio Aragonés de Salud en dicha Zona Básica de Salud. Para el análisis estadístico de estos datos se empleó el programa informático SPSS.15. Resultados principales: Se observa un aumento destacable en los apartados 'Interés del personal de enfermería', 'Satisfacción de los cuidados sanitarios' (medicina y enfermería) y 'Solución dada a problemas'. No hubo aspectos negativos y el 100% de los encuestados expresó una satisfacción general y un 88% destacó el aspecto de la paciencia del profesional hacia los pacientes. Conclusión: El proyecto de mejora de calidad realizado con pacientes crónicos de la consulta de enfermería de Atención Primaria, ha sido valorado muy satisfactoriamente, llegando a mejorar la puntuación de los resultados globales del Sistema Aragonés de Salud en esta Zona Básica de Salud (AU)

Introduction: According to the 2008 report of the National Health System, there is a 4.7% the users who believes that the health system should be completely redone and almost 27% consider it is necessary to make important changes to improve it. Hypothesis: The development of a specific weight control program for obese patients in Primary Care, allows improving the quality of the attention perceived by the patient in Primary Health Care. Objectives: To assess the influence of a quality improvement program in Primary Care on the global results of a satisfaction survey conducted between the users of a given Basic Health Zone. Materials and Methods: Prospective study of quasiexperimental intervention focused on the treatment of obesity in Primary Care, carried out from January 2012 through December 2014. Its final evaluation was done by conducting a self-managed Satisfaction survey and was compared to the results obtained with the same questionnaire from the Aragon’s Health Service in that Basic Health Zone. The statistical analysis of the data was carried out by using the SPSS.15 software program. Main results: Results improve in the following aspects: "Interest displayed by the nursing staff ', 'Satisfaction of health cares (medical and nursing)' and 'Solution given to problems'. There were not negatives aspects and the 100% of respondents stated a general satisfaction and 88% remarked the patience of the professional with the patients. Conclusion: The quality improvement project done with chronic patients from the Primary Care Nursing Practice, has been very successfully valued, leading to improve the global results score of the Aragon’s Health System in the Basic Health Zone (AU)

Modificación de la calidad de vida en pacientes con obesidad tras participar en un programa de pérdida de peso en Atención Primaria / Quality of life modification in obesity patients after taking part in a Weight Loss Program at Primary Care

OBJETIVO: evaluar la modificación en calidad de vida autopercibida y en motivación en pacientes con obesidad que participaron en un programa de pérdida de peso en el contexto de la Atención Primaria de Salud. MÉTODO: estudio de intervención cuasi experimental antes-después sobre50 pacientes con obesidad, en un centro de salud rural de la provincia de Teruel (España). La intervención consistió en un plan individualizado centrado en: dieta hipocalórica, actividad física y sesiones de educación. VARIABLES: escala de motivación por diferencial semántico (escala de 1 a10) y cuestionario de calidad de vida SF-36. Para el análisis estadístico se empleó la prueba de Wilconxon para muestras apareadas. RESULTADOS: 38 pacientes siguieron la intervención. La motivación antes de la intervención fue de 7,6 y después de 8,5 (p= 0,015). La puntuación media global del SF-36 antes de la intervención fue de 78,8 y de86,5 tras la intervención. Excepto la escala función social, rol emocional y el ítem transición de salud, se produjeron mejoras estadísticamente significativas (p< 0,05) en todas la escalas. CONCLUSIONES: hay una mejora en la autopercepción de calidad de vida en los pacientes con obesidad que participan en un programa de reducción de peso en el entorno de la Atención Primaria, además de un aumento de la motivación, lo cual es fundamental para el mantenimiento de los logros conseguidos

OBJECTIVE: to assess the self-perceived modification in quality of life and in motivation among patients with obesity who participated in a Weight Loss Program in the Primary Care Healthcare Setting. METHOD: quasi-experimental before and after intervention study on 50patients with obesity, in a rural health center from the province of Teruel (Spain). The intervention consisted in an individualized plan involving a low-calorie diet, physical activity, and education sessions. VARIABLES: semantic differential motivation scale (from 1 to 10) and SF-36 Quality of Life Questionnaire. For statistical analysis, Wilcoxon Test was used for paired samples. RESULTS: 38 patients continued the intervention. Motivation before the intervention was 7.6, and 8.5 afterwards (p= 0.015). The overall mean score in SF-36 before the intervention was 78.8, and 86.5 after the intervention. Except for the social function scale, emotional role, and the health transition item, there were statistically significant improvements (p< 0.05) in all scales. CONCLUSIONS: there is an improvement in quality of life self-perception in obesity patients who are involved in a weight loss program in the Primary Care setting, as well as an increase in motivation, which is essential for sustaining the success achieved

Estudio de hábitos alimentarios dentro de un programa dietoterápico para pérdida de peso en la consulta de enfermería de atención primaria / Study of the alimentary habits inside of a dietetic therapeutic programme for losing weight in the primary care nursing practice

Introducción: La modificación de los hábitos higiénico-dietéticos y de actividad física en el paciente obeso es clave para el logro y mantenimiento de los resultados a largo plazo. Por ello, conocer y detectar la variación de los hábitos de vida tras el tratamiento de la obesidad, puede orientar al profesional de Enfermería de Atención Primaria. Hipótesis: Existe modificación de las costumbres higiénico-dietéticas de pacientes adultos obesos en un programa dietoterápico de una consulta de enfermería de Atención Primaria. Objetivos: Comparar los hábitos de vida antes y después de un programa de pérdida de peso en una consulta de enfermería de Atención Primaria para estimular en el paciente el mantenimiento de los logros y orientar la educación a la corrección de los errores. Metodología: Estudio prospectivo de intervención cuasiexperimental realizado desde Enero de 2012 a Diciembre de 2013 con un grupo de pacientes de la consulta de enfermería de un Centro de Salud rural de la provincia de Teruel. El proyecto piloto estuvo compuesto por 50 pacientes (26 hombres y 24 mujeres) con estudios básicos de 35 a 65 años, edad media 54,84 años (± 8,04 DT) e IMC 33,52 kg/m2 (±3,43 DT). Se les elaboró un tratamiento personalizado consistente en: dieta hipocalórica, actividad física y sesiones de educación y se evaluó a los pacientes con: «Test sobre Obesidad incluido en la Guía de Actuación Clínica en Atención Primaria de la Generalitat Valenciana (Corbacho Godes, Adelina et al.)» y un «Cuestionario de Frecuencia de Consumo Semanal». Para el análisis estadístico de estos datos ha sido empleado el programa informático SPSS.15. Resultados principales: Existen mayores modificaciones relacionadas con la cantidad de la ración que con la frecuencia de consumo. Otros aspectos como «cocinar por sí mismo», «comer fuera de casa» o «ir al trabajo a pie» no sufrieron variaciones. En cambio, «realización habitual de actividad física» que, obtuvo previamente contestaciones negativas de los pacientes seleccionados en el 43,59% (17 personas), al finalizar lo fueron en el 0% de las personas. Además, «nº de ingestas diarias <3» o «comer entre horas», disminuyó cada uno en un 33,33% y 12,82% desde el comienzo. Conclusión: Existe modificación higiénico-dietéticas de los pacientes obesos dentro de un programa dietoterápico en Atención Primaria. A pesar de existir una gran dificultad para modificar conductas adquiridas, conocer la variación de los hábitos de vida tras el tratamiento de la obesidad, ayuda a orientar el trabajo enfermero de Atención Primaria (AU)

Introduction: The modification of the dietetic habits and of the physical activity in the obese patient is essential for the achievement and maintenance of the results in the long term. Hence, knowing and detecting the variation in the daily life habits after the obesity treatment has been completed may be useful for the professionals working in the field of Primary Care Nursing. Hypothesis: There exists an alteration in the hygienic- dietetic habits of obese adult patients undergoing a dietetic therapeutic programme in a Primary Care Nursing Practice. Objectives: To compare the life habits of a group of patients before and after finishing a dietetic programme for losing weight established in a Primary Care Nursing Practice. The goal of the programme is to stimulate the patient in maintaining the achievements and to focus the patient education on the correction of errors. Methodology: Prospective study of cuasi-experimental intervention, carried out from January of 2012 through December of 2013 with a group of patients from the Primary Care Nursing Practice of a rural Health Center in the province of Teruel (Spain). The pilot project was composed of 50 patients (26 men and 24 women) with basic educational background, ages between 35 and 65, average age 54.84 (± 8.04 SD) and average BMI of 33.52 kg/m2 (±3,43 SD). A customized treatment was elaborated for each patient, consisting of: hypocaloric diet, exercise and educational sessions. The patients were evaluated by means of the Obesity test included in the Clinical Actuation Guide in Primary Care Nursing from the Generalitat Valenciana (Corbacho, Godes, Adelina et al.) and a Questionaire on Weekly Consumption Frequency. The statistical analysis of the data has been done using the SPSS 15 software. Main Results: Significant modifications in the alimentary habits have been observed, more related to the amounts of the rations rather than to the frequency of consumption. Other factors such as «self-cooking», «eating out», or «going to work on foot» were not significantly varied. Notwithstanding, factors such as «fixed schedule for meals» or «frequent practice of physical activity», which previously had had negative replies from 43.59% (17 people) of the selected sample of patients, were significantly modified and no negative replies were obtained from the patients after the termination of the treatment. In addition, the «number of daily meals < 3» and «eating between hours» factors became significantly decreased by 33 % and 13 % respectively since the startup of the project. Conclusions: There is a modification of the hygienic and dietetic habits of the obese patients undergoing a dietetic therapeutic programme in a Primary Care Nursing Practice. Despite the great difficulty inherent to modifying the acquired habits, knowing the variation in daily life habits after the obesity treatments, helps better orienting the work of Primary Care Nursing professionals in this field (AU)

Evaluación de los conocimientos de un grupo de pacientes obesos de atención primaria a travéss de la pirámide alimentaria / Dietetic knowledge assessment usiing the food guide pyramid in a group of obese patients in primary care

Justidicación: La comprobación de los conocimientos de una guía alimentaria pueden ayudar al profesional de enfermería de Atención Primaria a mejorar la adherencia el tratamiento de la obesidad. Objetivo: Evaluar los conocimientos dietéticos de un grupo de pacientes en un programa de prevención secundaria de obesidad en un centro de Atención Primaria y los cambios logrados mediante sesiones individuales de consejo dietético. Metodología: Se ha realizado un estudio de evaluación de un programa piloto para prevención secundaria de obesidad en la consulta de enfermería desde enero 2012 a diciembre 2013, con observaciones antes y después de la intervención del grupo participante. En cada paciente se recogieron datos de la historia clínica informatizada (OMI-AP), se evaluaron los estadios de cambio del paciente; se aplicó el test de Framingham y una prueba de evaluación de conocimientos mediante la "Pirámide alimentaria". Resultados: Se realizó tratamiento de adelgazamiento durante las primeras 48 semanas (Enero a Diciembre de 2012) de 50 pacientess. Siguió e tratamietno el 76,0% y lo abandonó el 24%. Se consiguió una mejora en los conocimientos nutricionales próxima al 100%. Conclusión: Las sesiones de educación nutricional continua de forma individual han logrado una alta adherencia terapéutica y una buena asimilación de los conocimientos transmitidos. Este tipo de experiencias podrían incentivar las estrategias de mejora de la calidad en Atención Primaria (AU)

Background: The assessment of knowledge about the food guide may help Primary Health care professionals to gain better adherence to treatment of obese patients. Objective: to assess dietetic knowledge in a group of obese patiets and change achieved with an intervention based on individual dietary counseling sessions in a Primary Health care setting. Methods: An evaluation study of a pilot secondary prevention program for obese patients was conducted in nursing practice form january 2012 to december 2013 with observations before and after in the intervention group. Data collectedd for each participant included computerized Clinical History (OMI-AP); staes of change of the patient, Framinghan Test ad knowledge test related to the food guide pyramid. Results: A roup of 50 patients were on a diet during the ffirst 48 weeks (January through December, 2012) Treatment was followed by 76,0% and 24% withdrew. Positive change in knoeledge reached almost 100%. Conclusion: Continuous nutritional education sessions, conducted as individual counseling helped to enhance therapeutic adherence and the assimilation of knowledge. This type of experiences can contribute to encourange better quality in Primary Health Care (AU)

A descriptive study of health status and health related quality of life in selected outpatients with type 2 diabetes, pathological body mass index and cardiovascular risk in Spain.

BACKGROUND: Ottawa Charter defined health as a resource for everyday life and as an important dimension of health related quality of life (HRqol). Diabetes and obesity have repeatedly been shown as diseases that diminish health status and HRqol. The aim of this study was to measure health status and HRqol in a Spanish sample of obese patients with type 2 diabetes at cardiovascular risk and analyze behavioural, biological and social determinants of health. METHODS: Outpatients from external specialized clinic in Endocrinology were evaluated. MEASUREMENTS: sex, age, family history, employment status, comorbidities, pain, lifestyle habits, anthropometrics, blood pressure, blood analysis and HRqol with COOP/WONCA questionnaire (7 dimensions). STATISTICS: univariate, bivariate, multivariate and comparative analysis. RESULTS: Mean age was 59.1 ± 7.6 [95%IC: 56.6-61.6], 74% were women and 63.2% were physically active. WONCA values were; summary index (SI): 18.7 ± 4 [95%IC: 17.3-20] (maximum 35); physical fitness: 3.3 ± 1, feelings: 2.3 ± 1.1, social activities: 1.5 ± 1, daily activities: 2.1 ± 1.2, change in health: 2.7 ± 0.9, overall health: 3.6 ± 0.7 and pain: 3.5 ± 1.2 (maximum 5). High fibrinogen values (339.3 ± 85.8 [95%IC: 309.8-368.8]) negatively influenced pain visual analogic scale (p = 0.029). Physically active patients (63.2%) had better values in daily activities dimension (p = 0.025). More than the half of the sample (51.5%) reported a good quality of sleep, but the pain worsened it (p = 0.040). High BMI values (34.8 ± 5.8 [95%IC: 32.9-36.7]) harmed the COOP-WONCA SI (p = 0.009). High glycated hemoglobin (HbA1c) values (6.8 ± 1.3 [95%IC: 6.3-7.2]) had a negative impact on COOP-WONCA SI (p = 0.018). Nor tailored diet (15.8%) or being employed (18.4%) influenced the HRqol. The regression that best models COOP-WONCA SI was adjusted for BMI and HbA1c. SI = 3.509 + 0.335BMI +0.330HbA1c. CONCLUSIONS: HRqol was worse than in general population, but better than in previous studies of diabetes patients, without differences by sex or age, though feelings, daily activities and pain dimensions scored worse than in these studies. Higher levels of HbA1c, obesity and procoagulative state had a negative impact in these last dimensions. Pain impaired quality of sleep and physical activity had a positive impact in daily activities. BMI and HbA1c modeled the HRqol.

Descriptive study of stress and satisfaction at work in the Saragossa university services and administration staff.

BACKGROUND: The notion of stress in connection with the work environment became an important topic during the 1970's, when the first studies on the subject were published and the term of work stress was first coined. In 1974, Freudenberger proposed the term burnout to refer to the condition of physical and emotional exhaustion, as well as the associated negative attitudes, resulting from the intense interaction in working with people. The aim of our study is to examine burnout and job satisfaction in Saragossa University Services and Administration Staff (SAS) and detect the main factors which could contribute to too much stress, because job stress has emerged as a major psychosocial influence on mental health, associated with burnout. METHODS: 24 people from the Services and Administration Staff in the University of Saragossa participated in the study. The research was carried out during the implementation of a module on Stress Management organised by the University of Saragossa and commissioned to the Unit for Research in Physical Therapy (University School of Health Sciences) from that University. This research is an exploratory research to improve the stress management program. A personal interview was carried out and additionally, participants were given the Maslach Burnout Inventory and the Scale of Satisfaction at Work of Warr, Cook & Wall. RESULTS: However using small sample this is worth to state that participants present most of them low burnout levels in the burnout scale. Only in one person high exhaustion level was reflected, even though other seven showed mean levels; in the professional self-esteem section, most of them showed high self-esteem, with two cases of low self-esteem and five with mean level.With regard to satisfaction people participating in the study show mean levels in intrinsic as much as in extrinsic factors and general satisfaction. CONCLUSIONS: Services and Administration Staff from the University of Saragossa shows low burnout levels linked with high professional self-esteem and low emotional exhaustion and depersonalization.It has been found also medium levels in work satisfaction probably related with the continuous quality improvement efforts in the academics environment to create protective factors in decreasing levels of job stress.These results show that not only personality or temperament have an influence on burnout and stress, also the job conditions are related with these diseases. These aspects should be taken into account in the design of stress prevention programme at work.