Calidad de vida relacionada con la salud en pacientes con diabetes mellitus en una zona básica de salud / Health-related quality of life in diabetes mellitus patients in primary health care

Objetivo: Analizar la relación entre la calidad de vida relacionada con la salud (CVRS) y variables sociodemográficas y clínicas de pacientes diagnosticados de diabetes mellitus, comparando además con los valores de referencia para la población española. Método: Estudio descriptivo-analítico observacional trasversal por muestreo no probabilístico intencional en pacientes con diabetes mellitus del Centro de Salud San Roque (Badajoz, España), usando cuestionarios de datos sociodemográficos y de cuidado de la diabetes, los cuestionarios SF-36 y Duke-UNC, y datos de la historia clínica. Resultados: Se estudiaron 60 pacientes (55% mujeres) fundamentalmente con diabetes tipo 2 (90%) y una edad media de 68,67±11,09 años. Las mujeres mayores de 75 años presentaron valores de CVRS significativamente inferiores a los de su grupo poblacional de referencia. Las mujeres mostraron una peor CVRS que los hombres. La edad, los años de evolución de la diabetes, la presencia de complicaciones agudas y crónicas, así como de comorbilidades, el régimen farmacológico y el control glucémico afectan a la CVRS. Vivir solo, tener un nivel socioeconómico bajo, un apoyo social percibido bajo y necesitar ayuda para el cuidado de la diabetes están relacionados con una deficiente CVRS. Conclusiones: La evaluación de la CVRS permite detectar alteraciones en sus diferentes dominios e intervenir precozmente, pudiendo incorporar estos aspectos a la valoración e intervención enfermera en el plan de cuidados, lo que permite establecer estrategias individualizadas de atención y programas de educación diabetológica que contribuyan a la mejora de la calidad de vida en pacientes con diabetes.(AU)

Objective: To analyse the relationship between health-related quality of life (HRQoL) and sociodemographic and clinical factors in patients with diabetes mellitus, also comparing with Spanish population-based reference values. Method: Cross-sectional descriptive-analytical observational study through nonprobability sampling on diabetic patients from San Roque Primary Health Centre (Badajoz, Spain), using a questionnaire regarding sociodemographic and diabetes care data, SF-36 and Duke-UNC questionnaires, and clinical history data. Results: Sixty patients (55% women) fundamentally with type 2 diabetes and a mean age of 68.67±11.09 years were studied. Women older than 75 presented poorer HRQoL than their reference group. Women showed worse HRQoL than men. Age, evolution of diabetes, presence of acute and chronic complications, and comorbidities, pharmacological treatment, and glycaemic control affect HRQoL in these patients. Living alone, having a low socioeconomic status, and needing help with diabetes-related self-care can negatively affect quality of life. Conclusions: HRQoL assessment allows us to detect alterations in the different domains and perform an early intervention. This way, we can incorporate these aspects into the nursing evaluation and interventions in the nursing care plan; allowing us to develop individualized care strategies and diabetes education programmes that contribute to improving HRQoL in patients with diabetes.(AU)

Health-related quality of life in diabetes mellitus patients in primary health care.

OBJECTIVE: To analyse the relationship between health-related quality of life (HRQoL) and sociodemographic and clinical factors in patients with diabetes mellitus, also comparing with Spanish population-based reference values. METHOD: Cross-sectional descriptive-analytical observational study through nonprobability sampling on diabetic patients from San Roque Primary Health Centre (Badajoz, Spain), using a questionnaire regarding sociodemographic and diabetes care data, SF-36 and Duke-UNC questionnaires, and clinical history data. RESULTS: Sixty patients (55% women) fundamentally with type 2 diabetes and a mean age of 68.67 ± 11.09 years were studied. Women older than 75 presented poorer HRQoL than their reference group. Women showed worse HRQoL than men. Age, evolution of diabetes, presence of acute and chronic complications, and comorbidities, pharmacological treatment, and glycaemic control affect HRQoL in these patients. Living alone, having a low socioeconomic status, and needing help with diabetes-related self-care can negatively affect quality of life. CONCLUSIONS: HRQoL assessment allows us to detect alterations in the different domains and perform an early intervention. This way, we can incorporate these aspects into the nursing evaluation and interventions in the nursing care plan; allowing us to develop individualized care strategies and diabetes education programmes that contribute to improving HRQoL in patients with diabetes.

Relationship of Depression Scores and Ranges in Women Who Suffer From Fibromyalgia by Age Distribution: A Case-Control Study.

BACKGROUND: Fibromyalgia may be defined as a chronic widespread pain condition that generates a functional impairment with various symptoms, such as depression. PURPOSE: The main aim of this research was to compare the Beck Depression Inventory (BDI) scores and depression ranges in women who suffered from fibromyalgia with respect to healthy controls, overall and by age distributions. METHODS: A case-control observational study was performed. Two hundred women with a mean age of 58.61 ± 15.65 years old were recruited. The women were divided into case (women with fibromyalgia) and control (healthy women) groups. The BDI scores and depression ranges were collected. RESULTS: The depression ranges and BDI scores mean ± SD showed statistically significant differences (p < .001) between participants with fibromyalgia (19.30 ± 11.21 points; moderate depression) and healthy controls (6.37 ± 5.35 points; no depression). Regarding the age distributions, statistically significant differences were shown between fibromyalgia and control groups for adults (p < .001; 19.06 ± 6.55 vs. 4.69 ± 4.48 points) and older adults (p = .001; 20.25 ± 13.79 vs. 7.63 ± 5.47 points), respectively. ANOVA of the BDI scores with two factors and interaction (fibromyalgia presence and age distribution) determined no interaction between the two factors (p = .534) and statistically significant differences of BDI scores for fibromyalgia presence (p < .001; R2  = 35.50%), but not for age distribution (p = .144). LINKING EVIDENCE TO ACTION: Measurable differences in higher BDI scores and depression ranges were shown in women who suffered from fibromyalgia with respect to healthy controls, regardless of age distribution. Greater probabilities (odds ratio = 15.88) of suffering from some level of depression (according to BDI scores) were found in women with fibromyalgia in comparison with healthy women. Although these findings did not seem to be influenced by age distribution, interventions targeting depression in practice, research, policy, management, or education must equally include adult and older adult women who suffer from fibromyalgia.

Interés para la enfermería de los nuevos anticuerpos monoclonales. Una revolución terapéutica / Monoclonal antibodies: a new revolutionary therapy

Los anticuerpos monoclonales (mAb) son una poderosa herramienta para el diagnóstico y tratamiento de muchas enfermedades. En los últimos años la Agencia Española de Medicamentos y Productos Sanitarios (AEMPS) ha autorizado la comercialización de nuevos mAb y otros se incorporarán en un futuro próximo. Los profesionales de enfermería, como responsables de la administración, deben conocer las características más importantes de este tipo de herramientas terapéuticas. Se pretende relacionar los diferentes tipos de mAb aprobados en España, sus indicaciones terapéuticas y reacciones adversas, así como destacar otros aspectos importantes sobre el desarrollo de estos nuevos fármacos en el mercado. Los mAb son eficaces para el tratamiento de enfermedades oncológicas, reumatológicas, dermatológicas o neurológicas, entre otras. Además, se están desarrollando numerosos ensayos clínicos con otros nuevos mAb que incrementarán el número de fármacos disponibles, así como nuevas indicaciones para los ya existentes. Aunque la introducción de estos nuevos productos en el mercado está contribuyendo a disminuir la mortalidad y mejorar la calidad de vida de los pacientes, en la práctica clínica existe un gran debate sobre la necesidad de aprobar tantos nuevos fármacos con altos costes para el sistema sanitario y con un beneficio dudoso con respecto al resto de los de su grupo ya comercializados (AU)

Monoclonal antibodies (mAb) are a powerful tool for numerous illnesses' diagnosis and therapy. Over the last few years, the Spanish Agency for Medical Drugs and Health Products (AEMPS) has approved the merchandising of new mAb. Many more approvals are expected to come in the near future. Nursing professionals, responsible for drug administration, should know the most important characteristics of this type of therapeutic tools. Our aim is to link the different types of mAb licensed in Spain, their therapeutic indications, adverse effects, and point out important aspects of the development of these new drugs in the pharmacological market. MAb are very effective for the treatment of oncologic, dermatologic and neurologic diseases among others. Ongoing medical trials with new mAb will increase the current available arsenal, including new indications on the already approved drugs. Although the introduction of this new class of drugs in the pharmaceutical market is reducing mortality and improving the quality of patients' lives, an important debate is going on in real clinical practice over the need to endorse so many new drugs, which pose a huge economic burden on the National Health System and doubtful advantages in comparison to the rest of readily commercialized mAb (AU)