Association of General and Abdominal Obesity With Hypertension, Dyslipidemia and Prediabetes in the PREDAPS Study.

INTRODUCTION AND OBJECTIVES: Some anthropometric measurements show a greater capacity than others to identify the presence of cardiovascular risk factors. This study estimated the magnitude of the association of different anthropometric indicators of obesity with hypertension, dyslipidemia, and prediabetes (altered fasting plasma glucose and/or glycosylated hemoglobin). METHODS: Cross-sectional analysis of information collected from 2022 participants in the PREDAPS study (baseline phase). General obesity was defined as body mass index ≥ 30kg/m2 and abdominal obesity was defined with 2 criteria: a) waist circumference (WC) ≥ 102cm in men/WC ≥ 88cm in women, and b) waist-height ratio (WHtR) ≥ 0.55. The magnitude of the association was estimated by logistic regression. RESULTS: Hypertension showed the strongest association with general obesity in women (OR, 3.01; 95%CI, 2.24-4.04) and with abdominal obesity based on the WHtR criterion in men (OR, 3.65; 95%CI, 2.66-5.01). Hypertriglyceridemia and low levels of high-density lipoprotein cholesterol showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.49; 95%CI, 1.68-3.67 and OR, 2.70; 95%CI, 1.89-3.86) and with general obesity in men (OR, 2.06; 95%CI, 1.56-2.73 and OR, 1.68; 95%CI, 1.21-2.33). Prediabetes showed the strongest association with abdominal obesity based on the WHtR criterion in women (OR, 2.48; 95%CI, 1.85-3.33) and with abdominal obesity based on the WC criterion in men (OR, 2.33; 95%CI, 1.75-3.08). CONCLUSIONS: Abdominal obesity indicators showed the strongest association with the presence of prediabetes. The association of anthropometric indicators with hypertension and dyslipidemia showed heterogeneous results.

Relationship between anxiety level of patients and their satisfaction with different aspects of healthcare.

OBJECTIVE: The objective of this study was to explore the possible association between the anxiety level of patients and their satisfaction with different aspects of healthcare. METHOD: This analytical cross-sectional study included 301 patients undergoing scheduled trauma surgery from October 2004 to May 2005 at the Virgen de las Nieves University Hospital in Granada (Spain). They completed a sociodemographic and clinical questionnaire before their discharge and, at 15 days after discharge, they responded to an ad hoc questionnaire comprising three items (satisfaction with information received, privacy and comfort of the setting, and friendliness of healthcare professionals), and were scored on an interviewer-administered Zung anxiety scale. Descriptive analysis and unadjusted logistic regression were performed for each factor, followed by multivariate logistic regression to model the association between satisfaction and anxiety with study of confounding variables. RESULTS: For each higher point in the Zung test, patients had a 4% higher risk of feeling dissatisfied with the information received, an 8% higher risk of dissatisfaction with the hospital setting and a 6% higher risk of dissatisfaction with the friendliness of healthcare personnel. CONCLUSION: A higher anxiety level in the patient was associated with greater dissatisfaction with the three healthcare aspects studied.

[Evaluation of a health care programme with nursing tutor in a hospital traumatological facility in a hospital, Granada, Spain, 2004]. / Evaluación de un programa de atención sanitaria con enfermera tutora en cirugía de traumatologia en un hospital de Granada, 2004.

BACKGROUND: The current trend in patient care is towards a more humanized and higher-quality healthcare. The objective of the present study was to evaluate the results of implementing a programme of healthcare with a reference nurse who welcomes the patient at hospital admission, visits regularly during hospital stay, and resolves doubts and problems. METHODS: Quasi-experimental study (149 cases and 454 non-tutored controls) in patients admitted for scheduled trauma surgery at the Virgen de las Nieves University Hospital, Granada. Sociodemographic and clinical data were gathered at admission. At 15 days after discharge, patients were administered with an interviewer-administered Zung score and an ad hoc questionnaire on satisfaction with different healthcare aspects during hospital stay and understanding of information received. Bivariate analyses and linear and multivariate logistic regression analyses were performed with a study of confounding variables. RESULTS: For the outcome variable anxiety level non-tutored patients had a B coefficient of 2.64 (p<0,01) in the multivariate linear regression analysis controlling for the other variables in the final model: sex, presence of informal career, professional activity, days of hospital stay and understanding of health information. For the outcome variable inadequate understanding information non-tutored patients showed an odds ratio of 3.48 in the multivariate analysis controlling for educational level and presence of informal career. Satisfaction with he friendliness of health care personnel and with the hospital setting did not significantly difference, although the percentage of dissatisfied patients was higher in the non-tutored group: 15% vs 11% (p= 0.34) and 18% vs 12 % (p= 0.11) respectively. CONCLUSIONS: The implemented continued care programme proved effective for these patients, increasing their understanding of information received and reducing anxiety levels.

Evaluación de un programa de atención sanitaria con enfermera tutora en cirugía de traumatología en un hospital de Granada, 2004 / Evaluation of a health care programme with nursing tutor in a hospital traumatological facility in a hospital. Granada, Spain, 2004

Fundamento: La tendencia actual en la atención al paciente es hacia un aumento de la calidad en los servicios sanitarios. El objetivo de este trabajo fue evaluar los resultados de la aplicación de un programa de atención sanitaria a través de una enfermera de referencia que acogía al paciente al ingreso hospitalario, le visitaba regularmente durante su estancia y le resolvía dudas y problemas. Métodos: Estudio cuasi-experimental realizado en pacientes (149 casos y 454 controles) ingresados para cirugía traumatológica en el Hospital Virgen de las Nieves de Granada. Al ingreso se recogieron variables sociodemográficas y clínicas. A los 15 días tras el alta se les administró la "Escala heteroevaluada de ansiedad de Zung" y un cuestionario ad hoc sobre la satisfacción con diferentes aspectos de la atención sanitaria durante la estancia en el hospital y la comprensión de la información recibida. Se realizó análisis bivariante y análisis de regresión lineal y regresión logística multivariante con estudio de variables confundentes. Resultados: Para la variable nivel de ansiedad los pacientes no tutorizados en el análisis de regresión lineal multivariante tenían un coeficiente B=2,64 (p<0,01), controlando por la otras variables en el modelo final: sexo, presencia de cuidador informal actividad profesional, días de estancia, y comprensión de la información sanitaria. Para la variable de resultado insuficiente comprensión de la información los pacientes no tutorizados tenían una Odds Ratio de 3,48 en el análisis de regresión logística multivariante controlando por educación y presencia de cuidador informal. La satisfacción con la amabilidad del personal y con el medio hospitalario no se modificó significativamente aunque el porcentaje de insatisfacción fue mayor en el grupo no tutorizado, 15% frente a 11% (p= 0,34), y 18% frente a 12% (p=0,11) respectivamente. Conclusiones: El programa de atención continuada aplicado se ha manifestado eficaz para los pacientes, aumentando la comprensión de la información y disminuyendo los niveles de ansiedad (AU)

Background: The current trend in patient care is towards a more humanized and higher-quality healthcare. The objective of the present study was to evaluate the results of implementing a programme of healthcare with a reference nurse who welcomes the patient at hospital admission, visits regularly during hospital stay, and resolves doubts and problems. Methods: Quasi-experimental study (149 cases and 454 non-tutored controls) in patients admitted for scheduled trauma surgery at the Virgen de las Nieves University Hospital, Granada. Sociodemographic and clinical data were gathered at admission. At 15 days after discharge, patients were administered with an interviewer-administered Zung score and anad hoc questionnaire on satisfaction with different healthcare aspects during hospital stay and understanding of information received. Bivariate analyses and linear and multivariate logistic regression analyses were performed with a study of confunding variables. Results: For the outcome variable anxiety level non-tutored patiens had a B coeficient of 2.64 (p<0,01) in the multivariate linear regression analisys controlling for the other variables in the final model: sex, presence of informal carer, professional activitiy, days of hospital stay and understanding of health information. For the outcome variable inadequate understanding information non-tutored patients showed an odds ratio of 3.48 in the multivariate analysis controlling for educational level and presence of informal carer. Satisfaction with he friendliness of health care personnel and with the hospital setting did not significantly diference, although the percentage of dissatisfied patiens was higher in the non-tutored group: 15% vs 11% (p= 0.34) and 18% vs 12 % (p= 0.11) respectively. Conclusions: The implemented continued care programme proved effective for these patients, increasing their understanding of information received and reducing anxiety levels (AU)

Información recibida por los pacientes acerca de su estado de salud y su comprensión, antes y durante su hospitalización / Information received by patients on their health status and their understanding of it, before and during hospital admission

Objetivos. Determinar la cantidad de información que reciben los pacientes acerca de su estado de salud antes de su ingreso en el hospital y durante su estancia en él, su comprensión de la información y la relación de estas variables con el perfil sociodemográfico. Método. Estudio trasversal en el que se incluyeron 289 pacientes, de 16 años o más, ingresados desde octubre de 2004 hasta junio de 2005 en cirugía traumatológica programada, con buen estado cognitivo y capacidad auditiva para contestar preguntas por teléfono. Se recogieron variables sociodemográficas, grado de información y comprensión acerca de su problema de salud previo al ingreso y durante su estancia en el hospital. Resultados. En el análisis univariante tenían más riesgo de no comprender la información (p < 0,05) las personas que consideraron que habían sido poco o nada informadas acerca de su problema de salud, las que no tenían estudios o tenían sólo estudios primarios y las que vivían en áreas urbanas con menos de 10.000 habitantes. En el análisis multivariante, la percepción acerca de la cantidad de información recibida y el nivel de estudios mantuvieron la asociación con la comprensión previa de la información. Conclusiones. La información al paciente durante la estancia en el hospital es mejor comprendida que la recibida antes de su ingreso. La percepción de la cantidad de información recibida acerca de su salud es la variable más fuertemente relacionada con la comprensión de la información

Objective. To determine the amount of information received by patients on their health status before and during their hospital stay and their understanding of this information, and to relate these variables to their sociodemographic profile. Method. We performed a cross sectional study that included 289 patients aged >= 16 years old admitted for elective trauma surgery from october 2004 to june 2005. The patients had good cognitive status and sufficient auditory capacity to answer questions by telephone. Data were gathered on demographic variables, the amount of information received, and patients' understanding of their health problems before and during hospital stay. Results. In the univariate analysis, individuals who considered that that they had been little- or uninformed about their health problem or who had only primary schooling and lived in urban areas with < 10,000 inhabitants were at highest risk of not understanding the information (p < 0.05). In the multivariate analysis, perception of the amount of information received and educational level maintained the association with prior understanding of the information. Conclusions. Patients understand information given to them during hospital stay better than that received before hospital admission. Patients' perception of the amount of information received on their health is the variable most strongly related to their understanding of the information

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