ABSTRACT
Antecedentes y objetivo La educación terapéutica (ET) es eficaz e imprescindible en un contexto de prevalencia creciente de enfermedades crónicas, siendo necesarias herramientas para la planificación de programas estructurados. El objetivo fue elaborar una guía para el diseño y evaluación de un programa de ET. Métodos 1) Se constituyó un grupo multidisciplinario de 8 referentes en ET, cronicidad, calidad y seguridad, del hospital y la universidad. 2) Se realizó una revisión exhaustiva de la literatura científica sobre planificación de programas de ET dirigidos a pacientes crónicos, familiares o cuidadores. 3) El texto final se sometió a comentarios y sugerencias de participantes, del hospital y de atención primaria, en un curso sobre metodología de información y ET. Las recomendaciones fueron consensuadas, por unanimidad, por el grupo redactor. Resultados Se obtuvo un procedimiento normalizado de trabajo dirigido a profesionales implicados en planificación de programas de ET, basado en recomendaciones internacionales. El documento está estructurado en apartados: a) Definición del problema de salud y análisis de situación. b) Estructura del programa (recursos humanos y materiales); objetivos (salud, conducta y educativos) y metodología. c) Circuito que sigue el paciente y familia/cuidador en el programa. d) Evaluación e indicadores. La evaluación del procedimiento, en el marco de los cursos de metodología, fue favorable. Conclusiones La metodología aportada por este documento servirá de instrumento para planificar de forma homogénea y sistematizada los programas educativos, unificando criterios en su redacción. Sin embargo, requerirá su adaptación a la condición y la población a que se dirija cada programa (AU)
Background and objective Therapeutic patient education (TPE) is effective and essential in the context of the growing prevalence of chronic diseases in which tools are needed for planning structured programs. The objective of this project was to develop guidelines for designing and assessing a TPE program. Methods 1) We assembled a multidisciplinary group of 8 leaders in TPE, chronicity, quality and safety from the hospital and the university. 2) We conducted an exhaustive review of the scientific literature on the planning of TPE programs directed at chronically ill patients, their relatives and caregivers. 3) The final text underwent comments and suggestions by participants from the hospital and primary care centre during a course on information and TPE methodology. The recommendations were unanimously agreed upon by the writing group. Results We obtained a standardised work procedure targeted at professionals involved in planning TPE programs, based on international recommendations. The document is structured into sections: a) Definition of the health problem and analysis of the situation; b) Program structure (human resources and materials); objectives (health-related, behaviour-related and educational) and methodology; c) Path the patient and family/caregiver follows in the program; and d) Assessment and indicators. Assessment of the procedure, within the framework of the methodology courses, was favourable. Conclusions The methodology provided by this document serves as an instrument for the standardised and systematic planning of educational programs and unifies the criteria in their drafting. However, the document needs to be adapted to the condition and population to which each program is address (AU)
Subject(s)
Humans , Caregivers , Primary Health Care , Patient Education as Topic , Chronic Disease/therapyABSTRACT
BACKGROUND AND OBJECTIVE: Therapeutic patient education (TPE) is effective and essential in the context of the growing prevalence of chronic diseases in which tools are needed for planning structured programs. The objective of this project was to develop guidelines for designing and assessing a TPE program. METHODS: 1) We assembled a multidisciplinary group of 8 leaders in TPE, chronicity, quality and safety from the hospital and the university. 2) We conducted an exhaustive review of the scientific literature on the planning of TPE programs directed at chronically ill patients, their relatives and caregivers. 3) The final text underwent comments and suggestions by participants from the hospital and primary care centre during a course on information and TPE methodology. The recommendations were unanimously agreed upon by the writing group. RESULTS: We obtained a standardised work procedure targeted at professionals involved in planning TPE programs, based on international recommendations. The document is structured into sections: a) Definition of the health problem and analysis of the situation; b) Program structure (human resources and materials); objectives (health-related, behaviour-related and educational) and methodology; c) Path the patient and family/caregiver follows in the program; and d) Assessment and indicators. Assessment of the procedure, within the framework of the methodology courses, was favourable. CONCLUSIONS: The methodology provided by this document serves as an instrument for the standardised and systematic planning of educational programs and unifies the criteria in their drafting. However, the document needs to be adapted to the condition and population to which each program is addressed.
Subject(s)
Caregivers , Primary Health Care , Chronic Disease , HumansABSTRACT
Nasal intermittent positive-pressure ventilation (NIPPV) has been showed useful for the treatment of chronic respiratory failure in patients with chest wall diseases due to sequelae of tuberculosis. We present a report of a patient with a thoracoplasty and a cavernostomy in situation of chronic respiratory failure. Nasal intermittent positive pressure ventilation improved diurnal hypoxaemia and hypercapnia.
Subject(s)
Home Care Services , Intermittent Positive-Pressure Ventilation , Postoperative Care , Postoperative Complications/therapy , Respiratory Insufficiency/therapy , Tuberculosis, Pulmonary/therapy , Aged , Chronic Disease , Female , Humans , Lung/surgery , Postoperative Complications/etiology , Reoperation , Respiratory Insufficiency/etiology , Thoracoplasty , Tuberculosis, Pulmonary/complicationsABSTRACT
La ventilación con presión positiva intermitente por vía nasal (NIPPV) se ha mostrado eficaz en el tratamiento de la insuficiencia respiratoria secundaria a alteraciones de la caja torácica, provocadas a consecuencia del tratamiento quirúrgico de la tuberculosis pulmonar. Presentamos un caso de una paciente sometida a una toracoplastia, seguida de una cavernostomía, que en la actualidad se encontraba en fase de insuficiencia respiratoria. La aplicación de NIPPV ha conseguido mejorar el intercambio de gases mejorando la hipoxemia y corrigiendo la hipercapnia (AU)
