La calidad de vida desde la perspectiva de las adicciones / Quality of life from the perspective of addiction

Introducción. La calidad de vida (CV) es un concepto que incorpora la percepción del individuo sobre el estado de salud, estilo y satisfacción con la vida, estado mental o bienestar y ayuda a identificar déficits en áreas de funcionamiento, facilitando la identificación de grupos de riesgo y la planificación de medidas preventivas. El objetivo del estudio es evaluar la calidad de vida relacionada con la salud (CVRS) en pacientes en tratamiento por consumo de sustancias adictivas en la Unidad Asistencial de Drogodependencias de Monforte de Lemos (Lugo). Métodos. En la muestra de 100 usuarios se estudiaron variables sociodemográficas, de salud y de consumo, así como otras relacionadas con la CV medida a través del cuestionario SF-36. Los datos se analizaron con el paquete estadístico SPSS 15. Resultados. Existieron diferencias de medias en la mayor parte de las 8 dimensiones analizadas, con puntuaciones más altas en general por parte de los varones, aunque dichas diferencias no alcanzaron significación estadística salvo en el rol físico (p = 0,03). Se recogieron datos significativos el análisis en función de la situación sociolaboral, la droga principal, las enfermedades infecciosas y las somáticas. Conclusiones. En general la CVRS es más baja en nuestros usuarios que en la población general, y en los hombres es mayor que en las mujeres; el área más comprometida es la vitalidad. En las circunstancias actuales encontrarse en situación laboral activa repercute en una mejor CVRS (AU)

Introduction. Quality of life (QoL) is a concept that incorporates an individual's perception of health status, style and life satisfaction, mental state or well-being, and helps identify gaps in areas of functioning, facilitating the identification of risk groups and planning of preventive measures. The aim of the study is to assess the quality of life related to health (HRQOL) in patients treated for substance use in the Drug Dependency Care Unit of Monforte de Lemos (Lugo). Methods. Sociodemographic variables, health, consumer and other related QoL measured by the SF-36 questionnaire were studied in a sample of 100 users. Data were analysed with SPSS 15. Results. There were differences in the means in most of the eight dimensions analysed, with higher scores generally by men, although these differences did not reach statistical significance except for physical role (P = .03). A meaningful data analysis is presented based on the work situation, primary drug, and infectious and somatic diseases. Conclusions. Overall HRQOL is lower in our users than in the general population, and it is higher in men than in women, with the most compromised area being vitality. In the present circumstances, being in active employment leads to a better HRQOL (AU)

[Quality of life from the perspective of addiction]. / La calidad de vida desde la perspectiva de las adicciones.

INTRODUCTION: Quality of life (QoL) is a concept that incorporates an individual's perception of health status, style and life satisfaction, mental state or well-being, and helps identify gaps in areas of functioning, facilitating the identification of risk groups and planning of preventive measures. The aim of the study is to assess the quality of life related to health (HRQOL) in patients treated for substance use in the Drug Dependency Care Unit of Monforte de Lemos (Lugo). METHODS: Sociodemographic variables, health, consumer and other related QoL measured by the SF-36 questionnaire were studied in a sample of 100 users. Data were analysed with SPSS 15. RESULTS: There were differences in the means in most of the eight dimensions analysed, with higher scores generally by men, although these differences did not reach statistical significance except for physical role (P=.03). A meaningful data analysis is presented based on the work situation, primary drug, and infectious and somatic diseases. CONCLUSIONS: Overall HRQOL is lower in our users than in the general population, and it is higher in men than in women, with the most compromised area being vitality. In the present circumstances, being in active employment leads to a better HRQOL.

Análisis de la calidad de vida en pacientes con insuficiencia cardíaca mediante el cuestionario genérico SF-36 / Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure

Objetivo. La insuficiencia cardíaca es una de las principales enfermedades crónicas que afectan a la calidad de vida relacionada con la salud. El objetivo del presente estudio ha sido evaluar la calidad de vida en pacientes con clase funcional i - iii de la New York Heart Association mediante el cuestionario SF-36 usando una cohorte de supervivientes del Grupo de Estudio EPICOUR y compararlo con la calidad de vida de la población general española para el mismo sexo y grupo de edad. Material y métodos. Se diseñó un estudio de cohorte, observacional y prospectivo con los supervivientes del Grupo de Estudio EPICOUR a los que se les realizó control clínico-evolutivo y cuestionario SF-36. Resultados. Se estudió la calidad de vida en 50 pacientes (60% hombres). La edad media de los hombres fue de 64,8 años y de las mujeres de 68,3. Al analizar el SF-36 se observó que los resultados fueron más bajos en la esfera física que en la esfera mental. La calidad de vida empeoraba a medida que aumentaba la clase funcional. Al comparar los pacientes con la población general para el mismo sexo y edad, los pacientes con insuficiencia cardíaca mostraron puntuación inferior en todas las escalas (diferencias significativas en función física, dolor corporal, vitalidad y función social para los hombres y función física y rol emocional para las mujeres). Conclusiones. La insuficiencia cardíaca provoca un impacto negativo en la calidad de vida, tanto en la función física como en la función psicosocial, agravándose el deterioro con el incremento de la clase funcional(AU)

Objective: Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class i-iii using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. Material and methods: A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. Results: The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). Conclusions: Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class (AU)

[Analysis of quality of life using the generic SF-36 questionnaire in patients with heart failure]. / Análisis de la calidad de vida en pacientes con insuficiencia cardíaca mediante el cuestionario genérico SF-36.

OBJECTIVE: Heart failure is one of the major chronic diseases that affect health related quality of life. The objective of this study was to evaluate the quality of life in patients with New York Heart Association functional class I-III using the SF-36 on a cohort of survivors of the EPICOUR Study Group and compare the quality of life with the general Spanish population of the same sex and age group. MATERIAL AND METHODS: A cohort study, observational, and prospective study was conducted on survivors of the EPICOUR Study Group, on whom a clinical-progression-outcome review was performed along with the SF-36. RESULTS: The quality of life was studied in 50 patients (60% male). The average age of men was 64.8 years and women 68.3. When analyzing the SF-36, it was observed that the results were lower in the physical dimensions than in the mental dimensions. The quality of life worsened with increasing functional class (statistically significant differences for scales of physical functioning, social functioning and borderline significance in mental health scale). When comparing patients with the general population of the same age and sex, patients with heart failure showed lower scores on all scales (significant differences in physical functioning, body pain, vitality, and social role for men, and physical function and emotional role for women). CONCLUSIONS: Heart failure causes a negative impact on quality of life, physical functioning, as well as psychosocial function, with the impairment becoming worse with increased functional class.

Monforte y O Barco de Valdeorras, dos áreas sanitarias diferentes, ¿dos perfiles diferentes? / Monforte and O Barco de Valdeorras are two different health areas. Do they have two different profiles?

Objetivo. La Unidad Asistencial de Drogodependencias (UAD) de Monforte atiende dos áreas sanitarias con características sociodemográficas y económicas distintas (Monforte de Lemos y O Barco de Valdeorras). La oferta asistencial es homogénea, con la particularidad de que desde el año 2002 profesionales de la UAD se desplazan semanalmente a O Barco. El objetivo es verificar si las diferencias de las dos áreas se reflejan en el perfil del usuario de la UAD. Material y métodos. Se incluyeron 186 usuarios que estuvieron en tratamiento durante el 2006 en la UAD de Monforte. Los datos se obtuvieron de la revisión de las historias clínicas de dichos usuarios y se analizaron mediante el programa estadístico SPSS 12.0. Conclusiones. Existen diferencias en las dos áreas sanitarias en lo que se refiere a la vía de acceso, el hábitat, la adicción principal y el nivel de estudios. El nivel de estudios inferior en O Barco se debe probablemente a la corta edad con que los usuarios acceden al mercado laboral, por la amplia oferta de trabajo sin ningún requisito académico. La edad media de consumo es similar en ambas áreas. Resultados. Las vías de acceso mayoritarias después de la iniciativa del sujeto son sustancialmente diferentes. La proporción de usuarios del medio urbano es ligeramente superior en el área monfortina. Sin embargo, si el análisis se realiza en función de la adicción principal, el porcentaje de usuarios que demanda tratamiento por alcohol muestra una diferencia relevante aunque no estadísticamente significativa, el 81,8 % del medio rural de Valdeorras acude por esta sustancia (AU)

Objectives. The Drug Dependency Unit (DDU) of Monforte attends to two different health areas having different socio-demographic and economical characteristics (Monforte de Lemos and O Barco de Valdeorras). The health care offered is homogeneous, with the special characteristic that since 2002 the professionals from the DDU have been going to O Barco de Valdeorras every week. Material and methods. A total of 186 users treated in the DDU of Monforte during 2006 were included. The information has been obtained from the medical records of these users, analyzing it with the statistical program SPSS 12.0. Results. The majority of the pathways used since the initiative of the subject are very different. There is a slightly higher proportion of patients from the urban area than from the Monforte one. However, regarding the principal drug addiction, the percentage of users demanding treatment because of alcohol addiction has a relevant, although not statistically different difference, 81.8 % of the users from O Barco de Valdeorras come due to alcohol addiction. Conclusions. There are differences between both health areas in regards to access pathway, habitat, principal drug and education level. The lower education level in O Barco de Valdeorras is probably due to the younger age of the users who access the work market, due to the large offer for work not requiring an education. The mean age of consumption is similar in both areas (AU)

Pasado y presente. ¿Hay diferencia en el perfil del usuario de la Unidad Asistencial de Drogodependencias de Monforte? 1996-2006 / Past and present. Are there any differences in the user’s profile of the Drug Dependency Unit of Monforte? 1996-2006

Objetivos. El perfil de los consumidoresque solicitan tratamiento en las Unidades Asistencialesde Drogodependencias (UAD) está cambiandoen nuestro país. Nuevos consumos, edad deacceso y nivel formativo, entre otros, suponen unreto para los equipos de las unidades asistenciales.El objetivo de este trabajo es describir el cambio enel perfil del usuario de la UAD de Monforte, atendiendoa variables sociodemográficas y de consumo.Material y métodos. Se han incluido 145 pacientes.El criterio de selección ha sido: que iniciaran oreiniciaran tratamiento en los años 1996 y 2006 enla UAD de Monforte. Se revisaron en las historiasclínicas las entrevistas de inicio/reinicio de tratamiento y se analizaron los datos mediante el programa estadístico SPSS 12.0.Resultados. Se han encontrado diferencias significativasen la edad media, sexo, droga principal, nivelacadémico y vía de acceso.Conclusiones. El porcentaje de pacientes que acudena nuestra UAD por consumo de alcohol y tabacoha aumentado significativamente (p < 0,05), tambiénel número de mujeres a tratamiento.Asimismo, se aprecia un aumento significativo de laedad media de aproximadamente 10 años; en el casode las mujeres es de 14 años (p < 0,05). La vía de accesoprincipal a la UAD sigue siendo por iniciativapropia, evidenciándose un aumento de los pacientesremitidos por Atención Primaria y Unidad deSalud Mental (USM) y una considerable disminuciónde los pacientes que acuden a través de otrosdrogodependientes. La mayoría de los pacientesmantiene el graduado escolar como nivel educativo;se observa que en 2006 la formación era superior,pues se dieron más casos con estudios universitarios

Objectives. The profile of the consumerswho solicit treatment in the Drug DependencyUnits (DDU) is changing in our country. New consumers,age of access and formative level mean a challengefor the teams of the welfare units. The aim isto describe this new user’s profile of the MonforteDDU, in accordance with consumption and sociodemographicvariables.Material and methods. One hundred and fortyfivepatients have been included. The selection criteriawere: patients who commence or recommencetreatment in Monforte DDU from 1996 to 2006. Clinicstories were revised and information was examinedby the statistical program SPSS 12.0.Results. Significant differences were found in theaverage age, sex, principal drug, academic level andaccess tract.Conclusions. The percentage of patients who attendour DDU because of alcohol and tobacco consumptionhas increased significantly (p < 0.05) andthe number of women in the treatment has also increased.Likewise, there is a significant increase inthe average age: approximately 10 years; in the caseof the women is 14 years (p < 0.05). The principalaccess tract in the DDU is still own initiative, proofof the patients remitted by Primary Attention andMental Health Unit (MHU) increase and the decreaseof patients who attend DDU because of othersdrug-dependents. Most of patients have the primaryeducation qualification as educative level. In2006 the educative level is higher among patients,having more cases of patients with university studies

Infección por VIH, consumo de drogas y rendimiento neuropsicológico / HIV-1 infection, use of drugs and neuropsychologic efficiency

Introducción: El abuso de sustancias ha sido considerado como un factor explicativo del deterioro neuropsicológico. Sin embargo, persisten dudas sobre la distinción entre efectos directos o indirectos e incluso sobre la interacción entre el efecto del VIH y el consumo de sustancias. El objetivo de esta investigación consistió en estudiar el efecto del consumo de drogas y la seropositividad al VIH-1 sobre el rendimiento neuropsicológico. Método: Tras obtener el consentimiento informado fueron reclutados 113 suetos, integrados en cuatro grupos (34 seropositvos exconsumidores de drogas por vía parenteral; 33 seropositivos en programas de mantenimiento con metadona; 19 seronegativos exconsumidores de drogas por vía parenteral; y 27 seronegativos sin antecedentes de consumo. A todos ellos se les aplicó una batería neuropsicológica integrada diseñada ad hoc, una entrevista semiestructurada sobre aspectos sociodemográficos, toxicológicos, neuropsiquiátricos y clínico-biológicos y una evaluación de la sintomatología ansioso-depresiva. Resultados: los sujetos seropositivos en metadona presentan mayores tasas de prevalencia del deterioro que el resto de los grupos (c2 = 32.22, p ,000). Conclusiones: El consumo de drogas y la seropositividad son factores que se asocian al bajo rendimiento neuropsicológico. Además, la situación respecto al consumo explica diferencias en los niveles de ejecución y tasas de deterioro neuropsicológico, siendo los sujetos en programas de mantenimiento con metadona los que presentan los peores niveles de ejecución, así como las tasas más elevadas de afectación neuropsicológica

Introduction: The abuse of substances has been considered as an explanatory factor of the neuropsychologic failure. However, doubts persist on the distinction among direct or indirect efects and even on the interaction between the effect of the HIV and the use of substances. The objective of this investigation consisted on studying the effect of the use of drugs and the seropositivity to the HIV-1 on the neuropsychologic efficiency. Method: After obtaining the informed consentiment 113 patients they were recruited, integrated in four groups (34 seropositives ex-UDPP; 33 seropositives in maintenance programs with methadone; 19 seronegatives; and 27 seronegatives without previous use of drugs. To all they were applied a neuropsychologic battery designed ad hoc, an semistructured interview about sociodemographical, toxicological, neuropsychiatric and clinical-biological aspects and an evaluation of the ansious-depressive symptomatology. Results: The seropositive patients in methadone present bigger rates of prevalence of the damage that the rest of the groups (X2 = 32.22, p .000). Conclusions: The abuse of drugs and the seropositivity are factors that associate to the decrease neuropsychologic efficiency. Also, the situation regarding the abuse explains differences in the execution levels and rates of neuropsychologic damage, being the patients in maintenance programs with methadone those that present the worst execution levels, as well as the highest rates in neuropsychologic affectation

[HIV-1 infection, use of drugs and neuropsychologic efficiency]. / Infección por VIH, consumo de drogas y rendimiento neuropsicológico.

INTRODUCTION: The abuse of substances has been considered as an explanatory factor of the neuropsychologic failure. However, doubts persist on the distinction among direct or indirect effects and even on the interaction between the effect of the HIV and the use of substances. The objective of this investigation consisted on studying the effect of the use of drugs and the seropositivity to the HIV-1 on the neuropsychologic efficiency. METHOD: After obtaining the informed consent 113 patients they were recruited, integrated in four groups (34 seropositives ex-UDPP; 33 seropositives in maintenance programs with methadone; 19 seronegatives; and 27 seronegatives without previous use of drugs. To all they were applied a neuropsychologic battery designed ad hoc, an semistructured interview about sociodemographical, toxicological, neuropsychiatric and clinical-biological aspects and an evaluation of the anxious-depressive symptomatology. RESULTS: The seropositive patients in methadone present bigger rates of prevalence of the damage that the rest of the groups (X2 = 32.22, p < .000) and lower rates of execution in all the studied factors. Also, it is observed that the seropositive patients as group present lower execution levels and higher rates of damage. Also, all the groups had lower levels of execution that the people seronegative non consumers (F = 15.661, p > .000). CONCLUSIONS: The abuse of drugs and the seropositivity are factors that associate to the decrease neuropsychologic efficiency. Also, the situation regarding the abuse explains differences in the execution levels and rates of neuropsychologic damage, being the patients in maintenance programs with methadone those that present the worst execution levels, as well as the highest rates in neuropsychologic affectation.