Impact of a long-term tobacco-free policy at a comprehensive cancer center: a series of cross-sectional surveys.

BACKGROUND: Spain has passed two smoke-free laws in the last years. In 2005, the law banned smoking in indoor places, and in 2010 the ban was extended to outdoor areas of certain premises such as hospitals. This study assesses the impact of smoking consumption among hospital workers at a comprehensive cancer center after the passage of two national smoke-free laws. METHODS: Six cross-sectional surveys were conducted among a representative sample of hospital workers at a comprehensive cancer center in Barcelona (2001-2012) using a standardized questionnaire. Logistic regression was used to compare differences in the odds of smoking after the laws took effect (baseline vs. 1st law; 2nd law vs. 1st law). RESULTS: Baseline smoking prevalence was 33.1%. After passage of the 1st and 2nd laws, prevalence decreased, respectively, to 30.5% and 22.2% (p for trend =0.005). Prevalence ratios (PR) indicated a significant decrease in overall smoking after the 2nd law (PR = 0.65, 95% CI = 0.47-0-89). Smoking dropped in all professional groups, more prominently among those ≥35 years old, doctors, and women. Observed trends over the time included an increase in occasional smokers, a rise in abstinence during working hours but an increase in smoking dependence, and an increase in the employees' overall support for the smoke-free hospital project. CONCLUSIONS: A long-term tobacco control project combined with two smoke-free national laws reduced smoking rates among health workers and increased their support for tobacco control policies. The decrease was more significant after the passage of the outdoor smoke-free ban.

Factors influencing burden among non-professional immigrant caregivers: a case-control study.

AIM: To identify factors related to the burden that is experienced by untrained immigrant caregivers. BACKGROUND: There is growing concern about how to provide the care required by an ageing population. Although elder care has usually been provided by family members, this role is increasingly being fulfilled by immigrant caregivers with no formal training. DESIGN: Case-control study (burdened/non-burdened according to the Zarit Burden Interview). METHODS: The study took place between May 2005-October 2009. Anonymous questionnaires were distributed to 110 immigrant caregivers and their corresponding older care recipients (n = 110), who were receiving care in their homes in Barcelona (Spain). The questionnaires included measures of burden, social support, quality of life and social integration, and items about the physical/psychological status of the care recipient and the nature of the care tasks. Two groups of immigrant caregivers were defined according to their scores on the Zarit Burden Interview: burdened (n = 55) and non-burdened (n = 55). RESULTS: Burdened caregivers reported less social support, a poorer quality of life, and problems with social integration. Furthermore, 48% said that they lacked knowledge about the care task, while 44% had difficulty performing certain care tasks, which constitutes a risk situation. CONCLUSION: Burden among untrained immigrant caregivers may be reduced by improving their social support systems and quality of life, thereby helping to ensure the availability of the caregiver services, which society increasingly needs.

Informal caregiving: perceived needs.

With the increasing population of persons over the age of 65 who need daily assistance in Spain, there is considerable need to better understand informal caregivers' views, particularly about the resources that are available to them, or should be available to them. With that purpose in mind, a grounded theory method was used with focus groups in Barcelona, Malaga, Seville, and Tenerife. All of the participants were caring for family members with dementia, cancer, or other neurodegenerative conditions. The findings generated 86 codes, which were grouped into two categories: understanding the experience of caregiving, and caregiving resources. The first category was the need for caregivers to talk about their experiences and to be listened to. The second category included the presence of resources and support requirements. The caregivers said that their ability as caregivers was limited; many did not know what resources were available or how to locate new resources. Many caregivers are carrying out their role dutifully, but feel isolated, suggesting that there is a lack of social understanding and policies about informal caregivers in Spain.

Recursos y consecuencias de cuidar a las personas mayores de 65 años: Una revisión sistemática / Resources and consequences of caregiving for people older than 65: a systematic review

Introducción: El cuidado prestado por los cuidadores principales de personas mayores constituye el principal soporte que éstas reciben. Proporcionar estos cuidados afecta de diferente manera a cada cuidador. La literatura es amplia y extensa al describir estas repercusiones de la tarea de cuidar sobre el cuidador, así como en referencia a los recursos de apoyo utilizados. Método: Se ha realizado una revisión sistemática de la literatura, en las principales bases de datos nacionales e internacionales, sobre las intervenciones, recursos y repercusiones de la tarea de cuidar sobre los cuidadores informales de personas mayores. Conclusiones: Los cuidadores informales españoles de personas mayores parecen disponer de diferentes recursos de apoyo en su tarea de cuidado, aunque sigue siendo la familia la principal fuente de ayuda frente a los sistemas formales. La literatura recoge repercusiones tanto positivas como negativas derivadas de la responsabilidad del cuidado. Entre estos últimos, encontramos como máximo exponente los estados ansioso-depresivos, así como la sobrecarga del cuidador. Sin embargo, estas consecuencias negativas se entrelazan e interactúan con las afectaciones positivas. La revisión realizada nos invita a afirmar que se precisa el desarrollo de más estudios para tratar de esclarecer la relación entre ambos polos de la experiencia del cuidado (AU)