ABSTRACT
Objetivo Determinar si la información terapéutica escrita de calidad, frente a la información escrita estándar, incrementa la satisfacción con el servicio de fisioterapia durante la estancia hospitalaria de intervenidos quirúrgicamente por fractura de cadera. Material y método Estudio de diseño experimental, aleatorizado, con grupo control, desarrollado en el servicio de fisioterapia del Hospital Neurotraumatológico de Jaén. Se reclutaron 48 pacientes que cumplían los siguientes criterios de inclusión: mayor de edad, intervenido quirúrgicamente de fractura de cadera y adecuado nivel de alfabetización. Se perdieron 10 sujetos durante el seguimiento. Se aleatorizó la inclusión a 2 grupos: experimental (n=18) y control (n=20). Ambos grupos recibieron tratamiento estandarizado de fisioterapia. El grupo control recibió un panfleto con información estándar y el grupo experimental recibió un nuevo modelo que cumplía criterios de calidad: legibilidad, validado por 10 expertos y sometido al cuestionario Ensuring Quality Information for Patients (EQIP). En ambos grupos se midieron las variables: número de sesiones, duración de sesión, capacidad para caminar, dolor, índice de Barthel (inicio-final) y satisfacción con el servicio de fisioterapia (cuestionario MedRisk).Resultados El tratamiento de fisioterapia fue efectivo en ambos grupos: disminución significativa del dolor y mejora de la discapacidad (p<0,05). La información de calidad se asoció con la satisfacción, encontrándose diferencias estadísticamente significativas entre ambos grupos (t= 2,66, g.l=36, p=0,011) con una diferencia de medias de 5,033 puntos (clínicamente significativa) en el cuestionario MedRisk a favor del grupo experimental. Conclusiones La información terapéutica escrita de calidad contribuye a mejorar la satisfacción del paciente con el servicio de fisioterapia (AU)
Objective To determine whether providing quality written information versus standard written information improves satisfaction with physical therapy services during hospital stay of hip fracture patients after surgery. Material and methods A randomized, experimental, control group designed study was performed in the physiotherapy service of Hospital Neurotraumatológico of Jaen. A total of 48 patients who met the following criteria were recruited: adult, who underwent surgery for hip fracture and had adequate level of literacy. Ten subjects were lost to follow up. Enrolled subjects were randomized into 2 groups: experimental (n=18) and control (n=20). Both groups received standard physiotherapy treatment. The control group received a standard information pamphlet and the experimental group a new model that met the following quality criteria: readability, validated by 10 experts and subjected to the questionnaire Ensuring Quality Information for Patients (EQIP). In both groups, the following variables were measured: number of sessions, session time, walking ability, pain, Barthel Index (start and end) and patient satisfaction with physiotherapy (MedRisk).Results Treatment was effective in both groups: significant reduction in pain and improvement in disability in both groups (P<.05). Quality information was associated to patient satisfaction: with a mean difference of 5,003 points (MedRisk Questionnaire) in favor of the experimental group (that was clinically and statistically significant) (t=2.66, df=36, P=.011).Conclusions Quality written information contributes to the improvement of patient satisfaction with the physiotherapy service (AU)
Subject(s)
Humans , Hip Fractures/rehabilitation , /trends , Physical Therapy Department, Hospital/organization & administration , Patient Satisfaction , Quality ImprovementABSTRACT
OBJECTIVES: To systemise the pharmaceutical care provided to patients with chronic diseases. To evaluate the pharmacist's participation in the drug treatment plan, studying their intervention in the reconciliation of the patient's habitual treatment and the detection and resolution of drug-related problems. METHOD: A multicentre study based on the comparison of two cohorts: one with the intervention of the pharmacist and one without. Inclusion criteria were as follows: patients over the age of 70 with chronic cardiovascular conditions being treated with more than 6 drugs. They were selected between 24-48 hours from admittance; a control patient was chosen for each patient in the intervention group. The pharmaceutical intervention consisted of medication reconciliation on admittance, drug treatment monitoring and reconciliation on discharge. Drug-related problems, their seriousness, the pharmaceutical intervention, the degree of resolution and the clinical outcomes on discharge were all recorded. A total of 24 hospitals participated, with a total of 356 patients: 180 in the intervention cohort and 176 in the control one. RESULTS: A total of 602 drug-related problems were identified: 66.9% belonging to the intervention group and 33% to the control group. Interventions were made in 359 (89%) patients belonging to the intervention group, 66% were resolved after the pharmaceutical intervention, producing a total or partial improvement in the patient in 36.3% of cases. CONCLUSIONS: Pharmaceutical care has been systematised, providing an instrument that enables all the hospitals to work in a standardised manner. The active participation of the pharmacist in the healthcare team contributes to preventing and resolving drug-related problems.
Subject(s)
Cardiovascular Diseases/drug therapy , Pharmacists , Aged , Clinical Protocols , Female , Follow-Up Studies , Humans , Male , Prospective StudiesABSTRACT
Objetivos: Sistematizar la atención farmacéutica al paciente con unaenfermedad crónica. Evaluar la participación del farmacéutico en elplan farmacoterapéutico mediante el estudio de su intervención enla conciliación del tratamiento habitual del paciente y en la deteccióny resolución de problemas relacionados con los medicamentos.Método: Estudio multicéntrico basado en la comparación de dos cohortes,una con intervención del farmacéutico y la otra no. Los criteriosde inclusión fueron: pacientes mayores de 70 años con enfermedadcardiovascular crónica y tratamiento con más de 6 fármacos. Seseleccionaban a las 24-48 h de su ingreso; por cada paciente del grupointervención se seleccionaba uno de control. La intervención farmacéuticaconsistía en la conciliación del tratamiento en el momentodel ingreso, el seguimiento farmacoterapéutico y la conciliación enel momento del alta. Se registraban los problemas relacionados conlos medicamentos, su gravedad, la intervención farmacéutica, el gradode resolución y los resultados clínicos en el momento del alta.Han participado 24 hospitales con un total de 356 pacientes: 180 dela cohorte de intervención y 176 de la de control.Resultados: Se ha identificado un total de 602 problemas relacionadoscon los medicamentos, el 66,9% perteneciente al grupo de intervencióny el 33% al de control. Se ha intervenido en 359 (89%) deellos pertenecientes al grupo intervención; un 66% se resolvió tras laintervención farmacéutica, que en el 36,3% de los casos produjo unamejoría total o parcial en el paciente.Conclusiones: Se ha sistematizado la atención farmacéutica y se haproporcionado un instrumento que permite trabajar de forma homogéneaen todos los hospitales. La participación activa del farmacéuticoen el equipo de salud contribuye a prevenir y resolver problemasrelacionados con los medicamentos
Objectives: To systemise the pharmaceutical care provided to patientswith chronic diseases. To evaluate the pharmacists participation inthe drug treatment plan, studying their intervention in the reconciliationof the patients habitual treatment and the detection and resolutionof drug-related problems.Method: A multicentre study based on the comparison of two cohorts:one with the intervention of the pharmacist and one without.Inclusion criteria were as follows: patients over the age of 70 withchronic cardiovascular conditions being treated with more than 6drugs. They were selected between 24-48 hours from admittance; acontrol patient was chosen for each patient in the intervention group.The pharmaceutical intervention consisted of medication reconciliationon admittance, drug treatment monitoring and reconciliation on discharge. Drug-related problems, their seriousness, the pharmaceuticalintervention, the degree of resolution and the clinical outcomeson discharge were all recorded. A total of 24 hospitals participated,with a total of 356 patients: 180 in the intervention cohort and 176 inthe control one.Results: A total of 602 drug-related problems were identified: 66.9%belonging to the intervention group and 33% to the control group.Interventions were made in 359 (89%) patients belonging to the interventiongroup, 66% were resolved after the pharmaceutical intervention,producing a total or partial improvement in the patient in36.3% of cases.Conclusions: Pharmaceutical care has been systematised, providingan instrument that enables all the hospitals to work in a standardisedmanner. The active participation of the pharmacist in the healthcareteam contributes to preventing and resolving drug-related problems
Subject(s)
Humans , Male , Female , Aged , Cardiovascular Diseases/drug therapy , Pharmaceutical Services , Adverse Drug Reaction Reporting Systems , Medication Errors/prevention & control , PolypharmacyABSTRACT
Extraction of oil from almond fruits using supercritical carbon dioxide (SC-CO(2)) was carried out at 50 degrees C and 330 bar on three sets of almonds: raw almond seeds, raw almond kernels, and toasted almond seeds. Three different oil extraction percentages were applied on each set ranging from approximately 15 to 16%, from approximately 27 to 33%, and from approximately 49 to 64%. Although no major changes were detected in the fatty acid composition between fresh and partially defatted samples, carbohydrate analysis of partially defatted materials revealed important changes in cell wall polysaccharides from almond tissues. Thus, at low extraction percentages (up to approximately 33%), pectic polysaccharides and hemicellulosic xyloglucans were the main type of polymers affected, suggesting the modification of the cell wall matrix, although without breakage of the walls. Then, as supercritical fluid extraction (SCFE) continues and higher extraction rates are achieved (up to approximately 64%), a major disruption of the cell wall occurred as indicated by the losses of all major types of cell wall polysaccharides, including cellulose. These results suggest that, under the conditions used for oil extraction using SC-CO(2), fatty acid chains are able to exit the cells through nonbroken walls; the modification of the pectin-hemicellulose network might have increased the porosity of the wall. However, as high pressure is being applied, there is a progressive breakage of the cell walls allowing the free transfer of the fatty acid chains from inside the cells. These findings might contribute to providing the basis for the optimization of SCFE procedures based on plant food sources.
