Primary care randomized clinical trial: manual therapy effectiveness in comparison with TENS in patients with neck pain.

This study investigated effectiveness of manual therapy (MT) with transcutaneous electrical nerve stimulation (TENS) to reduce pain intensity in patients with mechanical neck disorder (MND). A randomized multi-centered controlled clinical trial was performed in 12 Primary Care Physiotherapy Units in Madrid Region. Ninety patients were included with diagnoses of subacute or chronic MND without neurological damage, 47 patients received MT and 43 TENS. The primary outcome was pain intensity measured in millimeters using the Visual Analogue Scale (VAS). Also disability, quality of life, adverse effects and sociodemographic and prognosis variables were measured. Three evaluations were performed (before, when the procedure finished and six months after). Seventy-one patients (79%) completed the follow-up measurement at six months. In more than half of the treated patients the procedure had a clinically relevant "short term" result after having ended the intervention, when either MT or TENS was used. The success rate decreased to one-third of the patients 6 months after the intervention. No differences can be found in the reduction of pain, in the decrease of disability nor in the quality of life between both therapies. Both analyzed physiotherapy techniques produce a short-term pain reduction that is clinically relevant.

Estudio de la Calidad de Vida Profesional en trabajadores de Atención Primaria del Área 7 de la Comunidad de Madrid / Quality of Professional Life (QoPL) among primary care workers in the Area 7 of Madrid Autonomous Region

Objetivo. Conocer la percepción de los trabajadores de Atención Primaria del Área 7 respecto a su calidad de vida profesional (CVP) y describir su evolución desde el año 2004. Material y métodos. Estudio descriptivo transversal. Se realiza en junio de 2008, en el Área 7 de Atención Primaria. Los participantes son todos los profesionales del Área (n=1003). Las mediciones principales son: Cuestionario CVP-35, anónimo y autoadministrado y variables sociodemográficas y profesionales que pudieran tener relación con la CVP. Se estudió la variación de los resultados respecto a los años 2004 y 2006. Resultados. La tasa de respuesta fue del 47%, siendo las medias: percepción global de demandas=6,09, percepción del apoyo directivo=5,10 y motivación intrínseca=7,56. Por estamentos, enfermería-fisioterapeutas y auxiliares son los más motivados, con mejor percepción de apoyo directivo y mejor CVP sentida. Los sujetos que desempeñan tareas directivas puntúan mejor los ítems relacionados con percepción de apoyo directivo y presentan mayor motivación intrínseca. Se observa cierta mejoría en los resultados de percepción de apoyo directivo, demandas y calidad de vida. Conclusiones. El análisis por ítems nos permite, partiendo de los peor valorados, establecer líneas de mejora y evaluar sus resultados. Así pues, observamos cierta mejoría de los resultados, en consonancia con las intervenciones desarrolladas que daban respuesta a demandas percibidas en años previos. Algunas de las intervenciones han sido recientemente implantadas, siendo necesario seguir evaluando su efectividad a través de la aplicación de este cuestionario(AU)

Objective. To describe the QoPL as perceived by Primary Care workers in the Primary Care Area 7 and to describe the progress since 2004. Material and methods. Cross – sectional study carried out in the Primary Care Area 7 in June 2008. Participants were all primary care workers (n=1003). Main measurements were: the CVP-35 questionnaire (anonymous and self-administered) and socio-demographic and professional variables that could be associated with QoPL. Results were compared to those obtained in previous years (2004–2006). Results. Positive answers: 47%. By dimension, average scores were: perception of demands: 6.09, managerial support: 5.10 and intrinsic motivation: 7.56. Nurses, physiotherapists, and nursing assistants had significantly higher scores in intrinsic motivation, managerial support and quality of life. The individuals who carried out management activities had higher scores in managerial support and intrinsic motivation items. Slight improvements were seen in perception of demands, managerial support and quality of life. Conclusions. Item analysis allows us to develop improvement plans and subsequently evaluate their results. In this sense, we observed slight improvements, according to planned strategies, based on perceived demands in previous years. Some of these strategies have been recently introduced, so future evaluations using the CVP-35 questionnaire are needed in order to analyse their effectiveness(AU)

[Quality of professional life (QoPL) among primary care workers in area 7 of the Madrid Autonomous Region]. / Estudio de la Calidad de Vida Profesional en trabajadores de Atención Primaria del Área 7 de la Comunidad de Madrid.

OBJECTIVE: To describe the QoPL as perceived by Primary Care workers in the Primary Care Area 7 and to describe the progress since 2004. MATERIAL AND METHODS: Cross - sectional study carried out in the Primary Care Area 7 in June 2008. Participants were all primary care workers (n=1003). Main measurements were: the CVP-35 questionnaire (anonymous and self-administered) and socio-demographic and professional variables that could be associated with QoPL. Results were compared to those obtained in previous years (2004-2006). RESULTS: Positive answers: 47%. By dimension, average scores were: perception of demands: 6.09, managerial support: 5.10 and intrinsic motivation: 7.56. Nurses, physiotherapists, and nursing assistants had significantly higher scores in intrinsic motivation, managerial support and quality of life. The individuals who carried out management activities had higher scores in managerial support and intrinsic motivation items. Slight improvements were seen in perception of demands, managerial support and quality of life. CONCLUSIONS: Item analysis allows us to develop improvement plans and subsequently evaluate their results. In this sense, we observed slight improvements, according to planned strategies, based on perceived demands in previous years. Some of these strategies have been recently introduced, so future evaluations using the CVP-35 questionnaire are needed in order to analyse their effectiveness.

Coordinación asistencial entre atención primaria y especializada. Satisfacción con el proyecto especialista consultor / Coordination between primary and specialist care. Satisfaction with the consulting specialist project

Conocer la satisfacción de los médicos con el proyecto especialista consultor en el Área 7, y su opinión respecto a éste. Explorar la opinión de estos médicos sobre los problemas y soluciones en la relación entre atención primaria (AP) y atención especializada (AE). Material y métodos: Estudio descriptivo transversal mediante cuestionario autoadministrado. Población de estudio: Médicos de AP del Área 7 de Madrid (n=304). Variables Demográficas y profesionales, relacionadas con la satisfacción con el desarrollo del proyecto, relacionadas con la percepción general del proyecto, el beneficio potencial para los pacientes y con la opinión acerca de las dificultades en la relación AP-AE y las posibles soluciones. Resultados: La tasa de respuesta fue del 56% (contestaron el cuestionario 170 médicos). Respecto a la satisfacción con el proyecto, la puntuación global fue de 8,9 sobre 10. Al 83% de los médicos de AP les resultó fácil el contacto con el especialista de referencia, y el 90% refirió que las cuestiones planteadas se habían resuelto de forma satisfactoria. La herramienta peor valorada para establecer comunicación fue el teléfono. El 27% de los médicos de AP refirió registrar las actividades del proyecto siempre y el 39%, casi siempre. Resultados: En cuanto a la opinión sobre el proyecto, los encuestados reconocieron el mayor beneficio potencial para el proceso diagnóstico y valoraron la necesidad del proyecto en el área con un 9, su utilidad con 9,1 y la prioridad con un 8,7. El 74% de los médicos opinó que sería de interés incorporar un consultor de otra especialidad. Resultados: Los problemas de coordinación AP-AE priorizados fueron la falta de comunicación y diálogo y la masificación de la asistencia. La solución más valorada fue la historia única informatizada (AU)

Objective: To find out the level of satisfaction and opinions of doctors on the specialist consultant project (SCP) in Area 7. To report on these opinions on the difficulties and possible solutions in inter-relationships between of primary health care and specialised care. Material and Methods: Transversal descriptive study using a self-administered questionnaire. Study population: Doctors working in a primary health care district of Madrid (Area 7). Variables: Demographic and professional variables, including their satisfaction after the implementation of the SCP, their general opinion of SCP, potential benefits and their opinions on the difficulties and possible solutions in interrelationships between primary health care and specialised care. Results: A total of 170 (56%) doctors working in primary health care responded. As regards satisfaction with the SCP, the overall score in the evaluation was 8.9, (0 to 10). The majority of primary health care doctors (83%) found it easy to contact the specialist and 90% said that problems were solved satisfactorily. The telephone was the worst communication tool. Only 27% of primary health care doctors said they always register SCP activities, and 39% register them almost always. Results: They thought that the most useful part of this project was the potential benefit on diagnosis. The SCP need score was 9, SCP usefulness 9.1 and priority 8.7. A large majority (74%) of primary health care doctors thought it would be of great interest to incorporate consultants from other specialisations. Results: The main coordination problems found where the lack of communication, and overcrowding. The most valued solution to these problems is the computerised clinical history (AU)

[Coordination between primary and specialist care. Satisfaction with the consulting specialist project]. / Coordinación asistencial entre atención primaria y especializada. Satisfacción con el proyecto especialista consultor.

OBJECTIVE: To find out the level of satisfaction and opinions of doctors on the specialist consultant project (SCP) in Area 7. To report on these opinions on the difficulties and possible solutions in inter-relationships between of primary health care and specialised care. MATERIAL AND METHODS: Transversal descriptive study using a self-administered questionnaire. STUDY POPULATION: Doctors working in a primary health care district of Madrid (Area 7). VARIABLES: Demographic and professional variables, including their satisfaction after the implementation of the SCP, their general opinion of SCP, potential benefits and their opinions on the difficulties and possible solutions in interrelationships between primary health care and specialised care. RESULTS: A total of 170 (56%) doctors working in primary health care responded. As regards satisfaction with the SCP, the overall score in the evaluation was 8.9, (0 to 10). The majority of primary health care doctors (83%) found it easy to contact the specialist and 90% said that problems were solved satisfactorily. The telephone was the worst communication tool. Only 27% of primary health care doctors said they always register SCP activities, and 39% register them almost always. They thought that the most useful part of this project was the potential benefit on diagnosis. The SCP need score was 9, SCP usefulness 9.1 and priority 8.7. A large majority (74%) of primary health care doctors thought it would be of great interest to incorporate consultants from other specialisations. The main coordination problems found where the lack of communication, and overcrowding. The most valued solution to these problems is the computerised clinical history. CONCLUSIONS: Doctors are very satisfied with this project. They considered the project to be very useful, necessary and a priority, with high potential benefit in several areas of patient care. As quality improvement areas we stress the importance of continuing to promote SCP, of adequate telephone communications and to assess a new easy to fill-in register system.

Cómo el índice pronóstico PPI predice la supervivencia en pacientes oncológicos en situación terminal atendidos en un Equipo de Soporte de Atención Domiciliaria / No disponible

Objetivo: conocer si el índice pronóstico PPI descrito por Morita es capaz de predecir la supervivencia de los pacientes oncológicos en situación terminal atendidos por un ESAD de un Área de Salud de Madrid. Metodología: estudio observacional, longitudinal, prospectivo. Sujetos de estudio: pacientes con el diagnóstico de enfermedad oncológica en situación terminal, derivados al ESAD del Área 7 de Madrid. Variables: recogidas al captar a los pacientes: edad, sexo, localización del tumor, existencia de metástasis, número y localización de las mismas. Recogidas en las visitas semanales hasta el fallecimiento: PPS, estado de la vía oral, disnea de reposo, edema y delirium. Análisis estadístico: Se calcularon sensibilidad y especificidad y se realizó análisis de supervivencia con regresión de Cox. Resultados: se captaron 150 pacientes. El 57% hombres. La edad media de 71,5, DE 12,4. La mediana de supervivencia es de 23 días. Cuando el PPI es mayor de 6, predice en nuestra población una supervivencia menor de 3 semanas con una sensibilidad del 39% y una especificidad de 90%. Cuando el PPI es mayor de 4, predice en nuestra población una supervivencia menor de 6 semanas con una sensibilidad de 48% y una especificidad de 88%. Se identificaron 4 variables predictoras de supervivencia: PPS ≤ 50, vía oral moderada y severamente reducida, disnea de reposo y delirium. Conclusiones: el PPI es un índice pronóstico con una elevada especificidad, pero una baja sensibilidad en nuestra población. Su utilidad en la práctica clínica diaria como método de predicción es baja (AU)

Objective: to know if the PPI (Palliative Prognostic Index), can predict the survival of terminally ill cancer patients attended by a Home Care Support Team. Methodology: observational, prospective study. Were followed up with at least weekly visits until death. We collected the variables: age, sex, tumor's localization and the existence, number and localization of metastases, and the variables that integrate the PPI: PPS (Palliative Performance Status), the state of the oral intake, the presence or not of dyspnea at rest, edema and delirium. Results: 150 patients. The mean age was 71.5. The median of survival was 23 days. A PPI over 6 predicts in our population a survival below 3 weeks with a 39% sensitivity and a 90% specificity. A PPI over 4 predicts a survival below 6 weeks with a 48% sensitivity and a 88% specificity. Conclusions: the PPI is a prognostic index with a high specificity, but a low sensitivity in our population (AU)

[Primary Care research: attitudes and hindrances perceived by our doctors]. / Investigación en atención primaria: actitud y dificultades percibidas por nuestros médicos.

OBJECTIVES: To discover how much research doctors in our area do; to describe their attitudes to research; and to evaluate the hindrances to developing research that they found. DESIGN: Cross-sectional, descriptive study. SETTING: Area 7 of Primary Care, Madrid. PARTICIPANTS: Area 7 doctors. MAIN MEASUREMENTS: An anonymous self-administered questionnaire was designed in order to gather the following information: age, gender, professional details, training in research methodology, research activity, questions from a previously validated questionnaire for finding attitudes towards research (scores from 0 to 80), and a question for assigning a value to 6 hindrances to research. RESULTS: 174 were returned (49.4% response). 65.9% of the doctors were women, with an average age of 43.23+/-7.33 years; and 55.5% were specialists in Family and Community Medicine. Over the last 5 years, 49.4% had published a scientific paper and 38% had given reports at congresses. The mean score on attitudes to research was 53.49+/-10.59. Hindrances to research were given in the following order, from greatest to least: case-load, lack of time, structural deficiencies, absence of multi-centred research lines, lack of incentives, lack of training, no motivation. CONCLUSIONS: The research activity of our doctors is similar to that found in other studies. Attitude to research is no better than "acceptable." The main hindrances stated were: case-load and lack of time.

Investigación en atención primaria: actitud y dificultades percibidas por nuestros médicos / Primary Care Research: Attitudes and hindrances perceived by our doctors

Objetivo. Conocer de forma cuantitativa la actividad investigadora de los médicos de nuestra área, describir su actitud hacia la investigación y valorar las dificultades encontradas para el desarrollo de la investigación. Diseño. Estudio descriptivo transversal. Emplazamiento. Área 7 de atención primaria de Madrid. Participantes. Médicos del Área 7. Mediciones principales. Se diseñó un cuestionario anónimo autoadministrado en el que se recogieron la edad, el sexo, los datos profesionales, la formación en metodología de investigación, la actividad investigadora, las preguntas de un cuestionario previamente validado para conocer la actitud hacia la investigación (puntuación entre 0 y 80) y una pregunta con 6 dificultades para realizar actividades investigadoras para asignar un valor. Resultados. Se recibieron 174 cuestionarios (49,4% de respuestas). El 65,9% de los que respondieron fue mujer, con una edad media de 43,23 ± 7,33 años, y el 55,5% era especialista en medicina familiar y comunitaria (MFyC). En los últimos 5 años, el 49,4% había publicado un trabajo científico y el 38% había presentado comunicaciones a congresos. La media de la actitud hacia la investigación fue 53,49 ± 10,59. Las dificultades para la investigación a las que otorga un mayor valor fueron, en orden decreciente, la presión asistencial, la escasez de tiempo, las deficiencias estructurales, la ausencia de líneas de investigación multicéntricas, la falta de incentivación y preparación, y la ausencia de motivación. Conclusiones. La actividad investigadora de nuestros médicos es semejante a la de otros estudios. La actitud hacia la investigación es sólo aceptable. Las principales dificultades declaradas son la presión asistencial y la escasez de tiempo (AU)

Objectives. To discover how much research doctors in our area do; to describe their attitudes to research; and to evaluate the hindrances to developing research that they found. Design. Cross-sectional, descriptive study. Setting. Area 7 of Primary Care, Madrid. Participants. Area 7 doctors. Main measurements. An anonymous self-administered questionnaire was designed in order to gather the following information: age, gender, professional details, training in research methodology, research activity, questions from a previously validated questionnaire for finding attitudes towards research (scores from 0 to 80), and a question for assigning a value to 6 hindrances to research. Results. 174 were returned (49.4% response). 65.9% of the doctors were women, with an average age of 43.23±7.33 years; and 55.5% were specialists in Family and Community Medicine. Over the last 5 years, 49.4% had published a scientific paper and 38% had given reports at congresses. The mean score on attitudes to research was 53.49±10.59. Hindrances to research were given in the following order, from greatest to least: case-load, lack of time, structural deficiencies, absence of multi-centred research lines, lack of incentives, lack of training, no motivation. Conclusions. The research activity of our doctors is similar to that found in other studies. Attitude to research is no better than "acceptable." The main hindrances stated were: case-load and lack of time (AU)

[Clinical impressions of terminal cancer patients as an estimator of time of survival]. / La impresión clínica como estimador del tiempo de supervivencia en pacientes oncológicos en situación terminal.

OBJECTIVE: To evaluate the relationship between the prognosis of the survival time of terminal cancer patients by doctors and nurses belonging to a Home Care Support Team (HCST) and the actual time of survival found. The first assessment and the last before death were examined. DESIGN: Prospective, descriptive study. SETTING: Area 7 of primary care, Madrid. PARTICIPANTS: Were terminal cancer patients attended by the HCST between February 2001 and August 2002. MAIN MEASUREMENTS: Age, sex, location of the tumour, presence of metastasis, number and location of metastases, real survival time and the time estimated by the doctor and nurse at the first assessment and at the last before death. The quotient of survival time found/survival time estimated was calculated. If it was between 0.67 and 1.33, the prediction was considered correct; < 0.67, optimistic, and >1.33, pessimistic. RESULTS: 121 patients were studied, 57% men, with an average age of 72 +/- 12.8 years. At the first assessment, 30% of doctors' predictions were correct, 40% optimistic and 30% pessimistic. Of nurses' predictions, 40% were correct, 30% optimistic and 30% pessimistic. The intra-class correlation coefficients (ICC) between real and estimated survival times were 0.64 for doctors and 0.54 for nurses. At the final assessment, doctors had 38% correct predictions, 44% optimistic and 18% pessimistic; and nurses had 44% correct, 32% optimistic and 24% pessimistic. The ICCs were 0.83 and 0.84. CONCLUSIONS: The accuracy of professionals' clinical impression was only acceptable at the moment of quantifying the prognosis.

[Effectiveness of a training course in bioethics and of the introduction of a checklist to detect ethical problems in a home care support team]. / Efectividad de un curso de formación en bioética y de la implantación de una checklist en la detección de problemas éticos en un equipo de soporte de atención domiciliaria.

OBJECTIVE: To study the concordance in the number of ethical problems identified in the care of the terminally ill between the members of a home care support team (HCST) and a group of experts before and after a course in bioethics and the introduction of a checklist. DESIGN: Before-and-after intervention study. SETTING: Area 7 of Primary Care, Madrid. PARTICIPANTS: Terminally ill patients attended by the HCST between November 2001 and June 2002. INTERVENTION: Bioethics course and introduction of a checklist. MAIN MEASUREMENTS: Age, sex, basic illness, number of ethical problems identified by the HCST and by the group of experts before and after the intervention. The intraclass correlation coefficient (ICC) for the number of problems identified was calculated in both groups before and after the intervention. RESULTS: 31 cases before and 29 after the intervention were studied. Before the intervention the HCST identified an average of 2.7 +/- 2.3 ethical problems per case; and the group of experts found 11.8 +/- 6.1. The ICC for the number of problems identified was 0.53 (moderate correlation). After the intervention, the HCST identified 5.9 +/- 6.5 ethical problems per case; and the group of experts, 10.7 +/- 7.9. The ICC for the number of problems identified was 0.87 (close correlation). CONCLUSIONS: The course and the introduction of a checklist helped professionals who were not experts in bioethics to detect ethical problems in treating terminally ill patients.

Efectividad de un curso de formación en bioética y de la implantación de una checklist en la detección de problemas éticos en un equipo de soporte de atención domiciliaria / Effectiveness of a training course in bioethics and of the introduction of a "checklist" to detect ethical problems in a home care support team

Objetivo. Estudiar la concordancia en el número de problemas éticos identificados en la atención a enfermos en situación terminal entre los miembros de un equipo de soporte de atención domiciliaria (ESAD) y un grupo de expertos antes y después de un curso de bioética y de la implantación de una checklist. Diseño. Estudio de intervención antesdespués. Emplazamiento. Área 7 de Atención Primaria de Madrid. Participantes. Pacientes en situación terminal atendidos por el ESAD de noviembre de 2001 a junio de 2002.Intervención. Curso de bioética e implantación de una checklist. Mediciones principales. Edad, sexo, enfermedad de base, número de problemas éticos identificados por el ESAD y por el grupo de expertos antes y después de la intervención. Se calcula el coeficiente de correlación intraclase (CCI) en el número de problemas identificados por ambos grupos antes y después de la intervención. Resultados. Se estudian 31 casos antes de la intervención y 29 después. Antes de la intervención el ESAD identifica una media de 2,7 ñ 2,3 problemas éticos por caso y el grupo de expertos, 11,8 ñ 6,1. El CCI en el número de problemas identificados es de 0,53 (correlación moderada). Después de la intervención, el ESAD identifica 5,9 ñ 6,5 problemas éticos por caso y el grupo de expertos, 10,7 ñ 7,9. El CCI en el número de problemas identificados es de 0,87 (correlación alta).Conclusiones. El curso y la implantación de una checklist facilitan a los profesionales no expertos en bioética la detección de problemas éticos en pacientes en situación terminal (AU)

Resultados de un programa de deshabituación tabáquica en Atención Primaria / Results of smoking cessation program in Primary Health Care

FFundamento: la intervención de los profesionales sanitarios de Atención Primaria en la deshabituación tabáquica se recomienda desde diferentes instituciones sanitarias.Objetivos: conocer el porcentaje de individuos que dejan de fumar al finalizar un taller de deshabituación tabáquica y a los 3, 6 y 12 meses. Cuantificar la disminución en el número de cigarrillos fumados, y analizar variables predictores de deshabituación tabáquica.Material y métodos: población de estudio: todos los participantes en los talleres desarrollados desde enero de 1999 a mayo de 2000. Los talleres constan de 6 sesiones de 90 minutos de duración cada una. Variables estudiadas: edad, sexo, nº de cigarrillos inicialmente fumados, cigarrillos fumados al finalizar el taller y a los 3, 6 y 12 meses. Resultados : participantes: 143, 63 mujeres y 80 varones. Edad: media 50, desviación estándar (DE) 12,7, cigarrillos al inicio: media 25, DE 13,5. Abandonan el taller 44 participantes, (30,8 por ciento). Entre los 99 que terminan el taller, no fuman 62 (62,6 por ciento) al finalizar el taller y 33 (33,3 por ciento), 29 (29,3 por ciento), y 25 (27,5 por ciento) a los 3, 6 y 12 meses. La disminución media en el número de cigarrillos fumados es al final del taller y a los 3, 6 y 12 meses de 20,2, 14,4, 11,5 y 11, respectivamente. En los hombres, la edad actúa como variable predictora de deshabituación odds ratio (OR) 1,02 (1-1,03) p=0,04. Conclusiones: el porcentaje de participantes que dejan de fumar es satisfactorio, pero el número de abandonos del taller es alto. Nos planteamos establecer estrategias destinadas a reforzar la adherencia a los talleres y a mejorar su efectividad (AU)

[Continuing education in primary care: the educational needs of its professionals]. / Formación continuada en atención primaria: necesidades formativas de sus profesionales.

OBJECTIVES: To find professionals' suggestions for training contents, the value they place on various options, the difficulties they detect for attending activities and their preferences for time-table and format of courses. DESIGN: Cross-sectional, descriptive study. SETTING: Primary Care Area 7 in Madrid. PARTICIPANTS: Medical and office workers from the area (n=1,053). MAIN MEASUREMENTS: An anonymous self-filled questionnaire. RESULTS: 39% replied (46% nurses; 42% administrative assistants, and 40% doctors). The subjects for courses most often requested by doctors were dermatology, minor surgery and radiology; by nurses, emergency, functional bandages and computer skills; and by administrative assistants, computers, management of health service delivery and Internet. The continuing education options valued most highly were courses/workshops in the area's continuing education programme, self-training sessions and rotations. The main difficulties for attending courses were the lack of budget for cover and time-tables outside working hours. 42% preferred mornings; and 35%, courses lasting more than 20 hours. CONCLUSIONS: The training needs expressed by doctors and nurses are mainly clinical in content, whereas those of office staff are mainly computer-related. The most highly valued training options are the courses/workshops in the area's continuing education programme. The main difficulty for attending courses is the lack of cover for their job.

Formación continuada en atención primaria: necesidades formativas de sus profesionales / Continuing education in primary care: the educational needs of its professionals

Objetivo. Conocer las sugerencias en contenidos formativos expresadas por los profesionales, el valor que asignan a las diferentes opciones, las dificultades detectadas para la asistencia a las actividades presenciales y sus preferencias en cuanto a horario y formato de los cursos. Diseño. Estudio descriptivo transversal. Emplazamiento. Área 7 de Atención Primaria de Madrid. Participantes. Profesionales sanitarios y no sanitarios del área (n = 1.053). Mediciones principales. Encuesta autocumplimentada y anónima. Resultados. Porcentaje de respuestas: 39 per cent (enfermeras 46 per cent; auxiliares administrativos 42 per cent, y médicos 40 per cent). Las áreas temáticas que más solicitan los médicos son dermatología, cirugía menor y radiología; las enfermeras: urgencias, vendajes funcionales e informática, y los administrativos: informática, gestión de prestaciones del servicio sanitario y aplicaciones en Internet. Las opciones de formación continuada a las que asignan un mayor valor son cursos/talleres del programa de formación continuada del área, sesiones autoformativas y rotaciones. Las principales dificultades expresadas para la asistencia a los cursos son la falta de presupuesto de suplencias y horarios fuera de la jornada laboral. El 42 per cent prefiere el horario de mañana y el 35 per cent los cursos de más de 20 h. Conclusiones. Las necesidades formativas expresadas por los médicos y enfermeras son mayoritariamente de contenido clínico, y las de los administrativos están relacionadas con la informática. Las opciones formativas más valoradas son los cursos/talleres del programa de formación continuada del área y la principal dificultad expresada para la asistencia a cursos es la no suplencia del puesto de trabajo. (AU)