Safe Care and Medication Intake Provided by Caregivers at Home: Reality Care Study Protocol.

JUSTIFICATION: Providing care to patients with several conditions and simultaneously taking several medications at home is inexorably growing in developed countries. This trend increases the chances of home caregivers experiencing diverse errors related with medication or care. OBJECTIVE: To determine the effectiveness of four different educational solutions compared to the natural intervention (absence of intervention) to provide a safer care at home by caregivers. METHOD: Prospective, parallel, and mixed research study with two phases. Candidates: Home-based caregivers caring a person with multiple comorbid conditions or polymedication who falls into one of the three profiles of patients defined for the study (oncology, cardiovascular, or pluripathological patients). First phase: Experts first answered an online survey, and then joined together to discuss the design and plan the content of educational solutions directed to caregivers including the identification of medication and home care errors, their causes, consequences, and risk factors. Second phase: The true experiment was performed using an inter- and intrasubject single-factor experimental design (five groups: four experimental groups against the natural intervention (control), with pre- and post-intervention and follow-up measures) with a simple random assignment, to determine the most effective educational solution (n = 350 participants). The participants will be trained on the educational solutions through 360 V, VR, web-based information, or psychoeducation. A group of professionals called the "Gold Standard" will be used to set a performance threshold for the caring or medication activities. The study will be carried out in primary care centers, hospitals, and caregivers' associations in the Valencian Community, Andalusia, Madrid, and Murcia. EXPECTED RESULTS: We expect to identify critical elements of risk management at home for caregivers and to find the most effective and optimal educational solution to reduce errors at home, increasing caregivers' motivation and self-efficacy whilst the impact of gender bias in this activity is reduced. TRIAL REGISTRATION: Clinical Trial NCT05885334.

Comparison of Three Comorbidity Measures for Predicting In-Hospital Death through a Clinical Administrative Nacional Database.

BACKGROUND: Various authors have validated scales to measure comorbidity. However, the prognosis capacity variation according to the comorbidity measurement index used needs to be determined in order to identify which is the best predictor. AIMS: To quantify the differences between the Charlson (CCI), Elixhauser (ECI) and van Walraven (WCI) comorbidity indices as prognostic factors for in-hospital mortality and to identify the best comorbidity measure predictor. METHODS: A retrospective observational study that included all hospitalizations of patients over 18 years of age, discharged between 2017 and 2021 in the hospital, using the Minimum Basic Data Set (MBDS). We calculated CCI, ECI, WCI according to ICD-10 coding algorithms. The correlation and concordance between the three indices were evaluated by Spearman's rho and Intraclass Correlation Coefficient (ICC), respectively. The logistic regression model for each index was built for predicting in-hospital mortality. Finally, we used the receiver operating characteristic (ROC) curve for comparing the performance of each index in predicting in-hospital mortality, and the Delong method was employed to test the statistical significance of differences. RESULTS: We studied 79,425 admission episodes. The 54.29% were men. The median age was 72 years (interquartile range [IQR]: 56-80) and in-hospital mortality rate was 4.47%. The median of ECI was = 2 (IQR: 1-4), ICW was 4 (IQR: 0-12) and ICC was 1 (IQR: 0-3). The correlation was moderate: ECI vs. WCI rho = 0.645, p < 0.001; ECI vs. CCI rho = 0.721, p < 0.001; and CCI vs. WCI rho = 0.704, p < 0.001; and the concordance was fair to good: ECI vs. WCI Intraclass Correlation Coefficient type A (ICCA) = 0.675 (CI 95% 0.665-0.684) p < 0.001; ECI vs. CCI ICCA = 0.797 (CI 95% 0.780-0.812), p < 0.001; and CCI vs. WCI ICCA = 0.731 (CI 95% 0.667-0.779), p < 0.001. The multivariate regression analysis demonstrated that comorbidity increased the risk of in-hospital mortality, with differences depending on the comorbidity measurement scale: odds ratio [OR] = 2.10 (95% confidence interval [95% CI] 2.00-2.20) p > |z| < 0 using ECI; OR = 2.31 (CI 95% 2.21-2.41) p > |z| < 0 for WCI; and OR = 2.53 (CI 95% 2.40-2.67) p > |z| < 0 employing CCI. The area under the curve [AUC] = 0.714 (CI 95% 0.706-0.721) using as a predictor of in-hospital mortality CCI, AUC = 0.729 (CI 95% 0.721-0.737) for ECI and AUC = 0.750 (CI 95% 0.743-0.758) using WCI, with statistical significance (p < 0.001). CONCLUSION: Comorbidity plays an important role as a predictor of in-hospital mortality, with differences depending on the measurement scale used, the van Walraven comorbidity index being the best predictor of in-hospital mortality.

Impact of Penicillin Allergy Label on Length of Stay and Mortality in Hospitalized Patients through a Clinical Administrative National Dataset.

BACKGROUND: Penicillin allergy is a common problem in the management of infectious diseases. The aim of this study was to determine the impact of penicillin allergy on length of hospital stay (LOHS) among hospitalized adult patients and on in-hospital mortality at a national level. METHODS: A retrospective cohort study of adult patients discharged from the Spanish Hospital System between 2006 and 2015 was conducted using the Minimum Basic Data Set (MBDS). We compared LOHS and in-hospital mortality of adult patients whose records contained penicillin allergy code V14.0 (International Classification of Diseases, Ninth Revision, Clinical Modification) as a secondary diagnosis, with a random sample without such a code. RESULTS: We identified 981,291 admissions with code V14.0, which corresponded to 2.63% of all hospitalizations. Adults patients with a penicillin allergy label were significantly older than patients without such a label, with a median of 70 years (interquartile range [IQR]: 51-80) versus 63 years (IQR: 40-77). The proportion of women and the prevalence of infectious diseases were higher in the group with a penicillin allergy label (61.40% vs. 53.84%; 34.04% vs. 30.01%; respectively). We found a higher median Elixhauser-Van Walraven score in hospitalized patients with an allergy label. The median LOHS for hospitalizations with a penicillin allergy label (5 [IQR: 2-9]) was significantly longer than that in those without such a label (4 [IQR: 2-9]). Multivariate analysis showed an increase in LOHS due to the penicillin allergy label (odds ratio [OR] [95% confidence interval [CI]: 1.061 [1.057-1.065]) and a decrease in mortality in penicillin allergy records (OR [95% CI]: 0.834 [0.825-0.844]). CONCLUSION: In our study, the prevalence of a penicillin allergy label in hospitalized patients, using the MBDS, is low. Hospitalizations with an allergy label was associated with a longer LOHS. However, penicillin-allergic patients did not show higher mortality rates. Inaccurate reporting of penicillin allergies may have an impact on healthcare resources.

Addressing Acute Stress among Professionals Caring for COVID-19 Patients: Lessons Learned during the First Outbreak in Spain (March-April 2020).

Objectives: To describe lessons learned during the first COVID-19 outbreak in developing urgent interventions to strengthen healthcare workers' capacity to cope with acute stress caused by health care pressure, concern about becoming infected, despair of witnessing patients' suffering, and critical decision-making requirements of the SARS-CoV-2 pandemic during the first outbreak in Spain. Methods: A task force integrated by healthcare professionals and academics was activated following the first observations of acute stress reactions starting to compromise the professionals' capacity for caring COVID-19 patients. Literature review and qualitative approach (consensus techniques) were applied. The target population included health professionals in primary care, hospitals, emergencies, and nursing homes. Interventions designed for addressing acute stress were agreed and disseminated. Findings: There are similarities in stressors to previous outbreaks, and the solutions devised then may work now. A set of issues, interventions to cope with, and their levels of evidence were defined. Issues and interventions were classified as: adequate communication initiative to strengthen work morale (avoiding information blackouts, uniformity of criteria, access to updated information, mentoring new professionals); resilience and recovery from physical and mental fatigue (briefings, protecting the family, regulated recovery time during the day, psychological first aid, humanizing care); reinforce leadership of intermediate commands (informative leadership, transparency, realism, and positive messages, the current state of emergency has not allowed for an empirical analysis of the effectiveness of proposed interventions. Sharing information to gauge expectations, listening to what professionals need, feeling protected from threats, organizational flexibility, encouraging teamwork, and leadership that promotes psychological safety have led to more positive responses. Attention to the needs of individuals must be combined with caring for the teams responsible for patient care. Conclusions: Although the COVID-19 pandemic has a more devastating effect than other recent outbreaks, there are common stressors and lessons learned in all of them that we must draw on to increase our capacity to respond to future healthcare crises.

An Acute Stress Scale for Health Care Professionals Caring for Patients With COVID-19: Validation Study.

BACKGROUND: The COVID-19 pandemic has affected the response capacity of the health care workforce, and health care professionals have been experiencing acute stress reactions since the beginning of the pandemic. In Spain, the first wave was particularly severe among the population and health care professionals, many of whom were infected. These professionals required initial psychological supports that were gradual and in line with their conditions. OBJECTIVE: In the early days of the pandemic in Spain (March 2020), this study aimed to design and validate a scale to measure acute stress experienced by the health care workforce during the care of patients with COVID-19: the Self-applied Acute Stress Scale (EASE). METHODS: Item development, scale development, and scale evaluation were considered. Qualitative research was conducted to produce the initial pool of items, assure their legibility, and assess the validity of the content. Internal consistency was calculated using Cronbach α and McDonald ω. Confirmatory factor analysis and the Mann-Whitney-Wilcoxon test were used to assess construct validity. Linear regression was applied to assess criterion validity. Back-translation methodology was used to translate the scale into Portuguese and English. RESULTS: A total of 228 health professionals from the Spanish public health system responded to the 10 items of the EASE scale. Internal consistency was .87 (McDonald ω). Goodness-of-fit indices confirmed a two-factor structure, explaining 55% of the variance. As expected, the highest level of stress was found among professionals working in health services where a higher number of deaths from COVID-19 occurred (P<.05). CONCLUSIONS: The EASE scale was shown to have adequate metric properties regarding consistency and construct validity. The EASE scale could be used to determine the levels of acute stress among the health care workforce in order to give them proportional support according to their needs during emergency conditions, such as the COVID-19 pandemic.

Recomendaciones para la recuperación de las segundas víctimas del SARS-CoV-2 / No disponible

OBJETIVO: Enunciar un conjunto de recomendaciones para incrementar la resiliencia de las organizaciones y los profesionales sanitarios frente al impacto de la crisis ocasionada por la pandemia de SARS-CoV-2. MÉTODO: Estudio cualitativo para la búsqueda de consenso con participación de 30 profesionales de diferentes disciplinas (medicina preventiva, calidad asistencial, seguridad del paciente, atención primaria, psiquiatría y psicología). Principales resultados: Tras la identificación de las principales fuentes de estrés y la definición de los objetivos de la fase de recuperación, se consensuaron un total de 17 recomendaciones, 13 de ellas con foco organizacional y las cuatro restantes, centradas en profesionales. CONCLUSIONES: La recuperación del sistema sanitario tras la pandemia por la COVID19 pasa por restaurar la moral y el bienestar de sus profesionales, de lo contrario la calidad asistencial y la seguridad de los pacientes se verán comprometidas. Estas recomendaciones pretenden ser un punto de partida en esta dirección

OBJECTIVE: To provide a set of recommendations to increase the resilience of health care organizations and professionals to the impact of the SARS-CoV-2 pandemic crisis. METHOD: Consensual qualitative study with the participation of 30 professionals from different disciplines (preventive medicine, quality of care, patient safety, primary care, psychiatry and psychology). MAIN RESULTS: After the identification of the main sources of stress and the definition of the objectives of the recovery phase, a total of 17 recommendations were agreed upon, 13 of them with an organizational focus and the remaining four focused on professionals. CONCLUSIONS: The recovery of the health system after the COVID19 pandemic requires restoring the morale and well-being of its professionals, otherwise the quality of care and patient safety will be compromised. These recommendations are intended as a starting point in this direction

Preguntas más frecuentes sobre repercusión de la e-salud en la relación entre médico y paciente / FAQs on the effects of e-health on the doctor-patient relationship

Justificación: Los trabajos sobre e-salud y e-paciente se han desarrollado exponencialmente.Resultados: Se presentan preguntas frecuentes sobre cómo afecta internet a la relación entre médicos y pacientes junto con respuestas basadas en resultados de estudios empíricos.Conclusiones: Es previsible un incremento aun mayor del uso de internet como fuente de información sobre salud. Internet puede ser un aliado para que el paciente acceda a información fiable y su dinamismo puede aprovecharse para favorecer la autonomía del paciente(AU)

Background: Articles on e-health and e-patients have been increased exponentially.Results: Frequently asked questions (FAQs) are presented on how the Internet affects relationships between doctors and patients, along with the answers based on the results of empirical studies.Conclusions: An even higher use of the Internet is envisaged as a source of health information. The Internet can be an ally so that the patient may access reliable information and advantage can be taken of its dynamism to help the patient achieve autonomy(AU)

[FAQs on the effects of e-health on the doctor-patient relationship]. / Preguntas más frecuentes sobre repercusión de la e-salud en la relación entre médico y paciente.

BACKGROUND: Articles on e-health and e-patients have been increased exponentially. RESULTS: Frequently asked questions (FAQs) are presented on how the Internet affects relationships between doctors and patients, along with the answers based on the results of empirical studies. CONCLUSIONS: An even higher use of the Internet is envisaged as a source of health information. The Internet can be an ally so that the patient may access reliable information and advantage can be taken of its dynamism to help the patient achieve autonomy.

Uso de internet por médicos de primaria y hospitales y percepción de cómo influye en su relación con los pacientes / Internet use by primary care and hospital doctors: Perception of how it influences their relationships with patients

ObjetivoComparar el uso que hacen de internet médicos de atención primaria (MAP) y hospitalarios (MH) y analizar su percepción de cómo influye en la interacción con los pacientes.DiseñoEstudio observacional y descriptivo basado en encuesta.Emplazamiento7 hospitales y 8 áreas de salud del Sistema Público de Salud de las provincias de Alicante, Madrid, Zaragoza y Huesca.Participantes685 médicos (MAP, 49,3%; varones, 55,9%; media de edad, 43,2 años).Mediciones principalesCómo y para qué se recurre a internet en actividad profesional, ventajas/inconvenientes de internet para la relación con el paciente.ResultadosLos MH dedican más tiempo a internet (p<0,001), aprovechan más los recursos en la formación de residentes (p<0,001) y colaboran más con sitios web específicos (p=0,02). MAP y MH coinciden en qué supone internet en la interacción con los pacientes. Sólo a un 14% de los médicos sus pacientes no les han preguntado alguna vez sobre información leída en internet. El 27,6% recomienda sitios web a sus pacientes. Para un 30,8% de los médicos, internet complica su relación con los pacientes. La principal ventaja (42,2%) es que ayuda a conocer la enfermedad; sólo el 20,5% afirma que incrementa la autonomía del paciente. Para un 30,9% mina la credibilidad del médico.ConclusionesLos MH hacen un uso de internet más intenso. Unos y otros opinan igual sobre las ventajas de los recursos de la red para la relación con los pacientes(AU)

Objective: To compare Internet use among physicians working in primary health care and hospitals and their perception of the influence this has on patient-doctor relation ships.Design: Observational descriptive study based on survey.Setting: 7 public hospitals (H) and 8 primary health care centres (PH) from Alicante, Madrid, Saragossa and Huesca.Participants: 685 physicians. 49.3% PH, 55.9% male, meanage: 43.2 years.Main items: How and for what is the Internet used on duty, advantage sand disadvantages of Internet for medical-patient relation ships.Results: Hospital MDs spend more time on the Internet (po0.001), take more advantage of education resources(po0.001) and collaborate more frequently with specific web sites(p ¼ 0.02). Both groups agree that the Internet leads to interaction with patients. Only 14% of the MDs had not received any questions regarding Internet information; 27.6% recommend web sites to their patients; 30.8% considered that Internet use complicates medical–patient relation ships. Its main advantage (42.2%) is support in getting to know the disease; 20.5% considers that it improves patient autonomy; 30.9% thinks that itundermines physician credibility.Conclusions: Hospital MDs use the Internet more intensively. Both group shave the same opinion on the advantage sof the Webre sources for medical-patient relation ships(AU)

[Internet use by primary care and hospital doctors: perception of how it influences their relationships with patients]. / Uso de internet por médicos de primaria y hospitales y percepción de cómo influye en su relación con los pacientes.

OBJECTIVE: To compare Internet use among physicians working in primary health care and hospitals and their perception of the influence this has on patient-doctor relationships. DESIGN: Observational descriptive study based on survey. SETTING: 7 public hospitals (H) and 8 primary health care centres (PH) from Alicante, Madrid, Saragossa and Huesca. PARTICIPANTS: 685 physicians. 49.3% PH, 55.9% male, mean age: 43.2 years. MAIN ITEMS: How and for what is the Internet used on duty, advantages and disadvantages of Internet for medical-patient relationships. RESULTS: Hospital MDs spend more time on the Internet (p<0.001), take more advantage of education resources (p<0.001) and collaborate more frequently with specific web sites (p=0.02). Both groups agree that the Internet leads to interaction with patients. Only 14% of the MDs had not received any questions regarding Internet information; 27.6% recommend websites to their patients; 30.8% considered that Internet use complicates medical-patient relationships. Its main advantage (42.2%) is support in getting to know the disease; 20.5% considers that it improves patient autonomy; 30.9% thinks that it undermines physician credibility. CONCLUSIONS: Hospital MDs use the Internet more intensively. Both groups have the same opinion on the advantages of the Web resources for medical-patient relationships.

Influencia de la satisfacciónde los pacientes de unaunidad de diálisis enla adherencia terapéutica / Influence of dialysis patient satisfaction on therapeutic adherence

Existen múltiples factores que parecen estar relacionados con la deficiente adhesión terapéutica farmacológica. El objetivo de este trabajo ha sido valorar el grado de adherencia al tratamiento farmacológico de los pacientes en tratamiento renal sustitutivo de nuestra unidad, así como su posible relación con el grado de satisfacción de los pacientes con la atención recibida. Se realizó un estudio descriptivo y transversal durante los meses febrero, marzo de 2007, administrando dos cuestionarios, para valorar la satisfacción con los servicios sanitarios (SERVQHOS modificado)y la adherencia terapéutica de los pacientes(test Morisky-Green).Se estudiaron un total de 85 pacientes (tasa de respuesta de 87% en hemodiálisis y 100% en diálisis peritoneal). El 52,27% de los pacientes en hemodiálisis no tenían adherencia con el tratamiento farmacológico mientras que el 47,73% si la tenían.• La satisfacción media global fue de 3,33 en los pacientes de hemodiálisis y de 3,65 en diálisis peritoneal(escala de puntuación 1-4).No encontramos correlación entre la satisfacción media global de los pacientes en hemodiálisis y su adherencia al tratamiento. Tras análisis del test Morisky-Green, las principales causas de no adhesión al régimen terapéutico son, “deja de tomar la medicación cuando les sienta mal” (40%) y un 17,4% “se olvida alguna vez de tomar los medicamentos”; sin embargo más del 95% de los pacientes toman la medicación a la hora indicada y no suspenden el tratamiento cuando se encuentran bien. No hemos encontrado correlación entre la adherencia al tratamiento farmacológico y las variables sociodemográficas estudiadas (AU)

There are a number of factors that appear to be related to deficient adhesion to pharmacological therapy. The aim of this work was to evaluate the degree of adherence to pharmacological treatment by patients undergoing renal replacement therapy a tour unit, and its possible relation to the degree of patient satisfaction with the treatment received. A descriptive and transversal study was carried out during the months of February and March2007, administering two questionnaires, to evaluate satisfaction with healthcare services (modified SERVQHOS) and therapeutic adherence by patients(Morisky-Green test).A total of 85 patients were studied (rate of response of 87% in haemodialysis and 100% in peritoneal dialysis). 52.27% of patients on haemodialysis had no adherence with the pharmacological treatment while 47.73% did. The overall average satisfaction was 3.33 in haemodialysis patients and 3.65 in peritoneal dialysis(score range 1-4).We did not find any correlation between overall average satisfaction of patients undergoing haemodialysis and their adherence to treatment. After analysing the Morisky-Green test, the main causes of failure to adhere to therapy are, “stopp ing medication when not feeling well” (40%)and 17,4% “sometimes forget to take their medication”; however more than 95% of patients take their medication at the right time and do not suspend treatment when they feel well. We have not found any correlation between adherence to pharmacological treatment and the sociodemographic variables studied (AU)

Seguridad clínica percibida por los pacientes en diálisis peritoneal / Clinical safety perceived by patients on peritoneal dialysis

Aunar esfuerzos y conseguir el máximo grado de calidad y seguridad en la atención prestada es una responsabilidad de los profesionales sanitarios. Nos propusimos evaluar la percepción de la seguridad clínica en diálisis peritoneal percibida por el paciente y determinar la importancia que tiene la comunicación-información del personal sanitario. Estudio descriptivo y transversal, a todos los pacientes en diálisis peritoneal, administrando una encuesta de opinión sobre seguridad clínica. Se analizaron 38 encuestas (tasa respuesta 100 %). El 60.5% eran hombres y el 39.5% mujeres. Edad media 59,1±12 años y tiempo medio en técnica 24.4 ±19.7 meses. El 71 % de los pacientes manifestó que les preocupaba mucho sufrir un error médico. El 100 % de los pacientes que habían sufrido un efecto indeseado como consecuencia de la asistencia o de la medicación administrada, manifestaron estar muy preocupados por sufrir un error médico. Al analizar las preguntas relacionadas con la información- comunicación entre el personal sanitario y el paciente, el 81% manifestaron que les habían explicado, con detalle, los efectos y precauciones del tratamiento y el 84,2% respondió que habían podido consultar sus dudas y preocupaciones a la enfermera y al médico con la suficiente intimidad. Sin embargo, aquellos pacientes que detectaron un déficit en la información-comunicación en alguno de estos aspectos, comentaron estar muy preocupados por poder sufrir un error médico. La seguridad clínica suscita interés y preocupación entre los pacientes. La falta de información comunicación se relaciona con una mayor preocupación de sufrir un error médico (AU)

Combining efforts and achieving the maximum degree of quality and safety in the care provided is the responsibility of healthcare professionals. We proposed to assess the perception of clinical safety in peritoneal dialysis perceived by the patient and to determine the importance of communication-information provided by healthcare personnel. Descriptive transversal study, encompassing all patients on peritoneal dialysis, distributing a survey seeking their opinion on clinical safety. 38 surveys were analysed (response rate 100%). 60.5% were men and 39.5% women. Average age 59.1 ±12 years and average time on the dialysis technique 24.4 ±19.7 months. 71% of the patients stated that they were very concerned about suffering a medical error. 100% of the patients who had suffered an undesired effect as a result of the care or medication administered stated that they were very worried about medical errors. On analysing the questions relating to information communication between healthcare personnel and the patient, 81% indicated that the effects and precautions of the treatment had been explained to them in detail, and 84.2% responded that they had been able to discuss their doubts and concerns with the nurse and doctor in sufficient privacy. However, those patients who detected a deficit in the information-communication in any of these aspects mentioned that they were very concerned about suffering from a medical error. Clinical safety arouses interest and concern among patients. The lack of information-communication is related to greater concern about suffering from a medical error (AU)

El valor de la prescripción de sitios web / The value of web-site prescription

No disponible

No disponible

Factores determinantes de la satisfacción del paciente en tratamiento renal sustitutivo / Factors determining patient satisfaction in kidney replacement treatment

El interés de los profesionales de enfermería se ha centrado siempre en prestar cuidados de calidad, sería errónea esta concepción sin tener en cuenta la opinión de los pacientes. Los objetivos del estudio son: 1. Determinar el grado de satisfacción y capacidad funcional de los pacientes en diálisis, valorando si existe diferencia según el tratamiento sustitutivo que realicen. 2. Identificar los aspectos del proceso asistencial que generan mayor satisfacción. Estudio descriptivo transversal a todos los pacientes de la unidad en marzo-abril 2005. Se administró el cuestionario SERVQHOS modificado. Se utilizó el índice de Karnosky para medir el grado de autonomía. Para el análisis de datos se utilizó el programa SPSS obteniendo las frecuencias y medias de puntación en cada ítem. Se utilizó el Alpha de Cronbach para el análisis de fiabilidad. Mediante análisis factorial se identificaron los atributos determinantes dela satisfacción. Se analizaron 77 cuestionarios. Tasa de respuesta del 95%. Las características demográficas son las siguientes: de los pacientes encuestados HD/DP55/22, el 65/85 % de los pacientes eran hombres. Edad media 68,8±14 / 54,6±12,4 años. El alpha de Cronbach fue de 0,95/0,90. El grado de satisfacción de los pacientes de HD es 3,28, en los de DP 3,68. No se ha encontrado correlación entre la capacidad funcional y la satisfacción de los pacientes en diálisis. Las variables que determinan el grado de satisfacción de los pacientes en HD son aquellas relacionadas con la atención que reciben. En DP están relacionadas con la responsabilidad de asumirla técnica (AU)

The interest of nursing professionals has always been focused on providing quality care. This focus would be incorrect if it failed to take into account patients’ opinions. The objectives of the study are: 1. To determine the degree of satisfaction and functional capacity of patients on dialysis, evaluating whether there is a difference depending on there placement treatment they receive, and 2. To identify the aspects of the care process that generate greatest satisfaction. Transversal descriptive study of all the patients in the unit in March-April 2005. The modified SERVQHOS questionnaire was administered. The Karnofsky index was used to measure the degree of autonomy. To analyse the data the SPSS program was used, obtaining score frequencies and averages on each item. Cronbach’s Alpha was used to analyse reliability. The attributes that determined satisfaction were identified using factorial analysis. A total of 77 questionnaires were analysed. Response rate of 95%. The demographic characteristics are as follows: of the patients surveyed HD/PD 55/22, 65/85 % of the patients were men. Average age 68.8±14 / 54.6±12.4 years. Cronbach’s Alpha was 0.95/0.90. The degree of satisfaction is 3.28 in HD patients, and 3.68 in PD patients. No correlation was found between functional capacity and the satisfaction of patients on dialysis. The variables that determine the degree of satisfaction of patients on HD are those related to the attention they receive. In DP they are related to the responsibility of undertaking the technique (AU)

Satisfacción del paciente en una unidad de hemodiálisis: objetivo de calidad asistencial en enfermería / Patient satisfaction in a haemodialysis unit: objective of care quality in nursing

La evaluación de la satisfacción de los pacientes permite por un lado identificar aquellas áreas deficitarias desde el punto de vista del paciente y por otra parte nos sirve para evaluar los resultados de los cuidados, ya que las necesidades del paciente son el eje sobre el que se articulan las prestaciones asistenciales. Los objetivos son: 1. Determinar el grado de satisfacción de los pacientes en hemodiálisis crónica en relación con la atención recibida y 2. Conocer los aspectos del proceso asistencial que generan mayor satisfacción e identificar oportunidades de mejora. Estudio descriptivo transversal a todos los pacientes en tratamiento con hemodiálisis crónica de la unidad de HD del hospital de referencia para nefrología del Área 8 de la Comunidad de Madrid, entre marzo y abril de 2004. Se administró el cuestionario SERVQHOS modificado. Cada ítem se puntuó en una escala Likert (de 1 a 5) según el grado de satisfacción. Para el análisis de datos se utilizó el programa SPSS. Se utilizó el Alpha de Cronbach para el análisis de fiabilidad. La muestra la constituyeron 61 cuestionarios con una tasa de respuesta del 98,3%. 51,8% de los pacienteseran hombres y el 48,2% mujeres. Edad media 71,18 ±13,3 años. La puntuación media obtenida en la primera parte del cuestionario fue superior a 3,5 en todos los atributos analizados excepto en la “facilidad para llegar al hospital”. Los atributos con los que los pacientes están menos satisfechos son el “tiempo de espera para ser atendidos por el médico”, “la facilidad de llegada al hospital” y la “comunicación que el personal de la unidad mantiene con los familiares”. Los aspectos que influyen en la satisfacción de los pacientes son “la puntualidad de las sesiones de hemodiálisis”, “la rapidez con que consigue lo que necesita”, “el interés del personal de enfermería por los pacientes” y el “tiempo de espera para ser atendido por el médico”. La satisfacción media global fue de 3,81. No se encontró correlación entrelas variables sociodemográficas y el nivel de satisfacción

The evaluation of patient satisfaction enables the deficient areas to be identified from the patient’s point of view, and also helps us to evaluate the results of the care, as patient needs are the axis on which the care service is based. The objectives are the following: 1. to determine the satisfaction of patients in chronic haemodialysis with the attention they receive, and 2. to know the aspects of the care process that cause greatest satisfaction and to identify opportunities for improvement. A transversal descriptive study of all patients with chronic haemodialysis in the HD unit of the referred hospital for nephrology of Area 8 of Madrid Community between March and April 2004. The modified SERVQHOS questionnaire was administered. Each item was scored on a Likert scale (1 to 5) according to the degree of satisfaction. The SPSS programme was used for data analysis. The Cronbach Alpha was used to analyse the reliability. The sample comprised 61 questionnaires with a reply rate of 98.3%.51.8% of the patients were men and 48.2% women. Average age 71.18 ± 13.3.The average score achieved in the first part of the questionnaire was over 3.5 in all attributes analysed except for “ease for arriving at the hospital”. The attributes with which patients are least satisfied are the “waiting time to be attended by the doctor”, “ease of arriving at the hospital” and the “communication of the unit personnel with the relatives”. The aspects influencing the satisfaction of the patients are “the punctuality in the haemodialysis sessions”, “the speed with which we get what we want”, “the interest of the nursing staff in the patients” and the “waiting time to be attended by a doctor”. The average overall satisfaction was 3.81. No correlation was found between the socio-demographic variables and the degree of satisfaction