ABSTRACT
Introducción. Las consultas de enfermería en reumatología (CER) son modelos organizativos asistenciales en el ámbito de competencias de enfermería. Hay diversos modelos de CER, pero no existe una definición operacional. El objetivo del proyecto es elaborar estándares de calidad para definir y caracterizar una CER. Método. Estudio Delphi a 2 rondas. El panel estuvo constituido por 67 expertos: reumatólogos y enfermeras del Grupo de Trabajo de Enfermería de la Sociedad Española de Reumatología (SER). El cuestionario se elaboró tras revisión bibliográfica y experiencias de proyectos previos de la SER. El cuestionario consta de 7 apartados: consideraciones generales, estándares de estructura, de proceso, de tratamiento y seguimiento, educación sanitaria, formación e investigación y calidad asistencial. Cada ítem se puntuó de 1 (menos importante) a 9 (más importante) o mediante una cifra. El grado de acuerdo de los expertos se categorizó según el coeficiente de variación (CV) entre muy alto (CV ≤ 25%) y muy bajo (CV > 100%). Resultados. El cuestionario de la segunda ronda (182 ítems) fue respondido por 46 panelistas (34 reumatólogos y 12 enfermeras). Se obtuvo un grado de acuerdo muy importante en los estándares generales, de estructura, de proceso, de tratamiento y seguimiento, educación sanitaria y calidad asistencial. Se encontró menor acuerdo en los estándares relacionados con el tiempo para formación, el número de proyectos de investigación propios de enfermería y de publicaciones recomendables. Conclusión. Los estándares desarrollados en este estudio permitirían establecer mínimos deseables de calidad de estructura, proceso, labor asistencial, investigadora y docente que se pueden utilizar para desarrollar y evaluar las CER (AU)
Background. Nursing clinics in rheumatology (NCR) are organizational models in the field of nursing care. There are various NCR models, but there is no consensus on its operational definition. Our objective is to develop quality standards to define and characterize a NCR. Method. Two-round Delphi method. The panel consisted of 67 experts: rheumatologists and nurses of the nursing working group of the Spanish Society of Rheumatology (SSR). The Delphi questionnaire was developed after a literature and experience review from previous SSR projects. The questionnaire consists of 7 sections: general considerations, standards of structure, process, treatment and monitoring, health education, training and research and quality of care. Each item was scored from 1 (least important) to 9 (most important) or by assigning a number (e.g. waiting days). The degree of agreement among the experts was categorized according to the coefficient of variation (CoV) between very high (CoV≤25%) and very low (CoV>100%). Results. The second round questionnaire (182 items) was answered by 46 panelists (34 rheumatologists and 12 nurses). A very important agreement was reached on the general standards of structure, process, treatment and monitoring, health education and quality of care. Less agreement was observed on standards related to training time, number of recommended nurses research projects and publications. Conclusion. The standards developed in this study would be useful for establishing desirable quality standards of structure and process, and criteria for clinical work, research and teaching that can be used to develop and evaluate the NCRs (AU)
Subject(s)
Humans , Male , Female , Professional Review Organizations/legislation & jurisprudence , Professional Review Organizations/standards , Professional Review Organizations , /legislation & jurisprudence , /standards , Rheumatic Diseases/epidemiology , Rheumatic Diseases/nursing , Nursing Diagnosis/legislation & jurisprudence , Nursing Diagnosis/methods , Professional Review Organizations/organization & administration , /organization & administration , Rheumatology/legislation & jurisprudence , Rheumatology , Nursing Care/organization & administration , Nursing Diagnosis/organization & administration , Nursing Diagnosis/standards , Nursing Diagnosis/trendsABSTRACT
BACKGROUND: Nursing clinics in rheumatology (NCR) are organizational models in the field of nursing care. There are various NCR models, but there is no consensus on its operational definition. Our objective is to develop quality standards to define and characterize a NCR. METHOD: Two-round Delphi method. The panel consisted of 67 experts: Rheumatologists and nurses of the nursing working group of the Spanish Society of Rheumatology (SSR). The Delphi questionnaire was developed after a literature and experience review from previous SSR projects. The questionnaire consists of 7 sections: general considerations, standards of structure, process, treatment and monitoring, health education, training and research and quality of care. Each item was scored from 1 (least important) to 9 (most important) or by assigning a number (e.g., waiting days). The degree of agreement among the experts was categorized according to the coefficient of variation (CoV) between very high (CoV≤25%) and very low (CoV>100%). RESULTS: The second round questionnaire (182 items) was answered by 46 panelists (34 rheumatologists and 12 nurses). A very important agreement was reached on the general standards of structure, process, treatment and monitoring, health education and quality of care. Less agreement was observed on standards related to training time, number of recommended nurses' research projects and publications. CONCLUSION: The standards developed in this study would be useful for establishing desirable quality standards of structure and process, and criteria for clinical work, research and teaching that can be used to develop and evaluate the NCRs.
Subject(s)
Models, Nursing , Quality of Health Care/standards , Rheumatic Diseases/nursing , Rheumatology , Humans , Surveys and QuestionnairesABSTRACT
La fiebre de origen desconocido supone un reto diagnóstico. Entre sus causas se encuentran las vasculitis de grandes vasos (VGV), que incluyen la arteritis de Takayasu (AT) y de células gigantes (ACG). Resulta de vital importancia su diagnóstico precoz para evitar la fibrosis de la pared vascular, y como consecuencia, estenosis, aneurismas u oclusiones. Las técnicas de imagen nos pueden resultar de gran ayuda, destacando en los últimos años la ecografía de la arteria temporal, la RM y el PET-TAC (AU)
Fever of unknown origin is a diagnostic challenge. Among its causes are of large caliber vessels vasculitis (LCVV), including Takayasu arteritis (TA) and giant cell arteritis (GCA). Early diagnosis is vital to prevent fibrosis of the vessel wall, and consequently, stenoses, aneurysms or occlusions. Imaging techniques can be of great help in recent years, highlighting the temporal artery through ultrasound, MRI and PET-CT (AU)
Subject(s)
Humans , Female , Adult , Middle Aged , Early Diagnosis , Vasculitis/complications , Vasculitis/diagnosis , Vasculitis/therapy , Giant Cell Arteritis/complications , Giant Cell Arteritis , Takayasu Arteritis/complications , Takayasu Arteritis , Vasculitis/physiopathology , Vasculitis , Positron-Emission Tomography/instrumentation , Positron-Emission Tomography/methods , Positron-Emission Tomography , Positron Emission Tomography Computed Tomography , Magnetic Resonance Imaging/methods , Temporal Arteries/pathology , Temporal ArteriesABSTRACT
Fever of unknown origin is a diagnostic challenge. Among its causes are of large caliber vessels vasculitis (LCVV), including Takayasu arteritis (TA) and giant cell arteritis (GCA). Early diagnosis is vital to prevent fibrosis of the vessel wall, and consequently, stenoses, aneurysms or occlusions. Imaging techniques can be of great help in recent years, highlighting the temporal artery through ultrasound, MRI and PET-CT.
Subject(s)
Giant Cell Arteritis/diagnosis , Multimodal Imaging , Positron-Emission Tomography , Takayasu Arteritis/diagnosis , Tomography, X-Ray Computed , Adult , Aged , Female , Giant Cell Arteritis/diagnostic imaging , Humans , Takayasu Arteritis/diagnostic imagingABSTRACT
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