Efectos de la edad y de la formación académica en la comprensión de la información escrita que entregamos habitualmente a nuestros pacientes / Effects of age and educational background in understanding the written information normally deliver to our patients

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Desarrollo y validación de un cuestionario para medir la reputación de los hospitales / Development and validation of a questionnaire to measure hospitals’ social reputation

Objetivo Diseñar y validar un cuestionario (MeFío) para medir la reputación social de un hospital desde el punto de vista de los ciudadanos y de los pacientes. Material y método Revisión de la literatura para acotar los límites del concepto de reputación social de un hospital. Se realizaron cuatro grupos nominales con la participación de 47 directivos y profesionales y de 32 posibles clientes para establecer factores a priori del cuestionario MeFío. Se elaboraron ítems reactivos y se realizó una prueba piloto de comprensión. Se seleccionó una muestra aleatoria de 385 sujetos y se analizaron los efectos suelo y techo, la consistencia interna, la fiabilidad y la validez de constructo y de criterio. Resultados Se obtuvieron 343 cuestionarios válidos (tasa de respuesta del 89%). MeFío cuenta con 21 ítems agrupados en cinco factores. En todos los casos los valores de correlación ítem-total fueron superiores a 0,30, las cargas factoriales superiores a 0,5, el rango de varianza explicada entre el 66,2% y el 80,4%, y el valor alfa de Cronbach entre 0,7 y 0,88. Los índices de fiabilidad compuesta fueron mayores de 0,7. La estrategia de modelos rivales mostró un mejor ajuste del modelo con dos factores de segundo orden. En el análisis de validez convergente-discriminante, todas las cargas estandarizadas fueron superiores a 0,6. Los factores explicaron un 50% de la variabilidad de la satisfacción con las atenciones sanitarias (F = 66,5; p <0,001).Conclusiones MeFío explora de forma fiable y válida las cinco dimensiones que delimitan la reputación de un hospital en nuestro país (AU)

Objective To design and validate a questionnaire (MeFio) to measure the social reputation of a hospital from patients’ and citizens’ perspective. Material and methods We performed a literature review to define the concept of a hospital's social reputation. Four nominal groups were conducted to set up the a priori factors of the MeFio questionnaire. These groups consisted of 47 managers and health professionals and 32 potential customers. Reactive items were identified and a pilot test was conducted to examine comprehension. A random sample of 385 subjects was selected. Ceiling and floor effects, internal consistency, reliability, and construct and criteria validity were analyzed. Results A total of 343 validated questionnaires (response rate 89%) were collected. The MeFio questionnaire has 21 items grouped into five factors. All items had an item-total correlation higher than 0.30. All factor loads were higher than 0.5; between 66.2% and 80.4% of the variance was explained and Cronbach's alpha was 0.7- 0.88. The construct-composite-reliability scores were higher than 0.7. Standardized scores in the convergent discriminant validity test were higher than 0.6. The factors explained 50% of the variability in satisfaction with the health care received (F = 66.5; p <0.001).Conclusion The MeFio questionnaire is a valid and reliable tool to measure the five dimensions that define the reputation of a hospital in Spain (AU)

[Development and validation of a questionnaire to measure hospitals' social reputation]. / Desarrollo y validación de un cuestionario para medir la reputación de los hospitales.

OBJECTIVE: To design and validate a questionnaire (MeFio) to measure the social reputation of a hospital from patients' and citizens' perspective. MATERIAL AND METHODS: We performed a literature review to define the concept of a hospital's social reputation. Four nominal groups were conducted to set up the a priori factors of the MeFio questionnaire. These groups consisted of 47 managers and health professionals and 32 potential customers. Reactive items were identified and a pilot test was conducted to examine comprehension. A random sample of 385 subjects was selected. Ceiling and floor effects, internal consistency, reliability, and construct and criteria validity were analyzed. RESULTS: A total of 343 validated questionnaires (response rate 89%) were collected. The MeFio questionnaire has 21 items grouped into five factors. All items had an item-total correlation higher than 0.30. All factor loads were higher than 0.5; between 66.2% and 80.4% of the variance was explained and Cronbach's alpha was 0.7- 0.88. The construct-composite-reliability scores were higher than 0.7. Standardized scores in the convergent discriminant validity test were higher than 0.6. The factors explained 50% of the variability in satisfaction with the health care received (F = 66.5; p <0.001). CONCLUSION: The MeFio questionnaire is a valid and reliable tool to measure the five dimensions that define the reputation of a hospital in Spain.

[Frequency of medication errors by patients]. / Frecuencia de errores de los pacientes con su medicación.

OBJECTIVE: Analyze the frequency of medication errors committed and reported by patients. METHODS: Descriptive study based on a telephone survey of a random sample of adult patients from the primary care level of the Spanish public health care system. A total of 1 247 patients responded (75% response rate); 63% were women and 29% were older than 70 years. RESULTS: While 37 patients (3%, 95% CI: 2-4) experienced complications associated with medication in the course of treatment, 241 (19.4%, 95% CI: 17-21) reported having made some mistake with their medication. A shorter consultation time (P < 0.01) and a worse assessment of the information provided by the physician (P < 0.01) were associated with the fact that during pharmacy dispensing the patient was told that the prescribed treatment was not appropriate. CONCLUSIONS: In addition to the known risks of an adverse event due to a health intervention resulting from a system or practitioner error, there are risks associated with patient errors in the self-administration of medication. Patients who were unsatisfied with the information provided by the physician reported a greater number of errors.

Frecuencia de errores de los pacientes con su medicación / Frequency of medication errors by patients

OBJETIVO: Analizar la frecuencia de errores de medicación que son cometidos e informados por los pacientes. MÉTODOS: Estudio descriptivo basado en encuestas telefónicas a una muestra aleatoria de pacientes adultos del nivel primario de salud del sistema público español. Respondieron un total de 1 247 pacientes (tasa de respuesta, 75 por ciento). El 63 por ciento eran mujeres y 29 por ciento eran mayores de 70 años. RESULTADOS: Mientras 37 pacientes (3 por ciento, IC 95 por ciento: 2-4) sufrieron complicaciones asociadas a la medicación en el curso del tratamiento, 241 (19,4 por ciento, IC 95 por ciento: 17-21) informaron haber cometido algún error con la medicación. Un menor tiempo de consulta (P < 0,01) y una peor valoración de la información proporcionada por el médico (P < 0,01) se asociaron al hecho de que en la dispensación en la farmacia le indicaran al paciente que el tratamiento prescrito no era apropiado. CONCLUSIONES: A los riesgos conocidos de sufrir un evento adverso, fruto de la intervención sanitaria por error del sistema o del profesional, hay que sumar los asociados a los errores de los pacientes en la autoadministración de la medicación. Los pacientes insatisfechos con la información proporcionada por el médico informaron un mayor número de errores.

OBJECTIVE: Analyze the frequency of medication errors committed and reported by patients. METHODS: Descriptive study based on a telephone survey of a random sample of adult patients from the primary care level of the Spanish public health care system. A total of 1 247 patients responded (75 percent response rate); 63 percent were women and 29 percent were older than 70 years. RESULTS: While 37 patients (3 percent, 95 percent CI: 2-4) experienced complications associated with medication in the course of treatment, 241 (19.4 percent, 95 percent CI: 17-21) reported having made some mistake with their medication. A shorter consultation time (P < 0.01) and a worse assessment of the information provided by the physician (P < 0.01) were associated with the fact that during pharmacy dispensing the patient was told that the prescribed treatment was not appropriate. CONCLUSIONS: In addition to the known risks of an adverse event due to a health intervention resulting from a system or practitioner error, there are risks associated with patient errors in the self-administration of medication. Patients who were unsatisfied with the information provided by the physician reported a greater number of errors.

Noticias de prensa sobre errores clínicos y sensación de seguridad al acudir al hospital / News items about clinical errors and safety perceptions in hospital patients

Objetivo Analizar el tratamiento informativo que realiza la prensa de los errores clínicos y su influencia en los pacientes.MétodosEstudio cualitativo y cuantitativo. Primero, análisis de contenido de las noticias publicadas en 6 periódicos entre abril y noviembre de 2007. Segundo, encuesta a 829 pacientes de 5 hospitales de 4 comunidades autónomas.ResultadosSe analizan 90 casos que generan 128 noticias, con una media de 16 impactos mensuales. En 91 (71,1%) se contrastó la fuente. En 78 (60,9%) apareció el autor. El impacto de las noticias fue de −4,86 puntos (intervalo de confianza del 95% [IC95%]: −4,15–5,57). En 59 casos (57%) se atribuye el error al sistema, en 27 (21,3%) a los profesionales y en 41 (32,3%) a ambos. Ni el número de columnas (p=0,702), ni la inclusión de postitular (p=0,195), ni el apoyo gráfico (p=0,9) se mostraron relacionados con las consecuencias del error. De 829 pacientes, 515 (62,1%; IC95%: 58,8–65,4%) afirmaron haber visto u oído recientemente noticias sobre errores clínicos en prensa, radio o televisión. La percepción de seguridad disminuye cuando coinciden la preocupación por ser víctima de un error clínico y el impacto reciente de noticias sobre errores en la prensa (χ2=15,17; p=0,001).ConclusionesTodas las semanas aparece alguna noticia sobre errores clínicos en algún medio. El tratamiento en el periódico de las denuncias de supuestos errores es similar al de las noticias sobre sentencias judiciales por negligencia con daño irreparable. Las noticias sobre errores generan inseguridad en los pacientes. Es aconsejable crear espacios de encuentro entre periodistas y profesionales sanitarios(AU)

Objective To analyze how news items about clinical errors are treated by the press in Spain and their influence on patients.MethodsWe performed a quantitative and qualitative study. Firstly, news items published between April and November 2007 in six newspapers were analyzed. Secondly, 829 patients from five hospitals in four autonomous regions were surveyed.ResultsWe analyzed 90 cases generating 128 news items, representing a mean of 16 items per month. In 91 news items (71.1%) the source was checked. In 78 items (60.9%) the author could be identified. The impact of these news items was −4.86 points (95% confidence interval [95%CI]: −4.15–5.57). In 59 cases (57%) the error was attributed to the system, in 27 (21.3%) to health professionals, and in 41 (32.3%) to both. Neither the number of columns (p=0.702), nor the inclusion of a sub-header (p=0.195), nor a complementary image (p=0.9) were found to be related to the effect of the error on safety perceptions. Of the 829 patients, 515 (62.1%; 95%CI: 58.8–65.4%) claimed to have recently seen or heard news about clinical errors in the press, on the radio or on television. The perception of safety decreased when the same person was worried about being the victim of a clinical error and had seen a recent news item about such adverse events (χ2=15.17; p=0.001).ConclusionsEvery week news items about clinical errors are published or broadcast. The way in which newspapers report legal claims over alleged medical errors is similar to the way they report judicial sentences for negligence causing irreparable damage or harm. News about(AU)

[News items about clinical errors and safety perceptions in hospital patients]. / Noticias de prensa sobre errores clínicos y sensación de seguridad al acudir al hospital.

OBJECTIVE: To analyze how news items about clinical errors are treated by the press in Spain and their influence on patients. METHODS: We performed a quantitative and qualitative study. Firstly, news items published between April and November 2007 in six newspapers were analyzed. Secondly, 829 patients from five hospitals in four autonomous regions were surveyed. RESULTS: We analyzed 90 cases generating 128 news items, representing a mean of 16 items per month. In 91 news items (71.1%) the source was checked. In 78 items (60.9%) the author could be identified. The impact of these news items was -4.86 points (95% confidence interval [95%CI]: -4.15-5.57). In 59 cases (57%) the error was attributed to the system, in 27 (21.3%) to health professionals, and in 41 (32.3%) to both. Neither the number of columns (p=0.702), nor the inclusion of a sub-header (p=0.195), nor a complementary image (p=0.9) were found to be related to the effect of the error on safety perceptions. Of the 829 patients, 515 (62.1%; 95%CI: 58.8-65.4%) claimed to have recently seen or heard news about clinical errors in the press, on the radio or on television. The perception of safety decreased when the same person was worried about being the victim of a clinical error and had seen a recent news item about such adverse events (chi(2)=15.17; p=0.001). CONCLUSIONS: Every week news items about clinical errors are published or broadcast. The way in which newspapers report legal claims over alleged medical errors is similar to the way they report judicial sentences for negligence causing irreparable damage or harm. News about errors generates insecurity in patients. It is advisable to create interfaces between journalists and health professionals.