[Change in the quality of life as an indicator of the clinical course of disease. Comparison of 2 indices]. / El cambio en la calidad de vida como indicador de curso clínico de la enfermedad. Comparación de dos índices.

Quality of life is an important outcome measurement to judge disease impact and response to treatment; however it is very difficult to measure. We compared the MacKenzie's Change in Maximal Function Index (CMFI) with the Change in Quality of Life Index (CQLI) developed by our group. Both indices were applied on admission and upon discharge of 23 medical and surgical inpatients. The CQLI's interobserver reliability was somewhat better (Ri = 0.69) than that of the CMFI (Kw = 0.49). Both indices correlated with patient, close relative and physician assessments (rs = 0.52 to 0.86, p < 0.05). There was no correlation with Karnofsky scores. Both showed adequate responsiveness with Guyatt's coefficients between 2 and 4. Ninety five percent of the patients thought the questionnaires were easy to answer and approximately 5 minutes were enough to complete them. Both indices seem to perform better when applied by a social worker than when applied by a physician. Our results suggest that it is feasible to obtain consistent estimates of changes in quality of life. Either one of these indices may be used to assess the impact of medical intervention.

[What patients think of the services of the Instituto Nacional de la Nutrición "Salvador Zubirán"]. / Lo que opinan los pacientes de los servicios del Instituto Nacional de la Nutrición "Salvador Zubirán" (INNSZ).

The quality of care has always been a subject of interest to the Instituto Nacional de la Nutrición "Salvador Zubirán", in order to improve its services. This interest led to the present survey which aims to evaluate the patient's global satisfaction and to identify specific problems susceptible of improvement. One hundred and seventy-one patients or relatives attending eight different services of the Institute were interviewed. Opinions about the following aspects were explored by means of service-specific questionnaires: sociodemographic characteristics, satisfaction with care, waiting periods, patient-personnel relationship, hospital environment, food quality, drug availability and costs. Results of the survey show a high level of satisfaction with the services provided, i.e. 33% of the patients considered it good, and 64% excellent. However, and in agreement with other reports, this high level of satisfaction does not necessarily reflect an absence of problems, i.e. long waiting periods, insufficient restrooms, failures in getting information about their health status, and occasional absence of drugs in the pharmacy were identified. Continuation of this kind of surveys in our setting leads not only to the identification of problems, but also to the evaluation of the impact that resulting measures may have on the patient's satisfaction.