Estudio de la hiperfrecuentación en un distrito de atención primaria / Frequent attendance in a Primary Health Care District

Objetivo: Describir la distribución de los pacientes hiperfrecuentadores en los diferentes centros de atención primaria del Distrito Sanitario Córdoba-Guadalquivir. Métodos: Estudio de diseño ecológico, que incluye datos de 2011 a 2015. Se define hiperfrecuentador como aquel paciente que realiza más de 12 visitas por año. Se analiza de manera independiente para enfermería, medicina familiar y pediatría. Las variables dependientes son la prevalencia de hiperfrecuentación y la ratio de pacientes hiperfrecuentadores por profesional. Otras variables examinadas son las características demográficas de los usuarios del Distrito, el número de profesionales de la salud de cada centro y la utilización de las consultas por la población general. Para el estudio de la distribución de los hiperfrecuentadores se clasifican los centros de atención primaria en función del tamaño y del medio territorial (urbano, suburbano y rural). Resultados: La prevalencia media de hiperfrecuentadores es, para enfermería, del 10,86% (error estándar [EE]: 0,5); para medicina familiar, del 21,70% (EE: 0,7); y para pediatría, del 16,96% (EE: 0,7). Las ratios de pacientes hiperfrecuentadores en las diferentes categorías profesionales son 101,07 (EE: 5,0) para enfermería; 239,74 (EE: 9,0) para medicina familiar y 159,54 (EE: 9,8) para pediatría. Conclusiones: Existe una parte importante de usuarios de atención primaria que realiza un número elevado de consultas. De este grupo, las mujeres utilizan más las consultas de enfermería y medicina que los hombres. Se observa una mayor prevalencia en centros de menor tamaño en áreas rurales. Tomando como medida la ratio de pacientes hiperfrecuentadores por profesional, los centros de tamaño intermedio son los que presentan mayor hiperfrecuentación

Objective: To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). Methods: An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). Results: The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. Conclusions: A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused

[Frequent attendance in a Primary Health Care District]. / Estudio de la hiperfrecuentación en un distrito de atención primaria.

OBJECTIVE: To describe the distribution of frequent attenders (FA) through the different primary care practices in Cordoba-Guadalquivir Health District (Córdoba, Spain). METHODS: An ecological study was performed, including data from 2011 to 2015. Defining FA as those subjects who made12 or more appointments per year; independently analysed for nursing, general practice and paediatrics. Prevalence of frequent attendance and FA/professional ratio were used as dependent variables. Demographic characteristics from district population, number of health professionals and use of general facilities were also examinated. Aiming to understand FA distribution, primary health settings were classified according to facility size and environmental location (urban, suburban and rural). RESULTS: The mean prevalence for FA was 10.86% (0.5 SE) for nursing; general practice 21.70% (0.7 SE) and for paediatrics 16.96% (0.7 SE). FA/professional ratios for the different professional categories were: 101.07 (5.0 SE) for nursing, 239.74 (9.0 SE) for general practice and 159.54 (9.8 SE) for paediatrics. CONCLUSIONS: A major part of primary health care users make a high number of consultations. From this group, women overuse nursing and general practitioner services more compared to men. A higher prevalence of FAs was observed in smaller settings, in rural areas. Although taking the FAs:professional ratio as the bar, medium-size practices are more highly overused.

Violencia del compañero íntimo: estudio con profesionales de enfermería / Intimate partner violence: study with female nurses

ObjetivoDescribir la violencia ejercida por el compañero íntimo en mujeres que además son enfermeras, en una muestra de profesionales que prestan sus servicios en Andalucía.DiseñoEstudio descriptivo transversal.EmplazamientoHospitales y distritos sanitarios de Andalucía.ParticipantesSe incluyó en el análisis a 622 mujeres enfermeras que desarrollaban sus actividades profesionales en las ocho provincias andaluzas.Mediciones principalesCaracterísticas sociodemográficas y presencia de malos tratos (psíquico, físico y sexual).ResultadoEl 78,5% de las enfermeras estaban casadas o con pareja estable y un sustento económico familiar con ambos sueldos; el 71,1% poseían hijos y/o personas mayores dependientes. Se comprobó asociación significativa entre maltrato y: estado civil; convivencia; sustento económico familiar; hijos y/o personas mayores dependientes. La media de edad fue de 42,5 años±8,1 (22-62 años); superior entre maltratadas (44 años) que en no maltratadas (41,8 años). El 21,7% de las parejas pertenecían a la clase social I y el 16,9% a la clase II. El 33,0% de las enfermeras sufrió maltrato. De estos, el 75,1% fue psicológico (P). Del total de casos de abuso, el 60,0% era menos grave o de menor gravedad y el 40,0% era más grave o de mayor gravedad.ConclusionesSe constata la presencia de maltrato, por el compañero íntimo, en mujeres que tienen como profesión la Enfermería, predominando las manifestaciones referidas al aspecto psicológico, aunque se dan también otras formas de maltrato(AU)

AimDescribe gender-based violence by intimate partners against female nurses in a sample of nurses in Andalucia, Spain.DesignDescriptive transversal study.SettingHospitals and primary health care districts in Andalucia.ParticipantsSix hundred and twenty-two female nurses that wok as nurses in the eight provinces in Andalucia (Spain).MeasuresSocial-demographic characteristics and presence of abuse (psychological, physical and sexual).Results78.5% of the nurses were married or with a regular partner and had the economic income based on both salaries; 71.1% had a child or an elderly dependent person. It was proved that there can be a statistical association between abuse and: marital status; life together; familiar economic support and children and/or dependent elderly person. The average age was 42.5±8.1 years old (22-62 years) and presented statistical age differences comparing both groups: abused (average 44 years) and non-abused (average 41.8 years). Between the married couples studied, 21.7% of them belong to the social class I and 16.9% to the social class II. Between all studied nurses, 33.0% suffered abuse, among which 75.1% were psychologically abused. Of all the abuse cases 60% were less severe and 40% more serious.ConclusionsIt was confirmed the presence of intimate partner violence (IPV) against nurses, which was predominantly psychological abuse, but others classes of abuse were present too(AU)

[Intimate partner violence: study with female nurses]. / Violencia del compañero íntimo: estudio con profesionales de enfermería.

AIM: Describe gender-based violence by intimate partners against female nurses in a sample of nurses in Andalucia, Spain. DESIGN: Descriptive transversal study. SETTING: Hospitals and primary health care districts in Andalucia. PARTICIPANTS: Six hundred and twenty-two female nurses that work as nurses in the eight provinces in Andalucia (Spain). MEASURES: Social-demographic characteristics and presence of abuse (psychological, physical and sexual). RESULTS: 78.5% of the nurses were married or with a regular partner and had the economic income based on both salaries; 71.1% had a child or an elderly dependent person. It was proved that there can be a statistical association between abuse and: marital status; life together; familiar economic support and children and/or dependent elderly person. The average age was 42.5±8.1 years old (22-62 years) and presented statistical age differences comparing both groups: abused (average 44 years) and non-abused (average 41.8 years). Between the married couples studied, 21.7% of them belong to the social class I and 16.9% to the social class II. Between all studied nurses, 33.0% suffered abuse, among which 75.1% were psychologically abused. Of all the abuse cases 60% were less severe and 40% more serious. CONCLUSIONS: It was confirmed the presence of intimate partner violence (IPV) against nurses, which was predominantly psychological abuse, but others classes of abuse were present too.