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1.
Rev Esp Cardiol ; 56(8): 775-82, 2003 Aug.
Article in Spanish | MEDLINE | ID: mdl-12892622

ABSTRACT

OBJECTIVES: To estimate the degree of incorporation of cardiac rehabilitation in the Spanish National Health Service, to describe the characteristics of the programs, and to report on the opinions of those responsible for them regarding their progress. PATIENTS AND METHOD: Cardiac rehabilitation centers were identified from different sources. A questionnaire which included items about coverage, resources, activities and services, selection of patients, and opinions was mailed to the heads of all units. RESULTS: Twelve public centers with cardiac rehabilitation programs were identified. Cardiac rehabilitation was offered to 53% of all eligible patients. All units treated patients with myocardial infarction, 64% treated those with heart failure; and 60% high risk patients. Approximately 10-19% of all patients were women. The physicians involved most frequently in programs were cardiologists; nonmedical professionals who participated most often were physiotherapists, and 64% of all units had a staff psychologist. Phase II rehabilitation was provided by all units, and phase III treatment was provided mainly by units that operated in coordination with out-patient services (45%). All units provided physical exercise training and counseling about the disease and risk factors, and 73% of them provided psychological support. The main reasons cited for providing rehabilitation were its efficacy and ability to prevent illness; and the main barriers to more widespread use were lack of resources and support. About three-fourths (73%) of all doctors interviewed thought that primary health care centers could play an important role in rehabilitation programs. CONCLUSIONS: Cardiac rehabilitation is poorly implemented in the Spanish National Health Service. The most significant differences between programs were related to the inclusion of high risk patients and with a diagnosis other than myocardial infarction, coordination with out-patient services, and provision of phase III rehabilitation.


Subject(s)
Cardiology Service, Hospital/organization & administration , Heart Diseases/rehabilitation , National Health Programs/organization & administration , Cardiology Service, Hospital/statistics & numerical data , Female , Humans , Male , Program Development , Spain
2.
Rev. esp. cardiol. (Ed. impr.) ; 56(8): 775-782, ago. 2003.
Article in Es | IBECS | ID: ibc-28097

ABSTRACT

Objetivos. Estimar el grado de implantación de la rehabilitación cardíaca en el Sistema Nacional de Salud, describir las características de los programas y las opiniones de sus responsables sobre su desarrollo.Pacientes y método. Se identificaron las unidades de rehabilitación cardíaca a partir de diversas fuentes. Se envió un cuestionario postal a sus responsables, con preguntas sobre cobertura, recursos, actividades y servicios, selección de pacientes, y opiniones.Resultados. Se localizaron 12 hospitales públicos que llevaban a cabo rehabilitación cardíaca. Como media, ésta se oferta al 53 por ciento de los pacientes elegibles. Todas las unidades incluyen a pacientes con infarto de miocardio, un 64 por ciento con insuficiencia cardíaca y un 60 por ciento pacientes de alto riesgo. Un 10-19 por ciento de los pacientes son mujeres. Los médicos más implicados son los cardiólogos; los profesionales no médicos que más participan son los fisioterapeutas, y un 64 por ciento de las unidades cuenta con psicólogo. La realización de la fase II es generalizada, y la fase III se realiza más en unidades coordinadas con centros extrahospitalarios (45 por ciento). Además del ejercicio físico, todas las unidades ofrecen consejo sobre la enfermedad y los factores de riesgo, y el 73 por ciento, apoyo psicológico. Las principales motivaciones mencionadas para hacer rehabilitación son su carácter preventivo y la eficacia, y las principales barreras, la falta de medios y apoyo. Se cree que la atención primaria puede desempeñar un papel importante.Conclusiones. La rehabilitación cardíaca está escasamente implantada en el sistema sanitario público. Las mayores diferencias entre programas son la inclusión de pacientes de alto riesgo y con diagnósticos distintos del infarto, la coordinación con centros extrahospitalarios y realización de fase III (AU)


Subject(s)
Male , Female , Humans , Spain , Cardiology Service, Hospital , Program Development , National Health Programs , Heart Diseases
3.
Rev Esp Cardiol ; 55(8): 816-22, 2002 Aug.
Article in Spanish | MEDLINE | ID: mdl-12199977

ABSTRACT

INTRODUCTION AND OBJECTIVES: A variable percentage of patients with myocardial infarction treated with successful primary angioplasty and restoration of coronary flow show persistent ST-segment elevation, probably due to inadequate cellular reperfusion. We studied if persistent ST-segment elevation was a predictor of worse prognosis. PATIENTS AND METHODS: We comparatively studied the clinical and angiographic results of 116 acute myocardial infarction patients after successful primary angioplasty, which were classified into two groups depending on the persistence (> 50%) or reduction (

Subject(s)
Angioplasty, Balloon, Coronary , Electrocardiography , Myocardial Infarction/surgery , Aged , Chi-Square Distribution , Coronary Angiography , Coronary Circulation , Data Interpretation, Statistical , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/mortality , Myocardial Infarction/physiopathology , Myocardial Reperfusion , Prognosis , Recurrence , Stroke Volume , Survival Analysis , Time Factors
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