Significados atribuídos por mulheres com câncer de mama ao grupo de apoio / Meanings attributed by women with breast cancer to a support group / Significados atribuidos por las mujeres con cáncer de mama al grupo de apoyo

A sobrevivência ao câncer de mama é um problema de saúde pública que demanda serviços especializados com foco na reabilitação psicossocial. Entre as necessidades identificadas nesse contexto está o incentivo à adoção de estratégias de promoção de autocuidados pelas mulheres. Uma das estratégias adotadas consiste no grupo de apoio psicológico, que auxilia as pacientes a enfrentar a longa jornada do tratamento. Assim, o objetivo deste estudo é compreender os significados produzidos por mulheres com câncer de mama sobre sua participação em um grupo de apoio. Trata-se de um estudo qualitativo, descritivo e exploratório realizado com dez mulheres com câncer de mama usuárias de um serviço de reabilitação para mastectomizadas. Como referencial metodológico foi utilizada a Teoria Fundamentada nos Dados. A coleta de dados foi realizada por meio de entrevista aberta em profundidade e os conteúdos foram transcritos e codificados. A análise indutiva e o método de comparação constante foram aplicados nos processos de codificação aberta, axial e seletiva, que permitiram identificar três categorias nucleares: percepção das atividades realizadas no grupo, identificação de benefícios e barreiras do convívio no grupo e transformações decorrentes da participação. As participantes significaram sua presença no grupo como fonte de acolhimento, apoio, desenvolvimento de recursos pessoais e amizades, contribuindo para promover sua qualidade de sobrevida. Além dos potenciais benefícios, também foram identificadas barreiras que podem dificultar a adesão e continuidade da participação no grupo, o que sugere a necessidade de incorporar no cuidado um olhar para as dimensões subjetivas da saúde da mulher.(AU)

Surviving breast cancer is a public health problem and depends on services focused on psychosocial rehabilitation. Healthcare providers must encourage women to adopt strategies to promote their self-care. The psychological support group is a resource that helps women to face the long journey of treatment. This study aimed to understand the meanings women with breast cancer produced about their participation in a support group. This exploratory cross-sectional study was carried out with 10 women with breast cancer who use a rehabilitation service for mastectomized patients. Grounded Theory was used as a methodological reference. An open in-depth interview was applied for data collection. The contents were transcribed and coded. Inductive analysis and the constant comparison method were applied in the open, axial, and selective coding processes, which enabled the identification of three core categories: perception of the activities carried out in the group, identification of benefits and barriers of living in the group, and transformations resulting from participation. Participants denote their involvement with the group as a source of shelter, support, development of personal resources and friendships that helps promoting quality of life. Besides these potential benefits, participants also evinced barriers that can hinder adherence and continuity of participation in the group, suggesting the importance of incorporating a look at the subjective dimensions of women's health into care.(AU)

Sobrevivir al cáncer de mama es un problema de salud pública que depende de los servicios centrados en la rehabilitación psicosocial. Entre las necesidades identificadas en esta materia se encuentra el uso de estrategias para promover el autocuidado. Uno de los recursos que ayuda a afrontar el largo camino del tratamiento es el grupo de apoyo psicológico. El objetivo de este estudio es conocer los significados que producen las mujeres con cáncer de mama sobre su participación en un grupo de apoyo. Se trata de un estudio cualitativo, descriptivo y exploratorio, realizado con diez mujeres con cáncer de mama usuarias de un servicio de rehabilitación para mastectomizadas. Como referencia metodológica se utilizó la teoría fundamentada en los datos. Se aplicó una entrevista abierta en profundidad para la recogida de datos, cuyos contenidos fueron transcritos y codificados. El análisis inductivo y el método de comparación constante se aplicaron en los procesos de codificación abierta, axial y selectiva, lo que permitió identificar tres categorías centrales: percepción de las actividades realizadas en el grupo, identificación de los beneficios y las barreras de vivir en el grupo y transformaciones resultantes de la participación. Las mujeres denotan su participación en el grupo como una fuente de acogida, apoyo, desarrollo de recursos personales y amistades, que ayuda a promover la calidad de vida. Además de los beneficios potenciales, también se identificaron barreras que pueden dificultar la adherencia y continuidad de la participación en el grupo, lo que sugiere la necesidad de incorporar en la atención una mirada centrada en las dimensiones subjetivas de la salud de las mujeres.(AU)

Psicologia e diabetes no Brasil: um mapeamento de profissionais e de suas ações / Psychology and diabetes in Brazil: the mapping of professionals and their practices / Psicología y diabetes en Brasil: un mapeo de los profesionales y sus acciones

Pouco se sabe sobre a atuação do psicólogo no Brasil junto a pessoas com Diabetes Mellitus. O objetivo desta pesquisa foi identificar os psicólogos brasileiros que trabalham com essa população e suas ações. Foram convidados a responder a um questionário online psicólogos que atuam ou atuaram junto a pessoas com diabetes. Participaram 79 psicólogos, principalmente da região Sudeste (59,5%). Todos declararam que haviam cursado pósgraduação. Na amostra, predominou o gênero feminino (89,9%), com idade entre 26 e 40 anos (46,8%). A maioria dos que atuam com diabetes declarou-se autônoma ou voluntária, e quase metade trabalhava menos do que 10 horas semanais. Entre aqueles que deixaram de trabalhar com diabetes, apenas uma minoria tinha vínculo empregatício. Além do trabalho com pessoas com diabetes, a maior parte declarou exercer outras atividades profissionais, como atendimentos clínicos em consultórios particulares, sugerindo que esta não é a atividade principal. Majoritariamente, os respondentes declararam não ter conhecimentos suficientes para o atendimento específico às pessoas com diabetes. Discute-se a qualidade da formação profissional dos psicólogos no Brasil, a necessidade de aprimoramento em relação à atuação com pessoas com diabetes e as condições de trabalho.(AU)

Little is known about the practice of psychologists in Brazil caring for people with Diabetes Mellitus. The aim of this research was to identify the Brazilian psychologists who work with this population and describe their actions. Psychologists who work or have worked with people diagnosed with diabetes were invited to answer an online questionnaire. The 79 participants lived mainly in the Southeast Region (59.5%). All of them declared to have a graduate degree, most were female (89.9%), aged 26 to 40 years (46.8%). Most of those working with diabetes declared to be autonomous or voluntary, and almost half had a workload of less than 10 hours a week. Among those who stopped working with diabetes, only a minority had a formal employment contract. In addition, most of them stated that they had other professional activities related to clinical care in private offices, suggesting that working with diabetes is not their main activity. Mostly, respondents stated that they did not have enough knowledge to care for people with diabetes. The quality of professional education of psychologists in Brazil, the need for specific improvement in labor relations and conditions were discussed.(AU)

Son escasas las informaciones del trabajo de los psicólogos en Brasil con las personas con Diabetes Mellitus. El objetivo de este estudio fue identificar los psicólogos brasileños que trabajan con esta población y describir sus acciones. Se invitó a psicólogos que trabajan o hayan trabajado con personas con diabetes a responder un cuestionario en línea. Participaron 79 psicólogos, principalmente de la región Sureste de Brasil (59,5%). Todos declararon tener posgrado. En la muestra hubo una mayor prevalencia del género femenino (89,9%), de edades de entre 26 y 40 años (46,8%). La mayoría de los que trabajan con personas con diabetes se declararon autónomos o voluntarios, y casi la mitad trabajaba menos de 10 horas a la semana. Entre los que dejaron de trabajar con las personas con diabetes, solo una minoría tenía una relación laboral. Además de trabajar con personas con diabetes, la mayoría afirmó tener otras actividades profesionales, como la atención clínica en consultorios privados, lo que sugiere que esta no es su actividad principal. La mayoría de los encuestados afirmaron que no tenían los conocimientos suficientes para atender específicamente a las personas con diabetes. Se discuten la calidad de la formación profesional de los psicólogos en Brasil, la necesidad de mejora en relación con el trabajo con personas con diabetes y las condiciones laborales.(AU)

Construction of a non-contact community treatment centre for asymptomatic and mildly symptomatic COVID-19 patients during the COVID-19 pandemic.

The explosive outbreak of COVID-19 led to a shortage of medical resources, including isolation rooms in hospitals, healthcare workers (HCWs) and personal protective equipment. Here, we constructed a new model, non-contact community treatment centres to monitor and quarantine asymptomatic and mildly symptomatic COVID-19 patients who recorded their own vital signs using a smartphone application. This new model in Korea is useful to overcome shortages of medical resources and to minimise the risk of infection transmission to HCWs.

Levels of type 1 diabetes care in children and adolescents for countries at varying resource levels.

Optimal care for children and adolescents with type 1 diabetes is well described in guidelines, such as those of the International Society for Pediatric and Adolescent Diabetes. High-income countries can usually provide this, but the cost of this care is generally prohibitive for lower-income countries. Indeed, in most of these countries, very little care is provided by government health systems, resulting in high mortality, and high complications rates in those who do survive. As lower-income countries work toward establishing guidelines-based care, it is helpful to describe the levels of care that are potentially affordable, cost-effective, and result in substantially improved clinical outcomes. We have developed a levels of care concept with three tiers: "minimal care," "intermediate care," and "comprehensive (guidelines-based) care." Each tier contains levels, which describe insulin and blood glucose monitoring regimens, requirements for hemoglobin A1c (HbA1c) testing, complications screening, diabetes education, and multidisciplinary care. The literature provides various examples at each tier, including from countries where the life for a child and the changing diabetes in children programs have assisted local diabetes centres to introduce intermediate care. Intra-clinic mean HbA1c levels range from 12.0% to 14.0% (108-130 mmol/mol) for the most basic level of minimal care, 8.0% to 9.5% (64-80 mmol/mol) for intermediate care, and 6.9% to 8.5% (52-69 mmol/mol) for comprehensive care. Countries with sufficient resources should provide comprehensive care, working to ensure that it is accessible by all in need, and that resulting HbA1c levels correspond with international recommendations. All other countries should provide Intermediate care, while working toward the provision of comprehensive care.

Agencia de autocuidado de la persona con enfermedad renal crónica en diálisis / Self-care agency in persons with chronic kidney disease in dialysis

Introducción: Las personas con Enfermedad Renal Crónica en diálisis permanentemente toman decisiones sobre lo que pueden y deben hacer en relación a su situación de salud, limitación y requerimiento personal para mantener la homeostasis y controlar los factores de riesgo; por lo tanto conocer y potenciar su capacidad de autocuidado es fundamental para diseñar estrategias que impacten sus necesidades. Objetivo: Determinar la capacidad de autocuidado de las personas con Insuficiencia Renal Crónica en diálisis, así como su relación con las características sociodemográficas y clínicas. Material y Método: Estudio cuantitativo descriptivo de corte transversal. La población estuvo conformada por 111 personas dializadas en una unidad renal de Florencia (Colombia). Se aplicaron los instrumentos: caracterización sociodemográfica y clínica, y capacidad de agencia de autocuidado en el paciente hipertenso. Los datos se analizaron mediante la estadística descriptiva. Resultados: Edad promedio de la población 56 años (DE:+14); género masculino 55.9%; su capacidad de agencia de autocuidado fue alta y media (80,2% y 19,8%) respectivamente; se encontró significación entre la variable capacidad de autocuidado y edad, que indica que a mayor edad, disminuye la capacidad de autocuidado (p=0,024<0,05), además manifestaron mejor percepción del estado de salud aquellas personas con mayor grado de capacidad de agencia de autocuidado (p=0,004<0,05). Conclusiones: La capacidad de agencia de autocuidado de las personas dializadas, se caracterizó por estar entre los niveles de alta y media capacidad, sin embargo se requiere de intervenciones del profesional de Enfermería y del equipo de salud, basadas en las necesidades individuales para mantener y mejorar su autocuidado (AU)

People with Chronic Kidney Disease in dialysis permanently make decisions about what they can and should do in relation to their health situation, limitation and personal requirement to maintain homeostasis and control risk factors; therefore, knowing and strengthening their self-care capacity is fundamental to design strategies that impact their needs. Objective: To determine the capacity of self-care of the people with Chronic Kidney Disease in dialysis, such as their relation with the sociodemographic and clinical characteristics. Material y Method: A quantitative, descriptive, cross-sectional study. The population was formed by one hundred and eleven dialyzed people at the Medilaser Renal Unit in Florencia (Colombia). Sociodemographic and clinical variables and capacity of self-care agency in hypertensive patient were obtained. Data were analyzed through descriptive statistics. Resultados: Mean age of the population: fifty-six (56) years old (SD±14); male gender: Fifty-five point nine per cent (55.9%); their capacity of self-care agency was high and medium (80,2% and 19,8%, respectively). Significance was found between the self-care capacity variable and age, which indicates that higher age the self-care capacity decreases (p=0.024), as well as a better perception of the state of health with greater capacity of people self-care agency (p=0.004). Conclusiones: The capacity of self-care agency of dialyzed people is between the high and medium capacity levels; however, it requires interventions from the nursing professional and health-care professionals, based on individual needs to maintain and improve their self-care (AU)

Effect of a mobile health, sensor-driven asthma management platform on asthma control.

BACKGROUND: Asthma inflicts a significant health and economic burden in the United States. Self-management approaches to monitoring and treatment can be burdensome for patients. OBJECTIVE: To assess the effect of a digital health management program on asthma outcomes. METHODS: Residents of Louisville, Kentucky, with asthma were enrolled in a single-arm pilot study. Participants received electronic inhaler sensors that tracked the time, frequency, and location of short-acting ß-agonist (SABA) use. After a 30-day baseline period during which reference medication use was recorded by the sensors, participants received access to a digital health intervention designed to enhance self-management. Changes in outcomes, including mean daily SABA use, symptom-free days, and asthma control status, were compared among the initial 30-day baseline period and all subsequent months of the intervention using mixed-model logistic regressions and χ2 tests. RESULTS: The mean number of SABA events per participant per day was 0.44 during the control period and 0.27 after the first month of the intervention, a 39% reduction. The percentage of symptom-free days was 77% during the baseline period and 86% after the first month, a 12% improvement. Improvement was observed throughout the study; each intervention month demonstrated significantly lower SABA use and higher symptom-free days than the baseline month (P < .001). Sixty-nine percent had well-controlled asthma during the baseline period, 67% during the first month of the intervention. Each intervention month demonstrated significantly higher percentages than the baseline month (P < .001), except for month 1 (P = .80). CONCLUSION: A digital health asthma management intervention demonstrated significant reductions in SABA use, increased number of symptom-free days, and improvements in asthma control. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02162576.

Sociodrama: estratégia para autorreflexão de enfermeiros sobre a cegueira / Sociodrama: strategy for nurses’ self-reflection on blindness

Investigar as auto expressões de mestrandas acerca dos sentimentos, dificuldades e desafios decorrentes da participação em sociodrama “como se” fossem cegas. Métodos: estudo qualitativo. Participaram oito mestrandas em enfermagem. Utilizaram-se sociodrama, uma filmadora e Análise de Conteúdo. Na execução do sociodrama, foram seguidas as etapas de aquecimento, dramatização, comentários e processamento teórico.Resultados: emergiram as categorias temáticas: O papel de cega desencadeando limitação, bloqueio e medo; O papel de cega desencadeando uma noção confusa do próprio corpo; A espontaneidade-criatividade manifestada pelas mestrandas. Conclusão: as mestrandas expressaram o sentimento de medo ao se mobilizarem em ambiente com o qual já estavam familiarizadas, tiveram dificuldade para se alimentar devido à noção confusa do próprio corpo, e puderam refletir acerca do desafio que é cuidar da pessoa cega, pois perceberam que,profissionalmente, estavam despreparadas para cuidar destes indivíduos.

Objective: to investigate the master students’ expressions about feelings, difficulties and challenges arising from participation in sociodrama “as if” they were blind. Methods: qualitative study. Participants were eight Master students in nursing. They used sociodrama, a video recorder and the Content Analysis technique. In implementing the sociodrama, the steps were followed were warm-up, drama, comments and theoretical processing. Results: the following thematic categories emerged: the role as blind person triggering limitation, blocking and fear; the role as blind person triggering a confused notion of one’s own body; spontaneity and creativity expressed by Master students. Conclusion: the Master students expressed the feeling of fear to walking in an environment with which they were already familiar, had difficulty in eating because of the confused notion of their own body, and could reflect on the challenge of caring for the blind person, because they realized that they were professionally unprepared to take care of these individuals.

Validación de apariencia, contenido y consistencia interna de la Escala de Apreciación de Agencia de Autocuidado (ASA) para Costa Rica, segunda versión en español / Validation of appearance, content and internal consistency of the scale Appraisal of Self-care Agency (ASA) to Costa Rica, second versión in Spanish

Resumen:Introducción:Este artículo presenta los resultados obtenidos del proceso de validación de apariencia, contenido y consistencia interna al que fue sometida la segunda versión en español de la escala ASA aplicada a población costarricense.Método:Este estudio es descriptivo, transversal, con un enfoque cuantitativo, con un diseño no experimental y psicométrico, realizado con una muestra de 211 personas en la etapa de la adultez temprana, intermedia y tardía, según su condición de salud conocidas como sanas o con diagnóstico de enfermedad crónica.Resultados:La investigación determinó que el análisis factorial con la aplicación de métodos estadísticos, la prueba de Kaiser-Meyer-Olkin (KMO) con resultado de 0,79, evidenció la viabilidad de la escala, en la que las variables miden factores comunes con una varianza total del 64,14%.Conclusión:El análisis factorial arrojó siete ejes factoriales y obtuvo valores adecuados que demuestran su validez.

Abstract:Introduction:This paper presents the results of the validation process of appearance, content and internal consistency that was submitted the second versión in Spanish of the ASA scale Costa Rican population.Method:It is a descriptive, cross-sectional non-experimental and psychometric study with a quantitative approach, design, conducted with a sample of 211 people at the stage of early, middle and late adulthood, according to your health condition and healthy known or diagnosed disease chronic.Results:The investigation determined that the factor analysis with the application of statistical methods, testing Kaiser-Meyer-Olkin (KMO) resulting in 0.79, showed the feasibility of the scale, which measured variables with a common variance factors Total 64.14%.Conclusion:Factor analysis showed seven factorial axes, appropriate values obtained demonstrate the validity of the same reflecting that is able to measure what it claims.

Using Nursing Activities Score to Assess Nursing Workload on a Medium Care Unit.

BACKGROUND: The medium care unit (MCU) or "stepdown" unit is an increasingly important, but understudied care environment. With an aging population and more patients with complex multiple diseases, many patients often require a higher level of inpatient care even when full intensive care is not indicated. However, the nurse-to-patient ratio required on a MCU is neither well defined nor clear whether this ratio should be adjusted per shift. The Nursing Activities Score (NAS) is an effective instrument for measuring nursing workload in the intensive care unit (ICU) but has not been used in an MCU. The aim of this study was to measure the nursing workload per 8-hour shift on an MCU using the NAS and compare it with the NAS from an ICU in the same hospital. We also compared the NAS between groups of patients with different admission sources. METHODS: The NAS was prospectively measured per patient per shift for 2 months in a 9-bed tertiary referral university hospital MCU and during a similar period in an ICU in the same hospital. RESULTS: The mean NAS per patient did not differ between day (7:30 AM to 4:00 PM) and evening (3:00 PM to 11:30 PM) shifts, but the NAS was significantly lower during the night shift (11:00 PM to 8:00 AM) than during the day (P < 0.0001) and evening (P < 0.0001) shifts. The mean NASs in the ICU for day and night shifts were significantly lower than the scores in the MCU (P = 0.0056 and P < 0.0001, respectively), but NAS during the evening shift did not differ between the ICU and the MCU. The mean NAS for patients admitted to the MCU from the accident and emergency department was significantly higher than for those admitted from the ICU (P = 0.002), recovery (P = 0.002), and general ward (P < 0.0001). Patients on the MCU had a NAS comparable with that of ICU patients. CONCLUSIONS: In our university hospital, NAS was higher during the day and evening hours and lower at night. We also found that patients from accident and emergency had a higher NAS than those admitted to the MCU from other locations. NAS in the MCU was not lower than the NAS in the ICU. Because of its ability to discriminate between day and evening workloads and between patients from different sources, the NAS may assist MCU managers in assessing staffing needs.

Semana del autocuidado semFYC / SemFYC Self-Care Week

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Cooperación internacional para el desarrollo. Desde la teoría de autocuidado de orem / International development cooperation from the d. orem self-care theory

This article aim is to analyze the performance of Spanish cooperation from the perspective of Orem self-care theory, from the next hypothesis: the Spanish international cooperation programs works as total compensation systems. Methods: cross sectional and descriptive study in which qualitative analysis was performed 3 African countries: Mozambique, Angola and Namibia. The variables were management, focused area and resources used. Results: All countries have a shared management of the cooperation. Mozambique has developed training activities (72%), management support (38%) and direct health care (27%), focused on the area of the fight against infection and tropical diseases. In Angola, the activities are based in training (37%), management support (37%) and health care (75%) in the area of basic health services (25%), fighting against tropical diseases (50%) and improving maternal and child health (25%). Namibia focuses on the health care area (100%) through direct assistance activities and management support. Discussion: Health cooperation programs developed by the Spanish state have probed to work as partial compensation system(AU)

Monitores y consejeros en virus de la inmunodeficiencia humana y salud sexual y reproductiva: formación profesional con responsabilidad social / Monitors and counselors on HIV and sexual and reproductive health: professional training with social responsibility

El sida y las infecciones de transmisión sexual (ITS) son un grave problema sanitario y psicosocial que afecta a los usuarios, las familias y La sociedad en general, extendiéndose por todos los continentes. La formación de estudiantes de la carrera de Obstetricia y Puericultura de la Universidad Autónoma de Chile (Talca, Chile) desde el año 2006como monitores y consejeros en virus de la inmunodeficiencia humana/sida, ITS y salud sexual y reproductiva, les capacita para desarrollar estrategias de intervención educativa individual, grupal y comunitaria(especialmente en adolescentes y jóvenes) orientadas al cuidado de la salud sexual, evitando conductas sexuales de riesgo, promoviendo el autocuidado y el mutuo cuidado de todas las personas, estableciendo una coordinación intersectorial efectiva y fomentando la responsabilidad social (AU)

Aids and sexually transmitted infections (STI) are a very serious health and psychosocial problem that affect users, families and society at large, extending across all continents. The training of Students belonging to the Midwifery career at Universidad Autonoma de Chile, Talca (Chile), since 2006 as Monitors and Counselors on HIV/AIDS, STI, sexual and reproductive health, enables them to develop individual, group and community educational intervention strategies, especially in adolescents and youth, aimed at sexual health care, avoiding risky sexual behaviours, promoting self care and mutual care of all the people, establishing effective intersector coordination and fomenting social responsibility (AU)

Factores psicosociales relacionados con el autocuidado en la prevención, tratamiento y postratamiento del cáncer de mama / No disponible

En el presente artículo se discute acerca de los factores psicosociales asociados al autocuidado en el cáncer de mama durante la prevención, el tratamiento y el postratamiento. El autocuidado se refiere a un conjunto de actividades que la persona realiza de manera consciente para mantener su vida, su salud y su bienestar, y es necesario que sea incentivado durante todas las etapas de la enfermedad. Se presentan distintos modelos teóricos - Modelo de Creencias de la Salud, Teoría de la Acción Razonada y Modelo de Autorregulación en Salud - que intentan entender cómo y porqué las personas se cuidan en situaciones de enfermedad crónica y su aplicación en el cáncer de mama. Por último, se reflexiona sobre la importancia del estado de ánimo de la mujer afectada, de la familia y de las intervenciones psicológicas para fomentar el autocuidado en las distintas etapas de la enfermedad (AU)

This paper discusses psychosocial factors which influence self-care in breast cancer patients during prevention, treatment and after-treatment phases. Self-care is defined as the set of activities that a patient consciously develops to look after her life, health and well-being, an it must be supported all over the different stages of the disease. Three different theoretical models are presented - Health Beliefs Model, Theory of Reasoned Action and Self-regulation Model - that try to understand how and why people practice self-care in chronic conditions and in breast cancer. Finally, the paper reflects upon the importance of women’s strength of spirit, of family relations and psychological interventions to improve self-care in the different phases of the disease (AU)

Escuela Gallega de Salud para Ciudadanos. Estructura para la participación de los ciudadanos en las políticas de Salud / No disponible

No disponible

The importance of health literacy in the development of ‘Self Care’ cards for community pharmacies in Ireland / Importancia de la literacía en salud en el desarrollo de tarjetas «Auto Cuidado» para las farmacia comunitarias en Irlanda

Objectives: «Self Care» cards play a significant role in delivering health education via community pharmacies in Australia and New Zealand. The primary objective of this study was to evaluate whether such an initiative could have a similar impact in an Irish context. The secondary objective was to understand the importance of health literacy to this initiative. Methods: Ten cards were developed for the Irish healthcare setting and trialed as a proof of concept study. The pilot study ran in ten community pharmacies in the greater Cork area for a six-month period. Using a mixed methods approach (Questionnaires & focus group) staff and patient reactions to the initiative were obtained. Concurrent to the pilot study, readability scores of cards (Flesch-Kincaid, Fry, SMOG methods) and the Rapid Estimate of Adult Literacy in Medicine (REALM) health literacy screening tool was administered to a sample of patients. Results: 88.7% of patient respondents (n=53) liked the concept of the ‘Self Care’ cards and 83% of respondents agreed that the use of the card was beneficial to their understanding of their ailment. Focus groups with Pharmacy staff highlighted the importance of appropriate training for the future development of this initiative. An emerging theme from designing the cards was health literacy. The pilot ‘Self Care’ cards were pitched at too high a literacy level for the general Irish public to understand as determined by readability score methods. It was found that 19.1% of a sample population (n=199) was deemed to have low health literacy skills. Conclusion: The ‘Self Care’ initiative has the potential to be Pharmacy’s contribution to health education in Ireland. The initiative needs to be cognizant of the health literacy framework that equates the skills of individuals to the demands placed upon them (AU)

Objetivos: Las tarjetas «Auto Cuidado» [Self Care] juegan un papel significativo en la provisión de educación sanitaria a través de las farmacias comunitarias en Australia y Nueva Zelanda. El objetivo primario de este estudio fue evaluar si una iniciativa similar podría tener impacto en el contexto irlandés. El objetivo secundario fue entender la importancia de la literacía en salud para esta iniciativa. Métodos: Se desarrollaron 10 tarjetas para el entorno sanitario irlandés y se ensayaron con un estudio de prueba de concepto. El estudio piloto corrió en 10 farmacias comunitarias en el gran Cork durante seis meses. Se obtuvieron las reacciones del personal y pacientes hacia la iniciativa con el uso de métodos mixtos (cuestionarios y grupos focales). Simultáneamente al estudio piloto, se calcularon las puntuaciones de legibilidad de las tarjetas (métodos de Flesch-Kincaid, Fry, SMOG) y se administró a una muestra de pacientes el instrumento de rastreo de literacía en salud Rapid Estimate of Adult Literacy in Medicine (REALM). Resultados: Al 88,7% de los pacientes (n=53) les gustó el concepto de tarjetas ‘Auto Cuidado’ y el 83% de los respondentes aceptó que el uso de la tarjeta era beneficioso para la comprensión de su enfermedad. Los grupos focales con personal de la farmacia resaltaron la importancia del entrenamiento adecuado para el futuro desarrollo de esta iniciativa. Un tema emergente del desarrollo de las tarjetas fue la literacía en salud. Las tarjetas piloto ‘Auto Cuidado’ tenían inclinación hacia un nivel demasiado elevado de literacía para que el público general irlandés las entendiese, como se determinó por los métodos de legibilidad. Se vio que el 19,1% de la muestra (n=199) estaba considerada como de bajas habilidades en literacía de la salud. Concusión: La iniciativa ‘Auto Cuidado’ [Self Care] tiene la posibilidad de ser una contribución de la farmacia a la educación sanitaria en Irlanda. La iniciativa necesita ser consciente del marco de literacía en salud que conecta las habilidades de los individuos a las demandas que se les solicitan (AU)

Procedimiento de colocación del catéter de bomba de insulina / Procedure for placing an insulin pump catheter

La terapia con Infusión Subcutánea Continua de Insulina (ISCI) o bomba de insulina puede ser una buena alternativa terapéutica para las personas con diabetes tipo 1 en situaciones concretas. El aprendizaje de esta técnica ha de realizarse mediante un programa de educación sanitaria impartido por un equipo multidisciplinar, con el que se capacita al paciente en el manejo del dispostivo y en cuidado de la zona de la inserción de la cánula. Cumpliendo estas condiciones básicas, la persona puede obtener beneficios, tanto en el control glucémico como en la reducción de la incidencia de hipoglucemias y, por lo tanto, una mejoría en su calidad de vida.El objetivo de este artículo consiste en explicar las indicaciones, el equipo necesario y el procedimiento de autoaplicacion de la bomba de insulina,así como las posibles complicaciones asociadas, con el fin de garantizarlas máximas condiciones de seguridad y las mínimas incomodidades para la persona que sigue este tipo de tratamiento (AU)

Continuous subcutaneous insulin infusion (CSII) therapy or an insulinpump can be a good therapeutic alternative for people with type 1 diabetes in specific situations.The learning of this technique must be performed by means of a health education programme taught by a multidisciplinary team, in which thepatient is taught to manage the device and to care for the cannula’s insertion area. If the patient adheres to these basic conditions, he/she can reap the benefits, both in glycemic control and in the reduction of the incidence of hypoglycaemias, which in turn improves his or her quality of life.The objective of this article is to explain the indications, the equipment that is needed and the self-application procedure for the insulin pump, as well as possible complications, in order to guarantee the best safety conditions and to decrease the discomfort experienced by the patient who undergoes this type of treatment (AU)

Efectividad de las recomendaciones al altaen los pacientes con derivación urinaria Brickeren el Hospital Santiago de Vitoria. Un reto en los cuidados / No disponible

La cistectomía radical es el tratamiento de elección en pacientes con cáncer vesical infiltrante siendo, la derivación urinaria tipo Bricker latécnica más utilizada en nuestra unidad.Con el fin de conocer el grado de información de los pacientes intervenidos de cistectomía Bricker hemos evaluado tanto la informaciónoral como escrita sobre los cuidados que reciben nuestros pacientes durante el ingreso con el fin de lograr un mayor autocuidado al altahospitalaria.Para ello hemos realizado un estudio descriptivo transversal mediante entrevistas personales. El cuestionario constaba de 7 ítems relacionadoscon hábitos higiénicos, cuidados del estoma, valoración de la hoja de recomendaciones al alta, cambios en sus hábitos de vida ydificultades que encontraron una vez en su domicilio. El resultado de este estudio evidencia que para un alto porcentaje de pacientes lainformación dada durante el ingreso de cara al alta les ha sido de utilidad. Por el contrario, un porcentaje menor demanda más informaciónde la recibida. Dado que hay variables que pueden influir en la adecuada recepción de la información y que la hoja de recomendacionesno cumple las expectativas esperadas, creemos necesario reforzar la información mediante la elaboración de una guía de actuación (AU)

Radical cystectomy is the treatment of choice in patients with invasive bladder cancer, being the urinary diversion Bricker type, the mostcommon technique used in our unit.In order to meet the grade of information patients have about Bricker cystectomy interventions, we had evaluated oral and written informationabout the care that receive our patients during hospitalization in order to achieve greater self-care at discharge.Therefore, we had carried out a cross-sectional study by personal interviews. Questionnaire was made by 7 items related to hygienehabits, stoma’s care, discharge recommendation booklet assessment, changes in life habits and troubles found once they are at their homes.The result of this study shows that a high percentage of patients found useful data given during their hospitalization to face discharge properly.By contrast, a smaller percentage claim received more information.As there are many variables that can modify properly patient’ perception on information and recommendation booklet does not meetthe expectation expects, we believe that there’s need to enforce information by actuation guidelines elaboration (AU)

Seguimiento telefónico de las complicaciones en cirugía mayor ambulatoria / No disponible

Objetivos: Conocer los principales problemas postoperatorios, por los que los pacientes hacen uso del teléfono de contacto de 24 horas de la unidad y evaluar si el personal de enfermería es capaz de resolverlos por sí mismo haciendo uso del protocolo establecido en la unidad. Material y método: Estudio retrospectivo de las llamadas recibidas en la unidad durante el año 2007. Para la realización del estudio se realizó una recogida de datos, utilizando los registros de enfermería de las llamadas al teléfono de contacto de 24 horas que nos hacen los pacientes intervenidos en la unidad. Resultados: En el año 2007 en nuestra unidad se realizaron un total de 8.480 intervenciones. Se recibieron 260 llamadas al teléfono de contacto. Entre los principales motivos de llamada destacan el dolor con un 29,6%, el sangrado un 16,2%, la fiebre con un 11,5%, en siguiente lugar con un 7,3% las consultas de algún tipo de duda, seguidas de las llamadas por inflamación con un 5,4%, el estreñimiento con un 3,8%, el dolor simultáneamente con fiebre con un 3,8% y tener el apósito manchado con un 3,4%, recibiéndose la mayoría de las llamadas entre el segundo día después de la intervención y el octavo. Conclusiones: El fomentar los autocuidados y la formación del cuidador principal, junto con la protocolización de las actuaciones en estas unidades, son fundamentales para la correcta recuperación del paciente en su domicilio (AU)

Objetives: The purpose of this study was to identify the main postoperative complications which cause patients to make use of the 24 hour contact telephone number with our unit and to assess whether the nursing staff is able to solve these problems on their own using the protocol we set out in the Unit. Material and method: For this retrospective study of the calls received in the unit during 2007, we collected data from the nursing staff’s registry of the phone calls made by patients who underwent surgery in our unit. Results: During the year 2007, a total of 8,480 surgical procedures were performed. We received 260 calls to the contact telephone number. The main causes for these calls were: 29.6%for pain, 16.2% for bleeding, 11.5% for fever and 7.3% for doubts regarding postoperative care, followed by 5.4% for inflammation, 3.8% for constipation, 3.8% for pain and fever and 3.4%for blood on the dressing. Most of the calls were made between the second and eighth day after the operation. Conclusions: Promoting self-care and giving the necessary information to the main caregiver, together with the use of protocols for each of the procedures in these Units is essential for the correct recovery of patients after discharge (AU)