Valoración de la acogida de pacientes que inician terapia renal sustitutiva: nivel de satisfacción / Assessment of reception of patients initiating renal replacement therapy: level of satisfaction

Introducción: En los últimos años han cobrado especial importancia aspectos tales como la calidad de vida, la salud percibida y la satisfacción del enfermo.El objetivo de este estudio, es valorar el nivel de satisfacción de pacientes con enfermedad renal crónica con los cuidados recibidos, cuando inician por primera vez la terapia renal sustitutiva. Material y métodos: Estudio descriptivo de corte transversal, en pacientes que inician por primera vez terapia renal sustitutiva. La muestra estuvo compuesta por 83 pacientes. Se recogieron variables sociodemográficas relacionadas con la enfermedad renal y seguimientos en consulta. Para valorar la satisfacción con los cuidados recibidos, a los pacientes se les entregó el cuestionario para medir Calidad de Vida Relacionada con la Salud (KDQOL-SF), específico para pacientes renales. Dentro de este cuestionario existe un apartado que mide la satisfacción con los cuidados recibidos. Resultados: En el ítem SF23, el 62,7% de la muestra consideró que la amabilidad del personal sanitario fue la mejor posible (43,4%) o excelente (19,3%). Por otro lado, en los ítems SF24a y 24b, el 51,8% de los pacientes opinan que el personal sanitario les anima a ser independientes y el 59% considera que les apoyan a hacer frente a la enfermedad. En el modelo de regresión ordinal utilizado, SF23 y SF24 obtiene mejores puntuaciones para diálisis peritoneal cuando se controlan el resto de variables demográficas, que no son significativas (p<0,05). Conclusión: Valorando como muy positivos los resultados de satisfacción obtenidos hay que resaltar que resultan comparativamente mejores en la diálisis peritoneal (AU)

Introduction: In recent years have become very important issues such as quality of life, perceived health and patient satisfaction.The aim of this study is to assess the level of satisfaction of patients with chronic kidney disease with care received when they first start renal replacement therapy. Objective: A descriptive cross-sectional study in patients who start first renal replacement therapy. The sample consisted of 83 patients. Sociodemographic variables related to kidney disease and follow-on care clinics. To assess satisfaction with the care received, patients were given a questionnaire to measure Quality of Life Related to Health, specific for kidney patients. Within this section there is a questionnaire which measures satisfaction with the care received. Results: In item SF23, 62.7% of the sample felt that the friendliness of health workers was the best (43.4%) or excellent (19.3%). On the other hand, in SF24a and 24b items, 51.8% of patients believe that health staff encourages them to be independent and 59% think it will support coping with illness. In the ordinal regression model used, SF23 and SF24 gets top scores for PD when other demographic variables that are not significant (p <0.05) are controlled. Conclusion: Considering as positive satisfaction. results obtained should be highlighted that are comparatively better in peritoneal dialysis (AU)

Análisis de la discapacidad en el paciente crónico mediante la herramienta WHODAS II / Analysis of disability in chronic patients, using the WHODAS II tool

La Dependencia Funcional se define como la pérdida de autonomía física, psíquica o intelectual a causa de procesos relacionados con la salud del individuo. La discapacidades un atributo inseparable de la dependencia, pero no recíproco. La dependencia funcional es el resultado de una discapacidad, pero no todos los discapacitados tienen dependencia funcional puesto que no precisan ayuda de terceros. El objetivo del estudio es valorarla discapacidad y dependencia funcional y comparar los resultados obtenidos mediante el Índice de Barthel, con los obtenidos según el World Health Organization Disability Schedule versión 2 y relacionarlos con una variable predictora de dependencia funcional como el Índice de Comorbilidad de Charlson modificado por edad para evaluar la congruencia de ambas medidas. Material y método: Estudio epidemiológico de corte trasversal. Resultados: Analizando conjuntamente los valores de Índicede Barthel y World Health Organization Disability Schedule versión 2 con el Índice de Comorbilidad deCharlson modificado por edad obtuvimos que si bien ambas correlacionan significativamente con la comorbilidad (p<0,05), parece que la dependencia funcional lo hace con mayor fuerza que la discapacidad. Conclusiones: La medida de la discapacidad y su adscripción y tabulación en una clasificación como la Clasificación Internacional del Funcionamiento, la Discapacidad y la Salud nos permite identificar de forma precoz áreas de discapacidad física, psíquica o relacional que en un futuro pudieran abocarse a dependencia funcional (AU)

Functional dependency is defined as the loss of physical, mental or intellectual autonomy due to health related factors. Disability is an inseparable but not reciprocal attribute of dependency. Functional dependency is therefore a consequence of a disability but not all persons with disabilities are functionally dependents as they may not require any help from others. The objective of the study is to evaluate disability and functional dependency comparing the scores obtained using the Barthel Index and the World Health Organization Disability Assessment Schedule version 2 and relate these scores to the age adjusted - functional dependency predictor Charlson Comorbidity Index to assess the consistency of all these methods. Material and method: Cross - sectional epidemiological study. Result: Significant comorbidity correlation (p<0,05) between the Barthel Index and the World Health Organization Disability Assessment Schedule version 2 scores and the age adjusted Charlson Comorbidity Index was found by analyzing together all the values but functional dependency correlation seems to be stronger than disability’s. Conclusions: The evaluation of disability and its ascription and tabulation in the frame of a classification such as the International Functionality, Disability and Health Classification allow us to early identify physical, mental or relational disability areas that may evolve to a functional dependency (AU)

Impact of incident comorbidity on functional loss in elderly chronic kidney disease patients undergoing hemodialysis.

The incidence of end stage renal disease in older persons has been increasing progressively over the last 10 years. Improved survival rates with renal replacement therapy are making this increased prevalence even more pronounced. The usual risks of morbidity and requirements for specialized care associated with older people increase dramatically when they have chronic kidney disease (CKD). It has been seen that the majority of patients in hemodialysis units are over the age of 60, and have significant co-morbidities. The relationship between older age, chronic disorders and functional dependence (FD) is well known. Accordingly, nursing care planning must be designed with this in mind. The aim of this study was to assess whether the comorbidity associated with CKD modifies FD in patients on hemodialysis. We undertook a prospective longitudinal cohort study of hemodialysis outpatients in Málaga, Spain, using the Barthel test to establish FD and the Charlson comorbidity index to quantify comorbidity. All health events were analyzed to select those study patients with incident comorbidity, understood as the appearance of a new disease that could modify the Charlson comorbidity index, and determine the change in FD. Multivariate linear regression showed that the best model for predicting functional loss was that which considered comorbidity adjusted for age, particularly when it occurred as a result of hospital admission, as it was shown to have an important predictive value for the onset of a decrease in functional dependency scores in patients with CKD.