RESUMO
Objetivo: Determinar la prevalencia de úlceras de pierna y caracterizar los pacientes afectados, las lesiones y el tratamiento recibido. Método: Estudio observacional, transversal de prevalencia. Se diseñó un cuestionario online ad hoc que se envió a todas las enfermeras de Atención Primaria de la Gerencia de Atención Integrada de Cuenca (España), y se recogieron variables relativas a los pacientes estudiados (sociodemográficas y clínicas), a las lesiones y a las intervenciones recibidas (preventivas y de tratamiento). Resultados: Contestaron 152 profesionales (tasa de respuesta=98,1%), y fue posible estudiar a 131.190 habitantes. En total, se identificaron 63 pacientes (edad=75,5±12,6 años) con 75 lesiones, por lo que la prevalencia global fue de 0,480 (IC 95%: 0,375-0,614), y las lesiones se distribuyeron como: úlcera de etiología venosa 0,274 (n=36), pie diabético 0,145 (n=19), y úlcera de etiología arterial 0,061 (n=8). La prevalencia fue similar en hombres y mujeres (0,535 vs. 0,426 respectivamente, p=0,365), pero los hombres mostraron más pie diabético (0,214 vs. 0,076, P=0,037). Para los tres tipos de lesiones, las prevalencias aumentaron al subir la edad, llegando a 1,743 en mayores de 65 años. La mediana de duración y el área corregida de las úlceras fue 190,0±340,0 días y 5,0±13,7 cm2, respectivamente, y el 74,7% fueron recurrentes. Conclusiones: La prevalencia de úlceras de pierna encontrada es inferior a la de otros estudios, aunque con altas tasas de recurrencia. Los estimadores globales de estudios anteriores pueden haber sobreestimado la prevalencia, especialmente en regiones con un alto componente rural.(AU)
Objective: To determine the prevalence of leg ulcers, and to describe the affected patients, wounds, and treatment. Method: Observational, cross-sectional prevalence study. An ad hoc online questionnaire was sent to all nurses attending Primary Care centres of the Gerencia de Atención Integrada de Cuenca (Integrated Care Management of Cuenca, Spain). Data regarding patient sociodemographic and clinical variables, lesion characteristics and the type of intervention (concerning prevention and treatment) were collected. Results: In total, 152 professionals (response rate=98.1%) completed the questionnaire, collecting data from 131,190 inhabitants. A total of 63 patients (75.5±12.6 years old) with 75 ulcers were identified, finding an overall prevalence of 0.480 (CI 95%: 0.375-0.614), distributed as: venous ulcer 0.274 (n=36), diabetic foot 0.145 (n=19), and arterial ulcer 0.061 (n=8). The prevalence was similar regarding gender (0.535 vs. 0.426, respectively, p=.365), but men exhibited more diabetic foot (0.214 vs. 0.076, p=.037).In all three types of lesions prevalence increased with age, reaching 1.743 in 64+age group.The median of the leg ulcer duration and corrected area were 190.0±340.0 days and 5.0±13.7cm2, respectively, with a recurrence rate of 74.7%. Conclusions: The prevalence of chronic leg ulcers was lower than that reported in other studies, although with high recurrence rates. Overall estimators from previous studies may have overestimated the prevalence, especially in regions with a high rural component.(AU)
Assuntos
Humanos , Masculino , Feminino , Atenção Primária à Saúde , Enfermagem , Cuidados de Enfermagem , Pé Diabético , Infecção dos Ferimentos , Úlcera da Perna , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To determine the prevalence of leg ulcers, and to describe the affected patients, wounds, and treatment. METHOD: Observational, cross-sectional prevalence study. An ad hoc online questionnaire was sent to all nurses attending Primary Care centres of the "Gerencia de Atención Integrada de Cuenca" (Integrated Care Management of Cuenca, Spain). Data regarding patient sociodemographic and clinical variables, lesion characteristics and the type of intervention (concerning prevention and treatment) were collected. RESULTS: In total, 152 professionals (response rate = 98.1%) completed the questionnaire, collecting data from 131,190 inhabitants. A total of 63 patients (75.5 ± 12.6 years old) with 75 ulcers were identified, finding an overall prevalence of .480 (CI 95%: .375-.614), distributed as: venous ulcer .274 (n = 36), diabetic foot .145 (n = 19), and arterial ulcer .061 (n = 8). The prevalence was similar regarding gender (.535 vs .426, respectively, p = .365), but men exhibited more diabetic foot (.214 vs .076, p = .037). In all three types of lesions prevalence increased with age, reaching 1.743 in 64+ age group. The median of the leg ulcer duration and corrected area were 190.0 ± 340.0 days and 5.0 ± 13.7 cm2, respectively, with a recurrence rate of 74.7%. CONCLUSIONS: The prevalence of chronic leg ulcers was lower than that reported in other studies, although with high recurrence rates. Overall estimators from previous studies may have overestimated the prevalence, especially in regions with a high rural component.
Assuntos
Úlcera da Perna , Úlcera Varicosa , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Humanos , Úlcera da Perna/epidemiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Atenção Primária à Saúde , Úlcera Varicosa/epidemiologiaRESUMO
OBJECTIVE: To determine the prevalence of leg ulcers, and to describe the affected patients, wounds, and treatment. METHOD: Observational, cross-sectional prevalence study. An ad hoc online questionnaire was sent to all nurses attending Primary Care centres of the "Gerencia de Atención Integrada de Cuenca" (Integrated Care Management of Cuenca, Spain). Data regarding patient sociodemographic and clinical variables, lesion characteristics and the type of intervention (concerning prevention and treatment) were collected. RESULTS: In total, 152 professionals (response rate=98.1%) completed the questionnaire, collecting data from 131,190 inhabitants. A total of 63 patients (75.5±12.6 years old) with 75 ulcers were identified, finding an overall prevalence of 0.480 (CI 95%: 0.375-0.614), distributed as: venous ulcer 0.274 (n=36), diabetic foot 0.145 (n=19), and arterial ulcer 0.061 (n=8). The prevalence was similar regarding gender (0.535 vs. 0.426, respectively, p=.365), but men exhibited more diabetic foot (0.214 vs. 0.076, p=.037). In all three types of lesions prevalence increased with age, reaching 1.743 in 64+age group. The median of the leg ulcer duration and corrected area were 190.0±340.0 days and 5.0±13.7cm2, respectively, with a recurrence rate of 74.7%. CONCLUSIONS: The prevalence of chronic leg ulcers was lower than that reported in other studies, although with high recurrence rates. Overall estimators from previous studies may have overestimated the prevalence, especially in regions with a high rural component.
RESUMO
BACKGROUND: The quality of care in nursing homes is weakly defined, and has traditionally focused on quantify nursing homes outputs and on comparison of nursing homes' resources. Rarely the point of view of clients has been taken into account. The aim of this study was to ascertain what means "quality of care" for residents of nursing homes. METHODS: Grounded theory was used to design and analyze a qualitative study based on in-depth interviews with a theoretical sampling including 20 persons aged over 65 years with no cognitive impairment and eight proxy informants of residents with cognitive impairment, institutionalized at a public nursing home in Spain. RESULTS: Our analysis revealed that participants perceived the quality of care in two ways, as aspects related to the persons providing care and as institutional aspects of the care's process. All participants agreed that aspects related to the persons providing care was a pillar of quality, something that, in turn, embodied a series of emotional and technical professional competences. Regarding the institutional aspects of the care's process, participants laid emphasis on round-the-clock access to health care services and on professional's job stability. CONCLUSIONS: This paper includes perspectives of the nursing homes residents, which are largely absent. Incorporating residents' standpoints as a complement to traditional institutional criteria would furnish health providers and funding agencies with key information when it came to designing action plans and interventions aimed at achieving excellence in health care.
