Análisis de la salud de la población sin hogar de un distrito desfavorecido de Barcelona. Estudio ESSELLA / Analysis of the homeless population health in a disadvantaged district of Barcelona: ESSELLA study

Objetivo: Conocer el estado de salud de la población sin hogar. Diseño: Estudio descriptivo transversal. Emplazamiento: Centro de Salud de Atención Primaria de Raval Sud (Barcelona). Participantes: Personas mayores de edad en situación de sinhogarismo que han pernoctado en la calle en algún momento. Mediciones principales: Datos sociodemográficos y tiempo en situación de sinhogarismo. Patologías crónicas, enfermedades infecciosas transmisibles, enfermedades mentales y trastornos por uso de sustancias adictivas. Cuestionario HAD sobre ansiedad y depresión. Cuestionario CVRS EQ-5D-3L. Estadística descriptiva. Resultados: Se analizó la información de 146 pacientes con una media de edad de 51,6 años (DE=12,8), 87% de sexo masculino y una media de 12 años (DE=11,9) en situación de sinhogarismo. Se comparó la carga de enfermedad entre el perfil CAS Drogodependencias (Baluard) y el perfil sociosanitario (Arrels Fundació). Los usuarios del CAS presentaron mayores porcentajes de trastornos por uso de sustancias, enfermedades mentales y enfermedades infecciosas transmisibles. Las personas de perfil sociosanitario presentaron en mayor porcentaje enfermedades crónicas (respiratorias, cardiovasculares y oncológicas) y más de la mitad presentaron un trastorno por uso de alcohol y un mayor porcentaje de enfermedad asociada a su consumo. Conclusiones: La población sin hogar presenta una elevada carga de enfermedad especialmente para enfermedad mental, adicciones y enfermedades infecciosas transmisibles. Creemos que son necesarios estudios para evaluar el exceso de enfermedad respecto a la población general con sus costes derivados y el diseño de nuevas estrategias para atender dicha carga de enfermedad y su especificidad.(AU)

Objective: To assess the health status of the homeless population. Design: Cross-sectional descriptive study. Setting: Raval Sud Primary Care Health Center (Barcelona). Participants: Homeless legal age people who have slept rough at some point in their lives. Main measurements: Sociodemographic data and time in a situation of homelessness. Chronic pathologies, transmissible infectious diseases, mental illnesses and substance use disorders. HAD questionnaire on anxiety and depression. CVRS EQ-5D-3L questionnaire. Descriptive statistics. Results: The information of 146 patients with a mean age of 51.6 years (SD=12.8), 87% male and a mean of 12 years (SD=11.9) in a situation of homelessness was analyzed. The burden of disease was compared between the CAS profile (Drug addiction center – Baluard) and the socio-sanitary profile (Arrels Foundation). CAS users presented higher percentages of substance use disorders, mental illnesses and transmissible infectious diseases. People with a socio-health profile presented a higher percentage of chronic diseases (respiratory, cardiovascular and oncological) and more than half presented an alcohol use disorder and a higher percentage of disease associated with its consumption. Conclusions: The homeless population presents a high burden of disease, especially for mental illness, addictions and transmissible infectious diseases. We believe that studies are necessary to evaluate the disease excess compared to the general population with its derived costs and to design new strategies to address this burden of disease and its specificity.(AU)

[Analysis of the homeless population health in a disadvantaged district of Barcelona: ESSELLA study]. / Análisis de la salud de la población sin hogar de un distrito desfavorecido de Barcelona. Estudio ESSELLA.

OBJECTIVE: To assess the health status of the homeless population. DESIGN: Cross-sectional descriptive study. SETTING: Raval Sud Primary Care Health Center (Barcelona). PARTICIPANTS: Homeless legal age people who have slept rough at some point in their lives. MAIN MEASUREMENTS: Sociodemographic data and time in a situation of homelessness. Chronic pathologies, transmissible infectious diseases, mental illnesses and substance use disorders. HAD questionnaire on anxiety and depression. CVRS EQ-5D-3L questionnaire. Descriptive statistics. RESULTS: The information of 146 patients with a mean age of 51.6 years (SD=12.8), 87% male and a mean of 12 years (SD=11.9) in a situation of homelessness was analyzed. The burden of disease was compared between the CAS profile (Drug addiction center - Baluard) and the socio-sanitary profile (Arrels Foundation). CAS users presented higher percentages of substance use disorders, mental illnesses and transmissible infectious diseases. People with a socio-health profile presented a higher percentage of chronic diseases (respiratory, cardiovascular and oncological) and more than half presented an alcohol use disorder and a higher percentage of disease associated with its consumption. CONCLUSIONS: The homeless population presents a high burden of disease, especially for mental illness, addictions and transmissible infectious diseases. We believe that studies are necessary to evaluate the disease excess compared to the general population with its derived costs and to design new strategies to address this burden of disease and its specificity.

Test Raval Sud para medir habilidades de soporte vital básico y desfibrilación en médicos y enfermeras de atención primaria / Test to measure basic life support and defribillation skills in primary care doctors and nurses

ObjetivoElaborar y validar un instrumento para medir aptitudes en soporte vital básico (SVB) y desfibrilación semiautomática (DSA) adaptado a los profesionales sanitarios de equipos de atención primaria. Proponer una versión actualizada y demostrar autosuficiencia del equipo para utilizarlo en evaluación formativa.DiseñoValidación de instrumentos de medida. Estudio de fiabilidad con medidas repetidas tras intervención formativa.EmplazamientoCentro de atención primaria Drassanes. Área Básica de Salud Raval Sud.ParticipantesTreinta y siete rescatadores voluntarios (total entre médicos y enfermeras), cámara profesional, médico controlador, maniquí informatizado, 6 evaluadores.IntervencionesMetodología de elaboración de test. Modelo Cardiff versión 3.1 (que se encuentra en internet). Ejecución: 2 series filmadas (una profesional y otra doméstica), de 26 a 25 simulaciones “tipo estación”, separadas por un mes. Taller formativo entre series. Evaluación retrospectiva de grabaciones DVD (6 evaluadores). Segunda serie nuevamente puntuada a las 3 semanas con ciego de versión filmada y orden aleatorizado.Mediciones principalesVariables: actuaciones categorizadas de peor a mejor ejecución. Análisis psicométrico: validez (contenido/aparente). Fiabilidad test-retest, intraobservador y sensibilidad al cambio.ResultadosRespecto al test de Cardiff (46 ítems), este test de 83 ítems contiene 38 (46%) nuevos, 34 (41%) modificados y 11 (13%) similares. La fiabilidad entre evaluadores fue excelente/buena en 51 de 62 ítems analizados; fiabilidad intraevaluador y entre filmaciones excelente/buena en todos los ítems, menos en uno; la prueba dobló la puntuación tras intervención formativa. Se propone una versión del test según las recomendaciones actuales en SVB y DSA(AU)

ConclusionesAl no disponer de instrumentos útiles para los médicos y enfermeras de atención primaria se ha elaborado uno con suficientes garantías psicométricas y se ha probado autosuficiencia evaluativa. Se propone aplicabilidad inmediata de la versión actualizada con fines de evaluación formativa(AU)

ObjectiveTo prepare and validate a tool to measure Basic Life Support (BLS) and semi-automatic defibrillator (SAD) skills adapted for use by health professionals in Primary Care Teams (PCT). To propose an updated version and demonstrate self-sufficiency of the team to use it in a training evaluation.DesignValidation of measurement tools. Study of reliability with repeated measurements after a training course.SettingDrassanes Primary Care Centre. Raval Sud Basic Health Area. Barcelona. Spain.ParticipantsA total of 37 voluntary resuscitators (all doctors/nurses), professional camera, medical controller, computerised mannequin, 6 evaluators.InterventionsTest preparation methodology. Cardiff Model 3.1. Implementation: 2 filmed series (professional+domestic), of 26-25 “station type” simulations, separated by 1 month. A training workshop between series. Retrospective evaluation of DVD recordings (5 evaluators). 2nd series scored again at 3 weeks with a blind and random order filmed version.Main measurementsVariables: performances classified from worse to best execution. Psychometric analysis: Validity (content/apparent). Test-retest reliability, between-observer and sensitivity to change.ResultsCompared to the Cardiff test (46 items) our 83 item test contained 38(46%) new, 34(41%) modified and 11(13%) similar. Between-evaluator reliability, excellent/good in 51/62 items analysed; Within-evaluator and between-filming reliability, excellent/good in all except 1 item; the test score doubled after the training course. A version of the test according to BLS-SAD recommendations is proposed.ConclusionsOn there not being useful tools available for Primary Care doctors and nurses, one has been prepared with adequate psychometric guarantees and proven self-sufficient evaluation. We propose the immediate application of the updated version for training evaluation purposes(AU)

[Test to measure basic life support and defibrillation skills in primary care doctors and nurses]. / Test Raval Sud para medir habilidades de soporte vital básico y desfibrilación en médicos y enfermeras de atención primaria.

OBJECTIVE: To prepare and validate a tool to measure Basic Life Support (BLS) and semi-automatic defibrillator (SAD) skills adapted for use by health professionals in Primary Care Teams (PCT). To propose an updated version and demonstrate self-sufficiency of the team to use it in a training evaluation. DESIGN: Validation of measurement tools. Study of reliability with repeated measurements after a training course. SETTING: Drassanes Primary Care Centre. Raval Sud Basic Health Area. Barcelona. Spain. PARTICIPANTS: A total of 37 voluntary resuscitators (all doctors/nurses), professional camera, medical controller, computerised mannequin, 6 evaluators. INTERVENTIONS: Test preparation methodology. Cardiff Model 3.1. IMPLEMENTATION: 2 filmed series (professional+domestic), of 26-25 "station type" simulations, separated by 1 month. A training workshop between series. Retrospective evaluation of DVD recordings (5 evaluators). 2nd series scored again at 3 weeks with a blind and random order filmed version. VARIABLES: performances classified from worse to best execution. Psychometric analysis: Validity (content/apparent). Test-retest reliability, between-observer and sensitivity to change. RESULTS: Compared to the Cardiff test (46 items) our 83 item test contained 38(46%) new, 34(41%) modified and 11(13%) similar. Between-evaluator reliability, excellent/good in 51/62 items analysed; Within-evaluator and between-filming reliability, excellent/good in all except 1 item; the test score doubled after the training course. A version of the test according to BLS-SAD recommendations is proposed. CONCLUSIONS: On there not being useful tools available for Primary Care doctors and nurses, one has been prepared with adequate psychometric guarantees and proven self-sufficient evaluation. We propose the immediate application of the updated version for training evaluation purposes.