Obesity as a Risk Factor in the Appearance of Haematomas Caused by Low-Molecular-Weight Heparin: A Cross-Sectional Study.

Thromboembolic disease (TED) is an important health problem in Europe due to its high morbimortality. Pharmacological prevention is achieved with low-molecular-weight heparin (LMWH), among other strategies, which are supported by a high degree of evidence in the scientific literature. According to its safety data sheet, this injection produces local injuries at a rate of 0.1-1% after administration; however, these percentages are much lower than others reported in several studies focusing on LMWH (44-88%). This high incidence of injuries might be associated with procedural or individual variables. (1) Background: Among the most frequent side effects after the administration of LMWH are pain and haematomas (HMTs), which are influenced by obesity. We aimed to determine the relationship between abdominal skinfold (ASF) value and incidence of HMTs. In addition, I sought to determine how the risk of HMT changed with each mm increase in ASF. (2) Methods: A cross-sectional descriptive study developed in the hospital unit of orthopaedic and trauma surgery was conducted over one year. All participants in the sample were classified based on their ASF and the appearance and area of HMTs were assessed after the administration of enoxaparin. The STROBE checklist was used to evaluate the study. Descriptive statistical analysis and analysis of variance of non-parametric factors were carried out. (3) Results: In a sample of 202 participants (808 Clexane injections), more than 80% presented HMTs. More than 70% of the sample was overweight and more than 50% had an ASF > 36 millimetres (mm). (4) Conclusions: An ASF over 36 mm confers a higher risk of developing HMTs: with each mm increase in the ASF, the risk increases by 4%. Participants who are overweight or obese also present a higher risk of HMT, and these conditions correlate positively with the area of the HMTs. Providing education for the self-administration of the drug after discharge and information about the probability of suffering from local injuries in a more individualised way will lead to fewer primary care nursing consultations, more adherence to the antithrombotic treatment, and, as a consequence, a decrease in TED and health costs.

Conocimientos adquiridos mediante una intervención educativa grupal en pacientes con tratamiento anticoagulante oral / Knowledge acquired through a group educational intervention in patients on oral anticoagulant therapy

Objetivo: analizar el incremento de conocimientos y el grado de satisfacción obtenidos mediante una intervención educativa para las personas en tratamiento anticoagulante (TAO) seguidas en Atención Primaria. Método: estudio antes-después sin grupo control. La población fueron personas en TAO en seguimiento en el Área de Salud de Gran Canaria (40 centros de salud (CS); N= 11.808). Se estimó una muestra de 250 personas. Se realizó una sesión educativa teórica (40 min) y práctica (60 min) dirigida por una enfermera con grupos de ocho a 16 personas. Se midieron basalmente variables sociodemográficas, clínicas, de tratamiento, conocimientos en anticoagulación medidos con el cuestionario OAK (mín. 0 a máx. 20 puntos) y la satisfacción con la sesión. Se reevaluó el conocimiento a los cuatro meses. Se llevó a cabo estadística descriptiva y bivariante. Resultados: participaron 145 personas de 23 centros de salud (x= 66,9 años; 55,2% hombres). Hubo un aumento del porcentaje de respuestas acertadas y una disminución de las respuestas en blanco en todas las preguntas, siendo estadísticamente significativo el cambio en 16 de ellas (p< 0,05). La media de puntuación del cuestionario OAK aumentó de manera estadísticamente significativa [pretest (= 9,6); postest (=13,8);p= 0,000)]. Un 84,8% de los sujetos había mejorado sus conocimientos tras haber participado en la sesión. El 80% o más encontró muy adecuados distintos aspectos de la sesión. El 91% la recomendaría a otros pacientes. Conclusión: hubo un mayor nivel de conocimientos en anticoagulación a los cuatro meses de la participación en la sesión educativa grupal guiada por una enfermera.(AU)

Objective: to analyse the increase in knowledge and level of satisfaction achieved through an educational intervention for persons on anticoagulant therapy (OAT) followed up at Primary Care. Method: a before-and-after study without control arm. The population was formed by patients on OAT followed up at the Gran Canaria Health Area (40 primary care centres (PCCs); N=11,808). The sample was calculated at 250 persons. A theoretical education session (40 minutes), and a practical session (60 minutes) were led by a nurse with groups from eight to sixteen persons. The following variables were measured at baseline: sociodemographic, clinical, treatment-related, knowledge on anticoagulation measured with the OAK questionnaire (minimum score: 0, maximum score: 20 points), and satisfaction with the session. Knowledge was re-evaluated at four months. Descriptive and bivariate statistics was conducted. Results: the study included 145 persons from 23 PCCs (x= 66.9 years; 55.2% male). There was an increase in the proportion of correct answers and a reduction in blank answers for all questions; the change in 16 of them was statistically significant (p< 0.05). There was a statistically significant increase in the mean score for the OAK questionnaire [pre-test (= 9.6); post-test (=13.8); p= 0.000)]. In total, 845 of the subjects had improved their knowledge after their participation in the session; 80% or more found that different aspects of the session were very adequate, and 91% would recommend it to other patients. Conclusion: there was a higher level of knowledge regarding anticoagulation four months after participating in the group educational session led by a nurse.(AU)

Influence of Hospital Environmental Variables on Thermometric Measurements and Level of Concordance: A Cross-Sectional Descriptive Study.

During a pandemic, and given the need to quickly screen febrile and non-febrile humans, it is necessary to know the concordance between different thermometers (TMs) and understand how environmental factors influence the measurements made by these instruments. OBJECTIVE: The objective of this study is to identify the potential influence of environmental factors on the measurements made by four different TMs and the concordance between these instruments in a hospital setting. METHOD: The study employed a cross-sectional observational methodology. The participants were patients who had been hospitalised in the traumatology unit. The variables were body temperature, room temperature, room relative humidity, light, and noise. The instruments used were a Non Contract Infrared TM, Axillary Electronic TM, Gallium TM, and Tympanic TM. A lux meter, a sound level meter, and a thermohygrometer measured the ambient variables. RESULTS: The study sample included 288 participants. Weak significant relationships were found between noise and body temperature measured with Tympanic Infrared TM, r = -0.146 (p < 0.01) and likewise between environmental temperature and this same TM, r = 0.133 (p < 0.05). The concordance between the measurements made by the four different TMs showed an Intraclass Correlation Coefficient (ICC) of 0.479. CONCLUSIONS: The concordance between the four TMs was considered "fair".

Influence of Skin Phototype on the Level of Pain Perceived by Patients Receiving Enoxaparin: A Cross-Sectional Study.

Low Molecular Weight Heparin (LMWH) is commonly used as an antithrombotic in patients with reduced mobility. Its administration is performed by invasive technique (injections) that can cause pain: (1) Background: Pain and bruising are the most common side effects in patients treated with LMWH, but the skin phototype (PT) has never been included; (2) Methods: A cross-sectional descriptive study, developed in the Hospital Unit of Orthopedic and Trauma Surgery over one year. To classify all participants in the sample considering their skin PT and the different pain levels "during" and "after" the administration of enoxaparin. The STROBE checklist was used to evaluate the study. Data analyses were carried out: descriptive statistical analysis and analysis of Variance ANOVA of a non-parametric factor; (3) Results: The sample was 202 participants. The most frequent skin PTs were PT II 43.6% and PT III 33.2%. Mean pain after injection (1.96) was greater than pain during injection (1.4). Better natural protection against sunlight (high PT) would indicate greater post-injection pain; (4) Conclusions: Participants with a medium-high phototype (≥III) perceive a greater pain sensation than participants with a low phototype (≤II) after the administration of enoxaparin.

Situation of the Elderly Living Alone: Morbidity and Services Provided from the Field of Primary Health Care of Gran Canaria.

The elderly suffer a greater number of health problems and have greater need for assistance and care. (1) Background: to determine the profile of the elderly who live alone, identified according to the Primary Care Health Record of Gran Canaria, and to analyze the sociodemographic data of the target population and determine the characteristics related to morbidity. (2) Methods: descriptive, prospective, cross-sectional study carried out in the Primary Health Care Management of Gran Canaria. The study population was all adults over 65 years of age living alone. The instrument used was the Drago-Electronic Health Record. Data analysis was carried out using RStudio version 1.1.447 software, and descriptive analysis and inferential analysis were carried out using the Chi-square values, T-test for independent samples, and ANOVA. (3) Results: The sample amounted to 8679 subjects, predominantly female sex (86.14%) and with a mean age of 79.4 years. Of the sample, 6.4% lived alone. Based on the classification by Adjusted Morbidity Groups (AMG), subjects with "moderate complications" predominated at 45.5%. (4) Conclusions: It is necessary to implement this type of stratification tool, which allows interventions to be carried out in elderly people at risk.