Vivencias y percepción de los profesionales sanitarios de las urgencias extrahospitalarias ante las agresiones / Experiences and perception of health professionals of out-of-hospital emergencies in the face of attacks

Objetivo: Conocer las opiniones de los profesionales sanitarios que trabajan en el Punto de Atención Continuada de Ourense (PAC) con relación a las agresiones laborales. Diseño: Estudio cualitativo con enfoque fenomenológico realizado entre enero y mayo del 2019. Emplazamiento: PAC. Participantes: Veinte profesionales de distintas categorías. Médodo: Muestreo estructural. Se emplearon entrevistas abiertas grabadas en audio, previo consentimiento de los participantes. Resultados: Los profesionales entrevistados manifiestas haber sido víctimas de agresiones, sobre todo verbales. Estas agresiones según los participantes son tan habituales que las han normalizado dentro de su jornada laboral. Ninguno ha denunciado nunca este tipo de conductas, en gran medida porque consideran que la burocracia y los trámites administrativos son tediosos, y otros por desconocimiento del procedimiento. Este tipo de situaciones, a nivel laboral, les causa sentimientos de tristeza, rabia e impotencia y son la causa, según ellos, del aumento de la medicina defensiva. Los profesionales consideran que la causa del aumento de las agresiones entre el colectivo es la mala educación y la gestión inadecuada del empoderamiento del paciente. Conclusiones: Los profesionales sanitarios sufren continuamente agresiones, sobre todo de tipo verbal, siendo algo habitual en su día a día. Estas agresiones no son denunciadas, pero les causan múltiples sentimientos negativos y disruptivos, llegando a modificar su manera de trabajar.(AU)

Objective: To know the opinions of the health professionals who work at the Ourense Continuous Care Point (PAC) regarding work aggressions. Design: Qualitative study with phenomenological approach carried out between January and May 2019. Setting: PAC. Participants: Twenty professionals of different categories. Method: Structural sampling. Open interviews recorded in audio were used, with the prior consent of the participants. Results: The interviewed professionals state that they have been victims of aggressions, especially verbal ones. These aggressions according to the participants are so common that they have normalized them within their working day. None has ever denounced this type of behavior, largely because they consider that the bureaucracy and administrative procedures are tedious, and others due to ignorance of the procedure. These types of situations, at work level, cause them feelings of sadness, anger and helplessness and are the cause according to them, of the increase in defensive medicine. Professionals believe that the cause of the increase in aggressions among the group is due to poor education and inadequate management of patient empowerment. Conclusions: Health professionals continually suffer aggressions, especially verbal, being common in their day to day. These attacks are not reported, but they cause multiple negative and disruptive feelings, changing their way of working.(AU)

[Experiences and perception of health professionals of out-of-hospital emergencies in the face of attacks]. / Vivencias y percepción de los profesionales sanitarios de las urgencias extrahospitalarias ante las agresiones.

OBJECTIVE: To know the opinions of the health professionals who work at the Ourense Continuous Care Point (PAC) regarding work aggressions. DESIGN: Qualitative study with phenomenological approach carried out between January and May 2019. SETTING: PAC. PARTICIPANTS: Twenty professionals of different categories. METHOD: Structural sampling. Open interviews recorded in audio were used, with the prior consent of the participants. RESULTS: The interviewed professionals state that they have been victims of aggressions, especially verbal ones. These aggressions according to the participants are so common that they have normalized them within their working day. None has ever denounced this type of behavior, largely because they consider that the bureaucracy and administrative procedures are tedious, and others due to ignorance of the procedure. These types of situations, at work level, cause them feelings of sadness, anger and helplessness and are the cause according to them, of the increase in defensive medicine. Professionals believe that the cause of the increase in aggressions among the group is due to poor education and inadequate management of patient empowerment. CONCLUSIONS: Health professionals continually suffer aggressions, especially verbal, being common in their day to day. These attacks are not reported, but they cause multiple negative and disruptive feelings, changing their way of working.

Vivencias y sentimientos de los pacientes con Parkinson / Experiences and feelings of patients with Parkinson's

OBJETIVO: Conocer a través de los propios pacientes cómo es el proceso de convivir con la enfermedad de Parkinson. MÉTODO: Estudio cualitativo de enfoque fenomenológico. La muestra estuvo constituida por 6 participantes. Los datos se obtuvieron a través de una entrevista individual semiestructurada. Las conversaciones fueron grabadas en audio, con el consentimiento de los participantes, y luego fueron transcritas haciendo un análisis temático. Este estudio fue aprobado por el pertinente comité de ética de investigación. RESULTADOS: Del análisis de los datos surgieron 6 categorías: aceptación; afrontamiento; familia y amigos; la sociedad y el Parkinson; instituciones e investigación; y futuro. Todos los sujetos recuerdan el día del diagnóstico y coinciden en que este se prolonga demasiado en el tiempo. A partir de ese momento empezaron a desarrollar mecanismos de adaptación y afrontamiento que se vieron beneficiados o perjudicados por diversos aspectos como: la medicación, los síntomas presentes, el trabajo o el estado anímico, otorgando al apoyo familiar un papel fundamental. Expresan que actualmente la sociedad no comprende a las personas con Parkinson. CONCLUSIONES: El Parkinson es una enfermedad muy desconocida para la sociedad, lo que dificulta la aceptación y afrontamiento de la enfermedad por parte de los afectados. El estado anímico es fundamental para lograr adaptarse a la enfermedad e integrarla en el día a día, mientras que la familia es un pilar importante en dicho proceso

OBJECTIVE: To discover through the patients themselves the process of coexisting with Parkinson's disease. METHOD: Qualitative study of phenomenological approach. The sample consisted of 6 participants. The data was obtained through a semi-structured individual interview. The conversations were audio recorded, with the consent of the participants, and then transcribed to make a thematic analysis. This study was approved by the relevant Research Ethics Committee. RESULTS: From the analysis of the data, 6 categories emerged: Acceptance; Coping; Family and friends; Society and Parkinson's; Institutions and research; Future. All the subjects remembered the day of the diagnosis, and agreed that this takes too long. From that moment they began to develop adaptation and coping mechanisms that were benefited or harmed by various aspects such as: medication, present symptoms, work or mood, making family support fundamental. They expressed that society does not currently understand people with Parkinson's disease. CONCLUSIONS: Parkinson's disease is largely unknown to society, which makes it difficult for those affected to accept and cope with the disease. State of mind is essential to adapt to the disease, and integrate it into daily living, while the family is an important pillar in this process

Percepción y sentimientos ante la estigmatización de personas con esquizofrenia / Perception and feelings towards stigmatization of people with schizophrenia

OBJETIVO: conocer qué piensan y sienten las personas con esquizofrenia ante la autopercepción del estigma de su enfermedad. MÉTODO: se realizó un estudio cualitativo con enfoque fenomenológico. La población de estudio fueron los usuarios del Centro de Día de la Asociación Morea (Asociación de familiares y enfermos mentales) de Ourense. El muestreo fue intencional, seleccionándose siete personas mayores de edad con diagnóstico de esquizofrenia (DMS-5), con una evolución mínima de dos años. Para la recogida de los datos se utilizó entrevista semiestructurada individual (dos entrevistas consecutivas al mismo sujeto), efecuada por dos entrevistadores, que fueron grabadas y transcritas. Se llevó a cabo análisis temático (identificación y categorización de los principales ejes de significado subyacentes en los datos). RESULTADOS: tras el análisis de las entrevistas se detectaron cinco categorías temáticas: "culpabilidad", "roles sociales", "miedo al rechazo y peligrosidad", "responsabilidad" y "pérdida de capacidades y control". Todos los participantes son conscientes de su enfermedad, de su cronicidad y de que tendrán que tomar tratamiento de por vida. Manifiestan haber perdido relaciones con amigos e incluso familia a raíz de su enfermedad. La mayoría percibe que el resto de la población les tiene miedo. Todos consideran que la enfermedad les ha hecho perder capacidades como la memoria, la atención y la autonomía para algunas facetas de la vida. CONCLUSIONES: las personas con esquizofrenia se sienten estigmatizadas por la sociedad. A colación de los resultados obtenidos parece necesario aumentar la información y educación en la población para disminuir el estigma y los prejuicios hacia las personas que padecen esquizofrenia y poder así facilitar su plena integración en la sociedad

OBJECTIVE: to understand the feelings and thoughts of people with schizophrenia faced with their own perception of the stigma associated with their disease. METHODS: a qualitative study with phenomenological approach. The study population was the users of the Morea Association Day Centre (Association of mental patients and relatives) in Ourense. The sample was intentional, and seven persons of age with diagnosis of schizophrenia were selected (DMS-5), with a minimum two-year evolution. Individual semi-structured interview was used for data collection (two consecutive interviews with the same subject), conducted by two interviewers, which were recorded and transcribed. Thematic analysis was conducted (identification and classification of the main axes of meaning underlying in data). RESULTS: after the analysis of the interviews, five thematic categories were detected: "guilt", "social roles", "fear of rejection and danger", "responsibility" and "loss of abilities and control". All participants were aware of their disease, its chronicity and that they would have to take life-long treatment. They stated that they had lost contact with friends and even relatives due to their disease. Most of them perceived that the rest of the population was afraid of them. All of them considered that their disease had led them to lose abilities such as memory, attention, and independence for some aspects in life. CONCLUSIONS: people with schizophrenia feel stigmatized by society. Based on the results obtained, it seems necessary to increase information and education among the population in order to reduce the stigma and prejudices towards people who suffer schizophrenia, and thus facilitate their complete integration into the society

Experiences and feelings of patients with Parkinson's. / Vivencias y sentimientos de los pacientes con Parkinson.

OBJECTIVE: To discover through the patients themselves the process of coexisting with Parkinson's disease. METHOD: Qualitative study of phenomenological approach. The sample consisted of 6 participants. The data was obtained through a semi-structured individual interview. The conversations were audio recorded, with the consent of the participants, and then transcribed to make a thematic analysis. This study was approved by the relevant Research Ethics Committee. RESULTS: From the analysis of the data, 6 categories emerged: Acceptance; Coping; Family and friends; Society and Parkinson's; Institutions and research; Future. All the subjects remembered the day of the diagnosis, and agreed that this takes too long. From that moment they began to develop adaptation and coping mechanisms that were benefited or harmed by various aspects such as: medication, present symptoms, work or mood, making family support fundamental. They expressed that society does not currently understand people with Parkinson's disease. CONCLUSIONS: Parkinson's disease is largely unknown to society, which makes it difficult for those affected to accept and cope with the disease. State of mind is essential to adapt to the disease, and integrate it into daily living, while the family is an important pillar in this process.

Afrontamiento y manejo de la enfermedad en pacientes con diabetes mellitus tipo 1 / Coping and management of the disease in patients with diabetes mellitus type 1

Objetivo. Indagar sobre el tipo de afrontamiento que realizan los pacientes con DM tipo 1 que acuden a una consulta de educación de enfermería y analizar si existe relación entre el tipo de afrontamiento (EA) y el control-automanejo de la enfermedad. Método. Estudio descriptivo transversal realizado sobre todos los pacientes que acuden a una consulta de educación diabetológica en el Hospital de Ourense. Se recogieron variables sociodemográficas, clínicas y relacionadas con el manejo de la DM. Para la evaluación de los EA se utilizó el Cuestionario Médico de Estrategias de Afrontamiento de Feifel, que diferencia 3 EA: confrontación (C), evitación (E) y/o aceptación resignada (AR), estableciendo un índice total de afrontamiento (IMCMQ). Los datos fueron analizados con el programa SPPS 15.0. Resultados. Participaron 51 pacientes. El perfil de paciente es un hombre que lleva 14,56 años (± 11,44) diagnosticado de DM, siendo sus últimas cifras de hemoglobina glicosilada (HbGl) de 7,5% (± 1,04). Las puntuaciones para los EA fueron: C 21 ± 3,4; E 11,73 (± 3,5); AR 8,47 (± 1,02); IMCMQ 1,013 (± 0,23). Encontramos diferencias significativas (p=0,01) entre el IMCMQ y los valores de HbGl. Conclusiones. Nuestros pacientes utilizan un EA-C, entendido éste como aquel en el que la persona trata de entender y abordar abiertamente la situación. Es el estilo más eficaz y el de mejor pronóstico. A la luz de los datos obtenidos podemos inferir que nuestros pacientes poseen un EA activo y adecuado hacia la DM y que éste influye positivamente en el control de sus valores de HbGl (AU)

Objective. To investigate how patients with DM Type 1 attending a nursing education clinic cope with the disease and to analyse the relationships between the style of coping (CS) and control-self-management of the disease. Method. A cross sectional study was performed on all patients attending a diabetes education consultation at the Hospital of Ourense. The sociodemographic and clinical variables, as well as those related to the management of DM were collected. The Medical Questionnaire Coping Strategies of Feifel was used to assess the CS using 3 different models: confrontation (C), avoidance (A) and/or resigned acceptance (RA), and a total coping index (IMCMQ) was established. The data were analysed with SPSS 15.0 statistics program. Results. A total of 51 patients. The average profile of patient is of a male who had been diagnosed with DM for 14.56 years (±11.44), and with latest HbA1c levels of 7.5% (±1.04). The scores for the CS were: C 21±3.4, A 11.73 (±3.5), RA 8.47 (±1.02); IMCMQ 1.013 (±0.23). As for the relationship between the IMCMQ score and the latest HbA1c values, there were significant differences (P=0.01). Conclusions. Our patients use the CS-C, understood as one in which a person tries to understand and address the situation openly. This style is the most effective and associated with best prognosis. In light of the data obtained, we can infer that our patients have an active and appropriate CS and it has a positive impact on their HbA1c values (AU)

[Coping and management of the disease in patients with diabetes mellitus type 1]. / Afrontamiento y manejo de la enfermedad en pacientes con diabetes mellitus tipo 1.

OBJECTIVE: To investigate how patients with DM Type 1 attending a nursing education clinic cope with the disease and to analyse the relationships between the style of coping (CS) and control-self-management of the disease. METHOD: A cross sectional study was performed on all patients attending a diabetes education consultation at the Hospital of Ourense. The sociodemographic and clinical variables, as well as those related to the management of DM were collected. The Medical Questionnaire Coping Strategies of Feifel was used to assess the CS using 3 different models: confrontation (C), avoidance (A) and/or resigned acceptance (RA), and a total coping index (IMCMQ) was established. The data were analysed with SPSS 15.0 statistics program. RESULTS: A total of 51 patients. The average profile of patient is of a male who had been diagnosed with DM for 14.56 years (±11.44), and with latest HbA1c levels of 7.5% (±1.04). The scores for the CS were: C 21±3.4, A 11.73 (±3.5), RA 8.47 (±1.02); IMCMQ 1.013 (±0.23). As for the relationship between the IMCMQ score and the latest HbA1c values, there were significant differences (P=0.01). CONCLUSIONS: Our patients use the CS-C, understood as one in which a person tries to understand and address the situation openly. This style is the most effective and associated with best prognosis. In light of the data obtained, we can infer that our patients have an active and appropriate CS and it has a positive impact on their HbA1c values.

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