[Design and validation of SAHERA questionnaire to assess patient satisfaction in a Rehabilitation Service]. / Diseño y validación del cuestionario SAREHA para evaluar la satisfacción de los pacientes en un Servicio de Rehabilitación.

The development of a questionnaire that measures user satisfaction in the area of Rehabilitation is essential in order to measure the success achieved and to be able to introduce actions to improve health care. OBJECTIVE: To design and validate a questionnaire to assess the satisfaction of the care received in a Rehabilitation Department. MATERIAL AND METHODS: A cross-sectional study was carried out in the Rehabilitation Department of the Complejo Asistencial Universitario de Salamanca (CAUSA). A questionnaire was designed and prepared by experts using the Delphi technique. For the face validity, a pilot study was used using focal groups (doctors, nursing staff, physiotherapists, occupational therapists, and patients). An evaluation was made of the reliability (intraclass correlation coefficient) and internal consistency (Cronbach alpha). In a second stage, it was completed by 207 patients. The questionnaire consisted of 24 items that evaluated 4 dimensions: care/relationship, information/treatment, infrastructure, and general evaluation. RESULTS: A Cronbach alpha and intraclass correlation of greater than 0.8 was obtained in the first stage using a pilot test on 40 patients with a mean age of 58 years (SD ±16). The scale showed a good internal consistency in its final version (Cronbach alpha of 0.82) and an adequate stability (intraclass correlation of 0.8). CONCLUSIONS: The data obtained in the study showed that the designed questionnaire had a reliability of validity. And for this reason, it would be a valid and reliable tool for measuring the satisfaction of the care received by patients in Rehabilitation Departments.

[Prognostic factors in severe traumatic brain injury]. / Factores pronósticos del traumatismo craneoencefálico grave.

OBJECTIVE: To describe the factors associated to mortality of patients with severe traumatic brain injury (TBI). DESIGN: A retrospective observational study was made of patients with severe TBI covering the period between 1 January 2007 and 31 December 2010. SETTING: Virgen de la Vega Hospital, Salamanca (Spain). PATIENTS: All patients hospitalized during the consecutive study period. MAIN VARIABLES OF INTEREST: The dependent variable has been the death rate, while the independent variables were divided into two groups: epidemiological and clinical. RESULTS: The mean patient age was the 50.84 years; 75.5% were males. The average score on the Glasgow Coma Scale (GCS) was 5.09, and the average Injury Severity Score (ISS) was 30.8. Higher mortality was observed in older patients with a higher ISS score. A total of 68.1% of the patients in which intracranial pressure (ICP) was monitored showed intracranial hypertension (ICH). The mortality rate in patients with severe TBI was 36.8%, and was associated mainly to a lower GCS score, the existence of hyperglycemia, coagulopathy, hypoxemia, the presence of mydriasis and shock. The independent mortality indicators in patients with severe TBI were the existence of mydriasis (OR: 32.75), the GCS score (OR: 2.65) and hyperglycemia (OR: 6.08). CONCLUSIONS: The existence of mydriasis, the GCS score and hyperglycemia should be taken into account as prognostic factors in TBI patients.