Long-term sickness absence due to adjustment disorder.

BACKGROUND: Although adjustment disorder is frequently reported in clinical settings, scientific evidence is scarce regarding its impact on sickness absence and the variables associated with sickness absence duration. AIMS: To report sickness absence duration and to identify predictors of long-term sickness absence in patients with adjustment disorder. METHODS: This observational, prospective study included subjects with non-work-related sickness absence (>15 days) after a diagnosis of adjustment disorder. A stepwise logistic regression analysis was conducted to identify the best predictors of long-term sickness absence (≥ 6 months). RESULTS: There were 1182 subjects in the final analysis. The median duration of sickness absence due to adjustment disorder was 91 days. Twenty-two per cent of the subjects reported long-term sickness absence. After multivariate analysis, comorbidity (OR = 2.23, 95% CI 1.43-3.49), age (25-34 years old versus <25 years old: OR = 2.78, 95% CI 1.27-6.07; 35-44 years old versus <25 years old: OR = 3.70, 95% CI 1.71-7.99; 45-54 years old versus <25 years old: OR = 3.58, 95% CI 1.60-8.02; ≥ 55 years old versus <25 years old: OR = 6.35, 95% CI 2.64-15.31) and occupational level (blue collar versus white collar: OR = 1.52, 95% CI 1.10-2.09) remained significantly associated with long-term sickness absence. Comorbidity was the strongest predictor. CONCLUSIONS: It is possible to predict long-term sickness absence due to adjustment disorder on the basis of demographic, work-related and clinical information available during the basic assessment of the patient.

Actitud de los profesionales de Atención Primaria frente al tabaco / No disponible

OBJETIVOS. 1.o Cuantificar el número de fumadores entre los profesionales sanitarios (PS) de Atención Primaria(AP). 2.o Conocer el nivel de formación en el abordaje del fumador. 3.o Analizar los factores que pueden influir en dicho abordaje. DISEÑO. Estudio descriptivo-transversal. EMPLAZAMIENTO. Atención Primaria. PARTICIPANTES. Población diana (N): 1.250 profesionales. Población muestral (n): 297 (intervalo de confianza [IC]95%, e = 5%, p = 40%).MEDICIONES PRINCIPALES. Encuesta anónima (29ítems) y auto-cumplimentada. Variables: sociodemográficas, patrón-consumo, actitud ante su abandono, abordaje de la deshabituación. Análisis estadístico: descriptivo, t-Test, ANOVA, ji-cuadrado, regresión logística. RESULTADOS. El 56,8% son médicos (IC 95% 51,2-62%).Edad: 41,71 (IC 95% 41,1-42,3 años). El 28,7% son fumadores (17% fuma > 20 cigarrillos/día). Los fumadores (p =0,003), enfermeros/as (p = 0,007) y PS mujeres (p = 0,021)piensan que debe crearse un lugar en el centro de salud (CS) para fumadores (p = 0,003). El 17,2% no quiere abandonarlo. El 41,2% ha recibido formación en tabaco, estando más formado el médico (p = 0,0001) y el exfumador (31,8%; p =019), que es el que más recomienda el abandono a sus pacientes (24,3%; p = 0,017). La edad superior y el género masculino son los factores diferenciadores (y = -8,35+1,63 x género+ 0,69 x edad) (p = 0,0001). El 23% de los PS consideran fumar un hábito. El tabaquismo es poco valorado como factor de riesgo cardiovascular (p = 0,002). CONCLUSIONES. 1. Alto número de fumadores con consumo elevado. 2. El fumador valora la necesidad de tener un lugar para fumar. 3. El exfumador está más formado, aconseja y presenta mayor capacidad para abordar el tabaquismo. 4. Edad y género son los factores más determinantes en el abordaje del fumador

OBJECTIVES. 1. Measure number of smokers among primary health care professionals (PHCP). 2. Know the training level in the approach to the smoker. 3. Analyze the factors that may influence such approach. DESIGN. Descriptive-cross-sectional study. SITE. Primary Health Care. PARTICIPANTS. Target population (N): 1250 professionals. Sample population (N): 297 (95% CI, e = 5%, p = 40%).PRIMARY MEASUREMENTS. Anonymous survey (29items) and self-applied. Variables: sociodemographic, pattern-consumption; attitude to abandonment; de habituation approach. Statistical analysis: descriptive, T-test, ANOVA, chi-squared, logistic regression. RESULTS. 59.8% doctors (95% C 51.2%-62%). Age: 41.71(95% CI 41.1 - 42.3 years). 28.7% smokers (17% smoke > 20cig/day). Smokers (p = 0.003), ill subjects (p = 0.007) and female PHCP (p = 0.021) think that a site should be created for smokers (p = 0.003) in the health care sites (HCS). A total of 17.2% subjects do not want to quit and 41.2% have received education about smoking, it being the male doctor (p =0.0001) and ex-smoker (31.8%; p = 019), who most recommends their patient to quit smoking (24.3%; p = 0.017). Older age and male gender are the differentiating factors (y = -8.35+1.63 x gender + 0.69 x age) (p = 0.0001). A total of 23% PHCP consider that smoking is a habit. Smoking is not very evaluated as a cardiovascular risk factor (p = 0,002). CONCLUSIONS. 1. A high number of smokers with elevated consumption. 2. The smoker evaluates the need to have a place to smoke. 3. The ex-smoker is more trained, and recommends and has greater capacity to approach the smoking habit. 4. Age and gender are the most determining factors in the approach to the smoker