Efectividad de la técnica de resolución de problemas aplicada por enfermeras: disminución de la ansiedad y la depresión en cuidadoras familiares / Effectiveness of problem solving technique applied by nurses: Decreased anxiety and depression in family caregivers

Objetivo: Conocer la efectividad de la técnica de resolución de problemas en la reducción de la ansiedad y la depresión, y en el aumento del bienestar percibido en cuidadoras familiares de personas dependientes. Diseño: Ensayo clínico. Emplazamiento: Centros de atención primaria de Tarragona, España. Período 2007-2011. Participantes: Muestra 122 cuidadoras de pacientes incluidos en programa de atención domiciliaria, con síntomas de ansiedad, depresión o bienestar emocional comprometido. Se asignaron aleatoriamente al grupo control o de intervención. Intervenciones: En el grupo experimental las enfermeras aplicaban a la cuidadora, durante las visitas domiciliarias, la técnica según protocolo de 4 sesiones. En el grupo control la enfermera realizó la atención habitual. Al mes de finalizar la intervención, se realizó nuevamente la medición de las variables dependientes en ambos grupos. Mediciones principales: Las variables dependientes, ansiedad y depresión, se midieron mediante la escala Goldberg y el bienestar emocional mediante la escala de salud emocional del cuidador principal. Resultados: Se detecta una mejora estadísticamente significativa en el grupo intervención de los síntomas de ansiedad, depresión y bienestar percibido en relación con el grupo control. Conclusiones: La técnica de resolución de problemas es una herramienta terapéutica útil para la disminución de los síntomas de malestar emocional de las cuidadoras familiares de pacientes crónicos(AU)

Objective: To determine the effectiveness of Problem Solving Technique in reducing anxiety and depression, and increased perceived well-being in women family caregivers of chronic patients. Design: A clinical trial. Field of study: Health centres in Tarragona, Spain, during 2007-2011. Participants: A sample 122 caregivers of patients in home care programs that met the inclusion criteria, were assigned to intervention or control group according to a simple random process. Interventions: In the experimental group, the nurses applied the Problem Solving Technique to the caregiver according to a four-session protocol. The nurses provided the usual care to the caregivers In the control group. One month after intervention, the dependent vriables were measured again in both groups. Principal measurement: The dependent variables of anxiety and depression were measured using the Goldberg scale, and the emotional well-being variable by the scale of emotional health of the primary caregiver. Results: A statistically significant improvement was detected in the anxiety and depression symptoms, as well as the perceived well-being in the intervention group compared to the control group. Conclusions: Implementation of the Problem Solving Technique is a useful therapeutic tool for reducing symptoms of distress in family caregivers of chronic patients(AU)

[Effectiveness of problem solving technique applied by nurses: decreased anxiety and depression in family caregivers]. / Efectividad de la técnica de resolución de problemas aplicada por enfermeras: disminución de la ansiedad y la depresión en cuidadoras familiares.

OBJECTIVE: To determine the effectiveness of Problem Solving Technique in reducing anxiety and depression, and increased perceived well-being in women family caregivers of chronic patients. DESIGN: A clinical trial FIELD OF STUDY: Health centres in Tarragona, Spain, during 2007-2011. PARTICIPANTS: A sample 122 caregivers of patients in home care programs that met the inclusion criteria, were assigned to intervention or control group according to a simple random process. INTERVENTIONS: In the experimental group, the nurses applied the Problem Solving Technique to the caregiver according to a four-session protocol. The nurses provided the usual care to the caregivers In the control group. One month after intervention, the dependent vriables were measured again in both groups. PRINCIPAL MEASUREMENT: The dependent variables of anxiety and depression were measured using the Goldberg scale, and the emotional well-being variable by the scale of emotional health of the primary caregiver. RESULTS: A statistically significant improvement was detected in the anxiety and depression symptoms, as well as the perceived well-being in the intervention group compared to the control group. CONCLUSIONS: Implementation of the Problem Solving Technique is a useful therapeutic tool for reducing symptoms of distress in family caregivers of chronic patients.

[Incidence and clinical characteristics of community-acquired pneumonia managed as outpatient among elderly people in Tarragona-Valls, Spain]. / Incidencia y características clínicas de las neumonías tratadas ambulatoriamente en las personas mayores de 65 años del área de Tarragona-Valls, 2002-2005.

BACKGROUND: Few information exists about community-acquired pneumonia (CAP) not hospitalized. This study assessed incidence and clinical characteristics of community-acquired pneumonia (CAP) managed as outpatient among elderly population. METHODS: Prospective cohort study that included 11,240 individuals 65 years or older who were assigned to 8 Primary Care Centers in the region of Tarragona-Valls, Spain. All cases of CAP managed as outpatient occurred among cohort members from January 1, 2002 to April 30, 2005 were included. All cases were x-ray proved and validated by checking clinical records. RESULTS: An amount of 118 cases of CAP managed as outpatient were observed (45 diagnosed in Primary Care and 73 diagnosed in Emergence Units) which means an incidence of 34.8 cases per 10,000 elderly persons-year (95% CI: 28.8-41.7). Incidence was greater among males (41.9 per 10,000) and among those aged 75 years or older (47.5 per 10,000). When diagnosis, 68.6% of patients had fever, (80% in 65-74 years and 60.3 in 75 years or older, p=0.037), 36.4% dyspnea, 44.9% pleural pain, 77.1% cough, 50.0% expectoraton and 5.7% had altered mental state. The combination of "fever, cough and pleural pain" occurred in 27.1% of cases (95% CI: 19.3-36.1). CONCLUSIONS: The incidence of outpatient CAP among elderly people is considerable. A great proportion of cases, specially older patients, had not typical clinical manifestations of pneumonia.

Incidencia y características clínicas de las neumonías tratadas ambulatoriamente en las personas mayores de 65 años del área de Tarragona-Valls, 2002-2005 / Incidence and clinical characteristics of community-acquired pneumonia managed as outpatient among elderly people in Tarragona-Valls, Spain

Fundamentos: La información existente sobre la epidemiología de la neumonía adquirida en la comunidad (NAC) tratada extrahospitalariamente es limitada. Este estudio analizó la incidencia poblacional y características clínicas de las NAC no hospitalizadas en personas de edad avanzada. Métodos: Estudio prospectivo de cohortes sin grupo control, ámbito poblacional, que incluyó un total de 11.240 personas mayores de 65 años adscritas a 8 Areas Básicas de Salud (ABS) de Tarragona-Valls. Se reclutaron todos los casos de NAC trata- dos ambulatoriamente (diagnosticados en Servicios de Urgencia hospitalarios de referencia y/o en las ocho ABS participantes) ocurridos en la cohorte de estudio entre enero de 2002 y abril de 2005. Todos los casos incluidos fueron radiográficamente confirmados y validados mediante revisión de historia clínica. Resultados: Se observaron un total de 118 casos de NAC que no requirieron hospitalización (73 diagnosticados en Servicios de Urgencias hospitalarios y 45 en las diferentes ABS), con una densidad de incidencia de 34,8 casos por 10.000 personas- año (IC 95%: 28,8-41,7). La incidencia fue más alta en varones (41,9 por 10.000) y en personas mayores de 75 años (47,5 por 10.000). Al diagnóstico, 68,6% de los pacientes presentaban fiebre (80% en 65-74 años y 60,3 en mayores de 75 años; p=0.037), 36,4% disnea, 44,9% dolor torácico, 77,1% tos, 50,0% expectoración, y 5,7% confusión mental. La tríada “fiebre, tos y dolor torácico” estaba presente en el 27,1% (IC 95%: 19,3-36,1). Conclusiones: Entre las personas mayores, la incidencia de NAC tratada ambulatoriamente es considerable. Más de la mitad de los pacientes no presentan los signos y síntomas típicos, especialmente los de mayor edad (AU)

Background: Few information exists about community- acquired pneumonia (CAP) not hospitalized. This study assessed incidence and clinical characteristics of community- acquired pneumonia (CAP) managed as outpatient among elderly population. Methods: Prospective cohort study that included 11,240 individuals 65 years or older who were assigned to 8 Primary Care Centers in the region of Tarragona-Valls, Spain. All cases of CAP managed as outpatient occurred among cohort members from January 1, 2002 to April 30, 2005 were included. All cases were x-ray proved and validated by checking clinical records. Results: An amount of 118 cases of CAP managed as outpatient were observed (45 diagnosed in Primary Care and 73 diagnosed in Emergence Units) which means an incidence of 34.8 cases per 10,000 elderly persons-year (95% CI: 28.8-41.7). Incidence was greater among males (41.9 per 10,000) and among those aged 75 years or older (47.5 per 10,000). When diagnosis, 68.6% of patients had fever, (80% in 65-74 years and 60.3 in 75 years or older, p=0.037), 36.4% dyspnea, 44.9% pleural pain, 77.1% cough, 50.0% expectoraton and 5.7% had altered mental state. The combination of “fever, cough and pleural pain” occurred in 27.1% of cases (95% CI: 19.3-36.1). Conclusions: The incidence of outpatient CAP among elderly people is considerable. A great proportion of cases, specially older patients, had not typical clinical manifestations of pneumonia (AU)