[Recruitment, selection and retention staffing policies in health services directly managed. SESPAS Report 2024]. / Reclutamiento, selección y retención de profesionales en servicios de salud de gestión directa. Informe SESPAS 2024.

In an organization with highly specialized and changing services over the course of a working life, such as health services managed directly by public administrations (DM-NHS) are, the issues related to the recruitment, selection and retention of professionals should receive special attention. much larger than what is provided. For too long, the DM-NHS has mainly been working to resolve the problems that affect the organization, with enormous disregard for those suffer by the recipients of its services, the real population to which it provides assistance. In the DM-NHS, its administration (rather than management) of human resources is circumscribed by the contours of the Framework Statute and its implementing regulations and rulings. This is an inadequate instrument, both empirically in view of the results obtained (50% temporary employment among professionals working in the NHS), and conceptually, since it fails to comply with the reasons that normatively justify its existence: "that its legal regime is adapts to the specific characteristics of the practice of health professions, as well as the organizational peculiarities of the National Health System". The text describes the characteristics of statutory regulation and reviews how regulatory restrictions affect recruitment, selection and retention policies. Finally, possible alternatives are proposed to have coherent and rational permanent staffing policies that cover the real needs of the health services.

Caring to care: Nurturing ICU healthcare professionals' wellbeing for enhanced patient safety.

Healthcare professionals working in the Intensive Care Unit (ICU) care for patients suffering from a critical illness and their relatives. Working within a team of people with different personalities, competencies, and specialties, with constraints and demands might contribute to a working environment that is prone to conflicts and disagreements. This highlights that the ICU is a stressful place that can threaten healthcare professionals' wellbeing. This article aims to address the concept of wellbeing by describing how the stressful ICU work-environment threatens the wellbeing of health professionals and discussing how this situation jeopardizes patient safety. To promote wellbeing, it is imperative to explore actionable interventions such as improve communication skills, educational sessions on stress management, or mindfulness. Promoting ICU healthcare professionals' wellbeing through evidence-based strategies will not only increase their personal resilience but might contribute to a safer and more efficient patient care.

[The euthanasia law and professional experiences: tensions in clinical practice]. / La ley de eutanasia y experiencias profesionales: tensiones en la práctica clínica.

OBJECTIVE: To analyze the process of assisted death provision in Catalonia and identify the main tensions, difficulties, and/or sources of discomfort related to professional practice. METHOD: A qualitative study was conducted based on interviews (n=29) and focus groups (n=19) with professionals who participated in the euthanasia process. The selection of participants combined the snowball and maximization of variability procedures, taking into account the variables of professional profile, setting, gender, age and territoriality. Intentional and theoretical sampling process. RESULTS: The assisted death process is divided into four main moments: 1) reception of the request, 2) medical-bureaucratic procedure, 3) the actual procedure, and 4) closure. At each of these moments, difficulties arise that can be a source of discomfort and have to do with the limits and tensions between the legal and moral, the conception of one's own professional role, the lack of recognition of some professional roles, stress and overload, the lack of formal and informal support, and the relationship with the patient and his/her family. The bureaucratic-administrative stress derived from a protective law, with both prior and subsequent verifying control, stands out, given that it stresses the professionals immersed in a healthcare system already under high pressure after budget cuts and the COVID-19 epidemic. CONCLUSIONS: Throughout the assisted death process, the sources of distress are diverse and of a psychological, psychosocial, and structural nature. These results may lead to interventions for psychological and peer support, information, training, institutional involvement, and burden reduction.

Attitudes toward death and burnout syndrome in geriatrics and gerontology healthcare personnel / Actitudes hacia la muerte y síndrome de burnout en el personal sanitario de geriatría y gerontología

Introduction Geriatric and gerontology healthcare workers are associated with a series of psychosocial risks such as death, bereavement and illness, and this implies a significant emotional and work overload, which can lead to negative attitudes toward death. Objective The aims of this study were to assess attitudes toward death, the level of burnout and the relationship between geriatrics and gerontology professionals. Method A correlational, cross-sectional study was conducted, in which the 42 participants in the sample completed an online questionnaire including the Revised Profile of Attitudes to Death (PAM-R) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Results The results obtained show that the predominant attitude toward death in the sample is that of neutral acceptance, and with regard to burnout syndrome, moderate average levels are found in the dimensions of emotional exhaustion and personal accomplishment, but a low level of depersonalisation. Conclusion Healthcare workers with attitudes of greater fear of death or acceptance of escape tend to experience higher levels of emotional exhaustion and depersonalisation, as do those with an attitude of death avoidance, who also have lower personal fulfillment (AU)

Introducción El personal sanitario de geriatría y gerontología se relaciona con una serie de riesgos psicosociales como son la muerte, el duelo y la enfermedad, esto implica una sobrecarga emocional y laboral importante, las cuales pueden derivar en actitudes hacia la muerte negativas.Objetivos Los objetivos de este estudio fueron evaluar las actitudes hacia la muerte, el nivel de burnout y la relación entre profesionales de geriatría y gerontología. Método Se realizó un estudio correlacional y transversal, en el que los 42 participantes de la muestra cumplimentaron un cuestionario online que incluía el Perfil Revisado de Actitudes hacia la Muerte (PAM-R) y el Maslach Burnout Inventory-Human Services Survey (MBI-HSS). Resultados Los resultados obtenidos muestran que la actitud hacia la muerte predominante en la muestra es la de aceptación neutral, y en cuanto al síndrome de burnout, se encuentran niveles medios moderados en las dimensiones de agotamiento emocional y realización personal, pero un nivel bajo de despersonalización. Conclusión Los trabajadores sanitarios con actitudes de mayor miedo a la muerte o de aceptación de la fuga tienden a experimentar mayores niveles de agotamiento emocional y despersonalización, al igual que los que tienen una actitud de evitación de la muerte, que además presentan una menor realización personal (AU)

Post-traumatic Stress Disorder after the first wave of the Pandemic in Hospitalized COVID-19 Patients and Health Professionals in a Front-line Spanish Tertiary Hospital: a retrospective observational study / Trastorno por estrés postraumático tras la primera ola de la pandemia en pacientes hospitalizados por COVID-19 y profesionales sanitarios de primera línea en un hospital terciario español: un estudio observacional retrospectivo

The COVID-19 pandemic had a serious impact on mental health, associated with Post Traumatic Stress Disorder (PTSD) after infection and within healthcare professionals. We propose to compare the semiology, evolution and trauma-associated variables between both groups in a sample of patients. An observational retrospective study was performed, including 42 hospitalized COVID-19 patients and 31 health professionals, treated at the Mental Health Service of the Hospital 12 de Octubre, between June 2020/21, with a diagnosis of PTSD. Mental state evaluation was performed through a standard clinical interview. Additionally, the 8-item treatment-outcome post-traumatic stress disorder scale (TOP-8) was administered. Demographic data, variables related to hospital stay and pre/peri/post-trauma variables considered of interest were collected. All analyses were performed using the Stata 16 program. Health professionals showed higher levels of recovery, however no significant differences were found in the initial severity of the PTSD. Regarding the symptom pattern it was similar between both groups, except that professionals presented more dissociation during the traumatic event. In general, the subjects presented mainly intrusive symptoms, hyperarousal and sleep-related difficulties. Having witnessed suffering or death, and the gypsy ethnic group, were the variables with the greatest impact in the PTSD severity. These results suggest that the COVID-19 leaves important psychological sequelae such as PTSD, both in infection survivors and in health professionals. Differences found could be due to dissimilarities in coping resources and therapeutic adherence styles. We consider that knowing the variables involved can help improve intervention in these vulnerable groups.(AU)

La pandemia por COVID-19 ha tenido grave impacto sobre la salud mental, asociándose con Trastorno por estrés postraumático (TEPT) tras la infección y en profesionales sanitarios. Nos proponemos comparar la semiología, evolución y variables asociadas al trauma entre ambos grupos en una muestra de pacientes. Se realizó un estudio observacional retrospectivo, incluyendo 42 pacientes hospitalizados por COVID-19 y 31 profesionales sanitarios, tratados en el Servicio de Psiquiatría del Hospital 12 de Octubre, entre junio 2020/21, con diagnóstico de TEPT. Se realizó entrevista clínica estándar. Adicionalmente, se pasó la Escala de 8 ítems para los resultados del tratamiento del TEPT (TOP-8). Se recogieron datos demográficos, variables relacionadas con la estancia hospitalaria y variables pre/peri/post-trauma. Se analizaron los datos usando el programa Stata 16. Los profesionales sanitarios mostraron mayores niveles de recuperación, sin embargo, no hubo diferencias significativas en la severidad inicial del TEPT. El patrón sintomático fue similar entre ambos grupos, excepto que los profesionales presentaron más disociación durante el evento traumático. Todos presentaron principalmente síntomas intrusivos, hiperactivación y dificultades de sueño. Haber presenciado sufrimiento o muerte, y la etnia gitana, fueron las variables con mayor impacto en la severidad del TEPT. Estos resultados sugieren que la COVID-19 deja importantes secuelas psicológicas como el TEPT, tanto en supervivientes de la infección como en profesionales sanitarios. Las diferencias encontradas podrían ser debidas a disimilitudes en recursos de afrontamiento y estilos de adherencia terapéutica. Consideramos que conocer las variables involucradas puede ayudar a mejorar la intervención en estos grupos vulnerables.(AU)

Attitudes toward death and burnout syndrome in geriatrics and gerontology healthcare personnel.

INTRODUCTION: Geriatric and gerontology healthcare workers are associated with a series of psychosocial risks such as death, bereavement and illness, and this implies a significant emotional and work overload, which can lead to negative attitudes toward death. OBJECTIVE: The aims of this study were to assess attitudes toward death, the level of burnout and the relationship between geriatrics and gerontology professionals. METHOD: A correlational, cross-sectional study was conducted, in which the 42 participants in the sample completed an online questionnaire including the Revised Profile of Attitudes to Death (PAM-R) and the Maslach Burnout Inventory-Human Services Survey (MBI-HSS). RESULTS: The results obtained show that the predominant attitude toward death in the sample is that of neutral acceptance, and with regard to burnout syndrome, moderate average levels are found in the dimensions of emotional exhaustion and personal accomplishment, but a low level of depersonalisation. CONCLUSION: Healthcare workers with attitudes of greater fear of death or acceptance of escape tend to experience higher levels of emotional exhaustion and depersonalisation, as do those with an attitude of death avoidance, who also have lower personal fulfillment.

Workplace violence in hospital emergency departments and consequences for health care professionals and support staff: a cluster analysis. / Violencia laboral de usuarios y sus consecuencias sobre profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios: análisis de clúster.

OBJECTIVES: Workplace violence of any type is influenced by multiple factors and leads to physiological, psychological, social, and organizational change. Emergency and other urgent care settings have assault rates up to 5-fold higher than other health care settings. This study aimed to analyze the consequences of physical and nonphysical violence on health care and support personnel in hospital emergency departments. MATERIAL AND METHODS: Cross-sectional descriptive analysis of responses to a 121-item survey of 584 health care and support workers in 12 Spanish hospital emergency departments. We analyzed the magnitude of the problem with a two-step self-clustering method and then assessed the associations between variables and workplace violence. RESULTS: Two groups were identified. The first consisted of 298 cases with high mean (SD) scores for nonphysical assaults (51.5 [7.9]) and low scores for physical violence (4.8 [2.9]). The second group consisted of 285 cases with intermediate scores for nonphysical assaults (27.1 [8.4]) and low scores for physical violence (3.4 [1.3]). CONCLUSION: Emergency departments have incidents of nonphysical workplace violence more often than physical violence. Emergency personnel with high exposure to workplace violence, particularly nonphysical assaults, experience physiological, psychosocial, and organizational changes.

OBJETIVO: La violencia laboral en cualquiera de sus modalidades se halla influenciada por múltiples factores, dando lugar a cambios fisiológicos, psicológicos, sociales y organizacionales, y los entornos de urgencias y emergencias presentan una incidencia de hasta cinco veces más con respecto al resto de servicios sanitarios. El objetivo de este estudio es analizar las características que desarrollan los profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios (SUH) que sufren violencia laboral física y no física. METODO: Es un diseño trasversal, descriptivo-analítico mediante la aplicación de un formulario de 121 ítems a una muestra de 584 profesionales sanitarios y no sanitarios de 12 hospitales españoles con SUHS, se aplicó análisis estadístico para magnitud del evento y análisis de clúster mediante método stepwise con solución de autoclustering y posterior relación de variables del estudio con violencia laboral. RESULTADOS: Tras la aplicación inicial del método descrito, se conformaron 2 grupos, el primero de ellos incluye a 298 casos y se caracteriza por puntuaciones altas en violencia no física (media: 51,5, desviación estándar: 7,9) y bajas en física (4,8, 2,9). Por otro lado, el segundo grupo está compuesto por 285 casos y se caracteriza por puntuaciones intermedias en violencia no física (27,1, 8,4) y bajas en física (3,4, 1,3). CONCLUSIONES: En los SUH existen manifestaciones de violencia laboral no física que presentan una mayor incidencia que las manifestaciones de violencia física. Aquellos profesionales con elevada exposición a violencia laboral, y en concreto a violencia no física, presentan alteraciones biopsicosociales y organizacionales.

[Validation of the questionnaire on vaccines and hesitancy to be vaccinated in the Spanish Society of Epidemiology]. / Validación del cuestionario sobre vacunas y reticencia a vacunarse en la Sociedad Española de Epidemiología.

OBJECTIVE: To develop and validate a survey aimed at epidemiologists to measure factors associated with vaccine reluctance. METHOD: Vaccination hesitancy refers to delayed acceptance or refusal of vaccination despite the availability of vaccination services. WHO included vaccination hesitancy among the 10 global health threats in 2019. Within this conceptual framework proposed by WHO, a committee of six experts from the Spanish Society of Epidemiology (SEE) designed a self-administered questionnaire to study factors associated with vaccination hesitancy in epidemiologists. This questionnaire was approved by the SEE Board, and was sent online to all members in 2019. Based on the responses obtained, the following characteristics were validated: face validity, internal validity, construct validity, criterion validity, reliability, as well as the characteristic curves of each item and the information function per item and overall. RESULTS: The final questionnaire showed two well-defined components, perception of vaccines and confidence in the transparency of vaccine data with high degrees of fit in all aspects of validation. Both components have shown that the higher the reluctance to vaccinate the better the questionnaire reports on these aspects. CONCLUSIONS: The study has allowed the development of a validated instrument in Spanish to measure the factors associated with vaccine reluctance among epidemiologists.

Violencia laboral de usuarios y sus consecuencias sobre profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios: análisis de clúster / Workplace violence in hospital emergency departments and consequences for health care professionals and support staff: a cluster analysis

Introducción: La violencia laboral en cualquiera de sus modalidades se halla influenciada por múltiples factores, dando lugar a cambios fisiológicos, psicológicos, sociales y organizacionales, y los entornos de urgencias y emergencias presentan una incidencia de hasta cinco veces más con respecto al resto de servicios sanitarios. El objetivo de este estudio es analizar las características que desarrollan los profesionales sanitarios y no sanitarios de los servicios de urgencias hospitalarios (SUH) que sufren violencia laboral física y no física. Método: Es un diseño trasversal, descriptivo-analítico mediante la aplicación de un formulario de 121 ítems a una muestra de 584 profesionales sanitarios y no sanitarios de 12 hospitales españoles con SUHS, se aplicó análisis estadístico para magnitud del evento y análisis de clúster mediante método stepwise con solución de autoclustering y posterior relación de variables del estudio con violencia laboral. Resultados: Tras la aplicación inicial del método descrito, se conformaron 2 grupos, el primero de ellos incluye a 298 casos y se caracteriza por puntuaciones altas en violencia no física (media: 51,5, desviación estándar: 7,9) y bajas en física (4,8, 2,9). Por otro lado, el segundo grupo está compuesto por 285 casos y se caracteriza por puntuaciones intermedias en violencia no física (27,1, 8,4) y bajas en física (3,4, 1,3). Conclusiones: En los SUH existen manifestaciones de violencia laboral no física que presentan una mayor incidencia que las manifestaciones de violencia física. Aquellos profesionales con elevada exposición a violencia laboral, y en concreto a violencia no física, presentan alteraciones biopsicosociales y organizacionales. (AU)

Background and objective: Workplace violence of any type is influenced by multiple factors and leads to physiological, psychological, social, and organizational change. Emergency and other urgent care settings have assault rates up to 5-fold higher than other health care settings. This study aimed to analyze the consequences of physical and nonphysical violence on health care and support personnel in hospital emergency departments. Methods: Cross-sectional descriptive analysis of responses to a 121-item survey of 584 health care and support workers in 12 Spanish hospital emergency departments. We analyzed the magnitude of the problem with a two-step self-clustering method and then assessed the associations between variables and workplace violence. Results: Two groups were identified. The first consisted of 298 cases with high mean (SD) scores for nonphysical assaults (51.5 [7.9]) and low scores for physical violence (4.8 [2.9]). The second group consisted of 285 cases with intermediate scores for nonphysical assaults (27.1 [8.4]) and low scores for physical violence (3.4 [1.3]). Conclusions: Emergency departments have incidents of nonphysical workplace violence more often than physical violence. Emergency personnel with high exposure to workplace violence, particularly nonphysical assaults, experience physiological, psychosocial, and organizational changes. (AU)

Análisis de las propiedades psicométricas de un cuestionario para medir la actitud hacia el humor en los profesionales sanitarios / Analysis of the psychometric properties of a questionnaire to measure the attitude towards humor in healthcare professionals

Objetivo principal: Analizar las propiedades psicométricas de un instrumento diseñado específicamente para evaluar la actitud ante el humor en profesionales sanitarios. Métodos: Estudio de validación, transversal. Se determinó la fiabilidad con el índice de discriminación, el coeficiente de correlación intraclase e ítem-total, el α de Cronbach y el índice de Pearson. La validez de constructo se analizó con el análisis factorial exploratorio. Resultados principales: La Escala Multidimensional del Humor en Profesionales Sanitarios (EMHUPS) consta de 35 ítems y 8 factores: humor con el paciente, en el trabajo, en los cuidados, en el entorno privado, formación en humor, en el entorno sanitario, demanda de formación en humor y humor y ocio. Presenta una varianza del 60,99% y una fiabilidad de 0,88. Conclusión principal: La escala EMHUPS presenta unas propiedades psicométricas aceptables en la medida del humor en profesionales sanitarios. (AU)

Objective: To evaluate the psychometric properties of an instrument designed specifically designed to determine attitude towards humor in health professionals. Methods: A cross-sectional and a validation study. The reliability study analysed the discrimination capacity of the items with discrimination index, the intraclass and item-total correlation coefficient, the Cronbach's α coefficient and the Pearson's correlation coefficient. In the validation study, the Exploratory Factor Analysis was carried out. Results: The Multidimensional Scale of Humor in Healthcare Professionals (EMHUPS) consists of 35 items divided into 8 factors: humor with the patient, humor at work, humor and care, humor in the private environment, training in humor, humor and the sanitary environment, demand for training in humor and humor and leisure. These factors explained a total variance of 60.99% with overall reliability of 0.88. Conclusions: EMHUPS presents acceptable psychometric properties in the measurement of humor in healthcare professionals. (AU)

Arterial hypertension diagnosis: A problem? / Diagnóstico de hipertensión arterial: ¿un problema?

Introduction: Arterial hypertension (AHT), a leading risk factor in terms of attributable mortality, is a major public health problem, especially for primary care where most patients are diagnosed and followed up. Correct AHT diagnosis requires adequate theoretical knowledge and technical skills in physicians and nurses. The aim of this study was to evaluate the knowledge and skills used in initial AHT diagnosis by health professionals and to describe the factors that contribute to variability. Methodology: Cross-sectional observational study in a sample of 385 primary care physicians and nurses recruited in a Catalan health region. Using a validated questionnaire called ARC, we evaluated theoretical knowledge and analysed factors that may contribute to response variability. We also evaluated practical measurement skills using objective structured clinical examination tests. Results: Medical and nursing primary care professionals had deficient knowledge and skills for initial AHT diagnosis and measurement, despite self-perceiving their knowledge to be sufficient. However, professionals who had received postgraduate or other AHT training in the previous year scored better in the ARC questionnaire. Conclusions: The results of this study point to insufficient AHT expertise to ensure quality clinical practice, suggesting that ongoing theoretical and practical training needs to be improved. (AU)

Introducción: La hipertensión arterial (HTA) es un factor de riesgo destacado en términos de mortalidad atribuible, y un gran problema de salud pública, en especial para la atención primaria, donde se diagnostica y se realiza el seguimiento a la mayoría de los pacientes. El diagnóstico correcto de HTA requiere un conocimiento teórico y una competencia técnica adecuados por parte de médicos y enfermeros. El objetivo de este estudio fue evaluar el conocimiento y las competencias aplicados al diagnóstico inicial de HTA por parte de los profesionales sanitarios, así como describir los factores que contribuyen a la variabilidad. Metodología: Estudio observacional transversal de una muestra de 385 médicos y enfermeros de atención primaria seleccionados en una región sanitaria de Cataluña. Utilizando un cuestionario validado denominado ARC, evaluamos el conocimiento técnico y analizamos los factores que probablemente contribuyen a la variabilidad de la respuesta. También evaluamos las técnicas prácticas de medición utilizando una prueba de examen clínico objetivo. Resultados: Los profesionales médicos y enfermeros de atención primaria tenían un conocimiento deficiente para realizar el diagnóstico y la medición iniciales de HTA, a pesar de autopercibir que dicho conocimiento es suficiente. Sin embargo, los profesionales que recibieron formación de posgrado en HTA durante el último año obtuvieron una mejor puntuación en el cuestionario ARC. Conclusiones: Los resultados de este estudio señalan una experiencia insuficiente sobre HTA para garantizar una práctica clínica de calidad, lo cual demuestra que debe mejorarse la formación teórica y práctica continua. (AU)

La visión de los profesionales sanitarios del proceso diagnóstico de las mujeres con cáncer de ovario en Catalunya: estudio cualitativo / Health professionals’ perspective about women's experiences during the diagnostic process of ovarian cancer in Catalonia: Qualitative study

Objetivo: Identificar las oportunidades perdidas en el diagnóstico del cáncer de ovario (CO) en el sistema sanitario público de Catalunya mediante el análisis de la visión de los profesionales sobre el relato de las experiencias de las pacientes con CO. Diseño: Estudio cualitativo exploratorio-descriptivo, con dos grupos focales. Emplazamiento: Atención primaria, noviembre de 2017. Participantes: Treinta y cuatro profesionales en base a un muestreo teórico: 21médicos de familia, 8profesionales de centros de salud sexual y reproductiva y 5ginecólogos de hospital. Métodos: Los participantes debatieron sobre diferentes itinerarios de procesos diagnósticos de mujeres con CO mediante la exposición de tres flujogramas elaborados a partir de los relatos obtenidos en entrevistas a pacientes. Se realizó un análisis de contenido temático. Resultados: Se identificaron tres temas con diversos subtemas: a)falta de sospecha diagnóstica (desconocimiento de los síntomas, obviar la anamnesis y la exploración física, fragmentación de la atención y sesgos y prejuicios); b)dificultades para activar el proceso diagnóstico (acceso limitado a pruebas, accesibilidad desigual a ginecología y falta de seguimiento), y c)ausencia de circuitos rápidos preestablecidos. Conclusiones: Los resultados ofrecen una visión de las dificultades del diagnóstico precoz del CO en nuestro ámbito. Creemos que su identificación permitirá la elaboración de estrategias para mejorar la precisión diagnóstica y la calidad de la atención en las mujeres con CO en nuestro medio.(AU)

Objective: To identify missed opportunities in the diagnosis of ovarian cancer (OC) in the public health system of Catalonia, through the analysis of the perceptions of health professionals on the stories's experiences of OC patients. Design: Qualitative exploratory-descriptive study, with two focus groups. Setting: Primary Care, November 2017. Participants: Thirty-four professionals based on theoretical sampling: 21 family doctors, 8 professionals from sexual and reproductive health centres and 5 hospital gynaecologists. Methods: Participants discussed the different diagnostic pathways for women with OC through the presentation of flowcharts which were developed with three storie's and experiences of OC patients. Results: Three themes with various sub-themes were identified as follow: a)lack of cancer diagnostic suspicion (lack of knowledge of symptoms of OC, anamnesis and physical examination overlooked, fragmentation of patient's care and bias and prejudice); b)difficulties in activating the diagnostic process (limited access to tests, unequal accessibility to gynaecology and lack of follow-up); and c)absence of fast-track referral system.Conclusions: The results offer insight into the difficulties of early diagnosis of OC in our setting. We believe that their identification will allow the development of strategies to improve diagnostic accuracy and quality of care for women with OC in our setting.(AU)

[Health professionals' perspective about women's experiences during the diagnostic process of ovarian cancer in Catalonia: Qualitative study]. / La visión de los profesionales sanitarios del proceso diagnóstico de las mujeres con cáncer de ovario en Catalunya: estudio cualitativo.

OBJECTIVE: To identify missed opportunities in the diagnosis of ovarian cancer (OC) in the public health system of Catalonia, through the analysis of the perceptions of health professionals on the stories's experiences of OC patients. DESIGN: Qualitative exploratory-descriptive study, with two focus groups. SETTING: Primary Care, November 2017. PARTICIPANTS: Thirty-four professionals based on theoretical sampling: 21 family doctors, 8 professionals from sexual and reproductive health centres and 5 hospital gynaecologists. METHODS: Participants discussed the different diagnostic pathways for women with OC through the presentation of flowcharts which were developed with three storie's and experiences of OC patients. RESULTS: Three themes with various sub-themes were identified as follow: a)lack of cancer diagnostic suspicion (lack of knowledge of symptoms of OC, anamnesis and physical examination overlooked, fragmentation of patient's care and bias and prejudice); b)difficulties in activating the diagnostic process (limited access to tests, unequal accessibility to gynaecology and lack of follow-up); and c)absence of fast-track referral system. CONCLUSIONS: The results offer insight into the difficulties of early diagnosis of OC in our setting. We believe that their identification will allow the development of strategies to improve diagnostic accuracy and quality of care for women with OC in our setting.

Diseño de un instrumento de medida del humor en profesionales sanitarios / Design of an instrument to measure humor in health professionals

Objetivo: Diseñar un instrumento de medida del humor en los profesionales sanitarios. Método: Estudio descriptivo, observacional y transversal de metodología mixta. Se elaboró el instrumento en varias fases: revisión bibliográfica, generación de los ítems, determinación del formato, evaluación por panel de expertos, estudio piloto, reevaluación por panel de expertos y test-retest. Se analizó la pertinencia, la relevancia y el grado de comprensión de los ítems. Se calculó la validez interobservador con el índice kappa y el coeficiente de correlación intraclase, considerándose los valores ≥ 0,61. Se utilizó la t de Student para muestras relacionadas y el coeficiente de correlación de Pearson. Para todas las pruebas se aceptó un valor de p<0,05. Resultados: La Escala Tridimensional del Humor en Profesionales Sanitarios consta de 50 ítems medidos con una escala Likert de 5 puntos en función del grado de acuerdo. El panel de expertos valoró la escala global con 3,57 (0,79) puntos sobre 5. Se obtuvo una fiabilidad interobservador de 0,69 (p<0,001) en el estudio piloto, un coeficiente de correlación de Pearson de 0,71 (p=0,002) y un coeficiente de correlación intraclase de 0,69 (p=0,001) en el test-retest. No se observaron diferencias estadísticamente significativas entre las puntuaciones del test-retest. Conclusión: La Escala Tridimensional del Humor en los Profesionales Sanitarios es una herramienta innovadora en la medida del humor en el contexto sanitario, creada específicamente para profesionales sanitarios. Antes de su utilización, es necesario analizar su validez y fiabilidad en futuros estudios.(AU)

Aim: The objective of this study was to develop an instrument for measuring humor in health professionals. Methods: Observational, transversal and descriptive study of mixed methodology. The instrument was designed in several phases: literature review, item generation, determination of the scale format, review by the expert panel, pilot study, reevaluation by the expert panel, and test-retest. The pertinence, relevance and comprehension of the items were analyzed. Interobserver agreement was calculated with Kappa and the intraclass correlation coefficient considering values ≥ 0.61. Pared sample Student's t test and Pearson's correlation coefficient were used. A level of statistical significance was established at P<0,05. Results: The Three-Dimensional Scale of Humor in Health Professionals consists of 50 items measured with a 5-point Likert scale based on the degree of agreement. Experts’ panel evaluated the global scale with 3.57 (0.79) points out of 5. An interobserver reliability of 0.69 (P<0.001) was obtained in the pilot study. A Pearson correlation coefficient of 0.71 (P=0.002) and an intraclass correlation coefficient of 0.69 (P=0.001) resulted in the test-retest. No statistically significant differences were observed between test-retest scores. Conclusion: The Three-Dimensional Scale of Humor in Health Professionals is an innovative tool for measuring humor in the health context. This scale is created specifically for health professionals. It́s necessary its validation in future studies.(AU)

Valoración de la salud mental en profesionales médicos que ejercieron su actividad durante la crisis sanitaria de Covid-19 / Assessment of mental health in medical professionals who exercised their activity during the COVID-19 health crisis

Objetivos: Estudiar el impacto de la crisis sanitaria sobre el estado de salud mental de los profesionales médicos que han trabajado durante la pandemia de COVID-19. Material y Métodos: Encuesta online anónima con variables ocupacionales y no ocupacionales, cuestionario de ansiedad y depresión de Goldberg y el SF-12 de calidad de vida percibida, realizada en septiembre de 2022, evaluando situación actual y un año atrás en profesionales médicos. Resultados: En 2021, un 58,1% presentaban ansiedad y en 2022 un 46,5%. Respecto a la depresión, en 2021 fue del 39,5% y en 2022 del 37,2%. La disminución de la puntuación de ansiedad fue significativa (p <0,001). Y la calidad de vida percibida (SF-12) en su escala mental en 2021 fue de 42,4 ± 13,0 vs 47,1 ± 11,8 en 2022, mejorando de forma significativa (p <0,033). Conclusiones: Encontramos una alta prevalencia de ansiedad y depresión que se mantiene actualmente, por lo que es de interés implantar programas de intervención sobre salud mental en los trabajadores sanitarios. (AU)

Objectives: To study the impact of the health crisis on the mental health status of medical professionals who worked during the COVID-19 pandemic. Material and Methods: Anonymous online survey with occupational and non-occupational variables, Goldberg anxiety and depression questionnaire and the SF-12 perceived quality of life, conducted in September 2022, assessing current situation and one year ago in medical professionals. Results: In 2021, 58.1% had anxiety and in 2022, 46.5%. Regarding depression, in 2021 it was 39.5% and in 2022 it was 37.2%. The decrease in the anxiety score was significant (p <0.001). And the perceived quality of life (SF-12) on its mental scale in 2021 was 42.4 ± 13.0 vs 47.1 ± 11.8 in 2022, improving significantly (p <0.033). Conclusions: We found a high prevalence of anxiety and depression that is currently maintained, so it is of interest to implement mental health intervention programs for healthcare workers. (AU)

Evidence-based medicine needs patient and public involvement to remain relevant: A proposal for a new curriculum / La medicina basada en la evidencia requiere la participación de la ciudadanía para mantener su relevancia: Propuesta para un nuevo plan de estudios

Introduction Public partnerships, a route to sharing expertise, networks and resources anchored in the United Nations Sustainable Development Goals, has been championed by multiple stakeholders. Objective To propose a new evidence-based medicine (EBM) curriculum for harnessing patient and public expertise to ensure that EBM teaching and learning can become more relevant and impactful. Methods A curriculum development group comprising of EBM teachers, patient and public involvement representatives, clinicians, clinical epidemiologists, public health experts and educationalists, with experience of delivering and evaluating face-to-face and online EBM courses across many countries and continents, prepared a new EBM course. Results A student-centred, problem-based and clinically integrated course for teaching and learning EBM was developed. In the spirit of shared decision-making, practitioners can learn to support patients, articulate their perspectives, recognise the need for their contribution and ensure community involvement when generating and applying evidence. With end users in mind, the application of research findings, delivery of care and EBM effectiveness in the workplace would carry increased priority. Conclusion Embracing patients as EBM collaborators can help deliver cognitive diversity and inspire different ways of thinking and working. Adopting the proposed approach in EBM education lays the foundations for a joint practitioner–patient partnership to ask, acquire, appraise and apply EBM in a more holistic context which will strengthen the EBM proposition (AU)

Introducción Las asociaciones de pacientes y ciudadanos constituyen una vía para compartir experiencias, redes y recursos siendo promovidas por los objetivos de desarrollo sostenible de la Organización de Naciones Unidas (ONU), y defendidas por todas las partes y sectores interesados. Objetivo Proponer un nuevo plan de estudios de medicina basada en la evidencia (MBE) para aprovechar la experiencia de los pacientes con el fin de garantizar de que la enseñanza y el aprendizaje de la MBE sean más relevantes e impactantes. Métodos Un grupo de expertos compuesto por profesores del área de MBE, representantes de pacientes, médicos, epidemiólogos clínicos, expertos en salud pública y pedagogos, con experiencia en la impartición y evaluación de cursos de MBE presenciales y online en el ámbito internacional, desarrolló e implementó un curso de MBE. Resultados Se desarrolló un curso centrado en el estudiante, basado en problemas y clínicamente integrado para la enseñanza y el aprendizaje de la MBE. En el espíritu de la toma de decisiones compartida, los profesionales pueden aprender a apoyar a los pacientes, a articular sus perspectivas, a reconocer la necesidad de su contribución y a garantizar la participación de la comunidad a la hora de generar y aplicar las pruebas. La aplicación de los resultados de la investigación, la prestación de cuidados y la eficacia de la MBE en el lugar de trabajo son las áreas de mayor prioridad para los asistentes. Conclusiones Adoptar a los pacientes como colaboradores de la MBE puede ayudar a proporcionar diversidad cognitiva e inspirar diferentes formas de pensar y trabajar. La adopción del enfoque propuesto en la formación en MBE sienta las bases para una colaboración conjunta entre profesionales y pacientes para preguntar, adquirir, valorar y aplicar la MBE en un contexto más holístico que reforzará la propuesta de MBE (AU)

Evaluación del clima de seguridad en varios servicios con labor asistencial de un hospital valenciano de segundo nivel / Assessment of the safety climate in several services with assistance work in a second-level valencian hospital

INTRODUCCIÓN: Durante la atención sanitaria se producen incidentes derivados de su alta complejidad, con impacto sobre la seguridad difícilmente cuantificable. MÉTODOS: Estudio observacional descriptivo, de evaluación del cuestionario HSOPS sobre la percepción de seguridad, distribuido en 2021 en varios servicios de un hospital de segundo nivel. Los hallazgos se compararon con una encuesta nacional de 2009. RESULTADOS: Se recogen 194 encuestas de trabajadores sanitarios, 76,29 % mujeres. Del total, 48,5% son enfermeras, 26,29% TCAEs, 23,19% médicos, 1,55% celadores y 0,51% trabajadora de limpieza. Hasta 11,86% proceden de Planta Médica, 24,74% de Planta Quirúrgica 4,08% de Quirófano, 15,46% de Pediatría / Maternidad, 6,63% de Oncología y 35,05% de UCI. La puntuación de calidad es 7,84 +/- 1,53, con valores superiores a 2009. En este trabajo observamos un mayor porcentaje de respuestas positivas en todas las dimensiones que en 2009. Las dimensiones 1ª “Frecuencia de eventos adversos notificados”, 2ª “Percepción de seguridad”, 6ª “Franqueza en la comunicación”, 7ª “Feed-back y comunicación sobre errores” y 11ª “Trabajo en equipo entre unidades” fueron Debilidades en el estudio nacional y no en el nuestro. En ambos las dimensiones 9ª “Dotación de personal” y 10ª “Apoyo de la gerencia del hospital” son Debilidades. Las dimensiones 3ª “Expectativas de acciones por jefe de servicio / supervisora” y 5ª “Trabajo en equipo en mi servicio” no son Fortalezas en 2009 y sí ahora. CONCLUSIONES: Este estudio permite comprender mejor la seguridad de los pacientes, recoger información sobre la percepción de condiciones laborales y planear acciones de mejora. (AU)

INTRODUCTION: Incidents arise from their high complexity occur during healthcare, with an impact on safety that is difficult to quantify. METHODS: Descriptive observational study, evaluation of the HSOPS questionnaire on the perception of security, distributed in 2021 in several services of a second level hospital. Findings were compared to a 2009 national survey. RESULTS: 194 answers of health workers were collected, 76.29% women. Of the total, 48.5% are nurses, 26.29% TCAEs, 23.19% doctors, 1.55% warders and 0.51% cleaning workers. Up to 11.86% come from the Medical Plant, 24.74% from the Surgical Plant, 4.08% from the Operating Room, 15.46% from Paediatrics/Maternity, 6.63% from Oncology and 35.05% from the ICU. The quality score is 7.84 +/- 1.53, with values ​​higher than 2009. In our study, we observed a higher percentage of positive responses in all dimensions than in 2009. Dimensions 1st “Frequency of events reported”, 2nd “Overall perception of patient safety”, 6th “Communication openness”, 7th “Feed-back and communication about errors” and 11th “Teamwork between units” were Weaknesses in the national study and not in ours. In both dimensions 9th “Staffing” and 10th “Management support for patient safety” are Weaknesses. The 3rd dimension “Expectations of actions by service manager/supervisor” and the 5th “Teamwork in my service” are not Strengths in 2009 and they are now. CONCLUSIONS: Our study allows us to better understand the safety of our patients, collect information on the perception of working conditions and plan improvement actions. (AU)

Evidence-based medicine needs patient and public involvement to remain relevant: A proposal for a new curriculum.

INTRODUCTION: Public partnerships, a route to sharing expertise, networks and resources anchored in the United Nations Sustainable Development Goals, has been championed by multiple stakeholders. OBJECTIVE: To propose a new evidence-based medicine (EBM) curriculum for harnessing patient and public expertise to ensure that EBM teaching and learning can become more relevant and impactful. METHODS: A curriculum development group comprising of EBM teachers, patient and public involvement representatives, clinicians, clinical epidemiologists, public health experts and educationalists, with experience of delivering and evaluating face-to-face and online EBM courses across many countries and continents, prepared a new EBM course. RESULTS: A student-centred, problem-based and clinically integrated course for teaching and learning EBM was developed. In the spirit of shared decision-making, practitioners can learn to support patients, articulate their perspectives, recognise the need for their contribution and ensure community involvement when generating and applying evidence. With end users in mind, the application of research findings, delivery of care and EBM effectiveness in the workplace would carry increased priority. CONCLUSIONS: Embracing patients as EBM collaborators can help deliver cognitive diversity and inspire different ways of thinking and working. Adopting the proposed approach in EBM education lays the foundations for a joint practitioner-patient partnership to ask, acquire, appraise and apply EBM in a more holistic context which will strengthen the EBM proposition.

[Factors associated with the hospital at home workload: A Delphi consensus study]. / Factores relacionados con la carga de trabajo en hospitalización a domicilio: estudio de consenso Delphi.

OBJECTIVES: To identify and prioritize a list of factors that contribute to the workload of the hospital at home (HaH) professionals. MATERIAL AND METHODS: A qualitative methodology study performed between January and December 2019 in the 10 HAH units of the Basque Country. The data were obtained in 4phases: 1. Systematic literature search and review; 2. Expert group meeting; 3. Consensus method: Delphi technique (2 survey rounds) and nominal group meeting; 4. Meeting of the research team. RESULTS: In the systematic literature search and review 85 factors were initially identified. These were reduced to 38 after the 8-person expert group meeting, in which 10 new factors were added. After the 2 Delphi rounds (106 and 57 professionals, respectively), 17 factors were maintained and 12 remained in doubt. The latter were evaluated at the nominal group meeting, consisting of 13 professionals who decided to eliminate 5 factors, include 3, and keep 3 as doubt. After the 8-person research team meeting, 14 potential factors were finally selected. They are related to the place of residence, the health state and social situation of the patients, as well as the health care provided at home. CONCLUSIONS: The identified factors could serve for improving the organization and optimize the daily word of the HaH professionals.

Design of an instrument to measure humor in health professionals.

AIM: The objective of this study was to develop an instrument for measuring humor in health professionals. METHODS: Observational, transversal and descriptive study of mixed methodology. The instrument was designed in several phases: literature review, item generation, determination of the scale format, review by the expert panel, pilot study, reevaluation by the expert panel, and test-retest. The pertinence, relevance and comprehension of the items were analyzed. Interobserver agreement was calculated with Kappa and the intraclass correlation coefficient considering values ≥0.61. Pared sample Student's t test and Pearson's correlation coefficient were used. A level of statistical significance was established at P < 0.05. RESULTS: The Three-Dimensional Scale of Humor in Health Professionals consists of 50 items measured with a 5-point Likert scale based on the degree of agreement. Experts' panel evaluated the global scale with 3.57 (0.79) points out of 5. An interobserver reliability of 0.69 (P < 0.001) was obtained in the pilot study. A Pearson correlation coefficient of 0.71 (P = 0.002) and an intraclass correlation coefficient of 0.69 (P = 0.001) resulted in the test-retest. No statistically significant differences were observed between test-retest scores. CONCLUSION: The Three-Dimensional Scale of Humor in Health Professionals is an innovative tool for measuring humor in the health context. This scale is created specifically for health professionals. It's necessary its validation in future studies.