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Ramírez-Durán MDV, Gutiérrez-Alonso C, Moreno-Casillas L, Del Río-Gutiérrez A, González-Cervantes S, Coronado-Vázquez V. An Educational Intervention to Explore and Overcome Nursing Students' Breastfeeding Barriers: A Mixed-Methods Quasi-experimental Study. J Perinat Neonatal Nurs 2024; 38:E3-E13. [PMID: 37319350 PMCID: PMC10807748 DOI: 10.1097/jpn.0000000000000742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
BACKGROUND Nursing and midwifery students do not feel adequately prepared during their clinical training to support women who breastfeed, demanding more effective communication skills and knowledge. AIM The aim was to evaluate changes in students' breastfeeding knowledge. METHODS This was a mixed-methods quasi-experimental design. Forty students voluntarily participated. Using a 1:1 ratio, 2 groups were randomly created and completed the validated questionnaire ECoLaE (pre-post). The educational program consisted of focus groups, a clinical simulation, and a visit to the local breastfeeding association. FINDINGS The control group's posttest scores ranged from 6 to 20 (mean = 13.1, standard deviation [SD] = 3.0). The intervention group ranged from 12 to 20 (mean = 17.3, SD = 2.3). A Student's t test for independence samples was calculated ( P < .005, t = 4.5, median = 4.2). The intervention group had a mean difference of 10 points in improvement (mean =10.53, SD = 2.20, min = 7, max = 14), whereas the control group had a mean of 6 points (mean = 6.80, SD = 3.03, min = 3, max = 13). The multiple linear regression explained the intervention's effect. The regression model had statistical significance ( F = 4.87, P = 0.004), with an adjusted R2 = 0.31. The linear regression between the posttest scores and group variables after adjusting by age showed an increment of 4.1 points in the intervention posttest scores ( P < .005, 95% confidence interval [CI] = 2.1-6.1). CONCLUSIONS The educational program "Engage in breaking the barriers to breastfeeding" improved nursing students' knowledge.
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Affiliation(s)
| | | | - Luis Moreno-Casillas
- Department of Nursing, Catholic University “Santa Teresa de Jesús” Ávila, Avila, Spain
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Coronado-Vázquez V, Ramírez-Durán MDV, Barrio-Cortes J, Benito-Alonso E, Holgado-Juan M, Dorado-Rabaneda MS, Gómez-Salgado J. The Influence of Socioeconomic and Educational Factors on the Level of Anxiety and Fear of COVID-19. Healthcare (Basel) 2024; 12:99. [PMID: 38201005 PMCID: PMC10778703 DOI: 10.3390/healthcare12010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
During the COVID-19 pandemic, there were reports of heightened levels of anxiety and fear of contagion in the general population. Such psychological responses may be influenced by the socio-environmental context in which individuals reside. This study aimed to examine the relationship between socioeconomic and educational factors and the level of anxiety and fear related to COVID-19. A multicenter, cross-sectional design was used, including patients aged 18 years or older who attended primary care physician consultations at various primary health centers in Toledo, Spain, between October 2020 and January 2021. By means of a non-probabilistic sampling, a total of 150 participants were selected for the study, with 146 of them providing responses to the AMICO questionnaire The level of fear and anxiety associated with COVID-19 was assessed using the validated Anxiety and Fear of COVID-19 Assessment Scale (AMICO). A significant linear relationship was revealed between social class, employment status, and anxiety levels. Specifically, as social class decreased (p = 0.001) and employment situation worsened (unemployment) (p = 0.037), the proportion of participants reporting a high level of anxiety increased. During the second phase of the pandemic, more than half of the patients attending family medicine consultations exhibited a high level of fear and anxiety towards COVID-19, which was significantly associated with lower social class and unemployment.
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Affiliation(s)
- Valle Coronado-Vázquez
- Las Cortes Health Centre, Madrid Health Service, 28014 Madrid, Spain
- Investigacion facultad de Medicina, Universidad Francisco de Vitoria, 28223 Madrid, Spain
| | | | - Jaime Barrio-Cortes
- Fundación para la Investigación e Innovación Biosanitaria en Atención Primaria (FIIBAP), 28003 Madrid, Spain;
- Faculty of Health, Universidad Camilo José Cela, 28013 Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), 28009 Madrid, Spain
- Red de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud (RICAPPS), 28029 Madrid, Spain
| | - Elena Benito-Alonso
- El Viso de San Juan Health Centre, Servicio de Salud de Castilla La Mancha, 45215 Toledo, Spain
| | - Marina Holgado-Juan
- Illescas Health Centre, Servicio de Salud de Castilla La Mancha, 45200 Illescas, Spain
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil 092301, Ecuador
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Álvarez-Montero S, Crespí P, Gómez-Salgado J, Ramírez-Durán MV, Rodríguez-Gabriel MDP, Coronado-Vázquez V. Assessment of a medical student mentoring programme to improve attitudes related to grief and coping with death. Heliyon 2023; 9:e20959. [PMID: 37916093 PMCID: PMC10616318 DOI: 10.1016/j.heliyon.2023.e20959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 09/28/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives To evaluate the impact of a mentoring programme for medical students doing a palliative care rotation, aimed at improving coping with death and attitudes towards the suffering produced by illness. Methods A quasi-experimental study without a control group was carried out on second-year medical students. Five 1-h group sessions were conducted. Attitudes towards grief and coping with death were assessed before the mentoring programme began and afterwards, using the Brief Humanizar Scale and the Bugen's Coping with Death Scale, respectively. Results In terms of the sense of grieving as measured by the Brief Humanizar Scale, the mean score for the 'Burden' factor was 7 points and for the 'Change' factor it was 28.6, indicating that suffering makes more sense as a lever for positive change than as a burden. Regarding Bugen's Coping with Death Scale, the mean score was 127.8 points before the mentoring programme and 139.2 afterwards. Hence, the score after the mentoring programme increased by 11.4 points, improving strategies to cope with death. Conclusion Medical professionals must cope with death and end-of-life patients. In addition to scientific knowledge, students need to acquire competencies for better coping with the death of patients, with mentoring programmes helping to enhance this process of learning.
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Affiliation(s)
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Program. Universidad Espíritu Santo, Guayaquil, Ecuador
| | | | | | - Valle Coronado-Vázquez
- Universidad Francisco de Vitoria, Madrid, Spain
- B21-20R Group, Instituto Aragonés de Investigaciones Sanitarias, University of Zaragoza, Zaragoza, Spain
- Las Cortes Health Centre, Madrid Health Service, Madrid, Spain
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Coronado-Vázquez V, Gómez-Salgado J. Moving forward shared-decisions with patients: Need or urgency. Med Clin (Barc) 2023; 160:447-449. [PMID: 36801107 DOI: 10.1016/j.medcli.2023.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/18/2023]
Affiliation(s)
- Valle Coronado-Vázquez
- Universidad Francisco de Vitoria, Madrid, España; Grupo B21-20R, Instituto de Investigación Sanitaria de Aragón (IIS), Zaragoza, España; Centro de Salud Las Cortes, Servicio Madrileño de Salud, Madrid, España
| | - Juan Gómez-Salgado
- Departamento de Sociología, Trabajo Social y Salud Pública, Facultad de Ciencias del Trabajo, Universidad de Huelva, Huelva, España; Programa de Postgrado en Seguridad y Salud, Universidad Espíritu Santo, Guayaquil, Ecuador.
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Coronado-Vázquez V, Antón-Rodríguez C, Gómez-Salgado J, Ramírez-Durán MDV, Álvarez-Montero S. Evaluation of learning outcomes of humanities curricula in medical students. A meta-review of narrative and systematic reviews. Front Med (Lausanne) 2023; 10:1145889. [PMID: 37138737 PMCID: PMC10150636 DOI: 10.3389/fmed.2023.1145889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 03/14/2023] [Indexed: 05/05/2023] Open
Abstract
Objectives To assess the expected learning outcomes of medical humanities subjects in medical studies curricula. To connect those expected learning outcomes with the types of knowledge to be acquired in medical education. Methods Meta-review of systematic and narrative reviews. Cochrane Library, MEDLINE (Pubmed), Embase, CINAHL, and ERIC were searched. In addition, references from all the included studies were revised, and the ISI Web of Science and DARE were searched. Results A total of 364 articles were identified, of which six were finally included in the review. Learning outcomes describe the acquisition of knowledge and skills to improve the relationship with patients, as well as the incorporation of tools to reduce burnout and promote professionalism. Programs that focus on teaching humanities promote diagnostic observation skills, the ability to cope with uncertainty in clinical practice, and the development of empathetic behaviors. Conclusion The results of this review show heterogeneity in the teaching of medical humanities, both in terms of content and at the formal level. Humanities learning outcomes are part of the necessary knowledge for good clinical practice. Consequently, the epistemological approach provides a valid argument for including the humanities in medical curricula.
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Affiliation(s)
- Valle Coronado-Vázquez
- B21-20R Group, Instituto Aragonés de Investigaciones Sanitarias, University of Zaragoza, Zaragoza, Spain
- Las Cortes Health Centre, Madrid Health Service, Madrid, Spain
- Faculty of Medicine, Universidad Francisco de Vitoria, Madrid, Spain
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil, Ecuador
- *Correspondence: Juan Gómez-Salgado,
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Bravo-Garrido N, Morán-Cortés JF, Coronado-Vázquez V, Ramírez-Durán MDV. Impact of creative workshops in an institutionalized patient with moderate/severe cognitive impairment with behavioral disorders: A case report. Front Psychiatry 2023; 14:1132659. [PMID: 36970293 PMCID: PMC10033970 DOI: 10.3389/fpsyt.2023.1132659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 02/24/2023] [Indexed: 03/29/2023] Open
Abstract
The Hospital Care Unit for individuals with intellectual disabilities and behavioral disorders provides comprehensive care in a controlled and video-surveyed facility that minimizes access to potentially manipulative materials during aggression or pica episodes. The patient was admitted to the unit due to issues including ingestion of non-edible fluids, aggression toward staff and other patients, and self-injury. All patients participated in occupational activities led by an occupational therapist from Monday to Friday from 10 a.m. to 11:30 a.m. In addition, creative workshops such as cinema forums and cooking workshops were held on some afternoons. During the analyzed period from January to June 2022, the patient experienced three episodes of pica, 14 assaults toward staff, and eight toward peers. All of these incidents occurred after dinner and were triggered either by the inability to eat dessert or by refusal to brush teeth afterward. In our case study, the implementation of creative workshops such as cooking had a positive effect on decreasing instances of pica and aggression. These workshops slightly improved participation in other occupational therapy activities and stabilized the patient's behavior, increasing the likelihood of her being able to return to her habitual residence.
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Affiliation(s)
| | | | - Valle Coronado-Vázquez
- Department of Semiology and Clinical Communication, Universidad Francisco de Vitoria, Madrid, Spain
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Coronado-Vázquez V, Benito-Alonso E, Holgado-Juan M, Dorado-Rabaneda MS, Bronchalo-González C, Gómez-Salgado J. Telephone Monitoring of Isolated Patients With Suspected COVID-19 Disease in Primary Care: Prospective Cohort Study. Int J Public Health 2022; 67:1604747. [PMID: 36111198 PMCID: PMC9468220 DOI: 10.3389/ijph.2022.1604747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 08/04/2022] [Indexed: 01/08/2023] Open
Abstract
Objective: Isolation of suspected cases of COVID-19 has been shown effective in reducing disease transmission and monitoring these patients from primary care allows to detect complications. The objective of this study is to determine the evolution of a cohort of patients with suspected COVID-19, and to analyse the factors associated with hospital admissions due to their unfavourable evolution.Methods: Prospective cohort study. A cohort of 166 patients with COVID-19 symptoms was selected and was followed-up by telephone calls during 14 days of home isolation.Results: By the end of the follow-up, a hospital admission had taken place in 14.7% of patients. The mean survival time until admission among diabetics was 12.6, 10.9 days for chronic kidney diseases, and 9.3 days in immunocompromised patients. Immunosuppression was a risk factor for admission over 50 years of age.Conclusion: Hospital admissions for suspected cases of COVID-19 are associated with diabetes, chronic kidney disease, and immunosuppression. Telephone monitoring of these patients from primary care allows for home isolation and early detection of disease complications.
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Affiliation(s)
- Valle Coronado-Vázquez
- B21-20R Group, Instituto Aragonés de Investigaciones Sanitarias, Universidad de Zaragoza, Zaragoza, Spain
- Las Cortes Health Centre, Madrid Health Service, Madrid, Spain
- Universidad Francisco de Vitoria, Madrid, España
| | - Elena Benito-Alonso
- El Viso de San Juan Health Centre, Servicio de Salud de Castilla La Mancha, Toledo, Spain
| | | | | | | | - Juan Gómez-Salgado
- Sociology, Social Work and Public Health, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Programme, Escuela de Posgrado, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador
- *Correspondence: Juan Gómez-Salgado,
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Coronado-Vázquez V, Ramírez-Durán MDV, García Aragón C, Gómez-Salgado J. [Pcr persistentemente positiva tras la COVID-19. ¿Cómo diagnósticar las reinfecciones?]. Rev Esp Salud Publica 2022; 96:202206044. [PMID: 35642578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/03/2022] [Indexed: 06/15/2023] Open
Abstract
Persistence of a long-term positive polymerase chain reaction (PCR) test in patients with severe coronavirus-associated respiratory syndrome may interfere with the diagnosis of reinfections, causing false positives of the disease, with the potential implications to determine the need for isolation and, consequently, for Public Health. In these field notes we present the experience of a patient with positive PCR of eight months of evolution to which an erroneous diagnosis of COVID-19 reinfection was made due to a gastrointestinal disease, resulting in a Campylobacter jejuni infection.
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Affiliation(s)
- Valle Coronado-Vázquez
- Grupo B21-20R. Instituto de Investigación Sanitaria de Aragón (IIS). Zaragoza. España
- Centro de Salud Las Cortes. Servicio Madrileño de Salud. Madrid. España
- Universidad Francisco de Vitoria. Madrid. España
| | | | - Celia García Aragón
- Centro de Salud de Illescas. Servicio de Salud de Castilla La Mancha. Toledo. España
| | - Juan Gómez-Salgado
- Área de Medicina Preventiva y Salud Pública. Universidad de Huelva. Huelva. España
- Universidad Espíritu Santo. Guayaquil. Ecuador
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Coronado-Vázquez V, Gil-de-Gómez MJ, Rodríguez-Eguizábal E, Oliván-Blázquez B, Gómez-Salgado J, Magallón-Botaya R, Sánchez-Calavera MA. Evaluation of primary care responsiveness by people with mental illness in Spain. BMC Health Serv Res 2022; 22:133. [PMID: 35101052 PMCID: PMC8805273 DOI: 10.1186/s12913-022-07516-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/17/2022] [Indexed: 11/14/2022] Open
Abstract
Background The health system responsiveness is a concept developed by the World Health Organization that measures patients’ expectations for the non-medical care they receive. The aim of this study is to assess primary care responsiveness as seen by people with mental illness and to analyse the factors associated with poor responsiveness. Methods Cross-sectional descriptive study on 426 people with mental illness who had attended primary care consultations at least once in the previous 12 months. The responsiveness of the health system was determined through the short questionnaire “Multi-country Survey Study on Health and Health Systems Responsiveness”. Differences in responsiveness by sociodemographic characteristics were compared through the Chi-squared test. Logistic regression identified the factors associated with poor responsiveness. Results Overall responsiveness was measured as good by 77.4% of patients, being this probability higher in the domains: dignity, confidentiality, and communication. The most valued domains by people with mental illness were prompt attention (42.4%), dignity (30.1%), and communication (17%). Only prompt attention scored high importance and poor responsiveness. In patients with an income lower than 900 euros per month and low level of studies, the probability of poor confidentiality responsiveness was multiplied by 3 and 2.7 respectively. Conclusions People with mental illness perceive good responsiveness from primary care in terms of dignity, confidentiality, and communication. Prompt attention, as the domain of greatest importance and worst valuation, should be prioritised through the implementation of organisational measures in health centres to reduce waiting times, especially in urban areas. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07516-2.
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Affiliation(s)
- Valle Coronado-Vázquez
- Aragonese Institute for Health Sciences (IACS), 50009, Zaragoza, Spain.,School of Medicine, Universidad Francisco de Vitoria, 28223, Madrid, Spain.,Illescas Primary Care Health Center, Castilla-La Mancha Health Service, 45200, Toledo, Spain.,Group B21-20R, Health Research Institute of Aragon (IIS), 50009, Zaragoza, Spain.,redIAPP group RD16/0007/0005, Aragonese Primary Care Research Group, 50009, Zaragoza, Spain
| | - María Josefa Gil-de-Gómez
- Aragonese Institute for Health Sciences (IACS), 50009, Zaragoza, Spain.,San Pedro Hospital, La Rioja Health Service, 26006, Logroño, Spain
| | - Eva Rodríguez-Eguizábal
- Aragonese Institute for Health Sciences (IACS), 50009, Zaragoza, Spain.,Puerta de Arnedo Primary Care Health Center, La Rioja Health Service, 26580, Arnedo, Spain
| | - Bárbara Oliván-Blázquez
- Group B21-20R, Health Research Institute of Aragon (IIS), 50009, Zaragoza, Spain.,redIAPP group RD16/0007/0005, Aragonese Primary Care Research Group, 50009, Zaragoza, Spain.,University of Zaragoza, 50009, Zaragoza, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Campus El Carmen, Universidad de Huelva, Av. de 3 de Marzo, 21007, Huelva, Spain. .,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301, Guayaquil, Ecuador.
| | - Rosa Magallón-Botaya
- Group B21-20R, Health Research Institute of Aragon (IIS), 50009, Zaragoza, Spain.,redIAPP group RD16/0007/0005, Aragonese Primary Care Research Group, 50009, Zaragoza, Spain.,University of Zaragoza, 50009, Zaragoza, Spain.,Arrabal Primary Care Health Center, Aragon Health Service, 50009, Zaragoza, Spain
| | - María Antonia Sánchez-Calavera
- Group B21-20R, Health Research Institute of Aragon (IIS), 50009, Zaragoza, Spain.,redIAPP group RD16/0007/0005, Aragonese Primary Care Research Group, 50009, Zaragoza, Spain.,University of Zaragoza, 50009, Zaragoza, Spain.,Fuentes Norte Primary Care Health Center, Aragon Health Service, 50002, Zaragoza, Spain
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Coronado-Vázquez V, Ramírez-Durán MDV, Gómez-Salgado J, Dorado-Rabaneda MS, Benito-Alonso E, Holgado-Juan M, Bronchalo-González C. Evolution of a Cohort of COVID-19 Infection Suspects Followed-Up from Primary Health Care. J Pers Med 2021; 11:jpm11060459. [PMID: 34073666 PMCID: PMC8224796 DOI: 10.3390/jpm11060459] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/20/2021] [Accepted: 05/22/2021] [Indexed: 12/15/2022] Open
Abstract
Diagnosis and home follow-up of patients affected by COVID-19 is being approached by primary health care professionals through telephone consultations. This modality of teleconsultation allows one to follow the evolution of patients and attend early to possible complications of the disease. The purpose of the study was to analyze the evolution of a cohort of patients with suspected SARS-CoV-2 disease followed by primary care professionals and to determine the factors that are associated with hospital admission. A prospective cohort study was carried out on 166 patients selected by consecutive sampling that showed symptoms compatible with COVID-19. The follow-up was approached via telephone for 14 days analyzing hospitalization and comorbidities of the patients. There were 75% of the hospitalized patients that were male (p = 0.002), and 70.8% presented comorbidities (p < 0.001). In patients with diabetes, the risk of hospitalization was 4.6-times larger, in hypertension patients it was 3.3-times, those suffering from renal insufficiency 3.8-times, and immunosuppressed patients 4.8-times (IC 95%: 1.9–11.7). In 86.7% of the cases, clinical deterioration was diagnosed in the first seven days of the infection, and 72% of healing was reached from day seven to fourteen. Monitoring from primary care of patients with COVID-19 allows early diagnosis of clinical deterioration and detection of comorbidities associated with the risk of poor evolution and hospital admission.
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Affiliation(s)
- Valle Coronado-Vázquez
- Group B21-20R, Health Research Institute of Aragon (IIS), 50009 Zaragoza, Spain;
- Centro de Salud de Illescas, Servicio de Salud de Castilla-La Mancha, 45200 Toledo, Spain;
- Department of Health Sciences, Universidad Católica Santa Teresa de Jesús de Ávila, 05005 Ávila, Spain
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21071 Huelva, Spain
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador
- Correspondence: ; Tel.: +34-959219700
| | - María Silvia Dorado-Rabaneda
- Consultorio Yuncos, ZBS Illescas, Servicio de Salud de Castilla-La Mancha, 45210 Toledo, Spain; (M.S.D.-R.); (C.B.-G.)
| | - Elena Benito-Alonso
- Consultorio El Viso de San Juan, Servicio de Salud de Castilla-La Mancha, 45215 Toledo, Spain;
| | - Marina Holgado-Juan
- Centro de Salud de Illescas, Servicio de Salud de Castilla-La Mancha, 45200 Toledo, Spain;
| | - Cristina Bronchalo-González
- Consultorio Yuncos, ZBS Illescas, Servicio de Salud de Castilla-La Mancha, 45210 Toledo, Spain; (M.S.D.-R.); (C.B.-G.)
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Cerezo-Espinosa de los Monteros J, Castro-Torres A, Gómez-Salgado J, Fagundo-Rivera J, Gómez-Salgado C, Coronado-Vázquez V. Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions. Int J Environ Res Public Health 2021; 18:4051. [PMID: 33921426 PMCID: PMC8069692 DOI: 10.3390/ijerph18084051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/16/2022]
Abstract
Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.
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Affiliation(s)
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Postgraduate Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador
| | - Javier Fagundo-Rivera
- Health Sciences Doctorate School, University of Huelva, 21007 Huelva, Spain;
- Centro Universitario de Enfermería Cruz Roja, University of Seville, 41009 Seville, Spain
| | | | - Valle Coronado-Vázquez
- Illescas Health Centre, Castilla-La Mancha Health Service, 45200 Toledo, Spain;
- Health Science Institute of Aragon, 50009 Zaragoza, Spain
- Department of Health Sciences, Santa Teresa de Jesus Catholic University of Avila, 05005 Avila, Spain
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12
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Rodríguez-Eguizabal E, Oliván-Blázquez B, Coronado-Vázquez V, Sánchez-Calavera MA, Gil-de-Goméz MJ, Lafita-Mainz S, Garcia-Roy Á, Magallón-Botaya R. Perception of the primary health care response capacity by patients with and without mental health problems, and health professionals: qualitative study. BMC Health Serv Res 2021; 21:285. [PMID: 33784998 PMCID: PMC8011075 DOI: 10.1186/s12913-021-06205-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 02/12/2021] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The objective of this study is to deepen our understanding of perceptions towards Primary Health Care Response Capacity by specifically using patients with and without mental disorders, as well as family doctors and a manager, in order to compare and endorse perspectives. For it, a qualitative study was performed. In-depth interviews were conducted with 28 patients with and without mental health disorders and focus groups were held with 21 professionals and a manager. An inductive thematic content analysis was performed in order to explore, develop and define the emergent categories of analysis. RESULTS The fundamental domains for patients are dignity, communication, and rapid service. People with mental health problems also highlight the domain of confidentiality as relevant, while patients who do not have a mental health problem prioritize the domain of autonomy. Patients with mental health disorders report a greater number of negative experiences in relation to the domain of dignity. Patients do not consider their negative experiences to be a structural problem of the system. These findings are also endorsed by health care professionals. CONCLUSIONS It is necessary to take these results into account as responsive systems can improve service uptake, ensure adherence to treatment, and ultimately enhance patient welfare.
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Affiliation(s)
- Eva Rodríguez-Eguizabal
- Health Service of La Rioja, Primary Health Center Arnedo, Av de Benidorm, 57, Arnedo, La Rioja 26580 Spain
| | - Bárbara Oliván-Blázquez
- Health Research Institute of Aragon (IIS Aragón), Edificio CIBA, Avda. San Juan Bosco, 13, Zaragoza, 50009 Spain
- Research network on preventive activities and health promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud) (RedIAPP), Gran Via de les Corts Catalanes, 587, Barcelona, 08007 Spain
- Department of Psychology and Sociology, University of Zaragoza, Violante de Hungría 23, Zaragoza, 50009 Spain
| | - Valle Coronado-Vázquez
- Aragonés Health Science Institute, Avda. San Juan Bosco, 13, Zaragoza, 50009 Spain
- Health Service of Castilla La Mancha. Primary Health Center Illescas, C/ Sandro Pertini S/N. 45.200, Toledo, Illescas Spain
| | - Mª. Antonia Sánchez-Calavera
- Health Research Institute of Aragon (IIS Aragón), Edificio CIBA, Avda. San Juan Bosco, 13, Zaragoza, 50009 Spain
- Research network on preventive activities and health promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud) (RedIAPP), Gran Via de les Corts Catalanes, 587, Barcelona, 08007 Spain
- Aragones Health Service, Plaza de la Convivencia, 2, Zaragoza, 50017 Spain
- Department of Medicine and Psychiatry. University of Zaragoza, Domingo Miral, S/N, Zaragoza, 50002 Spain
| | - Mª. Josefa Gil-de-Goméz
- Health Services of La Rioja, Teaching Unit of San Pedro Hospital, San Pedro. C/ Piqueras 98, 26006 Logroño, Spain
| | - Sergio Lafita-Mainz
- Health Research Institute of Aragon (IIS Aragón), Edificio CIBA, Avda. San Juan Bosco, 13, Zaragoza, 50009 Spain
- Aragones Health Service, Plaza de la Convivencia, 2, Zaragoza, 50017 Spain
| | - África Garcia-Roy
- Health Research Institute of Aragon (IIS Aragón), Edificio CIBA, Avda. San Juan Bosco, 13, Zaragoza, 50009 Spain
- Aragones Health Service, Plaza de la Convivencia, 2, Zaragoza, 50017 Spain
| | - Rosa Magallón-Botaya
- Health Research Institute of Aragon (IIS Aragón), Edificio CIBA, Avda. San Juan Bosco, 13, Zaragoza, 50009 Spain
- Research network on preventive activities and health promotion (Red de Investigación en Actividades Preventivas y Promoción de la Salud) (RedIAPP), Gran Via de les Corts Catalanes, 587, Barcelona, 08007 Spain
- Aragones Health Service, Plaza de la Convivencia, 2, Zaragoza, 50017 Spain
- Department of Medicine and Psychiatry. University of Zaragoza, Domingo Miral, S/N, Zaragoza, 50002 Spain
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Gómez-Salgado J, Allande-Cussó R, Domínguez-Salas S, García-Iglesias JJ, Coronado-Vázquez V, Ruiz-Frutos C. Design of Fear and Anxiety of COVID-19 Assessment Tool in Spanish Adult Population. Brain Sci 2021; 11:328. [PMID: 33807643 PMCID: PMC8001709 DOI: 10.3390/brainsci11030328] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 02/28/2021] [Accepted: 03/02/2021] [Indexed: 12/29/2022] Open
Abstract
The aim of this study was to develop a specific scale to measure anxiety and fear levels in the general Spanish population. For this, a transcultural adaptation to Spanish of the fear of coronavirus disease 2019 (COVID-19) scale, in its original version of 10 items, was carried out. Then, the Anxiety and Fear of COVID-19 Assessment Scale (AMICO, for its acronym in Spanish) was designed by translating the tool and Delphi technique into three rounds. Ten experts participated voluntarily, and inter-observer match rates and the reliability study of the designed scale were calculated. A pilot study was carried out with the final version of the scale for the validity and reliability study. The instrument did not raise problems in semantic and cultural terms during the first and second rounds of the translation process, with an overall weighted Kappa value of 0.9. In the third round, eight new items were designed and consensual, obtaining a weighted overall value of 0.89. The pilot study sample was made up of 445 subjects, of which 60.3% were women with a mean age of 46.2 years. The final version consisted of 16 items, 2 factors, and a Cronbach's alpha value of 0.92. The AMICO scale was developed to assess the level of anxiety and fear of COVID-19 and proved to be valid and reliable for its use in the adult Spanish population.
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Affiliation(s)
- Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; (J.J.G.-I.); (C.R.-F.)
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador
| | | | - Sara Domínguez-Salas
- Department of Psychology, Universidad Loyola Andalucía, 41704 Dos Hermanas, Spain;
| | - Juan Jesús García-Iglesias
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; (J.J.G.-I.); (C.R.-F.)
| | - Valle Coronado-Vázquez
- Illescas Health Centre, Castilla-La Mancha Health Service, 45200 Toledo, Spain;
- Bioethics Group of the Society of Family and Community Medicine of Madrid (SoMaMFyC), 28004 Madrid, Spain
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain; (J.J.G.-I.); (C.R.-F.)
- Safety and Health Postgraduate Programme, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador
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Gómez-Salgado J, Domínguez-Salas S, Romero-Martín M, Romero A, Coronado-Vázquez V, Ruiz-Frutos C. Work engagement and psychological distress of health professionals during the COVID-19 pandemic. J Nurs Manag 2021; 29:1016-1025. [PMID: 33400325 DOI: 10.1111/jonm.13239] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 01/18/2023]
Abstract
AIMS To describe the level of work engagement of active health care professionals during the COVID-19 pandemic, and its relationship with psychological distress according to the professional category. BACKGROUND Health care professionals working on the front line of the COVID-19 pandemic are at risk of psychological distress, and work engagement could be a positive attitude that could serve as a protective factor. METHODS Cross-sectional observational study of 1,459 health care professionals. Psychological distress was measured with the General Health Questionnaire and work engagement with the Utrecht Work Engagement Scale. Data were analysed with bivariate analyses and correlations. RESULTS Psychological distress was reported by 80.6% of health care professionals. Work engagement as high with a total mean score of 5.04 (SD = 1.14). The results showed that distressed professionals showed significantly lower levels of work engagement. CONCLUSIONS The present study identified psychological distress and work engagement experienced by health care professionals during the COVID-19 pandemic. Most of the variables included in the study revealed a significant relationship with psychological distress and work engagement. IMPLICATIONS FOR NURSING MANAGEMENT The relationship between the working conditions with psychological distress and work engagement suggests that improvements in the workplace are needed to promote protective measure for the mental health of health care professionals.
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Affiliation(s)
- Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Sara Domínguez-Salas
- Department of Psychology, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
| | | | - Adolfo Romero
- Nursing and Podiatry Department, Health Sciences School, Instituto de Investigación Biomédica de Málaga (IBIMA), University of Málaga, Málaga, Spain
| | - Valle Coronado-Vázquez
- Department of Nursing, Catholic University of Ávila, Ávila, Spain.,Group B21-20R, Health Research Institute of Aragon (IIS), Zaragoza, Spain
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health. Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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Coronado-Vázquez V, Castro-Martín J, Cámara-Escribano C, Gómez-Salgado J, Martín-López C, García-Iglesias JJ. [Ethical dimensions of prevention and planning in assisted-living facilities during the SARS-CoV-2 pandemic (Covid-19): a public health emergency.]. Rev Esp Salud Publica 2020; 94:e202009105. [PMID: 32894259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/19/2020] [Indexed: 06/11/2023] Open
Abstract
The SARS-CoV-2 pandemic (Covid-19) has had a major impact on residents of assisted-living facilities. While it is plausible that the characteristics of these patients and their special clinical fragility have contributed to their greater vulnerability to infection, other related factors cannot be ruled out, such as the quality of management at these centers and the lack of planning for actions taken before and during the health crisis. Both aspects pertain to the field of public health, where the ethics of the common good conflicts with the autonomy of the individual.
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Affiliation(s)
- Valle Coronado-Vázquez
- Centro de Salud de Illescas. Toledo. España
- Grupo de Bioética de la Sociedad Madrileña de Medicina de Familia y Comunitaria (SoMaMFyC). Madrid. España
| | - Josefa Castro-Martín
- Grupo de Bioética de la Sociedad Madrileña de Medicina de Familia y Comunitaria (SoMaMFyC). Madrid. España
- Centro de Salud Benita de Ávila. Madrid. España
| | - Carmen Cámara-Escribano
- Grupo de Bioética de la Sociedad Madrileña de Medicina de Familia y Comunitaria (SoMaMFyC). Madrid. España
- Centro de Salud Dos de Mayo. Madrid. España
| | - Juan Gómez-Salgado
- Departamento de Sociología, Trabajo Social y Salud Pública. Universidad de Huelva. Huelva. España
- Programa de Posgrado de Seguridad y Salud. Universidad Espíritu Santo. Guayaquil. Ecuador
| | | | - Juan Jesús García-Iglesias
- Departamento de Sociología, Trabajo Social y Salud Pública. Universidad de Huelva. Huelva. España
- Escuela Superior de Salud. Universidade Atlântica. Lisboa. Portugal
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Coronado-Vázquez V, Canet-Fajas C, Delgado-Marroquín MT, Magallón-Botaya R, Romero-Martín M, Gómez-Salgado J. Interventions to facilitate shared decision-making using decision aids with patients in Primary Health Care: A systematic review. Medicine (Baltimore) 2020; 99:e21389. [PMID: 32769870 PMCID: PMC7593011 DOI: 10.1097/md.0000000000021389] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Shared decision making (SDM) is a process within the physician-patient relationship applicable to any clinical action, whether diagnostic, therapeutic, or preventive in nature. It has been defined as a process of mutual respect and participation between the doctor and the patient. The aim of this study is to determine the effectiveness of decision aids (DA) in primary care based on changes in adherence to treatments, knowledge, and awareness of the disease, conflict with decisions, and patients' and health professionals' satisfaction with the intervention. METHODS A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted in Medline, CINAHL, Embase, the Cochrane Central Register of Controlled Trials, and the NHS Economic Evaluation Database. The inclusion criteria were randomized clinical trials as study design; use of SDM with DA as an intervention; primary care as clinical context; written in English, Spanish, and Portuguese; and published between January 2007 and January 2019. The risk of bias of the included studies in this review was assessed according to the Cochrane Collaboration's tool. RESULTS Twenty four studies were selected out of the 201 references initially identified. With the use of DA, the use of antibiotics was reduced in cases of acute respiratory infection and decisional conflict was decreased when dealing with the treatment choice for atrial fibrillation and osteoporosis. The rate of determination of prostate-specific antigen (PSA) in the prostate cancer screening decreased and colorectal cancer screening increased. Both professionals and patients increased their knowledge about depression, type 2 diabetes, and the perception of risk of acute myocardial infarction at 10 years without statins and with statins. The satisfaction was greater with the use of DA in choosing the treatment for depression, in cardiovascular risk management, in the treatment of low back pain, and in the use of statin therapy in diabetes. Blinding of outcomes assessment was the most common bias. CONCLUSIONS DA used in primary care are effective to reduce decisional conflict and improve knowledge on the disease and treatment options, awareness of risk, and satisfaction with the decisions made. More studies are needed to assess the impact of shared decision making in primary care.
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Affiliation(s)
- Valle Coronado-Vázquez
- Aragonese Primary Care Research Group B21-17R. Health Research Institute of Aragon (IIS). Department of Nursing. Faculty of Health Sciences. Catholic University of Ávila. Castilla La Mancha Health Service, Toledo
| | | | - Maria Teresa Delgado-Marroquín
- Bioethics Research Group. Health Research Institute of Aragon (IIS). Faculty of Medicine, University of Zaragoza. Delicias Norte Primary Care Health Center, Zaragoza
| | - Rosa Magallón-Botaya
- Aragonese Primary Care Research Group B21-17R. Health Research Institute of Aragon (IIS). Department of Medicine, University of Zaragoza. Arrabal Primary Care Health Center, Zaragoza
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain
- Safety and Health Postgraduate Program, Espiritu Santo University, Guayaquil, Ecuador
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Coronado-Vázquez V, Museros-Sos D, Oliván-Blázquez B, Magallón-Botaya R, Gómez-Salgado J, Sánchez-Calavera MA, Masluk B, Gil-de-Gómez MJ, Rodríguez-Eguizábal E. Mental Health Patients' Expectations about the Non-Medical Care They Receive in Primary Care: A Cross-Sectional Descriptive Study. Healthcare (Basel) 2020; 8:healthcare8030235. [PMID: 32726908 PMCID: PMC7551225 DOI: 10.3390/healthcare8030235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/18/2022] Open
Abstract
A health system’s responsiveness is the result of patient expectations for the non-medical care they receive. The objective of this study was to assess mental patients’ responsiveness to the health system in primary care, as related to the domains of dignity, autonomy, confidentiality, and communication. Data were collected from 215 people over the age of 18 with mental disorders, using the Multi-Country Survey Study (MCSS) developed by the World Health Organization. Of them, 95% reported a good experience regarding the dignity, confidentiality, communication, and autonomy domains. Regarding responsiveness, patients valued the dignity domain as the most important one (25.1%). Among the patients who experienced poor confidentiality, five out of seven earned less than 900 euros per month (Χ2 = 10.8, p = 0.004). Among those who experienced good autonomy, 85 out of 156 belonged to the working social class (90.4%), and among those who valued it as poor (16.1%), the highest proportion was for middle class people (Χ2 = 13.1, p = 0.028). The two students and 87.5% of retirees experienced this dimension as good, and most patients who valued it as poor were unemployed (43.5%) (Χ2 = 13.0, p = 0.011). Patients with a household income higher than 900 euros more frequently valued responsiveness as good, regarding those domains related to communication, with OR = 3.84, 95% CI = 1.05–14.09, and confidentiality, with OR = 10.48, 95% CI = 1.94–56.59. To conclude, as regards responsiveness in primary care, the dignity domain always obtained the best scores by people with mental disorders. Low economic income is related to a poor assessment of confidentiality. Working class patients, students, and retirees value autonomy as good.
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Affiliation(s)
- Valle Coronado-Vázquez
- Instituto Aragonés de Ciencias de la Salud (IACS), 50009 Zaragoza, Spain; (V.C.-V.); (D.M.-S.); (B.M.); (M.J.G.-d.-G.); (E.R.-E.)
- Castilla-La Mancha Health Service, Illescas Primary Care Health Center, 45200 Toledo, Spain
- Department of Nursing, Universidad Católica de Ávila, 05005 Ávila, Spain
- Health Research Institute of Aragon (IIS), Group B21-20R, 50009 Zaragoza, Spain; (B.O.-B.); (R.M.-B.); (M.A.S.-C.)
- Aragonese Primary Care Research Group, redIAPP Group 016/07/01, 50009 Zaragoza, Spain
| | - Dolores Museros-Sos
- Instituto Aragonés de Ciencias de la Salud (IACS), 50009 Zaragoza, Spain; (V.C.-V.); (D.M.-S.); (B.M.); (M.J.G.-d.-G.); (E.R.-E.)
- Emergency Department, Miguel Servet University Hospital, 50009 Zaragoza, Spain
| | - Bárbara Oliván-Blázquez
- Health Research Institute of Aragon (IIS), Group B21-20R, 50009 Zaragoza, Spain; (B.O.-B.); (R.M.-B.); (M.A.S.-C.)
- Aragonese Primary Care Research Group, redIAPP Group 016/07/01, 50009 Zaragoza, Spain
- University of Zaragoza, 50009 Zaragoza, Spain
| | - Rosa Magallón-Botaya
- Health Research Institute of Aragon (IIS), Group B21-20R, 50009 Zaragoza, Spain; (B.O.-B.); (R.M.-B.); (M.A.S.-C.)
- Aragonese Primary Care Research Group, redIAPP Group 016/07/01, 50009 Zaragoza, Spain
- University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Service, Arrabal Primary Care Health Center, 50009 Zaragoza, Spain
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, 21007 Huelva, Spain
- Safety and Health Posgraduate Program, Universidad Espíritu Santo, 092301 Guayaquil, Ecuador
- Correspondence: ; Tel.: +34-95-921-9700
| | - María Antonia Sánchez-Calavera
- Health Research Institute of Aragon (IIS), Group B21-20R, 50009 Zaragoza, Spain; (B.O.-B.); (R.M.-B.); (M.A.S.-C.)
- Aragonese Primary Care Research Group, redIAPP Group 016/07/01, 50009 Zaragoza, Spain
- University of Zaragoza, 50009 Zaragoza, Spain
- Aragon Health Service, Fuentes Norte Primary Care Health Center, 50002 Zaragoza, Spain
| | - Bárbara Masluk
- Instituto Aragonés de Ciencias de la Salud (IACS), 50009 Zaragoza, Spain; (V.C.-V.); (D.M.-S.); (B.M.); (M.J.G.-d.-G.); (E.R.-E.)
- Aragonese Primary Care Research Group, redIAPP Group 016/07/01, 50009 Zaragoza, Spain
- University of Zaragoza, 50009 Zaragoza, Spain
| | - María Josefa Gil-de-Gómez
- Instituto Aragonés de Ciencias de la Salud (IACS), 50009 Zaragoza, Spain; (V.C.-V.); (D.M.-S.); (B.M.); (M.J.G.-d.-G.); (E.R.-E.)
- La Rioja Health Service, San Pedro Hospital, 26006 Logroño, Spain
| | - Eva Rodríguez-Eguizábal
- Instituto Aragonés de Ciencias de la Salud (IACS), 50009 Zaragoza, Spain; (V.C.-V.); (D.M.-S.); (B.M.); (M.J.G.-d.-G.); (E.R.-E.)
- La Rioja Health Service, Puerta de Arnedo Primary Care Health Center, 26580 Arnedo, Spain
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Coronado-Vázquez V, Navarro-Abal Y, Magallón-Botaya R, Cerezo Espinosa de Los Monteros J, Cruz-Salgado Ó, Gómez-Salgado J, Ramírez Durán MDV. [Applicability of decision aids in emergency departments: an exploratory review]. Rev Esp Salud Publica 2019; 93:e201911109. [PMID: 31723118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 10/19/2019] [Indexed: 06/10/2023] Open
Abstract
BACKGROUND Decision aid tools (DAT) have been widely used in chronic diseases, but there are few studies on their usefulness in emergency departments. The objective of this study was to analyse the applicability of DAT in emergency services. METHODS An exploratory review was conducted. Between January 1, 2012 and August 1, 2019, searches of randomised and controlled clinical trials, systematic reviews and other secondary studies where DAT are used to assist patients of any age in emergency services were conducted. The databases used were: Pubmed, Embase, Web Of Science, Cuiden, Patient Decision Aids Research Group IPDAS Collaboration, Cochrane, Centres for Reviews and Dissemination, National Guideline Clearinghouse, Guidelines International Network. Two reviewers analysed and selected the studies. RESULTS Twelve studies of moderate-low quality were included. The patients in the intervention group (IG) were more aware of their illness (M=3.6 vs 3 correct answers and M=4.2 vs 3.6), and more involved in the decisions (score in OPTION: 26.6 vs 7 and 18.3 vs 7). The conflict was reduced in the IG regarding those imaging tests in the TBI (traumatic brain injury; M=14.8 vs 19.2). In the IG, admittance to perform effort tests was reduced in low-risk chest pain (58% vs 77%; CI95%=6%-31%, 37% vs 52%; p<0.001). When DAT were used in children with diarrhoea or vomiting, in 80% of the cases the decision was to use oral rehydration against 61% in the control group (CG, p=0.001). CONCLUSIONS DAT in emergency services improve patient's knowledge about the disease and their participation in care. More studies are needed to develop DAT in emergency services.
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Affiliation(s)
| | - Yolanda Navarro-Abal
- Departamento de Psicología Social, Evolutiva y de la Educación. Facultad de Ciencias de la Educación. Universidad de Huelva. Huelva. España
| | | | | | - Óscar Cruz-Salgado
- Unidad de Calidad. Hospital Universitario Virgen del Rocío. Servicio Andaluz de Salud. Sevilla. España
| | - Juan Gómez-Salgado
- Departamento de Sociología, Trabajo Social y Salud Pública. Facultad de Ciencias del Trabajo de la Universidad de Huelva. Huelva. España
- Universidad Espíritu Santo. Guayaquil. Ecuador
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Coronado-Vázquez V, Gómez-Salgado J, Cerezo-Espinosa de los Monteros J, García-Colinas MA. Shared Decision-Support Tools in Hospital Emergency Departments: A Systematic Review. J Emerg Nurs 2019; 45:386-393. [DOI: 10.1016/j.jen.2019.01.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 12/11/2018] [Accepted: 01/03/2019] [Indexed: 11/27/2022]
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Azogil-López LM, Pérez-Lázaro JJ, Medrano-Sánchez EM, Gómez-Salgado J, Coronado-Vázquez V. DETELPROG Study. Effectiveness of a New Model of Scheduled Telephone Referral from Primary Care to Internal Medicine. A Randomised Controlled Study. J Clin Med 2019; 8:jcm8050688. [PMID: 31100835 PMCID: PMC6572186 DOI: 10.3390/jcm8050688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/09/2019] [Accepted: 05/13/2019] [Indexed: 12/16/2022] Open
Abstract
In Spain, the average waiting time for a specialist consultation is 58 days. A determinant factor that contributes to this situation is the poor communication between primary care and specialised care, which is mainly due to the waiting days for a consultation, number of avoided/avoidable face-to-face referrals, and waiting days for the resolution of the process. DETELPROG is a referral system in which the family physician requests a scheduled outpatient internal medicine consultation, integrated into the usual consultations agenda of both physicians, the family, and the outpatient clinic physician, in order to have a telephone consultation. A randomized controlled clinical trial has been carried out to assess the effectiveness of DELTELPROG. In a sample of 255 patients, the experimental group was referred via a scheduled telephone call, and those in the control group, by face-to-face hospital consultation area. The results showed statistically significant differences between both groups of 27 days (95% confidence interval (CI): 20–33) regarding specialised consultation, 47 days (95% CI: 17–74) as for the resolution of the process, and 91.7% for avoided face-to-face consultations. The DETELPROG resulted as a low coverage system (53%), which makes it a complementary referral model. It is necessary to make an in-depth analysis of the causes that have led to this technologically low coverage.
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Affiliation(s)
| | - Juan José Pérez-Lázaro
- Andalusian School of Public Health, Department of Preventive Medicine and Public Health, University of Granada, 18080 Granada, Spain.
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, University of Huelva, 21007 Huelva, Spain.
- Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador.
| | - Valle Coronado-Vázquez
- General Directorate of Health Assistance-Aragonese Health Service, 50071 Zaragoza, Spain.
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Coronado-Vázquez V, Gómez-Salgado J, Cerezo Espinosa de Los Monteros J, Canet Fajas C, Magallón Botaya R. [Equity and patient autonomy in the care strategies for patients with chronic disease of health services in Spain]. Gac Sanit 2018; 33:554-562. [PMID: 30064703 DOI: 10.1016/j.gaceta.2018.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/09/2018] [Accepted: 05/14/2018] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To examine the chronic care models of the different Spanish health services and to discuss the ethical questions derived from implementing some of their components. METHOD Narrative review of care strategies and programmes for chronic patients in the different Autonomous Communities, searching in official health departments' web pages, using the terms "Programmes", "Strategies", "Chronic patients", and "Chronicity". RESULTS 15 programmes were found. Most of them include all components of the chronic care model, "decision-making support" being under-represented. The main conflicts in the autonomy of patients arise from the use of big data to stratify the population and from telemonitoring. The stratification of population does not consider the social factors that accompany the disease. CONCLUSIONS Chronic care strategies should consider the autonomy and privacy of patients in the use of clinical data and telemonitoring. In order to be equitable, they would have to provide an integrated health care system, incorporating measures to reduce the inequalities due to the social determinants that accompany the disease.
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Affiliation(s)
- Valle Coronado-Vázquez
- Grupo de Investigación de Bioética de Aragón, Dirección General de Asistencia Sanitaria, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, España
| | - Juan Gómez-Salgado
- Departamento de Enfermería, Facultad de Enfermería, Universidad de Huelva, España; Universidad Espíritu Santo, Guayaquil, Ecuador.
| | | | | | - Rosa Magallón Botaya
- Centro de Salud Arrabal, Servicio Aragonés de Salud, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España
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Abstract
Patient safety and quality of care in a highly complex healthcare system depends not only on the actions of professionals at an individual level, but also on interaction with the environment. Proactive risk management in the system to prevent incidents and activities targeting healthcare teams is crucial in establishing a culture of safety in centres. Nurses commonly lead these safety strategies. Even though safety incidents are relatively infrequent in primary care, since the majority are preventable, actions at this level of care are highly effective. Certification of services according to ISO standard 9001:2008 focuses on risk management in the system and its use in certifying healthcare centres is helping to build a safety culture amongst professionals.
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Affiliation(s)
- Valle Coronado-Vázquez
- Dirección General de Asistencia Sanitaria, Departamento de Sanidad, Gobierno de Aragón, Zaragoza, España.
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