Health literacy of patients on oral anticoagulation treatment- individual and social determinants and effect on health and treatment outcomes

Background Assessment health literacy in people with cardiovascular health problems would facilitate the development of appropriate health strategies for the care and reduction of complications associated with oral anticoagulation therapy. Aim: To evaluate the relationship between health literacy and health and treatment outcomes (concordance with oral anticoagulants, Normalized Ratio control and occurrence of complications) in patients with cardiovascular pathology. Methods Observational, analytic and cross-sectional study carried out on 252 patients with cardiovascular pathology (atrial fibrillation, flutter or valve prosthesis), aged 50-85 years, accessing primary care services in Valencia (Spain) in 2018-2019. Variables referring to anticoagulant treatment with vitamin K antagonists (years of treatment, adequate control, polypharmacy and occurrence of complications, among others) and health literacy (Health Literacy Questionnaire) were analysed. Results All dimensions of health literacy were significantly related to the level of education (p < 0.02), social class (p < 0.02), an adequate control of acenocoumarol (p < 0.001), frequentation of health services (p < 0.001), information by patients to health professionals about anticoagulant treatment (p < 0.03), emergency care visits (p < 0.001) and unscheduled hospital admissions (p < 0.001). Conclusion Health literacy has a relevant influence on the adequate self-management of anticoagulation treatment and the frequency of complications. The different dimensions that comprise health literacy play an important role, but the 'social health support' dimension seems to be essential for such optimal self-management. Trial registration ACC-ACE-2016-01. Registration date: December 2015

Qualitative Analysis by Experts of the Essential Elements of the Nursing Practice Environments Proposed by the TOP10 Questionnaire of Assessment of Environments in Primary Health Care

Background: A short TOP10 scale based on the Practice Environment Scale-Nursing Work Index questionnaire measures the characteristics of nursing work environments. Positive environments result in better quality care and health outcomes. Objective: To identify a small number of core elements that would facilitate more effective interventions by nurse managers, and compare them with the essential elements proposed by the TOP10. Method: Qualitative research by a nominal group of eight experts. The content analysis was combined with descriptive data. Results: Ten most important items were selected and analyzed by the expert group. A high level of consensus in four items (2, 15, 20, 31) and an acceptable consensus in five items was reached (6, 11, 14, 18, 26). The tenth item in the top ten was selected from content analysis (19). The expert group agreed 90% with the elements selected as essential to the TOP10. Conclusion: The expert group achieved a high level of consensus that supports 90% of the essential elements of primary care settings proposed by the TOP10 questionnaire. Organizational changes implemented by managers to improve working environments must be prioritized following our results, so care delivery and health outcomes can be further improved

Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review.

Background Oral anticoagulants (OAC) are widely used in patients with cardiovascular diseases. However, for optimal OAC self-care patients must have skills, among which health literacy (HL) is highlighted. We aimed to describe the relation between HL and self-care in cardiovascular patients on OAC treatment. Methods Electronic searches were carried out in the PubMed, Scopus, Embase, CINAHL, Web of Science, Cochrane Library, SciELO, IME-Biomedicina, CUIDEN Plus and LILACS databases, limited to Spanish and English language and between January 2000-December 2016. Papers reported on adults older than 18 years, taking OAC by themselves for at least three months. PRISMA guidelines were used for paper selection. Results We identified 142 articles and finally included 10; almost all of them about warfarin. Our results suggest that in patients taking OAC treatments there is a positive relationship between HL and the level of knowledge. In addition, a small percentage of participants on the selected papers recognized the side effects and complications associated with OAC treatment. Lower HL level was associated with greater knowledge deficits and less adherence to treatment. Conclusion There is a paucity of research evaluating the effect of HL on diverse aspects of OAC treatments. There is a need to expand the evidence base regarding appropriate HL screening tools, determinants of adequate knowledge and optimal behaviours related to OAC self-management

Transversal education in the degree of nursing: impressions about the integration of the subject of pharmacology in a clinical simulation activity

Sin financiación3.097 JCR (2015) Q2, 72/255 Pharmacology & Pharmacy, 24/90 ToxicologyUE

Transversal education in the degree of nursing: impressions about the integration of the subject of pharmacology in a clinical simulation activity

Sin financiación3.097 JCR (2015) Q2, 72/255 Pharmacology & Pharmacy, 24/90 ToxicologyUE

La tutorización compartida en trabajos de final de grado: pilotaje de una experiencia en el Grado en Enfermería

El presente artículo describe una experiencia con alumnos de 4º de enfermería que están matriculados en el trabajo de fin de grado (TFG). Se les asigna doble tutor como guía y recurso para mejorar su aprendizaje y competencia investigadora. Diseñamos una intervención cualitativa Phillips 66 para valorar las fortalezas y las debilidades del modelo innovador elegido de tutorización. Los resultados obtenidos fueron 1 fortaleza clara, la obtención de 2 puntos de vista distintos sobre su proyecto, y 2 debilidades o riesgos, que pueda existir diferencia de criterio entre ambos tutores, y que alguno de los dos tutores pueda no tener los conocimientos suficientes sobre su itinerario.SIN FINANCIACIÓNNo data 2014UE

Sociodemographic Determinants for the Health-Related Quality of Life of Patients with Vascular Amputations as Determined with the Prosthesis Evaluation Questionnaire

Background: To identify the sociodemographic variables independently related to the different dimensions of the Prosthesis Evaluation Questionnaire (PEQ). Methods: An observational, cross-sectional study was conducted, with a sample of 61 Spanish vascular amputees (Valencia, Spain). Included in this study are the results of the PEQ and explanatory-sociodemographic variables, as well as a descriptive and analytic analysis. Results: Gender differences were observed in "appearance" and "perception of appearance" (significantly higher levels for men). Older patients tended to have worse scores in "utility", "frustration", "social burden" and "deambulation". More favorable scores were obtained for those residing in rural areas in "social burden" and "deambulation". Educational level had a positive correlation with scores. Conclusion: Gender, age, place of residence, and educational level could be considered determinants of the quality of health related to prosthesis adaptation in vascular amputees. Clinical relevance: Knowing the influential variables in the process of prosthetization will allow better adaptation and an improvement in the quality of life.Sin financiación3.390 JCR (2020) Q1, 42/176 Public, Environmental & Occupational Health0.747 SJR (2020) Q2, 182/560 Public Health, Environmental and Occupational HealthNo data IDR 2020UE

Sociodemographic Determinants for the Health-Related Quality of Life of Patients with Vascular Amputations as Determined with the Prosthesis Evaluation Questionnaire

Background: To identify the sociodemographic variables independently related to the different dimensions of the Prosthesis Evaluation Questionnaire (PEQ). Methods: An observational, cross-sectional study was conducted, with a sample of 61 Spanish vascular amputees (Valencia, Spain). Included in this study are the results of the PEQ and explanatory-sociodemographic variables, as well as a descriptive and analytic analysis. Results: Gender differences were observed in "appearance" and "perception of appearance" (significantly higher levels for men). Older patients tended to have worse scores in "utility", "frustration", "social burden" and "deambulation". More favorable scores were obtained for those residing in rural areas in "social burden" and "deambulation". Educational level had a positive correlation with scores. Conclusion: Gender, age, place of residence, and educational level could be considered determinants of the quality of health related to prosthesis adaptation in vascular amputees. Clinical relevance: Knowing the influential variables in the process of prosthetization will allow better adaptation and an improvement in the quality of life.Medicin

La inversión de roles: cuando el alumno se convierte en profesor

El presente artículo describe una experiencia basada en técnicas de dinámicas activas de grupo. Se trabaja con el alumnado incentivando la práctica activa, el estudio autónomo, el aprendizaje colaborativo y el aprendizaje experiencial. Para conseguirlo, se diseña una intervención educativa en la que en pequeños grupos y de forma individual, diseñan un tema de estudio para posteriormente presentarlo en gran grupo. Los resultados demuestran en nuestra muestra que la intervención incrementa el aprendizaje autónomo y colaborativo al tiempo que estimula la capacidad creativa del alumnado.SIN FINANCIACIÓNNo data 2013UE