Escalas de calidad de vida relacionada con la salud y funcionalidad en pacientes con patologías de hombro: revisión sistemática, evaluación estandarizada y validación de un cuestionario

189 p.El hombro, es una de las articulaciones más flexibles del ser humano, hecho que lo hace susceptible a varias lesiones. En el ámbito de la salud, los datos relacionados con el estado de una persona se pueden obtener mediante observación clínica, por cuestionarios auto-cumplimentados de Calidad de Vida Relacionada con la Salud (CVRS), o por escalas que combinan ambos tipos de datos. Estos instrumentos tienen que contar con ciertas propiedades psicométricas, como la fiabilidad, la validez y la sensibilidad al cambio, entre otras. Se estudiaron las propiedades de 11 escalas de CVRS, que se usan en la patología de hombro, y una de ellas se validó al castellano. Además, se revisaron y evaluaron las propiedades psicométricas de la escala funcional Constant-Murley score (CMS), en diferentes grupos de patología de hombro. El CMS combina datos auto-cumplimentados con datos del especialista, y se considera por muchos como regla de oro en la evaluación de la patología de hombro. Se realizaron búsquedas sistemáticas y la evaluación se realizó por pares de revisores, con la herramienta Evaluating the Measurement of Patient Reported Outcomes (EMPRO). Entre las escalas de CVRS evaluadas, la American Shoulder and Elbow Surgeons form (ASES-p), compuesta por 11 ítems fue la finalmente seleccionada. Nuestros resultados indican que ASES-p tiene validez convergente, sensibilidad al cambio y es reproducible. Los modelos factoriales y Rasch, apoyaron su uni-dimensionalidad. El ítem del deporte y la distribución de la puntuación en dos sub-escalas son aspectos que requieren de más estudio. En cuanto a la escala CMS, la evidencia disponible sugiere que es sensible al cambio. Se puede usar para la evaluación de sujetos con patología sub-acromial, pero los datos no apoyan su uso en fracturas, inestabilidad, artritis y hombro congelado. El CMS no se puede percibir como regla de oro en la evaluación de hombro

Escalas de calidad de vida relacionada con la salud y funcionalidad en pacientes con patologías de hombro: revisión sistemática, evaluación estandarizada y validación de un cuestionario

189 p.El hombro, es una de las articulaciones más flexibles del ser humano, hecho que lo hace susceptible a varias lesiones. En el ámbito de la salud, los datos relacionados con el estado de una persona se pueden obtener mediante observación clínica, por cuestionarios auto-cumplimentados de Calidad de Vida Relacionada con la Salud (CVRS), o por escalas que combinan ambos tipos de datos. Estos instrumentos tienen que contar con ciertas propiedades psicométricas, como la fiabilidad, la validez y la sensibilidad al cambio, entre otras. Se estudiaron las propiedades de 11 escalas de CVRS, que se usan en la patología de hombro, y una de ellas se validó al castellano. Además, se revisaron y evaluaron las propiedades psicométricas de la escala funcional Constant-Murley score (CMS), en diferentes grupos de patología de hombro. El CMS combina datos auto-cumplimentados con datos del especialista, y se considera por muchos como regla de oro en la evaluación de la patología de hombro. Se realizaron búsquedas sistemáticas y la evaluación se realizó por pares de revisores, con la herramienta Evaluating the Measurement of Patient Reported Outcomes (EMPRO). Entre las escalas de CVRS evaluadas, la American Shoulder and Elbow Surgeons form (ASES-p), compuesta por 11 ítems fue la finalmente seleccionada. Nuestros resultados indican que ASES-p tiene validez convergente, sensibilidad al cambio y es reproducible. Los modelos factoriales y Rasch, apoyaron su uni-dimensionalidad. El ítem del deporte y la distribución de la puntuación en dos sub-escalas son aspectos que requieren de más estudio. En cuanto a la escala CMS, la evidencia disponible sugiere que es sensible al cambio. Se puede usar para la evaluación de sujetos con patología sub-acromial, pero los datos no apoyan su uso en fracturas, inestabilidad, artritis y hombro congelado. El CMS no se puede percibir como regla de oro en la evaluación de hombro

A Pilot Study to Assess the Feasibility of the Spanish Diabetes Self-Management Program in the Basque Country

is properly cited. Purpose. The purpose of this study was to assess the feasibility of the Spanish Diabetes Self-Management Program (SDSMP) in the primary care setting of the Basque Health Service and offer initial estimations of the randomized controlled trial (RCT) effects. Methods. Ten health centers (HCs) participated in a single-arm pilot study with a 6-month follow-up period between February 2011 and June 2012. Recruitment was performed via invitation letters, health professionals, and the local media. Each intervention group consisted of 8-15 people. The ability of each HC in forming up to 2 groups, participants' compliance with the course, and coordination and data collection issues were evaluated. Glycated haemoglobin (HbA1c) was the main outcome variable. Secondary outcomes were cardiovascular risk factors, drugs consumption, medical visits, quality of life, self-efficacy, physical exercise, and diet. Results. Two HCs did not organize a course. A total of 173 patients initiated the program, 2 dropped out without baseline data, and 90% completed it. No pre-post HbA1c differences existed. Certain improvements were observed in blood pressure control, self-efficacy, physical activity, and some dietary habits. Conclusion. The SDSMP is feasible in our setting. Our experience can be of interest when planning and conducting this program in similar health settings. The trial is registered with ClinicalTrials.gov identifier NCT01642394

A brief self-administered psychological intervention to improve well-being in patients with cancer: Results from a feasibility study

Background: Patients with cancer have relatively high rates of anxiety and distress, adversely affecting their well-being and quality of life. Recent studies indicate that addressing these symptoms could result in better response to cancer treatment. Researchers have found that interventions that focus on increasing mental awareness and the frequency of positive experiences may have a greater impact on reducing psychological morbidity and increasing quality of life than interventions that target relief of psychological symptoms. Aim: To develop and test a brief, easy to use intervention that could improve well-being and quality of life in cancer patients. Methods: We developed a simple well-being intervention that made few demands on patient time and required little training resource. Participants were randomly assigned to an intervention group or a deferred entry group. Measures of anxiety, depression, well-being and quality of life were administered at baseline and at follow-ups. Results: Twenty-two women with metastatic breast cancer and 24 men with metastatic prostate cancer were recruited from oncology clinics. Thirteen women and 14 men completed the study. Both qualitative and quantitative data showed that the intervention was acceptable to users. There was statistically significant improvement in quality of life scores on WHOQOL-BREF post-intervention (p=0.046). Compliance with the intervention was good. Conclusions: This brief well-being intervention appears to be a promising technique for improving quality of life of cancer patients, without making undue demands on staff resources or patient time. If further studies confirm its effectiveness, it could prove to be a cost-effective intervention

Variables associated with COVID-19 severity: an observational study of non-paediatric confirmed cases from the general population of the Basque Country, Spain

Objectives To investigate which were the most relevant sociodemographic and clinical variables associated with COVID-19 severity, and uncover how their inter-relations may have affected such severity.Design A retrospective observational study based on electronic health record data.Participants Individuals ≥14 years old with a positive PCR or serology test, between 28 February and 31 May 2020, belonging to the Basque Country (Spain) public health system. Institutionalised and individuals admitted to a hospital at home unit were excluded from the study.Main outcome measure Three severity categories were established: primary care, hospital/intensive care unit admission and death.Results A total of n=14 197 cases fulfilled the inclusion criteria. Most variables presented statistically significant associations with the outcome (p<0.0001). The Classification and Regression Trees recursive partitioning methodology (based on n=13 792) suggested that among all associations, those with, age, sex, stratification of patient healthcare complexity, chronic consumption of blood and blood-forming organ, and nervous system drugs, as well as the total number of chronic Anatomical Therapeutic Chemical types were the most relevant. Psychosis also emerged as a potential factor.Conclusions Older cases are more likely to experience more severe outcomes. However, the sex, underlying health status and chronic drug consumption may interfere and alter the ageing effect. Understanding the factors related to the outcome severity is of key importance when designing and promoting public health intervention plans for the COVID-19 pandemic