Health Literacy among Health and Social Care University Students

Health literacy has been defined by the World Health Organization as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health. Its importance in reducing inequalities makes health literacy a thematic area that should be addressed in the training of professionals in the fields of healthcare, Social Work and Education. The objective of this study was to define the health literacy levels of students from the Universities of Girona and Barcelona (Spain) and the Regional Institute of Social Work in Perpignan (France). A cross-sectional study was conducted among students of Nursing, Social Work, Primary Education and Special Education in the 2017-2018 academic year. Sociodemographic and academic variables were considered and the HLS-EU-Q16 questionnaire was used to study health literacy levels. In total, 219 students with an average age of 24.9 participated. Of these, 64.4% were studying Social Work, 23.7% Nursing, 5.9% Primary Education, and 5.9% Special Education. Of the total sample, 36.5% were classified as sufficient in health literacy. The total average score of the health literacy index was 11.1; 13.2 among Nursing students; 10.5 among Social Work students; 10.1 among Primary Education students, and 10.1 among Special Education students (p < 0.001). Nursing students obtained the best results and healthcare was the highest rated subdomain, more than disease prevention and health promotion

Évolution du suivi des recommandations en soins infirmières, en trois éditions d’audit de l’AVC en Catalogne

Contexte : Trois audits de l’AVC ont été menés en Catalogne en 2005, 2007 et 2010. Ces audits évaluent un nombre limité des recommandations à l’aide d’indicateurs. Le but de l’étude est de décrire le suivi des recommandations spécifiques aux soins infirmiers en 2010, d’analyser l’évolution du suivi en 2005, 2007 et 2010 et d’identifier des facteurs reliés à ce suivi. Méthode : Il s’agit d’une étude descriptive/corrélationnelle. Six indicateurs spécifiques aux soins infirmiers ont été mesurés. Les données ont été collectées à partir des dossiers médicaux des patients admis dans 46 hôpitaux publics. L’évolution du suivi a été analysée à l’aide des chi-carrés et des modèles de régression ont été utilisés afin d’identifier les facteurs reliés à ce suivi. Résultats : Au total 2190 cas ont été évalués. Trois des six indicateurs évalués montrent un suivi >70% : mobilisation précoce (78,6%), réalisation d’un ECG basal (97%) et réalisation d’une glycémie basale (97,7%). Le dépistage de la dysphagie améliore au cours des trois audits (p<0,001). L’évaluation de l’humeur, s’est détériorée par rapport à 2007 (p=0,002). Les analyses ajustées pour les caractéristiques et la gravidité des patients montrent un majeur suivi du dépistage de la dysphagie parmi les cas admis en neurologie (OR : 5,28, IC 95%, 1,35 à 20,6) et/ou dans les centres de plus de 300 admissions/année par AVC (OR : 4,31, IC 95%, 1,04 à 17,8) ainsi que de l’éducation au patient/famille quand le patient est admis en fin de semaine (OR : 1,62 IC 95%, 1,03 à 2,54). Discussion : L’évolution dans le suivi des recommandations montre que la qualité des soins infirmières aux personnes ayant subi un AVC s’améliore progressivement en Catalogne. Toutefois, une amélioration de certaines recommandations est possible. Ainsi, il s’avère nécessaire de renforcer et promouvoir des interventions plus ciblées et spécifiques

Control of Therapeutic Levels of Anticoagulation and Associated Factors: A Prospective Cohort Study

Teràpia anticoagulant; Vitamin K; Estudis de cohortsTerapia anticoagulante; Vitamin K; Estudios de cohortesAnticoagulant therapy; Vitamin K; Cohort StudiesMaintaining therapeutic levels of anticoagulation is essential to avoid health complications in people who take vitamin K antagonists. This study aimed to analyze the influence of people’s characteristics and the presence of changes in their lives in the control of therapeutic levels of anticoagulation. A longitudinal multicenter study with a 1-year follow-up of a cohort of 199 people receiving anticoagulant therapy was performed. The effect of biological, clinical, social, lifestyle, and changes in life on the international normalized ratio (INR) was analyzed. During the follow-up, 46.7% of participants presented good INR control. At baseline, a diagnosis of atrial fibrillation (P = .00), the lack of comorbidities (P = .03), absence of depression (P = .04), and not following a pharmacological treatment with hypoglycemia drugs (P = .01) were associated with good INR control. During the follow-up, the variable of making changes to the usual diet was associated with poor INR control (P = .05). In the binary multiple regression model, factors associated with poor control were taking hypoglycemia drugs (P = .02) and the presence of depression (P = .04), and only the diagnosis of atrial fibrillation was associated with good control (P = .03). People with a diagnosis of atrial fibrillation had good INR control. Having comorbidities, suffering depression, taking hypoglycemia drugs, and making changes to the diet have a negative effect on INR control

Smoking among hospitalized patients: a multi-hospital cross sectional study of a widely neglected problem

Introduction: A comprehensive smoking ban was recently enacted for acute-care hospital campuses in Spain. The aim of this study was to assess the prevalence and patterns of smoking among inpatients before and during hospitalization. Methods: Multi-center cross-sectional study was conducted in 13 hospitals in the province of Barcelona, Spain from May 2014 to May 2015. Participants were adults who provided informed consent. The sample size was calculated to be representative of each hospital (prevalence 29.4%, precision ± 5%, error 5%). We approached 1228 subjects, 888 accepted to participate and 170 were replaced (were not available or declined to participate). Final sample comprised 1047 subjects. We used a computer-assisted personal interview system to collect data, including sociodemographic variables and use of tobacco before and during hospitalization. Smoking status was validated with exhaled carbon monoxide. We calculated overall tobacco prevalence and investigated associations with participant and center characteristics. We performed multiple polytomous and multilevel logistic regression analyses to estimate odds ratios (ORs) and 95% confidence intervals (CIs), with adjustments for potential confounders. Results: In all, 20.5% (95% CI: 18.1-23.0) of hospitalized patients were smokers. Smoking was most common among men (aOR=7.47; 95% CI: 4.88-11.43), young age groups (18-64 years), and individuals with primary or less than primary education (aOR=2.76; 95% CI: 1.44-5.28). Of the smokers, 97.2% were daily consumers of whom 44.9% had medium nicotine dependence. Of all smokers, three-quarters expressed a wish to quit, and one-quarter admitted to consuming tobacco during hospitalization. Conclusions: Our findings indicate the need to offer smoking cessation interventions among hospitalized patients in all units and service areas, to avoid infringements and increase patient safety, hospital efficiency, and improve clinical outcomes. Hospitalization represents a promising window for initiating smoking interventions addressed to all patients admitted to smoke-free hospitals, specially after applying a smoke-free campus ban

Prospective individual patient data meta-analysis of two randomized trials on convalescent plasma for COVID-19 outpatients

Data on convalescent plasma (CP) treatment in COVID-19 outpatients are scarce. We aimed to assess whether CP administered during the first week of symptoms reduced the disease progression or risk of hospitalization of outpatients. Two multicenter, double-blind randomized trials (NCT04621123, NCT04589949) were merged with data pooling starting when = 50 years and symptomatic for <= 7days were included. The intervention consisted of 200-300mL of CP with a predefined minimum level of antibodies. Primary endpoints were a 5-point disease severity scale and a composite of hospitalization or death by 28 days. Amongst the 797 patients included, 390 received CP and 392 placebo; they had a median age of 58 years, 1 comorbidity, 5 days symptoms and 93% had negative IgG antibody-test. Seventy-four patients were hospitalized, 6 required mechanical ventilation and 3 died. The odds ratio (OR) of CP for improved disease severity scale was 0.936 (credible interval (CI) 0.667-1.311); OR for hospitalization or death was 0.919 (CI 0.592-1.416). CP effect on hospital admission or death was largest in patients with <= 5 days of symptoms (OR 0.658, 95%CI 0.394-1.085). CP did not decrease the time to full symptom resolution

Cessació de l'hàbit tabàquic en pacients afectats de malaltia vascular cerebral aguda

S'han estudiat 1003 pacients amb el diagnòstic de Malaltia Vascular Cerebral (MVC) aguda ingressats a la unitat de neurologia de l'Hospital Josep Trueta de Girona en el període de gener de 2005 a juliol de 2007. S'ha realitzat un estudi de cohorts prospectiu d'un any en 110 pacients que eren fumadors en el moment de l'ictus. Un elevat percentatge dels pacients afectats de MVC aguda presenten factors de risc vascular que es poden evitar com el consum de tabac o d'alcohol, i factors de risc vascular que cal controlar com la hipertensió, la dislipèmia, la diabetis o la cardiopatia. Només 4 de cada 10 pacients fumadors diagnosticats d'ictus havien abandonat l'hàbit un any després de presentar la MVC aguda. Les variables que millor prediuen la cessació tabàquica en aquests pacients són la localització de la lesió a l'ínsula cerebral i la intenció de deixar de fumar prèvia a l'ictus.Patients with a diagnosis of acute cerebrovascular disease (CVD) admitted to the Neurology Department of the Joseph Trueta Hospital of Girona between January 2005 and July 2007 were included (n: 1003). A one-year prospective cohort study of 110 patients who were smokers at the time of having the CVD was conducted. A high percentage of patients affected by acute CVD have avoidable vascular risk factors such as the use of tobacco and alcohol, and vascular risk factors which need to be controlled such as hypertension, dyslipidemia, diabetes and cardiopathy. Only 4 out of 10 patients diagnosed with stroke who were smokers had given up the habit one year after having an acute CVD. Patients who have the intention of stopping smoking before having the stroke and/or those that have a stroke lesion affecting the insular cortex are more likely to stop smoking. These factors are therefore the variables which best predict giving up smoking in these patients

La prevención de la enfermedad vascular cerebral aguda. Primera parte

El objetivo de este trabajo es revisar los factores de riesgo de la enfermedad vascular cerebral aguda, se trataran los factores siguiendo la clasificación de Sacco et al.(1997), los factores potencialmente modificables se sub-clasificarán en factores que se pueden prevenir y factores no prevenibles. También se analizarán los factores no modificables como la edad, el sexo o la herencia. Respeto los potencialmente modificables que se pueden prevenir se revisará el hábito tabáquico, el abuso de alcohol, o el consumo de otras drogas. En una segunda parte de este trabajo se revisarán los factores de riesgo que no se pueden prevenir como la hipertensión arterial, la diabetes, las cardiopatías, las dislipemias y los antecedentes de ictus transitorio. Finalmente, se desarrollaran los modelos de prevención de las enfermedade

Alfabetización para la salud, más que información

La alfabetización para la salud se ha tratado de forma extensa y con diversas perspectivas desde 1974, cuando en el marco de una conferencia sobre educación y salud el profesor Scott K. Simonds1 utilizó por primera vez el binomio. Desde entonces, no solo se ha puesto de relieve su importancia, sino que se considera una estrategia global2. Son muchas las definiciones que se han formulado y también las simplificaciones respecto a su aplicación, asimilando el concepto a facilitar información. En este editorial se pretende presentar diferentes aspectos que faciliten la comprensión del concepto de alfabetización para la salud, los actores involucrados y las condiciones necesaria

El impacto de la pandemia de la COVID-19 en el control de las enfermedades crónicas en atención primaria

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Malaltia crònica; Atenció primàriaCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Enfermedad crónica; Atención primariaCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Chronic Disease; Primary Health CareDurante los primeros meses de la pandemia del coronavirus, la AP utilizó la mayoría de recursos para contenerla, y este esfuerzo afectó la calidad y la continuidad de la atención a las personas con enfermedades crónicas. Los objetivos del estudio fueron analizar el impacto de la COVID-19 sobre el modelo asistencial en AP, sobre los indicadores de calidad asistencial de las enfermedades crónicas y sobre las actividades de promoción de la salud