Propostes per a l’hospital de dia sociosanitari

Hospital de dia sociosanitari; Cartera de serveis; Pla director sociosanitariHospital de día sociosanitario; Cartera de servicios; Plan director sociosanitarioSociosanitary day hospital; Portfolio of services; Socio-sanitary master planDocument que descriu la cartera de serveis sociosanitaris a Catalunya. A cada nivell d’intervenció es presta assistència a les quatre grans línies objecte del Pla director

Adequació de la xarxa sociosanitària en l’atenció a la cronicitat

Programa de Prevenció i Atenció a la Cronicitat; Xarxa sociosanitària; Atenció individualitzadaPrograma de Prevención y Atención a la Cronicidad; Red sociosanitaria; Atención individualizadaChronicity Prevention and Care Program; Social health network; Individualized attentionAquest document proposa una transformació del model amb una orientació als malalts amb patologies cròniques amb l’objectiu de la xarxa sociosanitària de millorar l’atenció de salut a les persones que necessiten atenció geriàtrica, les que requereixen cures pal·liatives, les que pateixen algun tipus de deteriorament cognitiu i les que pateixen malalties neurològiques que poden cursar amb discapacitat

Enquesta de salut a la població institucionalitzada de Catalunya, 2006: residències i centres de llarga estada

Població institucionalitzada; Indicadors de salut; ESPI; Institutionalized population; Health Status Indicators; Catalonia; Población institucionalizada; Indicadores de salud; CataluñaL’ESPI és una enquesta dirigida a les persones de 65 anys i més que viuen a residències i centres de llarga estada (població institucionalitzada). Per primera vegada es disposa d’informació sobre el seu estat de salut, els hàbits i estils de vida i la utilització dels serveis sanitaris. L’ESPI ha entrevistat 1.379 persones de 65 anys i més amb permanència indefinida a residències i centres de llarga estada de més de 15 places de capacitat. La selecció de la mostra s’ha realitzat mitjançant un disseny mostral aleatori en dues etapes que ha tingut en compte el tipus d’institució (residència i centre de llarga estada) i la representativitat per regió sanitària

Exploring Vision-Related Quality of Life : A Qualitative Study Comparing Patients' Experience of Cataract Surgery with a Standard Monofocal IOL and an Enhanced Monofocal IOL

To explore quality of life related with intermediate vision of patients before and after cataract surgery, and to make patients' experience available for the design of future scales that assess visual function related with intermediate distance. A qualitative research methodology based on thematic content analysis was used to explore vision-related quality of life based on the experiences of patients with cataract. Patients were recruited at the Service of Ophthalmology of the Hospital de Sant Pau (Barcelona, Spain). Data were collected through nineteen semi-structured interviews conducted with patients diagnosed with cataract and implanted with a standard aspheric monofocal intraocular lens (IOL) (Tecnis ® ZA9003) (n = 6), an enhanced monofocal IOL (Tecnis ® Eyhance ICB000) (n = 6), and patients from the waiting list (n = 7). The data analysis consisted in coding, aggregation, and theme development of the transcribed audios. Patients on waiting lists reported difficulty and insecurity in performing daily and meaningful tasks related to near visual ranges (eg: threading a needle, reading price tags), intermediate (eg: using a computer or dialling numbers on a smartphone), and distant (eg: recognizing faces, walking on uneven surfaces). Patients after surgery with the standard IOL reported improvement in performing activities mainly in the distant visual range, but also the need for a better communication with clinical staff to adjust their own expectations on the results of the surgery. Finally, patients implanted with the enhanced IOL reported satisfaction and improved visual function in performing daily activities, especially those related to the intermediate visual range. Our exploratory study found that patients after cataract surgery with the enhanced IOL reported a better performance in activities that require the intermediate vision. These results will inform the development of scales to assess vision-related quality of life in the intermediate visual range prioritizing outcomes according to patients' daily and meaningful activities

A multi-domain group-based intervention to promote physical activity, healthy nutrition and psychological wellbeing in older people with losses in intrinsic capacity: AMICOPE development study

The World Health Organization has developed the Integrated Care of Older People (ICOPE) strategy, a program based on the measurement of intrinsic capacity (IC) as 'the composite of all physical and mental attributes on which an individual can draw'. Multicomponent interventions appear to be the most effective approach to enhance IC and to prevent frailty and disability since adapted physical activity is the preventive intervention that has shown the most evidence in the treatment of frailty and risk of falls. Our paper describes the development of a multi-domain group-based intervention addressed to older people living in the community, aimed at improving and/or maintaining intrinsic capacity by means of promoting physical activity, healthy nutrition, and psychological wellbeing in older people. The process of intervention development is described following the Guidance for reporting intervention development studies in health research (GUIDED). The result of this study is the AMICOPE intervention (Aptitude Multi-domain group-based intervention to improve and/or maintain IC in Older PEople) built upon the ICOPE framework and described following the Template for Intervention Description and Replication (TIDieR) guidelines. The intervention consists of 12 face-to-face sessions held weekly for 2.5 h over three months and facilitated by a pair of health and social care professionals. This study represents the first stage of the UK Medical Research Council framework for developing and evaluating a complex intervention. The next step should be carrying out a feasibility study for the AMICOPE intervention and, at a later stage, assessing the effectiveness in a randomized controlled trial.This research was funded by the program POCTEFA (European Union) in the context of the APTITUDE project, reference EFA232/16. Nicolás Martínez-Velilla received funding from La Caixa Foundation (ID 100010434), under agreement LCF/PR/PR15/51100006

Pla estratègic d’atenció geriàtrica especialitzada de Catalunya: bases del model de futur

Pla estratègic; Atenció geriàtrica; Atenció centrada en la personaPlan estratégico; Atención geriátrica; Atención centrada en la personaStrategic plan; Geriatric care; Attention focused on the personAquest Pla aborda la planificació estratègica de l’atenció a les persones grans per part dels equips i dispositius geriàtrics especialitzats (atenció geriàtrica especialitzada), mentre que de forma conjunta amb la direcció estratègica d’atenció primària serà necessari el replantejament de l’atenció a la gent gran de forma transversal, així com amb Salut Pública

Identification of decreased intrinsic capacity: Performance of diagnostic measures of the ICOPE Screening tool in community dwelling older people in the VIMCI study.

peer reviewed[en] BACKGROUND: The World Health Organization (WHO) has developed the Integrated Care for Older People (ICOPE) strategy to face the challenges of ageing societies. This strategy is focused on person centered care and the assessment intrinsic capacity (IC). Early identification of five domains of IC (cognition, locomotion, vitality, sensory (hearing and vision), and psychological) has been shown to be related with adverse outcomes and can guide actions towards primary prevention and healthy ageing. IC assessment proposed by the WHO ICOPE guidelines is composed by two steps: First, Screening for decreased IC by the ICOPE Screening tool; second, by the reference standard methods. The aim was to assess the performance of diagnostic measures (sensibility, specificity, diagnostic accuracy, and agreement of the ICOPE Screening tool) compared to the reference standard methods in European community-dwelling older adults. METHODS: Cross-sectional analysis of the baseline of the ongoing VIMCI (Validity of an Instrument to Measure Intrinsic Capacity) cohort study, which was carried out in Primary Care centers and outpatient clinics from 5 rural and urban territories in Catalonia (Spain). Participants were 207community dwelling persons ≥ 70-year-old with Barthel ≥ 90, without dementia or advanced chronic conditions who provided their consent to participate. The 5 IC domains were assessed by the ICOPE Screening tool and the reference methods (SPPB, gait speed, MNA, Snellen chart, audiometry, MMSE, GDS5) during patients' visit. Agreement was assessed with the Gwet AC1 index. RESULTS: ICOPE Screening tool sensitivity was higher for cognition (0.889) and ranged between 0.438 and 0.569 for most domains. Specificity ranged from 0.682 to 0.96, diagnostic accuracy from 0.627 to 0.879, Youden index from 0.12 to 0.619, and Gwet AC1 from 0.275 to 0.842. CONCLUSION: The ICOPE screening tool showed fair performance of diagnostic measures; it was helpful to identify those participants with satisfactory IC and showed a modest ability to identify decreased IC in older people with high degree of autonomy. Since low sensitivities were found, a process of external validation would be recommended to reach better discrimination. Further studies about the ICOPE Screening tool and its performance of diagnostic measures in different populations are urgently required

Tests ràpids d'infeccions respiratòries pediàtriques

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Tests ràpids; Pacient pediàtricCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Tests rápidos; Paciente pediátricoCoronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Quick tests; Pediatric patientL’atenció als infants suposa al voltant de 7,5 milions de visites anuals a l’atenció primària. D’aquestes, al voltant d’1,6 milions estan relacionades amb les infeccions respiratòries. La majoria de les infeccions són víriques i les més freqüents estan originades per rinovirus, adenovirus, parainfluença, influença i virus respiratori sincític. El diagnòstic diferencial entre les infeccions respiratòries pediàtriques és difícil en infants, una dificultat que està en relació inversa amb l’edat. La pandèmia obliga a descartar la infecció per COVID-19 en els infants que es presenten amb símptomes d’infecció respiratòria. La incertesa del diagnòstic, donada la clínica i la sensibilitat dels tests disponibles, i el diferent tractament que s’ha de fer en el cas d’una infecció per SARS-CoV-2, fa necessari posar a disposició dels professionals d’atenció primària totes les eines disponibles per poder millorar el diagnòstic diferencial de les infeccions respiratòries. Per aquesta raó, s’ha considerat necessari dotar les consultes de pediatria d’atenció primària de tests ràpids d’infeccions respiratòries (VRS, influença A i B i adenovirus). El protocol que es presenta ha estat elaborat per un conjunt de pediatres que representen la Societat Catalana de Pediatria, les entitats proveïdores agrupades en les patronals (UCH i CSC) i l’Institut Català de la Salut. És un protocol clínic però que té en consideració la situació epidemiològica actual de pandèmia per COVID-19. Com qualsevol protocol d’aquest període 2020-21, haurà d’anar canviant conforme es disposi de més coneixement sobre la COVID-19. Els resultats dels tests ràpids han de ser interpretats sempre en el context de la clínica que presenta el pacient

Exercise referral schemes enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity among community-dwelling older adults from four European countries: protocol for the process evaluation of the SITLESS randomised controlled trial

Introduction: SITLESS is a randomised controlled trial determining whether exercise referral schemes can be enhanced by self-management strategies to reduce sedentary behaviour and increase physical activity in the long term, in community-dwelling older citizens. The intervention is complex and requires a process evaluation to understand how implementation, causal mechanisms and context shape outcomes. The specific aims are to assess fidelity and reach of the implementation, understand the contextual aspects of each intervention site, evaluate the mechanisms of impact, and explore perceived effects. Methods and analysis: Following the Medical Research Council guidance on complex interventions, a combination of qualitative and quantitative procedures is applied, including observational checklists and attendance registries, standardised scales (ie, Marcus’s Self-Efficacy Questionnaire, Physical Activity Self-Regulation Scale and the Lubben Social Network Scale) at baseline, postintervention and follow-up assessments, semistructured questionnaires gathering contextual characteristics, and participant observations of the sessions. Semistructured interviews and focus groups with the participants and trainers are conducted at postintervention and during the follow-up to explore their experiences. Outcomes from the standardised scales are analysed as moderators within the impact evaluation. Descriptive results on context and perceived effects complement results on impact. The qualitative and quantitative findings will help to refine the logic model to finally support the interpretation of the results on the effectiveness of the intervention. Ethics and dissemination: The study design was approved by the respective Ethical Committee of Ramon Llull University, Southern Denmark, Northern Ireland and Ulm University. Participation is voluntary, and all participants are asked to sign informed consent before starting the study. A dissemination plan operationalises how to achieve a social impact by reaching academic and non-academic stakeholders. A data management plan describes the specific data sets and regulates its deposition and curation. All publications will be open access

Projecte de programa d’atenció al pacient crònic complex

Programa d’atenció al pacient crònic complex; Atenció sanitària; PlanificacióPrograma de atención al paciente crónico complejo; Atención sanitaria; PlanificaciónComplex chronic patient care program; Health care; PlanningAquest document presenta el Programa d’atenció al pacient crònic complex mitjançant estratègies orientades perquè els pacients rebin una atenció proactiva, resolutiva, adequada, eficient i satisfactòria en qualsevol moment i amb la intensitat que calgui