Mental Health Patients' Expectations about the Non-Medical Care They Receive in Primary Care: A Cross-Sectional Descriptive Study

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 (X-2 = 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 (X-2 = 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%) (X-2 = 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

Aplicabilidad de las herramientas de ayuda a la toma de decisiones compartidas en los servicios de Urgencias: una revisión exploratoria

Fundamentos: Las herramientas de ayuda en la toma de decisiones (HATD) han sido muy utilizadas en las enfermedades crónicas, pero existen pocos estudios sobre su utilidad en los servicios de urgencias. El objetivo de este estudio fue analizar la utilización de las HATD en los servicios de urgencias. Métodos: Se realizó una revisión exploratoria. Se realizaron búsquedas de ensayos clínicos aleatorizados y controlados, revisiones sistemáticas y otros estudios se-cundarios donde se utilizaran las HATD para la asistencia a pacientes de cualquier edad en los servicios de urgen-cias, entre el 1 de enero de 2012 y el 1 de agosto de 2019. Dos revisores examinaron y seleccionaron los estudios. Se utilizaron las siguientes bases de datos: 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. Resultados: Se incluyeron doce estudios, de calidad metodológica moderada-baja. Los pacientes del Grupo de Intervención (GI) tenían mayor conocimiento de la enfer-medad (?=3, 6 frente a 3 preguntas correctas y ?=4, 2 frente a 3, 6) y más implicación en las decisiones (puntuación en OPTION: 26, 6 contra 7 y 18, 3 contra 7). El conflicto se redujo en el GI en las decisiones sobre pruebas de imagen en el traumatismo craneoencefálico (TCE) (?=14, 8 frente a 19, 2). En el GI era menos frecuente el ingreso para realizar una prueba de esfuerzo en casos de dolor torácico de bajo riesgo (58% contra 77%; IC95%=6%-31%, y 37% contra 52%; p<0, 001). Cuando se utilizaba una HATD en niños con diarrea o vómitos, en el 80% la decisión era seguir una rehidratación oral frente al 61% en el GC (p=0, 001). Conclusiones: Las HATD en los servicios de urgen-cias mejoran el conocimiento de los pacientes sobre la en-fermedad y la participación en los cuidados. Se necesitan más estudios para desarrollar HATD en los servicios de urgencias. 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 ((X) over bar =3.6 vs 3 correct answers and (X) over bar =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; (X) over bar =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

Bienestar y familia, una mirada desde la psicología positiva

Este libro está dirigido a estudiantes y profesionales en psicología y áreas afines, como enfermería, trabajo social o educación, y a los interesados en personalidad positiva. Cada capítulo se presenta de manera sencilla y con una estructura didáctica, pero sin perder rigor científico y calidad de la revisión, con el fin de facilitar el acceso a la información sobre bienestar individual, familiar y social de una forma accesible para adentrarnos al estudio de temas de psicología positiva. Dadas las temáticas, se consideró pertinente dividir este libro en dos secciones: I. Psicología positiva y bienestar. II. Bienestar individual y familiar.Universidad Autónoma del Estado de México y Ediciones y Gráficos Eón, S.A. de C.V

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat