Variables relacionadas con la reducción de la satisfacción de los usuarios de emergencias

The information received by patients about the severity of their condition, the type of tests to be performed, or the average waiting time in the service are factors that influence their degree of satisfaction and, therefore, their possible anger and/or aggressiveness. Users' discomfort can sometimes lead to violence towards health workers, and this, in turn, can lead to the commonly associated physical and psychological consequences. Our main objective is to explore the relationship between the waiting time, patients' perceived satisfaction with the service, as well as the other variables under study. We used a cross-sectional design was used to evaluate 320 hospital patients in the Region of Murcia (Spain). Our indicate that receiving information about their process, waiting time until the doctor's consultation, the degree of satisfaction with the professional, and the resolution of the doubts are predictors of the degree of overall patient satisfaction with the clinical experience.La información recibida por los pacientes sobre la gravedad de su condición, el tipo de pruebas a realizar o el tiempo promedio de espera en el servicio son factores que influyen en el grado de satisfacción. La incomodidad de los usuarios a veces puede conducir a la violencia hacia los trabajadores de salud, y esto, a su vez, a las consecuencias físicas y psicológicas comúnmente asociadas. Nuestro objetivo es explorar la relación entre el tiempo de espera, la satisfacción del paciente con el servicio y otras variables de interés. Se utilizó un diseño transversal para evaluar a 320 pacientes hospitalarios en la Región de Murcia (España). Los resultados indican que recibir información sobre su proceso, el tiempo de espera hasta la consulta, el grado de satisfacción con el profesional y la resolución de dudas son predictores del grado de satisfacción general del paciente con la experiencia clínica

Tough Love Lessons: Lateral Violence among Hospital Nurses

Background: Workplace violence is a growing social problem among many professions, but it particularly affects the health sector. Studies have mainly focused on evaluating user violence toward health professionals, with less attention being paid to other sources of conflict, such as co-workers themselves. There are different manifestations of this violence in what has been called a context of tolerated or normalized violence among co-workers. However, its effects are far from being tolerable, as they have an impact on general health and job satisfaction and contribute to burnout among professionals. Based on this idea, and following the line of the previous literature, nursing staff are a population at high risk of exposure to workplace violence. For this reason, the present study aims to evaluate exposure to lateral violence or violence among co-workers in nursing staff in public health services and the relationship of this exposure with some of the most studied consequences. (2) Methods: A cross-sectional associative study was carried out in which scales of workplace violence (HABS-CS), burnout (MBI-GS), job satisfaction (OJS), and general health (GHQ-28) were applied to a sample of 950 nursing staff from 13 public hospitals located in the southeast of Spain. (3) Results: The results show that nursing staff have a high exposure to violence from their co-workers, which is more common in male nurses. Greater exposure is observed in professionals with between 6 and 10 years of experience in the profession, and it is not characteristic of our sample to receive greater violence when they have less experience or are younger. A positive correlation is observed with high levels of burnout and a negative correlation with general health and job satisfaction. (4) Conclusions: The results of this work contribute to increasing the scientific evidence of the consequences of a type of workplace violence frequent among nursing staff and to which less attention has been paid in relative terms to other types of prevalent violence. Organizations should be aware of the importance of this type of workplace violence, its frequency and impact, and implement appropriate prevention policies that include the promotion of a culture that does not reward violence or minimize reporting. A change of mentality in the academic environment is also recommended in order to promote a more adequate training of nursing staff in this field

Users’ perception of violence and conflicts with professionals in primary care centers before and during covid-19. a qualitative study

Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users’ point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide

Profiles of lateral violence in nursing personnel of the Spanish public health system

Background Workplace violence in healthcare settings has long been studied in scientific literature, particularly in the nursing profession. Research has explored mostly user violence probably for its high prevalence and impact on health and job satisfaction. Yet this focus may overshadow another dangerous type of workplace violence: coworker violence. Exerted by co-workers with similar status, lateral violence differs from that yielded by a co-worker with a higher rank, known as vertical. This study aims to deepen the knowledge about lateral violence perceived by nurses and its interaction with other variables commonly associated with workplace violence in healthcare: burnout, job satisfaction, and self-perceived health. Method A random block sampling was performed, prompting a total sample of 925 nursing professionals from 13 public hospitals located in the southeast of Spain. The sample distribution (mean and standard deviation) and the response percentages according to the study variables of the ad-hoc questionnaire were analyzed and classified with cluster analysis. Results Through the cluster analysis, two subgroups were obtained: Cluster 1, composed of 779 participants, with low scores in the variables used for the classification, high levels of both extrinsic and intrinsic satisfaction, low levels of emotional exhaustion and cynicism, and low rates of somatization, anxiety, social dysfunction and depression; and Cluster 2, composed of 115 participants and characterized by moderate-high scores in the variables used for the classification, moderate extrinsic satisfaction, and low intrinsic satisfaction, high emotional exhaustion and cynicism and lower somatization, anxiety, social dysfunction, and depression scores. Excluded cases amounted to 31. Conclusion Nursing professionals who experience lateral violence reveal a lower intrinsic satisfaction, feeling less self-accomplished in their job, and less positive work experience. Emotional exhaustion rises as a concerning progressive and long-term outcome of experiencing this type of violence

Whiplash-Associated Disorders. Biopsychosocial Profiles of Pain Perception in Forensic Cases of Victims of Motor Vehicle Accidents

In order to make a complete diagnosis of all the factors influencing whiplash associated disorders (WAD), the evidence suggests that the condition evaluation should follow an integrated biopsychosocial model. This perspective would offer a fuller view of it, recognizing the interplay between the medical, biomechanical, social, and psychological factors. Despite the progress made in the subject, evidence of which psychosocial factors influence the experience of pain in litigant WAD patients is limited. A cross-sectional design and a cluster analysis was used to study the experience of pain and the psychosocial factors included therein in 249 patients with WAD assessed after suffering a motor vehicle accident. Three clusters were obtained: C1, with low scores of pain and a slight-moderate alteration of the Health-Related Quality of Life (HRQoL); C2, with medium scores of pain, alteration of HRQoL and a perception of moderate disability; and C3, with medium-high scores of pain, alteration of the HQoL, perception of moderate disability, presence of anxious-depressive symptomatology, poorer comprehension of the condition suffered, and the belief that it will extend over a long period of time. The results show a heterogeneous experience of pain in WAD, compatible with the biopsychosocial model of disease and the multidimensional approach to pain. The role of the psychologist in the evaluation of the condition could be useful to obtain a complete view of the condition, thus ensuring that the treatment is adapted to the needs of the patient

Variables relacionades amb la reducció de la satisfacció dels usuaris d’emergències

The information received by patients about the severity of their condition, the type of tests to be performed, or the average waiting time in the service are factors that influence their degree of satisfaction and, therefore, their possible anger and/or aggressiveness. Users' discomfort can sometimes lead to violence towards health workers, and this, in turn, can lead to the commonly associated physical and psychological consequences. Our main objective is to explore the relationship between the waiting time, patients' perceived satisfaction with the service, as well as the other variables under study. We used a cross-sectional design was used to evaluate 320 hospital patients in the Region of Murcia (Spain). Our indicate that receiving information about their process, waiting time until the doctor's consultation, the degree of satisfaction with the professional, and the resolution of the doubts are predictors of the degree of overall patient satisfaction with the clinical experience.La información recibida por los pacientes sobre la gravedad de su condición, el tipo de pruebas a realizar o el tiempo promedio de espera en el servicio son factores que influyen en el grado de satisfacción. La incomodidad de los usuarios a veces puede conducir a la violencia hacia los trabajadores de salud, y esto, a su vez, a las consecuencias físicas y psicológicas comúnmente asociadas. Nuestro objetivo es explorar la relación entre el tiempo de espera, la satisfacción del paciente con el servicio y otras variables de interés. Se utilizó un diseño transversal para evaluar a 320 pacientes hospitalarios en la Región de Murcia (España). Los resultados indican que recibir información sobre su proceso, el tiempo de espera hasta la consulta, el grado de satisfacción con el profesional y la resolución de dudas son predictores del grado de satisfacción general del paciente con la experiencia clínica.La informació rebuda pels pacients sobre la gravetat de la seva condició,el tipus de proves que cal realitzar o el temps mitjà despera en el serveisón factors que tenen influència en el grau de satisfacció. De vegades, laincomoditat dels usuaris pot conduir a expressions de violència adreçades als treballadors de la salut, i això, al seu torn, pot comportar lesconseqüències físiques i psicològiques que comunament hi estan associades. El nostre objectiu és explorar la relació entre el temps despera, lasatisfacció del pacient amb el servei i altres variables dinterès. Així, es vautilitzar un disseny transversal per avaluar 320 pacients hospitalaris ala regió de Múrcia (Espanya). Els resultats indiquen que rebre informaciósobre el procés, el temps despera fins a la consulta, el grau de satisfacció amb el professional i la resolució de dubtes són predictors del grau desatisfacció general del pacient amb lexperiència clínica

TAXONOMÍA Y REGISTROS DE CHRYSOPIDAE (INSECTA: NEUROPTERA) EN EL ESTADO DE MORELOS, MÉXICO

A total of 21 species of Chrysopidae occurring in the State of Morelos are presented, these are included in nine genera in the subfamily Chrysopinae. A key is given for the genera as well as keys to species in each genus and diagnosis and distribution data for each species. The identified species were as follows: Ceraeochrysa cincta (Schneider), Ceraeochrysa cubana (Hagen), Ceraeochrysa everes (Banks), Ceraeochrysa sanchezi (Navás), Ceraeochrysa valida (Banks), Chrysopa sp., Chrysoperla comanche (Banks), Chrysoperla exotera (Navás), Chrysoperla rufilabris (Burmeister), Eremochrysa hageni Banks, Leucochrysa maculata Navás, Leucochrysa pretiosa Banks, Leucochrysa texana Adams, Meleoma antennensis Tauber, Meleoma colhuaca Banks, Meleoma mexicana Banks, Meleoma pipai Tauber, Meleoma tezcucana (Banks), Plesiochrysa brasiliensis (Schneider), Plesiochrysa elongata (Navás) y Yumachrysa apache (Banks); 15 species are new records for Morelos, one of which (P. elongata) is a new record for Mexico. Ceraeochrysa and Meleoma were the genera with the largest number of species although Ceraeochrysa was the genus with the largest number of individuals. The most important species as far as their abundance in descending order were: Ceraeochrysa cincta, C. valida, C. cubana, Leucochrysa texana y Chrysoperla comanche.Se presentan 21 especies de Chrysopidae que ocurren en el Estado de Morelos, agrupadas en ocho géneros de la subfamilia Chrysopinae. Se proporciona una clave para los géneros y claves para las especies de cada género, diagnosis y datos de distribución de cada especie, así como imágenes que ilustran las claves. Las especies identificadas fueron: Ceraeochrysa cincta (Schneider), Ceraeochrysa cubana (Hagen), Ceraeochrysa everes (Banks), Ceraeochrysa sanchezi (Navás), Ceraeochrysa valida (Banks), Chrysopa sp., Chrysoperla comanche (Banks), Chrysoperla exotera (Navás), Chrysoperla rufilabris (Burmeister), Eremochrysa hageni Banks, Leucochrysa maculata Navás, Leucochrysa pretiosa Banks, Leucochrysa texana Adams, Meleoma antennensis Tauber, Meleoma colhuaca Banks, Meleoma mexicana Banks, Meleoma pipai Tauber, Meleoma tezcucana (Banks), Plesiochrysa brasiliensis (Schneider), Plesiochrysa elongata (Navás) y Yumachrysa apache (Banks); 15 especies son nuevos registros para Morelos, una de las cuales (P. elongata) representa un nuevo registro para México. Ceraeochrysa y Meleoma fueron los géneros con mayor número de especies, aunque Ceraeochrysa fue el género con el mayor número de individuos. Las especies más importantes por su abundancia en orden descendente fueron: Ceraeochrysa cincta, C. valida, C. cubana, Leucochrysa texana y Chrysoperla comanche

Clinical Predictors of Hyperperfusion Syndrome Following Carotid Stenting: Results From a National Prospective Multicenter Study

[Objectives] The aim of the HISPANIAS (HyperperfusIon Syndrome Post-carotid ANgIoplasty And Stenting) study was to define CHS rates and develop a clinical predictive model for cerebral hyperperfusion syndrome (CHS) after carotid artery stenting (CAS).[Background] CHS is a severe complication following CAS. The presence of clinical manifestations is estimated on the basis of retrospective reviews and is still uncertain.[Methods] The HISPANIAS study was a national prospective multicenter study with 14 recruiting hospitals. CHS was classified as mild (headache only) and moderate-severe (seizure, impaired level of consciousness, or development of focal neurological signs).[Results] A total of 757 CAS procedures were performed. CHS occurred in 22 (2.9%) patients, in which 16 (2.1%) had moderate-severe CHS and 6 (0.8%) had mild CHS (only headache). The rate of hemorrhages was 0.7% and was associated with high mortality (20%). Pre-operative predictors of moderate-severe CHS in multivariate analysis were female sex (odds ratio [OR]: 3.24; 95% confidence interval [CI]: 1.11 to 9.47; p = 0.03), older patients (OR: 1.09; 95% CI: 1.01 to 1.17; p = 0.02), left carotid artery treated (OR: 4.13; 95% CI: 1.11 to 15.40; p = 0.03), and chronic renal failure (OR: 6.29; 95% CI: 1.75 to 22.57; p = 0.005). The area under the curve of this clinical and radiological model was 0.86 (95% CI: 0.81 to 0.92; p = 0.001).[Conclusions] The rate of CHS in the HISPANIAS study was 2.9%, with moderate-severe CHS of 2.1%. CHS was independently associated with female sex, older age, history of chronic kidney disease, and a treated left carotid artery. Although further investigations are needed, the authors propose a model to identify high-risk patients and develop strategies to decrease CHS morbidity and mortality in the future.This study was supported by a Spanish grant from the Instituto de Salud Carlos III (ISCIII-FIS IP14/00971, 2014–2017). The ITRIBIS project has the registration number REGPOT-2013-1. Cooperative Cerebrovascular Disease Research Network (INVICTUS+) (RD16/0019/0015). Dr. Mancha is supported by a Río Hortega contract (CM16/00015). Abbott and Grifols have partial financial supported the conduction of the HISPANIAS project but had no role in the design of the study, interpretation of the data, or manuscript approval.Peer reviewe

Role of age and comorbidities in mortality of patients with infective endocarditis

[Purpose]: The aim of this study was to analyse the characteristics of patients with IE in three groups of age and to assess the ability of age and the Charlson Comorbidity Index (CCI) to predict mortality. [Methods]: Prospective cohort study of all patients with IE included in the GAMES Spanish database between 2008 and 2015.Patients were stratified into three age groups:<65 years,65 to 80 years,and ≥ 80 years.The area under the receiver-operating characteristic (AUROC) curve was calculated to quantify the diagnostic accuracy of the CCI to predict mortality risk. [Results]: A total of 3120 patients with IE (1327 < 65 years;1291 65-80 years;502 ≥ 80 years) were enrolled.Fever and heart failure were the most common presentations of IE, with no differences among age groups.Patients ≥80 years who underwent surgery were significantly lower compared with other age groups (14.3%,65 years; 20.5%,65-79 years; 31.3%,≥80 years). In-hospital mortality was lower in the <65-year group (20.3%,<65 years;30.1%,65-79 years;34.7%,≥80 years;p < 0.001) as well as 1-year mortality (3.2%, <65 years; 5.5%, 65-80 years;7.6%,≥80 years; p = 0.003).Independent predictors of mortality were age ≥ 80 years (hazard ratio [HR]:2.78;95% confidence interval [CI]:2.32–3.34), CCI ≥ 3 (HR:1.62; 95% CI:1.39–1.88),and non-performed surgery (HR:1.64;95% CI:11.16–1.58).When the three age groups were compared,the AUROC curve for CCI was significantly larger for patients aged <65 years(p < 0.001) for both in-hospital and 1-year mortality. [Conclusion]: There were no differences in the clinical presentation of IE between the groups. Age ≥ 80 years, high comorbidity (measured by CCI),and non-performance of surgery were independent predictors of mortality in patients with IE.CCI could help to identify those patients with IE and surgical indication who present a lower risk of in-hospital and 1-year mortality after surgery, especially in the <65-year group