SAS - D.S.A.P. Almería

Permanent URI for this collection


Recent Submissions

Now showing 1 - 20 of 28
  • Publication
    Recreational physical activity reduces breast cancer recurrence in female survivors of breast cancer: A meta-analysis.
    (2022-06-11) Zagalaz-Anula, Noelia; Mora-Rubio, María José; Obrero-Gaitán, Esteban; Del-Pino-Casado, Rafael
    The aim of this review was to systematically collect the published evidence to assess the effect of recreational physical activity (PA) in reducing breast cancer (BC) recurrence in female survivors. A bibliographic search was carried out in PubMed Medline, CINAHL Complete, Scopus and Lilacs until June 2021. We selected observational studies or clinical trials comprising women diagnosed with BC, in which the risk of recurrence of BC was measured before or after performing recreational PA. As a secondary outcome, we analyzed disease free survival for recurrence/disease-specific mortality. The methodological quality of observational studies was assessed with the Newcastle-Ottawa Scale and clinical trials with the PEDro scale. A random effects model was used to estimate the relative risks (RR) and their 95% confidence intervals (CI) to infer the results for any female survivor of BC. We performed separate meta-analyses for prediagnosis and postdiagnosis recreational PA. Eleven studies were included, providing data from 29,677 surviving women with BC with an age range of 18-79 years old. Postdiagnosis recreational PA reduced the risk of BC recurrence by 16% (RR, 0.84; 95% CI: 0.78 to 0.91) and the risk of recurrence/disease-specific mortality by 23% (RR, 0.77; 95% CI: 0.66 to 0.93). Prediagnosis PA reduced the risk of BC by 18% (RR, 0.82; 95% CI: 0.74 to 0.91). This systematic review with meta-analysis shows that recreational PA can be an interesting therapeutic tool to protect against recurrence of BC in female survivors.
  • Publication
    Development and Psychometric Assessment of a Questionnaire for the Detection of Invisible Violence against Women.
    (2022-09-05) Dobarrio-Sanz, Iria; Fernández-Vargas, Anabel; Fernández-Férez, Alba; Vanegas-Coveña, Diana Patricia; Cordero-Ahiman, Otilia Vanessa; Granero-Molina, José; Fernández-Sola, Cayetano; Hernández-Padilla, José Manuel
    Invisible violence against women (IVAW) can be understood as the set of attitudes, behaviors, and subtle beliefs that men use to subordinate women and that are culturally accepted. These behaviors can be a risk factor for intimate partner violence (IPV), so it is important to design tools that allow us to detect it early. The aim of this study was to design and psychometrically assess a questionnaire for the detection of invisible violence against women (Q-IVAW). A descriptive cross-sectional methodological study carried out in three phases: (1) development of the initial version; (2) pilot study (N = 51); and (3) final validation study (N = 990). The tool's reliability, validity, and legibility were assessed. To assess reliability, the internal consistency (Cronbach's α) was analyzed. The validity assessment included an analysis of content, criterion, and construct validity. The EFA revealed that the Q-IVAW was comprised of five factors that explained 55.85% of the total variance found. The Q-IVAW showed very high reliability (α = 0.937), excellent content validity, and good construct validity. The criterion validity analysis showed a moderate correlation between A-IPVAW and Q-IVAW (r = 0.30; p The psychometric assessment of the Q-IVAW yielded good results, which could support the tool's ability to assess how often women are subjected to inviable violent behaviors by their partners.
  • Publication
    Competence and Attitude of Family Physicians towards Sexuality Regarding Their Sexual Orientation, Age, or Having a Partner-Survey Study and Validation.
    (2022-09-03) Ramírez-Santos, Javier; Castro-Luna, Gracia; Lucas-Matheu, Manuel; Parrón-Carreño, Tesifón; Nievas-Soriano, Bruno José
    The main objective of this study was to assess different aspects of family physicians (sex, age, sexual orientation, or having a partner) regarding their competencies, attitudes, and procedures towards their patients' sexuality. We also sought to develop a valid questionnaire to perform this task. A cross-sectional study was performed among family and community medicine physicians in southeast Spain. A total of 259 family physicians participated. Overall, 69.9% were women, 80.7% were heterosexual, 80.7% had a partner, and 50.6% had not received specific sexology training. Homosexual physicians showed a slightly more positive attitude toward sexuality. Training in sexuality established differences in competencies and procedures, but no differences were found in the attitude regarding whether the physicians had a partner or their training. While younger ages were correlated with a more positive attitude, the global score was positively correlated with the age of the professionals. Competences, attitudes, and knowledge of procedures do not depend on whether the professional has a partner, but there may be slight differences regarding attitude when considering the sexual orientation of the physicians. The attitude toward sexuality may not depend on previous training. Albeit younger family physicians have a more positive attitude, all providers become more involved with sexuality as they gain professional experience.
  • Publication
    Consumption of Psychiatric Drugs in Primary Care during the COVID-19 Pandemic.
    (2022-04-14) González-López, María Del Carmen; Díaz-Calvo, Virginia; Ruíz-González, Carlos; Nievas-Soriano, Bruno José; Rebollo-Lavado, Belén; Parrón-Carreño, Tesifón
    The main objective of this research was to analyze whether there were changes in the use of antidepressants, anxiolytics, and hypnotic-sedative drugs, in the context of primary health care, during the COVID-19 pandemic compared to the pre-pandemic period. We further sought to study consumption in vulnerable population groups. A cross-sectional observational study was performed in a primary health district of Spain. The data were obtained from the Andalusian Public Health System database, for the pre-COVID-19 period, from March 2019 to February 2020, and for the COVID-19 period, from March 2020 to February 2021. Univariant and bivariant analyses were performed. The effect size was measured using the Rosenthal test. While the total number of medical prescriptions decreased by 2.5% in the COVID-19 period, the prescriptions of psychiatric drugs increased by 6.1%. The increase in the dose consumption per 1000 inhabitants (DHD) was highest for anxiolytics (7.2%), followed by hypnotic-sedatives (5.6%) and antidepressants (3.7%). The consumption of antidepressants, anxiolytics, and sedative-hypnotic drugs was higher in women, older people, and rural areas and lower in areas with social transformation needs, with these differences being statistically significant. The consumption of psychiatric drugs has increased over the COVID-19 pandemic, especially in women, older people, and rural areas. Thus, we should reflect on the adequate use of these drugs.
  • Publication
    Predictive Model and Mortality Risk Score during Admission for Ischaemic Stroke with Conservative Treatment.
    (2022-03-08) Lea-Pereira, María Carmen; Amaya-Pascasio, Laura; Martínez-Sánchez, Patricia; Rodríguez Salvador, María Del Mar; Galván-Espinosa, José; Téllez-Ramírez, Luis; Reche-Lorite, Fernando; Sánchez, María-José; García-Torrecillas, Juan Manuel
    Stroke is the second cause of mortality worldwide and the first in women. The aim of this study is to develop a predictive model to estimate the risk of mortality in the admission of patients who have not received reperfusion treatment. A retrospective cohort study was conducted of a clinical-administrative database, reflecting all cases of non-reperfused ischaemic stroke admitted to Spanish hospitals during the period 2008-2012. A predictive model based on logistic regression was developed on a training cohort and later validated by the "hold-out" method. Complementary machine learning techniques were also explored. The resulting model had the following nine variables, all readily obtainable during initial care. Age (OR 1.069), female sex (OR 1.202), readmission (OR 2.008), hypertension (OR 0.726), diabetes (OR 1.105), atrial fibrillation (OR 1.537), dyslipidaemia (0.638), heart failure (OR 1.518) and neurological symptoms suggestive of posterior fossa involvement (OR 2.639). The predictability was moderate (AUC 0.742, 95% CI: 0.737-0.747), with good visual calibration; Pearson's chi-square test revealed non-significant calibration. An easily consulted risk score was prepared. It is possible to create a predictive model of mortality for patients with ischaemic stroke from which important advances can be made towards optimising the quality and efficiency of care. The model results are available within a few minutes of admission and would provide a valuable complementary resource for the neurologist.
  • Publication
    The Influence of Cannabis and Alcohol Use on Sexuality: An Observational Study in Young People (18-30 Years).
    (2021-12-31) Roman, Pablo; Ortiz-Rodriguez, Ana; Romero-Lopez, Ana; Rodriguez-Arrastia, Miguel; Ropero-Padilla, Carmen; Sanchez-Labraca, Nuria; Rueda-Ruzafa, Lola
    The consumption of cannabis and alcohol results in a variety of effects on the psychic functions of young users. Notwithstanding their widespread and prevalent use, the impact of these drugs on sexual health remains unknown. Thus, the aim of this study is to analyse the influence of alcohol and cannabis consumption on sexual function in young people. An observational study was conducted in 274 participants aged 18-30 years. The following selection tools were used: Alcohol Use Disorders Identification Test, Cannabis Abuse Screening Test (CAST), and Changes in Sexual Functioning Questionnaire Short-Form. Participants who were at high risk of having cannabis-related problems performed better on the CAST concerning sexual function, arousal, and orgasm. Participants at high risk had higher arousal and orgasm scores than those who were not at risk for cannabis problems. Improvements in sexual function were found between people who were at high risk of having alcohol problems and those who were not at risk. Sexual function in young people who use cannabis and alcohol more frequently was shown to be better than in those who do not use either, highlighting the need for more information aimed at the young population.
  • Publication
    The Experiences of Home Care Nurses in Regard to the Care of Vulnerable Populations: A Qualitative Study.
    (2021-12-23) Fernández-Medina, Isabel María; Ruíz-Fernández, María Dolores; Gálvez-Ramírez, Felisa; Martínez-Mengíbar, Evangelina; Ruíz-García, Manuel Eduardo; Jiménez-Lasserrotte, María Del Mar; Ortega-Galán, Ángela María; Hernández-Padilla, José Manuel
    Home care nurses have become the main references in home care for vulnerable patients. In patients' homes they offer comprehensive and continuous care to both the vulnerable population and their families. The aim of this qualitative study was to explore experiences and perspectives of home care nurses regarding the care of vulnerable patients in Spain. We conducted in-depth semi-structured interviews with 15 home care nurses working with a vulnerable population. From a data analysis, two themes and four subthemes emerged: (1) "barriers to providing home care to vulnerable populations", with the following subthemes: "the particularities of the patient and their home caregivers" and "perceived barriers for the involvement of home care nurses in the care"; and (2) "the emotional cost of home care" with the subthemes "home care is draining for caregivers" and "the impact of home care on the home care nurses". These findings show us that nurses face a number of difficulties in home care for vulnerable patients. The training of nurses in certain competencies and skills by the social health services would enhance the quality of care offered to these patients.
  • Publication
    Effects of a 12-week supervised resistance training program, combined with home-based physical activity, on physical fitness and quality of life in female breast cancer survivors: the EFICAN randomized controlled trial.
    (2022-03-22) Soriano-Maldonado, Alberto; Díez-Fernández, David M; Esteban-Simón, Alba; Rodríguez-Pérez, Manuel A; Artés-Rodríguez, Eva; Casimiro-Artés, Miguel A; Moreno-Martos, Herminia; Toro-de-Federico, Antonio; Hachem-Salas, Nur; Bartholdy, Cecilie; Henriksen, Marius; Casimiro-Andújar, Antonio J
    This study assessed the effects of 12-week supervised resistance training combined with home-based physical activity on physical fitness, cancer-related fatigue, depressive symptoms, health-related quality of life (HRQoL), and life satisfaction in female breast cancer survivors. A parallel-group, outcome assessor-blinded, randomized controlled trial included 60 female breast cancer survivors who had completed their core treatments within the previous 10 years. Through computer-generated simple randomization, participants were assigned to resistance training (RTG; two sessions/week for 12 weeks plus instructions to undertake ≥ 10,000 steps/d) or control (CG; ≥ 10,000 steps/d only). Outcomes were evaluated at baseline and week 12. Muscular strength was assessed with electromechanical dynamometry. A standardized full-body muscular strength score was the primary outcome. Secondary outcomes included cardiorespiratory fitness, shoulder mobility, cancer-related fatigue, depressive symptoms, HRQoL, and life satisfaction. Thirty-two participants were assigned to RTG (29 achieved ≥ 75% attendance) and 28 to CG (all completed the trial). Intention-to-treat analyses revealed that the standardized full-body muscular strength score increased significantly in the RTG compared to the CG (0.718; 95% CI 0.361-1.074, P  and implication for cancer survivors. In female breast cancer survivors who had completed their core treatments within the past 10 years, adding two weekly sessions of supervised resistance training to a prescription of home-based physical activity for 12 weeks produced a large increase in upper-, lower-, and full-body muscular strength, while other fitness components and patient-reported outcomes did not improve. ISRCTN14601208.
  • Publication
    Socio-historical analysis of the social importance of pharmacovigilance
    (Frontiers media sa, 2022-11-25) Coca, Juan R. R.; Coca-Asensio, Raquel; Bueno, Gema Esteban; [Coca, Juan R. R.] Univ Valladolid, Fac Educ Soria, Unit Social Res Hlth & Rare Dis, Soria, Spain; [Coca-Asensio, Raquel] Univ Cadiz, Dept Neurosci Pharmacol, Cadiz, Spain; [Bueno, Gema Esteban] Andalusian Hlth Serv, Almeria Hlth Dist, Almeria Periphery Clin Management Unit, Almeria, Spain
    Pharmacovigilance is a scientific discipline that has changed a lot in recent years and is of great social importance. The case of the so-called sulfonamide elixir showed society the importance of this discipline. Since then, pharmacovigilance has evolved into a scientific discipline with a strong social character. In this paper, a historical review is made of several paradigmatic examples of this discipline to reflect on what pharmacovigilance could be like finally. We conclude that this discipline could be more closely related to other areas of the social sciences, which would help to promote a more democratic social environment taking into account the needs of individuals and social groups.
  • Publication
    The relationship between the age of music teachers in Andalucia and the development of the IT program Escuela TIC 2.0
    (Univ complutense madrid, servicio publicaciones, 2016-01-01) Martos Sanchez, Emilia; Perez-Garcia, Purificacion; Bernal Vazquez, Julia; [Martos Sanchez, Emilia] IES Rosa Navarro Olula Rio Almeria Espana, C Antonio Machado 8, Macael 04867, Almeria, Spain; [Perez-Garcia, Purificacion] Univ Granada, Fac Ciencias Educ, E-18071 Granada, Spain; [Bernal Vazquez, Julia] C Pedro Antonio Alarcon 37 5 A, Granada 18004, Spain
    The object of this paper was to discover if there was a relationship between the age of music teachers in compulsory secondary education (ESO) and the development of the Andalusian ICT school program Escuela TIC 2.0 [ICT School 2.0]. For this investigation a sample composed of 207 secondary education music teachers participated fulfilling a questionnaire on the different aspects of the program in connection to their area, such as their training in ICT, the technology available in the classrooms, the attitude towards ICT and competencies, digital resources and the ties between the families and the ICT School. This questionnaire was subjected both to a statistical validation of its principal components and at the same time to a validation by judges, and to reliability procedures using Cronbach's Alpha and the Split-half methodology. A contingency analysis was applied and the results showed that the lower the age, the higher was the use and the evaluation of ICT, and vice versa. This study demonstrated that the age of music teachers in secondary schools in Andalusia is directly related to the determination to incorporate ICT and to the development of the Escuela TIC 2.0 program.
  • Publication
    Erythematous nodules on lower limbs in a kidney transplantation patient
    (Elsevier science bv, 2017-10-01) Ramirez-Arriola, M. G.; Moreno-Baron, M.; Ruz-Legaza, M.; Casado-Martin, M.; Abad Vivas-Perez, J. J.; [Ramirez-Arriola, M. G.] Dist Sanitario Almeria, Serv Med Familiar & Comunitaria, Almeria, Spain; [Abad Vivas-Perez, J. J.] Dist Sanitario Almeria, Serv Med Familiar & Comunitaria, Almeria, Spain; [Moreno-Baron, M.] Delegac Igualdad Salud & Polit Sociales, Dept Informat, Almeria, Spain; [Ruz-Legaza, M.] Hosp Torrecardenas, Unidad Anat Patol, Almeria, Spain; [Casado-Martin, M.] Hosp Torrecardenas, Serv Aparato Digest, Unidad Hepatol, Almeria, Spain
  • Publication
    Description of clinical pathological concordance and patient satisfaction in minor surgery in a Primary Care centre
    (Ediciones doyma s a, 2017-02-01) Ramirez Arriola, Maria Gabriela; Hunt Mohamed, Naima; Abad Vivas-Perez, Juan Jose; Bretones Alcaraz, Juan Jose; Garcia Torrecillas, Juan Manuel; Huber, Evelyn; [Ramirez Arriola, Maria Gabriela] Med Familiar & Comunitaria, Dist Almeria, Almeria, Spain; [Hunt Mohamed, Naima] Med Familiar & Comunitaria, Dist Poniente, Almeria, Spain; [Abad Vivas-Perez, Juan Jose] Ctr Salud, Med Familia, Almeria Ctr, Almeria, Spain; [Bretones Alcaraz, Juan Jose] Ctr Salud, Med Familia, Almeria Ctr, Almeria, Spain; [Garcia Torrecillas, Juan Manuel] Hosp Torrecardenas, Med Familia, Almeria, Spain; [Huber, Evelyn] Ctr Salud, Almeria Ctr, Pediat, Almeria, Spain
    Aim: To describe the minor surgery (MS) characteristics in a Primary Care (PC) centre, and to evaluate the clinical pathological concordance and patient satisfaction.Design: Descriptive and retrospective study.Setting: Primary Care, urban health care centre, Almeria, Spain.Participants: The population were the patients belonging to urban Primary Health Care centre, referred by their family physicians or paediatricians for the performing of MS during year 2013, and who consented to the intervention. A sample of 223 patients was obtained.Main measurements: Variables analysed were: sex, age, locations of the lesions, type of intervention, clinical diagnosis, histopathology diagnosis, complications, and patient satisfaction. The data were extracted from the medical history, the histopathology reports, and by using a satisfaction questionnaire completed by post or telephone by the patients.Results: The population consisted of 53.8% males, and had a mean age of 51.12 years (SD 19.02). The location of the most intervened lesions was in the head (35.4%). Electro-surgery was the most used procedure (62.8%), with only 16.9% of the lesions being biopsied, of which the most frequent was fibroids (32.3%). The clinical pathological concordance was > 80% and the Kappa index was 0.783 (P 80% and the Kappa index was 0.783 (P
  • Publication
    Comparison of the Effectiveness of an Abbreviated Program versus a Standard Program in Mindfulness, Self-Compassion and Self-Perceived Empathy in Tutors and Resident Intern Specialists of Family and Community Medicine and Nursing in Spain.
    (2021-04-20) Pérula-de Torres, Luis Ángel; Verdes-Montenegro-Atalaya, Juan Carlos; Melús-Palazón, Elena; García-de Vinuesa, Leonor; Valverde, Francisco Javier; Rodríguez, Luis Alberto; Lietor-Villajos, Norberto; Bartolomé-Moreno, Cruz; Moreno-Martos, Herminia; García-Campayo, Javier; González-Santos, Josefa; Rodríguez-Fernández, Paula; León-Del-Barco, Benito; Soto-Cámara, Raúl; González-Bernal, Jerónimo J; The Minduudd Collaborative Study Group,
    Health professionals are among the most vulnerable to work stress and emotional exhaustion problems. These health professionals include tutors and resident intern specialists, due to the growing demand for the former and the high work overload of the latter. Mindfulness training programs can support these professionals during times of crisis, such as the current global pandemic caused by the coronavirus-19 disease. The objective of this study was to compare the effectiveness of an abbreviated Mindfulness-Based Stress Reduction (MBSR) and Mindful Self-Compassion (MSC) training program in relation to a standard training program on the levels of mindfulness, self-compassion, and self-perceived empathy in tutors and resident intern specialists of Family and Community Medicine and Nursing. A total of 112 professionals attached to six Spanish National Health System teaching units (TUs) participated in this randomized and controlled clinical trial. Experimental Group (GE) participants were included in the standard or abbreviated MBSR programs. The Five Facet Mindfulness Questionnaire (FFMQ), the Self-Compassion Scale short form (SCS-SF), and the Jefferson Scale of Physician Empathy (JSPE) were administered three times during the study: before, immediately after, and 3 months after the intervention. Adjusted covariance analysis (ANCOVA), using pretest scores as the covariate, showed a significant increase in mindfulness (F(2,91) = 3.271; p = 0.042; η2 = 0.067) and self-compassion (F(2,91) = 6.046; p = 0.003; η2 = 0.117) in the post-test visit, and in self-compassion (F(2,79) = 3.880; p = 0.025; η2 = 0.089) in the follow-up visit, attributable to the implementation of the standard training program. The standard MBSR and MSC training program improves levels of mindfulness and self-compassion, and promotes long-lasting effects in tutors and resident intern specialists. New studies are needed to demonstrate the effectiveness of abbreviated training programs.
  • Publication
    [Evaluation of treatment with intra-articular injections in osteoarticular pathology of the shoulder in primary care].
    (2021-04-22) Soler-Pérez, María Araceli; Serrano-Córcoles, Maria Del Carmen; Ferrer-Márquez, Manuel; López-González, María Del Mar; Pérez-Sáez, Miguel Ángel; García-Torrecillas, Juan Manuel
    To evaluate the clinical response at 24weeks after injection, measured as pain relief and functional recovery, in painful shoulder syndrome (PSS) in primary care (PC). Longitudinal case series with injection treatment in the scapulohumeral joint, describing functionality and pain evolution before and at 24weeks post injection. Non-urban primary care centres. Patients with osteoarticular shoulder pathology susceptible to injection, failure of pharmacological treatment and rating on the visual analogue scale (VAS) ≥4 or constant score (CS) ≤70. Intra-articular injection of corticosteroid and local anaesthetic into the scapulohumeral joint, describing its evolution at 1, 4, 12 and 24weeks post injection. Infiltration response according to EVA before and after, CS before and after, number of infiltrations, side effects, temporary inability to work (TIL). Sixty-six patients receiving injection, mean age 51.1years (SD 14.7), 57.6% were women and 63.3% were injection in the right shoulder. A 22.7% required TIL and were discharged with a median of 14days (range 7-56days). They required an injection (80.3%) and the most frequent injection pathology was rotator cuff tendinitis (90.9%). They suffered mild side effects (9.4%). We found a decrease in pain from severe to mild and a functional improvement from poor to good. The variables: being retired (OR: 37.82, P=.001) and having an EVA score prior to injection >8 (OR: 15.67, P=.055, almost significant) were associated with poor response. Intra-articular administration of corticosteroids in PSS reduces pain and provides functional improvement after the first week after injection, and is maintained in the long term. This allows a quick recovery to work after an injection at two weeks reducing recovery time by 50%, with few side effects.
  • Publication
    [Analysis of nutritional interventions in the care process of oncological patients in Andalusia - The NOA project].
    (2021) García Luna, Pedro Pablo; Calañas Continente, Alfonso; Villarrubia Pozo, Ana; Jiménez Lorente, Carmen Pilar; Vicente Baz, David; Castanedo, Olaya Isabel; Salvador Bofill, Javier; Rabat Restrepo, Juana María; Díaz Gómez, Laura; Mediano Rambla, María Dolores; Brozeta Benítez, Teresa; Muñoz Lucero, Teresa; Olveira, Gabriel
    Introduction: malnutrition in cancer patients can lead to a reduction in patient quality of life, increased morbidity and mortality, and associated healthcare costs. Objective: to analyze nutritional interventions in the different phases of the oncological process, integrating the needs of patients and those of healthcare professionals. Material and methods: "Design Thinking" techniques were used to address the analysis of the current situation and identify key aspects. Thirteen professionals from 8 public health centers (endocrinology and nutrition, medical and radiotherapy oncology, primary care (PC), nursing and dietetics) participated in the study. Results: nutritional screening is not carried out in a systematic way in the different phases of the oncological process, and there is no universal consensus on the protocols for action and nutritional intervention. A wide compliance with the pathways and referral times of the selected processes has been observed. In the therapeutic phase, there is the possibility of consulting the Clinical Nutrition and Dietetics Unit (UNCYD) and 75 % have specific referral protocols. The nurse case manager is present in all hospitals and in PC. Patient access to the center psychologist was possible in 87 % of the hospitals. Participation of the UNCYD in Tumor Committees was low (only in 25 % of the centers). In all centers there is some kind of collaboration and support by patient associations and the School of Patients, especially in the therapeutic and the control and follow-up phases. Conclusions: variations are observed between the different hospitals and areas in Andalusia, both in terms of means and structures and in activities and procedures. Key points have been selected and prioritized to improve nutritional care in oncology.
  • Publication
    Mindfulness in primary care healthcare and teaching professionals and its relationship with stress at work: a multicentric cross-sectional study.
    (2021-02-02) Magallón-Botaya, Rosa; Pérula-de Torres, Luis Angel; Verdes-Montenegro Atalaya, Juan Carlos; Pérula-Jiménez, Celia; Lietor-Villajos, Norberto; Bartolomé-Moreno, Cruz; Garcia-Campayo, Javier; Moreno-Martos, Herminia; Minduudd Collaborative Study Group
    Work stress is a common problem among the health personnel of the Spanish National Health System. The objective of this paper is to assess the state of mindfulness among Spanish primary care providers and to evaluate its potential relationship with work stress and basic labor and sociodemographic characteristics. Cross-sectional, multi-centric study. Primary care nurses, teachers, teaching collaborators and residents assigned to six Spanish Family Medicine/Family and Community Care Departments were invited to participate (n = 475). A template was designed in Google Forms, including sociodemographic and work-related variables. The state of mindfulness was measured with the Five Facet Mindfulness Questionnaire (FFMQ), while work-related stress was measured using an ordinal scale ranging from 0 to 10 points. Descriptive and inferential statistical analyses were carried out, as well as bivariate and multivariate statistics. The mean age of participants was 40,14 ± 13.12 (range:23-65 years); 66.9% were women, 42.5% internal medicine residents, 29.3% family physicians, and 20.2% nurses. More than half (54.5%) knew about mindfulness, with 24.0% have received training on it, and 22.5% were usual practitioners. The average level of mindfulness was 127.18 ± 15.45 (range: 89-177). The average score of stress at work was 6.00 ± 2.44; 49.9% (range: 0-10). 49.9% of participants scored 7 or more on the stress at work scale. There was an inverse correlation between the levels of mindfulness (FFMQ total score) and work-related stress (Spearman's r = - 0.155, p = 0.003). Significant relationships between the mindfulness practice and the level of mindfulness (F = 29.80, p  Levels of mindfulness in primary care health providers were in line with those levels observed in other groups of health professionals. Half of all of the primary care providers suffered from a high degree of stress. Although weak, inverse relationships were observed between levels of mindfulness and stress at work, with lower values of stress at work among those who practiced mindfulness. NCT03629457 .
  • Publication
    Consensus on Criteria for Good Practices in Video Consultation: A Delphi Study.
    (2020-07-27) Jiménez-Rodríguez, Diana; Ruiz-Salvador, Diego; Rodríguez Salvador, María Del Mar; Pérez-Heredia, Mercedes; Muñoz Ronda, Francisco José; Arrogante, Oscar
    The use of telemedicine has greatly increased, largely derived from the COVID-19 pandemic, which has created the need for a guide aimed towards the adequate management of a modality of health care: the video consultation. A Delphi study composed of three rounds was conducted with 16 experts in holding video consultations and managing non-technical skills from different specialties and nationalities to conceive a consensus on the criteria needed for properly managing video consultations by healthcare professionals. The consensus criteria were defined by three dimensions (preparation of video consultation, video consultation process, and post-video consultation) and their corresponding items. Excellent consensus data was obtained; therefore, use is recommended by any healthcare professional who is going to utilize a video consultation, in order to manage it effectively.
  • Publication
    Increase in Video Consultations During the COVID-19 Pandemic: Healthcare Professionals' Perceptions about Their Implementation and Adequate Management.
    (2020-07-15) Jiménez-Rodríguez, Diana; Santillán García, Azucena; Montoro Robles, Jesús; Rodríguez Salvador, María Del Mar; Muñoz Ronda, Francisco José; Arrogante, Oscar
    In response to the COVID-19 pandemic, health care modalities such as video consultations have been rapidly developed to provide safe health care and to minimize the risk of spread. The purpose of our study is to explore Spanish healthcare professionals' perceptions about the implementation of video consultations. Based on the testimonies of 53 professionals, different categories emerged related to the four identified themes: benefits of video consultations (for professionals, patients, and the health system, and compared to phone calls), negative aspects (inherent to new technologies and the risk of a perceived distancing from the professional), difficulties associated with the implementation of video consultations (technological difficulties, lack of technical skills and refusal to use video consultation among professionals and patients), and the need for training (technological, nontechnical, and social-emotional skills, and adaptation of technical skills). Additionally, the interviewees indicated that this new modality of health care may be extended to a broader variety of patients and clinical settings. Therefore, since video consultations are becoming more widespread, it would be advisable for health policies and systems to support this modality of health care, promoting their implementation and guaranteeing their operability, equal access and quality.
  • Publication
    Characterization of Burnout Among Spanish Family Physicians Treating Fibromyalgia Patients: The EPIFFAC Study.
    (2020) Torres, Xavier; Ojeda, Begoña; Collado, Antonio; Solé, Emília; Vergara, Jesús; Gómez, Emili; Castells, Xavier; Arias, Anna
    Burnout among physicians has increased, affecting not only doctors but also the quality of patient care. Treating challenging disorders, such as fibromyalgia, may increase the risk of feeling burned out. Health care of fibromyalgia patients is increasingly being assigned to family physicians. Therefore, we described the demographic characteristics, work contexts, component burnout scores (exhaustion, depersonalization, and personal accomplishment), and perceptions of fibromyalgia care of Spanish family medicine physicians with high and low levels of burnout. We then evaluated which of these variables were associated with having high or low levels of burnout. This cross-sectional study assessed 506 family physicians recruited from the Spanish Society of Family Physicians and randomly selected from Primary Health Care Centers. The subgrouping of family physicians based on their burnout scores was assessed by cluster analysis. Variables showing statistically significant differences between clusters and significance below 0.25 in univariate logistic regressions were assessed by multivariate logistic regression analysis. Family physicians reporting higher burnout scores (25%) felt that fibromyalgia patients on sick leave increased their workload, reported no support from nurses in the treatment of fibromyalgia patients, and had a more negative impression of fibromyalgia patients. One-quarter of family physicians reported feeling exhausted, detached from fibromyalgia patients, or less professionally accomplished. Several personal characteristics and contextual variables increased burnout. Several interventions to modify these variables and, thus, protect family physicians treating fibromyalgia from burnout are suggested.
  • Publication
    Communication with patients and the duration of family medicine consultations.
    (2017-10-18) Valverde Bolívar, Francisco Javier; Pedregal González, Miguel; Moreno Martos, Herminia; Cózar García, Inmaculada; Torío Durántez, Jesús
    To determine the distribution of consultation times, the factors that determine their length, and their relationship with a more participative, patient-centred consulting style. Cross-sectional multicentre study. Primary Healthcare Centres in Andalusia, Spain. A total of 119 tutors and family medicine physician residents. Consultation length and communication with the patient were analysed using the CICCAA scale (Connect, Identify, Understand, Consent, Help) during 436 interviews in Primary Care. The mean duration of consultations was 8.8min (sd: 3.6). The consultation tended to be longer when the physician had a patient-centred approach (10.37±4.19min vs 7.54±2.98min; p=0.001), and when there was joint decision-making (9.79±3.96min vs 7.73±3.42min: p=0.001). In the multivariable model, longer consultations were associated with obtaining higher scores on the CICAA scale, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and a smaller number of daily visits (r2=0.32). There was no correlation between physician or patient gender, or problem type. A more patient centred medical profile, increased shared decision-making, a wider range of reasons for consultation, whether they came accompanied, in urban centres, and less professional pressure all seem to be associated with a longer consultation.