Biomedical subjects

J López-Torres Hidalgo

Publications and source records attributed to J López-Torres Hidalgo.

11 recordsLinked to original sources

PubMed2005

[Mental health perceived demand and training necessities of primary care physicians].

OBJECTIVE: To know the opinion of the primary health care (PHC) physicians on the assistance demand in mental health (MH), their training necessities and their attitudes about this disorders. DESIGN: Observational and transversal study. SETTING: Primary care. PARTICIPANTS: The subjects of the study were PHC physicians. From a total of 1191 PHC physicians in Castilla-La Mancha region, 301 were selected by random stratified sampling. Main measurements. A self-complimented questionnaire was elaborated, being identified the following variables: professional and sociodemographics characteristics, their perceived demands of MH problems, perceived difficulties in resolution, training in MH, knowledge about specialized resources and their attitudes about mental disorders. RESULTS: 63.5% (95% confidence interval [CI], 57.6-69.4) considered that the mental problems are related with, at least, 20% of the consultations. Very frequent consulted problems were: anxiety disorders (75.9%), affective disorders (73.5%), and somatoform disorders (40.5%). 63.6% (95% CI; 57.8-69.6) considered to have enough information about specialized resources. About attitudes, 43.7% (95% CI; 37.7-49.8) said the PHC physicians cannot be taken charge of the existent demand. This opinion as significantly more frequents in physicians with more patient assigned, more assistance pressure, without postgraduate assistance formation (Spanish MIR system), with less perceived demand, without training in MH and worse knowledge of the specialized resources. CONCLUSIONS: In opinion of most of the physicians the mental disorders are related with, at least, 1 of each 5 consultations. A high proportion considers that the teams of PHC cannot be taken charge of the existent demand, mainly when it is high the assistance pressure. Most says that more specific training should exist in MH and more coordination with the specialized services.

Adult↗

PubMed2004

[Impact of cataract surgery upon functional capacity of the elderly].

PURPOSE: To determine the impact of cataract intervention on visual function of the elderly and on autonomy in daily activities, analyzing the influence of clinical and sociodemographic variables. METHODS: Observational and longitudinal study. 185 elderly patients having undergone cataract surgery were compared with 179 elderly patients on a surgical waiting list. The first group was evaluated prior to surgery and at 4 months post-intervention. Control group patients were evaluated at the same times, without having received surgery. For all subjects, the state of visual function was determined by the Activities of Daily Vision Scale (ADVS). Degree of dependence in carrying out basic daily activities, cognitive state and self-perception of vision were also measured. Other variables were visual acuity, other ocular diseases and sociodemographic characteristics. RESULTS: Amongst the elderly patients having undergone surgery, the proportion of subjects able to carry out basic activities 4 months post-intervention (60.7%) was very similar to the initial pre-intervention figure (62.2%). However, in the control group, the proportion (63.1%) diminished significantly at the 4-month mark (48.8%) (p= 0.0001). Of the intervened subjects, 75.7% demonstrated improved self-perception of vision after 4 months as opposed to 15.4% of the non-intervened patients (p= 0.00001). Post-intervention, the mean score on the ADVS rose from 51.0 S.D. 28.4 to 76.0 S.D. 25.4 (p < 0.001). In contrast, the control group's mean score dropped from 54.8 S.D. 24.8 to 46.5 S.D. 27.1 (p < 0.001). CONCLUSIONS: Cataract surgery in the elderly improves visual function and prevents loss of autonomy, delaying dependency in carrying out basic daily activities.

Activities of Daily Living↗

PubMed1998

[Health education: repercussions of a self-help program on the psychological status of perimenopausal women].

OBJECTIVE: To establish the effect caused by a self-help programme for climacteric and menopause on the psychological state of women of menopausal age. DESIGN: A semi-experimental study with a comparison group. SETTING: Primary Care. PARTICIPANTS: 106 women between 45 and 60, users of Albacete's Area IV Health Centre, of whom 53 were in the intervention group and the other 53 in the control group. Intervention. This consisted of developing an educational programme on the changes occurring in middle-aged women (biological, psychological and social), which included exercises in body movement, relaxation and group discussions. The intervention, aimed at groups of 8 to 10 women, was performed by 4 female nurses in 10 weekly hour-long sessions. MEASUREMENTS AND RESULTS: The participants were interviewed and information was gathered on their functional ability, medicine consumption, frequency of attendance, and their social and demographic data. Their psychological well-being was assessed through the Goldberg Health questionnaire before and after the intervention. At the start, 62 women (70.5%) presented a probable mental disorder, with no statistically significant difference between the two groups. Circumstances such as lower social class, having family members to look after, greater use of consultations, greater consumption of medicines and more functional disability were linked to a higher prevalence of psychological malaise. After the intervention, 82.5% of the women in the control group had probable psychological disorders, but only 8.3% of those in the intervention group. The difference was statistically highly significant (P < 0.00001; RR = 9.9; 95% Cl, 3.8-25.3). CONCLUSIONS: Self-help programmes have a favourable impact on the psychological state of menopausal women. They may be particularly justified when there are circumstances linked to greater prevalence of mental disorders. The results show that educational programmes are very useful in the Primary Care setting.

Female↗

PubMed1998

[Major depression in consumers of benzodiazepines].

OBJECTIVE: To determine the proportion of benzodiazepines consumers who present a mayor depressive disorder and to observe the clinical evolution after restoring an antidepressive treatment. DESIGN: An observational design with a transversal character to determine the prevalence of the depression and a pre and after intervention to observe the answer to the treatment. SETTING: Primary Care. PATIENTS: Patients of the Centro de Salud Zona IV of Albacete who consume benzodiazepines (size of the sample: 91 subjects, selected by means of a consecutive pattern in three medical offices of general practice). INTERVENTION: To install an antidepressive treatment. MEASUREMENTS AND MAIN RESULTS: We explored the presence of nuclear symptoms of depression by means of a interview. The other analyzed variables were: the cognitive state, the characteristics of the consume of benzodiazepines, the problems of health, the intake of other medicines, the frequentation, the installation of the antidepressive treatment and the sociodemographic characteristics. The patients diagnosed of mayor depression were interviewed again after one month and after three months. 37 patients presented criterion of mayor depression (40.7%) (CI 95%: 30.5-51.5). In these an antidepressive treatment was restored, corresponding to selective serotonin reuptake inhibitors in the 91.9% of the occasions. The proportion of depressive patients was higher in women (p = 0.04) and under the diagnosed people we observed a lower period of benzodiazepines consume (p = 0.02), although with a much higher daily consume (p = 0.01). Among the 37 patients who initiated the treatment, only 7 presented adverse reaction. 28 patients were appraised after one month, presenting 6 of them 5 or more nuclear symptoms of depression. CONCLUSIONS: The high proportion of mayor depressive frames can justify the systematic investigation of such disorder in benzodiazepines consumers, specially in women and in patients with a high intake. The identification of the nuclear symptoms can be considered as a useful technique to orientate a mayor depression and to evaluate also the results of an antidepressive treatment.

Adult↗

PubMed1997

[Work satisfaction of health personnel in primary care].

OBJECTIVE: To determine the level of work satisfaction of health professionals working in Primary Care and to establish the social, demographic and professional factors which determine it. DESIGN: An observational, crossover study using a self-administered questionnaire. SETTING: Primary Care. PARTICIPANTS: All the doctors and nurses working in the Primary Care teams in the Albacete Health Area (468 in all). MEASUREMENTS AND MAIN RESULTS: The scale of work satisfaction of health professionals in Primary Care teams was used. Social, demographic and professional data were collected. 9 dimensions or components of work satisfaction were identified through a factorial analysis. The lowest scores were for motivation, opportunities for professional development and coordination with specialists. CONCLUSIONS: The findings show, in general, indifference as to work satisfaction or lack of it in areas such as motivation and opportunities for professional development. The differences observed in those polled relate to their job and work-place, and also, in the case of doctors, to specialist training.

Adult↗

PubMed1997

[Factors associated with chronic drug consumption in the elderly].

BACKGROUND: To determine chronic drug intake in the non-institutionalised elderly population and identify factors associated with polypharmacy. PATIENTS AND METHODS: Cross-sectional study by means of home interview. 1,015 elderly individuals were selected systematically from the 1991 municipal electoral list of Albacete, Spain (level of confidence 95%, precision 3%, response rate 93.8%). The questionnaire included, disability scales (Minimental test, index of Katz and Lawton-Brody, Yesavage scale and DUKE-UNC questionnaire), a self-preceivement of health, demographic data and qualitative and quantitative information about drug intake. We employed the anatomic classification of drugs to obtain a profile of consumption. RESULTS: 75% of those interviewed admitted to taking medication chronically (CI 95%: 72.6-78.6). The mean number of drugs was 3.17 +/- 1.94 SD. Intake was significantly higher in women (p = 0.01), widows (p = 0.04), those of lower social status (p = 0.01), greater age (p < 0.02), and a greater number of illnesses (p < 0.001), more frequent users of health resources (p < 0.001), those physically dependent (p < 0.001) and those suffering from depression or cognitive impairment (p = 0.001). The most commonly taken drugs were: cardioactive drugs (22.1%), diuretics (19.4%) and vasodilators (14.2%). Using logistic regression analysis we found that the factors associated with higher drug intake were: three or more ilnesses (OR = 2.24), poor self-assessed status of health (OR = 1.45), physical dependence (OR = 1.59), age greater than 74 years (OR = 1.63), depression (OR = 1.68), > or = 4 contacts with health providers over a three-month period (OR = 2.73) and previous hospital admissions (OR = 2.67). CONCLUSIONS: The high intake of drugs by the elderly is determined, among other factors, by sociodemographic considerations, the subject's perceived status of health and different forms of disability. These factors should be taken into account by health professionals when planning a rational use of drugs. There is a high consumption of peripheral vasodilators despite their scanty therapeutic value.

Aged↗

PubMed1997

[Depression in older persons. Associated factors].

OBJECTIVE: To determine the proportion of elderly people with depressive disorders and study the possible association with sociodemographic factors, self-perception of health, cognitive function, diseases suffered, drug consumption, sleep disorders and use of services. DESIGN: An observational crossover study using a home interview. SETTING: Community-based. PARTICIPANTS: 787 elderly people aged 65 and over, not institutionalised and living in the city of Albacete. MEASUREMENTS AND MAIN RESULTS: A questionnaire designed for the study was used to gather data on the sociodemographic variables, self-perception of health, diseases suffered, drug consumption, cognitive function, sleep disorders and contacts with the health service. The variables found by logistic regression to be associated independently to the presence of depressive disorders were: being female (OR = 2.75), habitually suffering sleep disorders (OR = 2.75), having self-perception of poor health (OR = 17.61) and cognitive deterioration (OR = 2.45). CONCLUSIONS: It would be advisable to apply a screening test to detect depressive disorders in elderly people with associated factors (being female, having sleep disorders, self-perception of poor health and cognitive deterioration), so that they could benefit from early diagnosis and adequate treatment.

Aged↗

PubMed1996

[Utilization of contraceptive methods during the lactation period].

OBJECTIVES: To find the use of family planning methods during breast-feeding and establish whether there is a relationship with social-demographic questions or the breast-feeding. Secondly, to evaluate nursing mothers' understanding of these methods. DESIGN: An observational, crossover study using a self-administered questionnaire. SETTING: Primary care. PARTICIPANTS: 398 women in their 7th month of breast-feeding were chosen by simple random sampling from the register of births. Reply rate: 85.2%. MEASUREMENTS: The use of contraceptive methods (CM), type of breast-feeding, social-demographic characteristics, information received and women understanding of family planning (additive Likert-type scale). RESULTS: 78% of the women interviewed said they used some CM after delivery: barrier methods were the most common (63.7%). Use was significantly greater in women with a lower level of information or who had previously used CM. CONCLUSIONS: Women with a lower level of information or who had used family planning methods previously said they used them more during breast-feeding. There is insufficient information about contraceptive methods during this period, especially among less educated women. Understanding of CM increases when breast-feeding lasts longer. Activities performed by health staff are not connected to women better understanding of contraception.

Adolescent↗

PubMed1995

[Visual and auditory difficulties expressed by the aged].

OBJECTIVE: To determine the proportion of the elderly who have difficulties in their perceptive functions (seeing and hearing) and associated factors in the area of health self-perception and functional capacity. DESIGN: Observational and crossover, using an interview. SETTING: Community. PARTICIPANTS: 787 elderly people not in institutions; 93.8% reply rate. MEASUREMENTS AND MAIN RESULTS: Using a questionnaire, data were obtained on deficiencies in their sense organs and self-perceived health. Validated scales to determine functional capacity (physical, psychic and social) were used: Katz, Lawton and Brody indexes, Cognitive mini-test, DUKE-UNC questionnaire and Geriatric Depression scale. A serious difficulty or inability to read or watch television was expressed in 17.3% of cases (CI 95%; 14.8-20.0) and to follow a normal conversation in 10.5% (CI 95%; 8.4-12.6). The proportion of the elderly dependent on others to carry out their normal daily activities was 2.2 times greater among those who displayed severe visual problems (CI 95%; 1.7-2.9) and 1.8 times greater if they had hearing difficulties (C.I. 95%; 1.4-2.3). There was a linear tendency between greater visual or auditory problems and less social support (p = 0.01), greater dependency on others for basic daily activities (p < 0.001) and worse perceived health (p < 0.001). CONCLUSIONS: The elderly, especially the oldest among them, frequently display hearing and visual problems, which are related to low self-perception of health and greater functional incapacity.

Age Factors↗

PubMed1995

[Tetanus vaccination in adults: the situation in primary care].

OBJECTIVE: To describe the strategies adopted to increase anti-tetanus vaccination coverage in people over 24, as well as the record systems which exist in Castilla-La Mancha health centres. In addition, to determine those factors involved in achieving greater coverage which depend on the primary care team (PCT). DESIGN: An observational study of a crossover type. SETTING: Primary care. PARTICIPANTS: The PCT in Castilla-La Mancha existing in 1993. 72.5% reply rate. MEASUREMENTS AND MAIN RESULTS: The average coverage achieved, weighted according to population, was 10.55%. The main risk groups in which strategies to increase coverage were put into practice were: the chronically ill (49.5%), professionals at risk (37.6%) and pregnant women (32.6%). Patients were summoned for follow-up doses by 41.3% of PCTs as a matter of habit and by 41.3% occasionally. Normally the vaccination was recorded in the Medical Notes by 41.9% of PCTs. A linear tendency between a higher vaccination rate and, on the other hand, both greater insistence that patients attend for revaccination (p = 0.01) and better recording in the medical notes (p = 0.04) was confirmed. Vaccination coverage was significantly greater in health centres where less people were seen (p < 0.001) and which were more modern (p = 0.003). CONCLUSIONS: The low anti-tetanus vaccination coverage found justifies setting up initiatives of demonstrated efficacy to increase anti-tetanus immunisation. Better records and insistence on patients' attendance for follow-up doses are factors linked to greater vaccination coverage.

Adult↗

PubMed1992

[Mental disorders and the utilization of the general medicine consultation].

OBJECTIVE: To study the quantitative relationship that exists between mental problems and use of the general medical practitioner, and the association between such problems, increased use of the medical services, and morbidity and socio-demographic variables. DESIGN: Observational cross-section study. SITE. A primary care team's general medical consultations. PATIENTS: Patients aged over 15, attending the consultations. A sample of 310 patients was selected using systematic sampling. INTERVENTIONS: The Mental Health GHQ, 28 items questionnaire was administered to the patients, to detect the existence of significant mental health disorders. MEASUREMENT AND MAIN RESULTS: Amongst older patients there is a greater incidence of mental illness, statistically significant at p less than 0.01. Also significant at p < 0.01 were the greater number of visits to the doctor amongst patients previously diagnosed as having mental disorders, amongst the elderly, those patients included in health programmes and those who showed greater take-up of supplementary explorations and interim consultations. CONCLUSIONS: The results demonstrate an association between mental illness and greater number of visits to the general practitioner, leading to the hypothesis that a considerable number of such visits could be attributed to mental illness. There is no doubt that it is important to integrate the mental health services into primary care practice.

Age Factors↗