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Biomedical subjects

R Ruiz Moral

Publications and source records attributed to R Ruiz Moral.

At least 19 recordsLinked to original sources
PubMed2003

[Effectiveness of medical counseling for alcoholic patients and patients with excessive alcohol consumption seen in primary care].

AIM: To determine the effectiveness of medical counseling for alcohol abuse, when it is provided in primary care centers. DESIGN: Quasi-experimental, open, multicenter before-after study.Setting. 14 primary care physician's practices (7 rural, 7 urban) in the province of Córdoba (Spain). PARTICIPANTS: 306 patients of both sexes, recruited with a case-finding strategy, who consumed >=35 (men) or >=21 (women) IU per week, or who had alcohol dependence syndrome (ADS) (MALTS score O>=11). Interventions. All patients were offered brief counseling to reduce drinking, and all were followed to evaluate their status 3 months, 1 year and 2 years later. MAIN MEASURES: The response variable was self-reported alcohol consumption together with normal GGT values or confirmation of alcohol consumption by a relative. The results were subjected to intention-to-treat analysis. RESULTS: Of the 306 patients included in the study, 95.1% were men and 78.4% had ADS. After 2 years 38.89% (95% CI, 32.2%-44.3%) had attained their treatment goal: 23.85% were in complete abstinence, and 15.0% consumed moderate amounts of alcohol below the limit considered to indicate risk. Starting excessive consumption at less than 16 years of age (odds ratio [OR], 3.0885), living in a slum (OR, 3.2103), smoking (OR, 1.7187), and a positive CAGE test (OR, 1.9949) were associated with failure of the intervention (P<.05). CONCLUSIONS: Counseling provided by the family doctor was highly effective under the usual conditions of general practice, both for patients with excessive alcohol consumption and for patients with con ADS.

Adolescent↗
PubMed2002

[Evolution of the communication profile of family medicine residents].

AIMS: To study the development of patient relation skills, as used during interviews with patients for health problems that are common within their specialty, in family medicine residents during the third year of their residency program. METHODS: Quasi-experimental (before-after), national-level, multicenter study. The participants were 193 third-year residents in family medicine at 8 training units who were trained between 1996 and 1999. During this period all residents participated in the usual training and clinical activities included in the National Plan for this specialty. The GATHA-RES questionnaire was used to evaluated six clinical scenarios in video recordings of encounters with standardized patients (3 at the start of the third year and 3 at the end of the third year). Descriptive, bivariate and multivariate statistical analyses were used. RESULTS: A total of 1,024 interviews were analyzed. The time spent with each patient decreased significantly at the end of the residency program; the duration of the visit was directly proportional to the score on the GATHA-RES questionnaire (p < 0.05). Improvements were seen in formal and organizational aspects of the interview. In contrast, skills related with the exploration of personal and contextual aspects of the problem, and negotiating skills, were worse at the end of the study. The variables that best predicted residents' communicational profile were age (inverse relation), duration of the interview, training of the tutor in clinical interviewing, and teaching unit. CONCLUSIONS: Residents learn to shorten the duration of the visit to the detriment of communication skills that are basic to appropriate care for their patients' health problems. These results suggest the need for substantial changes in the training of family medicine residents in Spain.

Adult↗
PubMed2001

[Validity and reliability of an instrument to assess the clinical interviews of residents in family and community medicine: the GATHA-RES questionnaire].

OBJECTIVE: To check the validity of content, the internal consistency and the intra-observer reliability of a questionnaire to evaluate the doctor-patient communication of family medicine residents. DESIGN: Observation study, to validate a measurement instrument. SETTING: Primary care. Family and community medicine teaching units. STUDY POPULATION: For the validity analysis: 25 family and community medicine residents. For the reliability analysis: 48 doctors in the same speciality. MEASUREMENTS AND INTERVENTIONS: The questionnaire was constructed on the basis of a version (GATHA-BASE) composed of 42 items selected by a panel of 60 general practitioners. For content validity, 68 clinical encounters with simulated patients, video-recorded and evaluated, were used. The questionnaire's validity content was studied through a factorial analysis. To measure its internal consistency, Cronbach's alpha coefficients were calculated. Intra-observer reliability of the GATHA-RES version was evaluated through the kappa indexes and the intra-class correlation coefficients. RESULTS: We obtained a version of the GATHA-RES with 27 items. The factorial analysis revealed that there were 9 factors (< >, < >, < >, < >, < >, < >, < > and < >) which showed close correlation with the theoretical and formal contents of the original questionnaire (originally grouped in three sections: attitudes, communication tasks and skills). All the intraclass correlation coefficients had figures > or = 0.90. CONCLUSIONS: The GATHA-RES questionnaire is a valid and reliable instrument that can be used for evaluating the communication skills of general practitioners in training.

Communication↗
PubMed1998

[Health status and morbidity perceived by a group of school children].

OBJECTIVES: To find what self-perception of their health (SPH) and of their morbidity by school-children; and to analyse possible differences, in function of their social and demographic characteristics and life-styles. DESIGN: An observational crossover study, using a health questionnaire. SETTING: Community. PARTICIPANTS: 548 6th and 8th grade (EGB) children in the Occidente Health Area, Córdoba. INTERVENTIONS: Self-filled health questionnaire. MEASUREMENTS AND MAIN RESULTS: 43.7% of students felt very healthy. Bad SPH was independently associated with being a girl, poor state of physical fitness and feeling unhappy. Tiredness and nervousness were the most frequent disorders suffered by school-children. CONCLUSIONS: Although the SPH of the school-children was acceptable, we found high perceived morbidity and prevalence of accidents, along with a striking consumption of medication.

Child↗
PubMed1997

Biopsychosocial features of patients with widespread chronic musculoskeletal pain in family medicine clinics.

OBJECTIVES: We aimed to describe the clinical and psycho-socio-familial features of patients with widespread chronic musculoskeletal pain (WCMP)/fibromyalgia (FM) in primary care settings. To detect differences and similarities between both 'entities'. METHODS: An observational study was carried out with a newcoming clinical case series. Five family medicine surgeries were included. Patients aged from 18 to 50 attended the clinic to fulfil pain criteria for WCMP. Differences between WCMP and FM were based on the presence of 'tender points'. Measurements were made of general characteristics, occupation, pain description, symptoms, tender points, radiographic and laboratory studies, and questionnaires to assess self-rated health (NHP), social support (DUKE), family support (Family-APGAR), and psychopathological traits (CAQ). RESULTS: We identified 48 patients (23 WCMP;25 FM) with a mean age of 38.4 +/- 8.4; 95.8% were females. The back was the anatomical place most frequently reported (93.7%) and 34.8% of the patients pointed out the nape as being the most painful place. The average duration of pain was 6.7 +/- 7 years. Unsteadiness (72.9%), impairment in symptoms with weather (70.8%), with activity (70.8%) and general fatigue (68.8%) were the most frequently detected symptoms. 'Pain' (59.5) and 'energy' (54.4) were the scales of the NHP test most affected. Half of the patients were poorly satisfied with the responses of their families to their needs and over 60% showed psychopathological traits. The patients with FM reported worse self-rated health than those with WCMP; the number of years of pain (4.9 versus 8.2) and the number of symptoms (6.6 versus 8.9) were both greater in patients with FM. CONCLUSIONS: The clinical and psychological features of patients with WCMP-FM are similar to those reported by others. The self-rated health reported by these patients is poor and closer to that reported by patients suffering other chronic osteoarticular diseases. These results support the hypothesis that FM should be considered as more advanced clinical stage of the widespread musculoskeletal pain continuum.

Adult↗
PubMed1996

[Clinical situation, knowledge and risky behavior of patients with human immunodeficiency virus infection attending a health center].

OBJECTIVE: To establish what information patients diagnosed in our health centre as infected by HIV have about their infection, to evaluate possible changes in their hazardous behaviour and to establish the monitoring level and stage of the condition. DESIGN: An observational study of a crossover nature. Demographic data and data on patients' understanding of HIV infection, their hazardous behaviour and clinical situation were collected by means of a semistructured survey. SETTING: Occidente Health Centre, Córdoba. PATIENTS AND OTHER PARTICIPANTS: 35 people with HIV positive serology. MEASUREMENTS AND MAIN RESULTS: 92.6% were or had been users of parenteral drugs. 40.7% believed they had no health problem; 33.4% thought that the fact of having HIV antibodies was reversible; and 22.2% did not think they transmitted the infection. Their understanding of how infection occurred seemed sufficient, but in spite of this 39.1% continued to share syringes and 52.2% did not use condoms habitually. 56% had received what information they had from health staff; and 56.5% of these thought the information was insufficient. 28% did not regularly attend for medical check-ups. CONCLUSIONS: Knowing you are an HIV carrier and having adequate information on ways of infection appeared to modify hazardous behaviour in our sample, although to a still insufficient extent. The establishment of strategies which not only inform, but also educate, would be of vital importance in slowing down the transmission of the infection.

Cross-Over Studies↗