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Biomedical subjects

S Juncosa

Publications and source records attributed to S Juncosa.

At least 19 recordsLinked to original sources
PubMed2005

[Usefulness of relaxation techniques for patients with ischaemic cardiopathy: intervention in a health district].

OBJECTIVE: To determine the effectiveness of a programme of relaxation used in primary care for patients with ischaemic cardiopathy (IC) through evaluation of the anxiety levels and the quality of life of these patients. DESIGN: Controlled intervention study without randomisation. SETTING: Two primary care teams in the city of Sabadell. PARTICIPANTS: Patients from 15 to 69 years old with IC: intervention group (IG), 57 patients; control group (CG), 47. Interventions. In the IG, conventional treatment and relaxation techniques (RT). In the CG, conventional treatment. MAIN MEASUREMENTS: Degree of anxiety was measured by means of the STAI scale-questionnaire. Quality of life was measured by means of the SF-36 health questionnaire. Blood pressure and smoking were recorded. RESULTS: At 12 months, 70% of patients practised relaxation at least for a short time. In the IG, anxiety dropped significantly at 3, 6, and 12 months, especially the anxiety characteristics scale, which was still significant at 12 months (P=.002). Quality of life at 3 and 6 months in the IG showed better scores in most dimensions except body pain. At 12 months, scores continued to be better than at the start (social function P=.012), except in the mental health dimension. No significant changes were found in blood pressure or tobacco consumption. CONCLUSIONS: Our results suggest that an RT workshop in primary care is beneficial if correctly applied and leads to improved quality of life.

Adolescent↗
PubMed2003

[Job satisfaction and burnout in general practitioners].

OBJECTIVE: To describe job satisfaction in general practitioners (GP) in the province of Barcelona, and to analyse its relationship with their job burnout, and social and professional characteristics. DESIGN: Transversal observational study.Setting. Province of Barcelona, Spain. PARTICIPANTS: 603 General Practitioners had participated in ninety three primary care centers. MEASUREMENT: Through a direct interview (individual or in group) a validated questionnaire was administered in three parts: general data (social, demographic and professional), job satisfaction (Font Roja-9 dimensions) and job burnout (Maslach Burnout Inventory-3 scales). RESULTS: The job satisfaction questionnaire (score ranging from 1-5) showed a global satisfaction level of 3.02 (95%CI, 2.98%-3.05%) and we obtained a 18% non response rate. There was a positive association between overall satisfaction and the following variables: less years working in primary health, working in centres providing instruction, and willingness to receive information from the survey. Low levels of satisfaction were associated to high scores in emotional exhaustion and depersonalisation scales, and low scores in personal accomplishment scale. CONCLUSIONS: Overall satisfaction has a medium score in the Font-Roja questionnaire. Age seems to lead to a significant tendency to decrease satisfaction as practitioners grow older. Job satisfaction and job burnout present a closely linked behaviour, inversely, as satisfaction increases when job burnout presents low scores.

Adult↗
PubMed1999

[The consumption of drugs and natural remedies in the older population of a rural area].

OBJECTIVES: To evaluate the knowledge about medical treatment on people with more than 70 years old, specifically, the understanding, reason for prescription and dosage. To describe the use of natural remedies in the rural environment. To correlate the medication and the natural remedies consumption with health's self-perception. DESIGN: Cross-sectional study. SETTING: Health Center of Santa Eugènia de Berga. Barcelona. PATIENTS: Covered people aged 70 or more, not in an institution, selected by systematic sampling obtained from an updated age and sex register. MEASUREMENTS: A standard questionnaire was used, gathering aspects about medicine and natural remedies consumption and health's self-perception. RESULTS: The average of medicines was 3.08 (SD 2.5) for person. Therapeutics groups most prevalent were cardiovascular and nervous system drugs. The patients remembered correctly the reason of the prescription of the 77% of the medicines and the dosage of the 85%. The 25% of patients needed assistance of some family for to take the medication. We have found statistical significance between health's self-perception and the number of consumed drugs. The 47% of aged population used natural remedies. CONCLUSIONS: The knowledge of medical treatment of our elderly people is satisfactory. We detect in our study a high rate of polymedication. It is necessary, if possible, to rationalize and to reduce the number of drugs. It is useful to revise and to update periodically the elderly people medication. The natural remedies is included on the people's pharmacology and its use is important.

Aged↗
PubMed1998

[Is severity related to the utilization of resources? An exploration of the Duke Severity of Illness Scale (DUSOI)].

OBJECTIVE: To measure the distribution of the seriousness of illnesses and patients in primary care with the Duke Severity of Illness Scale (DUSOI) and relate it to resource use. DESIGN: Observational prospective study. SETTING: Eight primary care centres from the centre sub-section of the Catalan Health Service. PATIENTS AND OTHER PARTICIPANTS: For the first two months of the study, patients who attended for consultation at 9 general/family doctors' clinics were systematically sampled. 1,868 patients were selected and observed for 6 months. MEASUREMENTS AND MAIN RESULTS: The DUSOI was used to work out the seriousness of the illness and of the patient. The variables used as indicators of the use of resources for an illness were: the number of attendances, the time and costs of care. The same for the patient were: the number of attendances, number of episodes and costs of care. The average score for the seriousness of the episode was 31.4 with a standard deviation (SD) of 16.4. The correlations between use of resources and seriousness were under 0.4. The seriousness of the patient had an average of 44.9 (SD 21.3) and statistically significant correlations above 0.6 with the use of resources. CONCLUSIONS: The seriousness of the illnesses attended in primary care is low and is related moderately to the use of resources. DUSOI could be better employed in research, inasmuch as there are systems for classifying patients which have greater explanatory power and can be constructed from pre-existing data.

Adolescent↗
PubMed1998

[The rights of the hospital patient: the knowledge and perception of their fulfillment on the part of the professional. The Group in Catalonia of the Spanish Society of Care for the Health Services User].

BACKGROUND: The Customer Service Department includes the protection of the patient's rights. To analyze the work performed in this setting, we planned to quantitate and evaluate the knowledge and perception of fulfillment by medical staff. METHODS: Multicentric cross-sectional study. The population included health care professionals in nine Catalonian hospitals. The sample was selected at random with reposition and was segmented according to professional category. Data collection was carried out by personal interview supported by a questionnaire. Differences according to institution size were analyzed. RESULTS: A total of 1,014 professionals were interviewed; 84.4% reported to know the patient's rights and 64.4% to observe them. Significant differences (p < 0.05) according to institution size were observed. CONCLUSIONS: Discussion and diffusion of patient's rights is an useful tool to improve knowledge and evaluate the perception of its fulfillment by health care professionals.

Adult↗
PubMed1996

Tuberculin reactivity in Bacillus Calmette-Guérin vaccinated subjects.

SETTING: The Centre for Prevention and Control of Tuberculosis in Barcelona, Spain, where the staff appointed to Training Centers are examined. AIMS: To check for tuberculin sensitivity due to Bacillus Calmette-Guérin (BCG) vaccine and ascertain its duration. METHOD: We compared the results of a tuberculin test (TT) on vaccinated and non-vaccinated subjects. The induration diameter and the time elapsed between BCG vaccination and the TT were determined. RESULTS: Of the 2424 vaccinated subjects, 1489 (61.4%) reacted to TT (> or = 5 mm) and of the 3135 non-vaccinated, 905 (28.9%) reacted, a significant difference. Of 1978 subjects vaccinated between 6 and 14 years of age, 63.3% were TT reactors, compared to 23.9% of the 1948 non-vaccinated. Induration diameters > or = 15 mm amounted to 11% for vaccinated subjects and 8% for those not vaccinated, a significant difference. The time from vaccination to TT was 13-25 years. Of the 446 subjects vaccinated at birth, 237 were reactors (53.1%); of the 887 non-vaccinated subjects of the same age, 154 (17.4%) reacted. Reactors > or = 15 mm amounted to 40 (9%) for vaccinated subjects and 46 for non-vaccinated (5.2%), a significant difference. The time elapsed between vaccination and TT was 20-25 years. For 124 vaccinated subjects with a previous negative TT, a second test was positive for 87 (70.2%), and for 257 non-vaccinated it was positive for 64 (24.9%). The difference is due to a booster effect. CONCLUSIONS: BCG vaccination at birth and for school age children causes a reactivity to tuberculin which persists for 20 to 25 years. An induration diameter of > or = 15 mm does not exclude a vaccinal origin. For vaccinated subjects with a previous negative TT, it is necessary to exclude the booster effect.

Adult↗
PubMed1995

Air in the oesophagus: a sign of oesophageal involvement in systemic sclerosis.

An air oesophagogram, defined as a column of air involving the entire oesophagus, seen on a lateral chest X-ray was observed in 6 (20%) of 30 consecutive patients with systemic sclerosis (SSc) but in none of the controls. The presence of this sign was unrelated to the clinical subset of SSc and to age but was associated with the symptom of regurgitation.

Adult↗
PubMed1994

[The quality of antibiotic treatment in primary health care in the county of Osona (Barcelona)].

BACKGROUND: The evaluation and quality control of antibiotic prescription has become widespread in primary health care (PHC). Most of the studies performed have analyzed the quality of the drug and not the treatment. The aim of this study was to evaluate the quality of the antibiotic treatments of physicians in a concrete area and identify the most deficient aspects. METHODS: A prospective study was performed with the voluntary participation of general physicians and pediatricians of the PHC area of Osona (Barcelona, Spain) by the collection of a series of data of each antibiotic treatment carried out over 30 days. Consideration of each item to evaluate the quality of a given treatment was carried out by a nominal group. RESULTS: A total of 1,976 antibiotic treatments were administered by the 44 physicians participating in the study (68% of the target population). The aspect found to be most deficient was that 20% of the doctors prescribed an antibiotic in a diagnosis for which it was not susceptible and in 30% of the susceptible cases the choice of antibiotic was erroneous. The length of treatment was the aspect on posology showing the worst results (27% incorrect). The mean quality following the application of the scale elaborated by the nominal group was 72.6 (SD = 25.7) over a maximum of 100. Lower quality was observed in the pediatricians (p = 0.006), in the physicians working in the reformed network (p < 0.0001), in the prescriptions induced by another physician (p = 0.0001) and in those induced by the patient (p = 0.03). CONCLUSIONS: The number of antibiotics prescribed in non susceptible processes in primary health care should be reduced. Likewise, the choice of antibiotics prescribed should improve.

Anti-Bacterial Agents↗
PubMed1990

Appropriateness of hospital referral for hypertension.

OBJECTIVE: To examine the efficiency of referral to an outpatient clinic and particularly the differences between referrals from general practitioners practising in health centres and those from other general practitioners. DESIGN: Retrospective audit of referral letters and case notes by comparison with externally set standards of appropriateness of referrals over two years. SETTING: Outpatient hypertension clinic at Western Infirmary, Glasgow. PATIENTS: 306 Consecutive new referrals of patients over two years (1 May 1986 to 30 April 1988), for whom case notes were available in 298. MAIN OUTCOME MEASURES: Congruence of referrals with each of two standards of appropriateness based on published opinion on specialist referral (standard 1 was stricter than standard 2) and completeness of referral letters. RESULTS: Of the 298 referrals, those from general practitioners accounted for 205, from other hospital departments 68, and from other sources 25. Overall, 84 referrals of the 205 from general practice met the first standard and 134 met the second, more lenient standard. 58 Referral letters from outside the hospital had some item missing. Referrals from general practitioners working in health centres (a fifth of the total) were significantly more likely to meet both standards (p less than 0.01) and to send a complete referral letter (p less than 0.001) than the 145 referred by other general practitioners. CONCLUSIONS: According to the standards used, general practitioners in health centres made more appropriate referrals, and further investigation is needed to identify the underlying factors responsible.

Ambulatory Care↗
PubMedDate not supplied

[Minimum data sets in ambulatory care].

A sensible and rational approach is necessary in order to match the growing requirements of information on the ambulatory care sector characterised by a big deal of complexity and variability. This must be applied to any initiative attempting to obtain any degree of harmonization in ambulatory care data sets. This paper summarises a conceptual aspect of the work undertaken by the project Measurement Characterization and Control of Ambulatory Care in Europe (McACE) sponsored by the Commission of the European Communities under the exploratory phase of the Advanced Informatics in Medicine (AIM) programme. Our approach places in the first priority the efficiency when assessing the information needs of the different actors trying to make a balanced approach between the costs of collecting and processing a specific item and its use. For this we performed a conceptual validation of the term Minimum Basic Data Set and its potential application to the Ambulatory Care Sector. It is suggested its substitution by the term Minimum Data Set as a part of a practical tool for promoting the harmonization of the information in ambulatory care.

Ambulatory Care Facilities↗
PubMedDate not supplied

[The reasons for consultation and active problems. A key for the understanding of information in primary care].

The aim of this work is to assess the major differences found in the information content of the registers in primary care according to whether the registration includes the Reason (s) For Encounter (as ascertained by the professional) or the Active Health Problem (s). The information used is based on an observational study of a representative sample of the consultations to eight general practitioners from the Principate of Andorra. The study was performed during the period of May-June 1989. 547 consultations are analysed. A better specificity and information content is observed when both approaches are registered. Active Health Problems seem to be barely related to Reasons for Encounter and it seems that they could have as much, if no more. Influence in the process of care, than the RFEs it selves.

Adolescent↗
PubMedDate not supplied

[A patient classification system for our primary care: the ambulatory care groups (ACGs)].

OBJECTIVES: The ambulatory care groups (ACGs) were developed at the Johns Hopkins University in 1987 and they differ from other systems because their longitudinal approach and its capability to describe the case-mix of a population of reference. This paper describes the ACGs and assess its potential application to spanish primary care (PC). METHODS: Observational study with the voluntary participation of 13 physicians (general practitioner and paediatrician) and nursing staff. During six months all diagnoses and interventions to a sample of attended patients were gathered. RESULTS: The first stage in grouping involves ascribing one of the 34 ambulatory diagnostic groups (ADGs) to each of the health problems attended. The second stage involves, after several intermediates steps, assigning one of the 51 ACGs to each patient. The total number of episodes was 7,559 (input), the number of patients (output) 2,467, the ICD codes with error 292, and the number of patients with ICD codes with error 278. With 5 ACGs we classify 44% of all the patients and with 10 ACGs, 64% of all them. Only two ACGs were empty. The article explores the potential applications of the system in spanish PC: for provider financing when a capitation payment component were introduced, utilization review and quality assurance when we compare several providers or populations, and research interested to link the process and its outcomes. CONCLUSIONS: Among the various patients classification system for grouping ambulatory care, the ambulatory care groups (ACGs) appear as the method with more potentialities to PC in Spain. The ACGs should be validated before been applied and its adaption to a more suitable PC classification of diagnoses would assists its extension.

Adult↗