Anales del sistema sanitario de Navarra最新文献

Goldenhar syndrome is a rare congenital disorder characterized by defects in the development of structures derived from the first and the second branchial arches. This condition encompasses a range of symptoms, including craniofacial, ocular, vertebral, and auricular abnormalities. We present the case of a 6-year-old girl with right temporal bone hypoplasia and preauricular tag from birth, leading to a diagnosis of Goldenhar syndrome. She exhibited various middle and external ear defects, and her audiological treatment was crucial in ensuring optimal neurological and speech development. In adolescence, if the Eustachian tube remains stable, surgical repair of the ossicular chain may be considered.

Gastroschisis is a congenital malformation characterized by a visceral hernia and is one of the leading causes of short bowel syndrome in pediatric patients. This condition can result from congenital short bowel, but may also arise due to complications associated with the management of the abdominal wall defect. We present the case of a full-term newborn with simple gastroschisis who developed multiple gastrointestinal complications during initial management and was subsequently referred to our institution. On admission, the patient exhibited an open, frozen abdomen, enteroatmospheric fistulas, and loss of abdominal domain. Over the course of three months, various combined techniques were used, including primary intestinal sutures, jejunostomies with distal stoma feedback, botulinum toxin injections, and the construction of a polypropylene silo, with adjustments made based on the evolving complications. Ultimately, complete abdominal reconstruction was achieved. The patient's recovery was favorable, and he was discharged at five months of age with oral tolerance and appropriate weight and height gain.

Background: The management of mental health conditions may deteriorate in adolescents during the transition from adolescent mental health services to adult mental health services. This study aimes to assess the impact of interventions and transition programs on treatment continuity and mental health outcomes for individuals moving between these services.

Methods: A scoping review was conducted using the descriptors "Child Psychiatry", "Adolescent Psychiatry", "Transition to Adult Care", "Mental Health Services", and "Continuity of Patient Care" in Medline, Web of Science, Scopus, CINAHL, Cochrane Library, LILACS, and CUIDEN, from October to December 2023. Studies of any design published in English and Spanish were included, with no time restrictions. The quality of the studies was assessed using Joanna Briggs Institute tools.

Results: Eight studies were included (two reviews, four qualitative studies, and two cohort studies), with quality ratings ranging from moderate to excellent. Only 23.5% of young people experienced a successful transition, with many facing delays and reduced long-term follow-up. Key factors for a successful transition included the transfer of information, parallel care, and the involvement of patients and family, while voluntary discharge and prior drug use before hospitalization hindered the transition process.

Conclusions: To optimize the continuity of care during the transition from child/adolescent to adult mental health services, key strategies include the transfer of information, parallel care, and active participation. Implementing coordinated measures that address barriers, reduce delays, and enhance follow-up is essential. A proactive, individualized, and collaborative approach involving patients, families, and professionals is necessary to ensure comprehensive and effective care.

Background: This cross-sectional study assessed the global health needs of children aged 2 to 6 years and examined how socio-demographic characteristics influenced children's health needs observed following the COVID-19 pandemic.

Methodology: Cross-sectional study conducted between January and March 2021 in three regions of northern Spain with similar household incomes. Participants were selected through one-stage cluster sampling. A self-reported questionnaire, Necesidades de salud de la Población Infantil, was used to assess children's health needs across seven dimensions and 125 items.

Results: A total of 301 parents or caregivers completed the questionnaire. The dimensions parental self-efficacy, professional advice, child socio-emotional aspects, and situational influence were the most frequently reported as significant, while parent socio-emotional aspects, lifestyle, promotion of healthy lifestyles, and influence of significant people were the least emphasized. Life-style-related needs were particularly affected by the limited access to healthcare professionals and were more pronounced when children had a disability.

Conclusions: The findings of this study provide valuable insights for the development of strategies, programs, and interventions aimed at promoting children's health by addressing the identified needs.

Background: This study examines the relationship between unmet healthcare needs and employment status, with a focus on how this relationship was influenced by the Spanish economic recession of 2008-2012.

Methods: Data were obtained from the Spanish National Health Survey for 2006 and 2011-2012. The outcome variable was the presence of unmet healthcare needs, describing its reasons. The analysis included the period (pre-crisis/crisis), demographic variables (sex, age, Spanish citizenship), employment status, social factors (level of education, marital status, social-class), and health indicators (self-assessed health, chronic conditions, and limitations). Logistic regression was used to predict unmet health needs based on the period, employment status, and control variables.

Results: The frequency of unmet healthcare needs was low and decreased further during the crisis (5% pre-crisis vs 3% during the crisis). Unmet healthcare needs were more strongly associated with health status than with employment status. However, among the unemployed, unmet healthcare needs increased during the crisis compared to the pre-crisis.

Conclusions: The most vulnerable groups, characterized by higher unmet healthcare needs, included women, individuals with lower levels of education, and those in poorer health. These groups may require more targeted attention. These findings should be interpreted in the context of the Spanish National Health System, which is fully decentralized and provides healthcare and protection to all residents.

Background: Person-centered care (PCC) positively impacts individuals by enhancing self-care, autonomy, well-being, skills, quality of life, and satisfaction with their care experience. The Person-Centered Practice Inventory-Care (PCPI-C), grounded in the Person-Centered Practice theoretical framework, is designed to assess healthcare users' perceptions of the PCC they receive. This study aims to develop the first Spanish version of the PCPI-C, translated and adapted to the Spanish context.

Methods: The translation and cultural adaptation process followed the "Translation and Cultural Adaptation of Patient-Reported Outcomes Measures: Principles of Good Practice" guideline, which included a session with a group of experts and healthcare users. The clarity and relevance of each item, as well as the whole instrument, were assessed using the content validity index.

Results: No difficulties were found during the process. The committee unanimously agreed to include the definition of compassion in the instrument due to its complexity and potential confusion with other terms. Regarding clarity and relevance, the content validity index revealed excellent results for all 18 items in terms of relevance and for 16 items in terms of clarity. The overall validity index for the instrument showed excellent result for both clarity and relevance (=0.95).

Conclusions: The first Spanish-adapted version of the PCPI-C, conceptually and semantically aligned with the original, is now available and demonstrates excellent scores for both clarity and relevance.

Background: This study aims to assess the impact of transitioning a hospital/foundation from indirect management to direct management on the efficiency of hospital resource management.

Methodology: Until 2010, the Virxe da Xunqueira hospital/foundation, located in the Galicia-North Portugal Euroregion, operated under indirect management. In 2010, it transitioned to direct management as a health centre within the Galician Health Service (Spain). Public management of hospital resources was compared using data development analysis for two periods: indirect management (2005-2009) and direct management (2011-2015). Inputs included labour (number of workers) and capital (number of beds), while outputs were measured by the number of consultations, emergencies, interventions, admissions (inpatients), hospital stays, patients on waiting the list, average length of stay, waiting times, and hospital occupancy rate. The synthetic index used was the basic care units.

Results: Virxe da Xunqueira demonstrated greater efficiency as a hospital/foundation in terms of the number of consultations, emergencies, admissions, inpatients, and indicators related to patient stay (including number and average length of stay). After transitioning to direct management, the hospital showed improved efficiency in average waiting times, the number of patients on the waiting list, and the number of surgical interventions. The production factors exhibited decreasing returns to scale in both types of governance.

Conclusions: Both type of management show greater efficiency in certain inputs. However, there is insufficient evidence to conclude that the previous management model (indirect management) is more efficient than direct management.

Background: A Spanish nurse posted a video on TikTok criticizing the requirement of a certain level of Catalan to work in the public health system of Catalonia (Spain). The video went viral, eliciting reactions from social media users, politicians, and professional nursing organizations. This study aims to evaluate the reputational damage suffered by the nurse, her hospital, and the nursing profession, with the goal of proposing actions to prevent, avoid, or manage similar situations.

Methodology: A sequential exploratory mixed-methods design was used to analyse the content of the video, its impact on the press and social media, and the management of the communication crisis by the hospital and nursing organizations involved.

Results: The nurse exercised her right to freedom of expression. However, her choice to convey the message, wearing the uniform that identified her as a staff member of a specific hospital, and her criticism of the language level requirement, led to reputational damage after the video spread via the press and Twitter/X. The hospital's reputation was affected due to the nurse being identified as one of its employees. In contrast, the reputation of the nursing profession was not significantly harmed, as multiple information sources suggested the incident was isolated. The creation of a safe, self-regulatory framework and training in social media and communication management are proposed as measures for healthcare centres, nursing organizations, and academic institutions to implement.

Conclusions: The reputations of both the nurse and her hospital were impacted. A methodological model for analysing similar situations is proposed.