Atencion Primaria最新文献

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Factibilidad, fiabilidad y validez del cuestionario VIG-express como instrumento de valoración multidimensional/geriátrica rápida: estudio multicéntrico [将 VIG-Express 问卷作为快速多维老年评估工具的可行性、可靠性和有效性：一项多中心研究]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-24 DOI: 10.1016/j.aprim.2024.103108

Objective

To evaluate the feasibility, reliability and validity of the VIG-express questionnaire.

Design

Descriptive, observational, cross-sectional and multicenter study.

Setting

Catalonia.

Participants

24 professionals from 18 centers: 10 from Primary Care, 5 from hospitals acute, 2 intermediate care and 3 residential.

Main measurements

For the feasibility analysis, the administration time -mean and standard deviation (SD)-. The questionnaire was administered twice to the same patient by the same professional (intraobserver agreement), or by two different professionals (interobserver agreement), evaluating the intraclass correlation coefficient (ICC). Discriminant validity was calculated by comparing the responses of subgroup with higher fragility (percentile > 75) and subgroup with lower fragility (percentile < 25), for each item of the questionnaire.

Results

195 questionnaires were administered, 59 repeatedly, in a group of elderly (mean age of 79 years) and fragile (mean score of 0.33 in the Fragile Index-VIG). The average administration time was 6.52 minutes (DE: 6.02). The concordance in the degree of fragility score obtained a ICC of 0.95 (intraobserver) and 0.72 (interobserver). In discriminant validity, the differences in response frequencies between the two subgroups ranged from 1.7 (oncological disease) to 67.1 (medication management), all of which were statistically significant (p < 0.05), with the sole exceptions of the presence of oncological and neurological diseases.

Conclusions

The VIG-express questionnaire appears to be a feasible, reliable and valid tool for rapid multidimensional/geriatric assessment.

目的：评估 VIG-express 问卷的可行性、可靠性和有效性：评估 VIG-express 问卷的可行性、可靠性和有效性：描述性、观察性、横断面和多中心研究：参与者：来自 18 个中心的 24 名专业人员：主要测量指标：主要测量指标：可行性分析中的施测时间--平均值和标准差（SD）。由同一专业人员（观察者内部一致）或两名不同专业人员（观察者之间一致）对同一患者进行两次问卷调查，评估类内相关系数（ICC）。通过比较脆性较高的亚组（百分位数大于 75）和脆性较低的亚组（百分位数小于 75）的回答，计算判别效度：对一组老年人（平均年龄 79 岁）和脆性体质者（脆性指数-VIG 平均得分为 0.33）进行了 195 次问卷调查，其中 59 次重复进行。平均发放时间为 6.52 分钟（DE：6.02）。脆性程度评分的 ICC 为 0.95（观察者内）和 0.72（观察者间）。在判别有效性方面，两个亚组之间的回答频率差异从 1.7（肿瘤疾病）到 67.1（药物管理）不等，均具有统计学意义（p 结论：VIG-express 问卷似乎是一种可行、可靠且有效的多维度/老年医学快速评估工具。

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引用次数: 0

Recomendaciones «No hacer» en el síndrome de fibromialgia [纤维肌痛综合征 "不做 "的建议]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-24 DOI: 10.1016/j.aprim.2024.103115

引用次数: 0

Vacunación gripe-COVID-19: juntos, pero no revueltos [流感-COVID-19 疫苗接种：一起接种，但不能混合接种]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-22 DOI: 10.1016/j.aprim.2024.103107

引用次数: 0

Los problemas del tutor MIR siguen esperando solución [MIR 导师的问题仍有待解决]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-19 DOI: 10.1016/j.aprim.2024.103122

引用次数: 0

Signos cutáneos «sincrónicos» clásicos en una paciente con dermatomiositis amiopática [一名肌病性皮肌炎患者的典型同步皮肤症状］

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-19 DOI: 10.1016/j.aprim.2024.103111

引用次数: 0

Impact of COVID-19 on the prevalence of dyslipidemia in Ecuador: A cross-sectional study between 2017 and 2022 COVID-19 对厄瓜多尔血脂异常患病率的影响：2017年至2022年横断面研究。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-18 DOI: 10.1016/j.aprim.2024.103007

Objective

To determine changes in the prevalence of dyslipidemias during the pre-COVID-19 and COVID-19 years in three regions of Ecuador.

Design

Cross-sectional study.

Site

Quito, Guayaquil, and El Coca.

Participants

Adults with cholesterol, HDL, LDL, and triglyceride levels at primary care centers from January 2017 to December 2022.

Interventions

Not applicable.

Main measurements

Data were obtained from five BIODIMED primary care centers. Cholesterol, HDL, LDL, and triglyceride levels were classified according to the ATP III guidelines. Dyslipidemia was considered present when one or more parameters exceeded specific thresholds. Sociodemographic variables and the year of examination were included as independent variables.

Results

The study analyzed 110,521 participants’ laboratory results, where 65.3% were males and an average age of 38 ± 12 years. The study spanned the Andean (72.4%), Coast (15.4%), and Amazonic region (12.3%). Pre-pandemic exams constituted 60.9% of the sample. The prevalence of dyslipidemia increased gradually from 43.1% in 2017 to 64.1% in 2022. Cholesterol levels, HDL, and LDL exhibited changes during the pandemic, with an increased risk of hypercholesterolemia, low HDL, and high LDL.

Conclusions

During the COVID-19 pandemic, a notable increase in the prevalence of dyslipidemias, including hypercholesterolemia, high triglycerides, and high LDL, was determined across three regions in Ecuador.

目的：确定厄瓜多尔三个地区在 COVID-19 前和 COVID-19 期间血脂异常发生率的变化：确定厄瓜多尔三个地区在 COVID-19 之前和 COVID-19 期间血脂异常患病率的变化情况：设计：横断面研究。研究地点基多、瓜亚基尔和埃尔科卡：2017年1月至2022年12月在初级保健中心检测胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯水平的成年人：不适用：数据来自五个BIODIMED初级保健中心。根据 ATP III 指南对胆固醇、高密度脂蛋白、低密度脂蛋白和甘油三酯水平进行分类。当一个或多个参数超过特定阈值时，即认为存在血脂异常。社会人口学变量和检查年份被列为自变量：研究分析了 110 521 名参与者的化验结果，其中 65.3% 为男性，平均年龄为 38±12 岁。研究范围包括安第斯地区（72.4%）、沿海地区（15.4%）和亚马逊地区（12.3%）。大流行前体检者占样本的 60.9%。血脂异常患病率从2017年的43.1%逐渐上升到2022年的64.1%。胆固醇水平、高密度脂蛋白和低密度脂蛋白在大流行期间发生了变化，高胆固醇血症、低高密度脂蛋白和高低密度脂蛋白的风险增加：结论：在 COVID-19 大流行期间，厄瓜多尔三个地区的血脂异常（包括高胆固醇血症、高甘油三酯和高低密度脂蛋白）患病率明显增加。

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引用次数: 0

Desafíos y oportunidades: la telemedicina en la práctica sanitaria actual 挑战与机遇：当今医疗实践中的远程医疗

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-16 DOI: 10.1016/j.aprim.2024.102991

引用次数: 0

Necesidades formativas de los médicos de atención primaria respecto al deseo de adelantar la muerte 初级保健医生在希望提前死亡方面的培训需求

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-16 DOI: 10.1016/j.aprim.2024.103050

引用次数: 0

Creencias de profesionales de Atención Primaria frente a personas con conductas suicidas: un estudio cualitativo 初级保健专业人员对有自杀行为者的看法：一项定性研究。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-15 DOI: 10.1016/j.aprim.2023.102839

In Chile, suicide is a public health problem. The National Suicide Prevention Program has influenced the stabilization of suicide rates and considers as one of its components the training of primary care professionals in addressing suicidal behavior. It has been shown that the way in which professionals approach the phenomenon has a high influence on the implementation of preventive measures. The objective of this qualitative descriptive study. is to explore the beliefs of primary care professionals regarding people with suicidal behavior. It was developed in 3 family health centers in Santiago de Chile with fourteen health professionals participants. Semi-structured interviews were carried out. The data were analyzed according to the procedures proposed by Grounded Theory. The beliefs of the participating professionals regarding suicidal behavior are grouped into (1) validation of suicidal behavior and (2) suicidal behavior should not be judged. A frequent ambivalence of the participants between these 2 elements stands out, which makes it difficult for them to consider a single professional position regarding suicide. The beliefs reflect a relativization of the value of life, and ambivalent beliefs regarding the voluntary end of life, based on value judgments regarding suicide. The results can serve to guide future training for health teams in addressing suicidal behaviors.

在智利，自杀是一个公共卫生问题。国家预防自杀计划对稳定自杀率产生了影响，并将培训初级保健专业人员处理自杀行为作为其组成部分之一。事实证明，专业人员处理自杀现象的方式对预防措施的实施有很大影响。这项定性描述性研究的目的是探讨初级保健专业人员对有自杀行为者的看法。研究在智利圣地亚哥的 3 家家庭保健中心展开，共有 14 名医疗专业人员参与。研究人员进行了半结构化访谈。根据基础理论提出的程序对数据进行了分析。参与访谈的专业人员对自杀行为的看法可分为（1）对自杀行为的认可和（2）不应对自杀行为进行评判。参与者在这两个要素之间经常出现矛盾，这使得他们很难考虑对自杀采取单一的专业立场。这些信念反映了生命价值的相对化，以及基于对自杀的价值判断，对自愿结束生命的矛盾信念。研究结果可用于指导医疗团队今后在处理自杀行为方面的培训。

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引用次数: 0

Primary care referral causes and final neurodevelopmental diagnosis: Do they match? 初级保健转诊原因和最终神经发育诊断：它们相符吗？

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-10-09 DOI: 10.1016/j.aprim.2023.102832

引用次数: 0

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