Atencion Primaria最新文献

英文中文

Supervivientes del cáncer de mama: barreras y necesidades para una buena inserción en la sociedad, una investigación cualitativa (Cohort DAMA) [乳腺癌幸存者：良好融入社会的障碍和需求，一项定性调查（DAMA队列）]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-21 DOI: 10.1016/j.aprim.2024.103177

Marina Ochoa de Eribe , Rosa Puigpinós-Riera , Dolors Rodríguez , grupo Cohort DAMA

Purpose

Go deeply into the barriers and problems that long-term surviving breast cancer must face to continue with their lives and what are the demands they suggest to society.

Design

Qualitative study of interpretive type with a socio-constructivist perspective within the framework of the DAMA Cohort.

Site

the work was carried out in Barcelona.

Participants

The design of the sample was theoretical, and the participants were segmented taking into account the socioeconomic level and whether or not they had suffered any relapse.

Method

It was set up six discussion groups of 6 to 12 participants each. A thematic analysis of the literal transcription of the audio files of the focus groups was done.

Results

It has been found that the consequences of suffering breast cancer are not the same for those women who are self-employed as for those who work for someone else. However, tasks that require physical effort are difficult to continue doing, but those that require concentration and more intellectual effort are also difficult to perform too. Also, a series of aspects have been identified that women believe should be improved in the Health System: the lack or type of information given by professionals, the economic limit of the Health System and its consequences, the lack of medical care when treating something not directly related to the tumour, lack of sensitivity by some professionals and difficulties in accessing social benefits.

Conclusions

The results show that the main demands by long-lived breast cancer survivors are: having a balance between breast cancer, working life and a more Comprehensive Health System.

目的：深入了解长期存活的乳腺癌患者在继续生活中必须面对的障碍和问题，以及他们对社会的需求。设计：在DAMA队列的框架内，以社会建构主义视角对解释性类型进行定性研究。SITE：工作在巴塞罗那进行。参与者：样本的设计是理论性的，考虑到社会经济水平和他们是否有过复发，参与者被分割。方法：分为6个讨论组，每组6 ~ 12人。对焦点小组的音频文件的文字转录进行了专题分析。结果：研究发现，自雇妇女和为他人工作的妇女患乳腺癌的后果是不一样的。然而，需要体力努力的任务很难继续做下去，但那些需要集中精力和更多智力努力的任务也很难完成。此外，还确定了妇女认为卫生系统应改善的一系列方面：缺乏专业人员提供的信息或信息类型、卫生系统的经济限制及其后果、在治疗与肿瘤没有直接关系的疾病时缺乏医疗保健、一些专业人员缺乏敏感性以及难以获得社会福利。结论：结果表明，长寿乳腺癌幸存者的主要需求是：在乳腺癌、工作生活和更全面的健康体系之间取得平衡。

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引用次数: 0

The evaluation criteria of community protection on children's medical care in major pandemics 重大疫情中社区保护儿童医疗服务评价标准

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-19 DOI: 10.1016/j.aprim.2024.103174

Zhuo Zhao , Ruitong Liu , Bingqing Bi , Shugang Li

引用次数: 0

Colecistitis aguda alitiásica por Entamoeba histolytica en lactante [婴儿因组织溶解恩塔米巴虫引起的急性结石性胆囊炎]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-16 DOI: 10.1016/j.aprim.2024.103176

Luis Ortiz González , Mahmoud Yahdhih Noh , Juan Manuel Contreras Santana

引用次数: 0

Características clínicas, sociodemográficas y evolución de los pacientes con SARS-CoV-2 en dos áreas sanitarias de Extremadura en el primer semestre de la pandemia [大流行前六个月埃斯特雷马杜拉两个卫生区SARS-CoV-2患者的临床和社会人口学特征及进展]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-16 DOI: 10.1016/j.aprim.2024.103155

Manuel Tejero-Mas , Alba Palmerín-Donoso , Francisco Buitrago-Ramírez , Francisco Luis Pérez-Caballero , José Antonio Morales-Gabardino

Objective

To describe clinical and sociodemographic characteristics as well as the outcome of patients infected with SARS-CoV-2 in first six months of the pandemic.

Design

Observational and ambispective study.

Site

Primary Care (two Health Areas in Extremadura).

Participants

A total of 1,422 patients were included (mean age 45.6 years; 53.2% women) who had the ICPC-2 diagnostic code for “confirmed SARS-CoV-2 infection” recorded in their clinical history during the first six months of the pandemic.

Interventions

Not necessary.

Main measurements

Clinical and sociodemographic characteristics as well as outcome of patients (hospital visits, admissions and mortality).

Results

The mean age (50.8 vs. 42.3 years, p< 0.001), and prevalence of most of the comorbidities, dependent patients (13.8% vs. 4.0%), and residents in social care institutions (15.4% vs. 3.1%) were higher in the Don Benito-Villanueva area than in Badajoz. The predominant age group was 19-49 years (44.4%). 41.4% of patients were actively employed, mainly in National Classification of Occupations groups 2, 5, and 9, while 16.5% were social healthcare professionals. 16.5% of patients visited the hospital, 13.4% required hospitalization. Among those who consulted in hospital emergency departments independently, 46.2% were hospitalized, compared to 78.8% of those referred from primary care (p = 0.000). The overall mortality rate was 2.0% (3.1% in Don Benito-Villanueva versus 1.3% in Badajoz; p = 0.016) increasing to 8.9% among hospitalized patients.

Conclusions

Sociodemographic and clinical differences were noted between the two health areas. Most infections were managed in primary care, while those referred to the hospital had a higher hospitalization rate.

目的：描述SARS-CoV-2大流行前6个月感染患者的临床和社会人口学特征及其预后。设计：观察性和双视角研究。地点：初级保健（埃斯特雷马杜拉的两个保健区）。参与者：共纳入1422例患者(平均年龄45.6岁；在大流行的前六个月，其临床病史中记录了“确诊的SARS-CoV-2感染”的ICPC-2诊断代码（53.2%）。干预：没有必要。主要测量：临床和社会人口特征以及患者的结果（医院就诊、入院和死亡率）。结果：平均年龄（50.8岁vs. 42.3岁）。结论：两个健康区存在社会人口学和临床差异。大多数感染在初级保健中得到处理，而转介到医院的患者住院率较高。

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引用次数: 0

Análisis de la elección de la especialidad de Medicina Familiar y Comunitaria entre los candidatos MIR en el periodo 2020 a 2024: Índice de preferencia competitiva [分析 2020 至 2024 年医学研究院考生对家庭和社区医学专业的选择：竞争偏好指数]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-16 DOI: 10.1016/j.aprim.2024.103150

Yoseba Cánovas Zaldúa , Remedios Martín Álvarez , Aina Mas Tena , Jorge Lema Bartolomé , Ermengol Coma , Núria Nadal Braqué

Objective

To know the degree of attraction towards Family and Community Medicine (MFyC) among MIR candidates by calculating the Competitive Preference Index (CPI) in the 2020 to 2024 calls.

Design

Observational study of analysis of secondary sources based on information from the website of the Ministry of Health.

Site and participants

The MIR squares of the 5 most populated Spanish cities were chosen.

Interventions and Main measurements

The construction of the CPI is based on the comparison of MFyC with each specialty, taking into account the equal opportunity to choose MFyC or another specialty, and takes into account the percentage of choice of MFyC at the time in which the choice has been finalized of that other specialty.

Results

In relation to the specialties of laboratories and central services, the average CPI of MFyC has been positive with respect to all specialties, in all the cities analyzed, with the exception of radiodiagnosis.

In relation to medical specialties, the CPI is positive in all the cities analyzed with respect to 8 specialties (allergology, geriatrics, occupational medicine, physical medicine and rehabilitation, preventive medicine, nephrology, radiation oncology and rheumatology).

In relation to surgical specialties, it is positive in all the cities analyzed with respect to 3 specialties (vascular surgery, cardiovascular surgery and thoracic surgery).

Conclusions

The MFyC specialty presents notable attractiveness among MIR candidates, since positive results are obtained in comparison with the majority of specialties, and in the majority of the cities analyzed.

目的：通过计算2020 - 2024年高考竞争偏好指数（CPI），了解MIR考生对家庭与社区医学（MFyC）的吸引力程度。设计：基于卫生部网站信息的二手资料分析观察性研究。地点和参与者：选择了西班牙人口最多的5个城市的MIR广场。干预措施和主要测量方法：CPI的构建是基于MFyC与各专业的比较，考虑到选择MFyC或其他专业的平等机会，并考虑到MFyC在选择其他专业时选择的百分比。结果：与实验室和中心服务专业相关，除放射诊断外，MFyC的平均CPI在所有分析城市的所有专业中均为正。在医学专业方面，所有被分析的城市在8个专业（过敏症学、老年病学、职业医学、物理医学和康复、预防医学、肾脏病学、放射肿瘤学和风湿病学）的CPI均为正值。在外科专科方面，所有被分析的城市在3个专科（血管外科、心血管外科和胸外科）中均为正。结论：MFyC专业在MIR候选人中具有显著的吸引力，因为与大多数专业相比，在大多数被分析的城市中都获得了积极的结果。

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引用次数: 0

Percepción del teletrabajo como instrumento de mejora del burnout en médicos de familia [远程办公作为改善家庭医生职业倦怠的工具的认知]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-16 DOI: 10.1016/j.aprim.2024.103175

Luis Mifsud Grau , María del Carmen de Mingo Alemany , Tatiana Fernández Portillo , Carmen Rubio Martinez

引用次数: 0

Intervalos de tiempo para el diagnóstico y tratamiento en pacientes con cáncer de mama 【乳腺癌患者诊断与治疗的时间间隔】。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-07 DOI: 10.1016/j.aprim.2024.103153

Blanca Sánchez Galindo , Jesús López-Torres Hidalgo , Ángel López González , Carmen María Sánchez Martínez , Marta Castaño Díaz , Joseba Rabanales Sotos

Objective

To describe the delay in the diagnosis of breast cancer in primary care and to identify the patient, care process and disease variables involved in the delay to diagnosis and treatment.

Design

Retrospective study with follow-up of a cohort of women with breast cancer, from the first symptoms to the start of treatment.

Site

In total 24 family medicine practices with information from both primary care and hospital settings.

Participants

446 women were evaluated (period 2014-2023).

Main measurements

Patient characteristics (age, history and comorbidity), care process (screening, consultation site and referral priority) and disease characteristics (stage, presentation and risk factors) were included. Time intervals considered included, among others, «primary care interval», «health system interval», «diagnosis interval» and «treatment interval».

Results

The mean value of the «primary care interval» was 24.7 days (median: 16); that of the «hospital care interval», 77.2 days (median: 68); and that of the «health system interval», 93.6 days (median: 83). Multiple linear regression showed a significantly shorter duration of the interval in women referred preferentially, in advanced stages, with a breast lump at presentation and with risk factors.

Conclusions

Most are diagnosed in early stages at the health centre. The duration of the «health system interval» is shorter in preferential referrals, when the form of presentation is a breast lump, with risk factors and in advanced stages.

目的：描述乳腺癌在初级保健中的延误诊断，并确定延误诊断和治疗的患者、护理过程和疾病变量。设计：回顾性研究，随访一组乳腺癌妇女，从最初的症状到开始治疗。站点：共有24个家庭医学实践，信息来自初级保健和医院设置。参与者：对446名女性进行评估（2014-2023年）。主要测量：包括患者特征（年龄、病史和合并症）、护理过程（筛查、咨询地点和转诊优先级）和疾病特征（分期、表现和危险因素）。考虑的时间间隔包括“初级保健间隔”、“卫生系统间隔”、“诊断间隔”和“治疗间隔”。结果：“初级保健间隔”的平均值为24.7天（中位数：16）；“住院治疗间隔”77.2天（中位数：68）；“卫生系统间隔”为93.6天（中位数：83）。多元线性回归显示，在晚期、有乳房肿块和有危险因素的妇女中，首选的间隔时间明显较短。结论：大多数在保健中心的早期阶段被诊断出来。当表现形式为乳腺肿块、有危险因素且处于晚期时，优先转诊的“卫生系统间隔”时间较短。

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引用次数: 0

One hundred eighty days maintenance of information in basic life support training in primary education in a rural environment 180天维持农村环境中初级教育基本生命支助训练方面的资料。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-06 DOI: 10.1016/j.aprim.2024.103152

Rebeca Cunha , João Lopes Guedes , Luiz Miguel Santiago

引用次数: 0

Análisis retrospectivo de la efectividad del programa REDUCE en diabetes, hipertensión y medidas antropométricas 【REDUCE项目在糖尿病、高血压和人体测量方面的有效性回顾性分析】。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-12-04 DOI: 10.1016/j.aprim.2024.103151

Elizabeth Castro Mercado , Cristian Mercado Esquivel , Gloria Idaly Morales Rodriguez , Paulo César Gete Palacios , Aldo Ferreira-Hermosillo

引用次数: 0

Evaluación del nivel de satisfacción con un sistema de interconsulta telemática entre Atención Primaria y Cardiología [初级保健和心脏病科之间的电子转诊系统满意度评估]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

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Pub Date : 2024-12-04 DOI: 10.1016/j.aprim.2024.103154

Noelia Fernández Villa , Alberto Nieto López , María Isabel Sánchez López , Sergio Manzano Fernández

引用次数: 0

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