María José Cabañero-Martínez

Valores de referencia de la Short Physical Performance Battery para pacientes de 70 y más años en atención primaria de salud

OBJECTIVE To provide new reference values for the Short Physical Performance Battery (SPPB) for patients 70 years-old and over in primary health care (PHC), and analyse their relationship with demographic data, physical function, health and clinical status. DESIGN Baseline interviews and observations of a longitudinal study on physical function and adverse health results. SETTING Five Primary Care Centres in the provinces of Alicante and Valencia. PARTICIPANTS A total of 593 persons 70 years-old and over. MAIN MEASUREMENTS The SPPB was applied using direct observation, and the rest of the variables by interview. Reference values were calculated according to sex and three age groups (70-75, 76-80, > 80 years), and the validity of the Battery was analysed using association statistics with the demographic, clinical, and function data. RESULTS The reference values showed a poor performance in women, and a gradually poorer performance through the three age groups. The SPPB was significantly associated (P < 0.01) with age, sex, number of drugs taken, morbidity, body mass index, dependency in basic activities of daily living (BADL), instrumental activities of daily living (IADL) for health reasons, the 10-item Physical Functioning Scale (PF-10), depression and health perception. CONCLUSIONS The reference values of the complete SPPB by age and sex are provided, based category scores in Primary Care patients 70 years-old and over. The Battery results can give a rapid and valid assessment of the functional state of elderly patient in Primary Care.

Fiabilidad y validez de una versión corta de la escala de medida de la ansiedad STAI en pacientes respiratorios

BACKGROUND There is comorbidity between respiratory disease and anxiety. In order to measure the anxiety of hospitalized patients it is necessary to use reliable and valid, and preferably short questionnaires. OBJECTIVE To analyze the reliability and validity of a shortened version of the state subscale of the “State-Trait Anxiety Inventory (STAI)” in respiratory patients. PATIENTS AND METHODS A total of 103 respiratory patients admitted to the respiratory ward between February of 2009 and February of 2010 were non-consecutively selected. They answered two questionnaires: the Spanish version of the STAI-state and a short version consisting of 7 items. Sociodemographic and clinical variables of the patients were also obtained. The internal consistency, and convergent and construct validity of the short scale were analyzed. RESULTS The short scale did not have floor/ceiling effect, the α-Cronbach was acceptable (0.89), and correlated positively (r = 0.90; P = .01) and also maintained the factorial structure of the original scale (half anxiety-present items and half anxiety-absent items). CONCLUSIONS The short version of the state subscale of the STAI has showed good metric properties in hospitalized respiratory patients.

Reliability and Validity of Shortened State Trait Anxiety Inventory in Spanish Patients Receiving Mechanical Ventilation

BACKGROUND In order to measure anxiety in physically and cognitively debilitated patients, such as patients receiving invasive mechanical ventilation, the use of reliable and valid instruments is recommended; however, these instruments should be short. OBJECTIVE To analyze the reliability and validity of a short version of the state subscale from the Spielberger State-Trait Anxiety Inventory, developed by Chlan and colleagues and translated into Spanish (STAI-E6), in patients receiving invasive mechanical ventilation. METHODS An instrumental study was conducted of 80 patients receiving invasive mechanical ventilation in the intensive care unit at the Hospital of Alicante (Spain). The patients completed the 6-item STAI-E6 scale. Before the patients completed the scale, the interviewers indicated their impression of each patients level of anxiety by using a linear scale. Internal consistency, construct validity, and convergent validity of the scale were analyzed. RESULTS The scale did not present a floor/ceiling effect, the Cronbach α was 0.79, and the single-factor structure of the original scale was maintained. Scores on the scale correlated positively with the subjective assessment of the health professional. Significant differences were found only between anxiety level and duration of intubation. CONCLUSIONS The 6-item version of the state subscale from the STAI-E6 shows satisfactory reliability and validity for Spanish patients receiving invasive mechanical ventilation.

What do older people understand by mobility-related difficulties?

UNLABELLED Despite the centrality of the difficulty concept in the study of disability, there has been little research on its significance from the point of view of people with functional limitations. The main objective of this study was to describe what older people understand when asked about difficulty in undertaking mobility activities. As a secondary objective, we considered whether there are any differences depending on the type of activities, according to the International Classification of Functioning (ICF) mobility domains. METHODS Seventeen community-dwelling men and women aged 70 years old or over were interviewed by means of a questionnaire containing 55 items covering the ICF mobility domains. The participants responded to the items while thinking aloud, saying what led them to give a specific answer about their level of difficulty. Inductive content analysis was conducted and categories, subthemes and themes were identified. RESULTS Causes of difficulty (pathologies, impairments, symptoms) and accommodations (task modifications and use of aids) were the two themes identified; and their importance (and that of the subthemes included) varied across the types of activity. All the participants said that they had no difficulty in at least one task, despite mentioning changes in the way they performed them. CONCLUSIONS Older peoples opinions were consistent with theoretical models of disability and with the standard practice of measuring functional limitations by asking about the degree of difficulty; however, the design of these measures needs to be improved in order to detect perceptions of no difficulty in the presence of task modification.

Reliability and validity of a short version of the STAI anxiety measurement scale in respiratory patients.

Background: There is comorbidity between respiratory disease and anxiety. In order to measure the anxiety of hospitalized patients it is necessary to use reliable and valid, and preferably short questionnaires. Objective: To analyze the reliability and validity of a shortened version of the state subscale of the “StateTrait Anxiety Inventory (STAI)” in respiratory patients. Patients and methods: A total of 103 respiratory patients admitted to the respiratory ward between February of 2009 and February of 2010 were non-consecutively selected. They answered two questionnaires: the Spanish version of the STAI-state and a short version consisting of 7 items. Sociodemographic and clinical variables of the patients were also obtained. The internal consistency, and convergent and construct validity of the short scale were analyzed. Results: The short scale did not have floor/ceiling effect, the α-Cronbach was acceptable (0.89), and correlated positively (r = 0.90; P = .01) and also maintained the factorial structure of the original scale (half anxiety-present items and half anxiety-absent items). Conclusions: The short version of the state subscale of the STAI has showed good metric properties in hospitalized respiratory patients.

Análisis de referencias bibliográficas de originales publicados en revistas de enfermería nacionales e internacionales y de 2 disciplinas de la salud afines

Resumen Objetivo Comparar las publicaciones nacionales de enfermeria frente a 2 referentes estandar anglosajones y respecto al constituido por sus disciplinas afines del ambito nacional, como modo de evidenciar potenciales deficiencias cuanticualitativas en los niveles de documentacion cientifica. Metodo Estudio descriptivo y transversal, que analiza las referencias de 796 originales de 6 revistas espanolas pertenecientes a 3 disciplinas de la salud (2000-2002) y de 2 revistas de enfermeria anglosajonas (2000-2001), y se establecen comparaciones entre todas ellas, de forma individual y agrupandolas por disciplina y ambito de origen, en relacion con el numero total de referencias, tipo de documento y su idioma. Resultados Las revistas nacionales de enfermeria presentan la media de referencias por articulo mas baja ( X ¯ = 16,20 ), en comparacion con psicologia ( X ¯ = 31,24 ), medicina ( X ¯ = 31,39 ) y la media agrupada para la enfermeria internacional ( X ¯ = 37,11 ). Con respecto al idioma, de entre las disciplinas de ambito nacional medicina es la que mas bibliografia en ingles consume ( X ¯ = 26,28 ), y enfermeria se encuentra en el extremo opuesto ( X ¯ = 6,04 ), mientras que es la que mas cita en castellano ( X ¯ = 9,79 ), frente a medicina que es la que menos lo usa ( X ¯ = 4,43 ). Conclusiones Aunque la produccion cientifica de la enfermeria nacional ha mejorado, todavia no es equiparable a la de las ciencias afines ni a la de la enfermeria internacional. La baja citacion de documentos en ingles pone de manifiesto el riesgo de que la disciplina caiga en el aislamiento cientifico.

Content validity of the short version of the subscale of the State-Trait Anxiety Inventory (STAI)

Se tuvo por objetivo describir la validez de contenido de una version corta de la subescala Estado del State-Trait Anxiety Inventory (STAI) de Spielberger, a partir de la version original adaptada al espanol, en pacientes espanoles con ventilacion mecanica invasora (VMI). La muestra fue integrada por 16 pacientes con VMI en el hospital de Alicante (Espana), que seleccionaron los items de la version espanola completa del STAI-estado de mayor relevancia para ellos. Los items no: 1,5,9,10,12 y 20 de la escala original son los mas relevantes para los pacientes espanoles con VMI; siendo que 5 de ellos estan incluidos en la version corta de la escala (83.3% de acuerdo). La escala corta ha demostrado una adecuada validez de contenido para pacientes espanoles con VMI.Apoyo financiero del Ministerio de Sanidad y Consumo (gobierno de Espana), dentro de la convocatoria de ayudas para la realizacion de estudios de investigaciones sobre evaluacion de tecnologias sanitarias e investigacion en servicios de salud (expediente PI06/90476-90492).

Validez de contenido de versión corta de la subescala del Cuestionario State-Trait Anxiety Inventory (STAI)

Se tuvo por objetivo describir la validez de contenido de una version corta de la subescala Estado del State-Trait Anxiety Inventory (STAI) de Spielberger, a partir de la version original adaptada al espanol, en pacientes espanoles con ventilacion mecanica invasora (VMI). La muestra fue integrada por 16 pacientes con VMI en el hospital de Alicante (Espana), que seleccionaron los items de la version espanola completa del STAI-estado de mayor relevancia para ellos. Los items no: 1,5,9,10,12 y 20 de la escala original son los mas relevantes para los pacientes espanoles con VMI; siendo que 5 de ellos estan incluidos en la version corta de la escala (83.3% de acuerdo). La escala corta ha demostrado una adecuada validez de contenido para pacientes espanoles con VMI.Apoyo financiero del Ministerio de Sanidad y Consumo (gobierno de Espana), dentro de la convocatoria de ayudas para la realizacion de estudios de investigaciones sobre evaluacion de tecnologias sanitarias e investigacion en servicios de salud (expediente PI06/90476-90492).

Validation of a mobility item bank for older patients in primary care

BackgroundTo develop and validate an item bank to measure mobility in older people in primary care and to analyse differential item functioning (DIF) and differential bundle functioning (DBF) by sex.MethodsA pool of 48 mobility items was administered by interview to 593 older people attending primary health care practices. The pool contained four domains based on the International Classification of Functioning: changing and maintaining body position, carrying, lifting and pushing, walking and going up and down stairs.ResultsThe Late Life Mobility item bank consisted of 35 items, and measured with a reliability of 0.90 or more across the full spectrum of mobility, except at the higher end of better functioning. No evidence was found of non-uniform DIF but uniform DIF was observed, mainly for items in the changing and maintaining body position and carrying, lifting and pushing domains. The walking domain did not display DBF, but the other three domains did, principally the carrying, lifting and pushing items.ConclusionsDuring the design and validation of an item bank to measure mobility in older people, we found that strength (carrying, lifting and pushing) items formed a secondary dimension that produced DBF. More research is needed to determine how best to include strength items in a mobility measure, or whether it would be more appropriate to design separate measures for each construct.

Grado de conocimiento y actitudes de los profesionales sanitarios sobre el documento de voluntades anticipadas

OBJECTIVE To evaluate the degree of knowledge and attitudes of medical and nursing professionals in two health departments to advance directives, as well as to examine their association with the sociodemographic and occupational variables of the professionals. METHODS A cross-sectional survey on 329 health professionals was carried out through the internet and a standardised procedure. The knowledge and attitudes of the professionals about advance directives were examined using two validated questionnaires of 17 and 12 items, respectively. Sociodemographic and professional data were also collected from the participants. RESULTS 45% of the professionals were physicians, with X¯=13,1 (SD: 8.3) years of professional experience. Sixty-seven point five percent were women and the mean age was 38.9 (SD: 9.2) years. Professionals had very positive attitudes towards the advance directives document (X¯=75.37;SD: 11.97;R=0-90), although their level of knowledge about them was medium-low (X¯=9.31;SD: 2.73;R=0-18). Both the level of knowledge and self-perception were associated with previous training in palliative care, experience with document management, reading, or the demand for information. Completing the document related to self-perception of knowledge. Attitudes towards the document related to experience in its use and a positive attitude toward training. CONCLUSIONS The professionals showed positive attitudes towards the advance directive document although low knowledge about it. Experience with the document was the only variable associated with both the knowledge and the attitudes of the professionals.