Romana Albaladejo

Síndrome de Burnout en el personal de enfermería de un hospital de Madrid

Fundamento: El termino Burnout se refiere a una situacion que es cada vez mas frecuente entre los profesionales que prestan sus servicios a traves de una relacion directa y mantenida con las personas, entre los que se encuentran todos los profesionales sanitarios. El objetivo de nuestro estudio ha sido determinar la prevalencia del sindrome de Burnout y de sus tres componentes (cansancio emocional, despersonalizacion y falta de realizacion personal) entre los profesionales del area de enfermeria del Hospital Clinico Universitario San Carlos de Madrid y su relacion con determinados factores sociodemograficos, laborales e institucionales. Metodos: Se realizo un estudio tranversal entre los profesionales adscritos al area de enfermeria del mencionado hospital. Las variables implicadas se recogieron mediante un cuestionario de elaboracion propia. En cuanto al sindrome de Burnout se midio mediante el Maslach Burnout Inventory, en su version validada en espanol. Resultados: El personal de enfermeria esta mas despersonalizado (p=0,004) y menos realizado (p=0,036) que el grupo de auxiliares/tecnicos. Cuando se analizaron los resultados de las 4 escalas por servicios comprobamos que el agotamiento es superior en los trabajadores de oncologia y urgencias (p=0,001), la despersonalizacion en urgencias (p=0,007), y el Burnout es de nuevo mas alto en las areas de oncologia y urgencias (p=0,000). Los profesionales que respondian que su labor asistencial era poco reconocida obtenian las peores puntuaciones en el Burnout y sus tres dimensiones (p =0,000). A menor grado de satisfaccion laboral mas altas son las puntuaciones en las 4 escalas (p=0,000). Conclusiones: Podemos concluir que en nuestro estudio el perfil del sujeto afecto de Burnout se corresponde con el de un profesional con experiencia laboral que sin embargo manifiesta un escaso grado de reconocimiento a su labor asistencial y un alto nivel de insatisfaccion con la gestion de su centro de trabajo.

Plantago Ovata Consumption and Colorectal Mortality in Spain, 1995–2000

Background Consumption of Plantago ovata may protect against colorectal cancer. To test this hypothesis, an ecological study was performed to determine mortality rates and distribution of colorectal cancer, and the consumption and distribution of P ovata, in different provinces in Spain. The putative association between P ovata consumption and mortality from colorectal cancer was then evaluated. Methods We conducted a comparative ecological study of Spanish provinces, with colorectal cancer mortality as the dependent variable and per capita consumption of P ovata by province and year as the independent variable. Associations were analyzed by calculating Spearman’s correlation coefficients and a Poisson multiple regression model. Results Consumption of P ovata tended to be inversely correlated with mortality from colorectal cancer. In the Poisson regression analysis this tendency remained and reached statistical significance for the top quintile of P ovata consumption in the adjusted analysis (P = 0.042). Conclusions Our results show an inverse trend between the consumption of P ovata and colorectal cancer mortality. We recommend additional observational studies of individuals, in order to better control confounding factors.

Socioeconomic position and health services use in Germany and Spain during the Great Recession

Objective The relationship of socioeconomic position with the use of health services may have changed with the emergence of the economic crisis. This study shows that relationship before and during the economic crisis, in Germany and in Spain. Methods Data from the 2006 and 2011 Socio-Economic Panel carried out in Germany, and from the 2006 and 2011 National Health Surveys carried out in Spain were used. The health services investigated were physician consultations and hospitalization. The measures of socioeconomic position used were education and household income. The magnitude of the relationship between socioeconomic position and the use of each health services was estimated by calculating the percentage ratio by binary regression. Results In Germany, in both periods, after adjusting for age, sex, type of health insurance and need for care, subjects belonging to the lower educational categories had a lower frequency of physician consultations, while those belonging to the lower income categories had a higher frequency of hospitalization. In the model comparing the two lower socioeconomic categories to the two higher categories, the percentage ratio for physician consultation by education was 0.97 (95%CI 0.96–0.98) in 2006 and 0.96 (95%CI 0.95–0.97) in 2011, and the percentage ratio for hospitalization by income was 1.14 (95%CI 1.05–1.25) in 2006 and 1.12 (95%CI 1.03–1.21) in 2011. In Spain, no significant socioeconomic differences were observed in either period in the frequency of use of these health services in the fully adjusted model. Conclusion The results suggest that the economic crisis did not alter accessibility to the health system in either country, given that the socioeconomic pattern in the use of these health services was similar before and during the crisis in both countries.

Influencia de la mortalidad en las personas con bajo nivel educativo en la variación de las desigualdades de mortalidad en las comunidades autónomas

Background: Given the importance of mortality rates in each socioeconomic group, as explanation for the variation in mortality inequalities across populations, the objective of the present study is to evaluate whether regional variation in mortality inequalities in Spain is related to the mortality rates in different socioeconomic groups. Methods: The study included all persons aged 30-74 years living in Spain in 2001 and followed up for mortality over 7 years. In each of the 17 autonomous communities of Spain mortality rates were estimated for those with low and high education, as well as two measures of mortality inequality according to education: mortality rate difference and mortality rate ratio. Median value of mortality inequalities was calculated for the regions with the highest and lowest mortality rates and for those with intermediate mortality rates. And the Pearson correlation coefficient was used to estimate the relation between mortality rates and the measures of mortality inequality. Results: The correlation coefficients between mortality rate in low education and mortality rate difference and mortality rate ratio were 0.87 and 0.78 in women and 0.81 and 0.73 in men, respectively. The correlation coefficients between mortality rate in high education and mortality rate difference and mortality rate ratio were -0.07 and -0.24 in women and 0.10 and -0.06 in men, respectively. Conclusion: Regions with the lowest and highest mortality rates in low education people generally had the lowest and highest inequalities in mortality. The variation in the magnitude of inequalities in mortality from one place to another can be explained by the variation in mortality in low education people. No relation was observed between mortality rate in high education and mortality inequality

Risk behaviors and sports facilities do not explain the relationship between neighborhood socioeconomic context and childhood obesity in a city in Southern Europe.

To evaluate whether the relation between neighborhood socioeconomic context and childhood obesity can be explained by household socioeconomic position, obesity-related risk behaviors and sports facilities. 727 children and adolescent representative of the population aged 6–15 years resident in Madrid (Spain) in 2005 were analyzed. Using odds ratios calculated by multilevel logistic regression, the association between two indicators of neighborhood socioeconomic context – per capita income and percentage of population with tertiary education – and overweight and obesity was estimated. With respect to the richest neighborhoods and with respect to the neighborhoods having the highest percentage of population with university studies, children and adolescents living in the neighborhoods with the lowest per capita income and with lowest percentage of population with university studies, had an age- and sex-adjusted odds ratios for overweight 1.84 and 1.68 times greater, respectively. After adjusting for household socioeconomic position, unhealthy diet and physical inactivity the odds ratios were 1.80 and 1.56, respectively. In the case of obesity the age- and sex-adjusted odds ratios were 3.35 and 3.29, and its magnitude was increased 3.77 and 3.42 after adjustment for the rest of variables. No relation was found between the number of sports facilities and physical inactivity. The relation of socioeconomic context with childhood obesity could not be explained by household socioeconomic position or obesity-related risk behaviors. Availability of sport facilities does not explain this relation either.