Rosa Villanueva

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.

Area-based socioeconomic environment, obesity risk behaviours, area facilities and childhood overweight and obesity: socioeconomic environment and childhood overweight.

OBJECTIVE The objective of this study is to evaluate whether the relation between area-based socioeconomic environment and childhood obesity can be explained by household socioeconomic position, obesity-related risk behaviours and area facilities. METHODS Two indicators of socioeconomic environment based on wealth and deprivation were estimated in a sample of 4529 Spanish children and adolescents in 2006. Multilevel logit models were used to calculate the relation between each indicator and obesity. RESULTS After adjusting for socioeconomic position and risk behaviours, no relation was observed between wealth and overweight; however, obesity prevalence was 1.45 times higher in subjects living in areas with lower wealth than in those living in areas with higher wealth. After adjusting for these variables, the prevalence of overweight and obesity in subjects living in deprived areas was, respectively, 1.26 and 1.63 higher than in those living in non-deprived areas. There was a graded association between number of sports facilities and prevalence of physical inactivity, but no relation was found between the price of fruits and vegetables and frequency of consumption. CONCLUSION The relation of socioeconomic environment with childhood obesity could not be explained by household socioeconomic position or obesity-related risk behaviours. Availability of sport facilities may mediate this relation.

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.

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.