Quality of life and chronic disease in patients receiving primary health care

Problem Statement: Chronic disease entails physical, psychological and social issues with a decrease in the quality of life. The assessment of QoL has been applied as indicator in patients with chronic diseases. Research Questions: What is the quality of life in patients with chronic disease? What are the socio-demographic variables that influence the quality of life in patients? Purpose: To assess the quality of life in patients suffering from chronic disease and identify socio-demographic variables which influence the quality of life of patients suffering from chronic disease. Research Methods: We conducted a cross-sectional analytical study using a sample composed of 228 users (134 females) from a Family Health Unit in the municipality of Viseu. Data collection was made by means of a questionnaire, consisting of sociodemographic variables, the SF-12 scale and the existence of chronic disease was assessed through the questions – “Do you currently suffer from any chronic disease?”; “If so, which one(s)?”. Findings: The most common chronic diseases were hypertension (59.9%). Female patients with a chronic disease reported worse physical functioning, role-physical and role-emotional; increased bodily pain and better quality of life regarding general health. Male patients showed worse role-physical, increased bodily pain and vitality. Sociodemographic variables which were associated with quality of life were area of residence, academic qualifications and work situation. Conclusion: Chronic disease affects quality of life negatively. Quality of life in both patients groups was associated with socio-demographic variables. Health-related quality of life is an essential issue and should be considered as a priority in health policies.

Satisfaction of users of primary health care with nursing care : sample of the central region of Portugal

Introdução: A satisfação dos doentes constitui um indicador indispensável para a avaliação da qualidade dos cuidados e há evidência da sua correlação com os resultados em saúde. A satisfação com os cuidados de saúde é um conceito multidimensional que considera aspetos como acesso, organização e interação doente - profissional. Consideramos que os cuidados de enfermagem, em particular, são fundamentais no processo saúde/doença. Objetivos: Validar uma escala para avaliar a satisfação dos utentes face aos cuidados de enfermagem, adaptado do instrumento EUROPEP e avaliar a satisfação dos utentes dos cuidados de saúde primários da região centro de Portugal. Material e métodos: Estudo transversal, com uma amostra de 827 utentes adultos (maioria do sexo feminino 64,4%) com uma média de idade de 50,08±18,58 anos. Os dados foram recolhidos através de um questionário, constituído por variáveis sociodemográficas, o instrumento EUROPEP (Ferreira, 1995) para avaliar a satisfação com os cuidados de saúde primários e para avaliar a satisfação especificamente com a equipa de enfermagem elaboramos questões adaptadas do instrumento EUROPEP e agrupadas nas dimensões relação de ajuda, dimensão interpessoal e instrumental. A consistência interna, reprodutibilidade e análise de conteúdo foram avaliados com recurso ao SPSS 23.0; considerando a consistência aceitável para um de Cronbach > 0,70. O coeficiente para cada item é apresentado com um intervalo de confiança de 95%. Resultados: Em todas as dimensões do questionário EUROPEP, a maior percentagem de satisfação com os cuidados situou-se entre “boa” e “muito boa”. As dimensões criadas para avaliar especificamente os cuidados de enfermagem apresentaram um coeficiente de α de Cronbach total de 0,972. Conclusões: Estes resultados sugerem que as dimensões criadas para avaliar os cuidados de enfermagem serão úteis para a investigação na população Portuguesa. A satisfação do utente é decisiva para a qualidade e eficiência dos cuidados prestados, sendo necessário o compromisso de todos os prestadores na implementação de práticas sistemáticas de gestão que conduzam à satisfação, dando particular atenção à melhoria contínua dos processos organizacionais. Palavras-chave: Satisfação dos Utentes; cuidados de saúde primários, cuidados de enfermagem, adulto, Portugal

Nurses’ clinical communication skills

Abstract Background: Providing nursing care involves an interpersonal relationship between the nurse and the patient which is created through communication. The importance of clinical communication skills is a current priority when it comes to health care workers’ education and training and has been attracting more and more attention. As a consequence clinical communication skills are now present in more and more academic programmes. Objectives: To assess nurses’ clinical communication skills; to identify the variables that might inluence the clinical communication skills; to analyse nurses’ perspective regarding the training in the clinical communication ield. Material and methods: Quantitative, non-experimental, descriptive and correlational and crosssectional study. We used the questionnaire to collect socio-demographic and professional data, and the Clinical Communication Skills Scale based on the Kalamazoo Consensus Statement (KCS)1,2 and which had already been used in Portugal.3 The sample was formed by 275 practitioner nurses who have been working in health care institutions located in the center of Portugal. Results: The Scale we used presents 5 factors that explain 64.33% of the total variation: To in‑ volve the patient; To facilitate dialogue; To understand concerns; To communicate in an asser‑ tive way; To carry out the interview. The majority of the nurses consider that the training they had in the communication skills ield during their nursing course was good or very good, however we could see that 23.3% think it was mediocre. Almost all of them (98.9%) agree that there should be a better and more speciic training in the ield of clinical communication skills as far, as nurses as concerned. Nurses who had training in this area, older nurses, those who work directly with patients and those who have been working for a longer period of time show better communication skills. Conclusion: Although they think that the training they has was good, we could conirm that there was a deicit in nurses’ clinical communication skills and that nurses themselves refer they need more training in this area. Data point out to a more signiicant investment in clinical communication as far as nurses’ training is concerned and they suggest the promotion of lifelong learning opportunities in this area.