RESUMEN
Based on a randomized controlled multicentre-design the effect of school-based life skills programmes was investigated in a sample of 102 classes of secondary schools (Hauptschulen) in northern Germany. Self-reports of 1,057 pupils showed positive effects of the programmes on the reduction of smoking. Pupils' life skills improved in the teachers' assessment. The social and the migration status did not moderate the results. Both pupils and teachers evaluated the programmes very positive.
Asunto(s)
Conducta de Reducción del Riesgo , Servicios de Salud Escolar/estadística & datos numéricos , Instituciones Académicas/estadística & datos numéricos , Prevención del Hábito de Fumar , Fumar/epidemiología , Poblaciones Vulnerables/estadística & datos numéricos , Adolescente , Niño , Femenino , Alemania/epidemiología , Estilo de Vida Saludable , Humanos , Masculino , Evaluación de Programas y Proyectos de Salud , Factores de Riesgo , Clase Social , Migrantes/psicología , Migrantes/estadística & datos numéricos , Resultado del Tratamiento , Poblaciones Vulnerables/psicologíaRESUMEN
OBJECTIVE: The Anaesthesiological Questionnaire (ANP) is a self-rating method for the assessment of postoperative complaints and patient satisfaction. The questionnaire consists of two parts. Part 1 assesses the intensity of symptoms regarding the postoperative period in the "recovery-room and the first hours on the ward" (19 items) and the "current state" (17 items). Part 2 assesses patient satisfaction with the anaesthetic care as well as the unspecific perioperative care and postoperative convalescence. The questionnaire was designed to fulfill the criteria of reliability and validity and to serve as a practicable means of auditing the quality of routine clinical practice. METHODS: A total of 1,112 patients older than 18 years completed the questionnaire after an elective operation. Additionally data concerning the type of anaesthesia were recorded from the anaesthesia chart. To determine retest-reliability, 94 patients competed the ANP twice postoperatively. RESULTS: The participants of the survey represented 74.6% of the total collective. Out of 19 items 16 had a retest-reliability of r(tt)>0.70, the 3 other items had a reliability of r(tt)>0.50. Reliability (Cronbach's Alpha) of the patient satisfaction scales was between r(tt)=0.76 and r(tt)=0.91. In relation to the period immediately after anaesthesia,women reported more postoperative complaints than men but no differences were found between male and female patients with regard to satisfaction with perioperative care. Younger patients (18-49 years old) described more postoperative complaints than older patients and a lesser degree of satisfaction with perioperative care. There were plausible differences in postoperative complaints between patients who received general vs. regional anaesthesia. Patients reported less postoperative complaints after TIVA than after volatile anaesthetics. The configuration of patient characteristics and anaesthesia gives indications to "risk groups" who predominantly suffer after anaesthesia. CONCLUSIONS: The Anaesthesiological Questionnaire (ANP) is a reliable and valid method for the assessment of postoperative complaints and patient satisfaction.
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Anestesia , Comportamiento del Consumidor , Complicaciones Posoperatorias/epidemiología , Encuestas y Cuestionarios/normas , Adolescente , Adulto , Factores de Edad , Anciano , Anestesia/efectos adversos , Anestesia por Inhalación , Anestesia Intravenosa , Femenino , Humanos , Masculino , Persona de Mediana Edad , Garantía de la Calidad de Atención de Salud , Reproducibilidad de los Resultados , Medición de RiesgoRESUMEN
Currently, metabolic changes in ICU patients in critical states are determined mainly by indirect laboratory parameters (e.g. blood lactate). Microdialysis is a new means of performing metabolic monitoring that permits organ-specific objectification on the basis of interstitial fluid samples. Continuous endotoxin infusion was administered to 10 female pigs and, in addition to hemodynamic monitoring, lactate and glycerol in the subcutaneous, intramuscular and hepatic tissue were measured by microdialysis. The interstitial concentrations of lactate and glycerol rose significantly under endotoxaemia and showed an earlier increase than blood lactate levels. Microdialysis is simple to apply, appears to be a suitable means of obtaining important information about cellular metabolic changes in different tissues of the critically ill patient, and can detect subtle changes that laboratory parameters can identify only later and incompletely.
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Metabolismo Energético/fisiología , Microdiálisis/instrumentación , Monitoreo Fisiológico/instrumentación , Sepsis/fisiopatología , Animales , Diseño de Equipo , Espacio Extracelular/fisiología , Femenino , Humanos , Unidades de Cuidados Intensivos , Sepsis/diagnóstico , PorcinosRESUMEN
OBJECTIVE: There is an increasing demand for internal clinical quality assurance. For this reason methods for the assessment of patients' satisfaction and postoperative symptoms and complaints are needed. This article describes a new questionnaire for the measurement of these aspects. METHODS: The questionnaire consists of two parts. Part 1 assesses the intensity of symptoms related to the postoperative periods "recovery room", "first hours on ward" and "current state". Part 2 measures patients' satisfaction with anesthesiological care, unspecific perioperative care and postoperative convalescence. 431 patients completed the questionnaire after an elective operation. RESULTS: Results demonstrate a plausible difference in patients' symptoms between the three postoperative periods. The difference between the remembered complaints in the "recovery room" and the "first hours on ward" is of small degree. Related to the period immediately after anesthesia, women describe a worse state of health than men. Male and female patients do not differ in their satisfaction with anesthesiological care. Older patients describe greater satisfaction with perioperative care than younger ones. There are only a few significant correlations between the intensity of symptoms in the "recovery room" and data from anesthesiological documentation. CONCLUSIONS: The new questionnaire is sensitive for the change of symptoms in the course of postoperative time. Considering the results, a modification of the questionnaire ist suggested. This instrument is to be used in a greater and representative sample of patients now.