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      Qué hace el cuidador familiar en el hospital: Cómo se ve a sí mismo y cómo lo ven los profesionales Translated title: The role of the family caregivers in the hospital: Their self-concept and how they are seen by health professionals

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          Abstract

          Los cuidadores familiares han sido ampliamente estudiados en el ámbito domiciliario y de la atención primaria pero prácticamente no existen estudios que incidan sobre su realidad dentro de los hospitales. Con un enfoque cuantitativo y diseño descriptivo transversal mediante el uso de cuestionarios validados al efecto realizado a familiares que cuidan a ancianos ingresados en los hospitales se conoce el perfil de los mismos, qué actividades realizan y qué valoración hacen de ellos los profesionales de enfermería. Como conclusiones principales destacar: a) Las principales actividades del cuidador familiar en el hospital son de acompañamiento, entretenimiento, soporte emocional e intermediación. b) El desconocimiento de la actividad inhiben al cuidador familiar a realizar más actividades. c) Si se educa y entrena al cuidador familiar en las actividades de cuidado, se harán más. d) Los profesionales desconocen lo que los familiares dicen que hacen. No consideran que muchas de las acciones del cuidador sean realmente cuidados. Creen que los cuidadores familiares no ayudan tanto como ellos esperan al cuidado básico de los ancianos ingresados.

          Translated abstract

          Family caregivers have been widely studied in the home and primary care but virtually do no exits studies which influence the reality in hospitals. With a quantitative approach and cross-sectional design using questionnaires validated for that purpose made to relatives who care for elderly people in hospitals is called the profile them, what activities do and what makes them value the nurses. As main findings include: a) The main activities of family caregivers in the hospital are accompanying, entertainment, emotional support and brokerage. b) Lack of activity inhibit the family caregiver to be more active. c) If you educate and train the family caregiver in activities of care, will be more. d) Professionals know what family members say they do. Do not think that many of the actions of the caregiver are really cares. They believe that family caregivers do not help as much as they expect the basic care of hospitalized elders.

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          Comprehensive discharge planning and home follow-up of hospitalized elders: a randomized clinical trial.

          Comprehensive discharge planning by advanced practice nurses has demonstrated short-term reductions in readmissions of elderly patients, but the benefits of more intensive follow-up of hospitalized elders at risk for poor outcomes after discharge has not been studied. To examine the effectiveness of an advanced practice nurse-centered discharge planning and home follow-up intervention for elders at risk for hospital readmissions. Randomized clinical trial with follow-up at 2, 6, 12, and 24 weeks after index hospital discharge. Two urban, academically affiliated hospitals in Philadelphia, Pa. Eligible patients were 65 years or older, hospitalized between August 1992 and March 1996, and had 1 of several medical and surgical reasons for admission. Intervention group patients received a comprehensive discharge planning and home follow-up protocol designed specifically for elders at risk for poor outcomes after discharge and implemented by advanced practice nurses. Readmissions, time to first readmission, acute care visits after discharge, costs, functional status, depression, and patient satisfaction. A total of 363 patients (186 in the control group and 177 in the intervention group) were enrolled in the study; 70% of intervention and 74% of control subjects completed the trial. Mean age of sample was 75 years; 50% were men and 45% were black. By week 24 after the index hospital discharge, control group patients were more likely than intervention group patients to be readmitted at least once (37.1 % vs 20.3 %; P<.001). Fewer intervention group patients had multiple readmissions (6.2% vs 14.5%; P = .01) and the intervention group had fewer hospital days per patient (1.53 vs 4.09 days; P<.001). Time to first readmission was increased in the intervention group (P<.001). At 24 weeks after discharge, total Medicare reimbursements for health services were about $1.2 million in the control group vs about $0.6 million in the intervention group (P<.001). There were no significant group differences in post-discharge acute care visits, functional status, depression, or patient satisfaction. An advanced practice nurse-centered discharge planning and home care intervention for at-risk hospitalized elders reduced readmissions, lengthened the time between discharge and readmission, and decreased the costs of providing health care. Thus, the intervention demonstrated great potential in promoting positive outcomes for hospitalized elders at high risk for rehospitalization while reducing costs.
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            El impacto de cuidar en la salud y la calidad de vida de las mujeres

            Fundamentos: La atención informal se sitúa en el centro del debate sobre las políticas de bienestar en la actualidad, debido al creciente aumento de la demanda de cuidados y al cuestionamiento sobre la futura disponibilidad de cuidadores informales. Objetivo: En el presente trabajo se analiza la distribución del papel de cuidadores entre hombres y mujeres y sus consecuencias respecto a la sobrecarga, la salud y la calidad de vida. Métodos: Se revisan los datos disponibles en España y en países de nuestro entorno procedentes de diferentes bases bibliográficas, publicaciones e informes oficiales; en especial, se presentan datos procedentes de una investigación sobre cuidados informales en Andalucía realizada por las autoras utilizando una encuesta domiciliaria a 1.000 cuidadores/as principales. Resultados: Se pone de manifiesto el claro predominio de las mujeres como cuidadoras informales en nuestro medio. Son las mujeres de menor nivel educativo, sin empleo y de clases sociales menos privilegiadas las que componen el gran colectivo de cuidadoras. El impacto negativo de cuidar es identificado por una gran proporción de cuidadoras, en especial las repercusiones económicas, laborales y en el uso del tiempo. Las consecuencias sobre la salud son también importantes, sobre todo en la esfera psicológica, asociadas con altos niveles de sobrecarga. Conclusiones: Se evidencia la necesidad de replantear las políticas sociales y sanitarias y de prever recursos suficientes para cubrir la creciente necesidad de atención informal, que amortigüe el impacto y el coste que los cuidados suponen para las mujeres en diferentes aspectos de sus vidas.
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              Comprehensive discharge planning for the hospitalized elderly. A randomized clinical trial.

              To study the effects of a comprehensive discharge planning protocol, designed specifically for the elderly and implemented by nurse specialists, on patient and caregiver outcomes and cost of care. Randomized clinical trial. Hospital of the University of Pennsylvania. 276 patients and 125 caregivers. Patients were 70 years and older and were placed in selected medical and surgical cardiac diagnostic-related groups. Group differences in patient outcomes (length of initial hospital stay, length of time between initial hospital discharge and readmission, and rehospitalization rates) and charges for care (charges for initial hospitalization, rehospitalizations, health services after discharge, and nurse specialist services) were measured 2, 6, and 12 weeks after discharge. From the initial hospital discharge to 6 weeks after discharge, patients in the medical intervention group had fewer readmissions, fewer total days rehospitalized, lower readmission charges, and lower charges for health care services after discharge. No differences in these outcomes were found between the surgical intervention and control groups during this period. Study findings support the need for comprehensive discharge planning designed for the elderly and implemented by nurse specialists to improve their outcomes after hospital discharge and to achieve cost savings. The findings also suggest that this intervention had its greatest effect in delaying or preventing rehospitalization of patients in the medical intervention group during the first 6 weeks after discharge.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                geroko
                Gerokomos
                Gerokomos
                Idemm Farma, S.L. (Barcelona )
                1134-928X
                March 2012
                : 23
                : 1
                : 7-14
                Affiliations
                [1 ] Universidad de Jaén Spain
                [2 ] Complejo Hospitalario de Jaén Spain
                Article
                S1134-928X2012000100002
                10.4321/s1134-928x2012000100002
                108ca1bb-d247-4183-9d99-aff09e741d7a

                http://creativecommons.org/licenses/by/4.0/

                History
                Categories
                GERIATRICS & GERONTOLOGY
                NURSING

                Nursing,Geriatric medicine
                Family caregiver,elderly,hospital,care actions,Cuidador familiar,anciano,actividades de cuidados

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