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      Variables relacionadas con la calidad de atención de la consulta nutricional y percepción del éxito en el tratamiento para el control del peso corporal Translated title: Variables related to the quality of care nutritional consulting and perception of success in treatments for body weight control

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          Abstract

          Objetivo: Determinar la asociación entre variables relacionadas con la calidad de la consulta nutricional y la percepción del paciente en el éxito del tratamiento para el control del peso corporal en un grupo de mujeres mayores de 20 años, habitantes de la Ciudad Autónoma de Buenos Aires o del Gran Buenos Aires. Metodología: Diseño observacional, transversal de correlación. Muestreo aleatorio simple de 97 mujeres que concurrieron por lo menos una vez a una consulta nutricional llevada a cabo por un Licenciado en Nutrición. Se realizó encuesta estructurada y voluntaria analizando como variable dependiente la percepción del éxito del tratamiento nutricional y como variables independientes tres variables relacionadas con la calidad de la atención como la escucha del profesional (buena, regular o mala), indicaciones adecuadas a gustos, hábitos y tolerancias digestivas y tipo de material entregado en la consulta. El análisis estadístico se realizó con SPSS 15,0 aplicando diferencia de proporciones y OR con valor p<0,05. Resultados: Del total de la muestra estudiada el 61,9% percibió como exitoso a su último tratamiento para el control del peso corporal. Para la mayoría el ámbito físico donde se desarrolló la consulta fue adecuado (95,9%), siendo suficiente el tiempo destinado a la misma (89,7%), con buena escucha llevada a cabo por el profesional (75,3%). La percepción del éxito fue asociada significativamente con una buena escucha del profesional en la consulta (p: 0,0001) y con el manejo de indicaciones adecuadas a los gustos y hábitos de las pacientes (p: 0,002). No se observo asociación entre las indicaciones adecuadas a la tolerancia digestiva y el tipo de material empleado con la percepción de éxito en la consulta nutricional. Conclusiones: La percepción del éxito en el tratamiento nutricional fue asociada significativamente con una buena escucha por parte del profesional en la consulta e indicaciones adecuadas en cuanto a sus gustos y hábitos alimentarios.

          Translated abstract

          Objective: to determine the association between variables related to the quality of care nutritional consulting and the patients´ perception of success in treatments for body weight control in a group of women over 20 years old, residents of the Autonomous City of Buenos Aires or Greater Buenos Aires. Methodology: Observational, cross-correlation design. Simple random sample of 97 women who attended, at least once, for nutritional consulting led by a registered dietitian. A voluntary and structured survey was carried out analyzing as dependent variable the perception of success of the nutritional treatment and as independent variables three variables related to quality of care: the professional's listening skills (good, fair or poor), adequate instructions based on tastes, habits and digestive tolerance and type of literature given in the consulting-room. Statistical analysis was performed using the SPSS 15.0, applying difference of proportions and OR with p <0.05. Results: Of the total sample studied, 61.9% perceived as successful their latest treatment for weight control. For the majority, the physical place where consulting took place was adequate (95.9%), time spent was enough (89.7%), and the professional´s listening skills were good (75.3%). The perception of success was significantly associated with good listening skills by the professional (p = 0.0001) and adequate instructions based on tastes and habits of the patients (p = 0.002). No association was observed between adequate instructions to digestive tolerance and the type of literature used and the perception of success in the consulting room Conclusions: the perception of success in the nutritional treatment was significantly associated with good listening skills by the professional and adequate instructions as to the patients´ preferences and eating habits.

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          Adherencia a los tratamientos a largo plazo: pruebas para la acción

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            A newer and broader definition of burnout: Validation of the "Burnout Clinical Subtype Questionnaire (BCSQ-36)"

            Background Burnout syndrome has been clinically characterised by a series of three subtypes: frenetic, underchallenged and worn-out, with reference to coping strategies for stress and frustration at work with different degrees of dedication. The aims of the study are to present an operating definition of these subtypes in order to assess their reliability and convergent validity with respect to a standard burnout criterion and to examine differences with regard to sex and the temporary nature of work contracts. Method An exploratory factor analysis was performed by the main component method on a range of items devised by experts. The sample was composed of 409 employees of the University of Zaragoza, Spain. The reliability of the scales was assessed with Cronbach's α, convergent validity in relation to the Maslach Burnout Inventory with Pearson's r, and differences with Student's t-test and the Mann-Whitney U test. Results The factorial validity and reliability of the scales were good. The subtypes presented relations of differing degrees with the criterion dimensions, which were greater when dedication to work was lower. The frenetic profile presented fewer relations with the criterion dimensions while the worn-out profile presented relations of the greatest magnitude. Sex was not influential in establishing differences. However, the temporary nature of work contracts was found to have an effect: temporary employees exhibited higher scores in the frenetic profile (p < 0.001), while permanent employees did so in the underchallenged (p = 0.018) and worn-out (p < 0.001) profiles. Conclusions The classical Maslach description of burnout does not include the frenetic profile; therefore, these patients are not recognised. The developed questionnaire may be a useful tool for the design and appraisal of specific preventive and treatment approaches based on the type of burnout experienced.
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              Complexity of attrition in the treatment of obesity: clues from a structured telephone interview.

              To investigate the causes of attrition reported by obese patients treated by medical centres. Observational study. Obese patients enrolled in a long-term study involving 18 Italian medical centres. A total of 940 obese patients (727 female; mean age, 49 years; mean BMI, 38.6 kg/m2). Causes of attrition reported by dropouts during a structured telephone interview. After a median observation period of 41 months (range, 25-50), 766 of 940 patients (81.5%) discontinued treatment. Sixty-two per cent of total dropout occurred in the first year of follow-up. Seventy-four per cent of dropouts reported a single primary reasons for treatment interruption. Two primary reasons were reported by 22.4% of patients, and three reasons by 3.4%. Practical difficulties, alone or in combination, were reported by more than half of dropouts (55%), and were the leading cause of attrition followed by perceived failure of treatment. Among practical difficulties, family problems or problems at work and logistics, coupled with health problems other than obesity, were the most frequent reasons of attrition, but also a perceived sense of abandonment or a bad interaction with therapists were frequently reported. Practical difficulties and psychological problems are the most important reasons of attrition reported by patients. A therapeutic alliance addressing these issues has a large potential to reduce treatment interruption and to improve outcome in obesity.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                diaeta
                Diaeta
                Diaeta
                Asociación Argentina de Dietistas y Nutricionistas Dietista (Ciudad Autónoma de Buenos Aires, , Argentina )
                1852-7337
                September 2011
                : 29
                : 136
                : 10-17
                Affiliations
                [01] orgnameUniversidad de Buenos Aires
                [02] orgnameUniversidad de Buenos Aires orgdiv1Facultad de Medicina orgdiv2Escuela de Nutrición
                Article
                S1852-73372011000300002
                89c2e694-c308-4d30-8149-31b5fcce8a6f

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

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