The study confirms the multidimensionality of the OLQ-13 scale, in which 3 factors were identified: external meaningful, comprehensibility and manageability, and internal comprehensibility and manageability. The OLQ-13 may be a valid and reliable scale for use in the Spanish university population.
15(4):220-6 38 ORIGINALES Objetivos. Conocer la opinión y vivencias de las cuidadoras, y las expectativas y demandas con respecto a los profesionales de enfermería que realizan las visitas domiciliarias. Método. Estudio cualitativo realizado en Andalucía en el año 1999. Participantes: mujeres cuidadoras de pacientes de cáncer en fase terminal, ancianos/as con demencia y enfermos terminales de sida. Estrategias para obtener información: entrevistas en profundidad y grupos de discusión. Análisis de contenido utilizando como marco de referencia el modelo de Virginia Henderson. Resultados. En los discursos de las cuidadoras se identificaron 6 tipos de cuidados realizados por las cuidadoras familiares: higiene, alimentación, eliminación, movilidad, realización de curas y administración de medicación. Las cuidadoras manifestaron su satisfacción con la competencia técnica y la comunicación de las enfermeras. Sin embargo, la valoración es deficiente con respecto a la frecuencia de las visitas domiciliarias y a la formación que reciben. Demandaron actividades formativas en técnicas específicas (curas, alimentación) y en actividades de prevención y promoción de salud (cambios posturales, ejercicios de movilidad). Conclusiones. La labor realizada por las cuidadoras supone una sobrecarga emocional y de trabajo que afrontan, en muchos casos, sin tener la competencia técnica adecuada. Para mejorar las visitas domiciliarias de enfermería se debe aumentar la frecuencia de éstas y la formación de las cuidadoras.
Resumen Experiences, expectations and perceived needs of informal caregivers of patients with longstanding diseasesObjectives. To determine informal caregivers' opinions and experiences of providing care and their expectations and needs concerning professional nurses who make home visits. Method. A qualitative study was carried out in 1999 in the Autonomous Community of Andalusia. Participants: Female homecarers of terminally-ill patients with cancer or AIDS and elderly persons with dementia. Strategies for obtaining information: indepth interviews and discussion groups. The content analysis used Virginia Henderson's model as a framework. Results. In the caregivers' statements, six types of care that they carried out related to hygiene, food, excretion, mobility, wound care, and medicine administration were identified. The caregivers were satisfied with professional nurses' technical and communication skills. However, their satisfaction with the number of visits and their own training was low. They requested training courses in specific skills (wound care, diet) and in prevention and health (postural changes, mobility exercises).Conclusions. The tasks carried out by the caregivers are physically and emotionally demanding, and caregivers frequently lack the required technical skills. To improve home care services, visits should be more frequent and caregivers' training should be up-graded.
We detected
Leishmania infantum
in 98 Norway rats (
Rattus norvegicus
) trapped in parks and sewers of Barcelona, Spain. The 84 rats from the sewers showed a prevalence of 33.3% and up to 2,272 estimated parasites. These results, in the most abundant potential reservoir in cities, is of public health concern.
Background
Classically, dogs have been considered to be the only reservoir of leishmaniasis in urban areas. However, in a previous study, we found a 33.3% prevalence of Leishmania infantum in the spleens of Norway rats (Rattus norvegicus) sampled in the underground sewer system of the city of Barcelona (Spain). The aim of the present study was to verify, using molecular methods, the potential reservoir role of these rats in the same sewer system.
Methods
A sensitive real-time PCR (qPCR) assay, DNA sequencing and phylogenetic analysis were carried out to identify and quantify the presence of L. infantum DNA in sand fly individuals captured in the same underground sewer system of Barcelona as in our previous study and in the spleens and ears of rats captured in the same sewer system.
Results
Leishmania infantum DNA was found in 14 of the 27 (51.9%) sand flies identified as Phlebotomus perniciosus, and 10 of the 24 (41.7%) rats studied were infected. Leishmania infantum was found in the spleens (70%) and in the ears (40%) of the infected rats. Quantitative results revealed the presence of high loads of L. infantum in the rats studied (> 3 × 106 parasites/g ear tissue) and among the sand flies (> 34 × 106 parasites in 1 individual).
Conclusions
The molecular methods used in this study demonstrated a high prevalence of L. infantum in the underground
sewer populations of both R. norvegicus and P. perniciosus. These results suggest that sewer rats, in addition to dogs, are likely to act as reservoirs of leishmaniasis in cities, where sewer systems seem to offer the ideal scenario for the transmission of leishmaniasis. Therefore, to achieve the WHO 2030 target on the elimination of leishmaniasis as a public health problem successfully, an efficient control strategy against leishmaniasis in rats and sand flies should be implemented, particularly in the sewer systems of urban areas of endemic countries.
Graphical Abstract
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