The aim of this study was to determine the incidence of laryngotracheal injuries following intubation and/or tracheotomy in intensive care unit (ICU) patients and to analyze their prognostic factors. This prospective study includes the clinical data and endoscopic exploration of 654 ICU patients who underwent oro-tracheal intubation between September 1992 and February 1999. The prognostic factors for upper airway injuries were analyzed using a multivariate statistical study. Endoscopic exploration of the upper airway 6 to 12 months after extubation revealed laryngotracheal injuries in 30 of the 280 patients examined (11%). The most important factors influencing the development of laryngotracheal lesions were the duration of the oro-tracheal intubation and the length of time in the ICU. Patients at high risk of developing injuries were those with pathological background, a non-neurological or non-surgical (medical) admission or upper-airway injuries at an early stage. The length of oro-tracheal intubation is the most important factor in the development of laryngotracheal injuries. Consequently, it is essential to establish a time limit to perform tracheotomy in ICU patients. Such timing should be adapted to each patient and pathology.
Resumen: En este trabajo se presentan datos sobre la estr uctura factorial, fiabilidad y validez del cuestionario PANAS (Positive and Negative Affect Schedule) en personas mayores. Participaron un total de 436 personas con edad igual o superior a los 65 años (rango de edad: 65-91). Los resultados confirman la estructura de dos factores del cuestionario. Más aun, corroboran la fiabilidad (alfa de Cronbach) y validez, tanto convergente como discriminante, por sus relaciones con la ansiedad estado e intensidad de dolor.Palabras clave: PANAS; personas mayores; afecto positive; afecto negativo; salud.Abstract: This work provides information on the factorial structure, reliability and validity of the PANAS scales (Positive and Negative Affect Schedule) when used with the elderly. The participants in this study were 436 senior citizens aged 65 or older (age range: 65-91). Results conf irm the original 2-factor structure of the questionnaire. Fur thermore, they corroborate good reliability (Cronbach's alpha) and validity, both convergent and discriminant, on account of its relationships with state anxiety and pain intensity.
Medical students, residents and tutors consider training in communication skills an essential component for clinical practice and they agree about the need to learn these communication skills. Attention should be paid to measuring attitudes at all three levels of medical education in the design of communication skills courses.
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