Portillo, M.C. (María Carmen)
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- El automanejo de los pacientes con diabetes tipo 2: una revisión narrativa(2013) Portillo, M.C. (María Carmen); Campo-Guinea, N. (Natalia)Según la Organización Mundial de la Salud para el año 2030 la cifra de personas con diabetes mellitus alcanzará valores cercanos a 366 millones en el mundo, ocupando su mayor proporción la diabetes mellitus tipo 2. Las estrategias actuales de Cronicidad y de la Diabetes presentes en España abogan por un adecuado automanejo del paciente por medio de programas y/o intervenciones apropiadas para ello. Sin embargo, existen unos conocimientos y actitudes inadecuadas que limitan la asociación paciente-profesional que las estrategias de automanejo implican. A través de esta revisión bibliográfica se pretende mostrar las necesidades reales no cubiertas que los pacientes con diabetes mellitus tipo 2 tienen a la hora de automanejar la enfermedad. Así, se asentarán las bases para el desarrollo de futuros programas efectivos que se implementen ayudando al profesional sanitario a dirigir su trabajo diario hacía su principal objetivo, la persona con diabetes mellitus tipo 2 y sus necesidades.
- Implementation of a multidisciplinary psychoeducational intervention for Parkinson's disease patients and carers in the community: study protocol(BMC, 2018) Anaut-Bravo, S. (Sagrario); Díaz-de-Cerio-Ayesa, S. (Sara); Recio, M. (M.); Caparrós-Civera, N. (Neus); Álvarez-Urricelqui, M.J. (María Jesús); Portillo, M.C. (María Carmen); Senosiáin-García, J.M. (Juana María); Medina, M. (M.); Gorraiz, A. (A.); Navarta-Sánchez, M. V. (Mª Victoria); Ursua-Sesma, M.E. (M. Eugenia); Raquel; Riverol-Fernández, M. (M.); Ambrosio, L. (Leire)Background: Parkinson’s disease progressively limits patients at different levels and as a result family members play a key role in their care. However, studies show lack of an integrative approach in Primary Care to respond to the difficulties and psychosocial changes experienced by them. The aim of this study is to evaluate the effects of a multidisciplinary psychoeducational intervention focusing on improving coping skills, the psychosocial adjustment to Parkinson’s disease and the quality of life in patients and family carers in a Primary Care setting. Methods: This quasi-experimental study with control group and mixed methods was designed to evaluate a multidisciplinary psychoeducational intervention. Based on the study power calculations, 100 people with Parkinson’s disease and 100 family carers will be recruited and assigned to two groups. The intervention group will receive the ReNACE psychoeducational intervention. The control group will be given a general educational programme. The study will be carried out in six community-based health centres. The results obtained from the two groups will be collected for evaluation at three time points: at baseline, immediately after the intervention and at 6 months post-intervention. The results will be measured with these instruments: the Quality of Life Scale PDQ39 for patients and the Scale of Quality of Life of Care-givers SQLC for family carers, and for all participants the Psychosocial Adjustment to Illness scale and the Brief COPE Inventory. Focus groups will be organised with some patients and family carers who will have received the ReNACE psychoeducational intervention and also with the healthcare professionals involved in its development. Discussion: An important gap exists in the knowledge and application of interventions with a psychosocial approach for people with PD and family carers as a whole. This study will promote this comprehensive approach in Primary Care, which will clearly contribute in the existing knowledge and could reduce the burden of PD for patients and family carers, and also in other long-term conditions.
- Diferencias entre perfiles enfermeros: práctica avanzada, enfermería asistencial y gestión(Facultad de Enfermería, Universidad de Navarra, 2010) Portillo, M.C. (María Carmen)Este capítulo aborda un tema clave sobre el que hay mucho debate en la literatura relacionada con la Práctica Avanzada en Enfermería: los diferentes perfiles enfermeros: práctica avanzada, enfermería asistencial y gestión. Puede también considerarse de gran relevancia en España donde es ahora cuando están emergiendo estos temas y con el desarrollo de los programas de posgrado, comienza a verse la necesidad de desarrollar una enfermería con una visión más avanzada y con unos atributos que proporcionen las herramientas para poder cambiar y mejorar la práctica desde la investigación y la enfermería basada en la evidencia. El reto de diferenciar estos perfiles enfermeros es difícil por el tipo de evidencia disponible que está relacionada con el tema pero no lo aborda directamente.Por ello se presenta en este capítulo un análisis de contenido de la literatura que ayudará a entender mejor las diferencias y las similitudes entre estos perfiles y las posibles vías de colaboración entre ellos para potenciar al máximo la disciplina enfermera.
- Voluntary and community groups and health professionals contribution to selfmanagement and wellbeing(2015) Serrano-Gil, M. (Manuel); Portillo, M.C. (María Carmen); Mujika, A. (Agurtzane); Rogers, A. (Anne); Pumar-Mendez, M.J. (María Jesús); Regaira, E. (Elena)
- Elementos clave en el proceso de convivencia con la enfermedad de Parkinson de pacientes y familiares cuidadores(Gobierno de Navarra, 2014) Anaut-Bravo, S. (Sagrario); Díaz-de-Cerio-Ayesa, S. (Sara); Ursua-Sesma, C. (C.); Portillo, M.C. (María Carmen); Zaragoza-Salcedo, A. (Amparo); Senosiáin-García, J.M. (Juana María); Riverol, M. (Mario)Fundamento. La enfermedad de Parkinson produce un impacto considerable en la vida de las personas. Es necesario identificar los elementos clave que influyen en el proceso de convivencia con la enfermedad de Parkinson para que los profesionales de la salud puedan ayudar a los pacientes y sus familias a convivir lo mejor posible con los cambios y limitaciones producidos por la enfermedad. Material y método. Se llevó a cabo un estudio cualitativo descriptivo. Este estudio se corresponde con la primera fase de un diseño exploratorio secuencial (Mixed-methods) que incluye a su vez una fase cuantitativa. Se realizó un proyecto multicéntrico. Para la recogida de datos se aplicó un muestreo de conveniencia y se utilizó una entrevista semi-estructurada realizada individualmente a pacientes y familiares cuidadores y dos cuestionarios para pacientes: la Escala de Hoehn & Yahr y el Cuestionario PDNMS. Se realizó un análisis de contenido de las entrevistas y estadístico descriptivo de los cuestionarios. Resultados. La muestra la constituyeron 46 participantes. Se identificaron tres elementos clave en el proceso de convivencia con la enfermedad de Parkinson: aceptación, adaptación y automanejo. Estos elementos condicionaron dos modos de convivencia con la enfermedad de Parkinson: una convivencia positiva, caracterizada por sentimientos de armonía, equilibrio, y naturalidad; y una convivencia negativa caracterizada por sentimientos de frustración, pérdida de control y autoestima. Conclusiones. Es esencial que los profesionales de la salud conozcan a fondo estos elementos, así como los factores que los favorecen o dificultan. En la medida que se propicie la investigación en este ámbito y se identifiquen intervenciones efectivas se mejorará la atención integral de la personas en consonancia con las nuevas directrices para la cronicidad.
- Social support and health in diabetes patients: an observational study in six european countries in an era of austerity(Public Library of Science, 2015) Vassilev, I. (Ivo); Christos, L. (Lionis); Serrano-Gil, M. (Manuel); Wensing, M. (Michel); Foss, C. (Christina); Portillo, M.C. (María Carmen); Koetsenruijter, J. (Jan); Van-Lieshout, J. (Jan); Todorova, E. (Elka); Ruud-Knutsen, I. (Ingrid); Mujika, A. (Agurtzane); Rogers, A. (Anne); Roukova, P. (Poli); Kennedy, A. (Anne); Angelaki, A. (Agapi)Introduction Support from individual social networks, community organizations and neighborhoods is associated with better self-management and health outcomes. This international study examined the relative impact of different types of support on health and health-related behaviors in patients with type 2 diabetes. Methods Observational study (using interviews and questionnaires) in a sample of 1,692 type 2 diabetes patients with 5,433 connections from Bulgaria, Greece, Netherlands, Norway, Spain, and the United Kingdom. Outcomes were patient-reported health status (SF-12), physical exercise (RAPA), diet and smoking (SDCSCA). Random coefficient regression models were used to examine linkages with individual networks, community organizations, and neighborhood type (deprived rural, deprived urban, or affluent urban). Results Patients had a median of 3 support connections and 34.6% participated in community organizations. Controlled for patients’ age, sex, education, income and comorbidities, large emotional support networks were associated with decrease of non-smoking (OR = 0.87). Large practical support networks were associated with worse physical and mental health (B = -0.46 and -0.27 respectively) and less physical activity (OR = 0.90). Participation in community organizations was associated with better physical and mental health (B = 1.39 and 1.22, respectively) and, in patients with low income, with more physical activity (OR = 1.53). Discussion Participation in community organizations was most consistently related to better health status. Many diabetes patients have individual support networks, but this study did not provide evidence to increase their size as a public health strategy. The consistent association between participation in community organizations and health status provides a clear target for interventions and policies.
- Jornadas sobre rol avanzado en enfermería(Facultad de Enfermería, Universidad de Navarra, 2010) Portillo, M.C. (María Carmen); Arantzamendi-Solabarrieta, M. (María); Garcia-Vivar, C. (Cristina); Oroviogoicoechea, C. (Cristina)
- A pilot study on the Spanish version of the Psychosocial Adjustment to Illness Scale (PAIS‐SR) with carers of people with Parkinson's disease(Wiley, 2019) Portillo, M.C. (María Carmen); Navarta-Sánchez, M. V. (Mª Victoria); Ursua-Sesma, M.E. (M. Eugenia); Riverol, M. (Mario); Raquel; Ambrosio, L. (Leire)Aim: To report the cross-cultural adaptation and pilot study of the ongoing validation of the Spanish version of the Psychosocial Adjustment to Illness Scale with carers of people with Parkinson's disease. Design: Cross-cultural adaptation and pilot study with a cross-sectional validation design of the Spanish version of the Psychosocial Adjustment to Illness Scale - Carers. Methods: Twenty-one carers of people with Parkinson's disease from a Primary Care practice in Spain were recruited and completed the PAIS-Carers, the SF-36 Health Survey, the Brief COPE Inventory and an assessment form. SPSS 23.0 was used to determine viability/acceptability and preliminary aspects of internal consistency of the instrument. Results: Five of the seven domains presented floor effect (71.42%), and only one presented ceiling effect (14.28%). The internal consistency of the scale and domains showed acceptable values (over 0.7). The content validity of the Spanish version seemed satisfactory with positive comments in general from participants.
- Stakeholders in support systems for self-care for chronic illness: the gap between expectations and reality regarding their identity, roles and relationships(2017) Vassilev, I. (Ivo); Serrano, M. (Manuel); Christos, L. (Lionis); Wensing, M. (Michel); Foss, C. (Christina); Portillo, M.C. (María Carmen); Todorova, E. (Elka); Ruud-Knutsen, I. (Ingrid); Mujika, A. (Agurtzane); Rogers, A. (Anne); Roukova, P. (Poli); Pumar-Mendez, M.J. (María Jesús); Regaira, E. (Elena)Background and objective: The spread of self-care holds the promise of containing chronic illness burden. Falling within the framework of a FP7 collaborative research project, this paper reports the views of key informants from six countries regarding who the main stakeholders are at different levels in the support system for self-care for patients with chronic illness (SSSC) and how they accomplish their role and collaborate. Methods: 90 Interviews with purposefully selected key informants from Bulgaria, Greece, the Netherlands, Norway, Spain and United Kingdom were conducted. Interviews involved government and local authorities, politicians, academics, health professionals and private sector representatives. Interviewers followed an expert opinion-based guide. Analysis involved a cross-country examination with thematic analysis and framework method techniques. Results Key informants described the ideal SSSC as inclusive, interdependent and patient-centred. The following main stakeholders in SSSC were identified: patients, governments, health-care professionals, associations, private companies and the media. In the current SSSCs, collaboration among stakeholders within and across different levels was said to be lacking. Patients were seen as playing a passive subordinate role based on the following: their own attitudes; the paternalistic and medicalized attitudes of the health-care professionals; their misrepresentation by patient associations; and their exposure to the damaging influences of media and industries. Conclusions Making SSSC patient-centred constitutes the greatest challenge for European authorities. Strategies must be revised for promoting patient participation. They should undergo changes so as to promote industry and media social responsibility and patient association advocacy capacity.