Background: The COVID-19 pandemic imposed lockdown measures that affected caregiving. Understanding caregivers’ context provides reveals their adaptive strategies to continue caring in this situation of uncertainty and isolation. Objective: To better understand the caregiving experiences of caregivers looking after dependent individuals living in the community during the pandemic. Design: Qualitative research, phenomenological approach. Setting: Primary healthcare centers in Madrid region (Spain). Participants: 21 family caregivers. Methods: Purposive and theoretical sampling was used to recruit caregivers across nurses from primary healthcare centers. Participants were interviewed using a semi-structured interview guide to explore the caring experience. Interview transcripts were evaluated using thematic analysis. Results: The findings were categorized into two themes: “Caregivers during lockdown—providing care in a time of adversity” and “Caregiving toward normality”. The sub-themes identified were the re-structuring of before-care services and the introduction of new care approaches, managing the dependent person’s health problems, looking after oneself, and dealing with adversity. To adapt to the new normal, strategies were put in place designed to recover confidence and trust, reincorporate assistance, and reconnect with others. Conclusions: Care intensified during the pandemic. Caregivers took on the task without assistance, focusing on preventing contagion and protecting themselves to be able to continue giving care.

Pediatric patients with chronic conditions frequently have unmet care needs, make extensive use of healthcare services, and often encounter fragmented, non-centered care. This study aimed to analyze the differences in the utilization of primary care (PC) and hospital care (HC) services by these patients according to sex, age, and complexity and to identify associated factors. A cross-sectional study was conducted in a basic health area of Madrid, including patients under 18 years. Among these patients, 15.7% had ≥1 chronic disease, 54.1% were male, the average age was 9.5 years, 3.5% had complexity, and 11.3% had multimorbidity. The mean number of contacts/year with the healthcare system was 9.1, including 8.3 contacts/year with PC (4.9 with pediatricians and 1.9 with nurses) and 0.8 contacts/year with HC (0.8 in external consultations and 0.01 hospitalizations). The factors associated with PC utilization were complexity; female sex; European origin; and diseases like asthma, epilepsy, stroke, recurrent urinary infection, attention deficit hyperactivity disorder, and anxiety, while older age was negatively associated. Thyroid disorders were significantly associated with HC utilization. These findings could help guide the design of optimized pediatric patient-centered care approaches to coordinate care across healthcare services and reduce high healthcare utilization, therefore improving the healthcare outcomes and quality of life for these patients.

Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain.Design: Multicentric, mixed method concurrent study.Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022).Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic.Trial Registration: Identifier: NCT05249868 [ClinicalTrials.gov].

Objetivo: Determinar la proporción de personas en las que se realiza el seguimiento al alta estando indicado. Diseño Estudio observacional longitudinal retrospectivo, con enfoque analítico. Población: Personas dadas de alta en el Hospital Universitario de la Princesa de cualquier edad y sexo, con cualquier motivo de ingreso y con indicación de seguimiento al alta en Atención Primaria (AP). Se excluyeron los usuarios que no tenían Código de Identificación Personal Autonómico (CIPA) asignado. Muestra aleatoria (n = 289). Mediciones principales Realización del seguimiento al alta y reingresos (< 30 días). Se incluyeron variables sociodemográficas, clínicas y relacionadas con el seguimiento al alta recogidas de las Historias clínicas electrónicas de AP y Hospitalaria. Se realizó un análisis descriptivo de las características sociodemográficas y clínicas de la población de estudio y para analizar la asociación entre el seguimiento al alta y los reingresos se realizó un modelo de regresión logística. Resultados: Edad de 72,4 años (rango intercuartílico [RIQ] 60-87). El 55,2% de la población fueron mujeres. Se realizó seguimiento en un 61,2% de las personas que tenían indicación. Según el modelo de regresión logística realizado entre el reingreso temprano y el seguimiento al alta, ajustado por el resto de los factores, el grupo con seguimiento al alta tenía un 66% menos de posibilidades de reingreso hospitalario (Odds Ratio [OR] 0,34, intervalo de confianza [IC] 95% [0,18-0,67]). Conclusiones: Los datos sugieren que el seguimiento al alta de Enfermería realizado en AP reduce el riesgo de reingresos tempranos. Aim: To determine the proportion of people who undergo discharge follow-up when indicated. Design: Retrospective longitudinal observational study, with an analytical approach. Population: persons discharged from the Hospital Universitario de la Princesa of any age and sex, with any reason for admission and with an indication for discharge follow-up in Primary Care. Users who did not have an assigned Autonomous Personal Identification Code (CIPA) were excluded. Random sample (n = 289). Variables: Discharge follow-up and readmissions (<30 days). Sociodemographic, clinical and discharge follow-up variables were included from the electronic medical records of Primary and Hospital Care. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was conducted. To analyze the association between discharge follow-up and readmissions, a logistic regression model was used. Results: Age 72.4 years (RIQ 60-87). 55.2% of the population were women. Follow-up was conducted in 61.2% of those indicated. According to the logistic regression model performed between early readmission and discharge follow-up, adjusted for all other factors, the group with discharge follow-up had a 66% lower likelihood of hospital readmission (OR 0.34, 95% CI (0.18-0.67)). Conclusions: These findings suggest that nursing discharge follow-up conducted in primary care reduces the risk of early readmission.

Aims: To examine the association between perceived changes in daily routines due to the COVID-19 pandemic and health-related quality of life (HRQoL) among community-dwelling adults aged 75 and older in Spain, through a gender-stratified analysis.Design: Cross-sectional, community-based, multicentre study using baseline data from the CUIDAMOS+75 cohort.Methods: A total of 1,072 older adults over 75 from 11 Spanish regions were interviewed between June 2022 and June 2023. Data on SARS-CoV-2 exposure, sociodemographic and clinical characteristics and perceived changes in daily routines (basic-needs, healthcare and social routines) were collected. HRQoL was measured using the EQ-5D-5L utility index. Gender-stratified linear regression models were used to examine associations between changes in routines and HRQoL.Results: Over half of the participants (52%) reported considerable changes in their daily routines due to the pandemic, especially in social routines (48%). Women reported more frequent changes across all routine types. Although women had lower overall HRQoL scores, changes in routines were more strongly associated with poorer HRQoL among men, particularly when healthcare routines were affected. Among women, significant associations were observed for disruptions in combined basic and social routines as well as when all three routine types were simultaneously affected. Notably, COVID-19 infection status was not associated with HRQoL after adjustment.Conclusion: The COVID-19 pandemic led to substantial and persistent changes in daily routines among older adults in Spain, with gender-specific patterns in their association with HRQoL. These findings highlight the importance of incorporating a gender perspective in public health responses to health crises, particularly in strategies aimed at preserving daily routines to support autonomy and wellbeing in older populations.

Background/Objectives: The consumption of opioids is a public health problem that significantly affects quality of life. In Spain, 7585 people are enrolled in the Methadone Maintenance Programme (MMP), which is an effective intervention with a low adherence rate. In this study, factors associated with the quality of life of MMP users, especially perceived social support and treatment adherence, were analysed. We hypothesised that low levels of adherence and social support would be associated with poorer quality of life. Methods: This was a cross-sectional observational study with an analytical approach. Quality of life (WHOQoL-BREF), perceived social support (DUKE-UNC-11), and treatment adherence (MMAS-8) among MMP users were studied, and data on sociodemographic and clinical characteristics were collected through ad hoc questionnaires and a review of electronic medical records. Linear and logistic regression models were used. Results: A total of 70 individuals were included in this study. The mean age was 56.9 years, and 83% of the participants were male. The perceived quality of life was low in the four domains evaluated (range of 47.4–48.2). A total of 38.57% of the participants had low perceived social support. Treatment adherence was low or moderate in 77.1% of the participants. Greater perceived social support was associated with better quality of life in all domains (p < 0.05). Quality of social life was negatively associated with the use of nonbenzodiazepine neuroleptics and HIV status. Treatment adherence was lower in insulin therapy users. Conclusions: Social support is a key determinant of the quality of life of MMP users. Health policies should promote social support networks as a strategy to improve the well-being of this population.