Objective Evaluate patient experience and satisfaction with migraine during first visit to Headache and Facial Pain Unit (UCAF) after First Conversation in Migraine implementation. Method Observational, prospective, longitudinal, single-center study in first-time migraine patients at Hospital Clínic de Barcelona UCAF (January-September 2024; N = 98). Clinical variables (HIT-6, MSQ 2.1), patient experience (NPS, ad hoc survey) and professional satisfaction collected. Results Mean age: 39.9 years (SD = 14.7); 85% women. 48% chronic migraine; 44% severe impact (HIT-6 ≥ 60); MSQ mean 58.1 (SD = 15.0). NPS: 39 (61% promoters, 16% detractors). Patients > 45 years showed better perception of information clarity and doubt resolution (P < .01). 47% used Meu Clínic app; 23% downloaded materials. Professionals rated utility, clarity and implementation positively. Conclusions First Conversation in Migraine associated with positive first-visit experience perception and favorable professional evaluation. Digital adoption limited, though tool structured consultation and person-centered communication. Comparative studies needed to confirm effectiveness.
Introduction Amyotrophic lateral sclerosis (ALS) is a rare neurodegenerative disease. Receiving an ALS diagnosis is a complex process, making it essential to explore aspects of diagnostic communication and psychological adaptation to promote patient-centered care. Objective To explore the experiences of informal caregivers of people with ALS at the time of diagnosis. Subjects and methods A qualitative exploratory study was conducted under a phenomenological paradigm. Semi-structured interviews were carried out with ten informal caregivers of people with ALS in Argentina. A qualitative content analysis was performed, following a process of open, axial, and selective coding guided by the constant comparative method. Results Four main categories emerged from the analysis: diagnostic process and communication (diagnostic odyssey, communication of the diagnosis, and emotional impact), treatment decision-making (lack of information, hasty decisions, limited options, active participation, and delegation to the medical team), psychological adaptation (adjustments, grief, and restoration of control and self-esteem), and coping strategies (positive coping, humour, and social support), which together reflect the different dimensions of caregivers’ experiences. Conclusions There is marked variability in the quality and manner in which the ALS diagnosis is communicated. The diagnosis generates a strong emotional impact, where the inclusion of mental health professionals within interdisciplinary teams appears essential to provide emotional support and facilitate adaptation to the diagnosis. These findings have direct implications for clinical practice, highlighting the need for comprehensive, empathetic, and family-centered care. Introducción La esclerosis lateral amiotrófica (ELA) es una enfermedad neurodegenerativa poco frecuente. Recibir un diagnóstico de ELA es un proceso complejo, por lo que es necesario explorar los aspectos de la comunicación diagnóstica y adaptación psicológica para un abordaje centrado en el paciente. Objetivo Explorar la experiencia de los cuidadores informales de las personas con ELA al momento del diagnóstico. Sujetos y métodos Se realizó un estudio de enfoque cualitativo de alcance exploratorio, bajo el paradigma fenomenológico. Se llevaron a cabo entrevistas semiestructuradas con 10 cuidadores informales de personas con ELA en Argentina. Se aplicó análisis de contenido cualitativo, siguiendo un proceso de codificación abierta, axial y selectiva guiado por el método de comparación constante. Resultados Del análisis surgieron 4 categorías principales: proceso diagnóstico y comunicación (odisea diagnóstica, comunicación del diagnóstico e impacto emocional), toma de decisiones sobre el tratamiento (falta de información, decisiones apresuradas, limitaciones por falta de opciones, participación activa y delegación en el equipo médico), adaptación psicológica (modificaciones, duelo y restauración del control y la autoestima) y estrategias de afrontamiento (afrontamiento positivo, humor y apoyo social), que en conjunto reflejan las distintas dimensiones de la experiencia de los cuidadores informales. Conclusiones Existe una marcada variabilidad en la calidad y el modo en que se comunica el diagnóstico de ELA. Este genera un fuerte impacto emocional donde la presencia de profesionales de la salud mental en los equipos interdisciplinarios aparece como clave para contener emocionalmente y facilitar la adaptación al diagnóstico. Estos resultados aportan implicancias directas para la práctica clínica, señalando la necesidad de una atención integral, empática y centrada en la familia.
Introduction Fever within the first 24–72 h after stroke is associated with worse neurological outcomes and represents a clinical challenge, particularly in patients at risk of nosocomial infections or aspiration. Identifying factors that anticipate its onset may improve monitoring and guide early interventions. Objective To identify predictors of fever within the first 72 h in hemorrhagic stroke and in ischemic stroke treated with mechanical thrombectomy. Methods A retrospective study was conducted in the Stroke Unit of Hospital Universitario Torrecárdenas (2022–2023). Patients with hemorrhagic stroke and ischemic stroke undergoing thrombectomy were included. Clinical, demographic, and neurological variables (age, sex, temperature, NIHSS) were collected, along with procedural data (TICI, number of passes) and cardiovascular risk factors such as hypertension, diabetes, dyslipidemia, atrial fibrillation, heart disease, smoking, and alcohol use. Results A total of 308 patients were analyzed: 204 (66.23%) with ischemic stroke and 104 (33.77%) with hemorrhagic stroke. Between 13.31% and 19.67% developed fever within the first 72 h. Fever was associated with greater neurological severity, with higher NIHSS scores at 48 h in hemorrhagic stroke and at 72 h in ischemic stroke. In the multivariate analysis, age, elevated NIHSS, alcohol use, and hemorrhagic stroke were independent predictors of fever (p < 0.05). Complete recanalization (TICI 3) was also associated with fever at 48 h (p = 0.021). Conclusions Fever is common in the acute phase of stroke and is associated with greater neurological severity. Identifying factors such as advanced age, hemorrhagic stroke, and alcohol use may improve monitoring and guide future research.
Background Stroke is one of the leading causes of disability and mortality worldwide. It entails motor sequelae and neuropsychiatric complications such as cognitive impairment and depression, significantly impacting quality of life and functional recovery. Objective To analyse cognitive status, functionality, and the level of depressive symptomatology in patients who have experienced ischemic stroke or transient ischemic attack. Methods An analytical, observational, and prospective study was conducted at the Neurology and Neurosurgery Unit of the Lucus Augusti University Hospital. A sample of 36 patients diagnosed with ischemic stroke or transient ischemic attack was included. Patients were evaluated at 2 time points: hospital discharge and 3 months post-discharge. The main variables were cognitive status, depressive symptomatology, and functional dependence, assessed using the Mini-Mental State Examination, the Beck Depression Scale, and the Barthel Index. Results The sample consisted of 36 patients (83.3% with ischemic stroke), with a mean age of 69.17 ± 11.71 years and 27.8% women. The mean scores at discharge and 3 months were as follows: depression (8.03 ± 9.63 and 6.08 ± 6.83), cognitive status (26.7 ± 3.62 and 28.31 ± 2), and functional dependence (95.14 ± 13 at both time points). Depressive symptomatology decreased significantly from discharge to the three-month follow-up (P = .04). Significant correlations were identified between depressive symptomatology at discharge and at 3 months (P = .04), as well as with cognitive impairment at discharge (P = .01). Cognitive status showed relation between the 2 time points (P = .02) and was correlated with depressive symptomatology at 3 months (P = .03) and cognitive status at 3 months (P = .01). Functional independence demonstrated correlations with depressive symptomatology at discharge (P = .01) and at 3 months (P = .01), as well as with cognitive status at discharge (P = .05) and at 3 months (P = .02). Conclusion The analysis suggests improvements in cognitive status and reductions in depressive symptomatology from discharge to the three-month follow-up. Significant correlations between functional dependence, cognitive status, and depressive symptomatology underscore the interrelationship of these factors in recovery. These findings highlight the importance of a comprehensive evaluation encompassing functional, cognitive, and emotional aspects to optimize functional recovery in stroke patients.
Introduction Health literacy is a key outcome for evaluating the effectiveness of interventions aimed at informing, educating, and engaging people with multiple sclerosis (MS) in self-care. Its measurement requires valid, reliable, and culturally adapted instruments. In Spain, the lack of specific tools has hindered its assessment in this population. The recent availability of the Multiple Sclerosis Health Literacy Questionnaire in its Spanish version (MSHLQ-SPA) makes it possible to evaluate this construct rigorously. Aim To assess the level of health literacy of people diagnosed with MS using the MSHLQ-SPA. Methods A descriptive cross-sectional study conducted within the public health system of Catalonia (Spain). Data collection included sociodemographic and clinical variables, as well as administration of the MSHLQ-SPA. Statistical analysis focused on measures of central tendency, dispersion, and patterns of missing data. Results A total of 388 people with MS were included in the study. Scores were high for most MSHLQ-SPA items. The highest scores were observed in items related to therapeutic adherence and understanding of health information, while the lowest scores corresponded to critical appraisal of information. Conclusions People with MS showed a moderately high level of perceived health literacy, with room for improvement in the critical appraisal of health information. Systematic evaluation of this construct using specific instruments such as the MSHLQ-SPA could support the measurement of the impact of nursing educational interventions and promote self-care, informed decision-making, and quality of life in this population.
