Fundamento. El autocuidado y el manejo del régimen terapéutico por parte del paciente (adherencia a su medicación, conductas preventivas y desarrollo de estilos de vida saludables) son componentes clave del abordaje de las enfermedades crónicas. La enfermería dispone de lenguajes estandarizados para describir muchas de estas situaciones, como el diagnóstico "gestión ineficiente de la propia salud" (GIPS) o muchos indicadores de la Clasificación de Resultados de Enfermería (NOC). Los objetivos de este estudio, pretenden conocer la fiabilidad interobservador de un instrumento de valoración y ayuda al diagnóstico de la GIPS en pacientes crónicos que acuden a consultas de Atención Primaria, basado en indicadores NOC, además de determinar su validez diagnóstica y describir la prevalencia de pacientes con este problema. resultados. Doscientos veintiocho pacientes fueron incluidos, con un 37,7% de ellos con más de un proceso crónico concomitante. Los indicadores NOC mostraron una alta fiabilidad interobservador (CCI>0,70) y una consistencia interna buena (alfa de Cronbach: 0,81). Con un punto de corte en 10,5, se obtuvo una sensibilidad del 61% y una especificidad del 85%, con un área bajo la curva de 0,81 (IC95%: 0,77 a 0,85). La prevalencia de pacientes con GIPS fue del 36% (IC 95%: 34 a 40).conclusiones. El uso de indicadores de la NOC permite valorar el manejo del régimen terapéutico en pacientes crónicos, con una validez aceptable y aporta nuevos enfoques para el abordaje de este problema.Palabras clave. Adherencia del paciente. Diagnóstico enfermero. Fiabilidad. Validez. aBstract Background. Self-care and management of therapeutic regime (drugs adherence, preventive behaviours and development of healthy life-styles) are key components for managing chronic diseases. Nursing has standardized languages which describe many of these situations, such as the diagnosis "Ineffective Self Health Management" (ISHM) or many of the Nursing Outcomes Classification (NOC) indicators. The aims of this study were to determine the interobserver reliability of a NOC-based instrument for assessment and aid in diagnosis of the ISHM in patients with chronic conditions in Primary Health Care, to determine its diagnostic validity and to describe the prevalence of patients with this problem.

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Background: Effective interventions to improve prognosis in non-small cell lung cancer (NSCLC) are urgently needed. We assessed the effect of the early integration of interdisciplinary supportive care for patients with NSCLC on the quality of life, psychological state, cancer pain and nutritional status.

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Background:The decision to participate in phase I cancer clinical trials can be complex. Prior studies have suggested that some patients on early phase trials may not fully appreciate the purpose, risks and low chance of benefit. Question Prompt Lists (QPL) have proven benefit in studies across different medical specialties in empowering the patient to participate in their consultation. Although there is literature assessing the value of QPLs in cancer clinical trials, it has not been explored specifically in the phase I setting. This single centre qualitative study has described the patient's experience of using a customised phase I QPL.Methods: A phase I specific QPL was designed with patients using an experience based co-design process. Following this, 13 patients were given the QPL to use in their consent consultation. Semi structured interviews were conducted, recorded, transcribed verbatim and analyzed using Colaizzi's (1978) descriptive phenomenology. The questions explored the patients' experience during the consent consultation; how patients used the QPL, what value was placed on it and why it wasn't used.Results: Between July-September 2020, 13 patients were interviewed; age range 38-73; 7 male, 6 female. Five themes emerged: 1. Emotions expressed 2. Benefits of the QPL 3. Questions asked 4. Barriers to using the QPL 5. Future recommendations Described emotions included; vulnerability, fear, desperation and hope of trial success. Patients felt the QPL improved their participation, reminded patients what questions they wanted to ask and triggered questions not previously thought of. Barriers to using the QPL included; time pressures, fear of being judged and avoidance of distressing conversations. All 13 patients recommended using a QPL.Conclusions: A QPL is a simple tool that has the potential to improve the patient's ability to ask the questions that are important to them. Patients that used the QPL felt that their confidence was bolstered to articulate concerns. As early phase trials increase in complexity, better and earlier orientation to the QPL could address the described barriers of its use. Therefore a QPL has the potential to enhance the informed consent process for the patient.