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Background: Primary Health Care (PHC) plays a pivotal role in the healthcare system as the initial point of contact for users and patients. In the healthcare area, claims are presented and managed through a web app. It also enables systematic analysis of emerging information to drive continuous improvement. The present objective was to describe the complaints filed at PHC in 2022., Methods: A cross-sectional study was conducted, examining complaints filed by patients in 2022. For inclusion of the complaints, it was established that it had to do with the treatment received by healthcare personnel and that was presented through the web app. Complaint texts signaling dissatisfaction with the information received were subjected to qualitative coding., Results: The study involved 326 users who submitted a total of 358 complaints specifically related to treatment and information. The average age of the participants was 33.5 ± 16.2 years, and the majority were women (72.4 %, n = 236). In 2022, the Cumulative Incidence (CCI) was 55.2 complaints per 100,000 healthcare act and the Complaint Incidence Rate (CIR), defined as the number of complaints/1000 users/year, was 6.5. The prevalence of complaints related to information was 12.4 %. The main reasons for complaints about information were issues related to communication with the patient (79 %), followed by the patient's disagreement with the techniques applied by healthcare staff (17 %)., Conclusions: Results show us the fundamental characteristics of complaints in primary care with respect to the information received by health professionals, not allowing us to know where the authors can influence through interventions or training actions to try to improve., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 HCFMUSP. Published by Elsevier España, S.L.U. All rights reserved.)

The misuse and overuse of antibiotics represent a critical global issue and one of the most pressing public health challenges of the 21st century. Training future healthcare professionals effectively is essential for ensuring responsible antibiotic use. This study aimed to validate a questionnaire designed to evaluate the knowledge, attitudes, and perceptions of medical students regarding the education they receive on infectious diseases, antimicrobial resistance, and antibiotic stewardship during their university studies. Methods : A self-administered questionnaire was developed and distributed to medical students at the University of Santiago de Compostela. Comprising 44 items, the questionnaire assessed eight key dimensions: "infection diagnosis", "criteria for not prescribing antibiotics", "initial antibiotic therapy", "re-evaluation of therapy", "quality of care", "communication skills", "antibiotic resistance", and "teaching methodology". Validation was carried out in two stages: Phase 1 involved content and face validity, while Phase 2 focused on reliability analysis. Results : A total of 295 students completed the questionnaire, with a mean age of 23.15 ± 1.78 years. The sample included 86 male (29.2%) and 209 female (70.8%) respondents. Content and face validity were established by a nominal group of five experts and a focus group of medicine and pharmacy students to ensure consensus on item understanding in the Spanish language. The questionnaire demonstrated high internal consistency with a Cronbach's alpha of 0.92 and satisfactory item discrimination. Construct validity was confirmed through principal component analysis, which supported the presence of the eight predefined dimensions. Conclusions : The validated questionnaire exhibited strong reliability and validity, making it a valuable tool for assessing medical students' training in antibiotic-related topics. Its application will enable the identification of areas for improvement in university curricula, ultimately contributing to the promotion of appropriate antibiotic use and the reduction of antimicrobial resistance.

Background: Antimicrobial resistance is a major public health issue today. Therefore, it is essential to focus on the education of pharmacists as future dispensers. The objective of this study was to validate a questionnaire that assesses the knowledge, attitudes, and perceptions of pharmacy students regarding the education received during their university degree on the use and dispensation of antibiotics, as well as bacterial resistance., Methods: An online questionnaire was developed and distributed via RedCap v.13.7.1 to pharmacy students at the University of Santiago de Compostela using the WhatsApp social network. The questionnaire consisted of 28 items evaluating 5 dimensions: "quality of care", "communication skills", "antibiotic resistance", "teaching methodology", and "education on antibiotics at the faculty". The questionnaire validation was conducted in 2 steps: Step 1 involved content and appearance validation, and Step 2 involved reliability analysis., Results: A total of 61 completed questionnaires were received. The mean age was 21.82 ± 3.81 years, with 20 males (32.8%) and 41 females (67.2%). Content validation was performed through a nominal group of 5 experts, and appearance validation was conducted by a focus group of 6 university pharmacy students. The questionnaire demonstrated a Cronbach's alpha value of 0.80 and adequate item discrimination capability. Confirmatory factor analysis was performed to assess construct validity, confirming the 5 predefined dimensions., Conclusions: A questionnaire has been developed and validated with high reliability and validity. Its use will help identify areas for improvement in the university education of pharmacy students, ultimately contributing to better use and dispensation of antibiotics and thereby improving antimicrobial resistance.

Background: Breastfeeding is the optimal nourishment for infants and it is recommended that children commence breastfeeding within the first hour of birth and be exclusively breastfed for the initial 6 months of life. Our objective was to determine which factors related to mothers could influence the degree of exclusive breastfeeding during hospitalization, as well as to assess breastfeeding mothers' attitudes towards breastfeeding., Methods: A multicenter cross-sectional study was undertaken in the healthcare area of Santiago de Compostela, Spain. The necessary variables were collected using a specially designed ad hoc questionnaire. The researcher responsible for recruitment conducted the interviews with the participants. The reduced Iowa Infant Feeding Attitude Scale (IIFAS-s) was employed to gauge maternal attitudes toward feeding their baby., Results: In total, 64 women were studied. The overall score of IIFAS-s (mean ± standard deviation) was 36.95 ± 5.17. A positive attitude towards breastfeeding was therefore observed in our sample. No use of a pacifier by the newborn was associated with a positive attitude for breastfeeding. Having previous children (Ora = 6.40; IC95% 1.26-32.51) and previous experience with breastfeeding (Ora = 6.70; IC95% 1.31-34.27) increased the likelihood of exclusive breastfeeding during admission., Conclusions: In our study, exclusive breastfeeding during hospitalization is associated with having previous children and prior breastfeeding experience.

Antibiotic resistance is an issue of growing importance in the public health sphere. Medical interns are of great relevance when it comes to the source of this problem. This study therefore sought to ascertain which factors influence the management of antibiotic therapy by this population, in order to pinpoint the possible causes of misprescribing habits. We conducted a qualitative study based on focus group techniques, with groups consisting of medical interns from the Santiago de Compostela Clinical University Teaching Hospital. Our study identified factors which the participants considered to be determinants of antibiotic use and their relationship with the appearance of resistance. The single most repeated factor was the influence of the attending physician's judgement; other factors included a high healthcare burden or prescribing inertia. This stage is an opportunity to correct misprescribing habits, by implementing educational interventions aimed at modifying the identified factors.

Background: Antibiotic resistance is an important Public Health problem and many studies link it to antibiotic misuse. The population plays a key role in such misuse., Objective: The aim of this study was thus to explore the factors that might influence antibiotic use and resistance in the general population., Methods: Qualitative research using the focus group (FG) method. Groups were formed by reference to the following criteria: age (over and under 65 years); place of origin; and educational/professional qualifications. FG sessions were recorded, transcribed and then separately analysed by two researchers working independently. Written informed consent was obtained from all participants., Results: Eleven FGs were formed with a total of 75 participants. The principal factors identified as possible determinants of antibiotic misuse were: (i) lack of knowledge about antibiotics; (ii) doctor-patient relationship problems; (iii) problems of adherence; and, (iv) use without medical prescription. Antibiotic resistance is a phenomenon unknown to the population and is perceived as an individual problem, with the term "resistance" being confused with "tolerance". None of the groups reported that information about resistance had been disseminated by the health care sector., Conclusions: The public is unaware of the important role it plays in the advance of antimicrobial resistance. There is evidence of diverse factors, many of them modifiable, which might account for antibiotic misuse. Better understanding these factors could be useful in drawing up specific strategies aimed at improving antibiotic use., Competing Interests: The authors have declared that no competing interests exist.

Objective: To identify drug-related problems using the STOPP/START criteria of patients over 64 years polymedicated with 12 or more drugs., Method: Descriptive cross-sectional. We analysed 172 cases randomly selected from the register of 1500 polymedicated patients of the Quality Improvement Programme for Chronic and Polymedicated Patients of the Galician Health Service for the area of Santiago in 2017. Drug-related problems and the negative results associated with medication were recorded. Treatment compliance was assessed by the Morisky-Green-Levine test. Nursing interventions were recorded based on the Programme's nursing report. Bivariate analysis of the data was performed and the association between the variables was estimated by calculating the odds ratio (OR)., Results: The 56.4% of the patients were women. The mean age was 77.34±10.11 years. The most common problem was the likelihood of presenting adverse effects, observed in 64.1% of the patients. Women were more likely to have this problem than men (OR: 1.37; 95% CI: 1.06-1.78). Eighteen percent of the patients were considered non-compliant with the prescribed treatment, according to the Morisky-Green-Levine test. Of the patients, 25.6% had received health education interventions., Conclusions: Nurses must periodically re-evaluate patient medication to check adherence to treatment and determine whether it is causing any type of adverse effect, as well as incorporate health education interventions in this field into their activity., (Copyright © 2020 Elsevier España, S.L.U. All rights reserved.)

Aim: To explore the parent-related factors underlying antibiotic misuse/overuse and their implication in the development of resistance in the paediatric population., Methods: Qualitative study using the focus group (FG) method in Galicia (Spain). FG sessions were conducted with the parents, 27 mothers and three fathers, of children under 12 years old. A discussion topic guide was developed to lead the sessions, which were then transcribed by the researcher and independently interpreted by two researchers working separately. The grounded theory approach was used., Results: Five FG sessions were conducted. The principal factor detected among parents was fear, associated with the perception of poor parent-paediatrician communication. This factor was related to the following behaviours: (a) pressure on physicians; (b) lack of adherence to treatment; and (c) search for other ways of accessing antibiotics. No group highlighted antibiotic resistance as posing a real problem. All groups considered certain external agents to be responsible for such resistance. Four groups also acknowledged that patient behaviour can influence antibiotic resistance., Conclusion: Our study points to poor communication between the healthcare system and the population. Identifying the factors underlying the problem enables more efficient, tailor-made interventions to be designed for the purpose of improving antibiotic use and resistance., (© 2020 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)