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by Esther Ortega-Martin, Javier Alvarez-Galvez
ObjectiveTo characterize the heterogeneity of Long COVID (LC) by identifying distinct patient profiles based on symptoms and quality of life (QoL), and to examine the sociodemographic and clinical predictors associated with these profiles.
Study designA cross-sectional observational study was conducted.
MethodsWe recruited 363 patients with LC in Spain via an online survey. Symptom patterns were identified through latent class analysis of 15 binary symptoms. QoL was assessed with the patient-derived LC-6D-QoL across six dimensions, and cluster analysis defined QoL subgroups. Logistic regression was applied to examine clinical and sociodemographic predictors of QoL profiles.
ResultsTwo symptom profiles emerged: a low-burden profile, dominated by fatigue and cognitive problems, and a high-burden profile with multisystem involvement. QoL clustered into three profiles—high, middle, and low QoL—with more than half of participants in the low QoL group. Symptom burden and employment status were the strongest predictors of poor QoL, whereas age, sex, education, and income showed limited associations. Social support was more frequently reported among participants with low QoL.
ConclusionsLC is characterized by distinct clinical and QoL profiles, with strong interactions between multisystem symptom burden and social determinants. Identifying patients at greatest risk of poor QoL can inform stratified interventions and integrated policies that combine medical care, psychosocial support, and workplace reintegration.
by Eva Artigues-Barberà, Ester García-Martínez, José María Palacín Peruga, Marta Ortega-Bravo
IntroductionChronic musculoskeletal pain is one of the leading causes of disability worldwide, affecting 11–50% of the population. In Spain, it accounts for up to 50% of the chronic pain consultations conducted in primary care settings. The most common disorders are carpal tunnel and subacromial impingement syndromes, with treatments, including surgical and nonsurgical approaches, notably the use of ultrasound-guided injections to improve symptoms.
MethodsA qualitative, phenomenological, and inductive study was conducted on patients diagnosed with carpal tunnel syndrome or subacromial impingement syndrome at primary care centers in Lleida to identify patient‑reported domains relevant to the routine follow-up of CTS and SAIS in primary healthcare, and to examine barriers and facilitators of treatments to inform patient‑centered follow-up protocols. Purposive sampling was used, and five focus groups were organised, selecting participants aged >18 years with or without prior surgical treatment. Data were collected between December 2022 and February 2023 using a semi-structured guide. The focus groups were recorded and thematically analysed using Atlas.ti.
ResultsTwenty-one patients aged between 44–75 years, predominantly women, participated in the study. The results were organised into six themes and 12 subthemes. The barriers identified were delays in diagnostic testing, overload of healthcare personnel, lack of coordination between care levels, and brevity of consultations. Effective communication, empathy of primary care professionals, and prompt management of treatments, such as injections, were highlighted as facilitators.
ConclusionThis study highlighted the complexity of managing chronic musculoskeletal pain and the need for a multidimensional approach. The identified barriers, along with facilitators, such as effective communication and empathy of professionals, emphasize the relevance of strengthening problem-solving capacity in primary care and fostering better coordination between care levels. These findings suggest that addressing these aspects may support more tailored follow-up and contribute to improving patients’ experiences of care.
by Laura Sánchez-Bermejo, Pedro Jesús Milla-Ortega, José Manuel Pérez-Mármol
ObjectiveTo cross-cultural adapt the ADL Observation Scale and evaluate its psychometric properties in a sample of Spanish-speaking patients with stroke.
MethodsA validation study that included cross-cultural adaptation, structural validity assessment, reliability, and diagnostic accuracy analysis. The study followed COSMIN and STARD criteria. Translation and cross-cultural adaptation of the ADL Observation Scale followed a backward translation process. Structural validity was assessed with confirmatory factor analysis, and internal consistency was analyzed using Cronbach’s alpha and McDonald’s omega coefficient. Cut-off points were estimated using ROC analysis, and diagnostic accuracy was evaluated using sensitivity, specificity, and positive and negative predictive values. Internal consistency, cut-off points, and diagnostic accuracy were calculated for two different age groups (≥65 years; > 65 years).
ResultsThe Spanish version of the ADL Observation Scale was obtained after cross-cultural adaptation. The psychometric properties were tested in a sample of 180 patients with stroke. Structural validity showed a four-factor structure of the scale (RMSEA = 0.078; CFI = 0.952; TLI = 0.934). Internal consistency for each factor indicated Omega values between 0.641, 95% CI [0.495, 0.753], and 0.915, 95% CI [0.882, 0.936]. Cut-off points, also calculated for each factor, ranged from ≥1 to ≥4 points. Sensitivity, specificity, and positive and negative predictive values showed high values, indicating the scale’s discriminatory capacity for correctly classifying patients with praxis deficits.
ConclusionThe ADL Observation Scale has a four-factor structure, and it is a reliable instrument for evaluating the levels of praxis function in daily living among Spanish-speaking patients with stroke. The scale also has adequate diagnostic accuracy in detecting patients with praxis deficits.
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