Variables predictoras del uso de los métodos anticonceptivos en jóvenes: una revisión sistemática / Predictor variables of contraceptive method use in young people: A systematic review

Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME. Selección de estudios: Se realizó una evaluación de la calidad de los estudios que fue revisada por dos investigadores en paralelo. Como resultado, se seleccionaron un total de cinco investigaciones primarias. Extracción de datos: Se extrajo información sobre la población seleccionada en el estudio, método anticonceptivo estudiado y las variables predictoras identificadas. Resultados: Se identificaron siete variables predictoras que explican específicamente el uso del preservativo masculino, píldora anticonceptiva o píldora anticonceptiva de emergencia. Las variables más relevantes fueron el nivel de conocimiento y las actitudes hacia el empleo de los métodos anticonceptivos, de manera que un mayor conocimiento y unas actitudes positivas incrementan la probabilidad de uso de métodos anticonceptivos. Otro resultado destacado fue la presencia de un sesgo formativo con un mayor conocimiento de las mujeres sobre las opciones anticonceptivas hormonales y actitudes más positivas. Conclusión: Los futuros programas formativos deben orientarse hacia la evaluación de cambios en el comportamiento, mediante el desarrollo de actitudes positivas hacia el uso de los métodos anticonceptivos a través de la adquisición de un conocimiento de calidad sobre las opciones contraceptivas.(AU)

Objective: To analyse predictor variables of contraceptive method use in young people. Design: Systematic review. Data sources: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS and IME databases were consulted. Study selection: An assessment of the quality of studies was carried out by two researchers in parallel. As a result, a total of 5 primary research studies were selected. Data extraction: Information was extracted on the selected study population, contraceptive method studied and predictor variables identified. Results: Seven predictor variables were identified that specifically explain the use of the male condom, contraceptive pill or emergency contraceptive pill. The most relevant variables were the level of knowledge and attitudes towards contraceptive use, therefore high knowledge and positive attitudes increase the likelihood of contraceptive use. Another notable finding was the presence of a formative bias with womenhaving higher knowledge of hormonal contraceptive options and more positive attitudes. Conclusion: Future training programs should be oriented towards assessing behavioral changes through the development of positive attitudes towards contraceptive use by gaining knowledge of contraceptive options.(AU)

Subestructuración teórica: Modelo de Conducta Anticonceptiva en Madres Adolescentes / Theoretical Substructuring: Model of Contraceptive Behaviour in Adolescent Mothers

Objetivo principal: Describir el desarrollo de un modelo de conducta anticonceptiva en madres adolescentes. Metodología: La construcción del modelo fue a través de la metodología propuesta por Dulock y Holzemer (1991), compuesta por cuatro pasos: (1) Búsqueda, revisión de la literatura e identificación de conceptos, (2) Especificación de las relaciones entre los conceptos, (3) Orden jerárquico de los conceptos de acuerdo al nivel de abstracción, y finalmente (4) Ilustrar las relaciones actuales entre variables. Resultados principales: Se integraron nuevos conceptos a la teoría madre de la Conducta Planeada como: factores psicológicos, factores cognitivos, factores sociales y la influencia familiar. Conclusión principal: El modelo puede ser de utilidad en la explicación de la conducta anticonceptiva en madres adolescentes y contribuir en la formulación de nuevas intervenciones para disminuir el embarazo no planeado.(AU)

Objective: Describe the development of a contraceptive behavior model in adolescent mothers. Methods: The construction of the model was through the methodology proposed by Dulock and Holzemer (1991), composed of four steps, (1) Search, review of the literature and identification of concepts, (2) specification of the relationships between the concepts, (3) hierarchical order of the concepts according to the level of abstraction and (4) Illustrate the current relationships between variables. Results: New concepts were integrated into the mother theory of Planned Behavior, such as: New concepts were integrated into the mother theory of Planned Behavior such as: psychological factors, cognitive factors, social factors and family influence. Conclusion: The model can be useful in explaining contraceptive behavior in adolescent mothers and contribute to the formulation of new interventions to reduce unplanned pregnancy.(AU)

Experiencias de maternidad en mujeres peruanas adultas que fueron madres en su adolescencia / Maternity experiences of adult Peruvian women who became mothers in their adolescence

Objetivos: Conocer las experiencias de maternidad en mujeres peruanas adultas que fueron madres en su adolescencia. Material y método: Estudio cualitativo fenomenológico, realizado en mujeres peruanas adultas que fueron madres en su adolescencia. Se aplicó la estrategia de la entrevista no estructurada, y la información recolectada fue analizada utilizando la técnica del análisis temático. Resultados: Participaron 9 mujeres de edades comprendidas entre 42 y 46 años. Los principales hallazgos revelan que las participantes construyen en la actualidad una imagen de madres resilientes, protectoras y valientes. Esto se ha logrado, según refieren, porque en el proceso del embarazo y la crianza de sus hijos vivieron acontecimientos que cambiaron su vida: se casaron, dejaron de estudiar y tuvieron que asumir, en algunos casos, el rol de la figura paterna. Por otra parte, las mujeres reconocen que ciertos pensamientos y emociones, como inseguridad, desconfianza y tristeza, han estado presentes en el inicio de su maternidad y fueron importantes para afrontar el cuidado de sus hijos. Conclusiones: Ser madre en la adolescencia, aun en contextos socioeconómicos medio y alto, es un hecho sujeto a dificultades personales y familiares. A pesar de estas circunstancias, las mujeres que participaron en el estudio han afrontado la maternidad en su adolescencia y construyeron una figura de madres resilientes. En el inicio de la maternidad se reconocen pensamientos y emociones que fueron afrontándose en la medida en que se construía el vínculo del cuidado con sus hijos. (AU)

Objective: Become aware of the maternity experiences of Peruvian adult women who become mothers in their adolescence. Material y method: Qualitative phenomenological study, carried out in Peruvian adult women who were mothers in their adolescence. The unstructured interview strategy was applied, and the findings were analyzed using the thematic analysis technique. Results: 9 women participated whose ages ranged between 42 and 46 years. The main findings reveal that the participants currently build an image of resilient, protective and courageous mothers. This has been achieved, according to them, because during pregnancy and their offspring upbringing they experienced events that changed their lives: they got married as well as the need to interrupt their studies and assume in some of the cases the role of both parents in the absence of a father figure. Otherwise, women identify that thoughts and emotions such as insecurity, mistrust and sadness had been since the beginning of their maternity and were important to cope with the care of their children. Conclusions: Even in medium and high socioeconomic contexts, being a mother in adolescence mean to confront emotional, family and professional difficulties. Despite the circumstances, the women who participated in the study had been coping with maternity in their adolescence and they built a resilient mother figure. At the beginning of their maternity thoughts and emotions were recognized as women had been coping with it while they were building a family bond care with their children. (AU)

Análisis de la morbilidad y los costes en la resolución del embarazo adolescente / Analysis of morbidity and costs in the resolution of adolescent pregnancy

Objetivo: Establecer las diferencias respecto a la morbilidad y los costes en la resolución del embarazo entre mujeres adolescentes y adultas atendidas en un hospital público de Lima (Perú).Material y método: Estudio de casos y controles. Se incluyeron mujeres adolescentes de 10-19 y adultas de 20-30 años, primigestas y sin enfermedades crónicas subyacentes, atendidas en el Hospital Nacional Hipólito Unanue, de Lima (Perú), durante el año 2018. Se estudiaron las características demográficas y obstétricas, la morbilidad y los costes de la atención obstétrica.Resultados: Participaron 105 mujeres adolescentes y 210 adultas. Ambos grupos de mujeres desarrollaron alguna morbilidad durante el embarazo (63,8 % [n= 67] frente al 56,2 % [n= 118]) y el parto (71,4 % [n= 75] frente al 73,3 % [n= 154]), sin diferencias significativas. Las patologías más prevalentes en el embarazo fueron la anemia y la infección del tracto urinario, y en el parto, el desgarro del canal del parto, seguido de las distocias del trabajo de parto. En la morbilidad neonatal sí se encontraron diferencias significativas. Los recién nacidos de madres adolescentes tuvieron 2 veces más riesgo de presentar alguna morbilidad (odds ratio= 2,45; intervalo de confianza del 95 %: 1,51-3,97). Los costes en la resolución de los embarazos no presentaron diferencias significativas entre los grupos de estudio (51,01 ± 83,50 frente a 64,61 ± 79,40 dólares). (AU)

Objective: To establish the difference in morbidity and costs in the resolution of pregnancy between adolescents and adults treated in a public hospital in Lima (Peru).Material and methods: Cross-sectional, retrospective, observational study. Adolescent women and adult women between 20 and 30 years of age, primiparous and without underlying chronic diseases, were treated at the Hipólito Unanue National Hospital, Lima (Peru), during 2018. The variables were studied: demographic and obstetric characteristics, morbidity and costs of obstetric care.Results: 105 adolescents and 210 adults participated. Adolescents and adult women developed some morbidity in pregnancy (63.8 % [n= 67] vs. 56.2 % [n= 118]) and delivery (71.4 % [n= 75] vs. 73.3 % [n= 154]) without significant differences. The most prevalent in pregnancy were: anemia and urinary tract infection; in childbirth: tear of the birth canal, followed by dystocia of labor. Newborns of adolescent mothers had twice the risk of presenting some morbidity at birth (OR= 2.45; 95 % CI: 1.51-3.97). The costs in the resolution of the pregnancies did not have significant differences in the study groups ($ 51.01 ± 83.50 vs. $ 64.61 ± 79.40).Conclusions: A greater number of neonatal morbidities was found in newborns of adolescent mothers. The maternal pathologies found in both groups were anemia, urinary tract infection, labor tear and dystocia. The costs of obstetric care for adolescents and adults did not show significant differences. (AU)

Experiencia de adaptación psicosocial al embarazo en adolescentes gestantes de un hospital de Lima Metropolitana / Experience of psychosocial adaptation to pregnancy in pregnant adolescents at a hospital in Metropolitan Lima

Objetivo: Conocer la experiencia de la adaptación psicosocial al embarazo en madres adolescentes del área Lima Metropolitana.Metodología: Estudio de metodología cualitativa y diseño fenomenológico. Se utilizó un muestreo intencional por conveniencia. Participaron 19 adolescentes gestantes a quienes se les aplicó entrevistas semiestructuradas, las cuales fueron transcritas de manera literal. Se realizó un análisis de contenido temático, para lo cual se crearon categorías de significado que fueron discutidas por el equipo de investigación.Resultados: Las experiencias de adaptación se enmarcan en: 1) la aceptación del embarazo y sentimientos ambivalentes; 2) la identificación y preparación del rol materno; 3) la relación con los padres y/o tutores; 4) la relación afectiva con la pareja; 5) la preparación psicológica para el parto; 6) el temor al dolor y la pérdida de control durante el parto; 7) la afectación de la autoestima, y 8) la influencia social de lo educativo, lo laboral y lo económico.Conclusiones: Las adolescentes experimentan el embarazo como un proceso no planificado, pero sí esperado, el cual presenta sentimientos contradictorios. Las relaciones afectivas con sus padres y/o pareja proveen distintas formas de soporte. Además, las participantes se preparan psicológicamente para el trabajo de parto, haciendo frente al dolor y siendo conscientes de la posibilidad de perder el control. Asimismo, mantienen una imagen positiva de sí mismas. Por último, se ven influenciadas socialmente por los discursos de los campos de la educación, el trabajo y la economía. (AU)

Objective: To know the experience of psychosocial adaptation to pregnancy in adolescent mothers in Metropolitan Lima.Methodology: Study of qualitative methodology and phenomenological design. Intentional convenience sampling was used. 19 pregnant adolescents participated to whom semi-structured interviews were applied, which were transcribed verbatim. A thematic content analysis was carried out, for this purpose categories of meaning were created that were discussed by the research team.Results: The adaptation experiences are framed in: 1) acceptance of pregnancy and ambivalent feelings; 2) identification and preparation for the maternal role; 3) the relationship with parents and/or guardians; 4) the affective relationship with the partner; 5) psychological preparation for childbirth; 6) fear of pain and loss of control during childbirth; 7) impaired self-esteem, and 8) the social influence of education, labor and economy.Conclusions: Adolescents experience pregnancy as an unplanned but expected process, which presents contradictory feelings. Affective relationships with their parents and/or partner provide different forms of support. In addition, the participants prepare themselves psychologically for labor, coping with pain and being aware of the possibility of losing control. They also maintain a positive image of themselves. Finally, they are socially influenced by discourses from the fields of education, labor and economy. (AU)

Maternidad adolescente en el seno de una familia extensa: el rol de la familia / Adolescent motherhood within an extended family: the role of the family

Objetivo: Identificar, desde la vivencia de la adolescente, el rol que cumple en el ejercicio de su maternidad la familia extensa con la cual reside. Metodología: Se asumió una metodología cualitativa, con un diseño de estudio de caso único. Se entrevistó a 5 mujeres que fueron madres entre los 18 y los 19 años, con un niño(a) de 2 a 3 años, que vivían en casa de sus padres, sin el padre del hijo(a), usuarias de un centro de salud familiar chileno. Se aplicó una entrevista biográfica, en visita domiciliaria una vez que tanto el adulto responsable como la entrevistada hubieran firmado el consentimiento y asentimiento informado. Se examinaron los datos mediante un análisis interpretativo, realizándose una triangulación de los mismos y un contrachequeo. Resultados: Se presentan aportes de la familia extensa vinculados al cuidado del hijo/a, entrega de conocimientos y delimitación del rol materno de la adolescente, así como los obstáculos asociados a la negociación de pautas de crianza, y los cambios en las funciones relativas a la optimización de los cuidados y la reorganización del sistema familiar ante la nueva situación. Conclusiones: Se concluye planteando cómo un momento de estrés en el ciclo vital familiar puede transformarse en una oportunidad de crecimiento para la familia y la adolescente, destacando que, a través del apoyo entregado por la familia extensa, se distribuyen las funciones y se reorganiza el sistema familiar favoreciendo el desarrollo del binomio madre adolescente-hijo. (AU)

Objective: Identify, from the adolescent’s experience, the role played by the extended family with which she resides in the exercise of her motherhood. Methodology: A qualitative methodology, design of a single case study was assumed. Five women who were mothers between 18 and 19 years of age, of a child between 2 and 3 years old were interviewed; who lived in their parents' house, without the father of the child, users of a Chilean family health center. A biographical interview was applied, in a home visit once both the responsible adult and the interviewee had signed the informed consent and assent. The data were analyzed through interpretive analysis, triangulation of data and a counter check. Results: Contributions from the extended family related to the care of the child, delivery of knowledge and delimitation of the adolescent's maternal role are presented; obstacles associated with negotiating parenting guidelines; changes in the functions related to the optimization of care and reorganization of the family system in the face of the changes that have occurred. Conclusions: It concludes by proposing how a moment of stress in the family life cycle can become an opportunity for growth for the family and the adolescent, highlighting how, through the support provided by the extended family, functions are distributed and the family system is reorganized favoring the development of the adolescent mother-son binomial. (AU)

Fluctuaciones del estado emocional en adolescentes embarazadas de zonas rurales en el norte de Colombia. Un estudio cualitativo / Emotional fluctuations in pregnant adolescents from rural areas in the north of Colombia

Esta investigación analiza las fluctuaciones del estado emocional en adolescentes embarazadas de zonas rurales del departamento de Sucre (Colombia). Se halló que la mayoría de las adolescentes ha experimentado cambios bruscos de humor, fluctuando de emociones positivas a negativas y de negativas a positivas, variaciones asociadas principalmente al apoyo sociofamiliar percibido, a la vivencia de acontecimientos vitales estresantes y, al parecer, a cambios hormo-nales. Es positivo para aquellas que consideran que el embarazo les ha dado un motivo para vivir y cambiar su vida. Es negativo para aquellas que tienen problemas en su proceso de gestación (patologías asociadas, problemas con la salud del bebé) o para aquellas cuya familia o esposo no apoyan la nueva situación de la adolescente (AU)

The current study analyses the fluctuations of the emotional state in pregnant adolescents from rural areas of the north of Colombia. Most adolescent girls have experienced sudden positive and / or negative mood swings. The mood fluctuations occurred from positive to negative emotions and from negative to positive, this fluctuation depended mainly on perceived social and family support, the experience of stressful life events and, apparently, hormonal changes. It was positive for those who considered that pregnancy has given them a reason to live and change their life. It was negative for those who have problems in their gestation process (associated pathologies, problems with the baby’s health, among others) or for those whose family or husband did not support the new situation of the adolescent (AU)

Factores de riesgo asociados al embarazo en adolescentes / Risk factors associated with pregnancy in adolescents

OBJETIVO: Evaluar los factores de riesgo para el embarazo en adolescentes. MÉTODO: Estudio retrospectivo de casos y controles con una muestra no probabilística por conveniencia de 180 adolescentes: 60 gestantes (casos) y 120 no gestantes (controles). La recolección de datos se realizó entre los meses de setiembre y octubre del 2019 en un centro de salud público de Trujillo, mediante el FACES-III y una ficha de identificación de datos sociodemográficos y familiares. Para el análisis de datos se determinó el Odds ratio, se calcularon los intervalos de confianza (IC) y se procedió a estimar la magnitud de efecto. RESULTADOS: Tanto la exposición a la violencia (OR: 5.82), la funcionalidad familiar (OR: 3.87), la edad del primer embarazo de la madre (OR: 4.07) y la situación sentimental de los padres (OR: 4.24), actuaron como factores de riesgo con una magnitud de efecto moderada; en tanto que el grado de instrucción de la madre (OR: 2.03) se mostró como un factor de riesgo con magnitud de efecto pequeña y el grado de instrucción del padre (OR: 1.37) insignificante. CONCLUSIONES: La exposición a la violencia, la funcionalidad familiar, la edad del primer embarazo de la madre, la situación sentimental y el grado de instrucción de los padres actuaron como factores de riesgo para el embarazo en adolescentes

OBJECTIVE: To assess the risk factors for pregnancy in adolescents. METHOD: Retrospective case-control study with a non-probability sample for convenience of 180 adolescents: 60 pregnant women (cases) and 120 non pregnant women (controls) Data collection was carried out between September and October, 2019 in a public health center in Trujillo, using FACES-III and a card identifying sociodemographic and family data. For the data analysis the Odds ratio was determined, the confidence intervals (CI) were calculated and the magnitude of effect was estimated. RESULTS: Exposure to violence (OR: 5.82), family functionality (OR: 3.87), age of mother's first pregnancy (OR: 4.07), and parents' emotional situation (OR: 4.24) were risk factors with a moderate magnitude of effect, whereas mother's education (OR: 2.03) was a risk factor with a small magnitude of effect and father's education (OR: 1.37) was insignificant. CONCLUSIONS: Exposure to violence, family functionality, age of mother's first pregnancy, emotional situation and parents' level of education all acted as risk factors for adolescent pregnancy

Relationship between early marriage and teenager pregnancy to stunting in toddler at Bangun Rejo Village, Tanjung Morawa District, Tanjung Morawa, Deli Serdang 2019

The brain undergoes very rapid growth and development among toddler below 5 year of age. The fault in their upbringing during this period of time will cause them to undergo growth and development disorder, and parents who get married too young early have lack of knowledge of raising their young children. As a result, the latter become vulnerable during their growth and development. The objective of the research was to analyze the correlation between early marriage and teenager pregnancy to stunting in growth among toddlers. The research used descriptive analytic method with cross-sectional design. It was conducted at Bangun Rejo Village, Tanjung Morawa District, Deli Serdang regency from June to September 2019. The population consisted of 645 toddler aged between 0 and 59 months. The sample was chosen by using systematic random sampling technique. The data were gathered by using questionnaires in order to get the information about early marriage and by conducting observation in order to find out toddler stunting. The result of univariate analysis showed that 87 (82.1%) infants had normal growth. The result of bivariate analysis, using chi-square test, showed that there was correlation between early marriage and toddler stunting, teenager pregnancy (p = 0.000) and marriage age (p = 0.001). The conclusion of the research was that there was correlation between early marriage and teenager pregnancy to stunting in toddler. The study showed that toddlers in case of parent with early marriage was more vulnerable to growth and development disorder. It is recommended that health service of care for adolescents and integrated monitoring of toddler be established in order to decrease the risk of incidence of early marriage and toddler stunting

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The Titeer game as an effort to prevent teen pregnancy

OBJECTIVE: This study is aimed to analyze the effectiveness of Titeer game toward preventing of teenage pregnancy. METHOD: A quasi experiment with pre-posttest control group was used in this study. One hundreed and thirty eight of tenagers aged 2-10 years were recruited as participants (69 of tenagers each group). Titeer game was given to intervention group during a month. Conventional intervention (leaflet) were provided to control group. The illustrative questionnaires were measured before intervention, 2 and 10 weeks after intervention to measure knowledge, attitude, sefl-eficacy, life skill, peer influenced, behavior, and prevent of pregnancy of tenagers. Independent T-Test and General Linear Model Repeated Measured (GLM-RM) was used to complete of analysis. RESULTS: Knowledge, attitude, self efficacy, life skill peer influenced, and pregnancy prevention were significantly increase 2 and 10 of weeks after intervention. CONCLUSION: The Titeer game could be increase of preventing tenagers' pregnancy aged 2-10 years

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Efectividad de las intervenciones educativas para la prevención del embarazo en la adolescencia / Effectiveness of educational interventions for the prevention of pregnancy in adolescents

Objetivo: Evaluar la efectividad de las intervenciones educativas dirigidas a prevenir el embarazo en la adolescencia. Diseño: Revisión sistemática. Fuentes de datos: Se consultaron las bases de datos PubMed, CINAHL, Scopus, Cuiden Plus, LILACS e IME para buscar estudios sobre intervenciones educativas para la prevención del embarazo en la adolescencia. Selección de estudios: Se seleccionaron un total de 24 investigaciones primarias, donde se evaluaba el efecto de un programa educativo para la prevención del embarazo en la adolescencia. La calidad de los estudios seleccionados se evaluó usando la escala CASPe. Resultados: Los programas educativos que midieron una modificación de la tasa de embarazo en la adolescencia muestran resultados poco concluyentes, ya que 2 investigaciones obtienen una reducción y otros 2 no hallan cambios significativos. Sin embargo, los programas educativos se muestran efectivos para aumentar el nivel de conocimiento sobre sexualidad y métodos anticonceptivos, y para modificar las actitudes sobre el riesgo de embarazo en la adolescencia o las actitudes hacia el uso de los métodos anticonceptivos. No se encuentran diferencias estadísticamente significativas entre los estudios que muestran un resultado positivo y los estudios con resultado negativo (p > 0,05) para ninguno de los resultados analizados en la revisión. Conclusión: No existe una modalidad de intervención que sea la más efectiva para la prevención de un embarazo en la adolescencia. Se necesita un mayor número de investigaciones con un abordaje longitudinal que valoren no solo resultados intermedios, sino una modificación en la tasa de embarazo

Objective: To assess the effectiveness of the interventions to prevent a pregnancy in adolescence. Design: Systematic review. Data sources: The following databases were consulted: PubMed, CINAHL, Scopus, Cuiden Plus, LILACS, and IME, in order to identify interventions aimed at preventing a pregnancy in adolescence. Study selection: A total of 24 primary investigations, in which an educational program to prevent a pregnancy in the adolescence was evaluated, were selected. The quality of the selected studies was assessed according to the CASPe scale. Results: Educational programs for the modification of the teenage pregnancy rate show inconclusive results, as there are 2 studies that find a reduction, and 2 that find that there are no significant changes. For secondary outcomes, it was found that educational programs are effective for increasing the knowledge level about sexuality and contraceptive methods and changing attitudes about the risk of a teenage pregnancy or the use of contraceptive methods. There are no statistically significant differences between the studies with a positive and negative outcome (P > .05) for any of the results analysed in this review. Conclusion: There is no a single intervention modality that is the most effective for prevention of a teenage pregnancy. More research is needed with a longitudinal approach that assess not only intermediate results, but also a modification in the pregnancy rate

Factores de riesgo que inciden en el embarazo adolescente desde la perspectiva de estudiantes embarazadas / Risk factors that affect teenage pregnancy from the perspective of pregnant students

Introducción: los casos estudiados vivencian abandono emocional directo e indirecto por parte de sus padres y contextos de privación social y cultural. El embarazo en la adolescencia también acarrea desventajas expresadas por las alumnas: pérdida de la libertad, asumir responsabilidades parentales, exclusión del grupo de pares, dedicándose la madre adolescente al cuidado del bebé. Objetivo: el objetivo de este trabajo es dar a conocer los factores de riesgo que inciden sobre la ocurrencia de embarazos adolescentes desde la perspectiva de estudiantes embarazadas. Material y métodos: cualitativo, que se basa en la perspectiva fenomenológica. Se realizaron entrevistas semiestructuradas a 6 estudiantes embarazadas entre 16 y 19 años provenientes de un sector rural de Chile. Resultados: en la mayoría de los casos no hubo deserción del sistema escolar, pero estas adolescentes no vivencian la etapa de la adolescencia de manera similar a sus compañeras que no son madres, centrándose en su rol de madre y no de hija dependiente del cuidado de sus padres, lo que acarrea conflictos internos, generando angustia, miedo, sentimiento de culpa y frustración, cambiando drásticamente la reacción o respuestas ante los acontecimientos del diario vivir, acelerando el proceso de maduración cognitiva que a su edad correspondería, modificando su conducta, necesidades y prioridades. Conclusión: los resultados obtenidos constituyen un llamado de alerta y un incentivo a la revisión y promoción de estrategias para prevención del embarazo adolescente

Introduction: the students under study experienced direct and indirect emotional neglect by their parents within a context of social and cultural deprivation. Teenage pregnancy also involves disadvantages described by the students: loss of freedom, engagement in parental responsibilities and exclusion from the peer group, as the adolescent mother is devoted to the care of the baby. Objectives: the aim of this study was to establish the risk factors that play a role in teenage pregnancy from the perspective of pregnant students. Material and methods: we conducted a qualitative study from a phenomenological perspective. We performed semi-structured interviews with 6 pregnant students aged 16 to 19 years from a rural area in Chile. Results: most participants did not drop out of the school system, but they did not live adolescence like their peers that had no children, as they focused on their role as mothers and not as daughters dependent on their parents, which generated inner conflicts, anxiety, fear, feelings of guilt and frustration, drastically changing their reaction or responses to events in everyday life, accelerating the cognitive maturation process relative to their age, and changing their behaviour, needs and priorities. Conclusions: the results of our study raise a red flag and call for the revision and promotion of strategies for the prevention of teenage pregnancy

A concept analysis of maternal role in pregnant adolescent

Objective: The purpose of this study is to clarify the concept of maternal role in pregnant adolescent. Method: The Walker and Avant's concept analysis (2005) was used in this study. Results: The attributes are accepting pregnancy at young age, bonding and getting attached with their unborn baby, taking care of unborn baby, recognizing risk related to their pregnancy, dealing with emotions, and preparing for labor. The antecedents included: personal factor, environmental factors, and psychological factors. The consequences are improving adolescent health during pregnancy, increasing confidence, reducing the high risk of pregnancy at a young age, and giving birth safely. Empirical references to maternal roles of pregnant adolescent include their responsibility of the pregnancy, protecting unborn baby from harm, knowledge about pregnancy, changing behavior, and emotional well-being. Conclusions: This concept analysis will help the author for developing instrument about the ability of pregnant adolescent to perform the maternal role during pregnancy

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Asociación entre el bajo nivel socioeconómico del área de residencia y embarazo en adolescentes / Relationship Between Low Socioeconomic Level of the Area of Residence and Pregnancy in Adolescents

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Una escala para valorar el riesgo de embarazo adolescente no planificado / A scale to assess the risk of unplanned adolescent pregnancy

Objetivo: Diseñar y validar un cuestionario para valorar el riesgo de embarazo adolescente no planificado (EANP). Método: Diseño de un cuestionario para valorar el riesgo de EANP a partir de todos los factores relacionados descritos en la literatura. Se validó posteriormente sobre una muestra de adolescentes de La Palma clasificadas como EANP y no EANP con estimación de fiabilidad por test-retest. Resultados: El cuestionario partía de 36 ítems. Con la finalidad de validar la apariencia y el contenido de este cuestionario inicial, se constituyó un grupo de expertos y otro de adolescentes con EANP. La muestra de validación la conformaron 148 adolescentes, con una media de edad ± desviación estándar de 21 ± 2 años, entre las que figuraba un 36% de EANP. Se eliminaron 27 ítems por no tener relación con el EANP. Su coeficiente alfa de Cronbach alcanzó un valor de 0,78 con la eliminación de un ítem redundante, por lo que el cuestionario final quedó conformado por 8 ítems. La validez de constructo mediante análisis factorial confirmatorio ratificó la estructura de 5 dimensiones, con un 76% de variabilidad de respuestas explicada. Se establecieron reglas cualitativas de afectación de ítems, dimensiones y de salida global del cuestionario. La validez de criterio mostró una sensibilidad de 0,87 (intervalo de confianza [IC] del 95%: 0,81-0,93) y un valor predictivo de resultado negativo de 0,86 (IC del 95%: 0,80-0,92). La fiabilidad presentó un índice kappa de 0,77 (IC del 95%: 0,70-0,84). Todos estos parámetros alcanzaron un valor de p <0,001. Conclusión: Las propiedades métricas del cuestionario obtenido (Instrumento de valoración del Riesgo de Embarazo No Esperado [IRENE]), junto con su facilidad y rapidez de administración, lo convierten en un medio adecuado de cribado para detectar a una adolescente en situación de riesgo de embarazo no planificado y valorar sobre qué aspectos podemos incidir para intentar reducirlo

Objective: Design and validate a questionnaire to assess the risk of unplanned adolescent pregnancy (UAP). Method: The design of a questionnaire to assess the risk of UAP from all the related factors described in the literature. It is subsequently validated on a sample of adolescents from La Palma classified as UAP and not UAP with reliability estimation by test-retest. Results: The questionnaire starts from 36 items. An expert group and another group of teenagers with UAP carry out their validity of appearance and content. The validation sample is made up of 148 adolescents aged 21 ± 2 years with 36% of UAP. 27 items are eliminated because they are not related to the UAP. The Cronbach alpha reaches 0.78 with an elimination of a redundant item, the final questionnaire was formed by 8 items. The construct validity by confirmatory factor analysis confirms the 5-dimensional structure with 76% variability of responses explained. Qualitative rules of affectation of items, dimensions and global exit of the questionnaire are established. The criterion validity shows 0.87 (95% CI: 0.81-0.93) of sensitivity and 0.86 (95% CI: 0.80-0.92) of predictive value of negative result. Reliability presents a kappa index of 0.77 (95% CI: 0.70-0.84). All these parameters achieve p <0.001. Conclusion: The metric properties of the questionnaire obtained (Unexpected Pregnancy Risk Assessment Instrument [IRENE]), together with its ease and speed of administration, make it an adequate means of screening to detect a teenager at risk of unplanned pregnancy and assess what aspects we can influence to try to reduce it

Promotion of adjustment to the exercise of parental role in adolescente

Introduction: Parental exercise itself constitutes a very demanding challenge - however, when pregnancy occurs in adolescence, often unplanned, it converges tasks of different stages of development, irreversibly modifying an identity, roles and functions, not only of the young woman, but also of her family. Objectives: Applying the Dynamic Model of Family Assessment and Intervention (MDAIF), by Figueiredo (2012), and assessing the impact of nursing care in the pro-motion of skills for a transition to the parental role's exercise in the teenager and her family. Methods: Qualitative study, conducted based on MDAIF, as a theoretical and ope-rational reference, in clinical and community context in Primary Health Care, based on the process of family intervention who experienced an adolescent pregnancy. Seven nursing consultations to family were carried out, as a unit, from April to May 2016. Results and discussion: Extended family, with several subsystems and strict limits. Middle-class family. Although unplanned, and the antagonistic relationship with her parents, the instrumental and emotional support provided by them became critical in adapting to motherhood and the newborn's development. Conclusions: With MDAIF's use, nurses have developed their skills for a personalized approach to the family, centered on the adaptation and holistic transition to the parental process. It also made it possible to respond to the identified family needs, not only through the restructuring of a parental and personal identity, based on values, personal and professional goals and priorities (the teenager pursued her academic training), but also promoting a family environment based on trust and harmony

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Significado otorgado a la parentalidad durante el transcurso del embarazo por padres adolescentes / Significance given to parenting during the course of pregnancy by adolescent parents

El objetivo de este estudio consiste en comprender el significado que los padres adolescentes otorgan a la parentalidad. Se realizó un estudio cualitativo con una muestra de 10 adolescentes entre 15 y 19 años constituidos como parejas, que se encontraban cursando II o III trimestre de su primera gestación, su participación fue consentida y voluntaria. Se realizaron entrevistas hasta saturar la información, las que fueron transcritas y categorizadas resguardando la rigurosidad científica por medio del proceso de triangulación. Los principales resultados dan cuenta que los adolescentes definen la parentalidad en función de la responsabilidad de cuidar indefinidamente al hijo, como una ruptura del proyecto de vida, sin embargo se sienten invulnerables y gran parte de la muestra volvería a repetir la experiencia, lo cual es un factor de riesgo para un segundo embarazo en la adolescencia

The objective of this qualitative study isunderstand the meaning that parents give to parenting. The sample consisted of 10 adolescents aged between 15 and 19 years, constitutedas couples, were in the II or III trimester of their first gestation, their participation was voluntary and with informed consent voluntary. Interviews were carried out which were transcribed and categorized preserving the scientific rigor by means of the triangulation process. The main results show that adolescents define parenting according to the responsibility of taking care of the child indefinitely, as a break from the project of life, but they feel invulnerable and almost all would repeat the experience, which is a Risk factor for a second pregnancy in adolescence

Embarazo en adolescentes en los últimos 11 años. Motivos de consulta y factores de riesgo / Pregnancy in adolescents in the last 11 years. Reasons for consulting and risk factors

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Respuesta a embarazo en adolescentes en los últimos 11 años. Motivos de consulta y factores de riesgo / Response to pregnancy in adolescents in the last 11 years. Reasons for consulting and risk factors

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Embarazo en adolescentes en los últimos 11 años. Motivos de consulta y factores de riesgo. Respuesta de los autores / Response to pregnancy in adolescents in the last 11 years. Reasons for consulting and risk factors. Authors reply

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