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1.

Proceso educativo de enfermería para promover el autocuidado de la mujer durante el puerperio/ Nursing educational process to promote self-care of women during the postpartum period

Acevedo-Hernández, Beatriz Adriana; Pizarro, Norma; Moriel-Corral, Bernardina Leticia; González-Carrillo, Eliazar; Berumen-Burciaga, Luz Verónica
| Idioma(s): Español
Resumen: Introducción: en investigaciones referentes al cuidado de enfermería a la mujer durante el posparto, se han abordado diversas temáticas sin embargo, se identifica que la educación en el proceso de cuidado no ha sido una de ellas. Objetivo: explorar el desarrollo del proceso educativo del profesional de enfermería que promueva el autocuidado de la mujer durante el puerperio. Metodología: se realizó investigación cualitativa con el diario de campo, entrevista a profundidad y observación participante. El análisis se realizó con base en la Teoría Fundamentada de Strauss y Corbin. Resultados: socialmente el puerperio es un evento cotidiano influenciado por creencias personales, sociales y culturales, situación que el legado sociocultural no satisface con el cuidado genérico influenciado por la familia. Conclusiones: El puerperio es un evento único y transitorio en la mujer, mismo que se refleja en la actitud y las acciones que realiza con respecto al cuidado de sí misma y del recién nacido. La educación es una oportunidad para el profesional de enfermería en relación con la comunicación y educación de la mujer en puerperio.(AU) Abstract: Introduction: Research related to nursing care to women during the postpartum period have addressed various topics however, it is identified that education in the care process has not been one of them. Objective: To explore the development of educational process of professional nursing that promotes self-care of women during the postpartum period. Methods: Qualitative research was conducted with field notes, depth interviews and participant observation. The analysis was based on the Strauss and Corbin Grounded Theory. Results: Puerperium is socially a daily event influenced by personal, social and cultural beliefs, it is a socio-cultural legacy situation that does not meet with the generic influenced by family care. Conclusions: The postpartum period is a unique and temporary event in women; it is reflected in the attitude and the actions taken regarding care for herself and the newborn. Education is an opportunity for professional nursing in relation to communication and education of women in postpartum period.(AU)
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2.

Profiles Using Indicators of Marital Communication, Communication Styles, and Marital Satisfaction in Mexican Couples.

Sánchez Bravo, Claudia; Martínez, Alejandra Watty
| Idioma(s): Inglés
Marital problems have multiple causes. One factor leading to marital dissatisfaction is communication, both the inability to communicate in certain areas and the way in which communication is made. One hundred four Mexican couples who attend a reproductive health care institution in Mexico City took part in this study. The relationship between the amount and style of communication was studied in order to develop profiles with explanatory indicators. A study was carried out with two samples (men and women) that were classified in terms of marital satisfaction or dissatisfaction. Indicators related to marital satisfaction are talking about the marital relationship, discussing work (women and men), communicating about sexuality (women). Indicators of marital dissatisfaction are talking about children, having and perceiving a reserved and negative style of communication (men), having and perceiving a negative and violent style of communication (women).
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3.

Surveying the Knowledge and Practices of Health Professionals in China, India, Iran, and Mexico on Treating Tuberculosis.

Hoffman, Steven J; Guindon, G Emmanuel; Lavis, John N; Randhawa, Harkanwal; Becerra-Posada, Francisco; Dejman, Masoumeh; Falahat, Katayoun; Malek-Afzali, Hossein; Ramachandran, Parasurama; Shi, Guang; Yesudian, C A K
| Idioma(s): Inglés
Research evidence continues to reveal findings important for health professionals' clinical practices, yet it is not consistently disseminated to those who can use it. The resulting deficits in knowledge and service provision may be especially pronounced in low- and middle-income countries that have greater resource constraints. Tuberculosis treatment is an important area for assessing professionals' knowledge and practices because of the effectiveness of existing treatments and recognized gaps in professionals' knowledge about treatment. This study surveyed 384 health professionals in China, India, Iran, and Mexico on their knowledge and practices related to tuberculosis treatment. Few respondents correctly answered all five knowledge questions (12%) or self-reported performing all five recommended clinical practices "often or very often" (3%). Factors associated with higher knowledge scores included clinical specialization and working with researchers. Factors associated with better practices included training in the care of tuberculosis patients, being based in a hospital, trusting systematic reviews of randomized controlled double-blind trials, and reading summaries of articles, reports, and reviews. This study highlights several strategies that may prove effective in improving health professionals' knowledge and practices related to tuberculosis treatment. Facilitating interactions with researchers and training in acquiring systematic reviews may be especially helpful.
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4.

Adaptation and validation of the Distress Scale for Mexican patients with type 2 diabetes and hypertension: a cross-sectional survey.

Martinez-Vega, Ingrid Patricia; Doubova, Svetlana V; Aguirre-Hernandez, Rebeca; Infante-Castañeda, Claudia
| Idioma(s): Inglés
OBJECTIVES: The aim of this study was to adapt and validate the Distress Scale for Mexican patients with type 2 diabetes and hypertension (DSDH17M). SETTING: Two family medicine clinics affiliated with the Mexican Institute of Social Security. PARTICIPANTS: 722 patients with type 2 diabetes and/or hypertension (235 patients with diabetes, 233 patients with hypertension and 254 patients with both diseases). DESIGN: A cross-sectional survey. METHODS: The validation procedures included: (1) content validity using a group of experts, (2) construct validity from exploratory factor analysis, (3) internal consistency using Cronbach's α, (4) convergent validity between DSDH17M and anxiety and depression using the Spearman correlation coefficient, (5) discriminative validity through the Wilcoxon rank-sum test and (6) test-retest reliability using intraclass correlation coefficient. RESULTS: The DSDH17M has 17 items and three factors explaining 67% of the total variance. Cronbach α ranged from 0.83 to 0.91 among factors. The first factor of 'Regime-related Distress and Emotional Burden' moderately correlated with anxiety and depression scores. Discriminative validity revealed that patients with obesity, those with stressful events and those who did not adhere to pharmacological treatment had significantly higher distress scores in all DSDH17M domains. Test-retest intraclass correlation coefficient for DSDH17M ranged from 0.92 to 0.97 among factors. CONCLUSIONS: DSDH17M is a valid and reliable tool to identify distress of patients with type 2 diabetes and hypertension.
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5.

Educational Gradients and Pathways of Disability Onset Among Older Mexicans.

Saenz, Joseph L; Wong, Rebeca
| Idioma(s): Inglés
INTRODUCTION: Educational disparities research is less common in developing countries. We evaluate whether educational gradients of disability onset exist in Mexico across groups (birth cohort and sex) and whether the association is unexplained or indirect via health (health behaviors, chronic conditions, and self-rated health) or economic (income, wealth, and health insurance) pathways. METHOD: Data come from the Mexican Health & Aging study. Activities of daily living are reported in 2001, 2003, and 2012 by respondents and spouses aged 50+ (N = 9,560). Groups are analyzed using logistic regression to test education-disability onset associations. RESULTS: Significant education-ADL onset associations were observed across groups, and much of these associations were direct (unexplained by pathways). Indirect effects operated primarily through the health pathway. DISCUSSION: Those with less education were disadvantaged in terms of disability across birth cohorts and sex. Unexplained effects of education may suggest unobserved mediators or differential returns to resources by educational level.
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6.

Disminución de la seroprevalencia de hepatitis C en México: resultados de la Ensanut 2012./ [Decrease of HCV seroprevalence in Mexico: Results from the National Health and Nutrition Survey 2012].

Gutiérrez, Juan Pablo; Sucilla-Pérez, Héctor; Conde-González, Carlos J; Izazola, José Antonio; Romero-Martínez, Martin; Hernández-Ávila, Mauricio
| Idioma(s): Español
OBJECTIVE: To estimate seroprevalence of hepatitis C virus (HCV) among 15-49 years old Mexicans living in households and to describe the profile of seroreactive individuals. MATERIALS AND METHODS: Cross-sectional study implemented in 2012 using a national probabilistic sample with behavioral data from face-to-face interviews at households and HCV antibodies screening using capillary blood from same individuals. RESULTS: HCV seroprevalence in Mexico was estimated at 0.27% (IC95% 0.12-0.60), representing 161 000 persons. Seroprevalence was significantly higher among males (0.45% CI95% 0.01-0.89) than females (0.10% CI95% 0.00-0.22). Multivariate analysis suggests a higher possibility of HCV reactivity among men, increasing with age and higher among those sexually active, and lower for higher socioeconomic level. CONCLUSION: HCV seroprevalence in Mexico by 2012 seems significantly lower than the estimation from 2000 of 1.2% for the same age-group. Evidence of infection among individuals 15-19 years old suggests the need to strength preventive actions, particularly in subjects with risky behaviors.
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7.

Análisis de la evidencia sobre eficacia y seguridad de la vacuna de dengue CYD-TDV y su potencial registro e implementación en el Programa de Vacunación Universal de México./ [Analysis of the evidence on the efficacy and safety of CYD-TDV dengue vaccine and its potential licensing and implementation through Mexico's Universal Vaccination Program].

Hernández-Ávila, Mauricio; Lazcano-Ponce, Eduardo; Hernández-Ávila, Juan Eugenio; Alpuche-Aranda, Celia M; Rodríguez-López, Mario Henry; García-García, Lourdes; Madrid-Marina, Vicente; López Gatell-Ramírez, Hugo; Lanz-Mendoza, Humberto; Martínez-Barnetche, Jesús; Díaz-Ortega, José Luis; Ángeles-Llerenas, Angélica; Barrientos-Gutiérrez, Tonatiuh; Bautista-Arredondo, Sergio; Santos-Preciado, José Ignacio
| Idioma(s): Español
Dengue is a major global public health problem affecting Latin America and Mexico Prevention and control measures, focusing on epidemiological surveillance and vector control, have been partially effective and costly, thus, the development of a vaccine against dengue has created great expectations among health authorities and scientific communities worldwide. The CYD-TDV dengue vaccine produced by Sanofi-Pasteur is the only dengue vaccine evaluated in phase 3 controlled clinical trials. Notwithstanding the significant contribution to the development of a vaccine against dengue, the three phase 3 clinical studies of CYD-TDV and the meta-analysis of the long-term follow up of those studies, have provided evidence that this vaccine exhibited partial vaccine efficacy to protect against virologically confirmed dengue and lead to four considerations: a) adequate vaccine efficacy against dengue virus (DENV) infections 3 and 4, less vaccine efficacy against DENV 1 and no protection against infection by DENV 2; b) decreased vaccine efficacy in dengue seronegative individuals at the beginning of the vaccination; c) 83% and 90% protection against hospitalizations and severe forms of dengue, respectively, at 25 months follow-up; and d) increased hospitalization for dengue in the vaccinated group, in children under nine years of age at the time of vaccination, detected since the third year of follow-up. The benefit of the CYD-TDV vaccine can be summarized in the protection against infection by DENV 3 and 4, as well as protection for hospitalizations and severe cases in people over nine years, who have had previous dengue infection, working mainly as a booster. In this review we identified elements on efficacy and safety of this vaccine that must be taken into account in the licensing process and potential inclusion in the national vaccination program of Mexico. The available scientific evidence on the CYD-TDV vaccine shows merits, but also leads to relevant questions that should be answered to properly assess the safety profile of the product and the target populations of potential benefit. In this regard we consider it would be informative to complete the 6-year follow-up after starting vaccination, according to the company's own study protocol recommended by the World Health Organization. As with any new vaccine, the potential licensing and implementation of the CYD-TDV as part of Mexico's vaccination program, requires a clear definition of the balance between the expected benefits and risks. Particularly with a vaccine with variable efficacy and some signs of risk, in the probable case of licensing, the post-licensed period must involve the development of detailed protocols to immediately identify risks or any health event associated with vaccination.
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8.

Community Health Workers-Promotores de Salud in Mexico: History and Potential for Building Effective Community Actions.

Balcazar, Hector; Perez-Lizaur, Ana Bertha; Izeta, Ericka Escalante; Villanueva, Maria Angeles
| Idioma(s): Inglés
This article takes a historical perspective combining 3 illustrative examples of the origins of the community health worker (CHW) model in Mexico, as a community-based participatory strategy. Three examples were identified from the sparse literature about CHWs in Mexico emphasizing their key roles and functions in various community settings. The CHW models illustrate what is known of training-development and planning, implementation, and evaluation of the CHWs model in different settings addressing cardiovascular disease and risk factors. The potential exists for integrating CHW projects to expand the health promotion model with new emphasis on municipality and regional participation.
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9.

Salud, calidad de vida y entorno universitario en estudiantes mexicanos de una universidad pública/ Health, quality of life and university environment in mexican students at a public university/ Saúde, qualidade de vida e entorno universitario em estudantes mexicanos de uma universidade pública

Lara Flores, Norma; Delgadillo Gutiérrez, Héctor Javier; Saldaña Balmori, Yolanda; Fernández Vera, Norma
| Idioma(s): Español
Objetivo: Identificar la percepción de los estudiantes sobre su salud y calidad de vida relacionada con la satisfacción con el medio universitario. Método: Estudio transversal en una muestra aleatoria de 352 universitarios de la Universidad Autónoma Metropolitana-Xochimilco (UAM-X), en otoño de 2012. Previo consentimiento informado, se aplicó un cuestionario para obtener datos sociodemográficos, valoración de los servicios universitarios, satisfacción con sus estudios, estrés académico, problemas de salud y calidad de vida autopercibida. El análisis univariado y bivariado se realizó con los paquete estadísticos SPSS y STATA. Resultados: La media de edad fue de 21,7 (desviación estándar, DS = 4,1), el 55% fueron mujeres. El 80,2% asistió a todas las clases durante ese trimestre y el 84,1% estaba satisfecho con sus estudios; 74,4% contaba con apoyo de sus compañeros y 86,4% de profesores. El 70% valoraró positivamente las instalaciones y servicios universitarios y el 83,7% la calidad académica. El 63,9% sintió estrés en las dos últimas semanas y percibieron que éste afectó su salud. La percepción sobre su calidad de vida fue mejor en estudiantes que reportaron buen trato con profesores y compañeros, estaban satisfachechos con la calidad de la enseñanza y usaban las instalaciones deportivas (p < 0,05). Conclusiones: Se mostró que aspectos favorables del entorno universitario repercuten positivamente en la percepción de la calidad de vida de los estudiantes. Objective: To identify the perception students have on their health and life quality in relation to their satisfaction with the university environment. Method: Cross-sectional study in a random sample of 352 university students of the Universidad Autónoma Metropolitana-Xochimilco Unit (UAM-X), performed in autumn 2012. After obtaining the informed consent, a questionnaire was applied to gather sociodemographic data, assessment of university services and satisfaction with their studies, academic stress, health problems, and self-perceived quality of life. Univariate and bivariate analyses were performed using the SPSS-21 and the STATA statistical software. Results: The mean age was 21.7 years (SD 4.1) and 55% were women. Eighty percent of students attended all required courses during the trimester and 84.1% was satisfied with their studies; 74.4% had support from their classmates, and 86.4% had support from their professors. Seventy percent assessed positively the university infrastructure and services and 83.7% the academic quality. Out of the total students surveyed, 63.9% felt stress the last two weeks affecting their health. Perception about their quality of life was better in students that reported good relationship with professors and classmates who were satisfied with the quality of teaching and used sports facilitites (p < 0.05). Conclusions: Favorable aspects of the university environment affecting positively the perception about quality of life in students were shown. Objetivo: Identificar a percepção dos estudantes sobre sua saúde e qualidade de vida relacionada com a satisfação com o meio universitário. Método: Estudo transversal em uma amostra aleatória de 352 universitários da Universidade Autônoma Metropolitana-Xochimilco (UAM-X), em outono de 2012. Prévio consentimento informado se aplicou um questionário para obter dados socio-demográficos, valoração dos serviços universitários, satisfação com seus estudos, estresse acadêmico, problemas de saúde e qualidade de vida autopercebida. O análise univariado e bivariado se realizou com os paquete estatísticos SPSS e STATA. Resultados: A meia de idade foi de 21,7 (desvio standard, DS = 4,1), o 55% foram mulheres. O 80,2% foi a todas as classes durante esse trimestre e o 84,1% estava satisfeito com seus estudos; 74,4% contavam com apoio de seus colegas e 86,4% de professores. O 70% valorado positivamente as instalações e serviços universitários e o 83,7% a qualidade acadêmica. O 63,9% sentiu estresse nas duas últimas semanas e perceberam que este afetou sua saúde. A percepção sobre sua qualidade de vida foi melhor em estudantes que reportaram bom trato com professores e colegas, estavam satisfeitos com a qualidade de ensino e usavam as instalações esportivas (p < 0,05). Conclusões: Amostrou se que aspectos favoráveis do entorno universitário repercutem positivamente na percepção da qualidade de vida dos estudantes.
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10.

Determinantes sociales de la salud de la OMS en mujeres mexicanas con el virus de papiloma/ Social determinants of health WHO Mexican women with papillomavirus

Soltero-Rivera, Silvia Guadalupe; Cárdenas-Villarreal, Velia Margarita; Cerda-Flores, Ricardo Martin; Paz Morales, María de los Angeles; Patton-Leal, Adrián Carlos; Ramírez-García, Esther Justina; Guevara-Valtier, Milton Carlos
| Idioma(s): Español
Uno de los temas centrales de la OMS es el análisis de los problemas de salud mediante el modelo de Determinantes Sociales de la Salud (DSS: inadecuadas condiciones económicas, ambientales y de alimentación). El sistema sanitario de la OMS ha asociado algunas enfermedades tal como el Virus de Papiloma Humano (VPH) con los DSS. Desde el punto de vista de investigación cuantitativa, los DSS reportados por la OMS son: 1) edad de inicio de la actividad sexual, 2) múltiples compañeros sexuales, 3) estrato socioeconómico y 4) sistema inmunitario debilitado. En México, hasta el momento las investigaciones cualitativas en población de mujeres mexicanas con VPH son nulas. Objetivos: identificar los DSS en mujeres mexicanas con VPH mediante una investigación cualitativa. Material y Métodos: diseño cualitativo-descriptivo. La población estuvo conformada por 1800 mujeres con VPH atendidas en consulta externa de un hospital de tercer nivel. De este total solo a 9 mujeres se seleccionaron para entrevista a profundidad (Método de Saturación) Minayo. Mediante el método de saturación se obtuvieron las unidades de significado, categorías y subcategorías. Resultados: se identificaron cinco categorías. 1. Determinantes conductuales, 2. Ingreso y situación económica, 3. Educación para la salud, 4. Estilos de vida y 5. Servicios de salud; utilizando el método de saturación. De estas categorías se obtuvieron nueve subcategorías. Las categorías con mayor saturación fueron: determinantes conductuales, (subcategorías: relación de pareja y relación sexual) e ingreso y situación económica (subcategorías: apoyo económico de pareja e ingreso personal)... One of the central the mês of the WHO is the analysis of health problems through the Social Determinants of Health (SDH). The WHO health system associated with the DSS (inadequate economic, environmental and food) with some diseases. For the Human Papilloma Virus (HPV), the SDH reported by the WHO from the point of view of quantitative research are: 1) age of onset of sexual activity, 2) multiple sexual partners, 3) socioeconomic status and 4) system immune weaken ed. In Mexico, until this study itisnull qualitative research in Mexican women with HPV. Objectives: Identify the DSS in Mexican women with HPV through a qualitative research. Material and Methods: a descriptive qualitative design was carried out. The population consisted of 1800 women with HPV treated in an outpatient tertiary hospital. Of this total only 9 women were selected for in-depth interview using the Minayo saturation method. Method of saturation, units of meaning, categories, and subcategories were obtained. Results: five categories of SDH (1. Behavioral determinants, 2.Income and economic situation, 3.Health education, 4.Lifestyles, and 5. Health services) were identified. Nine subcategories were obtained by the saturation method. The categories with higher saturation were: behavioral determinants (subcategories: relationship and sex) and income and economic situation (subcategories: financial support and personal income couples)...
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