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1.
Artigo em Inglês | MEDLINE | ID: mdl-36078490

RESUMO

We aimed to evaluate the feasibility of a tailored physical activity (PA) prescription in overweight and obese people in a tertiary hospital in Lima, Peru. A feasibility pre-post-pilot study was conducted using mixed methods. Participants received a tailored prescription scheme for PA that lasted twelve weeks. It included two prescription sessions, three follow-up phone calls, and three evaluations. Primary feasibility outcomes were recruitment, visits, and phone call adherence. Primary intervention outcomes were self-reported PA levels and the 6 min walk test. Out of 228 people invited to participate, 30 were enrolled and received the first session of prescription, 11 went to the second session, and 21 went to the final evaluation; phone call participation decreased progressively during follow-up. There were no differences in the 6th week and the 12th week compared to the baseline for all the measures, except in the 6 min walk test. The participants considered the intervention was well designed, but they suggested complementing it with dietary instructions. The prescription of PA in overweight and obese people is feasible for promoting PA, but its implementation requires refinements to anticipate possible barriers to changing behavior.


Assuntos
Obesidade , Sobrepeso , Exercício Físico , Estudos de Viabilidade , Hospitais Públicos , Humanos , Projetos Piloto , Prescrições
2.
Rev. Cuerpo Méd. Hosp. Nac. Almanzor Aguinaga Asenjo ; 14(4): 438-446, Dic. 29, 2021. tab, graf
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1376246

RESUMO

RESUMEN Introducción: Las tecnologías de información y comunicación pueden ayudarnos a mejorar el control metabólico y la adherencia de las personas con diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de una intervención con llamadas telefónicas en pacientes ambulatorios con DM2 mal controlada de un hospital en Perú. Métodos: Ensayo clínico aleatorizado. Incluimos adultos con DM2 con mal control glicémico (HbA1c > 7%), quienes fueron aleatorizados al grupo control (cuidado usual) o al grupo intervención (cuidado usual más una intervención con llamadas telefónicas cada dos semanas por tres meses). El desenlace principal fue la reducción ≥ 1% de hemoglobina glicosilada a los tres meses. Resultados: Se reclutó 94 participantes (47 en cada grupo). La edad promedio fue 59,8 años (DE: 10,2), 69,2 % fueron mujeres. A los tres meses, solo 14/47 participantes del grupo control y 13/47 participantes del grupo intervención tuvieron medición de HbA1c. Entre estos, el porcentaje de los que lograron una disminución ≥ 1% de HbA1c fue de 35,7% (5/14) en el grupo control y 53,8% (7/13) en el grupo intervención (RR: 0,72, IC 95%: 0,35-1,47). No se encontró diferencias en la adherencia al tratamiento entre ambos grupos. Conclusiones: No se encontró diferencias estadísticamente significativas para los desenlaces de interés. Posiblemente esto se deba al bajo porcentaje de participantes a los que se logró completar el seguimiento.


ABSTRACT Introduction: Information and communication technologies can help us improve metabolic control and adherence in people with type 2 diabetes mellitus (DM2). Objective: To evaluate the effects of an intervention with telephone calls in outpatients with poorly controlled DM2 in a hospital in Peru. Methods: Randomized clinical trial. We included adults with DM2 with poor glycemic control, who were randomized to the control group (usual care) or to the intervention group (usual care plus a telephone intervention every two weeks for three months). The primary outcome was a ≥ 1% reduction in glycosylated hemoglobin at three months. Results: 94 participants were recruited (47 in each group). Mean age was 59.8 years (SD: 10.2), 69.2 % were women. At three months, only 14/47 participants in the control group and 13/47 participants in the intervention group had HbA1c measurement. Among these, the percentage of those who achieved a ≥ 1% decrease in HbA1c was 35,7% (5/14) in the control group and 53,8% (7/13) in the intervention group (RR: 0,72, 95% CI: 0,35-1,47). No differences were found in adherence to treatment between groups. Conclusions: No statistically significant differences were found for the outcomes of interest. This is possibly due to the low percentage of participants who were able to complete follow-up. Innovative solutions are needed to improve the control of people with DM2.

3.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1357574

RESUMO

Introducción: Las tecnologías de información y comunicación pueden ayudarnos a mejorar el control metabólico y la adherencia de las personas con diabetes mellitus tipo 2 (DM2). Objetivo: Evaluar los efectos de una intervención con llamadas telefónicas en pacientes ambulatorios con DM2 mal controlada de un hospital en Perú. Material y Métodos: Ensayo clínico aleatorizado. Incluimos adultos con DM2 con mal control glicémico (HbA1c > 7%), quienes fueron aleatorizados al grupo control (cuidado usual) o al grupo intervención (cuidado usual más una intervención con llamadas telefónicas cada dos semanas por tres meses). El desenlace principal fue la reducción ≥ 1% de hemoglobina glicosilada a los tres meses. Resultados: Se reclutó 94 participantes (47 en cada grupo). La edad promedio fue 59,8 años (DE: 10,2), 69,2 % fueron mujeres. A los tres meses, solo 14/47 participantes del grupo control y 13/47 participantes del grupo intervención tuvieron medición de HbA1c. Entre estos, el porcentaje de los que lograron una disminución ≥ 1% de HbA1c fue de 35,7% (5/14) en el grupo control y 53,8% (7/13) en el grupo intervención (RR: 0,72, IC 95%: 0,35-1,47). No se encontró diferencias en la adherencia al tratamiento entre ambos grupos. Conclusiones: No se encontró diferencias estadísticamente significativas para los desenlaces de interés. Posiblemente esto se deba al bajo porcentaje de participantes a los que se logró completar el seguimiento.


Introduction: Information and communication technologies can help us improve metabolic control and adherence in people with type 2 diabetes mellitus (DM2). Objective: To evaluate the effects of an intervention with telephone calls in outpatients with poorly controlled DM2 in a hospital in Peru. Material and Methods: Randomized clinical trial. We included adults with DM2 with poor glycemic control, who were randomized to the control group (usual care) or to the intervention group (usual care plus a telephone intervention every two weeks for three months). The primary outcome was a ≥ 1% reduction in glycosylated hemoglobin at three months. Results: 94 participants were recruited (47 in each group). Mean age was 59.8 years (SD: 10.2), 69.2 % were women. At three months, only 14/47 participants in the control group and 13/47 participants in the intervention group had HbA1c measurement. Among these, the percentage of those who achieved a ≥ 1% decrease in HbA1c was 35,7% (5/14) in the control group and 53,8% (7/13) in the intervention group (RR: 0,72, 95% CI: 0,35-1,47). No differences were found in adherence to treatment between groups. Conclusions: No statistically significant differences were found for the outcomes of interest. This is possibly due to the low percentage of participants who were able to complete follow-up. Innovative solutions are needed to improve the control of people with DM2.

4.
J Infect Dev Ctries ; 15(3): 428-435, 2021 03 31.
Artigo em Inglês | MEDLINE | ID: mdl-33839719

RESUMO

INTRODUCTION: We explore the limitations to adherence of hand-washing and evaluate the impact of a mHealth intervention for hand hygiene in residents. METHODOLOGY: We explore resident's perspectives about Hospital-acquired infections (HAI) and hand washing. In baseline, participants completed socio-demographic characteristics and hand-washing habits survey. The intervention consisted of sending SMS three times a week for two months about hand hygiene and "five moments" for hand washing. The cultures of hands and cell phones were analyzed at baseline, 2 months and 4 months. We used chi-square and adjusted Generalized Estimating Equations. RESULTS: Five physicians were interviewed and 33 participants were included for quantitative analysis. Critical barriers that hinder hand washing were identified. The proportion of Staphylococcus aureus in hands was 54.5% at baseline and was significantly reduced at 2 months follow-up (p = 0.009), but, benefit was lost when the intervention was discontinued; Escherichia coli and Klebsiella sp. were observed in 22.2% of hands, no changes were noted with intervention. In cell phones, there was a tendency to lower values of bacterial colonization after intervention for Staphylococcus aureus growth. CONCLUSIONS: High prevalence of contamination in hands and phones in medical residents were found. Serious barriers to compliance with hand washing must be overcome. It is possible that prolonged or continuous interventions could be necessary to optimize hand washing and reduce hand and cell phones contamination.


Assuntos
Telefone Celular , Desinfecção das Mãos , Promoção da Saúde/organização & administração , Internato e Residência , Adulto , Infecção Hospitalar/epidemiologia , Escherichia coli/isolamento & purificação , Feminino , Hospitais Públicos , Humanos , Klebsiella/isolamento & purificação , Masculino , Peru , Prevalência , Staphylococcus aureus/isolamento & purificação , Inquéritos e Questionários
5.
Acta méd. peru ; 36(2): 96-103, abr.-jun. 2019. ilus, tab
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1054736

RESUMO

Objetivo. Evaluar si el nivel de conocimiento sobre la diabetes mellitus 2 (DM2) se asocia con adherencia al tratamiento. Materiales y métodos. Se determinó el nivel de conocimientos sobre la enfermedad en pacientes con DM2 por medio del Diabetes Knowledge Questionnaire (DKQ-24) y se evaluó si existía asociación con adherencia al tratamiento, medida por la prueba de Morisky-Green-Levine (MGL). Se tomó una muestra consecutiva de 210 pacientes. Resultados. El conocimiento sobre DM2 fue considerado adecuado en el 78,1% de los pacientes y se verificó que el 25,7% de ellos estaban adheridos al tratamiento farmacológico. Se halló asociación positiva entre adherencia y conocimientos (OR: 1,12; IC 95%:1,01-1,25) y edad > 65 años (OR: 1,14; IC 95%: 1,03-1,28). Además, se halló una diferencia significativa entre las medias de los puntajes obtenidos entre adherentes versus no adherentes (15,3 vs 16,37; p<0,05). La adherencia al tratamiento de diabetes en nuestro estudio fue de 25%. Conclusiones. Existe asociación de la adherencia al tratamiento con las variables conocimiento adecuado y edad > 65 años. Existen resultados mixtos (no significancia bivariada y sí multivariada) respecto a nivel educativo secundario o superior y procedencia rural de los pacientes; lo que indica que se requieren realizar mayores estudios al respecto.


Objective: To assess whether knowledge about type II diabetes mellitus (T2DM) is associated with adherence to therapy. Materials and Methods: Knowledge about T2DM was assessed by using the Diabetes Knowledge Questionnaire (DKQ-24), and it was determined whether there was an association with adherence to treatment, which was measured using the Morisky-Green-Levine Test (MGL). A consecutive sample including 210 patients was taken. Results: Knowledge about T2DM was considered adequate in 78.1% of patients and it was verified that 25.7% of them were adherent to pharmacological treatment. A positive association between knowledge and adherence was found (OR= 1.12, 95% IC: 1.01-1.25), as well as for age >65 years old (OR: 1.14; 95% IC: 1.03-1.28). Also, a significant difference was found between mean scores obtained when adherent versus non-adherent subjects were compared (15.3 vs. 16.37; p<0.05). Adherence to diabetes treatment in our study was 25%. Conclusions: Factors associated with better adherence to therapy were knowledge level and being more of 65 years old. There are some mixed results (no bivariate significance, presence of multivariate significance) with respect to having gone to high school or college, and for having come from a rural area. Our findings indicate further studies need to be performed.

6.
Acta méd. peru ; 35(1): 51-54, ene. 2018.
Artigo em Espanhol | LILACS-Express | LILACS | ID: biblio-1010885

RESUMO

La enfermedad cerebro vascular (ECV) es una de las principales causas de mortalidad y discapacidad global. En países de ingresos bajos y medianos representa una situación crítica debido al incremento en su incidencia, discapacidad asociada y alta mortalidad en las últimas décadas. En sistemas de salud como el nuestro, con servicios saturados y una lenta capacidad de respuesta, brindar la atención adecuada y temprana que requieren los pacientes con ECV es una tarea pendiente, pero impostergable. La EVC puede producir hasta 19.7% de mortalidad hospitalaria y, en el seguimiento al año después del primer evento, una mortalidad adicional cercana al 20%. La mitad de los eventos son de una severidad moderada a grave y el sistema de salud tiene capacidad limitada para brindar una terapia de rehabilitación temprana adecuada; en consecuencia, la alteración de la funcionalidad evaluada al año se mantiene inalterada. Alrededor del 90% de eventos se asocian a factores de riesgo modificables donde la prevención es esencial. La ECV es una entidad sobre la que hay mucho esfuerzo por hacer


Stroke is one of the main causes of disability and mortality all over the world. In low- and middle income countries this condition may represent a critical situation because of its increasing incidence, associated disability, and high mortality rates seen in the past few decades. In health care systems such as ours, with saturated services and a slow capacity to respond, giving timely and adequate care to affected patients is a pending and unpostponable task. Stroke may cause up to 19.7% in-hospital mortality, and at one year follow-up after the event, the additional mortality rate may be as high as 20%. Half of the events are moderate to severe, and the health care system has a limited capacity for delivering adequate early rehabilitation therapy; consequently, functional limitations after one year are essentially the same. Nearly 90% of the events are associated to modifiable risk factors where prevention is essential. Stroke is a condition in which there is still plenty of work to be done

7.
Rev. neuropsiquiatr ; 73(2): 52-61, abr.-jun. 2010. tab
Artigo em Espanhol | LILACS, LIPECS | ID: lil-605397

RESUMO

Objetivo: Describir la sintomatología de los trastornos de la conducta alimentaria en una población adolescente de 13 a 17 años de un colegio del distrito de Independencia (Lima, Perú). Métodos: Se planificó aplicar el cuestionario EDI-2 (Eating Disorders Inventoryû2) a una muestra de 200 adolescentes. Sin embargo, luego del proceso de selección y llenado de encuestas, sólo se lograron incluir a 39 individuos. Resultados: De los 39 participantes, 24(62%) fueron mujeres y 15 (38%) varones. La edad promedio fue de 14,6 años (DE= 1,23). El 17,9% tuvo puntajes elevados para la subescala de obsesión por la delgadez, el 17,9% para bulimia y el 28,2% para insatisfacción corporal. Los puntajes de la subescala de obsesión por la delgadez fueron significativamente mayores en mujeres que en hombres (p=0,041). El resto de subescalas tuvieron valores similares en ambos sexos. Conclusiones: Los puntajes obtenidos para obsesión por la delgadez, bulimia e insatisfacción corporal fueron mayores a los descritos por otros autores. No se encontraron diferencias significativas entre géneros, excepto en la subescala de obsesión por la delgadez.


Objective: To describe symptoms of eating disorders in a teenage population between the ages of 13 and 17, froma school in the Independencia district (Lima, Perú). Methods: We planned to administer the EDI-2 (Eating Disorders Inventoryû2) to 200 teenagers; however after the selection process only 39 subjects remained. Results: Out of the 39 participants, 24 (62%) were females and 15 (38%) males. The mean age was 14.6 years old (SD= 1.23). The percentages of high scores for subscales were: 17.9% for drive for thinness, 17.9% for bulimia and 28.2% for body dissatisfaction. Also, the statistic analysis revealed no significant differences between genders for the subscales, except for drive for thinness (p=0.041). Conclusions: The percentage of high scores obtained for drive for thinness, bulimia and body dissatisfaction where higher than those described by other authors. No significant differences between genders were found, except in the drive for thinness subscale.


Assuntos
Humanos , Masculino , Feminino , Adolescente , Anorexia , Bulimia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia
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