Propuesta teórica para tratar los aspectos conductuales de la incontinencia urinaria.

Theoretical model for treating behavioural aspects of urinary incontinence SINOPSIS This reflective article presents a theoretical model of behavioural evaluation and intervention for women with urinary incontinence. Nola Pender's health promotion model (HPM) was used as a reference to develop this proposal. Behavioural measures were identified to build the model: constipation control, bladder training, urination position, reduction of irritating drinks, water intake, and pelvic floor muscle training. Next, specific actions were defined to investigate and intervene on certain behavioural aspects: previous related behaviour, personal factors, benefits, and obstacles regarding the proposed action, perceived self-efficacy, feelings related to the expected behaviour and the proposed action, interpersonal and situational influences, commitment to the action plan, competitive demands, and health promotion behaviour. The model proposed by the authors could help nurses to guide the conversation between them and the patient to modify certain behavioural aspects, to develop an achievable plan and, thus, enhance the achievement of the goals established for the treatment of urinary incontinence.

Sinopsis Este artículo de reflexión presenta un modelo teórico de evaluación e intervención conductual para mujeres con incontinencia urinaria (IU). El Modelo de Promoción de Salud de Nola Pender, enfermera estadounidense, fue usado como referencia para desarrollar la propuesta. Se identificaron medidas conductuales para construir el modelo: control del estreñimiento, entrenamiento vesical, posición para orinar, reducción de bebidas irritantes, ingesta de agua, y entrenamiento muscular del suelo pélvico. Luego, se definieron acciones determinadas para investigar e intervenir sobre ciertos aspectos conductuales: comportamiento previo relacionado, factores personales, beneficios y obstáculos percibidos acerca de la acción propuesta, autoeficacia percibida, sentimientos relacionados con el comportamiento esperado y la acción propuesta, influencias interpersonales y situacionales, compromiso con el plan de acción, exigencias competitivas, y comportamiento de la promoción de la salud. El modelo propuesto por los autores podría ayudar a enfermeros y enfermeras a orientar la conversación entre ellos y el paciente para modificar determinados aspectos conductuales, con el fin de elaborar un plan alcanzable y, así, potenciar el logro de las metas establecidas para el tratamiento de la IU.

[Analysis of the situation, evaluation and improvement proposals of the Preventive Activities and Health Promotion Program (PAPPS)]. / Análisis de la situación, evaluación y propuestas de mejora del Programa de Actividades Preventivas y de Promoción de la Salud (PAPPS).

OBJECTIVE: To analyze the situation, evaluation and proposals for improvement of the Preventive Activities and Health Promotion Program (PAPPS). MATERIAL AND METHODS: A qualitative study of situation analysis was carried out for the evaluation of the PAPPS in 2 phases: 1) Generation of ideas and collection of information through a DAFO matrix, using 2 types of criteria: internal (strengths and weaknesses), and external (threats and opportunities); 2) Prioritization of the improvement proposals collected. Selection of participants: Key informants were identified taking into account their relationship and knowledge of the PAPPS program. All members of the PAPPS, expert groups and members with past participation were included, as well as the coordinators, including the autonomous leaders of the PAPPS. Two invitations to participate in the study were sent: the first from December 29, 2017 to February 11, 2018, and the second from January 10 to 23, 2019. The information was obtained from a questionnaire designed to be self-completed. RESULTS AND CONCLUSIONS: A total of 73 subjects answered the questionnaire. 35% of the participants were members of the PAPPS working groups, followed by family doctors from other areas, with 20.5%. The order of prioritization of the improvement proposals was as follows: 1) Unify recommendations with other semFYC working groups; 2) Prepare lists with "Recommendations not to do" from the point of view of prevention; 3) Incorporate PAPPS in the political agenda; 4) Greater coordination and interaction between groups with common competences; 5) Teaching in undergraduate and teaching units; 6) Review, update and dissemination of the program in Primary Care.

[Attitudes of physicians and nurses towards health prevention and promotion activities in Primary Care]. / Actitudes de médicos y enfermeras ante las actividades preventivas y de promoción en atención primaria.

OBJECTIVE: To determine the attitudes of physicians and registered nurses in the Andalusian Public Health System towards preventive and health promotion (PHP) interventions in the context of Primary Health Care and the relationship with occupational variables and self-reported competence in PHP. DESIGN: Multicenter, observational, descriptive study. LOCATION: Primary Health Care (PHC), Andalusia, Spain. PARTICIPANTS: A total of 282 professionals (physicians and nurses) from 22 Healthcare centers of the Andalusian public health system and who participated in the validation of CAPPAP were included. PRINCIPAL MEASUREMENTS: The attitude of physicians and registered nurses towards PHP activities consisted of five dimensions: improvements necessary, perception of peers attitude, importance, obstacles, and improvement opportunities. The validated CAPPAP questionnaire was used. Occupational variables and questions about self-reported competence in PHP were also included. RESULTS: All dimensions of CAPPAP exceeded the midpoint of the scale (2.5), with their values varying between 3.06 (SD: 0.76) in "improvement necessary", and 4.39 (SD: 0.49) in "importance". The self-declared social, occupational, and competences variables have a statistically significant relationship with the dimensions of the attitude of the professionals except: job experience in PHC, training and implementation of scheduled PHP activities. CONCLUSIONS: The attitudes of physicians and registered nurses towards PHP activities are acceptable, and work must be done to sustain it. Healthcare organizations should implement interventions adapted to different professional profiles. They should also increase activities to improve professional skills in order to provide the appropriate care.

[How to design workshops to promote health in community groups]. / Cómo diseñar talleres para promover la salud en grupos comunitarios.

One of the strategies of health promotion is to develop life skills people considering themselves as the main health resource. A workshop has to get its participants become «asset¼ to make decisions and create health, focusing on the development and acquisition of skills in a motivating group and in order to achieve health objectives. The concepts behind the design of a workshop are: participatory planning, training, meaningful learning, group learning and participatory techniques. The steps to follow to design a workshop and facilitate their application are: Stage 0, founding; initial stage, host and initial evaluation; central or construction stage based learning in the acquisition of knowledge, attitudes and skills, and final stage or evaluation.

[Design and validation of a questionnaire on attitudes to prevention and health promotion in primary care (CAPPAP)]. / Diseño y validación de un cuestionario sobre las actitudes ante la prevención y promoción de la salud en atención primaria (CAPPAP).

OBJECTIVE: To develop and validate a questionnaire to measure attitudes towards prevention and health promotion. DESIGN: Cross-sectional study for the validation of a questionnaire. LOCATION: Primary Health Care (autonomous community of Andalusia, Spain). PARTICIPANTS: 282 professionals (nurses and doctors) belonging to the Public Health System. MAIN MEASUREMENTS: Content validation by experts, ceiling effects and floor effects, correlation between items, internal consistency, stability and exploratory factor analysis. RESULTS: The 56 items of the tool (CAPPAP) obtained, including those from the review of other tools and the contributions of the experts, were grouped into 5 dimensions. The percentage of expert agreement was over 70% on all items, and a high concordance between prevention and promotion item was obtained, thus, duplicates were removed leaving a final tool with 44 items. The internal consistency, measured by Cronbach's alpha, was 0.888. The test retest indicated concordance from substantial to almost perfect. Exploratory factor analysis identified five factors that accounted for 48.92% of the variance. CONCLUSIONS: CAPPAP is a tool that is quick and easy to administer, that is well accepted by professionals, and that has acceptable psychometric results, both globally and at the level of each dimension.

Creation and validation of an instrument to quantify attitudes, knowledge and difficulties in the approach to social problems.

OBJECTIVES: The aim of the study was to develop and validate a questionnaire to assess attitudes, knowledge and difficulties in the management of social problems by paediatric care providers. METHODS: The development of the tool started with a conceptualization phase, followed by the design, pilot testing and psychometric evaluation of the questionnaire based on the responses obtained from 407 professionals. We performed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity of the questionnaire. We used the normed fit index (NFI), the root mean square error of approximation (RMSEA), the χ2 test and the comparative fit index (CFI) to test the goodness of fit. We assessed reliability through the Cronbach's α coefficient of internal consistency. All quantitative analyses were performed with the Stata/SE software, version16.1. RESULTS: The EFA identified twelve factors. All factors exhibited a good internal consistency (Cronbach's α, 0.8434). The CFA showed the model was a good fit (RMSEA=0.037). The NAI and CAI values were 0.742 and 0.797, respectively. CONCLUSIONS: This questionnaire comprising 138 items distributed in twelve factors is a reliable and valid instrument to analyse the attitudes, knowledge and difficulties in the approach to social problems in children by paediatricians, which will allow the design of interventions according to the needs and deficiencies identified through it.

Knowledge and beliefs about dementia among the general public: A preliminary report on the Cuban population.

BACKGROUND: The number of people diagnosed with dementia globally has dramatically increased in recent years. The objective of this study was to explore beliefs and knowledge among the Cuban population with regard to the risk factors that may lead to dementia and the actions that may be taken to prevent it. METHOD: In an exploratory cross-sectional study, we surveyed a total of 391 people aged between 18 and 96 years. The results were stratified by sex, age range, level of education, and contact with dementia. RESULTS: Dementia was the fourth most worrying disease. A total of 64.5% of participants believed that the risk of dementia could be reduced, and 60% that the appropriate time to begin prevention measures is after the age of 40. Cognitive stimulation and healthy diet were more frequently cited as useful activities to reduce risk. Survey respondents reported little presence in their lifestyle of behaviours that are beneficial for reducing the risk of dementia. CONCLUSIONS: Although dementia is an important health issue for respondents, their knowledge about disease prevention is still insufficient. The results obtained constitute a starting point for the design of policies aimed at increasing knowledge about the disease and improving prevention.

[The demedicalisation of women's daily lives: socio-educational groups in the Andalusian Public Health System]. / La desmedicalización de la vida cotidiana de las mujeres: los grupos socioeducativos en el Sistema Sanitario Público Andaluz.

The socio-educational groups (GRUSE) are a health and emotional well-being promotion strategy, from an asset-based positive health approach. They principally target women who attend health centres with signs of discomfort with no organic basis finding. The strategy was evaluated through a quasi-experimental longitudinal design, with a mixed methodology. Information was collected from 228 women with a battery of scales and from an analysis of health system databases. Ten in-depth interviews with women were conducted, and 3 discussion groups with professionals. The aim of this article was to introduce the GRUSE strategy as a non-medical alternative intervention and to present the research design, seeking to identify the evidence of this practice implemented in primary health centres of Andalusia (Spain).

Modificación de conocimientos contra tabaquismo en fumadores activos desde la atención primaria de salud

Fundamento: el conocimiento y las convicciones en relación con el tabaco guardan relación, según se ha demostrado, con la conducta respecto al hábito tóxico. Objetivo: modificar los conocimientos sobre el tabaquismo en fumadores activos de un consultorio médico de la familia. Métodos: se realizó una intervención educativa en los 85 pacientes fumadores activos, pertenecientes al consultorio médico No. 4 del Policlínico Universitario "Ramón López Peña" de Santiago de Cuba, entre julio 2022-enero 2023. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético e inductivo-deductivo para la recogida de información y fundamentación de la investigación; del nivel empírico: el cuestionario y la observación. Resultados: se evidenció que antes de la intervención educativa, la mayoría de los pacientes tenían conocimientos inadecuados en los dominios: factores de riesgo, conducta a seguir y prevención; resultados que fueron modificados después de la intervención. Conclusiones: se logró una mejoría significativa de los indicadores de conocimientos evaluados.

Background: knowledge and beliefs regarding tobacco are related, as has been demonstrated, to behavior regarding the toxic habit. Objective: to modify knowledge about smoking in active smokers in a family doctor's office. Methods: an educational intervention was carried out on 85 active smoking patients, belonging to doctor´s office No. 4 from "Ramón López Peña" University Polyclinic of Santiago de Cuba, from July 2022 to January 2023. Theoretical methods were used: historical-logical, analytical-synthetic and inductive-deductive for the collection of information and foundation of the research; from the empirical level: the questionnaire and observation. Results: it was evident that before the educational intervention, the majority of patients had inadequate knowledge in the variables: risk factors, behavior to follow and prevention; results that were modified after the intervention. Conclusions: a meaningful improvement was achieved in the knowledge indicators evaluated.

La categoría bienestar psicológico y su importancia en la práctica asistencial: una revisión semisistemática / The psychological well-being category and its importance in healthcare practice: a semi-systematic review / The psychological well-being category and its importance in healthcare practice: a semi-systematic review / A categoria bem-estar psicológico e sua importância na prática assistencial: uma revisão semisistemática

Introducción: El bienestar psicológico es una categoría fundamental en el desempeño del personal asistencial, pues contribuye tanto a mejorar la atención integral al mismo como a sustentar su actuación profesional. Objetivo: Explorar las principales tendencias de conceptualización y líneas temáticas en el desarrollo de la categoría bienestar psicológico. Método: Se condujo un estudio con diseño de revisión semisistemática, que permitió la selección de un total de 30 artículos, su procesamiento y establecimiento de tópicos fundamentales en un espacio temporal de cuatro décadas. Resultados: Los principales resultados alcanzados sugieren que se ha producido un proceso de especialización en el estudio del bienestar psicológico, los enfoques y escuelas psicológicas dirigidos a su estudio se han consolidado y los principales cambios se manifiestan en la relación entre variables y el compromiso con la promoción de la salud mental. Conclusiones: La categoría estudiada ha ganado en relevancia en la literatura, con predominio de posiciones positivistas y estudios dirigidos a grandes poblaciones, sin que se aprecie profundidad en los aspectos profesionales de su observación por parte del personal asistencial. Se concluye en la necesidad de estudios mixtos que atiendan a la singularidad de los contextos y las necesidades de especialistas de la salud, pacientes y familiares.(AU)

Introduction: Psychological well-being is a fundamental category in the performance of healthcare personnel, as it contributes both to improving their comprehensive care and to supporting their professional performance. Objective: To explore the main conceptualization trends and thematic lines in the development of the psychological well-being category. Method: A study was conducted, with a semi-systematic review design, which allowed the selection of a total of 30 articles, their processing and fundamental topics ranging in a time period of four decades. Results: The main results achieved suggest that a specialization process has occurred in the study of psychological well-being, the psychological approaches and schools aimed at its study have been consolidated and the main changes are manifested in the relationship between variables and the commitment to mental health promotion. Conclusions: The category studied has gained relevance in the literature, with a predominance of positivist positions and studies aimed at large populations, without any depth being appreciated in the professional aspects of its observation by healthcare personnel. It is concluded that there is a need for mixed studies that address the uniqueness of the contexts and the needs of health specialists, patients and families.(AU)

Introdução: O bem-estar psicológico é uma categoria fundamental na atuação do pessoal de saúde, pois contribui tanto para melhorar o seu cuidado integral como para apoiar o seu desempenho profissional. Objetivo: Explorar as principais tendências de conceituação e linhas temáticas no desenvolvimento da categoria bem-estar psicológico. Método: Foi realizado um estudo com desenho de revisão semisistemática, que permitiu a seleção de um total de 30 artigos, seu processamento e estabelecimento de temas fundamentais em um período de quatro décadas. Resultados: Os principais resultados alcançados sugerem que ocorreu um processo de especialização no estudo do bem-estar psicológico, as abordagens psicológicas e as escolas voltadas para o seu estudo foram consolidadas e as principais mudanças se manifestam na relação entre as variáveis e no comprometimento com a promoção de saúde. Conclusões: A categoria estudada tem ganhado relevância na literatura, com predominância de posicionamentos positivistas e estudos voltados para grandes populações, sem que se aprecie qualquer aprofundamento nos aspectos profissionais de sua observação pelos profissionais de saúde. Conclui-se que há necessidade de estudos mistos que abordem a singularidade dos contextos e as necessidades dos especialistas em saúde, pacientes e familiares.(AU)

Estratégias de educação alimentar e nutricional em um grupo intergeracional: um relato de experiência / Food and nutrition education strategies in an intergenerational group: an experience report / Estrategias de educación alimentaria y nutricional en un grupo intergeneracional: un reporte de experiencia

O Brasil vive uma transição demográfica que favorece o aparecimento e desenvolvimento de doenças crônicas não transmissíveis (DCNT). Em um cenário em que as DCNT estão entre as principais causas de mortes, reforçar a importância de uma alimentação saudável é imprescindível, e medidas preventivas tomam lugar de destaque. Pensando nisso, foram realizadas 11 intervenções de educação alimentar e nutricional em um grupo de atividade física intergeracional, com o objetivo de promover autonomia alimentar. O estudo contou com 25 participantes, na faixa etária de 37 a 83 anos, sendo a maior incidência de 61 a 69 anos (n=12) e predominância de pessoas do gênero feminino (92%). Os parâmetros para avaliar o grupo foram os feedbacks das(os) participantes e o grau de adesão, no qual houve aumento significativo ao longo do período interventivo. Destaca-se a importância de ampliar a abordagem dos hábitos alimentares saudáveis em diversos ambientes, sendo os grupos de atividades físicas um campo fértil, que requer a adaptação da linguagem e formato das atividades, considerando o nível de escolaridade das(os) participantes. Assim, a educação alimentar e nutricional pode ser usada como ferramenta efetiva para a promoção da saúde, a prevenção e o tratamento de DCNT.

Brazil is undergoing a demographic transition that favors the onset and development of chronic non-communicable diseases (NCDs). In a scenario where NCDs feature among the main causes of death, reinforcing the importance of healthy eating is essential and preventive measures should take place. Consequently, eleven Food and Nutritional Education interventions were conducted with an intergenerational physical activity group to promote food autonomy. A total of 25 individuals aged 37 to 83 years participated in the study, with the highest prevalence of 61 to 69 years (n=12) and women (92%). Evaluation parameters were participant feedback and the degree of adherence, which increased significantly over the interventional period. Results highlight the importance of broadening the approach to healthy eating habits in various environments, with physical activity groups being a fertile setting which requires adapting language and the format of activities according to participants' schooling level. Nutritional Food Education can be used as an effective tool for health promotion, prevention and treatment of NCDs.

Brasil vive una transición demográfica que favorece la aparición y desarrollo de enfermedades crónicas no transmisibles (ECNT). En un escenario en que entre las principales causas de muerte están las ECNT, se hace imprescindible reforzar la importancia de una alimentación saludable; para ello se destacan las medidas preventivas. Así, se realizaron 11 intervenciones de educación alimentaria y nutricional en un grupo de actividad física intergeneracional, con el objetivo de promover la autonomía alimentaria. Este estudio contó con una muestra de 25 participantes, en la franja etaria de 37 a 83 años, siendo la mayor prevalencia de los de entre 61 y 69 años (n=12), y predominancia de personas del género femenino (92%). Los parámetros que evalúan al grupo fueron las respuestas de las(los) participantes y el grado de adhesión, en el cual hubo un aumento significativo a lo largo de la intervención. Se destaca la importancia de ampliar el foco en los hábitos alimentarios saludables en diversos ambientes, y los grupos de actividades físicas son un campo fértil que requiere la adaptación del lenguaje y el formato de las actividades, considerando el nivel de escolaridad de las(los) participantes. Así, la educación alimentaria nutricional puede ser utilizada como herramienta efectiva para la promoción de la salud, la prevención y el tratamiento de las ECNT.

Afecciones bucales y nivel de información de niños de primer grado, padres y personal docente / Oral diseases and level of information of first -grade children, parents and teaching personnel

Introducción: Las afecciones bucales se incrementan con la edad, y su resolución implica un costo elevado no solo a nivel presupuestario, sino también en cuanto a calidad de vida se refiere, lo cual motiva a buscar soluciones a través de políticas de salud que implementen planes especialmente diseñados a tal efecto. Objetivo: Determinar las afecciones bucales de los escolares de primer grado de la escuela «13 de Marzo», del municipio Santa Clara, así como el nivel de información de los niños, padres y personal docente. Métodos: Se realizó una investigación con metodología mixta, en el período comprendido entre marzo de 2017 y septiembre de 2018. Se trabajó en dos etapas y se utilizaron métodos e instrumentos para la obtención de la información, entre los que se destacaron la observación y las entrevistas. La muestra, conformada por 57 infantes, igual cantidad de padres y cuatro docentes, fue seleccionada de manera intencional por criterios. Se realizaron entrevistas, observación, lluvia de ideas, priorización de problemas por método de ranqueo, así como la triangulación de los resultados. Resultados: Presencia de afecciones en más del 80 % de la muestra, donde sobresalen las maloclusiones en mayor porciento que las caries; un nivel de información sobre salud bucodental inadecuado en los individuos estudiados; ausencia de actividades relacionadas con la promoción y educación para la salud bucal; así como la no existencia de áreas de juego relacionadas con este tema, ni cepilleros en la escuela. Conclusiones: Los niños, padres y personal docente mostraron un nivel de información sobre salud bucal insuficiente, y las maloclusiones resultaron ser la afección más frecuente encontrada.

Introduction: oral diseases increase with age, and their resolution implies a high cost not only at the budget level but also in terms of quality of life, which motivates the search for solutions through health policies that implement plans especially designed for this purpose. Objective: to determine oral diseases in first- grade students from "13 de Marzo" school in Santa Clara municipality, as well as the level of information of these children, their parents and teaching personnel. Methods: a mixed- method research was conducted between March 2017 and September 2018. It was carried out in two stages; methods and instruments were used to obtain the information, among which observation and interviews stand out. The sample made up of 57 infants, the same number of parents and 4 teachers was intentionally selected by criteria. We carried out interviews, observation, brainstorming, ranking method for prioritizing problems and triangulation of results. Results: presence of oral diseases in more than 80% of the sample where malocclusions stand out in a greater percentage than caries; an inadequate level of information on oral health in the studied individuals; absence of activities related to the promotion and education for oral health, as well as non-existence of play areas related to this subject, or brushing areas in the school. Conclusions: the children, parents and teaching personnel showed an insufficient level of information on oral health, and malocclusions were the most common condition found.

Analysis of 15 years of emergency service interaction with schools. / Análisis de una experiencia de 15 años de interacción entre urgencias y la comunidad educativa.

EN: For 15 years without interruption, the emergency department of the Hospital Clínic de Barcelona has been holding annual educational sessions for students in their last year of obligatory secondary school. The sessions are organized in collaboration with 3 other entities: the primary care center affiliated with the hospital and serving the area and adjacent to it (THE CAPSBE), the city's emergency ambulance service, and the University of Barcelona. Each year the session lasts 4 hours and covers such content as the organization of the city's emergency medical care (at primary care centers, in prehospital settings, and at the hospital) and the main reasons adolescents require emergency care (related to drugs, traffic accidents, psychiatric disorders, eating disorders, and gynecologic problems). The project seeks to develop the students' sense of social responsibility and to transfer knowledge to the community where the organizers carry out their usual work. The sessions are educational, providing key information intended to encourage individual reflection as well as debate in the student community outside of school hours. A total of 56 secondary schools and 12 260 students between the ages of 15 and 18 years old have participated thus far. This article presents a basic outline of the sessions, reports feedback from the students and their teachers, and analyzes whether there have been significant changes in their opinions over time. Our purpose is to provide information useful to other emergency health services that might consider starting similar programs in which they can interact with their community schools.

ES: Desde hace 15 años, el Área de Urgencias del Hospital Clínic de Barcelona, en colaboración con CAPSBE (su centro de salud adyacente), el Sistema d'Emergències Mèdiques y la Univesitat de Barcelona, viene realizando ininterrumpidamente unas jornadas anuales dirigidas a alumnos de último curso de enseñanza secundaria obligatoria (ESO), de una duración de 4 horas, y en las que se abordan los aspectos organizativos de la atención médica urgente (en atención primaria, prehospitalaria y hospitalaria) en Barcelona, así como los principales motivos de consulta médica urgente en los adolescentes (drogas, accidentes de tráfico, trastornos psiquiátricos y de conducta alimentaria, y urgencias ginecológicas). La actividad se enmarca dentro del desarrollo de una cultura de responsabilidad social corporativa y de transmisión de conocimiento a la comunidad en la que estos centros sanitarios desarrollan su actividad habitual. Las jornadas tienen una finalidad divulgativa y proporcionan claves que puedan generar tanto la reflexión individual del alumnado como el debate conjunto posterior en la escuela. Durante estos 15 años han participado del curso 56 centros de ESO y 10.260 alumnos de entre 15 y 18 años. El objetivo del presente artículo es recoger los aspectos fundamentales de esta actividad, conocer la opinión de los alumnos y profesores de ESO, y analizar si han existido cambios significativos en estas opiniones durante este periodo de tiempo, con la finalidad de que otros servicios de urgencias puedan plantearse la instauración de actividades similares que les permitan una interacción con la comunidad educativa de su entorno.

Competencias profesionales del Equipo Básico de Salud en prevención de violencia intrafamiliar / Professional competencies of the Basic Health Team in the prevention of intra-family violence

Fundamento: la violencia intrafamiliar representa un problema de salud y los profesionales de estas ciencias deben reconocer su existencia y estar debidamente preparados para prevenirla. Objetivo: identificar el nivel de competencia de los equipos básicos de salud en el manejo contra la violencia intrafamiliar en la edad pediátrica desde la atención primaria de salud. Métodos: se realizó un estudio descriptivo transversal en el Policlínico Universitario "Mártires del 10 de Abril", municipio Corralillo de enero a abril de 2021. Se utilizaron métodos teóricos y empíricos; para recogida de información se empleó el análisis de documentos y examen de competencia a profesionales de salud. Las variables en estudio fueron: categoría ocupacional, años de graduado, dimensiones cognitivas, procedimentales y actitudinales; y competencias profesionales en la prevención contra la violencia intrafamiliar. Resultados: El 52,94 % de los profesionales encuestados tenía más de 5 años de graduados, hubo predominio de residentes de MGI y licenciados en enfermería, respectivamente 44,12 % y 35,29 %. Las dimensiones de competencias en prevención contra la violencia intrafamiliar fueron evaluadas de medianamente adecuadas: la cognitiva en 18 (52,94 %), la procedimental en 21 (61,76 %) y la actitudinal en 24 (70,59 %). Conclusiones: el nivel de desarrollo de competencias profesionales resultó ser medianamente adecuado, como promedio. El diagnóstico realizado evidenció la necesidad de desarrollar competencias profesionales para la prevención contra la violencia intrafamiliar en edad pediátrica.

Background: intra-family violence represents a health problem and professionals in these sciences must recognize its existence and be properly prepared to prevent it. Objective: to identify the level of competence of the basic health team in the management of intra-family violence in the pediatric age. Methods: a cross-sectional descriptive study was carried out at the "Mártires del 10 de Abril" University Polyclinic, Corralillo municipality from January to April 2021. Theoretical and empirical methods were used; For the collection of information, the analysis of documents and the examination of the competence of health professionals were used. The variables under study were: occupational category, years of graduation, cognitive, procedural and attitudinal dimensions; and professional skills in the prevention of intra-family violence. Results: 52.94% of the surveyed professionals had more than 5 years working experience, there was a predominance of comprehensive General Medicine residents and nursing graduates, respectively 44.12% and 35.29%. The dimensions of competencies in intra-family violence prevention were evaluated as moderately adequate: cognitive in 18 (52.94%), procedural in 21 (61.76%), and attitudinal in 24 (70.59%). Conclusions: the level of development of professional skills turned out to be moderately adequate, on average. The diagnosis made showed the need to develop professional skills for the prevention of intra-family violence in children.

Salud y prevención en la preparación del Licenciado en Educación, especialidad Pedagogía-Psicología / Health and prevention in the training of the Bachelor of Education, specialty Pedagogy-Psychology

Fundamento: constituye una necesidad para la educación superior y el sistema cubano de salud fomentar el desarrollo de las habilidades profesionales pedagógicas en los estudiantes universitarios en los diferentes escenarios de la disciplina Educación Física, sustentada en prácticas saludables y estilos de vida sanos. Objetivo: construir un modelo de diseño curricular para la formación de la habilidad profesional de orientación educativa en temas de salud y prevención en los estudiantes de la Licenciatura en Educación, especialidad Pedagogía-Psicología. Métodos: se realizó una investigación con enfoque cualitativo en la sede pedagógica de la Universidad Central "Marta Abreu" de Las Villas durante el periodo 2015-2020 cuyo objeto de estudio fue la formación de las habilidades profesionales pedagógicas en los estudiantes de Pedagogía-Psicología. Para ello se emplearon métodos teóricos y empíricos predominantemente cualitativos. Resultados: se fundamentó el proceso de diseño de un modelo de formación de la habilidad profesional pedagógica de orientación educativa para desarrollar y formar acciones en temas de salud y prevención en los estudiantes universitarios de la carrera Licenciatura en Educación Pedagogía-Psicología. Contiene la determinación de necesidades, un sistema de acciones necesarias para la formación, ofrece recomendaciones metodológicas y finalmente se centra en la evaluación de los resultados una vez ejecutado. Conclusiones: el modelo fue valorado por criterios de expertos con predominio de Muy Adecuado por su pertinencia, factibilidad de aplicación y contribución al objetivo para el cual fue diseñado.

Background: it is a necessity for higher education and the Cuban health system to promote the development of professional pedagogical skills in university students in the different scenarios of the Physical Education discipline, supported by healthy practices and healthy lifestyles. Objective: to build a model of curricular design for the training of the professional skill of educational orientation in health and prevention issues in the students of the Bachelor of Education, specialty Pedagogy-Psychology. Methods: a research within the qualitative approach was carried out at the pedagogical university site of "Marta Abreu" Central University of Las Villas from 2015 to 2020 whose object of study was the training of professional pedagogical skills in Pedagogy-Psychology students. For this, predominantly qualitative theoretical and empirical methods were used. Results: the process of designing a training model for the professional pedagogical skill of educational orientation was based to develop and train actions on health and prevention issues in university students of the Bachelor of Education Pedagogy-Psychology degree. It contains the determination of needs, a system of actions necessary for training, it offers methodological recommendations and finally focuses on the evaluation of the results once implemented. Conclusions: the model was valued by expert criteria with a predominance of Very Adequate for its relevance, feasibility of application and contribution to the objective for which it was designed.

Fundamentos que sustentan la estrategia de superación profesional para la atención médica integral al trabajador / Fundamentals that support the strategy of professional improvement for the comprehensive medical attention to workers

Fundamento: los resultados científicos son los aportes que constituyen productos de la actividad investigativa en la cual se han utilizado procedimientos y métodos científicos; que permiten dar solución a problemas de la práctica o de la teoría. Objetivo: expresar los fundamentos que sustentan de forma teórica y práctica la estrategia de superación profesional para la atención médica integral a la salud del trabajador, en los consultorios médicos de familia del municipio de Santa Clara. Métodos: se realizó un estudio con enfoque cualitativo a partir del diseño de una investigación, de tipo cuasiexperimento en el municipio de Santa Clara, provincia de Villa Clara, en el período comprendido enero-mayo 2019. La información se obtuvo mediante el uso de los siguientes métodos del nivel teórico: analítico-sintético, inductivo-deductivo, histórico-lógico y como empírico: guía para el análisis documental. Resultados: en la conformación de la estructura de la estrategia de superación profesional para la atención médica integral a la salud del trabajador se establecieron un grupo de fundamentos: filosóficos, sociológicos, psicológicos, pedagógicos y de las ciencias de la educación médica, los cuales les ofrecieron un carácter científico, coherencia y organización al producto diseñado. Conclusiones: los fundamentos que sustentan la mencionada estrategia como resultado científico se convirtieron en la base para su estructuración, y aportaron tanto en la teoría como en la práctica, un grupo de regularidades que enriquecen, de forma general, las ciencias de la educación médica.

Background: the scientific results are the contributions that constitute products of the researching activity in which scientific procedures and methods have been used; that allow to solve problems of practice or theory. Objective: to express the fundamentals that theoretically and practically support the professional improvement strategy for comprehensive medical care for worker's health, in family medical offices in the municipality of Santa Clara. Methods: a study with a qualitative approach was carried out based on the design of a quasi-experimental investigation in the municipality of Santa Clara, Villa Clara province, from January to May 2019. The information was obtained through the use of the following theoretical level methods: analytical-synthetic, inductive-deductive, historical-logical and empirical ones: guide for documentary analysis. Results: in the conformation of the structure of the strategy of professional improvement for the comprehensive medical attention to health workers, a group of foundations were established: philosophical, sociological, psychological, pedagogical and of the sciences of medical education, which they offered a scientific character, coherence and organization to the designed product. Conclusions: the foundations that support the aforementioned strategy as a scientific result became the basis for its structuring, and contributed, both in theory and in practice, a group of regularities that enrich, in a general way, the sciences of medical education.

El envejecimiento poblacional: una mirada desde la práctica de enfermería basada en el modelo de Nola J. Pender

El envejecimiento poblacional no es un fenómeno exclusivo de la sociedad moderna; ha estado presente en todas las etapas del desarrollo social y ha sido siempre de interés para la filosofía, el arte y la medicina. Se presenta una revisión bibliográfica, con el objetivo de valorar la aplicación del modelo de Nola J. Pender en la promoción de salud y su aplicabilidad desde su visión teórica en la práctica de enfermería comunitaria en el envejecimiento poblacional. Se analizan los aspectos teóricos expresados por ella, sus principales supuestos y su relación con el envejecimiento poblacional, además de exponer sus aportes teóricos, la importancia de su aplicación para la familia, la comunidad y su contribución al desarrollo de la enfermería no solo de Cuba sino en el mundo; si partimos de que Cuba está entre los países más envejecidos de Latinoamérica. La promoción de la salud motivada por el deseo de aumentar el bienestar y actualizar el potencial humano, es considerada en la actualidad una poderosa herramienta que permite promover actitudes, motivaciones y acciones a partir del concepto de autoeficacia, del compromiso de los individuos con el cambio de conductas para fomentar salud, no solo sobre el envejecimiento en sí, sino desde el envejecimiento. Los principales supuestos de Nola J. Pender en el modelo de promoción de salud la sitúan como marco de referencia en la investigación, al fortalecer la profesión y fundamentar su quehacer de manera objetiva hacia los intereses de los profesionales y las necesidades de las personas.

Population aging is not an exclusive phenomenon of modern society; it has been present in all social development stages and has always been of interest to philosophy, art and medicine. A bibliographical review is presented for evaluating the Nola J. Pender model application in health promotion, and its applicability from its theoretical vision in the community nursing practice in aging population. The theoretical aspects expressed by her, her main assumptions and her relationship with population aging are analyzed, in addition to exposing her theoretical contributions, the importance of her application for the family, the community and her contribution to the development of nursing not only in Cuba but in the world; if we start from the fact that Cuba is among the oldest countries in Latin America. Health promotion motivated by the desire to increase well-being and update human potential is currently considered a powerful tool that allows promoting attitudes, motivations and actions based on the concept of self-efficacy, the commitment of individuals to change of behaviors to promote health, not only about aging itself, but from aging. The main assumptions of Nola J. Pender in the health promotion model place it as a reference framework in research, by strengthening the profession and basing its work objectively on the interests of professionals and the people needs.

Una aplicación web de promoción de salud para capacitación virtual de maestros

La capacitación del personal de los centros de estudio es escasa en el área salud bucal, siendo las TIC herramientas válidas para mejorarla. Objetivo: Diseñar una aplicación web sobre el tratamiento inmediato de las lesiones traumáticas bucales en escolares. Método: Se diseñó un protocolo virtual sobre el tratamiento inmediato a niños frente a una lesión traumática dental. Los contenidos siguen un diseño instruccional con un orden lógico de aparición. Resultados: La aplicación se planificó con analistas en TIC con la exigencia de compatibilidad con navegadores y de seguridad informática y lenguaje de programación PHP - Laravel y el motor de base de datos MySQL. Discusión: Los entornos educativos digitales son objetos o artefactos de naturaleza digital en una escenografía concreta, construida social y culturalmente que favorecen experiencias de aprendizaje valiosas. Conclusiones: Se generó una aplicación web de capacitación fomentando la utilidad de recursos educativos abiertos para la promoción de salud bucal.

A formação da equipe dos centros de estudo é escassa na área de saúde bucal, sendo as ferramentas válidas de TIC para melhorá-la. Objetivo: Elaborar uma aplicação web sobre o tratamento imediato de lesões bucais traumáticas em escolares. Método: Um protocolo virtual foi concebido sobre o tratamento imediato de crianças em face frente a uma lesão dentária traumática. O conteúdo segue um design instrutivo com uma ordem lógica de aparência. Resultados: O aplicativo foi planejado com analistas de TIC com a exigência de compatibilidade com navegadores e segurança de computadores e linguagem de programação PHP - Laravel e o mecanismo de banco de dados MySQL. Discussão: Ambientes educativos digitais são objetos ou artefatos de natureza digital em uma cenografia concreta, social e culturalmente construída que favorece valiosas experiências de aprendizagem. Conclusões: Foi gerado um aplicativo de treinamento web promovendo a utilidade dos recursos educacionais abertos para a promoção da saúde bucal.

Superación del médico general para la atención integral a niños con necesidades educativas especiales / Knowledge improvement of the general practitioner for comprehensive care for children with special educational needs

Fundamento: la superación especializada del médico general integral debe de estar encaminada a elevar su nivel profesional en la atención primaria de salud, particularizando en las características individuales de cada paciente. Objetivo: diagnosticar el estado actual de preparación de los médicos generales de la atención primaria de salud en cuanto al conocimiento para brindar atención integral y especializada a los niños con necesidades educativas especiales, pertenecientes al Policlínico Universitario "Ignacio Agramonte", de Camagüey. Métodos: se realizó un estudio descriptivo transversal entre los meses septiembre-diciembre de 2021. Se aplicaron métodos teóricos: histórico-lógico, análisis-síntesis e inducción-deducción; y empíricos, revisión documental y cuestionario a los médicos que laboran en los consultorios médicos del área. Resultados: el diagnóstico realizado permitió identificar falencias en la formación profesional del médico general desde su programa de formación en la especialidad Medicina General Integral, las que dificultan el trabajo exitoso en cuanto a la atención integral a niños con necesidades especiales, en aras de promover su inclusión social y el beneficio de su desarrollo individual. Conclusiones: las deficiencias encontradas ratifican la necesidad de implementar una estrategia de superación en cuanto al tema para perfeccionar el distintivo trabajo comunitario del médico general integral.

Background: the specialized improvement of the comprehensive general practitioner must be aimed at raising their professional level in primary health care, particularizing the individual characteristics of each patient. Objective: to diagnose the current state of preparation of general practitioners in primary health care in terms of knowledge to provide comprehensive and specialized care to children with special educational needs, belonging to the "Ignacio Agramonte" University Polyclinic in Camagüey. Methods: a cross-sectional descriptive study was carried out between from September to December 2021. Theoretical methods were applied: historical-logical, analysis-synthesis and induction-deduction; and empirical ones, documentary review and questionnaire to the doctors who work in the doctor´s offices of the area. Results: the diagnosis made possible to identify shortcomings in the professional training of the general practitioner from his training program in the Comprehensive General Medicine specialty, which hinder successful work in terms of comprehensive care for children with special needs, in order to promote their social inclusion and the benefit of their individual development. Conclusions: the deficiencies found ratify the need to implement an improvement strategy regarding the subject to improve the distinctive community work of the comprehensive general practitioner.

Effects of balanced diet associated with sports on the health of obese university students / Análise dos efeitos da dieta balanceada associada aos esportes na saúde dos estudantes universitários obesos / Análisis de los efectos de la dieta equilibrada asociada al deporte en la salud de estudiantes universitarios obesos

ABSTRACT Introduction The student, when entering university, is subject to new cycles and major changes in his routine, which includes exercise and nutritious habits. Objective Explore the effect of a balanced diet and physical exercise on the health of university students. Methods Through literature studies, a questionnaire was developed where the physical condition, nutritional habits, dietary structure, and exercise practice of obese college students were investigated and analyzed. Results The BMI index of those investigated exceeded the standard limit of BMI > 25. The longer the time of physical exercise, the more evident the difference between male and female students in terms of physical endurance factor. The body weight, BMI, and body fat index of both groups showed a downward trend after the intervention. Six weeks of aerobic exercise combined with a proper diet can significantly improve body mass index, body mass index, and physiological and biochemical indices of obese college students. Conclusion Balanced diet and exercise positively affect the health of obese college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O estudante, ao ingressar na universidade, está sujeito a novos ciclos e grandes mudanças em sua rotina, que inclui os hábitos de exercício e alimentares. Objetivo Explorar o efeito de uma dieta balanceada e exercícios físicos na saúde de estudantes universitários. Métodos Através de estudos da literatura, elaborou-se um questionário onde foram investigadas e analisadas a condição física, os hábitos alimentares, a estrutura alimentar e a prática de exercícios nos universitários com obesidade. Resultados o índice de IMC dos investigados ultrapassou o limite padrão de IMC > 25. Quanto maior o tempo de exercício físico, mais evidente é a diferença entre estudantes do sexo masculino e feminino no fator da resistência física. O peso corporal, IMC e índice de gordura corporal dos dois grupos apresentaram tendência de queda após a intervenção. Seis semanas de exercícios aeróbicos combinados com dieta razoável podem melhorar significativamente o índice de massa corporal, índice de massa corporal e índices fisiológicos e bioquímicos de estudantes universitários obesos. Conclusão Dieta balanceada e exercício físico possuem um efeito positivo sobre a saúde dos estudantes universitários obesos. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El estudiante, al entrar en la universidad, se ve sometido a nuevos ciclos y a grandes cambios en su rutina, que incluye el ejercicio y los hábitos alimenticios. Objetivo Explorar el efecto de una dieta equilibrada y el ejercicio físico en la salud de los estudiantes universitarios. Métodos A través de estudios bibliográficos, se elaboró un cuestionario en el que se investigó y analizó la condición física, los hábitos alimentarios, la estructura de la dieta y la práctica de ejercicio en estudiantes universitarios con obesidad. Resultados El índice de IMC de los investigados superaba el límite estándar de IMC > 25. Cuanto mayor es el tiempo de ejercicio físico, más evidente es la diferencia entre los alumnos y las alumnas en el factor de resistencia física. El peso corporal, el IMC y el índice de grasa corporal de ambos grupos mostraron una tendencia a disminuir después de la intervención. Seis semanas de ejercicios aeróbicos combinados con una dieta razonable pueden mejorar significativamente el índice de masa corporal, el índice de masa corporal y los índices fisiológicos y bioquímicos de los estudiantes universitarios obesos. Conclusión La dieta equilibrada y el ejercicio tienen un efecto positivo en la salud de los estudiantes universitarios obesos. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.