[Increasing participation of primary care in the management of people with human immunodeficiency virus: hospital care professionals express their views]. / Incremento de la participación de Atención Primaria en la asistencia al virus de la inmunodeficiencia humana: opinan los profesionales de las unidades hospitalarias.

AIM: To determine the opinions of infectious diseases professionals on the possibilities of monitoring patients with HIV in Primary Care. DESIGN: Qualitative study using in-depth interviews. LOCATION: Infectious Diseases Unit in the University Hospital "Virgen de la Victoria" in Málaga. PARTICIPANTS: Health professionals with more than one year experience working in infectious diseases. A total of 25 respondents: 5 doctors, 15 nurses and 5 nursing assistants. METHOD: Convenience sample. Semi-structured interviews were used that were later transcribed verbatim. Content analysis was performed according to the Taylor and Bogdan approach with computer support. Validation of information was made through additional analysis, expert participation, and feedback of part of the results to the participants. RESULTS: Hospital care professionals considered the disease-related complexity of HIV, treatment and social aspects that may have an effect on the organizational level of care. Professionals highlighted the benefits of specialized care, although opinions differed between doctors and nurses as regards follow up in Primary Care. Some concerns emerged about the level of training, confidentiality and workload in Primary Care, although they mentioned potential advantages related to accessibility of patients. CONCLUSIONS: Physicians perceive difficulties in following up HIV patients in Primary Care, even for those patients with a good control of their disease. Nurses and nursing assistants are more open to this possibility due to the proximity to home and health promotion in Primary Care.

[Social class, health inequalities, and health-related behaviors of working people in Chile]. / Clase social, desigualdades en saludy conductas relacionadas con la saludde la población trabajadora en Chile.

OBJECTIVE: To analyze links between social class and health-related indicators and behaviors in Chilean workers, from a neo-Marxian perspective. METHODS: A cross-sectional study based on the First National Survey on Employment, Work, Health, and Quality of Life of Workers in Chile, done in 2009-2010 (n = 9 503). Dependent variables were self-perceived health status and mental health, examined using the General Health Questionnaire (GHQ-12). Health-related behavior variables included tobacco use and physical activity. The independent variable was neo-Marxian social class. Descriptive analyses of prevalence were performed and odds ratio (OR) models and 95% confidence intervals (95%CI) were estimated. RESULTS: Medium employers (between 2 and 10 employees) reported a lower prevalence of poor health (21.6% [OR 0.68; 95%CI 0.46-0.99]). Unskilled managers had the lowest mental health risk (OR 0.43; 95%CI 0.21-0.88), with differences between men and women. Large employers (more than 10 employees) reported smoking the least, while large employers, expert supervisors, and semi-skilled workers engaged in significantly more physical activity. CONCLUSIONS: Large employers and expert managers have the best health-related indicators and behaviors. Formal proletarians, informal proletarians, and unskilled supervisors, however, have the worst general health indicators, confirming that social class is a key determinant in the generation of population health inequalities.

Incremento de la participación de Atención Primaria en la asistencia al virus de la inmunodeficiencia humana: opinan los profesionales de las unidades hospitalarias / Increasing participation of Primary Care in the management of people with human immunodeficiency virus: Hospital care professionals express their views

OBJETIVO: Conocer las opiniones de los profesionales de enfermedades infecciosas sobre las posibilidades de seguimiento del paciente con VIH en Atención Primaria (AP). DISEÑO: Estudio cualitativo fenomenológico mediante entrevistas en profundidad. Emplazamiento: Unidad de Enfermedades Infecciosas del Hospital Universitario «Virgen de la Victoria» de Málaga. Participantes: Profesionales de la salud con más de un año de experiencia laboral en enfermedades infecciosas. Un total de 25 entrevistados: 5 médicos, 15 enfermeras y 5 auxiliares enfermería. MÉTODO: Muestreo por conveniencia. Se realizaron entrevistas semiestructuradas que se transcribieron literalmente. Análisis de contenido según Taylor y Bogdan con soporte informático. Validación de la información mediante análisis complementarios, participación de expertos y devolución de parte de los resultados a los participantes. RESULTADOS: Los profesionales de AH atribuyeron características de complejidad al VIH en relación a la enfermedad, el tratamiento y sus aspectos sociales, con repercusiones sobre el nivel organizativo de la atención. Los profesionales resaltaron los beneficios de una atención especializada, aunque difieren las opiniones de facultativos y de enfermería en relación con el seguimiento en AP. Surgieron dudas sobre los niveles de formación, la gestión del secreto y la presión asistencial en este nivel, pero también se manifestaron las ventajas potenciales en cuanto a la accesibilidad de los pacientes a AP. CONCLUSIONES: Los facultativos perciben dificultades en el seguimiento del VIH en AP, incluso para usuarios con buen control del VIH. Enfermeras y auxiliares de enfermería se muestran más abiertos a esta posibilidad por la cercanía domiciliaria y la promoción de la salud de AP

AIM: To determine the opinions of infectious diseases professionals on the possibilities of monitoring patients with HIV in Primary Care. DESIGN: Qualitative study using in-depth interviews. Location: Infectious Diseases Unit in the University Hospital «Virgen de la Victoria» in Málaga. Participants: Health professionals with more than one year experience working in infectious diseases. A total of 25 respondents: 5 doctors, 15 nurses and 5 nursing assistants. METHOD: Convenience sample. Semi-structured interviews were used that were later transcribed verbatim. Content analysis was performed according to the Taylor and Bogdan approach with computer support. Validation of information was made through additional analysis, expert participation, and feedback of part of the results to the participants. RESULTS: Hospital care professionals considered the disease-related complexity of HIV, treatment and social aspects that may have an effect on the organizational level of care. Professionals highlighted the benefits of specialized care, although opinions differed between doctors and nurses as regards follow up in Primary Care. Some concerns emerged about the level of training, confidentiality and workload in Primary Care, although they mentioned potential advantages related to accessibility of patients. CONCLUSIONS: Physicians perceive difficulties in following up HIV patients in Primary Care, even for those patients with a good control of their disease. Nurses and nursing assistants are more open to this possibility due to the proximity to home and health promotion in Primary Care

Clase social, desigualdades en salud y conductas relacionadas con la salud de la población trabajadora en Chile / Social class, health inequalities, and health-related behaviors of working people in Chile

OBJETIVO: Analizar los vínculos entre la clase social y los diferentes indicadores y conductas relacionados con la salud, a partir de una perspectiva neomarxista en población trabajadora chilena. MÉTODOS: Se realizó un estudio transversal a partir de la Primera Encuesta Nacional de Condiciones de Empleo, Trabajo, Salud y Calidad de Vida de los Trabajadores y Trabajadoras en Chile, efectuada en 2009-2010 (n = 9 503). Las variables dependientes fueron el estado de salud autopercibido y la salud mental, examinada mediante el Cuestionario de Salud Global (GHQ-12, por sus siglas en inglés). Las variables de conductas relacionadas con la salud incluyeron el consumo de tabaco y la realización de actividad física. La variable independiente fue la clase social neomarxista. Se realizaron análisis descriptivos de prevalencia y se estimaron modelos de razón de probabilidades (RP) e intervalos de confianza de 95% (IC95%). RESULTADOS: Los medianos empresarios refirieron tener una menor prevalencia de mala salud (21,6% [RP 0,68; IC95% 0,46-0,99]). En relación a la salud mental, los que presentaban menor riesgo eran los gerentes básicos (RP 0,43; IC95% 0,21-0,88), observándose diferencias entre hombres y mujeres. Los que refirieron fumar con menor frecuencia fueron los empresarios, mientras que los que realizaban significativamente más actividad física fueron los empresarios, los supervisores expertos y los trabajadores semicalificados. CONCLUSIONES: Los empresarios y gerentes expertos son los que presentan mejores indicadores y conductas relacionados con la salud. El proletario formal, el proletario informal y los supervisores básicos, en cambio, son los que presentan los peores indicadores de salud global, confirmando así que la clase social es un determinante clave en la generación de desigualdades en materia de salud de la población.

OBJECTIVE: To analyze links between social class and health-related indicators and behaviors in Chilean workers, from a neo-Marxian perspective. METHODS: A cross-sectional study based on the First National Survey on Employment, Work, Health, and Quality of Life of Workers in Chile, done in 2009-2010 (n = 9 503). Dependent variables were self-perceived health status and mental health, examined using the General Health Questionnaire (GHQ-12). Health-related behavior variables included tobacco use and physical activity. The independent variable was neo-Marxian social class. Descriptive analyses of prevalence were performed and odds ratio (OR) models and 95% confidence intervals (95%CI) were estimated. RESULTS: Medium employers (between 2 and 10 employees) reported a lower prevalence of poor health (21.6% [OR 0.68; 95%CI 0.46-0.99]). Unskilled managers had the lowest mental health risk (OR 0.43; 95%CI 0.21-0.88), with differences between men and women. Large employers (more than 10 employees) reported smoking the least, while large employers, expert supervisors, and semi-skilled workers engaged in significantly more physical activity. CONCLUSIONS: Large employers and expert managers have the best health-related indicators and behaviors. Formal proletarians, informal proletarians, and unskilled supervisors, however, have the worst general health indicators, confirming that social class is a key determinant in the generation of population health inequalities.