[Effectiveness of a multidimensional therapeutic program for aged people attending senior centers]. / Efectividad a mediano plazo de un programa multidimensional en personas mayores en centros diurnos en Chile.

BACKGROUND: It is imperative to have effective programs to improve or maintain the health of aged people. AIM: To evaluate the effectiveness of an intervention based on a multidimensional program in Senior centers in Chile five months after its implementation, in the domains of physical and mental health, functionality and quality of life in aged people. MATERIAL AND METHODS: Sixty participants older than 60 years completed a multidimensional program for one month that included interventions of guided physical exercises, in addition to educational and social activities. They were evaluated at baseline and one and five months after the intervention. RESULTS: After the first and fifth months, significant improvements were observed in the five times sit to stand test (5TSTS) and gait speed (WST), in addition, significant improvements were observed in literacy measured by the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). At the fifth month, slight improvements were observed in the Yesavage and short Falls efficacy scales, Barthel index, Unipodal Station and EuroQol five-dimensional quality of life tests. CONCLUSIONS: A multidimensional program for aged people lasting one month, improved the physical health dimension and literacy by the fifth month of evaluation.

Efectividad a mediano plazo de un programa multidimensional en personas mayores en centros diurnos en Chile / Effectiveness of a multidimensional therapeutic program for aged people attending senior centers

BACKGROUND: It is imperative to have effective programs to improve or maintain the health of aged people. AIM: To evaluate the effectiveness of an intervention based on a multidimensional program in Senior centers in Chile five months after its implementation, in the domains of physical and mental health, functionality and quality of life in aged people. MATERIAL AND METHODS: Sixty participants older than 60 years completed a multidimensional program for one month that included interventions of guided physical exercises, in addition to educational and social activities. They were evaluated at baseline and one and five months after the intervention. RESULTS: After the first and fifth months, significant improvements were observed in the five times sit to stand test (5TSTS) and gait speed (WST), in addition, significant improvements were observed in literacy measured by the Short Assessment of Health Literacy for Spanish-speaking Adults (SAHLSA). At the fifth month, slight improvements were observed in the Yesavage and short Falls efficacy scales, Barthel index, Unipodal Station and EuroQol five-dimensional quality of life tests. CONCLUSIONS: A multidimensional program for aged people lasting one month, improved the physical health dimension and literacy by the fifth month of evaluation.

Herramientas prácticas para el desarrollo de la medicina ambulatoria / Practical tools for the development of ambulatory medicine

En medicina ambulatoria es fundamental brindar una atención integral, que esté centrada en la persona e incluya variables familiares, sociales y culturales, no solo biomédicas. El objetivo de este artículo es dar a conocer, de forma general, algunas herramientas prácticas utilizadas frecuentemente en un contexto de atención primaria de salud (APS) y la medicina ambulatoria, para cumplir tal desafío:El enfoque centrado en la persona, nos permite definir las necesidades específicas de los pacientes y sus familias, los recursos que tienen, además de lograr mayor participación en la toma de decisiones y mejores resultados en salud. Para poder determinar las redes, el nivel de funcionamiento y la vulnerabilidad familiar, existen diversas herramientas prácticas, fáciles de aplicar en la consulta ambulatoria, que todo médico y equipo de salud debieran conocer. En este artículo se revisan tres: el genograma, ecomapa y SALUFAM.Una vez definido el contexto familiar y social de los pacientes con las herramientas antes mencionadas, en caso de reconocer problemas o necesidades, la consejería familiar y el enfoque estratégico breve o centrado en la solución, son excelentes estrategias para abordar temáticas complejas y utilizar los recursos propios familiares, generando planes de acción participativos y atingentes a la realidad local.

In ambulatory care, it is essential to provide an integral attention, which is person centered, that includes family, social and cultural variables, not just biomedical. The objective of this article is to know, in a general way, some practical tools frequently used in Primary Health Care (PHC) and ambulatory medicine, to fulfill this challenge:The person centered approach allows us to define the specific needs of the patients and their families, the resources they have, and also, improve participation in decision-making and better health outcomes.In order to determine the networks, the level of functioning and family vulnerability, there are several practical tools, easy to apply in the outpatient consultation, that every doctor and healthcare team should know. Three tools are reviewed in this article: the genogram, ecomap and SALUFAM.Once the patient's family and social context has been defined with the tools mentioned before, in case of recognizing problems or needs, family counseling and the brief therapy or solution-focused therapy, are excellent strategies for approaching complex issues and using the family resources, generating participative action plans according to local reality

Apoyo social y salud cardiovascular: adaptación de una escala de apoyo social en pacientes hipertensos y diabéticos en la atención primaria chilena / Social support and cardiovascular health: Adaptation of a social support scale for hypertensive and diabetic patients in primary care, Chile

OBJETIVO: Validar un instrumento para medir el apoyo social percibido en pacientes bajo control por hipertensión arterial y diabetes mellitus tipo 2. DISEÑO: Estudio observacional, exploratorio, con métodos mixtos, cualitativos y cuantitativos. Emplazamiento: Dos centros de atención primaria de la comuna de Puente Alto, en Santiago de Chile. PARTICIPANTES: Pacientes hipertensos y/o diabéticos entre 18 y 65 años. Para el estudio cualitativo la selección fue por conveniencia. La aplicación final se realizó en una muestra aleatorizada. MÉTODOS: Se realizaron grupos focales y entrevistas semiestructuradas para explorar el constructo de apoyo social según los pacientes. Según opinión de expertos y revisión de la literatura, se seleccionó una escala de apoyo social y se realizó un piloto a 40 pacientes y se entrevistó en profundidad a algunos participantes. En estas fases se modificó el instrumento según los resultados iniciales de grupos focales y piloto. La versión final se aplicó a 250 participantes. RESULTADOS: Se verificó la existencia del constructo «apoyo social». En la adaptación se eliminó un ítem. El alfa de Cronbach fue 0,89 y el análisis factorial conservó los 4 factores descritos en el estudio original. Al agregar 9 ítems obtenidos de los grupos focales, se obtiene un alfa de Cronbach de 0,92. CONCLUSIONES: El instrumento obtenido posee buenas propiedades sicométricas y es aplicable en nuestra población. Los ítems agregados aumentan su consistencia interna pero no aportan información nueva sobre el apoyo social percibido, lo que sugiere la aplicación del instrumento en su versión original, lo cual es consistente con estudios anteriores

GOAL: Validate an instrument to measure the Perceived Social Support in outpatients who are in treatment to hypertension and/or diabetes mellitus ii. DESIGN: Observational and exploratory design with mixed methods, qualitative and quantitative. SETTING: Two community health centers from the municipality of Puente Alto (Santiago, Chile). PARTICIPANTS: Hypertensive and/or diabetic patients between 18 and 65 years old. A purposive sample was undertaken for the qualitative study, and a random sample for the final survey. METHODS: Focus groups and semi-structured interviews were conducted to explore the constructs of social support as perceived by PATIENTS: According to expert opinion and literature review, a scale of social support was selected and a pilot study was conducted in 40 patients, then we interviewed in depth to some of those PARTICIPANTS: The instrument was modified according the results of this process. The final version was applied to 250 PARTICIPANTS: RESULTS: The construct existence was verified in the population. In the adaptation, one item was eliminated. The alpha of Cronbach was 0.89 and the factorial analysis had the same four factors from the original study. Nine new items obtained from the focal groups were added to the instrument, obtaining an alpha of Cronbach of 0.92. CONCLUSIONS: The final instrument has good psychometric proprieties, and is applicable in our population. The additional items from the qualitative study improve its internal consistency, but don't add new information about Perceived Social Support. This is consistent with other studies, and suggests the application of the original version of the instrument

[Social support and cardiovascular health: Adaptation of a social support scale for hypertensive and diabetic patients in primary care, Chile]. / Apoyo social y salud cardiovascular: adaptación de una escala de apoyo social en pacientes hipertensos y diabéticos en la atención primaria chilena.

GOAL: Validate an instrument to measure the Perceived Social Support in outpatients who are in treatment to hypertension and/or diabetes mellitus ii. DESIGN: Observational and exploratory design with mixed methods, qualitative and quantitative. SETTING: Two community health centers from the municipality of Puente Alto (Santiago, Chile). PARTICIPANTS: Hypertensive and/or diabetic patients between 18 and 65 years old. A purposive sample was undertaken for the qualitative study, and a random sample for the final survey. METHODS: Focus groups and semi-structured interviews were conducted to explore the constructs of social support as perceived by patients. According to expert opinion and literature review, a scale of social support was selected and a pilot study was conducted in 40 patients, then we interviewed in depth to some of those participants. The instrument was modified according the results of this process. The final version was applied to 250 participants. RESULTS: The construct existence was verified in the population. In the adaptation, one item was eliminated. The alpha of Cronbach was 0.89 and the factorial analysis had the same four factors from the original study. Nine new items obtained from the focal groups were added to the instrument, obtaining an alpha of Cronbach of 0.92. CONCLUSION: The final instrument has good psychometric proprieties, and is applicable in our population. The additional items from the qualitative study improve its internal consistency, but don't add new information about Perceived Social Support. This is consistent with other studies, and suggests the application of the original version of the instrument.