Definition of self-medication: a scoping review.

Self-medication (SM) is a global and growing phenomenon. It represents a public health problem due to antibiotic resistance, risk of adverse drug reactions, drug-drug interactions, disease masking, and increased morbidity. There is not a consensus on the definition of SM. The definitions found in different studies make it difficult to address this problem from a theoretical perspective and therefore find an adequate solution to this public health problem. The aim of this article is to search the medical literature to characterize the current understanding of SM in the medical community. We conducted a scoping review of definitions of SM by searching on PubMed - Medline, Embase, and LILACS using the following combination of keywords: 'self-prescription' or 'self prescription', 'self-medication' or 'self medication', or 'automedication' and 'definition' or 'explanation'. The search was limited to articles containing the definition of SM, with no limit on language or year. Duplicate studies and those that did not mention the definition of SM were excluded from the final review. A total of 65 studies were included in the final selection. We found a vast heterogeneity in the definition of SM. Most articles based their definition of SM on the process of obtaining the drug, the nonparticipation of a specific health professional, the source of the medication, and the reason for SM. Other interesting concepts such as self-care, nonadherence to a prescription, reuse of stored drugs, and sharing and lending medicines were also considered forms of SM by other authors, however. This study highlights the need to reach a consensus regarding the definition of SM to adequately propose strategies to address this global health problem. This study shows the diverse concepts that need to be included in a future definition of SM. Plain Language Summary: Definition of self-medication: a review with systematic methodology Self-medication (SM) is a global and growing phenomenon that represents a public health problem due to antibiotic resistance, risk of dangerous side effects, interactions between drugs, and disease masking. Currently, there is not a consensus on the definition of SM, which makes it difficult to address this problem and therefore find an adequate solution. Making a standard definition would allow the development of programs focused on addressing drug-related problems associated with self-medication behavior. The purpose of this article is to search the medical literature to define the current understanding of SM in the medical community. We included a total of 65 studies and found a great variance in the definition of SM. Most articles based their definition of SM on the process of obtaining the drug, the nonparticipation of a specific health professional, the source of the medication, and the reason for SM. Other interesting concepts such as self-care, not following a prescription, reuse of stored drugs, and sharing and lending medicines were also considered forms of SM by other authors, however. Furthermore, this study highlights that SM is a wider concept that goes beyond aiming to promote and restore health, as aesthetic and recreational purposes are also reasons for SM that can put individuals at risk and compromise the correct and safe use of medications.

Prescription for COVID-19 by non-medical professionals during the pandemic in Colombia: a cross-sectional study.

Background: The COVID-19 pandemic has led to an increase in the behavior of self-medication (SM). Given the massive release of misleading information during the pandemic, some pharmacies recommend drugs such as ivermectin, azithromycin, and hydroxychloroquine that are not useful for preventing or treating COVID-19 and could expose patients to unnecessary adverse drug reactions (ADRs), drug-drug interactions (DDIs), disease masking, and antibiotic resistance. Rationale: SM with drugs advertised for COVID-19 can have consequences, and people should be aware of approved uses, potential contraindications, and ADRs. Thus, the aim of this study was to know the drug therapies including natural products and homeopathic drugs offered by Colombian pharmaceutical establishments for the prevention and treatment of COVID-19, as well as the information provided on the safe use of the product. Methods: An observational, cross-sectional mystery shopping study was carried out to determine the pharmaceutical alternatives for the management of COVID-19 offered by pharmaceutical establishments (drugstores, pharmacies, homeopathic pharmacies, and nutritional supplements stores) in Colombia, and information related to the safe use of the product. The study included 482 pharmaceutical establishments from 16 Colombian departments. Data collection was done through telephone calls to each of the establishments following an interview protocol pretending to be a patient who presents symptoms related to COVID-19. Results: About 57.3% (276) of the establishments recommended a product for the treatment of COVID-19 infection, 66.6% (321) asked whether the caller had COVID-19 symptoms and what they are, and 44.2% (213) suggested taking a COVID-19 test. Of 59 drugs suggested by pharmacies, the most recommended were azithromycin, ivermectin, acetaminophen, ibuprofen, and ASA (aspirin). From the establishments that recommended a product, dosage was indicated in 85.5% (236) of the pharmaceutical establishments and 14.5% (40) of the establishments reported the most common adverse effects of this substance. About 9.4% (26) of the establishments reported possible interactions of the recommended drugs and substances with food, beverages, or supplements.Conclusion: Pharmaceutical establishments in Colombia seem to have significantly contributed to self-medication for COVID-19 in Colombia during the pandemic. This behavior is inappropriate, since the mild forms of the disease do not have a specific treatment. Plain Language Summary: Self-medication induced by pharmaceutical establishments in Colombia during the COVID-19 pandemic Background: The COVID-19 pandemic has led to an increase in the behavior of self-medication (SM). Given the massive release of misleading information during the pandemic, some pharmacies recommend drugs such as ivermectin, azithromycin, hydroxychloroquine among others, which are not useful for preventing or treating COVID-19 and could expose patients to unnecessary side effects and interactions with other medications. People should be aware of the approved and non-approved uses, and potential side effects of these drugs. Rationale: The aim of this study was to know the drugs, including natural products and homeopathic drugs, offered by Colombian pharmaceutical establishments for the prevention and treatment of COVID-19, as well as the information provided on the safe use of the product. Methods: The study was done using the mystery shopping method, collecting data through telephone calls to each of the establishments by a trained individual pretending to be a patient with COVID-19 symptoms. The study included 482 pharmaceutical establishments from 16 Colombian departments. Results: Of 59 drugs suggested by pharmacies, the most recommended were azithromycin, ivermectin, acetaminophen, ibuprofen, and aspirin. The recommended dose was indicated in 85.5% (236) of the pharmaceutical establishments, and 14.5% (40) of them reported the most common adverse effects of the recommended product. About 9.4% (26) of the establishments reported possible interactions of the recommended drugs and substances with food, beverages, or supplements. Conclusion: The majority of the pharmaceutical establishments included in the study promoted inadequate self-medication for COVID-19 in Colombia during the pandemic.

Association between Psychopathological Dimensions and Sexual Functioning/Sexual Arousal in Young Adults.

Psychological-psychiatric factors have a different effect on sexual functioning in men and women. This research aimed to examine the association between psychopathological dimensions and dimensions of sexual functioning in Spanish young adults in two studies. Study 1 examined sexual functioning and psychopathological dimensions in 700 women and 516 men. Study 2 conducted an experimental laboratory task to evaluate subjective sexual arousal and genital sensations when watching visual sexual stimuli in a subsample of participants from Study 1 (143 women and 123 men). As a result, the first study showed that depression and anxiety-related symptoms had a negative effect, both in men and women, and having a partner had a positive influence on the dimensions of sexual functioning. The second study showed that anxiety symptoms were positively associated with subjective sexual arousal in both men and women, and anxiety was associated with the assessment of genital sensations in men. The differences between the results of anxiety may be explained because sexual arousal was evaluated in general terms in Study 1, whereas it was evaluated as a state in Study 2. These findings confirm that the presence of psychopathological symptoms contributes to sexual functioning, as well as the necessity of strengthening mental illness prevention programs that include sexual health components.

Validation of the Early Trauma Inventory Self Report-Short Form and trauma prevalence in Colombia.

OBJECTIVE: Early traumatic experiences are related to profound and long-lasting negative effects on mental and physical health. Colombia has been involved in a war for the last six decades. Thus, the main objective was to adapt and validate the Early Trauma Inventory Self Report-Short Form in Colombia, as well as assess trauma prevalence in this country. METHOD: For this purpose, a total of 2,080 Colombians participated in this study (57.3% women and 42.4% men). Age ranged from 18 to 77 years old. They answered the 27-item version of the Early Trauma Inventory Self Report-Short Form and a sociodemographic evaluation tool. Web-based sampling was carried out between March 16 and March 30, 2020. RESULTS: Original four factor structure was successfully explored and confirmed here. Reliability indexes were good with alphas ranging from .69 to .93. Items properties were also adequate. Most of the assessed sample suffered trauma in their early stages (99.8%). Gender differences were analyzed observing significant differences. As expected, sexual abuse is more prevalent in women. CONCLUSIONS: To the best of our knowledge, the Colombian population has suffered the highest prevalence of early trauma experiences so far when compared to other countries. Emotional and social implications are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

El Observatorio del Comportamiento de Automedicación de la Universidad del Rosario y su rol en la pandemia de COVID-19 / The Self-Medication Behavior Observatory of the Universidad del Rosario and its role in the COVID-19 Pandemic

El observatorio del Comportamiento de Automedicación (OCAM) estudia la automedicación (AM), básicamente, como un comportamiento individual que, según la definición de la Librería Nacional de Medicina (NLM, por sus siglas en inglés), consiste en "la autoadministración de medicamentos no recetados por un médico o de una manera no dirigida por un médico". La Organización Mundial de la Salud (OMS) entiende este comportamiento como "la práctica mediante la cual los individuos tratan sus enfermedades y condiciones con medicamentos que están aprobados y disponibles sin prescripción, y que son seguros y efectivos cuando se usan según las indicaciones". En este contexto, tradicionalmente la AM se ha entendido ligada al autocuidado, es decir, adscrita al contexto de la salud. Sin embargo, los trabajos realizados desde el OCAM hacen pensar que se trata de un comportamiento mucho más complejo y determinado por multitud de variables.

The Observatory of Self-Medication Behavior (OCAM) studies self-medication (SM), basically, as an individual behavior that, according to the National Library of Medicine (NLM) definition, consists of "the self-administration of medicines not prescribed by a physician or in a manner not directed by a physician". The World Health Organization (WHO) understands this behavior as "the practice whereby individuals treat their diseases and conditions with medicines that are approved and available without a prescription, and that are safe and effective when used as directed." In this context, MA has traditionally been understood as linked to self-care, that is, ascribed to the context of health. However, the work carried out by OCAM suggests that it is a much more complex behavior determined by a multitude of variables.

Developing guidelines for adapting questionnaires into the same language in another culture / Desarrollo de guías para adaptar cuestionarios dentro de una misma lengua en otra cultura

The adaptation of a test from a language into that same language in another culture is common; however, there are no clear guidelines for this process. The objective was to adapt a protocol providing some guidelines for adapting questionnaires from one language to the same language. a total of eight experts supported the adaption process and 825 participants from Spain and Colombia were evaluated in this study. Participants answered the brief version of the Sexual Assertiveness Scale, the Sexual Opinion Survey, the Massachusetts General Hospital-Sexual Functioning Questionnaire and the Sexuality Scale. The adaptation was made following some guidelines which have already been published. The results showed a strong partial invariance between countries. DIF analysis also replied this partial invariant form and adequate psychometric properties; guidelines to adapt questionnaires into same language in other cultures are presented. therefore, the adaptation process - in the absence of further evidence - could be effective.

La adaptación de test dentro de una misma lengua en varias culturas diferentes es común; sin embargo, no existen guías claras para realizar este proceso. El objetivo fue adaptar un protocolo generando unas guías para adaptar cuestionarios dentro de una misma lengua. Un total de ocho expertos realizaron el proceso de adaptación y 825 participantes de Espana y Colombia fueron evaluados en este estudio. Todos ellos contestaron a la versión breve de la Sexual Assertiveness Scale, la Sexual Opinion Survey, la Massachusetts General Hospital-Sexual Functioning Questionnaire y la Sexuality Scale. La adaptación se realizó siguiendo las directrices de algunas guías ya publicadas. Los resultados mostraron una invarianza fuerte entre los dos países. Estos hallazgos fueron replicados mediante DIF, además se observaron adecuadas propiedades psicométricas, finalmente las guías para el proceso de adaptación han sido presentadas. Por lo que concluimos que el proceso de adaptación - en ausencia de más evidencia- podría ser efectivo.

Adaptation, Validation, Reliability and Factorial Equivalence of the Rosenberg Self-Esteem Scale in Colombian and Spanish Population.

The Rosenberg Self-Esteem Scale is the most widely used instrument to assess self-esteem. In light of the absence of adaptations in Colombia, this study seeks to validate and adapt this scale in the Colombian population, and perform factorial equivalence with the Spanish version. A total of 1,139 seniors (633 Colombians and 506 Spaniards) were evaluated; the individuals answered the Rosenberg Self-Esteem Scale and sexual self-esteem scale. The average score of the items was similar to the questionnaire's theoretical average, and standard deviations were close to one. The psychometric properties of the items are generally adequate with alphas of .83 and .86 and significant (CI = .95) and correlations with the sexual self-esteem scale ranging from .31 and .41. Factorial equivalence was confirmed by means of a structural equation model (CFI = .912 and RMSEA = .079), thus showing a strong level of invariance.

Adaptation and validation of the brief sexuality scale in colombian and spanish populations

The Sexuality Scale is an instrument which evaluates what people think and how they feel about their own sexuality through three components: Sexual Self-Esteem, Sexual Depression and Sexual Preoccupation. Given the clinical implications and impact on sexual health after having demonstrated its relationship with various components of sexuality, and the little research on the last two components of the scale, this study undertook to translate, adapt and validate the brief version of the Sexuality Scale in a sample of 1167 Spanish and Colombian men and women. Two versions of the instrument were obtained -one for each country. In both versions, the results indicate high levels of reliability and adequate psychometric properties of the items. Configural invariance confirmed the three-dimensional structure of the scale for the two versions. The correlations with scales that evaluate various aspects of sexuality confirm adequate levels of concurrent validity. The scales may have important implications for evaluation and intervention of various dimensions of sexual behavior (AU)

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Adaptation and Validation of the Brief Sexual Opinion Survey (SOS) in a Colombian Sample and Factorial Equivalence with the Spanish Version.

Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias.

Adaptation, validation and reliability of the Massachusetts General Hospital-Sexual Functioning Questionnaire in a Colombian sample and factorial equivalence with the Spanish version / Adaptación, validación y fiabilidad del Cuestionario de funcionamiento sexual del Hospital General de Massachusetts en una muestra colombiana y equivalencia factorial con la versión en españo

Sexual dysfunctions are a highly prevalent problem. It is necessary to have instruments adapted to the Colombian population in order to evaluate their sexual functioning because to date none of them have been validated. The aim of this study was to adapt and validate the Massachusetts General Hospital-Sexual Functioning Questionnaire in Colombian population, and compare it with a similar sample from Spain. Two different samples were used in this study. On one hand, a sample of expert judges who performed the cultural adaptation and the evaluation of the scale, and on the other hand, a second end sample of 1117 participants -men and women of both nationalities- who answered the questionnaire -together with others-through a virtual platform. Some of the items were adjusted based on the initial results of the evaluation by the expert judges. Cronbach's alpha between .81 and .92 were obtained after the application of the test. The psychometric properties of the scale are adequate and this instrument properly correlates with other criterion variables. Construct validity was evaluated using factorial invariance. The unidimensional configural model for men (RMSEA= .000; CFI = 1) and for women (RMSEA= .048, CFI = .997) had an adequate fit, and a level of strict invariance was also reached. Screening can be performed with this first validated scale in order to evaluate the sexual difficulties of the Colombian population and compare them with the Spanish population.

Las disfunciones sexuales son un problema muy frecuente. Es necesario contar con instrumentos adaptados a la población colombiana con el fin de evaluar su funcionamiento sexual porque hasta la fecha ninguno de ellos se ha validado. El objetivo de este estudio fue adaptar y validar el Cuestionario de funcionamiento sexual del Hospital General de Massachusetts en la población colombiana y compararla con una muestra similar de España. Se utilizaron dos muestras diferentes en este estudio. Por una parte, una muestra de jueces expertos que realizaron la adaptación cultural y la evaluación de la escala, y por la otra, una segunda muestra final de 1.117 participantes - hombres y mujeres de ambas nacionalidades - que respondieron el cuestionario, junto con otros, a través de una plataforma virtual. Algunos de los elementos se ajustaron según los resultados iniciales de la evaluación realizada por jueces expertos. Se obtuvieron coeficientes alfa de Cronbach entre 0.81 y 0.92 después de la aplicación de la prueba. Las propiedades psicométricas de la escala son adecuadas y este instrumento se correlaciona debidamente con otras variables para el criterio. La validez del constructo se evaluó mediante invariancia factorial. El modelo configural unidimensional para los hombres (RMSEA = 0.000; CFI = 1) y para las mujeres (RMSEA = 0.048; CFI =0.997) tenía un ajuste adecuado, y también se alcanzó un nivel de estricta invariancia. Puede realizarse un cribado con esta primera escala validada para evaluar las dificultades sexuales de la población colombiana y compararlas con las de la población española.

Adaptation, validation, reliability and factorial equivalence of the Rosenberg-Self-Esteem Scale in Colombian and Spanish population

The Rosenberg Self-Esteem Scale is the most widely used instrument to assess self-esteem. In light of the absence of adaptations in Colombia, this study seeks to validate and adapt this scale in the Colombian population, and perform factorial equivalence with the Spanish version. A total of 1,139 seniors (633 Colombians and 506 Spaniards) were evaluated; the individuals answered the Rosenberg Self-Esteem Scale and sexual self-esteem scale. The average score of the items was similar to the questionnaire’s theoretical average, and standard deviations were close to one. The psychometric properties of the items are generally adequate with alphas of .83 and .86 and significant (CI = .95) and correlations with the sexual self-esteem scale ranging from .31 and .41. Factorial equivalence was confirmed by means of a structural equation model (CFI = .912 and RMSEA = .079), thus showing a strong level of invariance (AU)

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Relaciones deíciicas simples, toma de perspectiva y competencia socall / Simple dectic reelations, perspective-taking and social competence

En la Teoría de Marcos Relacionales (Hayes, Barnes-Holmes, & Roche, 2001) se ha planteado que la toma de perspectiva se puede entender como un repertorio de respuestas relacionales deícticas personales, espaciales y temporales, derivadas y aplicables arbitrariamente. Bajo esta óptica, en esta investigación se evaluó el impacto de múltiples ejemplares de reforzamiento por responder relacional en función de claves contextuales en el establecimiento de relaciones deícticas simples y el impacto de este entrenamiento en puntajes de ToM y competencia social. Se implementó un diseño de línea de base múltiple con cuatro participantes (41 a 58 meses), residentes en una fundación de protección y restitución de derechos. Los participantes requirieron entrenamiento en relaciones personales y/o temporales, siendo éstas últimas las más difíciles de aprender a partir de contingencias de reforzamiento. No se identificó una clara relación entre cambios en el repertorio de relaciones deícticas simples y los puntajes en tareas de teoría de la mente y competencia social. Se discuten las implicaciones teóricas y metodológicas de estos hallazgos.

Relational Frame Theory (Hayes, Barnes-Holmes & Roche, 2001) states that perspective-taking can be understood as a repertoire of personal, spatial and temporal deictic relations that are derived and arbitrarily applicable. Under this rubric, this research evaluated the impact of multiple reinforcement exemplars for relational responding according to contextual cues in establishing simple deictic relations and the impact of this training on ToM and social competence scores. A multiple baseline design was implemented with four participants (41 to 58 months old) raised in an institutional setting. Participants required training in personal and/or temporal relations, the latter being harder to learn after being exposed to reinforcement contingencies. No clear relationships among changes in the deictic relations repertoire and ToM and social competence scores were identified. Theoretical and methodological implications of these findings are discussed.

Programa de economía de fichas en el hogar / A home-based token economy program

Se aplica un programa de economía de fichas para modificar algunos comportamientos disruptivos de un niño. Se pretende decrementar el contestar de manera inadecuada, así como hacer pataletas y propiciar la ocurrencia del seguimiento de instrucciones relacionadas con conductas como arreglar la cama, recoger y organizar los juguetes, recoger y organizar la ropa, hacer sus deberes escolares. Se hace una profunda revisión de la aplicación del programa de Economía de Fichas en diversos campos y problemas de conducta. Siguiendo un diseño ABA, los resultados confirman el cambio de comportamiento y logran un mejor ajuste de la conducta del niño en la escuela y el ambiente familiar. Se hace un análisis desde algunos principios de la economía conductual.

It applies a token economy program to modify some disruptive behaviors of a child. It is intended to decrease the answer in an inappropriate manner and make tantrums and encourage the occurrence of follow-up instructions for behaviors such as to fix the bed, collecting and organizing toys, collect and organize your clothes, do their homework. It is a thorough review of the implementation of the token economy in various fields and behavioral problems. Following an ABA design, the results confirm the behavior change made a better adjustment of the child's behavior at school and home environment. An analysis is made from some of the principles of behavioral economics.