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1.
Invest Educ Enferm ; 37(3)2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31830400

RESUMEN

OBJECTIVES: To determine the factors associated with adherence to the therapeutic regime in patients with hypertension and type 2 diabetes mellitus cared for in primary care centers. METHODS: This was an analytical cross-sectional study, conducted with 500 patients from two institutions in Bucaramanga (Colombia). Adherence to the therapeutic regime was measured with the label of Nursing outcomes "Treatment Behavior: Illness or Injury" and the instrument "Factors that influence on adherence to pharmacological and non-pharmacological treatments" by Ortiz Suárez was used. RESULTS: Factors affecting negatively adherence to the therapeutic regime were: belonging to the subsidized regime, never being able to read written information about the management of their disease, and never receiving information about benefits of the medications ordered by the physician. On the contrary, positive influence was noted by referring "never" to the following statements, which impacted positively on adherence: the diverse occupations you have in and out of the house hinder your following the treatment; when your symptoms improve, do you interrupt the treatment? previously, have you had difficulties in complying with your treatment and believe there are difficult-to-change customs about foods and exercises? CONCLUSIONS: Two socioeconomic factors and one related with the health system and staff affected negatively on adherence to the therapeutic regime, while four factors related with the therapy favored it. The factors identified could be used in the design of nursing interventions to improve adherence in this population.


Asunto(s)
Diabetes Mellitus Tipo 2/terapia , Hipertensión/terapia , Cooperación del Paciente/estadística & datos numéricos , Anciano , Colombia , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Atención Primaria de Salud , Factores Socioeconómicos
2.
Invest. educ. enferm ; 37(3): [E02], 15 Octubre 2019. Tab 1, Tab 2, Tab 3
Artículo en Inglés | LILACS, BDENF - Enfermería, COLNAL | ID: biblio-1023469

RESUMEN

Objective. To determine the factors associated with adherence to the therapeutic regime in patients with hypertension and type 2 diabetes mellitus cared for in primary care centers. Methods. This was an analytical cross-sectional study, conducted with 500 patients from two institutions in Bucaramanga (Colombia). Adherence to the therapeutic regime was measured with the label of Nursing outcomes "Treatment Behavior: Illness or Injury" and the instrument "Factors that influence on adherence to pharmacological and non-pharmacological treatments" by Ortiz Suárez was used. Results. Factors affecting negatively adherence to the therapeutic regime were: belonging to the subsidized regime, never being able to read written information about the management of their disease, and never receiving information about benefits of the medications ordered by the physician. On the contrary, positive influence was noted by referring "never" to the following statements, which impacted positively on adherence: the diverse occupations you have in and out of the house hinder your following the treatment; when your symptoms improve, do you interrupt the treatment? previously, have you had difficulties in complying with your treatment and believe there are difficult-to-change customs about foods and exercises? Conclusion. Two socioeconomic factors and one related with the health system and staff affected negatively on adherence to the therapeutic regime, while four factors related with the therapy favored it. The factors identified could be used in the design of nursing interventions to improve adherence in this population.


Objetivo. Determinar los factores asociados a la adherencia al régimen terapéutico en pacientes con hipertensión y diabetes mellitus tipo 2 en centros de atención primaria. Métodos. Estudio de corte transversal analítico, realizado en 500 pacientes de dos instituciones de Bucaramanga (Colombia). La adherencia al régimen terapéutico se midió con la etiqueta de Resultados de Enfermería "Conducta terapéutica: enfermedad o lesión" y se empleó el instrumento "Factores que influyen en la adherencia a tratamientos farmacológicos y no farmacológicos" de Bonilla. Resultados. Los factores que afectaron negativamente la adherencia al régimen terapéutico fueron: pertenecer al régimen subsidiado, nunca poder leer información escrita sobre el manejo de su enfermedad y nunca recibir información sobre beneficios de los medicamentos ordenados por el médico. Por el contrario, influyeron positivamente referir "nunca" a las siguientes afirmaciones, que impactaron positivamente la adherencia: las diversas ocupaciones que tiene dentro y fuera del hogar le dificultan seguir el tratamiento; cuando mejoran sus síntomas, ¿usted suspende el tratamiento?; anteriormente, ¿ha presentado dificultades para cumplir su tratamiento y cree que hay costumbres sobre alimentos y ejercicios difíciles de cambiar?. Conclusión. Dos factores socioeconómicos y uno relacionado con el sistema y equipo de salud afectaron negativamente la adherencia al régimen terapéutico, mientras que cuatro factores relacionados con la terapia la favorecieron. Los factores identificados podrían ser utilizados en el diseño de intervenciones para mejorar la adherencia en esta población.


Objetivo. Determinar os fatores associados à aderência ao regime terapêutico em pacientes com hipertensão e diabetes mellitus tipo 2 atendidos nos centros de atenção primária. Métodos. Estudo de corte transversal analítico, realizado em 500 pacientes de duas instituições de Bucaramanga (Colômbia). A aderência ao regime terapêutico foi medida com a etiqueta de Resultados de Enfermagem "Conduta terapêutica: doença ou lesão" e se empregou o instrumento "Fatores que influem na aderência a tratamentos farmacológicos e não farmacológicos" de Ortiz Suárez. Resultados. Os fatores que afetaram negativamente a aderência ao regime terapêutico foram: pertencer ao regime subsidiado, nunca poder ler a informação escrita sobre o manejo da sua doença e nunca receber informação sobre benefícios dos medicamentos ordenados pelo médico. Pelo contrário, influíram positivamente referir "nunca" às seguintes afirmações, impacto positivamente a aderência: as diversidades ocupações que tem dentro e fora do lar lhe dificultam seguir o tratamento; quando melhoram seus sintomas, você suspende o tratamento; anteriormente há apresentado dificuldades para cumprir seu tratamento e acredita que há costumes sobre alimentos e exercícios difíceis de mudar. Conclusão. Dois fatores socioeconômicos e um relacionado com o sistema e equipamento de saúde, afetaram negativamente a aderência ao regime terapêutico, enquanto que quatro fatores relacionados com a terapia a favoreceram. Os fatores identificados poderiam ser utilizados no desenho de intervenções de enfermagem para melhorar a aderência nesta população.


Asunto(s)
Humanos , Estudios Transversales , Factores de Riesgo , Diabetes Mellitus Tipo 2 , Cumplimiento y Adherencia al Tratamiento , Hipertensión
3.
BMC Nurs ; 18: 22, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31171916

RESUMEN

Background: Worldwide, hypertension affects approximately 25% of the adult population and diabetes about 8.5%. Lack of adherence to prescribed treatment regimen remains a problem among patients undergoing long-term treatment, showing high non-adherence rates, at estimated range of between 36 and 93%. In our city, patients with hypertension and diabetes in primary care are looked after mainly by doctors with little nursing support; also, there is no published dataset among Colombian populations on the effect of nursing intervention to increase adherence to therapeutic regimen. The aim of this study was to evaluate the efficacy of nursing intervention "Teaching: Individual" compared with usual care, to increase adherence to therapeutic regimen in people with hypertension and/or type-2 diabetes, and to analyze the impact to glycosylated hemoglobin and systolic blood pressure levels. Methods: A two-arm, single-blinded, randomized controlled trial, with participants allocated to either intervention group with "Teaching: Individual" provided by two nurses, or control group receiving routine care only. Two Hundred patients attending cardiovascular risk programs of Bucaramanga, Colombia were included. Nursing intervention consisted of six educational sessions about Coping Enhancement; Behavior Modification; Teaching: Disease Process, Prescribed Medication, Prescribed Diet and Prescribed Exercise. The outcomes were Treatment Behavior: Illness or Injury (adherence to treatment), levels of both glycosylated hemoglobin (HbA1c) and systolic blood pressure for 24 h, to be measured at baseline and two follow-up time points. Basic characteristics of the groups were compared through chi-square/Fisher's exact or Students-T/Mann-Whitney U test. Outcomes were evaluated with repeated data methods and investigated changes in the outcomes over time and to compare these changes among treatment groups, and statistical significance with p-value < 0.05 were considered. Discussion: The nursing intervention "Teaching: Individual" to increase adherence to therapeutic regimen in people with hypertension and/or type-2 diabetes represents an innovative care approach intended for low-income population. The study will advise district health system policy makers and managers as to the efficacy of implementing this intervention. Should this intervention turn out efficacious, it can potentially achieve wide application in cardiovascular risk programs. Trial registration: ENURSIN was registered in ClinicalTrials.gov (NCT02758275) on April 27, 2016, protocol number 01.

4.
Univ. salud ; 19(1): 85-93, mar. 2017. tab
Artículo en Español | LILACS, COLNAL | ID: biblio-904643

RESUMEN

Resumen Introducción: El aumento de las enfermedades crónicas ha puesto en evidencia la problemática entre la oferta y demanda de los servicios de salud, generando el desplazamiento de cuidados al hogar y sobrecarga a los cuidadores familiares. Objetivo: determinar el soporte social percibido por los cuidadores familiares de personas con enfermedad crónica. Materiales y Métodos: Se realizó un estudio de corte trasversal, se aplicó el instrumento: Inventario de Soporte Social en Enfermedad Crónica de Hilbert a 129 cuidadores de personas con enfermedad crónica atendidos en un hospital de tercer nivel de atención. Resultados: Los cuidadores continúan siendo principalmente mujeres (89,9%). El puntaje promedio de la escala fue de 110,7, desviación estándar = 38,1, observándose diferencias significativas en la escolaridad (p=0,030), el estrato socioeconómico (p=0,013) y el alojamiento conjunto al paciente (p=0,010). Conclusión: Los cuidadores reportaron estar poco satisfechos con el soporte social percibido y esta percepción estuvo relacionada con las condiciones socioeconómicas de las personas.


Abstract Introduction: The increase in chronic diseases has put in evidence the problem between the supply and demand for health services, generating the displacement of care to home and the overload to family caregivers. Objective: To determine the social support perceived by family caregivers of people with chronic disease. Materials and methods: A transversal study was conducted and the Inventory of Social Support on Chronic Disease of Hilbert instrument was used with 129 family caregivers of people with chronic disease seen in a hospital of third level of attention. Results: The caregivers are primarily women (89.9%). The average score of the scale was of $110.7, standard deviation = 38.1. Significant differences were found in the schooling (p=0.030), socioeconomic status (p=0.013) and the housing to the patient (p=0.010). Conclusion: The caregivers reported to be unhappy with perceived social support and this perception was related to the socio-economic conditions of the people.


Asunto(s)
Humanos , Cuidadores , Apoyo Social , Enfermedad Crónica
5.
MedUNAB ; 20(1): 19-27, 2017. tab
Artículo en Español | LILACS, COLNAL | ID: biblio-878004

RESUMEN

Introducción: Enfermería juega un rol fundamental en las diferentes etapas de la atención de las personas con síndrome coronario agudo, entre ellas el egreso hospitalario. Brindar cuidado acorde a las necesidades propias de estas personas, requiere de la identificación de los principales diagnósticos de enfermería. Objetivo: Determinar la prevalencia de diagnósticos de Enfermería de las personas con síndrome coronario agudo al momento del alta hospitalaria. Metodología: Estudio de corte transversal en 196 personas hospitalizadas por el evento de interés, se utilizó instrumento de valoración focalizada que evaluaba las características definitorias de los diagnósticos de enfermería: ansiedad, afrontamiento ineficaz, disposición para mejorar la religiosidad, disposición para mejorar los conocimientos, intolerancia a la actividad; los cuales fueron identificados como prioritarios según la literatura científica y por consenso de expertos. Para determinar la prevalencia de los diagnósticos se realizó análisis de definición y características definitorias. Resultados: Se evidenció como principal problema de la población de estudio los conocimientos deficientes, seguido de la intolerancia a la actividad y la ansiedad. De igual forma se logró identificar diagnósticos positivos como la disposición para mejorar los conocimientos y la religiosidad. Conclusiones: El presente trabajo nos permitió identificar necesidades reales y reconocer factores protectores al momento del alta hospitalaria en personas que han vivido un evento coronario agudo, lo cual constituye un punto de partida para el diseño de planes de cuidado y la puesta en marcha de intervenciones que conduzcan a mejorar la situación de salud de este grupo de personas...(AU)


Introduction: Nursing plays a crucial role during the different stages of care of people with acute coronary syndrome, including hospital discharge. Providing care to these patients, according to their needs, requires the identification of the main nursing diagnoses. Objective: To determine the prevalence of nursing diagnoses of people with Acute Coronary Syndrome at the time of hospital discharge. Methodology: This is a cross-sectional study of 196 hospitalized people for this event; a focused assessment instrument was used to evaluate the defining characteristics of the nursing diagnoses: anxiety, ineffective coping of the problem, willingness to improve religiosity, readiness to improve knowledge, and intolerance to activity. These characteristics were identified as priorities according to the scientific literature and by the consensus of experts. A definition analysis and defining characteristics of the problem were performed to determine the prevalence of the diagnoses. Results: The main problem of the population studied was evidenced a deficient knowledge about the problem, followed by intolerance to activity and anxiety. Likewise, it was possible to identify some positive diagnoses such as the willingness to improve their knowledge about the problem and religiosity. Conclusions: The current study allowed identifying real needs and recognizing protective factors at the time of hospital discharge in people who have experienced an acute coronary event, which is a starting point for the design of care plans and the implementation of interventions that lead to improve the health situation of this group of people...(AU)


Introdução: a enfermagem desempenha um papel fundamental nas diferentes etapas do atendimento de pessoas com síndrome coronariana aguda, incluindo alta hospitalar. Prestar cuidados de acordo com as necessidades dessas pessoas requer a identificação dos principais diagnósticos de enfermagem. Objetivo: Determinar a prevalência de diagnósticos de enfermagem de pessoas com síndrome coronariana aguda no momento da alta hospitalar. Metodologia: Foi feito um estudo de corte transversal, com 196 pessoas hospitalizadas com a síndrome coronariana e se utilizou um instrumento de avaliação enfocado nas características que definem os diagnósticos da enfermagem. ansiedade, enfrentamento ineficaz, disposição para melhorar a religiosidade, disposição para melhorar o conhecimento, intolerância à atividade; que foram identificados como prioritários de acordo com a literatura científica e por consenso de especialistas. Para determinar a prevalência dos diagnósticos, realizamos a análise da definição e das características definidoras. Resultados: O principal problema da população estudada foi o conhecimento precário, seguido da intolerância à atividade e à ansiedade. Da mesma forma, foi possível identificar diagnósticos positivos, como a vontade de melhorar o conhecimento e a religiosidade. Conclusões: o presente estudo nos permitiu identificar necessidades reais e reconhecer fatores de proteção no momento da alta hospitalar, em pessoas que sofreram um evento coronariano agudo, que é um ponto de partida para o planeação de planos de cuidados e a implementação de intervenções que levaram a melhorar a situação de saúde desse grupo de pessoas...(AU)


Asunto(s)
Humanos , Alta del Paciente , Diagnóstico de Enfermería , Prevalencia , Síndrome Coronario Agudo , Proceso de Enfermería
6.
Hacia promoc. salud ; 21(1): 117-137, Jun. 2016. ilus, tab
Artículo en Español | LILACS | ID: biblio-953766

RESUMEN

OBJETIVO: realizar una síntesis del concepto de adherencia y describir los métodos empleados para medirla. METODOLOGÍA: artículo de revisión. Se realizó una búsqueda, selección y revisión de artículos originales y secundarios escritos en inglés o español, en las diferentes bases de datos: Scielo, Pubmed, Cinahl, Science@direct y Ovidsp; publicados entre 2004 y 2013. RESULTADOS: se seleccionaron 53 artículos, de los cuales 13 definían el concepto y la clasificación de los métodos, 32 fueron estudios de investigación que emplearon métodos indirectos, 17 combinaron métodos directos e indirectos y un estudio utilizó un método directo. CONCLUSIONES: se evidenció el uso de diferentes conceptos a la hora de definir la adherencia, sin que exista un consenso. Asimismo, para la medición se utilizaron diferentes técnicas, la más común fue el uso de métodos indirectos, seguidos de la combinación de directos e indirectos


OBJECTIVE: To carry out a synthesis of the concept of adherence and describe the methods used to measure it. METHODOLOGY: Review article. A search, selection and review of original and secondary articles published between 2004 and 2013, written in English or Spanish in different databases including Scielo, Pubmed, Cinahl, Science@direct and Ovidsp which were was carried out. RESULTS: A total of 53 articles were selected, 13 of which defined the concept and classification of methods; 32 were research studies that used indirect methods, 17 combined direct and indirect methods and one study used a direct method. CONCLUSIONS: The use of different concepts defining adherence, without a consensus was evident. Also, different techniques were used for measurement being the most widely used indirect methods, followed by the combination of direct and indirect methods


OBJETIVO: Realizar uma síntese do conceito de aderência e descrever os métodos empregados para medir-la METODOLOGIA: artigo de revisão. Realizou se uma busca, seleção e revisão de artigos originais e secundários escritos em inglês ou espanhol, nas diferentes bases de dados: Scielo, Pubmed, Cinahl, Science@direct e Ovidsp; publicados entre 2004 e 2013. RESULTADOS: Selecionaram se 53 artigos, dos quais 13 definiam o conceito e a classificação dos métodos, 32 foram estudos de pesquisa que empregaram métodos indiretos, 17 misturaram métodos diretos e indiretos e um estudo utilizou um método direto. CONCLUSÕES: Evidenciou se o uso de diferentes conceitos à hora de definir a aderência, sem que exista um consenso. Assim mesmo, para a medição se utilizaram diferentes técnicas, a mais comum foi o uso de métodos indiretos, seguidos da combinação de diretos e indiretos


Asunto(s)
Humanos , Terapéutica , Enfermedad Crónica , Cumplimiento de la Medicación , Métodos , Evaluación en Enfermería
7.
Rev. Univ. Ind. Santander, Salud ; 43(2): 191-201, mayo-ago. 2011. tab
Artículo en Español | LILACS-Express | LILACS | ID: lil-637319

RESUMEN

Introducción: El apoyo telefónico es una intervención que permite dar información, educación y soporte psicosocial a los cuidadores familiares, por tanto es importante describir las diferentes alternativas con su correspondiente metodología e impacto en la experiencia de ser cuidador. Objetivo: Revisar sistemáticamente la literatura en relación con la intervención apoyo telefónico y su eficacia en la población intervenida. Métodos: Se realizó una búsqueda de artículos en las diferentes bases de datos, publicados entre los años 1990 y 2010, considerando la solidez y la calidad de la evidencia sobre la temática. Resultados: De 17 estudios que describieron el apoyo telefónico para cuidadores familiares, 6 tuvieron un alto nivel de evidencia, permitiendo un análisis comparativo para determinar la eficacia de la intervención. Conclusión: Existen sólidos resultados que soportan la eficacia del apoyo telefónico en la disminución de la ansiedad, la depresión, el estrés y en general mejoría del bienestar de los cuidadores. Salud UIS 2011; 43 (2): 191-201.


Introduction: The telephone support is an intervention that can provide information, education and psychosocial support to family caregivers, therefore, is important to describe the different alternatives with theirs methodology and its impact on the experience of being caregiver. Purpose: Reviewing systematically the literature in relation with the intervention of telephone support and his efficacy in the population studied. Methods: We performed a structured search of the articles in the different databases, published between 1990 and 2010, recognizing the strength and quality of evidence. Results: Of 17 studies that described the telephone support as an intervention for family caregivers, only 6 studies were considered high quality, enabling a comparative analysis to determine the efficacy of the intervention. Conclusion: There is solid evidence supporting the efficacy of telephone support in reducing anxiety, depression, stress and in general improve of the welfare of caregivers. Salud UIS 2011; 43 (2): 191-201.

8.
Rev. cuba. enferm ; 27(1): 20-30, ene.-mar. 2011.
Artículo en Español | LILACS, BDENF - Enfermería, CUMED | ID: lil-615050

RESUMEN

El objetivo del estudio fue evaluar la eficacia de las intervenciones de enfermería en personas con enfermedad crónica y sus cuidadores, dadas mediante el programa Preparación y Apoyo para el Cuidado en el Hogar. Estudio cuasiexperimental. Se valoraron las etiquetas de resultado Conocimiento: proceso de la enfermedad, Conocimiento: régimen terapéutico, Preparación del cuidador familiar domiciliario, Bienestar del cuidador principal. Los participantes se asignaron a tres grupos. El primer grupo recibió preparación para el alta, el segundo grupo recibió preparación para el alta e intervención telefónica y el tercer grupo recibió además de lo anterior, una visita en su domicilio. Tras la intervención se encontró diferencias de 0.55 y 0.20 en el CRE final de la etiqueta Conocimiento Proceso de la Enfermedad de las personas del segundo y tercer grupo, respectivamente. Se encontró que las intervenciones de enfermería dadas mediante el programa son eficaces para las personas con enfermedad crónica y sus cuidadores familiares(AU)


The objective of present study was to assess the effectiveness of nursing interventions in persons presenting with a chronic disease and their carers according to the Training and Support Program for Home Care. Present study was quasi-experimental. The following labels were assessed: Knowledge result: disease course, Knowledge: therapeutic regimen, Training of family carer at home, Wellbeing of main carer. The participants were randomized to three groups. The first group received training related to discharge, the second one received training for the discharge and telephone intervention and the third one received also of above mentioned trainings, a visit in its home. After intervention there were differences of 0.55 and 0.20 in the final CRE of the Knowledge label of Disease Course of the persons of second and third group, respectively. We found that the nursing interventions applied by means of the program are effective for the persons presenting with a chronic diseases and their family carers(AU)


Asunto(s)
Humanos , Enfermedad Crónica/epidemiología , Cuidadores/psicología , Servicios de Atención de Salud a Domicilio/ética , Cuidados de Enfermería en el Hogar/métodos , Visita Domiciliaria
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