RESUMO
OBJECTIVE: To explore the association between immigrant status and performance of pap-smear and mammography, and to study the potential effect of social integration on that association. METHOD: Secondary analysis of the National Health Survey of Spain 2012. Individual data from 8944 women aged 18-75 were analyzed. Dependent variables were the performance of pap-smear tests and mammographies according to the guidelines of the state of residence. The level of integration in Spain was estimated through perceived social support (Duke-UNC scale) and the number of years living in Spain. Logistic regressions were used in order to obtain odds ratios (OR) and their 95% confidence intervals (95%CI), adjusted for confounders (sociodemographic and health-status). RESULTS: Compared to natives, immigrant women were more likely to not adhere to cervical cancer screening (OR: 1.31; 95%CI: 1.06-1.63) or breast cancer screening (OR:=3.13; 95%CI: 2.14-4.58). Additional adjustment by social support and length of residence in Spain attenuated the association, consequently losing statistical significance (OR: 1.08, 95%CI: .77-1.52 for pap-smear; OR: 1.62, 95%CI: .97-2.74 for mammographies). CONCLUSIONS: The probability of participating in the screening programs for gynecological cancer was lower if women were born abroad. Perceived social support and time living in Spain of immigrant women explained to a large extent the differences between immigrants and natives.
Assuntos
Neoplasias da Mama , Emigrantes e Imigrantes , Neoplasias do Colo do Útero , Neoplasias da Mama/diagnóstico , Detecção Precoce de Câncer , Feminino , Humanos , Mamografia , Programas de Rastreamento , Integração Social , Espanha , Neoplasias do Colo do Útero/diagnósticoRESUMO
Pharmacotherapy follow-up (PTF) is the professional practice in which the pharmacist takes charge of the needs of the patients related to their drugs. OBJECTIVE: To validate a questionnaire to measure the ASE psychosocial determinants (attitude, social influence, self-efficacy) of PTF and the Prochaska & DiClemente's stage of change in Spanish community pharmacists. METHOD: Postal survey to 482 Asturian community pharmacists (test and retest). Validity was estimated in 134 pharmacists answering the test. Stability was estimated in 85 pharmacists answering the test and retest. Exploratory factorial analysis was used to investigate construct validity and produced 4 factors and 104 items. Those factors had high reliability (Cronbach's a between 0,87 and 0,96). DISCRIMINANT VALIDITY: Pharmacists in extreme stages of change showed significant differences of attitude, motivation and self-efficacy. Repeatability was good and the questionnaire appears valid and reliable.