RESUMO
Objetivo: analizar la aplicabilidad del modelo Dominancia, Influencia, Serenidad y Cumplimiento de comportamiento en el consejo anticonceptivo. Métodos: estudio piloto llevado a cabo con 294 profesionales sanitarios en el que, mediante ejercicios de rol play, se evaluó la capacidad de identificación del modelo Dominancia, Influencia, Serenidad y Cumplimiento de pacientes figuradas. Resultados: el 100% de los participantes pudo identificar, al menos un perfil comportamental, un 84% fue capaz de identificar dos, el 52,4% identificó tres y el 41% identificó los cuatro modelos de comportamiento presentados durante el ejercicio. El modelo Dominancia fue identificado por el 78% de los participantes en el estudio; el modelo Influencia por el 97%; el modelo Serenidad por el 81% y el modelo Cumplimiento por el 83%. Conclusiones: ser capaces de identificar los modelos de comportamiento Dominancia, Influencia, Serenidad y Cumplimiento y realizar un consejo anticonceptivo más acorde con las necesidades específicas de las personas, puede ayudar a mejorar la elección y tasa de continuidad del método (AU)
Objective: To assess the validity of the Dominance, Influence, Stability, Compliance system during contraceptive counselling. Methods: In this role-play-based pilot study, 294 healthcare providers tried to identify the Dominance, Influence, Stability, Compliance model in four imaginary patients. Results: All the participants were able to identify at least one of the Dominance, Influence, Stability, Compliance models, 84% identified two, 52.4% identified three and 41% identified all four different models. Model Dominance was recognized by 78% of participants, model Influence by 97%, model Stability by 81% and model Compliance by 83%. Conclusions: The ability to identify Dominance, Influence, Stability, Compliance behavioural models and provide contraceptive counselling according to the specific needs of individuals could help to improve the choice of contraceptive method and its continuity rate (AU)
Assuntos
Conselhos de Saúde , Escala de Avaliação Comportamental/normas , Anticoncepção/normas , Anticoncepcionais/uso terapêutico , Conhecimentos, Atitudes e Prática em Saúde , Projetos Piloto , Serviços de Planejamento Familiar/normasRESUMO
BACKGROUND: Parasitic leiomyomas were first described as early as 1909 but are a rare condition. In recent years, due to the rise of laparoscopic surgery and power morcellation, several cases of parasitic leiomyomas associated with this surgical procedure have been reported. METHODS: A literature search was performed using PubMed, Embase and Google Scholar with the following combination of keywords: leiomyoma OR uterine neoplasms OR uterine myomectomy OR laparoscopy OR hysterectomy OR peritoneal neoplasms AND parasitic. Papers describing parasitic leiomyomas were included. The results of these studies are summarized herein. RESULTS: We retrieved abstracts of 756 papers. Of these, 591 were excluded for not fulfilling the inclusion criteria and 54 were removed as duplicates; after full-text assessment, 8 were rejected for presenting cases of malignancy and finally 103 were included in our systematic review. From these, we present information about 274 patients with parasitic leiomyomas. The mean age of women was 40 years (range 18-79 years); and 154 (56%) had no history of uterine surgery, the others (120, 44%) having had a previous myomectomy or hysterectomy. Of the total, 106 (39%) women had a history of power morcellation. The most frequent clinical symptom was abdominal pain (49%) and the most frequent presentation was disseminated peritoneal leiomyomatosis. CONCLUSIONS: While parasitic leiomyoma was first described a century ago, the recent introduction of laparoscopic power morcellation has increased the number of reported cases.
Assuntos
Histerectomia/métodos , Leiomiomatose/cirurgia , Morcelação/métodos , Neoplasias Uterinas/cirurgia , Feminino , Humanos , Resultado do Tratamento , Miomectomia Uterina/métodosRESUMO
Objetivo: Evaluar el coste-efectividad de diferentes métodos anticonceptivos hormonales combinados. Material y método: Estudio de farmacoeconomía utilizando un modelo de Markov sobre los costes de 3 métodos anticonceptivos hormonales combinados: un anticonceptivo oral financiado, un parche transdérmico y un anillo vaginal. Resultados: El coste total para el Sistema Nacional de Salud, teniendo en cuenta todas las mujeres en edad fértil que utilizan anticoncepción hormonal combinada, sería de 410.122.928 euros en el caso del anticonceptivo oral financiado, de 296.961.568 euros en el caso del parche y de 295.380.316 euros en el caso del anillo vaginal. Para las mujeres los costes serían de 106.164.890 euros, 521.386.383 y 534.474.699 euros respectivamente. Conclusión: Desde la perspectiva del Sistema Nacional de Salud el método de anticoncepción hormonal combinada más coste-efectivo es el anillo vaginal. Desde la perspectiva de las mujeres el uso del anillo vaginal les cuesta más dinero, pero se exponen menos al riesgo de un embarazo no deseado (AU)
Objective: To assess the cost-effectiveness of different combined hormonal contraceptive (CHC) methods. Material and method: A pharmacoeconomic study was conducted using a Markov model of three CHC methods: a reimbursed oral contraceptive, a contraceptive patch, and a vaginal ring. Results: The total cost to the National Health Service would be Euros 410,122,928 if all women of fertile age who employed CHC used a financed oral contraceptive, Euros 296,961,568 if they used the transdermal patch, and Euros 295,380,316 if they used the vaginal ring. For women, these costs would be Euros 106,164,890, Euros 521,386,383, and Euros 534,474,699, respectively. Conclusion: From an National Health Service perspective, the most cost-effective CHC method is the vaginal ring. For women, the vaginal ring is most expensive method, but the excess price could be balanced by a greater protection against unwanted pregnancies (AU)
