Association between Cervical Cancer and Dietary Patterns in Colombia.

Cervical cancer is a global public health problem. It is the second leading cause of death among women of childbearing age worldwide. Several factors, including diet, have been shown to influence the risk of persistent HPV infection and tumor progression. This paper determines the relationship between dietary patterns and cervical cancer. It is an ecological study of multiple groups, based on two national sources: the High-Cost Account and the National Survey of Nutritional Situation of Colombia of 2015. The population consisted of 3472 women aged 35 to 64. The incidence of cervical cancer was used as the dependent variable while the independent variables included food consumption according to established patterns, area of residence, age, physical activity, and BMI, among other variables. The statistical analysis performed through associations between variables was evaluated by multiple linear regression using R2. 38.9% of the evaluated population belonged to the first quartile of wealth, and 76.5% resided in the municipal capital. The incidence of cervical cancer in Colombia was associated with being affiliated to a state-subsidized health regime and having diabetes mellitus. A conservative eating pattern, as well as belonging to a rural area, are evidenced as protective factors. These results invite the need to encourage public policies and promote healthy lifestyles.

Factors Associated with Dietary Patterns in Colombia.

The selection of food depends on various factors such as cultural, social, economic and biological. This paper determines the factors associated with dietary patterns in Colombia. It is an observational, descriptive exploratory study collecting secondary data from the National Survey of Nutritional Status of Colombia (ENSIN, 2015) of 16,216 people between 15 and 64 years of age. The variables were the following: area, age range, sex, educational level, high blood pressure arterial hypertension (HTA), diabetes (DM), cancer, wealth quartile and dietary pattern. For the data analysis, logistic regression models were generated for each pattern and OR was used as a measure of association. Of those studied, 74.6% live in urban areas, all were aged between 15 and 49 years and 45.4% were in the first wealth quartile (Q1). There was a greater probability of traditional and conservative dietary patterns in people with diabetes and hypertension. Consumption of the conservative pattern was associated with being a woman, while consumption of the traditional pattern was associated with people in the first and second wealth level. Consumption of grill/beverage was more likely in men. Socio-demographic factors and chronic non-communicable diseases are associated with dietary patterns. This makes it relevant for health professionals to take into account these characteristics for nutritional interventions.

Design and validation of a predictive model for determining the risk of developing fibromyalgia.

OBJECTIVES: Fibromyalgia is a prevalent disease of unknown aetiology and is difficult to diagnose. Despite the availability of the American College of Rheumatology criteria for diagnosis, it continues to be a challenge in the field of primary health care in terms of identifying individuals with susceptibility to developing the disease. The aim of this study is to design and validate a predictive model of fibromyalgia in subjects with a history of chronic pain. METHODS: This multicentre observational retrospective cohort study was performed on patients aged >18 years, who visited four primary health centres between 2017 and 2020, with a diagnosis of fibromyalgia or arthritis. The Bootstrapping resampling method was used for the validation of the model. RESULTS: A total of 198 subjects with fibromyalgia (93 with osteoarthritis, 20 with other types of arthritis, 4 with rheumatoid arthritis) and 120 without fibromyalgia (116 with osteoarthritis, 23 with other types of arthritis, 7 with rheumatoid arthritis) participated in the study. The predictive factors of the final model were self-reported age at onset of symptoms, first-line family history of neurological diseases, exposure to levels of stress, history of post-traumatic acute emotional stress, and personal history of chronic widespread pain prior to diagnosis, comorbidity, and pharmacological prescription during the year of diagnostic confirmation. The predictive capacity adjusted by Bootstrapping was 0.972 (95% CI: 0.955-0.986). CONCLUSIONS: The proposed model showed an excellent predictive capacity. The risk calculator designed from the predictive model allows health professionals to have a useful tool to identify subjects at risk of developing fibromyalgia.

Impacto de una intervención socioeducativa para mejorar la calidad de vida en pacientes con fibromialgia: un diseño cuasiexperimental / Impact of a socio-educational intervention to improve the quality of life of patients with fibromyalgia: A quasi-experimental design

OBJETIVO: Evaluar el impacto de una intervención socioeducativa para mejorar la calidad de vida en pacientes con fibromialgia. MÉTODO: De 132 elegibles, participaron 128 pacientes mayores de 18 años, con diagnóstico de fibromialgia (ACR 1990/2010), que no tuvieron problemas cognitivos o trastornos mentales en fase aguda y pertenecieron al área de influencia de los CAP participantes. Los pacientes recibieron durante 5 semanas una intervención para fortalecer la autogestión del dolor y mejorar la calidad de vida. Se estudiaron las variables sociodemográficas, satisfacción y calidad de vida (SF-36). Las mediciones pre-post se hicieron en los 128 participantes y el seguimiento a los 2 meses en 120 (8 no aceptaron ser contactados). RESULTADOS: Al comparar las puntuaciones pre-postintervención (test no paramétrico de Wilcoxon), se encontró que el 71,09% refirió mayor percepción de la calidad de vida en el dominio Salud mental y menor porcentaje de mejoría (28,91%) en el dominio Rol físico. Al comparar las puntuaciones pre-postseguimiento (prueba de Friedman), la media de percepción mejoró en todos los dominios y se mantuvo a los 2 meses de seguimiento (p < 0,001). Finalmente, la media de satisfacción con la intervención recibida fue de 90,55% (DE 9,86; mín.41, máx.100). CONCLUSIONES: Al valorar el impacto de la intervención, se observó una mejora en las puntuaciones post y seguimiento. Este hallazgo puede deberse a que la intervención fortalece en el paciente el autodominio de sus habilidades para controlar el dolor y mejorar la percepción de la calidad de vida

OBJECTIVE: To evaluate the impact of a socio-educational intervention to improve the quality of life of patients with fibromyalgia. METHOD: Out of 132 eligible candidates, 128 patients participated with a diagnosis of fibromyalgia (ACR 1990/2010), over 18 years of age, who did not have cognitive problems or mental disorders in acute phase and lived in the catchment area of the participating CAPs. The patients underwent intervention for 5 weeks to strengthen self-management of pain and improve quality of life. Socio-demographic variables, satisfaction and quality of life (SF-36) were studied. Pre-post measurements were made on the 128 participants and follow-up at 2 months on 120 (8 did not agree to be contacted). RESULTS: Comparing the pre-post-intervention scores (non-parametric Wilcoxon test), it was found that 71.09% reported a higher perception of quality of life in the Mental health domain and lower percentage of improvement (28.91%) in the Physical role domain. When comparing pre-post-follow-up scores (Friedman's test), mean perception improved in all domains and remained at 2-month follow-up (P<.001). Finally, the average satisfaction with the intervention received was 90.55% (SD 9.86; min.41, max.100). CONCLUSIONS: When assessing the impact of the intervention, there was an improvement in the post and follow-up scores. This finding is largely due to the fact that the intervention strengthens the patient's self-mastery of their abilities to control pain and improve their perception of quality of life

Impact of a socio-educational intervention to improve the quality of life of patients with fibromyalgia: A quasi-experimental design. / Impacto de una intervención socioeducativa para mejorar la calidad de vida en pacientes con fibromialgia: un diseño cuasiexperimental.

OBJECTIVE: To evaluate the impact of a socio-educational intervention to improve the quality of life of patients with fibromyalgia. METHOD: Out of 132 eligible candidates, 128 patients participated with a diagnosis of fibromyalgia (ACR 1990/2010), over 18 years of age, who did not have cognitive problems or mental disorders in acute phase and lived in the catchment area of the participating CAPs. The patients underwent intervention for 5 weeks to strengthen self-management of pain and improve quality of life. Socio-demographic variables, satisfaction and quality of life (SF-36) were studied. Pre-post measurements were made on the 128 participants and follow-up at 2 months on 120 (8 did not agree to be contacted). RESULTS: Comparing the pre-post-intervention scores (non-parametric Wilcoxon test), it was found that 71.09% reported a higher perception of quality of life in the Mental health domain and lower percentage of improvement (28.91%) in the Physical role domain. When comparing pre-post-follow-up scores (Friedman's test), mean perception improved in all domains and remained at 2-month follow-up (P<.001). Finally, the average satisfaction with the intervention received was 90.55% (SD 9.86; min. 41, max. 100). CONCLUSIONS: When assessing the impact of the intervention, there was an improvement in the post and follow-up scores. This finding is largely due to the fact that the intervention strengthens the patient's self-mastery of their abilities to control pain and improve their perception of quality of life.

[Validation of the Spanish version of the Primary Care Assessment Survey questionnaire]. / Validación de la versión en español del cuestionario PCAS para evaluar la atención primaria de salud.

OBJECTIVE: Adapt the Primary Care Assessment Survey (PCAS) questionnaire to the Spanish language and determine its validity and reliability in identifying strengths and weaknesses in primary health care (PHC). METHODS: Study of the adaptation and validation of a questionnaire-survey. The suitable sample selected was 244 users of PHC services. The users were over 18 years of age and had had at least two institutional visits prior to being included in the study. The variables used were access, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment, and trust. Participation was confirmed through analysis of the distribution of responses; participation and patterns of nonresponse; the construct, through exploratory factorial analysis, using principal component analysis and the varimax rotation; the criterion, through the Pearson product-moment correlation coefficient; and reliability using Cronbach's alfa and the intraclass correlation coefficient. RESULTS: The exploratory factorial analysis obtained 11 factors that explain 68.38% of the original variability. The criterion validity showed a sufficient correlation between the summary measure of the scale and the ad hoc variables Q33b (value of r x1x2 = 0.569; P = 0.01) and Q32 (value of r x1x2 = 0.600; P = 0.01). The scale obtained a coefficient of Cronbach's alfa of 0.94. The test-retest reliability (F [1 140] = 0.155 [P = 0.694]) demonstrated that the scale is stable over time. CONCLUSIONS: The psychometric properties of the adapted version of the PCAS questionnaire make it possible to state that it is a valid and reliable scale to evaluate primary care from a standpoint of ongoing care based on the physician-patient relationship.

Validación de la versión en español del cuestionario PCAS para evaluar la atención primaria de salud / Validation of the Spanish version of the Primary Care Assessment Survey questionnaire

OBJETIVO: Adaptar el cuestionario PCAS (del inglés Primary Care Assessment Survey) al idioma español y determinar su validez y su fiabilidad cuando se trata de identificar las debilidades y las fortalezas que se observan en la atención primaria de salud (APS). MÉTODOS: Estudio de adaptación y validación de un cuestionario-encuesta. Se seleccionó una muestra por conveniencia de 244 usuarios de servicios de APS, mayores de 18 años y con al menos dos visitas institucionales al momento de ser incluidos en el estudio. Se utilizaron las variables: accesibilidad, continuidad, integralidad, integración, interacción clínica, trato interpersonal y confianza. Se validaron la apariencia, mediante análisis de distribución de las respuestas, análisis de participación y patrones de no respuesta; el constructo, mediante análisis factorial exploratorio usando el método de componentes principales y rotación Varimax; el criterio, mediante el coeficiente de correlación de Pearson, y la fiabilidad, usando el alfa de Cronbach y el coeficiente de correlación intraclase. RESULTADOS: En el análisis factorial exploratorio se obtuvieron 11 factores que explicaron 68,38 por ciento de la variabilidad original. La validez de criterio mostró una correlación adecuada entre la medida resumen de la escala y las variables "ad hoc" Q33b (valor de r×1×2 = 0,569; P = 0,01) y Q32 (valor de r×1×2 = 0,600; P = 0,01). La escala obtuvo un coeficiente de alfa de Cronbach de 0,94. La fiabilidad test-retest (F [1,140] = 0,155 [P = 0,694]) demostró que la escala es estable en el tiempo. CONCLUSIONES: Las propiedades psicométricas de la versión adaptada del cuestionario PCAS permiten afirmar que se trata de una escala válida y fiable para evaluar la atención primaria desde un enfoque de continuidad asistencial basada en la relación médico-paciente.

OBJECTIVE: Adapt the Primary Care Assessment Survey (PCAS) questionnaire to the Spanish language and determine its validity and reliability in identifying strengths and weaknesses in primary health care (PHC). METHODS: Study of the adaptation and validation of a questionnaire-survey. The suitable sample selected was 244 users of PHC services. The users were over 18 years of age and had had at least two institutional visits prior to being included in the study. The variables used were access, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment, and trust. Participation was confirmed through analysis of the distribution of responses; participation and patterns of nonresponse; the construct, through exploratory factorial analysis, using principal component analysis and the varimax rotation; the criterion, through the Pearson product-moment correlation coefficient; and reliability using Cronbach's alfa and the intraclass correlation coefficient. RESULTS: The exploratory factorial analysis obtained 11 factors that explain 68.38 percent of the original variability. The criterion validity showed a sufficient correlation between the summary measure of the scale and the ad hoc variables Q33b (value of r x1x2 = 0.569; P = 0.01) and Q32 (value of r x1x2 = 0.600; P = 0.01). The scale obtained a coefficient of Cronbach's alfa of 0.94. The test-retest reliability (F [1 140] = 0.155 [P = 0.694]) demonstrated that the scale is stable over time. CONCLUSIONS: The psychometric properties of the adapted version of the PCAS questionnaire make it possible to state that it is a valid and reliable scale to evaluate primary care from a standpoint of ongoing care based on the physician-patient relationship.

Estudio descriptivo de la tipología de pacientes atendidos en un programa de enfermeras de enlace / Descriptive study of the type of patient cared for in a link-nursing program

Objetivo. Determinar la tipología de los pacientes atendidos en un programa de enfermería de enlace de ámbito urbano. Métodos. Estudio observacional y descriptivo realizado en el Hospital Clínic de Barcelona. La población de estudio fueron los pacientes hospitalizados en los institutos de Traumatología, Medicina Interna, Cardiología, Cirugía Vascular y Unidad Poscoronaria. La recogida de datos se obtuvo mediante el registro de los pacientes incluidos en el programa entre noviembre de 2006 y abril de 2008. Se analizaron variables sociodemográficas (género, edad, motivo de ingreso, instituto en el que estuvo hospitalizado, días de estancia hospitalaria, centro de atención primaria [CAP] de referencia, destino del paciente al alta hospitalaria) y necesidades físicas (índice de dependencia de Barthel y recomendaciones de las enfermeras de enlace a los CAP de referencia). Resultados. De 2.040 pacientes elegibles, se analizó la información de 2.025 pacientes (99,26%). Quince pacientes fueron excluidos porque no tenían la información completa para el análisis de los datos. Resultados. La media de edad en los hombres fue de 73,55 años y en las mujeres fue de 66,53 años (p<0,01). Noventa y dos hombres (9,10%) y 61 mujeres (6,02%) mostraron dependencia severa (p<0,01). La media de días de estancia en los hombres fue de 9,7 y en las mujeres fue de 9,65 (p<0,01). En 571 hombres (56,48%) y 605 mujeres (59,66%) no se requirió la continuidad de cuidados asistenciales en el domicilio. Conclusiones. La mayoría de la población fue anciana con un índice de dependencia leve, lo que demuestra que esta población es susceptible de requerir un seguimiento después del alta hospitalaria, a pesar de que el índice de dependencia de Barthel no sea severo o total(AU)

Objective. Determine the type of patients in a program of link nursing of the urban area. Methods. Descriptive observational study conducted at the Hospital Clinic de Barcelona (HCB). The study population were patients hospitalized in the Institute of Orthopedics, Internal Medicine, Cardiology, Vascular Surgery and Post Coronary Care. The data was obtained through the registration of patients enrolled in the program between November 2006 and April 2008. We analyzed sociodemographic variables (gender, age, reason for admission, the institution where hospitalized, hospital stay, primary care (PAC) reference destination of the patient on discharge from hospital) and physical variables (Barthel dependency score and recommendations of the link nurse to reference PAC). Results. Information was analysed from 2025 (99.26%) out of 2040 eligible patients. Fifteen were excluded because they did not have complete information for data analysis. The average age for men was 73.55 years and 66.53 years for women (P<0.01). There was sever dependence in 92 (9.10%) males and 61 (6.02%) women (P<0.01). The average number of hospital stays for men was 9.7 and 9.65 for women (P<0.01). Continuity of care at home was not required in 571 (56.48%) males and 605 (59.66%). Conclusions. The majority of the population was elderly with an index of slight dependence, demonstrating that this population need continuous monitoring of their progress after discharge, although the Barthel index was not severe or total(AU)

[Descriptive study of the type of patient cared for in a link-nursing program]. / Estudio descriptivo de la tipología de pacientes atendidos en un programa de enfermeras de enlace.

OBJECTIVE: Determine the type of patients in a program of link nursing of the urban area. METHODS: Descriptive observational study conducted at the Hospital Clinic de Barcelona (HCB). The study population were patients hospitalized in the Institute of Orthopedics, Internal Medicine, Cardiology, Vascular Surgery and Post Coronary Care. The data was obtained through the registration of patients enrolled in the program between November 2006 and April 2008. We analyzed sociodemographic variables (gender, age, reason for admission, the institution where hospitalized, hospital stay, primary care (PAC) reference destination of the patient on discharge from hospital) and physical variables (Barthel dependency score and recommendations of the link nurse to reference PAC). RESULTS: Information was analysed from 2025 (99.26%) out of 2040 eligible patients. Fifteen were excluded because they did not have complete information for data analysis. The average age for men was 73.55 years and 66.53 years for women (P<0.01). There was sever dependence in 92 (9.10%) males and 61 (6.02%) women (P<0.01). The average number of hospital stays for men was 9.7 and 9.65 for women (P<0.01). Continuity of care at home was not required in 571 (56.48%) males and 605 (59.66%). CONCLUSIONS: The majority of the population was elderly with an index of slight dependence, demonstrating that this population need continuous monitoring of their progress after discharge, although the Barthel index was not severe or total.