Computer System for the Capture and Preparation of Cytopathological Reports for Cervical Cancer Detection and His Utility in Training for Health Personnel.

Health information systems and training are tools that support process management. The current study describes the results of the implementation of technological innovation in the process of the capture and preparation of cytopathological reports. The electronic system was structured based on national standards regarding cervical cancer control. PHP was used to design the software and MYSQL was used for the structure of the database. The total number of health personnel assigned to the cytology department participated, along with a pathologist, who made the records of the patients who came for cervical cytology to a university health center in San Luis Potosi, Mexico. The system was evaluated based on the indicators of structure, process, and results. Structure: comply with the official Mexican regulations for the registration of cervical cancer and electronic health information systems. Process: all records were legible and accurate, with varying percentages of completeness in the patient identification sections (46%) and alternate contact data (80%). Result: percentages above 80% were obtained in the satisfaction of the professionals who used the system. The system was effective as it yielded readable and accurate data that made the process of information capture and delivery of cervical screening results more efficient and faster.

Factibilidad para implementar un sistema electrónico de registros de citología cervical / Feasibility to implement an electronic cervical cytology record system

Introducción: para garantizar la información y la atención de calidad, la Organización Mundial de la Salud, la Organización Panamericana de la Salud y las normas oficiales del cáncer cervicouterino y los sistemas de salud en México sugieren fortalecer los sistemas de información en salud con el uso de herramientas tecnológicas. Objetivo: el propósito de este estudio es conocer la factibilidad de un proyecto para la innovación de procesos, a través de un sistema electrónico para los registros de las citologías cervicales. Metodología: estudio observacional, transversal, prospectivo, realizado del 4 al 25 de junio de 2018 en la Unidad de Cuidados Integrales e Investigación en Salud de la Universidad Autónoma de San Luis Potosí, México. Se estudió al universo del personal sanitario que implementa el Programa de Detección Oportuna de Cáncer Cervico Uterino, con 7 participantes: personal directivo (2) y operativo (5). Resultados: las políticas y recursos institucionales permiten la implementación del proyecto, pues consideran tendría impacto positivo en la atención. Conclusiones: actualmente, la totalidad del personal cuenta con las competencias básicas para el manejo de sistemas electrónicos.

Introduction: To guarantee quality information and care, World Health Organization, Pan American Health Organization and the Official Standards of Cervical Cancer and Health Systems in Mexico suggest strengthening health information systems with the use of technological tools. Objective: The purpose of the study is to know the feasibility of a project for process innovation, through an electronic system for records of cervical cytologies. Methods: An observational, cross-sectional, prospective study conducted from June 4 to 25, 2018 in the Unit of Integral Care and Health Research of the Autonomous University of San Luis Potosí, Mexico. The universe of health personnel that implements the Timely Detection of Cervical Cancer Program was studied, 7 participants: managerial staff (2) and operative staff (5). Results: Institutional policies and resources allow for the implementation of the project, as they consider it would have a positive impact on care. Conclusions: Currently, all the staff has the basic skills for the management of electronic systems.

Coleta de amostra para identificação de DNA do papilomavírus: conhecimento e habilidades / Toma de muestra para identificación de ADN del papilomavirus: conocimiento y habilidades / Sample taking for identification of papilomavirus DNA: skills and knowledge

Resumo Objetivo Estabelecer a relação entre o conhecimento e as habilidades dos profissionais da saúde em coletar amostras para a identificação do DNA do papilomavírus. Métodos Estudo transversal, realizado entre março e junho de 2017, com uma população de 313 pessoas. A amostra probabilística foi calculada considerando um r=0,306, 95% de confiança e poder de 90%, equivalente a 90 trabalhadores de 23 centros de saúde. Um teste de conhecimento e um checklist foram administrados para avaliar as habilidades na coleta de amostra utilizando o teste de Captura Híbrida 2 (teste HPV-CH2). Para análise dos dados, foi utilizada a correlação de Pearson e ANOVA. Resultados Foi encontrada uma correlação entre conhecimento e habilidades (r=0,438) (p<0,001). Quanto ao conhecimento, não houve diferença significativa nas médias obtidas nos três grupos de participantes (enfermeiros versus estagiários 3,27 p=0,557, médicos vs. enfermeiros 2,17 p=0,852, e médicos vs. estagiários 5,45 p=0,441). Quanto às habilidades, não houve diferença entre as médias obtidas entre médicos e enfermeiros (4,27 p=0,388), nem entre enfermeiros e estagiários (4,54 p=0,179), mas houve diferença entre médicos e estagiários (8,81 p=0,041). Conclusão Houve correlação entre o conhecimento e as habilidades em coletar amostras para a identificação do DNA do papilomavírus. Não houve diferenças significativas no conhecimento entre os grupos estudados, mas uma diferença em relação às habilidades foi encontrada entre médicos e estagiários.

Resumen Objetivo establecer la relación entre el conocimiento y las habilidades de los profesionales de la salud para tomar muestras para identificación del ADN del papilomavirus. Métodos estudio transversal realizado entre marzo y junio de 2017, con una población de 313 personas. El muestreo probabilístico fue calculado considerando un r=0,306, 95% de confianza y poder de 90%, equivalente a 90 trabajadores de 23 centros de salud. Se aplicó una prueba de conocimiento y una checklist para evaluar las habilidades de toma de muestra utilizando la prueba de captura de híbridos 2 (prueba HPV-CH2). Para el análisis de datos se utilizó la correlación de Pearson y ANOVA. Resultados se encontró una correlación entre conocimiento y habilidades (r=0,438) (p<0,001). Con relación al conocimiento, no hubo diferencia significativa en los promedios obtenidos en los tres grupos de participantes (enfermeros vs. practicantes 3,27 p=0,557, médicos vs. enfermeros 2,17 p=0,852 y médicos vs. practicantes 5,45 p=0,441). Respecto a las habilidades, no hubo diferencia en los promedios obtenidos entre médicos y enfermeros (4,27 p=0,388), ni entre enfermeros y practicantes (4,54 p=0,179), pero hubo diferencia entre médicos y practicantes (8,81 p=0,041). Conclusión hubo correlación entre el conocimiento y las habilidades para tomar muestras para identificar el ADN del papilomavirus. No hubo diferencias significativas en el conocimiento entre los grupos estudiados, pero se encontró una diferencia con relación a las habilidades entre médicos y practicantes.

Abstract Objective To establish the relationship between the knowledge and skills of health personnel in taking samples for the identification of papillomavirus DNA. Methods Cross-sectional study, conducted between March and June of 2017. Population of 313 people, the probabilistic sample was calculated considering a r = 0.306 expected, 95% confidence, and power of 90%, which equated to 90 workers from 23 health centers. A knowledge test and checklist were administered to evaluate sampling skills, with the hybrid capture method (HPV-CH2 test). For data analysis, Pearson's and the ANOVA correlation were used. Results A correlation between knowledge and skills was found (r=0.438) (p<0.001). Regarding knowledge, there was no significant difference in the means obtained from the three groups of participants (nurses vs. interns 3.27 p=0.557, physicians vs. nurses 2.17 p=0.852, physicians vs. interns 5.45 p=0.441). Regarding skills, there was no difference between the means obtained between physicians and nurses (4.27 p=0.388), nor between nurses and interns (4.54 p=0.179), but there was a difference between physicians and interns (8.81 p=0.041). Conclusion There was a correlation between the knowledge and skills in taking samples for the identification of papillomavirus DNA. There were no significant differences in knowledge between the groups studied; but a difference in means for skills was found between physicians and interns.

[Future type 2 diabetes mellitus scenario estimated with a predictive dynamic simulation model]. / Escenario futuro de la diabetes mellitus tipo 2 estimado con un modelo de simulación dinámico predictivo.

OBJECTIVE: Develop a predictive dynamic model to estimate future scenarios for the incidence rate of type 2 diabetes mellitus (T2DM). METHODS: A retrospective ecological study was conducted in 2013-2015 in the city of San Luis Potosí, Mexico. Secondary official data from the 58 municipalities making up the state of San Luis Potosí were analyzed. Linear correlation, multiple linear regression, and structural equations were carried out, and four predictive dynamic submodels were developed: T2DM, urban population, inhabited private dwellings that have television, and population aged 45-49 years. A holistic model was also developed. RESULTS: The structural model explains 27.2% of total variance in type 2 diabetes mellitus. Percentage of inhabited dwellings that have television weighs 4.46 non-standard units on diabetes; that of urban population, 2.84; and that of population aged 45-49 years, 156.69. Estimated scenarios for T2DM per 100 000 population for the years 2015, 2020, 2025, and 2030 were 1,052.4, 1,413.7, 1,850.1, and 2,351.1 respectively. CONCLUSION: The T2DM scenario shows exponential growth from 2000 to 2030. Risk factors according to the weight they represent in occurrence of the disease were: population aged 45-49 years, inhabited private dwellings that have television, and urban population.

Calidad de los registros en programa de detección oportuna de cáncer cervicouterino / Quality of records in a timely screening program for cervical cancer

Resumen Introducción: El cáncer cervicouterino es un problema de salud pública en México, en 2012 se estimaron 528 000 nuevos casos. Una línea de investigación con relación al programa de cáncer cervicouterino, es la calidad de los registros en cuanto a su legibilidad, completitud y precisión. Objetivo: Evaluar la calidad de los registros realizados por el personal de salud en el servicio de Detección de Cáncer Cervicouterino. Materiales y Métodos: Estudio transversal, realizado en el Instituto Mexicano del Seguro Social de San Luis Potosí, México, entre agosto de 2012 a septiembre de 2013. Ante un universo de 4139 registros, hoja de solicitud y resultados de la citología cervical, realizados durante enero a noviembre de 2012, se aplicó un muestreo probabilístico estratificado (1115 registros). Se utilizó una lista de verificación con 32 ítems divididos en siete apartados. Para analizar los datos se utilizaron tres indicadores: precisión, legibilidad y completitud. Se estableció una escala ordinal con el puntaje obtenido: bajo (0-64), medio (65-128) y alto (129-192). Se aplicó la prueba t de student para comparar los puntajes en la calidad de los registros. Resultados: En legibilidad se obtuvo un nivel medio en la calidad de los registros (80,6%), en la completitud un 59,6% en el nivel alto y en la precisión un 40,4% en el nivel medio. El personal de enfermería obtuvo mejor calificación en la calidad de los registros que los cito-tecnólogos (p= 0,05). Conclusión: La calidad de los registros realizados por el personal de salud es media. MÉD.UIS. 2017;30(3):59-65.

ABSTRACT Introduction: Cervical cancer is a public health problem in Mexico, in 2012 528 000 new cases. One line of research related to the cervical cancer program is the quality of records in terms of readability, completeness, and accuracy. Objective: To evaluate the quality of the records made by the health personnel in the Cervical Cancer Detection Service. Materials and Methods: A cross-sectional study carried out at the Mexican Social Security Institute of San Luis Potosí, Mexico, from august 2012 to september 2013. The universe of records, application forms and results of cervical cytology performed during january to november of 2012 was 4139. A stratified probabilistic sampling (1 115 records) was applied. We used a checklist with 32 items divided into 7 sections. Three indicators were used to analyze the data: accuracy, readability and completeness. An ordinal scale was established with the score obtained: low (0-64), medium (65-128) and high (129-192). Student's t-test was used to compare scores on the quality of the records. Results: Readability reached a median level in the quality of the records (80.6%), in the completeness 59.6% in the high level and in the precision 40.4% in the average level. Nurses received better quality of records than cytotechnologists (p = 0.05). Conclusion: The quality of the records made by the health personnel is medium. MÉD.UIS. 2017;30(3):59-65.

Escenario futuro de la diabetes mellitus tipo 2 estimado con un modelo de simulación dinámico predictivo

Objetivo. Desarrollar un modelo dinámico predictivo para estimar escenarios futuros de la tasa de incidencia de diabetes mellitus tipo 2 (TIDM2). Métodos. Se realizó un estudio ecológico retrospectivo durante el periodo 2013-2015 en la ciudad de San Luis Potosí, México. Se analizaron datos oficiales secundarios de los 58 municipios que integran el estado de San Luis Potosí. Se aplicó la correlación lineal, la regresión lineal múltiple, ecuaciones estructurales, y se desarrollaron cuatro submodelos dinámicos predictivos: TIDM2, población urbana, viviendas particulares habitadas que cuentan con televisión y población de 45-49 años de edad. Se desarrolló también un modelo holístico. Resultados. El modelo estructural explica 27,2% del total de la varianza de la diabetes mellitus tipo 2. El porcentaje de viviendas habitadas que cuentan con televisión pesan 4,46 unidades no estándar sobre la diabetes, el de población urbana, 2,84 y el de población de 45-49 años, 156,69. Los escenarios estimados de la TIDM2 por 100 000 habitantes, para los años 2015, 2020, 2025 y 2030 fueron 1 052,4, 1 413,7, 1 850,1 y 2 351,1 respectivamente. Conclusión. El escenario de la TIDM2 muestra un crecimiento exponencial del año 2000 al 2030. Los factores de riesgo según el peso que representan para la ocurrencia de la enfermedad fueron: población de 45-49 años, viviendas particulares habitadas que cuentan con televisión y población urbana.

Objective. Develop a predictive dynamic model to estimate future scenarios for the incidence rate of type 2 diabetes mellitus (T2DM). Methods. A retrospective ecological study was conducted in 2013-2015 in the city of San Luis Potosí, Mexico. Secondary official data from the 58 municipalities making up the state of San Luis Potosí were analyzed. Linear correlation, multiple linear regression, and structural equations were carried out, and four predictive dynamic submodels were developed: T2DM, urban population, inhabited private dwellings that have television, and population aged 45-49 years. A holistic model was also developed. Results. The structural model explains 27.2% of total variance in type 2 diabetes mellitus. Percentage of inhabited dwellings that have television weighs 4.46 non-standard units on diabetes; that of urban population, 2.84; and that of population aged 45-49 years, 156.69. Estimated scenarios for T2DM per 100 000 population for the years 2015, 2020, 2025, and 2030 were 1,052.4, 1,413.7, 1,850.1, and 2,351.1 respectively. Conclusion. The T2DM scenario shows exponential growth from 2000 to 2030. Risk factors according to the weight they represent in occurrence of the disease were: population aged 45-49 years, inhabited private dwellings that have television, and urban population.

Objetivo. Desenvolver um modelo dinâmico preditivo para estimar cenários futuros da taxa de incidência de diabetes mellitus tipo 2. Métodos. Foi realizado um estudo ecológico retrospectivo no período de 2013 a 2015 na cidade de San Luis Potosí, México. Foram analisados dados oficiais secundários dos 58 municípios que fazem parte do Estado de San Luis Potosí. Foi feita a análise de correlação linear, regressão linear múltipla e equações estruturais e construídos quatro submodelos dinâmicos preditivos: diabetes mellitus tipo 2, população urbana, domicílios particulares permanentes com televisão e população com idade de 45–49 anos. Foi também desenvolvido um modelo holístico. Resultados. O modelo estrutural explica 27,2% do total da variança da diabetes mellitus tipo 2. A porcentagem de domicílios permanentes com televisão tem o peso de 4,46 unidades não padronizadas na diabetes, 2,84 na população urbana e 156,69 na população de 45–49 anos. Os cenários estimados da diabetes mellitus tipo 2 por 100.000 habitantes para 2015, 2020, 2025 e 2030 foram de 1.052,4, 1.413,7, 1.850,1 e 2.351,1 respectivamente. Conclusão. O cenário da diabetes mellitus tipo 2 mostra um crescimento exponencial de 2000 a 2030. Os fatores de risco segundo o peso representado na ocorrência da doença foram população com 45–49 anos, domicílios particulares permanentes com televisão e população urbana.

Impact of Applying a Learning Strategy to Improve the Sample Quality in Cervical Screening in Nursing Staff in Social Service.

OBJECTIVES: The study sought to assess the impact of applying a learning strategy to improve the quality of sample collection during cervical screening by students from the Nursing Degree Program doing social service. METHODS: This was a longitudinal, quasi-experimental study with the participation of 23 interns from the Nursing Degree Program at a public university from San Luis Potosí, Mexico. The work assessed knowledge of practical skills in taking cervical cytology tests and the quality of samples before and after applying a learning strategy that included 10 h of theoretical training and 22 h of practices on themes related to sample collection in cervical screening. RESULTS: A statistically significant difference was obtained in improved knowledge (t = -12.8 p<0.001) and practical skills (t = -8.86 p<0.001) after the intervention. The increased percentage of suitable samples from 30.43% to 82.60% was attributed to the application of the learning strategy in the pre- and post-intervention phases (p<0.001). CONCLUSIONS: Training is effective to improve knowledge and practical skills to collect samples in cervical screening, as well as the quality of the samples for their interpretation.

Escenario futuro de la diabetes mellitus tipo 2 estimado con un modelo de simulación dinámico predictivo / Future type 2 diabetes mellitus scenario estimated with a predictive dynamic simulation model / Cenário futuro da diabetes mellitus tipo 2 estimado com um modelo preditivo de simulação dinâmica

RESUMEN Objetivo Desarrollar un modelo dinámico predictivo para estimar escenarios futuros de la tasa de incidencia de diabetes mellitus tipo 2 (TIDM2). Métodos Se realizó un estudio ecológico retrospectivo durante el periodo 2013-2015 en la ciudad de San Luis Potosí, México. Se analizaron datos oficiales secundarios de los 58 municipios que integran el estado de San Luis Potosí. Se aplicó la correlación lineal, la regresión lineal múltiple, ecuaciones estructurales, y se desarrollaron cuatro submodelos dinámicos predictivos: TIDM2, población urbana, viviendas particulares habitadas que cuentan con televisión y población de 45-49 años de edad. Se desarrolló también un modelo holístico. Resultados El modelo estructural explica 27,2% del total de la varianza de la diabetes mellitus tipo 2. El porcentaje de viviendas habitadas que cuentan con televisión pesan 4,46 unidades no estándar sobre la diabetes, el de población urbana, 2,84 y el de población de 45-49 años, 156,69. Los escenarios estimados de la TIDM2 por 100 000 habitantes, para los años 2015, 2020, 2025 y 2030 fueron 1 052,4, 1 413,7, 1 850,1 y 2 351,1 respectivamente. Conclusión El escenario de la TIDM2 muestra un crecimiento exponencial del año 2000 al 2030. Los factores de riesgo según el peso que representan para la ocurrencia de la enfermedad fueron: población de 45-49 años, viviendas particulares habitadas que cuentan con televisión y población urbana.

ABSTRACT Objective Develop a predictive dynamic model to estimate future scenarios for the incidence rate of type 2 diabetes mellitus (T2DM). Methods A retrospective ecological study was conducted in 2013-2015 in the city of San Luis Potosí, Mexico. Secondary official data from the 58 municipalities making up the state of San Luis Potosí were analyzed. Linear correlation, multiple linear regression, and structural equations were carried out, and four predictive dynamic submodels were developed: T2DM, urban population, inhabited private dwellings that have television, and population aged 45-49 years. A holistic model was also developed. Results The structural model explains 27.2% of total variance in type 2 diabetes mellitus. Percentage of inhabited dwellings that have television weighs 4.46 non-standard units on diabetes; that of urban population, 2.84; and that of population aged 45-49 years, 156.69. Estimated scenarios for T2DM per 100 000 population for the years 2015, 2020, 2025, and 2030 were 1,052.4, 1,413.7, 1,850.1, and 2,351.1 respectively. Conclusion The T2DM scenario shows exponential growth from 2000 to 2030. Risk factors according to the weight they represent in occurrence of the disease were: population aged 45-49 years, inhabited private dwellings that have television, and urban population.

RESUMO Objetivo Desenvolver um modelo dinâmico preditivo para estimar cenários futuros da taxa de incidência de diabetes mellitus tipo 2. Métodos Foi realizado um estudo ecológico retrospectivo no período de 2013 a 2015 na cidade de San Luis Potosí, México. Foram analisados dados oficiais secundários dos 58 municípios que fazem parte do Estado de San Luis Potosí. Foi feita a análise de correlação linear, regressão linear múltipla e equações estruturais e construídos quatro submodelos dinâmicos preditivos: diabetes mellitus tipo 2, população urbana, domicílios particulares permanentes com televisão e população com idade de 45-49 anos. Foi também desenvolvido um modelo holístico. Resultados O modelo estrutural explica 27,2% do total da variança da diabetes mellitus tipo 2. A porcentagem de domicílios permanentes com televisão tem o peso de 4,46 unidades não padronizadas na diabetes, 2,84 na população urbana e 156,69 na população de 45-49 anos. Os cenários estimados da diabetes mellitus tipo 2 por 100.000 habitantes para 2015, 2020, 2025 e 2030 foram de 1.052,4, 1.413,7, 1.850,1 e 2.351,1 respectivamente. Conclusão O cenário da diabetes mellitus tipo 2 mostra um crescimento exponencial de 2000 a 2030. Os fatores de risco segundo o peso representado na ocorrência da doença foram população com 45-49 anos, domicílios particulares permanentes com televisão e população urbana.

[The burden of cervical cancer in patients with limited access to health services]. / Repercusión del cáncer cervicouterino en pacientes con limitaciones de acceso a los servicios de salud.

BACKGROUND: Cervical cancer is caused by high-risk HPV, a sexually transmitted virus. In Mexico, this disease represents a public health problem. San Luis Potosi is located within ten states with the highest rates in the country. Indigenous women of Mexico will likely to develop cervical cancer due to inequality in access to health services and their determinants. Epidemiological studies can be supported by investigations of diverse geographical nature to undertake the identification and analysis of spatial patterns of disease. OBJECTIVE: To locate by geographical distribution of Huasteca Potosina women high-risk HPV positive to observe the burden of disease in patients with limited access to health services and propose specific primary prevention activities was made with a sample of 605 women. Cervico-vaginal specimens were taken. High-risk HPV infection was determined by hybrid capture. Age and date of the last Papanicolaou were obtained through a structured poll. It was use descriptive statistics and georeference was made in a map using the software ILWIS 3.3. RESULTS: Countyes with the highest and lowest percentages of infection were found. The prevalence of infection with high-risk HPV was 9.9% and age groups with the highest percentages of infection were in 51-60 and 41-50 years. Most women had been made the Papanicolaou at time of the present study. CONCLUSIONS: Georeferenceas like epidemiological tool for generating risk profiles allowed suggest strategies for improve prevention, early detection and control of the cervical cancer.

[Health staff performance taking of smear: knowledge, skills and practice]. / Desempeño del personal de salud en la toma de las citologías cervicales: conocimientos teóricos y ejecución práctica.

BACKGROUND: The quality of cervical cytology is one of the factors involved in the optimal performance of screening programs for cervical cancer in México, so it is necessary to design indicators to improve the skills of health personnel in this procedure. OBJECTIVE: To evaluate the performance of the health workers to take the Pap smear. MATERIAL AND METHODS: Cross-sectional study made in the period 2006-2007 in San Luis Potosí, México, in 21 health centers in a health jurisdiction. We studied the universe of professionals who take the Pap: 100 nurses, doctors and interns. A knowledge test and a check list were applied. The correlation of Pearson, Student's t and ANOVA was used for data analysis. RESULTS: There is a correlation between knowledge and qualification in the take of the Pap smear (r = 0.340) (p = 001). Providers have a performance on average 62.2% in knowledge and 78.5% in practice. Doctors obtained knowledge that the nurses (6.80) (p = .000) and trainees (4.14) (p = 014). In the practical implementation, there was no difference between the doctors and the nurses (2.68) (p = .718) but there was difference between the doctors and interns (6.47) (p = .036). To know one or more sections of the knowledge influences the qualification of the procedure. CONCLUSIONS: The performance of the service provider is regular. There is heterogeneity in the knowledge and practical skills. Educational interventions are needed to raise the skills.

[Performance of health staff in Papanicolauo test: theoretical knowledge and practical implementation]. / Desempeño del personal de salud en la toma de las citologías cervicales: conocimientos teóricos y ejecución práctica.

BACKGROUND: The quality of cervical cytology is one of the factors involved in the optimal performance of screening programs for cervical cancer in Mexico, so it is necessary to design indicators to improve the skills of health personnel in this procedure. OBJECTIVE: To evaluate the performance of the health workers to take the Pap smear. METHODOLOGY: cross-sectional study made in the period 2006-2007 in San Luis Potosí, Mexico, in 21 health centers in a health jurisdiction. We studied the universe of professionals who take the Pap: 100 nurses, doctors and interns. A knowledge test and a check list were applied. The correlation of Pearson, Student's t and ANOVA was used for data analysis. RESULTS: There is a correlation between knowledge and qualification in the take of the Pap smear (r = 0.340) (p = 0.001). Providers have a performance on average 62.2% in knowledge and 78.5% in practice. Doctors obtained higher score in the knowledge that the nurses (6.80) (p = 0.000) and trainees (4.14) (p = 0.014). In the practical implementation, there was no difference between the doctors and the nurses (2.68) (p = 0.718) but there was difference between the doctors and interns (6.47) (p = 0.036). To know one or more sections of the knowledge influences the qualification of the procedure. CONCLUSIONS: The performance of the service provider is regular. There is heterogeneity in the knowledge and practical skills. Educational interventions are needed to raise the skills.

Uso del Papanicolaou en mujeres que acuden al programa de detección oportuna de cáncer cérvico-uterino: un acercamiento a la satisfacción con el servicio / Use of Pap in women attending early detection of cervical cancer: an approach to meeting the service

Objetivo: describir la satisfacción de las usuarias con el servicio de detección oportuna de cáncer cérvico-uterino a través del análisis de indicadores y características socio-demográficas. Metodología: estudio descriptivo. Participan 101 mujeres que se someten al Papanicolaou entre junio y julio de 2007 en 13 centros de salud urbanos de la Jurisdicción 1 de la Secretaría de Salud de San Luis Potosí, México. Se aplica una encuesta con tres apartados: características socio demográficas, indicadores del uso del servicio y nivel de satisfacción. Resultados: la edad promedio de las mujeres es de 36 años, 42.6% tienen secundaria, 80.2% son casadas y 54.5% están afiliadas al Seguro Popular. Sus conocimientos acerca de la prueba del Papanicolaou y el cáncer son adecuados (51.5% y 76.2%, respectivamente), mientras que la accesibilidad a la prueba de tamizaje es adecuada en un 67.3%; las mujeres que más se presentan a la prueba por primera vez son las de 18 a 30 años y las casadas; asisten en menor proporción las de 51 a 61 años. El nivel de satisfacción es alto respecto al tiempo de espera, 66.3%; consideran la información completa, veraz, oportuna y comprensible 78.2%, y encuentran adecuado el trato 87.1%, Conclusiones: las usuarias están satisfechas con el servicio. En este estudio no se encuentra asociación entre la utilización de la prueba del Papanicolaou y la satisfacción de las usuarias; sin embargo, hay asociación entre la primera cita y la edad para realizarse el tamizaje y entre el estado civil y la edad de la primera cita al Papanicolaou.

Objective: to describe the satisfaction of service users with the timely detection of cervical cancer through the analysis of indicators and socio-demographic characteristics. Methodology: descriptive study. 101 women participate; they have PAP test in July 2007 in 13 urban health centers from San Luis Potosi Health Department Jurisdiction 1. Socio-demographic characteristics and use of service indicators are measured, including also satisfaction level. Results: the average age is 36 years old. Maximum level of education is ninth grade (42.6%) and 54.5% of the participants have Popular Insurance; 80.2% are married; the women that more attend for the first time are the youngest (18-31 years), and the married ones; and the ones that attend less are those between 51 and 61 years old. Those that are more willing for the first time are the married ones; and the ones with less attendance are the divorced, separated and widows. General knowledge about PAP test and uterine cervix cancer is adequate in 51.5% and 76.2%, respectively, whereas the accessibility is adequate in 67.3%. Satisfaction level was high on waiting time (66.3%); with complete, truthful, opportune, and understandable information (78.2%), as well as an appropriate treatment from health personal (87.1%) and accessibility (80.2%). Conclusions: the users are satisfied with the service. In this article we find that Papanicolaou test is not associated with women satisfaction. Age and marital status are associated to the appointment for the PAP.

Plataforma de investigación en salud: una experiencia de formación participativa en una universidad mexicana / Health research platform: a participatory training experience in a mexican university

Este trabajo presenta una experiencia de formación en investigación la cual se llevó a cabo en una facultad de enfermería de México. La Plataforma de Investigación en Salud, denominación dada a la iniciativa, se basa en principios de colaboración y participación. Además de impulsar un proceso incluyente, la Plataforma comenzó mediante la recuperación de experiencias, prácticas y propuestas del personal. El producto fue la identificación de prioridades y la elaboración de un programa de trabajo anual. Entre las actividades propuestas se encuentran un seminario permanente de investigación, cursos talleres, mecanismos de apoyo y asesorías individualizadas y el fortalecimiento de redes. A casi un año de la implementación de la Plataforma se observan avances en rubros como las asesorías, los cursos y el seminario; empero, persisten dificultades para realizar otras acciones planeadas. Se destacan áreas que se pueden fortalecer e identifican situaciones en las cuales se podría replantear el trabajo en el futuro.

This paper presents a training experience on research in a Mexican nursing school. The Health Research Platform, as the initiative was called, was carried out using a participatory and collaborative approach. Besides its interest in an inclusive process, the Platform started by retrieving experiences, practices and suggestions of those involved in the research. The product was the identification of priorities and the elaboration of an annual plan. The latter included a permanent research seminar, courses, and mechanisms of support at an individual level as well as the strengthening of networks. Almost one year after having started the Platform, some advances can be seen in certain areas such as in counseling, coursework and the permanent seminar. However, there are other activities which have not been implemented due to problems of diverse nature. In addition, some areas stand out in need of further development and they bring to light situations where future programs can be redefined.

Este trabalho apresenta uma experiência de formação em investigação desenvolvida em uma faculdade de enfermagem do México, designada de Plataforma de Investigação em Saúde. Esta Plataforma está baseada em princípios de colaboração e participação. Além de promover um processo de inclusão, a iniciativa começou mediante a recuperação das experiências, práticas e propostas do pessoal interessado na investigação. O produto foi a identificação de prioridades e a elaboração de um programa de trabalho anual. Entre as atividades propostas estão um seminário permanente de investigação, cursos sob a forma de oficinas, mecanismos de apoio e assessorias individualizadas e o fortalecimento de redes. Após quase um ano da implementação da Plataforma são observados avanços em aspectos como as assessorias, os cursos e o seminário; mas, persistem dificuldades para realizar outras ações planejadas. São destacadas áreas que podem ser fortalecidas e são identificadas situações nas quais se poderia replanejar o trabalho futuro.

Efectividad de un programa educativo en el control del enfermo con diabetes / Effectiveness of an educational program in the control of diabetic patients

Objetivo: evaluar la efectividad de un programa de intervención educativa dirigido a personas con diabetes mellitus tipo 2 en una Unidad de Medicina Familiar de San Luis Potosí, México. Metodología: es un estudio de intervención, longitudinal, comparativo; se utilizó muestreo probabilístico de tipo sistemático con asignación aleatoria. Las variables de estudio fueron: el nivel de conocimientos respecto a la enfermedad y el autocuidado y el control metabólico del enfermo. Al grupo de estudio se le aplicó un programa de intervención educativa durante nueve meses y el grupo control recibió la asistencia convencional establecida en la unidad de atención; a ambos grupos se les realizaron mediciones de hemoglobina glucosilada y del nivel de conocimientos antes y después de la intervención. Los datos se procesaron y analizaron mediante el paquete SPSS 8.0. Se aplicaron medidas de estadística descriptiva e inferencial. Resultados y Discusión: los resultados mostraron evidencia estadística de la efectividad del programa educativo ya que mejoró el nivel de conocimientos y porque a través de la prueba de Friedman se mostró que el promedio de hemoglobina glucosilada era menor en el grupo de estudio. Conclusiones: el programa evaluado es efectivos al favorecer tanto el incremento del nivel de los conocimientos sobre la enfermedad, las medidas para el control y la terapéutica, como el control metabólico del paciente.