Validez de contenido de una intervención educativa para mejorar conocimientos, actitudes y prácticas relacionados con la malaria en una comunidad indígena / Content validity of an educational intervention to improve knowledge, attitudes and practices related to malaria in an indigenous community / Validade de conteúdo de uma intervenção educativa para melhorar conhecimentos, atitudes e práticas relacionadas à malária em uma comunidade indígena

Introducción: Las intervenciones educativas en salud dirigidas a las poblaciones indígenas deben ser revisadas por expertos con el fin de evaluar si su adaptación cultural es apropiada y precisa. Objetivo: Determinar la validez de los contenidos contemplados en una intervención educativa para el mejoramiento de conocimientos, actitudes y prácticas relacionados con la malaria en la población Emberá Katío del departamento de Córdoba - Colombia, mediante el juicio de expertos. Materiales y métodos: Estudio de validación por medio de juicio de expertos de una intervención educativa que incluyó cuatro módulos, administrados en sesiones presenciales, en las que se utilizaron estrategias educativas como clases, discusiones guiadas y talleres. Participaron trece expertos en trabajo con comunidades indígenas, quienes evaluaron los criterios de claridad, pertinencia, relevancia y coherencia del contenido de cada módulo. Se estimó el índice de validez de contenido (IVC) de Lawshe modificado por Tristán y se asumió el valor ≥ 0.58 para considerar la aprobación de los criterios de los módulos. Resultados: Todos los módulos obtuvieron IVC globales que fluctuaron entre 0.83 y 0.90. La claridad del Módulo 1, 'Conociendo la malaria', tuvo un valor de 0.69 y el resto de los valores de los cuatro criterios osciló entre 0.77 y 1. Discusión: Los criterios evaluados superaron el punto de corte establecido por la literatura para aprobar la intervención, y las observaciones y recomendaciones de los expertos fueron consideradas para ajustes en la misma. Conclusión: Se determina que la intervención educativa evaluada por juicio de expertos, tiene alta validez de contenido en sus módulos según los criterios contrastados.

Introduction: Health education programs for the indigenous population must be reviewed by experts in order to assess whether their cultural adaptation is appropriate and accurate. Objective: To determine the validity of the content contemplated in an educational intervention to improve knowledge, attitudes and practices related to malaria in the Emberá Katío population in the department of Córdoba, Colombia. Materials and methods: Validation study by experts' judgment of an educational intervention that included four modules, administered in face-to-face sessions, in which educational strategies such as classes, guided discussions and workshops were used. Thirteen experts in work with indigenous communities participated, who evaluated the criteria of clarity, pertinence, relevance and coherence of the content of each module. The content validity index (CVI) of Lawshe modified by Tristán was estimated and the value ≥ 0.58 was assumed to consider the approval of the module criteria. Results: All the modules obtained global CVIs fluctuated between 0.83 and 0.90. The clarity of Module 1, 'Knowing malaria', had a value of 0.69 and the rest of the values of the four criteria ranged between 0.77 and 1. Discussion: The evaluated criteria exceeded the cut-off point established by the literature to approve the intervention, and the observations and recommendations of the experts were considered for adjustments in it. Conclusion: It is determined that the educational intervention evaluated by expert judgment has high content validity in its modules according to the contrasted criteria.

Introdução: As intervenções de educação em saúde voltadas para populações indígenas devem ser revisadas por especialistas a fim de avaliar se sua adaptação cultural é apropriada e precisa. Objetivo: Determinar a validade do conteúdo de uma intervenção educacional para a melhoria do conhecimento, das atitudes e das práticas relacionadas à malária na população Emberá Katío, no departamento de Córdoba - Colômbia, por meio do julgamento de especialistas. Materiais e métodos Estudo de validação por meio de julgamento de especialistas de uma intervenção educacional que incluiu quatro módulos, administrados em sessões presenciais, nos quais foram utilizadas estratégias educativas como aulas, orientadas e oficinas. Participaram treze especialistas em trabalhos com comunidades indígenas, que avaliaram os critérios de clareza, pertinência, relevância e coerência do conteúdo de cada módulo. Estimou-se o índice de validade de conteúdo (IVC) de Lawshe modificado por Tristán e assumiu-se o valor ≥ 0,58 para considerar a aprovação dos critérios do módulo. Resultados: Todos os módulos obtiveram IVC global que oscilou entre 0,83 e 0,90. A clareza do Módulo 1, 'Conhecendo a malária', tinha um valor de 0,69 e os demais valores dos quatro critérios variaram entre 0,77 e 1. Discussão: Os critérios avaliados excederam o ponto de corte estabelecido pela literatura para aprovar a intervenção, e as observações e recomendações dos peritos foram consideradas para ajustes no mesmo. Conclusão: Foi determinado que a intervenção educacional avaliada por julgamento de especialistas tem alta validade de conteúdo em seus módulos, de acordo com os critérios contrastados.

Do health literacy levels of nursing students change throughout the study programme? A cross-sectional study.

OBJECTIVES: The aim of this research was to analyse if the level of health literacy (HL) of nursing students changes throughout the study programme. DESIGN: A cross-sectional study with anonymous self-reporting was conducted. PARTICIPANTS/SETTING: 329 public university nursing students in Seville, Spain; 243 of the first year and 86 of the fourth. INTERVENTIONS: The short Spanish version of the Health Literacy Survey Questionnaire-European Union was used to evaluate HL. PRIMARY AND SECONDARY OUTCOME MEASURES: The proportions of the limited level of HL were compared between academic years and the crude and corrected OR were calculated with the Mantel-Haenszel test to evaluate the effect of confusion of the sex variable on the HL level and academic year relationship. A logistic regression model with step-by-step analysis was run, including the independent variables sex, age, marital status, academic year and HL level (limited/sufficient) as the dependent variable. RESULTS: 62.1% of the participants of the first year versus 47.7% of the fourth year had a limited literacy level for a crude OR of 1.5 (95% CI 1.10 to 2.21; p=0.014) and a corrected by sex OR of 1.8 (95% CI 1.10 to 2.96; p=0.026). Only the strata in women had a statistically significant relationship. The logistic regression model ratified that the HL was a function exclusive to the academic year. CONCLUSION: The HL level of nursing students increases from the first to the fourth academic year, even when controlling for sex. Although the HL level in the fourth academic year was greater than that of the first, both groups had inadequate HL levels. It is hence recommended to implement intervention strategies, which reinforce in the curriculum the knowledge and experiences related with health communication and education to ensure that future professionals improve their HL. Achieving adequate HL is crucial to be able to provide care to patients, their families and the community.

The Journal Investigación y Educación en Enfermería is Indexed in PubMed Central

As Editor, it is a joy to share with you the great news that the journal Investigación y Educación en Enfermería was accepted for indexation in PubMed Central (PMC), which is the world's largest repository of knowledge on health sciences. PubMed Central has close to seven million articles in full text and in Open Access that can be recovered through the PubMed search engine. Currently, PMC archives over 3018 journals accepted after demanding scientific and technical evaluations. Being included in this repository is a recognition distinction of the quality of our publication with the global academic community, with 22 nursing journals sharing this honor globally and only two of these are Latin American.

Countries' cultures and professional nursing values: Cross-cultural evidence from Spanish and Colombian nursing students.

This study aimed to identify countries' cultural values associated with the importance given to certain professional nursing values by nursing students from Spain and Colombia. Weis and Schank's Nurses Professional Values Scale-Revised (NPVS-R) in its Spanish version and the Hofstede cultural classification were used for this purpose. The sample was composed of 880 nursing students. Nursing students from both countries showed a greater importance for professional nursing values compared to evidence from other countries. Significant differences were also found in the total score, dimensions, and items, always being higher for Colombian students. Based on regression results, the impact that the academic year had on the importance given to NPVS-R is non-linear (U-inverted). Both groups of students gave the highest importance to the same group of items. Those showing the largest difference in the rankings were associated with country culture differences based on the scores identified by Hofstede. Colombian and Spanish societies present similarities in Power Distance and Uncertainty Avoidance, as well as differences in the other cultural dimensions.

Changes in anti-fat attitudes among undergraduate nursing students.

BACKGROUND: The number of people with obesity has been increasing significantly in recent decades. Nursing students play a role in the care of obese patients, but the presence of a stigma regarding this patient group reduces the quality of care due to a climate of mistrust and lack of expectations. OBJECTIVES: To analyse if the anti-fat attitudes of nursing students at the Faculty of Nursing, Physiotherapy and Podiatry at Universidad de Sevilla (Spain) change during their degree training. DESIGN: A cross-sectional study was carried out. SETTINGS: Undergraduate nursing institution in Spain. PARTICIPANTS: 578 nursing students enrolled at the Faculty in all academic years, from the first through the fourth. METHODS: Following ethical approval, each participant took part in an individual self-report via the Anti-Fat Attitudes (AFA) Questionnaire, in its validated Spanish version. RESULTS: The mean standardised AFA total was 2.29.; by domains: 1.29 in Dislike, 2.87 in Fear of fat, and 3.73 in Willpower. Analysis of variance tests showed significant differences in the AFA total score and domains by sex and academic year. Multiple linear regression analysis demonstrated that the highest prejudices were shown by enrolled participants in their first year, particularly when the AFA total score was considered. CONCLUSIONS: Nursing students at the Faculty do not have many prejudices towards obese people. Anti-obesity attitudes among nursing students decrease as the students progress in their degree, implying that the specific training received (degree curriculum) also enables students to develop their non-technical skills.

High-performance athletes’ attitude towards doping: Validation of the Spanish version of the Performance Enhancement Attitude Scale for Colombia / Actitud frente al dopaje de deportistas de alto rendimiento: Validación de la versión española de la Performance Enhancement Attitude Scale para Colombia

BACKGROUND: Doping is the use of substances to achieve a better performance in sports. This practice is considered to be growing worldwide. Despite regulations by the World Anti-Doping Agency, 14-39% of high-performance athletes have consumed prohibited substances at least once in their sports career. The attitudes towards this type of consumption are used as predictors of the intent of usage of prohibited substances to improve physical performance. OBJECTIVE: This study aimed to validate the Spanish Version of the Performance Enhancement Attitude Scale of high-performance athletes in the Colombian context. METHODOLOGY: A cross-sectional study was performed with a convenience sampling of 112 athletes aged 15 and older, registered in a State Sports Institute in Medellín, Colombia in 2016. The participants self-completed Petróczi and Aidman instrument, Performance Enhancement Attitude Scale, adapted into Spanish by Morente-Sánchez, et al. in 2014. The reliability of the scale was assessed using Cronbach's Internal Consistency Coefficient and an exploratory and confirmatory factor analysis (CFA) was conducted to evaluate the scale's structure. RESULTS: The scale had a reliability of 0.87 and the factor analysis confirmed the unidimensionality. Of all the athletes participating in the research, the Performance Enhancement Attitude Scale average was 35.8 of 102 points, indicating a low tendency of attitudes towards doping. CONCLUSION: The psychometric properties of the 17 items of the Performance Enhancement Attitude Scale are adequate and could be used when assessing attitudes towards doping of high-performance athletes in similar contexts. This information could be used for the purposes of developing educational strategies for doping prevention in our athletes

INTRODUCCIÓN: El dopaje es el uso de sustancias para lograr un mejor desempeño en los deportes. Esta práctica parece estar creciendo en todo el mundo. A pesar de las regulaciones de la World Anti-Doping Agency, 14-39% de los deportistas de alto rendimiento han consumido sustancias prohibidas al menos una vez durante su carrera deportiva. las actitudes hacia este tipo de consumo se emplean como predictores de la intención de uso de sustancias prohibidas para mejorar el rendimiento físico. OBJETIVO: El objetivo del estudio fue validar en deportistas de alto rendimiento en el contexto colombiano la versión española de la escala de Actitudes frente al mejoramiento del rendimiento. DISEÑO: Se realizó un estudio de corte transversal en 2016 con una muestra por conveniencia de 112 deportistas de 15 y más años inscritos en un instituto deportivo estatal en Medellín (Colombia). METODOLOGÍA: Los participantes autodiligenciaron el instrumento de Petróczi y Aidman Performance Enhancement Attitude Scale (PEAS), adaptado al español por Morente-Sánchez et al. Se evaluó la confiabilidad de la escala con el coeficiente de consistencia internal de Cronbach y se hicieron análisis factorial exploratorio y confirmatorio para evaluar la estructura de la escala. RESULTADOS: Los resultados indicaron que la escala tenía una confiabilidad de 0,87 y el análisis factorial confirmó la unidimensionalidad. En los deportistas participantes en la investigación el promedio de la PEAS fue de 35,8 de 102 puntos posibles, indicando baja tendencia de actitudes hacia el dopaje. CONCLUSIÓN: Las propiedades psicométricas de los 17 ítems de la PEAS son adecuadas, y podría ser utilizada en la evaluación de actitudes hacia el dopaje en deportistas de alto rendimiento en contextos similares. Esta información podría ser utilizada para el desarrollo de estrategias educativas para la prevención del dopaje en nuestros deportistas

Perfil clínico y epidemiológico de pacientes con enfermedad pulmonar obstructiva crónica hospitalizados en un centro de alta complejidad de la ciudad de medellín, colombia, durante el año 2015

Introducción. La enfermedad pulmonar obstructiva crónica (EPOC) es una condición que cursa con limitación del flujo aéreo espiratorio e inflamación crónica de las vías aéreas, y que representa un problema de salud pública a nivel mundial. Objetivo. Determinar el perfil clínico y epidemiológico de pacientes con EPOC en una institución hospitalaria de la ciudad de Medellín, Colombia. Metodología. Se realizó un estudio transversal, con una muestra de 50 pacientes, con diagnóstico clínico o espirométrico de enfermedad pulmonar obstructiva crónica, atendidos de forma intrahospitalaria en una institución privada en Medellín durante el año 2015. A las variables cuantitativas se les calculó el promedio, desviación estándar y valores mínimo y máximo. A las cualitativas, medidas de nivel nominal y ordinal y se les estimaron proporciones. Resultados. La edad promedio fue de 73,5±9,3 años, el 52% fueron mujeres. El promedio de tiempo de diagnóstico fue de 7,8±1,3 años. Las características clínicas más frecuentes fueron las siguientes: el 36% tenía como clasificación estadio D para la enfermedad, el 34% tenía VEF1 <30%, el 88% tenían antecedente de tabaquismo y el 52% utilizaba oxígeno en casa. Conclusiones. La mayoría de nuestra población fue clasificada como GOLD categoría D, con una limitación grave del flujo aéreo espiratorio (VEF1 < 30%) y requerimiento de uso de oxígeno domiciliario. Lo anterior indica un inadecuado control de la enfermedad, debido, probablemente, al contexto intrahospitalario de los pacientes incluidos en el estudio.

Introduction. Chronic Obstructive Pulmonary Disease (COPD) is a condition that limits the air flow and produce chronic inflammation of the airways, which represents a public health problem worldwide. Objective. To determine the clinical and epidemiological profile of patients with COPD in a hospital of the city of Medellin, Colombia. Methodology. A cross-sectional study was carried out, with a sample of 50 subjects, who had a clinical or spirometric diagnosis of Chronic Obstructive Pulmonary Disease, receiving Inpatient care in a private institution in Medellin in 2015. It was calculated on quantitative variables, the average, standard deviation and minimum and maximum values. It was estimated on qualitative variables, measures of nominal and ordinal level and proportions. Results. The average age was 73.5 ) 9,3 years, 52% were women. The average of Diagnostic time was 7.8 ) 1,3 years. The most common clinical characteristics were the following: 36% had a stage D classification for the disease, 34% had FEV1 <30%, 88% had a smoking history and 52% used oxygen at home. Conclusions. The majority of our population was classified as GOLD category D, with a severe limitation to breath (FEV1 <30%) and had to use oxygen at home. The foregoing indicates that there is an inadequate control of the disease, due to the inpatient environment of the subjects involved in the study.

Introdução. A doença pulmonar obstrutiva crônica (DPOC) é uma condição caracterizada por fluxo respiratório limitado e inflamação crônica das vias aéreas, e representa um problema de saúde pública em todo o mundo. Objetivo. Determinar o perfil clínico e epidemiológico dos pacientes com DPOC em uma instituição hospitalar da cidade de Medellín, Colômbia. Metodologia. Foi realizado um estudo transversal, com uma amostra de 50 pacientes, com diagnóstico clínico e espirométrico da doença pulmonar obstrutiva crônica, que receberam atenção hospitalar em uma instituição privada em Medellín durante o ano de 2015. Para as variáveis quantitativos foram calculados a média, desvio padrão e valores mínimo e máximo. Para medidas qualitativas de nível nominal e ordinal se estimaram proporções. Resultados. A idade média foi de 73,5 ± 9,3 anos, 52% eram mulheres. A média do tempo de diagnóstico foi de 7,8 ± 1,3 anos. As características clínicas mais frequentes foram: 36% tinham classificação no estádio D para a doença, 34% tinham VEF1 <30%, 88% tinham história de tabagismo e 52% usavam oxigênio em casa. Conclusões. A maioria da nossa população foi classificada como GOLD categoria D, com uma limitação severa do fluxo de ar (VEF1 <30%) e exigência de uso de oxigênio domiciliar. O que precede indica um controle inadequado da doença, devido, provavelmente, ao contexto hospitalar dos pacientes incluídos no estudo.

La persistencia de delirium a los 3 meses del egreso de los pacientes ancianos hospitalizados en una clínica universitaria / Persistent Delirium in Elderly patients Three Months After Hospital Discharge from a University Clinic

RESUMEN Objetivos: El delirium es muy prevalente entre los pacientes ancianos con enfermedad general. Si no se revierte en el momento del alta hospitalaria, se lo considera «delirium persistente¼ (DP). El propósito del estudio es describir la prevalencia y las características de los pacientes con DP 3 meses después del egreso hospitalario de la Clínica Universitaria Bolivariana (CUB). Métodos: Se realizó un estudio descriptivo longitudinal para evaluar la prevalencia y las características de los pacientes de 65 o más arios del servicio de hospitalización de la CUB que cumplieran criterios de delirium del DSM-5 al ingreso, el egreso y 3 meses después. Se determinaron las variables sociodemográficas y se aplicaron las escalas CGI-S y DRS-R98. Resultados: Se evaluó a 30 pacientes con diagnóstico de delirium con interconsulta por psiquiatría de enlace entre abril y octubre de 2013, y se excluyó a 6 por no cumplir los criterios de inclusión. Se incluyó en el estudio a 24 pacientes, de los que 9 fallecieron durante la hospitalización (37,5%). De los 15 sobrevivientes, 5 (el 20,8% de la muestra) presentaron remisión del delirium al egreso y 10 (41,6%) continuaron con síntomas y conformaron el grupo de DP. Del grupo de DP, 5 (20,8%) presentaron DP completo y los otros 5 (20,8%), DP subsindrómico (DPSS). A los 3 meses del egreso, solo 2 pacientes (8,3%) continuaron con DP completo y otros 2 (8,3%), con DPSS. En el grupo de pacientes con DP, la prevalencia fue del 30% (diagnóstico de delirium al ingreso) y una incidencia del 70% (aparición del delirium durante la hospitalización). Conclusiones: Un grupo importante de pacientes con delirium continúan sintomáticos 3 meses después del alta. El 40% de los pacientes con síntomas persistentes en el seguimiento a 3 meses indica una trayectoria de mejoría gradual del delirium, lo cual tiene implicaciones en la práctica clínica.

ABSTRACT Objective: The purpose of the study was to determine the prevalence and characteristics of patients with persistent delirium (PD) at three months after hospital discharge. Methodology: Longitudinal descriptive study to assess the prevalence and characteristics of in-patients aged 65 years and older in the Clinica Universitaria Bolivariana who met DSM-5 criteria for delirium at admission, at discharge, and at a 3-month follow up assessment. Socio-demographic features were determined, and CGI-S and DRS-R98 scales used. Results: A total of 30 patients were evaluated between April and October 2013, but 6 did not fulfil the inclusion criteria. The study included 24 patients, with 9 (37.5%) dying during hospitalisation. Of the 15 surviving patients, five (20.8% of the total sample) had their delirium resolved at discharge, and ten (41.6% of the sample) continued with symptoms. These established the PD group, of whom five of them (20.8%) had full PD, and the other five (20.8%) sub-syndromal PD (SSPD). At the final assessment, only two patients (8.3%) continued with full PD, and another two (8.3%) with SSPD. Among the PD group, 30% had a full delirium at admission (prevalence), and 70% developed full delirium during hospitalization (incidence). Conclusions: A significant number of patients did not recover from delirium at leaving hospital, and remained symptomatic three months after discharge. The study findings suggest a course of gradual improvement of delirium, with a persistence of symptoms over time in 40% of the patients, which would have implications for the clinical practice.

Persistent Delirium in Elderly patients Three Months After Hospital Discharge from a University Clinic. / La persistencia de delirium a los 3 meses del egreso de los pacientes ancianos hospitalizados en una clínica universitaria.

OBJECTIVE: The purpose of the study was to determine the prevalence and characteristics of patients with persistent delirium (PD) at three months after hospital discharge. METHODOLOGY: Longitudinal descriptive study to assess the prevalence and characteristics of in-patients aged 65 years and older in the Clinica Universitaria Bolivariana who met DSM-5 criteria for delirium at admission, at discharge, and at a 3-month follow up assessment. Socio-demographic features were determined, and CGI-S and DRS-R98 scales used. RESULTS: A total of 30 patients were evaluated between April and October 2013, but 6 did not fulfil the inclusion criteria. The study included 24 patients, with 9 (37.5%) dying during hospitalisation. Of the 15 surviving patients, five (20.8% of the total sample) had their delirium resolved at discharge, and ten (41.6% of the sample) continued with symptoms. These established the PD group, of whom five of them (20.8%) had full PD, and the other five (20.8%) sub-syndromal PD (SSPD). At the final assessment, only two patients (8.3%) continued with full PD, and another two (8.3%) with SSPD. Among the PD group, 30% had a full delirium at admission (prevalence), and 70% developed full delirium during hospitalization (incidence). CONCLUSIONS: A significant number of patients did not recover from delirium at leaving hospital, and remained symptomatic three months after discharge. The study findings suggest a course of gradual improvement of delirium, with a persistence of symptoms over time in 40% of the patients, which would have implications for the clinical practice.

Estresores en las prácticas clínicas de los estudiantes de enfermería de una universidad pública en Colombia / Stressors in Clinical Practices of Nursing Students of a Public University in Colombia / Estressores nas práticas clínicas dos estudantes de enfermagem de uma universidade pública em Antioquia, Colômbia

Objetivos: identificar los estresores en las prácticas clínicas de los alumnos de la Facultad de Enfermería de una universidad pública de Antioquia (Colombia) y explorar la relación entre el grado de estrés y las variables sexo y semestre académico. Métodos: estudio cuantitativo de tipo transversal realizado durante el primer semestre académico de 2016. La población de estudio fueron todos los estudiantes de quinto a octavo semestres en práctica clínica. No se hizo muestreo. Los participantes contestaron por autorreporte la escala KEZKAK de Zupiría et al. que evalúa 41 estresores en las prácticas clínicas de los estudiantes de enfermería. Los puntajes mayores de 1,5 indican que hay estrés. Resultados: participaron 156 de los 224 estudiantes matriculados (69,6% del total). El promedio de la escala fue de 2,0, que equivale a un estrés moderado. En el 88% de los ítems mostraron algún grado de estrés (3 ítems con nivel alto > 2,5: hacer mal mi trabajo y perjudicar al paciente, hacer daño físico al paciente, y confundirme de medicación). Se presentaron diferencias estadísticamente significativas en el puntaje promedio total en las variables sexo (mayor en el femenino) y semestre académico (mayor en el quinto). Se encontró que los dominios del KESKAK con mayores puntajes fueron: falta de competencia (2,2), sobrecarga de trabajo (2,2), contacto con el sufrimiento (2,0) y que el paciente busque una relación íntima (2,0). Conclusión: los estudiantes de enfermería tienen un estrés moderado ocasionado por situaciones de la práctica clínica; predominan los factores relacionados con la falta de competencia y la sobrecarga de trabajo.

Objective: To identify the stressors in clinical practices in students from the Faculty of Nursing at a public university in Antioquia (Colombia) and to explore the relationship between stress level and the variables sex and academic semester. Methods: A cross-sectional, quantitative study was conducted during the first 2016 academic semester. The study population was all students from 5th to 8th semester in clinical practice, no sampling was done. The participants answered by self-report the KEZKAK scale by Zupiria et al. to evaluate 41 stressors in the clinical practices of nursing students. Scores above 1,5 indicated the presence of stress. Results: 156 of the 224 enrolled students participated in the study (69.6% of the total). The mean for the scale was 2,0, which is equivalent to moderate stress level; 88% of the items showed some degree of stress (3 items with high level >2,5: poor work performance and harming the patient, causing physical harm to the patient, and confusing the types of medications). Statistically significant differences were found in the total average score by gender (highest in females) and academic semester (highest during the fifth). It was found that the KESKAK domains with the highest scores were: lack of skills (2,2), work overload (2,2), contact with suffering (2,0), and the patient seeking a close relationship (2,0). Conclusion: nursing students have a moderate level of stress caused by situations of the clinical practice, factors related to lack of skills and work overload were predominated.

Objetivo: identificar os estressores nas práticas clínicas nos alunos da Faculdade de Enfermagem de uma Universidade pública do Antioquia (Colômbia) e explorar a relação entre os níveis de estresse e sexo e semestre acadêmico. Métodos: estudo quantitativo de tipo transversal realizado durante o primeiro semestre acadêmico de 2016. A população do estudo consistiu de todos os alunos da 5a a 8a semestre na prática clínica, nenhuma amostragem foi feita. Os participantes responderam por autorreporte a escala KEZKAK de Zupiría et al. para avaliar 41 estressores nas práticas clínicas dos estudantes de enfermagem. As pontuações maiores de 1,5 indicavam que havia estresse. Resultados: 156 dos 224 alunos inscritos participaram (69,6% do total). A média da escala foi de 2,0 o que equivale a nível de estresse moderado. Em 88% dos itens mostraram algum grau de estresse (3 itens com nível alto >2,5: Fazer mal meu trabalho e prejudicar ao paciente, fazer dano físico ao paciente, e Confundir-me de medicação). Se apresentaram diferencias estatisticamente significativas na pontuação média total nas variáveis sexo (maior no feminino) e semestre acadêmico (maior no quinto). Se encontrou que os domínios de KESKAK com maiores pontuações foram: falta de competência (2,2), sobrecarga de trabalho (2,2), contato com o sofrimento (2,0) e que o paciente busque uma relação íntima (2,0). Conclusão: os estudantes de enfermagem têm um nível de estresse moderado ocasionado por situações da prática clínica, foram fatores predominantes os relacionados com a falta de competência e sobrecarga de trabalho.

Perfil clínico y epidemiológico de pacientes atendidos por hipertiroidismo e hipotiroidismo en el servicio de endocrinología de una institución hospitalaria de Medellín (Colombia) entre 2013 y 2015 / Clinical and epidemiological profile of patients with hyperthyroidism and hypothyroidism that receive endocrinological services from a medical institution in Medellín (Colombia) between 2013 and 2015

Objetivo: determinar el perfil epidemiológico en pacientes hipertiroideos e hipotiroideos que acudieron al servicio de endocrinología de una institución hospitalaria de Medellín (Colombia) entre 2013 y 2015.Materiales y métodos: se realizó un estudio descriptivo retrospectivo y se incluyeron todas las historias clínicas de pacientes con diagnóstico de hipertiroidismo o hipotiroidismo. Se realizó un análisis univariado con estadística descriptiva por medio de frecuencias absolutas y proporciones en el programa IBM SPSS versión 19.0. Resultados: se estudiaron 149 pacientes: 131 con hipotiroidismo y 18 con hipertiroidismo, la media de edad fue 57,8±17,8 años y 48,2±15,1 años respectivamente. La frecuencia de sexo femenino fue mayor en hipotiroideos que en hipertiroideos (86,3% versus 66,7%). Las principales etiologías en los hipotiroideos fueron el hipotiroidismo postquirúrgico 11,5% y la enfermedad de Hashimoto 5,3%,mientras que en el hipertiroidismo estuvieron la enfermedad de Graves 33,3% y tirotoxicosis 22,2%. El síntoma más frecuente en los pacientes estudiados fue el bocio con un 14,5% en los hipotiroideos versus un 38,9% en los hipertiroideos. Los antecedentes personales más frecuentes en ambos grupos de pacientes fueron hipertensión arterial y Diabetes Mellitus. Conclusión: los resultados del presente estudio son acordes a la información existente en la literatura, la presentación de patologías tiroideas es más común en el sexo femenino; y la principal etiología es cirugía y enfermedad de Graves para hipo e hipertiroidismo respectivamente..(AU)

Objective: determine the epidemiological profile of hyperthyroid and hypothyroid patients that receive endocrinological services from a medical institution in Medellin (Colombia) between 2013 and 2015. Materials and Methods: a descriptive, retrospective study was conducted and included the clinical records of patients diagnosed with hyperthyroidism or hypothyroidism. A univariate analysis was applied using descriptive statistics by means of absolute frequencies and proportions in the IBM SPSS software, version 19.0. Results: a sample of 149 patients was obtained 131 patients with hypothyroidism and 18 with hyperthyroidism, the average age was 57,8±17,8 years and 48,2±15,1 years, respectively. The frequency of female sex with hypothyroidism was greater than those patients with hyperthyroidism (86,3% versus 66,7%). Post-surgery hypothyroidism had a high prevalence 11,5% followed by the Hashimoto disease 5,3%.The principal etiologies in hyperthyroidism were Graves disease 33,3% and thyrotoxicosis 22,2%. With relation to the signs and frequent symptoms in the studied patients,the goiter was common in 14,5% of the patients with hypothyroidism versus 38,9% of those patients with hyperthyroidism. The most frequent diseases on past medical history in both groups of patients were high blood pressure and Diabetes Mellitus. Conclusion: the results of the present study are in agreement with the information existing in the literature, the presentation of thyroid pathologies is more common in the female sex; and the main etiology is surgery and Graves' disease for hypo and hyperthyroidism respectively..(AU)

Perfil clínico y epidemiológico de las enfermedades oculares no infecciosas en comunidades indígenas de Chocó, Colombia / Clinical and epidemiological profile of non-infectious eye diseases in indigenous communities from Choco, Colombia

Objetivo: determinar el perfil clínico y epidemiológico de las enfermedades oculares no infecciosas en población indígena del departamento de Chocó, Colombia. Materiales y métodos: estudio descriptivo transversal, en comunidades indígenas de la Asociación de Cabildos Indígenas Embera, Wounaan, Katío, Chami y Tule en 2015.No se realizó muestreo, se evaluaron líderes indígenas mayores de 18 años, sin enfermedades oftalmológicas infecciosas y que decidieron participar voluntariamente mediante consentimiento informado. Se diseñó un cuestionario para registrar variables sociodemográficas y oftalmológicas. Resultados: se evaluaron 46 indígenas, con un promedio de edad de 34,2 ± 9,5, 69,6% eran hombres, 21,7% eran Embera Dobida, 56,5% habían completado los estudios de secundaria y 23,9% se desempeñaban en el área de educación. El 82,6% de los participantes presentaron agudeza visual normal,15,2% presentaron déficit visual y ninguno presentó déficit visual severo o ceguera.Se encontraron alteraciones conjuntivales en el 56,5% y alteraciones al Cover test en 58,6%, siendo la endotropia y endoforia los hallazgos más frecuentes. No se encontraron alteraciones en la evaluación de la movilidad ocular, tonometría, campimetría, ni fondo de ojo. Conclusiones: se encontraron niveles aceptables de visión y salud oftalmológica entre la población evaluada, que no representan limitaciones considerables para su quehacer diario, pero que potencialmente las podrían ocasionar. La endotropia y las alteraciones conjuntivales corresponden a los hallazgos más frecuentes...(AU)

Objective: to determine the clinical and epidemiological profile of non-infectious ocular diseases in indigenous populations of Chocó, Colombia. Materials and methods:transversal descriptive study, in indigenous communities of the Asociación de Cabildos Indígenas Embera, Wounaan, Katío, Chami and Tule in 2015. Sampling was not performed,indigenous leaders over the age of 18, without infectious eye diseases were evaluated and decided to voluntarily participate by informed consent. A questionnaire was designed to register demographic and opthalmologic variables variables. Results: 46 indigenous people were evaluated, with an average age of 34,2 ± 9,5 years, 69,6% were men, 21,7% were Embera Dobida, 56,5% had completed secondary education and 23,9% worked in the education area. 82,6% of the participants presented normal visual acuity, 15,2% presented visual deficit and none had severe visual impairment or blindness. Conjunctival alterations were found in 56,5% and alterations in the coverage test in 58,6%, with endotropia and endophoria being the most frequent findings. No alterations were found in the assessment of ocular mobility, tonometry, campimetry, or ocular fundus. Conclusions: acceptable levels of vision and ophthalmological health were found among the evaluated population, which do not represent considerable limitations for their daily work, but could potentially cause them. Endotropia and conjunctival alterations correspond to the most frequent findings...(AU)

Validez y utilidad diagnóstica de la escala Eating Attitudes Test-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población / Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian male population masculina de Medellín, Colombia

OBJETIVO: Evaluar la validez y la utilidad diagnóstica de la escala Eating Attitudes Test-26 (EAT- 26) para la evaluación del riesgo de trastornos de conducta alimentaria (TCA) en población masculina. DISEÑO: Estudio observacional de validación de pruebas. Emplazamiento: Realizado en la ciudad de Medellín en nivel de atención comunitaria de consulta psiquiátrica mixta (pública y privada). PARTICIPANTES: Veintiún hombres con edad ≥ 14 años que cumplieran criterios DSM-IV-TR para anorexia nerviosa, bulimia nerviosa y eating disorder not otherwise specified (EDNOS), y 93 controles sin TCA. Mediciones principales: La muestra de casos fue por conveniencia y en controles, aleatoria simple. Se comparó el «criterio de oro» (entrevista estructurada por psiquiatra para determinar el cumplimiento o no de criterios de inclusión de caso de TCA) con el EAT-26, y al instrumento se le hizo validación cultural y semántica, validación factorial, evaluación de confiabilidad así como determinación del mejor punto de corte por medio de la curva ROC. RESULTADOS: En EAT-26 subyacen 4 dominios: dieta-bulimia y preocupación por comida, dieta, control oral-dieta y control oral-bulimia. El alfa de Cronbach fue de 0,89 y el mejor valor de corte el de ≥ 20 puntos (sensibilidad = 100%; especificidad = 97,8%). El valor predictivo positivo fue del 91,3% y el negativo, del 100,0%. CONCLUSIONES: El EAT-26 es un instrumento multidimensional con excelentes valores de confiabilidad, sensibilidad y especificidad, ideal para cribado de posibles TCA en población de riesgo, y podría ser de utilidad en atención primaria para la detección temprana en población masculina

OBJECTIVE: To establish the diagnostic validity and usefulness of Eating Attitudes Test-26 (EAT- 26) for the risk assessment of eating disorders in a male population. Description: Observational validation study questionnaire. SETTING: Performed in Medellin city at a community care level of mixed (public and private) psychiatric clinics. Subjects: The study included 21 male subjects aged ≥ 14 with DSM-IV-TR diagnostic criteria for anorexia nervosa, bulimia nervosa, and Eating Disorder Not Otherwise Specified (EDNOS), and 93 controls without ED. Main outcome measurements: A convenience sample was used for the cases and a simple, randomised one for controls. A reference standard (structured psychiatrist interview confirming the fulfilment of ED case inclusion criteria) was compared with the EAT-26 questionnaire. Reliability, cultural, semantics, and factorial validation were performed, and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: dieting-bulimia and food pre-occupation, dieting, oral control-dieting, and oral control-bulimia. The Cronbach's alpha was 0.89, and a score of ≥ 20 is the best cut-off (sensitivity = 100% and specificity = 97.8%). The positive predictive value was 91.3% and the negative predictive value was 100.0%. CONCLUSIONS: EAT-26 questionnaire is an ideal multidimensional instrument for Eating Disorder screening in risk populations, with excellent reliability, sensitivity and specificity values. EAT-26 could be a useful tool to be considered when strategies for early detection of Eating Disorders are implemented in the male population

Perfil clínico y epidemiológico de pacientes con hemofilia registrados en la Liga de Hemofílicos de Antioquia (Colombia) / Clinical and epidemiological profile of patients with hemophilia in Liga de Hemofilicos de Antioquia (Colombia)

Introducción: La hemofilia es una enfermedad hemorrágica hereditaria caracterizada por la ausencia o deficiencia de factores VIII y IX de la coagulación. Objetivo. Determinar el perfil clínico y epidemiológico de los pacientes con hemofilia registrados en la liga de hemofílicos de Antioquia (LIHEA) durante 2005-2011. Metodología. Estudio descriptivo transversal, la población fueron pacientes con hemofilia de la LIHEA que cumplieron con criterios de selección. Se diseñó un instrumento de recolección de información y se aplicó el instrumento Modelo de actitud en pacientes con hemofilia (MAPACHE). Las variables cuantitativas se analizaron con medidas de tendencia central y dispersión, a las variables cualitativas se les estimó frecuencias absolutas, proporciones y razones. Resultados. Se incluyeron 36 hombres con hemofilia, con una mediana de 22 años de edad. En cuanto a los antecedentes personales los más frecuentes fueron HTA (8.3%) y tromboflebitis (5.6%). El sedentarismo fue el factor de riesgo de estilo de vida más común (8.3%). Las manifestaciones clínicas más frecuentes fueron hemartrosis (94.4%), hematomas musculares (80.6%) y equimosis (77.8%). En la mitad de los pacientes la enfermedad generó algún tipo de discapacidad, siendo la más frecuente la física (44.4%). El tratamiento farmacológico más frecuente fue profilaxis con factor VIII con un 88.9%, acompañado de la natación como principal tratamiento no farmacológico con un 77.8%. En cuanto al MAPACHE el 30.6% manifestó una actitud negativa hacia la enfermedad, un 5.6% fue neutra y para el 63.9% restante fue positiva. Conclusión. La hemofilia tuvo grandes repercusiones físicas y emocionales para los pacientes estudiados que la padecen

Introduction: Hemophilia is a hereditary hemorrhagic disorder characterized by the absence or deficiency of factors VIII and IX of the coagulation. Objective. To determine the clinical and epidemiological profile of patients with hemophilia recorded in the Liga de Hemofilicos de Antioquia (LIHEA) during 2005-2011. Methodology. Descriptive transversal study, population were patients with hemophilia from LIHEA which met selection criteria. We designed a data collection instrument and applied the attitude instrument in patients with hemophilia (MAPACHE). The quantitative variables were analyzed using measures of central tendency and dispersion, the qualitative variables were estimated absolute frequencies, proportions and reasons. This research had the respective ethical guarantee. Results. We included 36 men with hemophilia, with a median of 22 years of age. In terms of the personal history, the most frequent were hypertension (8.3%) and thrombophlebitis (5.6%). Sedentariness was the most common lifestyle risk factor (8.3%). The most frequent clinical manifestations were hemarthrosis (94.4%), muscle hematomas (80.6%) and ecchymosis (77.8%). In half of the patients, disease generated some kind of disability, being the most common the physics (44.4%). The most common drug treatment was prophylactic factor VIII with 88.9 %, accompanied by swimming as the main non-pharmacological treatment with 77.8 %. Respect MAPACHE, the 30.6% expressed a negative attitude towards the disease, a 5.6% was neutral and the 63.9% was positive. Conclusion. Hemophilia is still a disease of great physical and emotional implications for studied patients who suffer it

[Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian male population]. / Validez y utilidad diagnóstica de la escala Eating Attitudes Test-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población masculina de Medellín, Colombia.

OBJECTIVE: To establish the diagnostic validity and usefulness of Eating Attitudes Test-26 (EAT-26) for the risk assessment of eating disorders in a male population. DESCRIPTION: Observational validation study questionnaire. SETTING: Performed in Medellin city at a community care level of mixed (public and private) psychiatric clinics. SUBJECTS: The study included 21 male subjects aged ≥14 with DSM-IV-TR diagnostic criteria for anorexia nervosa, bulimia nervosa, and Eating Disorder Not Otherwise Specified (EDNOS), and 93 controls without ED. MAIN OUTCOME MEASUREMENTS: A convenience sample was used for the cases and a simple, randomised one for controls. A reference standard (structured psychiatrist interview confirming the fulfilment of ED case inclusion criteria) was compared with the EAT-26 questionnaire. Reliability, cultural, semantics, and factorial validation were performed, and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: dieting-bulimia and food pre-occupation, dieting, oral control-dieting, and oral control-bulimia. The Cronbach's alpha was 0.89, and a score of ≥20 is the best cut-off (sensitivity=100% and specificity=97.8%). The positive predictive value was 91.3% and the negative predictive value was 100.0%. CONCLUSIONS: EAT-26 questionnaire is an ideal multidimensional instrument for Eating Disorder screening in risk populations, with excellent reliability, sensitivity and specificity values. EAT-26 could be a useful tool to be considered when strategies for early detection of Eating Disorders are implemented in the male population.

Caracterización de pacientes gestantes con valvulopatía mitral

Objetivo: Determinar las características clínicas y epidemiológicas de pacientes gestantes con valvulopatía mitral en una institución hospitalaria de la ciudad de Medellín 2005-2011. Métodos: Estudio descriptivo, retrospectivo, transversal, del tipo de series clínicas. La población fueron todas las pacientes gestantes con valvulopatía mitral atendidas en la institución hospitalaria, que cumplieron los criterios de inclusión. El análisis se realizó en el SPSS 21, se utilizaron medidas de tendencia central y dispersión para las variables cuantitativas; para las cualitativas se estimaron frecuencias absolutas, proporciones y razones. Resultados: Fueron incluidas 17 gestantes con valvulopatía mitral, la mediana de edad fue de 26 años. El 52,9 % tenían diagnóstico previo de patología valvular y en 25,5 % el diagnóstico fue en el primer trimestre de embarazo. La prótesis valvular mitral fue requerida por el 47,1 % de las mujeres, en la mayoría de estas, implantada previa al embarazo. En cuanto a los diagnósticos establecidos el 35,3 % de las mujeres presentó insuficiencia valvular, seguido por estenosis valvular con un 17,6 %. Respecto al uso de fármacos el 29,4 % usó enoxaparina, mientras que el 59 % no reportó uso de anticoagulantes. Se encontró una frecuencia relativa de complicaciones del 5,9 % por fibrilación auricular. Conclusión: En las mujeres con diagnóstico previo o temprano de valvulopatía estudiadas se apreció que el buen control prenatal, posibilitó que la mayoría de estos embarazos llegaran a término, sin complicaciones.

Objective: To determinate the clinical and epidemiological characteristics of pregnant patients with mitral valvulopathy in a medical institution in the city of Medellin from 2005 to 2011. Methods: Descriptive retrospective transversal study. All pregnant patients with mitral valvulopathy who were treated at the hospital institution and who fulfilled the inclusion criteria were evaluated. The analysis has done in the SPSS 21; the measures of central tendency and dispersion were used as quantitative variables; for the qualitative variables, absolute frequencies, proportions and ratios were estimated. Results : 17 pregnant patients with mitral valvulopathy were included, whose median age was 26 years old; 52.9% had a previous diagnosis of valvular disease and in 25.5% was diagnosed in the first trimester of pregnancy. The prosthetic mitral valvular was required by 47.1% of the women, the majority implanted prior to pregnancy. Regarding the established diagnoses, 35.3% of the women presented valvular insufficiency, followed by valvular stenosis at 17.6%. Regarding the use of drugs, 29.4% used enoxaparin, while 59% of the patients did not report the use of anticoagulants. A relative frequency of 5.9% was found due to complications of atrial fibrillation. Conclusion : in women with a previous or later diagnosis of valvulopathy, it was observed that a good prenatal care allowed that most of these pregnancies came to term without complications.