Impacto de una intervención psicoeducativa en la habilidad para el cuidado, del cuidador principal del paciente en diálisis peritoneal / Impact of a psychoeducational intervention on the caregiving skills of the primary caregiver of a patient on peritoneal dialysis

Introducción: Desarrollar la habilidad para el cuidado por parte del cuidador principal del paciente en diálisis peritoneal requiere de un proceso de adaptación, en el que las intervenciones psicoeducativas son una estrategia importante.Objetivo: Evaluar el impacto de una intervención psicoeducativa en la habilidad para el cuidado del cuidador principal.Material y Método: Estudio cuasi experimental, con un diseño prepost, con un único grupo. La muestra estuvo formada por 40 cuidadores de pacientes en diálisis peritoneal. Se analizaron habilidad del cuidado, de afrontamiento y de adaptación, preintervención y post-intervención, mediante el inventario de Habilidad de Cuidado y la escala de medición de Afrontamiento y Adaptación. La intervención consistió en un programa estructurado sobre estrategias para mejorar el proceso de afrontamiento, adaptación al rol y desarrollo de nuevas habilidades, por parte del cuidador, llevado a cabo por un equipo multidisciplinario. Se estudiaron, además, sexo, edad, estado civil, ocupación, parentesco, tiempo dedicado a recreación y tiempo dedicado al cuidado. Resultados: El cuidador fue principalmente mujer (80%, n=32), con dedicación al hogar 47,5% (n=19), y de estado civil casado, 62,5% (n=25). Encontramos diferencias pre y post intervención en la habilidad general (211,03 + 36,30 vs 230,60 + 16,72, p<0,001), y en la capacidad global de afrontamiento y adaptación (129,32 + 12,55 vs 136,70 + 16,28, p=<0,008).Conclusión: La intervención psicoeductiva aumenta las habilidades generales de cuidados y los mecanismos de afrontamiento y adaptación en los cuidadores de pacientes en diálisis peritoneal.(AU)

Introduction: Developing the caregiver’s ability to care for a patient undergoing peritoneal dialysis requires an adaptation process, in which psychoeducational interventions are important strategies.Objective: To evaluate the impact of a psychoeducational intervention on the caregiver’s ability to care for the patient. Material and Method: This quasi-experimental pre-post design study involved a single group of 40 caregivers of peritoneal dialysis patients. Caregiving, coping, and adaptation abilities were analyzed pre- and post-intervention using the Caregiving Ability Inventory and the Coping and Adaptation Scale. The intervention consisted of a structured program on strategies to improve coping, role adaptation, and the development of new skills by the caregiver, carried out by a multidisciplinary team. Gender, age, marital status, occupation, relationship to the patient, time spent on recreation, and time spent on caregiving were also studied.Results: The caregiver was mainly a woman (80%, n=32), 47,5% (n=19) were dedicated to the home, and 62,5% were married. Differences before and after the intervention in general ability (211,03 + 36,30 vs 230,60 + 16,72, p<0,001), and in the overall coping and adaptation ability (129,32 + 12,55 vs 136,70 + 16,28, p=<0,008) were found.Conclusion: Psychoeducational intervention increases general care skills and coping and adaptation mechanisms in caregivers of patients on peritoneal dialysis.(AU)

Satisfacción laboral del personal de guarderías del IMSS y participativas en Ciudad Juárez, Chihuahua / Job satisfaction of IMSS and participatory nursing staff in Ciudad Juárez, Chihuahua

Introducción: la satisfacción laboral es la sensación positiva de sentirse satisfecho y se encuentra relacionada con la experiencia de trabajo, esto es alcanzado de manera plena cuando el trabajador satisface sus necesidades. El objetivo de la investigación es identificar la satisfacción laboral del personal de guarderías del IMSS y participativas de Ciudad Juárez, Chihuahua. Material y métodos: estudio descriptivo transversal, se aplicó el cuestionario de Meliá y Peiró S21/26 a 270 trabajadores de guarderías de Ciudad Juárez, Chihuahua, México. Resultados: se identificó que los trabajadores declararon nivel de satisfacción alta cuando reportaron antigüedad laboral menor a 1 año. La guardería IMSS reportó satisfacción con un valor de p = 0.05. Conclusión: el grado de satisfacción laboral de los trabajadores de las guarderías, reflejan un mejor ambiente laboral y una mayor calidad en el servicio prestado, lo que de manera positiva impacta en la calidad de los servicios que se ofrecen.

Introduction: Job satisfaction is the positive sensation of feeling satisfied and is related to the work experience, this is fully achieved when the worker satisfies his needs. The objective of the research is to identify the job satisfaction of the staff of IMSS and participatory day care centers in Ciudad Juárez, Chihuahua. Material and methods: A cross-sectional descriptive study, the Meliá and Peiró S21/26 Questionnaire was applied to 270 nursery workers in Ciudad Juárez, Chihuahua, Mexico. Results: It was identified that the workers declared a high level of satisfaction when they reported employment seniority of less than 1 year. The IMSS nursery reported satisfaction with a value of p = 0.05. Conclusion: The degree of job satisfaction of nurseries workers reflects a better work environment and a higher quality of service provided, which positively impacts the quality of services offered.

Profesional de enfermería, experiencias y emociones frente a la pandemia de COVID-19 / Nursing, professional experiences and emotions in the face of the COVID-19 pandemic

Introducción: a finales del 2019, la humanidad sufrió cambios a consecuencia de una nueva enfermedad llamada COVID-19, ante la situación de esta nueva enfermedad de la cual no se tiene mucha información, el personal de enfermería ha tenido que adaptarse a la nueva modalidad y desarrollar diferentes estrategias para el cuidado de ellos y sus familias. Objetivo: conocer las experiencias y emociones que el personal de enfermería vivió durante la pandemia por COVID-19. Metodología: estudio cualitativo de enfoque fenomenológico, la población de estudio fue el personal de enfermería que estuvo en primera línea de atención a pacientes con COVID-19 en el área de Hospitalización, se realizó una entrevista semiestructurada de forma virtual a través de la plataforma digital Zoom. Resultados: se construyeron cinco categorías de análisis: Entorno familiar, Entorno laboral, Interacción con la sociedad, Afectaciones emocionales y Rol de la enfermera. Las enfermeras y enfermeros refirieron haber presentado miedo al contagio, incertidumbre, agotamiento, discriminación y falta de recursos. Conclusiones: las enfermeras y enfermeros experimentaron mayormente emociones negativas relacionadas a la atención del paciente y al interactuar con la sociedad. Coinciden que esta experiencia les permitió crecer en al ámbito laboral y personal, consideran que necesitan atención psicológica, sin embargo no acuden a recibirla.

Introduction: At the end of 2019, humanity suffered changes as a result of a new disease called COVID-19, facing the situation of this new disease of which there is not much information, the nursing staff has had to adapt to the new modality and develop different strategies for the care of them and their families. Objective: To learn about experiences and emotions that the nursing staff lived during the COVID-19 pandemic. Methodology: Qualitative study of phenomenological approach, the study population was 14 nurses who were in the first line of care for patients with COVID-19 in the hospitalization area, a semi-structured interview was conducted virtually through the digital platform Zoom. The Atlas.ti 9 program was used for qualitative data analysis. Results: Five categories of analysis were constructed: family environment, work environment, interaction with society, emotional affectations and role of the nurse. Nurses refer to having presented fear of contagion, uncertainty, exhaustion, discrimination and lack of resources. Conclusions: Nurses experienced mostly negative emotions related to patient care and interacting with society. They agree that this experience allowed them to grow in the work and personal environment, they consider that they need psychological care but do not seek it.

"Burnout syndrome and association with work stress in nursing staff in public hospital of the northern border of Mexico".

Currently in Mexico, there is a lack of published research assessing nursing burnout in a consistent manner. The pressure of having to provide quality care to low income patients can be a serious factor triggering work stress in the nursing professional. The aim of this study was to establish the connection between burnout, work stress and both demographic and labor factors in nursing staff. A sample of 424 nurses participated in the descriptive and cross-sectional study. Each of the participants answered a questionnaire with two validated instruments, the Maslach Burnout Inventory-Human Services Survey and the Nursing Stress Scale, both in their Spanish version, as well as a demographic and labor survey of the authors' own creation. A bivariate logistic regression analysis was used to determine any significant association between the variables. We found a prevalence of 65.09% in mid-level burnout syndrome among the female sex. Men, on the other hand, featured a high level of emotional exhaustion and depersonalization, whereas the female sex showed significantly lower levels of depersonalization. Most of the staff showed acute stress levels. Some factors found in the potential development of burnout were work shift, position, department and gender.

Habilidad de cuidado del cuidador principal del adulto mayor con diálisis peritoneal / Caregiver skills of the main caregiver of the older adult with peritoneal dialysis

Introducción: la enfermedad renal crónica tiene consecuencias graves para los adultos mayores. La diálisis peritoneal continua ambulatoria es una alternativa de tratamiento, pero afecta la calidad de vida del paciente, la familia y el cuidador primario, por lo que se requiere un cuidador con habilidades que ofrezca apoyo en algunas actividades elementales y, además, apoye emocional y espiritualmente al paciente. Objetivo: identificar el nivel de la habilidad del cuidador primario del adulto mayor con diálisis peritoneal. Metodología: estudio descriptivo en 80 cuidadores familiares de adultos mayores con diálisis peritoneal continua ambulatoria. Se utilizó el instrumento Habilidad de cuidado del cuidador familiar, que consta de 55 reactivos y se divide en tres dimensiones: relación, 27 reactivos; comprensión, 18 reactivos; y modificación de la vida, 10 reactivos. El instrumento incluye variables sociodemográficas, de parentesco y tiempo dedicado al cuidado. Se elaboró una base de datos y éstos se analizaron mediante estadística descriptiva. Resultados: la habilidad de cuidado fue alta en 65%; la dimensión de relación resultó alta en 38.8% y media en 61.3%, con una comprensión alta en 86.2% y modificación de la vida alta en 68.8%. Los cuidadoras fueron mujeres en 85%; 46.3% cuidó > 37 meses; 50% cuidó > 24 h, y padres y esposa(o) apoyaron en 91.3%. Conclusión: estos hallazgos muestran que las habilidades de los cuidadores primarios fueron en general buenas, con la notoria participación del personal de enfermería en la capacitación y el apoyo recibido.

Introduction: Chronic kidney disease has severe consequences for older adults, and continuous ambulatory peritoneal dialysis is an alternative treatment, but it affects the quality of life of patient, family, and primary caregiver. It requires a caregiver with caregiving skills to provide support in some elemental activities, as well as emotional and spiritual support to the patient. Objective: To identify the level of caregiving skills of the primary caregiver of the older adult on peritoneal dialysis. Methodology: Descriptive study in 80 family caregivers of older adults with continuous ambulatory peritoneal dialysis. It was used the Caregiving skill of the family caregiver instrument, which consists of 55 items, divided into three dimensions: relationship, 27 items; understanding, 18 items; and life modification, 10 items. The instrument includes sociodemographic, relationship and time spent variables. A database was created and it was used descriptive statistics analysis. Results: Caregiving skills were high in 65%; relationship dimension high in 38.8%, and medium in 61.3%; understanding high in 86.2%; life modification high in 68.8%. 85% were female caregivers; 46.3% spent > 37 months providing care, 50% provided care > 24 hours; parents and wife/husband supported in 91.3%. Conclusion: Our findings show that caregiving skills of pri- mary caregivers were generally good with the significant involvement of the nursing staff in the training and support received.

Satisfacción de los usuarios hospitalizados en una unidad del IMSS en Ciudad Juárez, Chihuahua / Satisfaction of hospitalized users in an IMSS hospital in Ciudad Juárez, Chihuahua

Introducción: la Organización Mundial de la Salud es una de las organizaciones interesadas en estudiar los factores que determinan la satisfacción de los usuarios en el sistema de salud, donde mencionan que la satisfacción de la población depende más de factores extrínsecos al sistema de salud. Objetivo: identificar el nivel de satisfacción de la atención integral de los usuarios hospitalizados con atención médica y/o quirúrgica. Metodología: estudio descriptivo, transversal, incluyó a 501 usuarios, se aplicó una encuesta de opinión sobre la calidad de la atención hospitalaria. Resultados: el 88.4% de los participantes fueron pacientes, el 93.1% de los usuarios respondieron sentirse entre muy y bastante satisfechos, la calificación que le brindaron a la enfermera fue alta, de 95.4%, seguida de la del médico (94.4%). El 98.4% de los pacientes egresados recomiendan el hospital. Conclusiones: la satisfacción global fue alta en el 93% de los entrevistados.

Introduction: The World Health Organizaron ¡s one of the organizations ¡nterested ¡n studying the factors that determine user satisfaction in the health system, where they mention that population satisfaction depends more on factors extrinsic to the health system. Objective: To identify the level of satisfaction with comprehensive care for users hospitalized with medical and / or surgical care. Methods: Descriptive, cross-sectional study, included 501 users, an opinión survey on the quality of hospital care was applied. Results: 88.4% of the participants were patients, 93.1% of the users responded feeling very and quite satisfied, the score given to the nurse was high, 95.4%; followed by that of the doctor (94.4%). 98.4% of graduated patients recommend the hospital. Conclusions: Overall satisfaction was high in 93% of the interviewees.

Dimensiones de la relación interpersonal del profesional de enfermería en una unidad de segundo nivel / Dimensions of interpersonal relationship of the nursing professional in a second-level unit

Introducción: las relaciones interpersonales tienen gran variedad de contextos. La familia y el trabajo son la base de los grupos sociales y de la sociedad en su conjunto. Objetivo: describir las dimensiones de la relación interpersonal del profesional de enfermería en una unidad de segundo nivel. Métodos: estudio transversal analítico, en el que se incluyeron 75 profesionales de enfermería. Se elaboró un instrumento validado por ronda de expertos, con alfa de Cronbach de 0.960, el cual estuvo conformado por tres dimensiones (comunicación, trabajo en equipo y manejo de conflictos) y tuvo un total de 53 ítems, elaborados con la técnica de Likert. Se utilizó estadística descriptiva y pruebas no paramétricas. Resultados: las relaciones interpersonales fueron regulares (54.7%). Al hacer las correlaciones de comunicación, trabajo en equipo y manejo de conflictos se encontró una p < 0.005. Conclusiones: el nivel regular de las relaciones interpersonales en el profesional de enfermería ofrece un área de oportunidad para mejorarlas.

Introduction: Interpersonal relationships have a great variety of contexts. Family and work are the bases of social groups and society as a whole. Objective: To describe the dimensions of the interpersonal relationship of the nursing professional in a second level unit. Methods: Analytical cross-sectional study including 75 nursing professional. An instrument validated by an expert round, with Cronbach's alpha of 0.960, was elaborated. This instrument was formed by three dimensions communication, teamwork and conflicto management) with a total of 53 items, made with a Likert scale. Descriptive statistics and nonparametric tests were used. Results: Interpersonal relationships were regular (54.7%). Once the correlations of communication, teamwork and conflict management were made, a significance of p < 0.005 was found. Conclusions: Interpersonal relationships were at a regular level, suggesting windows of opportunity to improve interpersonal relationships in nursing.

Satisfacción del adulto mayor con el cuidado de enfermería en un hospital de segundo nivel / Satisfaction of the elderly with nursing care in a second level hospital

Resumen:

Introducción: el deterioro fisiológico del adulto mayor puede acelerarse por la enfermedad, lo que incrementa la utilización de los servicios de salud. En la búsqueda de la satisfacción del usuario es necesario evaluar la calidad de los servicios que se le prestan.

Objetivo: analizar el nivel de satisfacción del adulto mayor hospitalizado con el cuidado que brinda el personal de enfermería.

Metodología: se llevó a cabo un estudio transversal analítico que incluyó a 191 adultos mayores con estancia hospitalaria > 48 horas. Se utilizó el instrumento CARE-Q, constituido por seis dimensiones. La satisfacción se clasificó como alta con 184 a 139 puntos, media con 138 a 93 y baja con 92 o menos. Se utilizó estadística descriptiva y coeficiente de correlación de Sperman.

Resultados: 37.7 % de los entrevistados tuvieron una edad entre 60 y 65 años, 61.8 % fue del sexo masculino, 83.2 % había estado hospitalizado por dos a ocho días, 25.1 % ingresó con diagnóstico de enfermedad cardiovascular y 50% era atendido por medicina interna. Respecto a la accesibilidad del personal de enfermería se obtuvo satisfacción alta (77.5 %); en explicación y facilitación, media (47.6 %); en capacidad para confortar, alta (61.8 %); en anticipación, media (75.4 %); en relación de confianza, alta (73.8 %); en monitoreo y seguimiento, alta (81.2 %). La correlación de satisfacción con el estado civil fue significativa (p > 0.05).

Conclusiones: la satisfacción global fue alta en 61.8 % de los entrevistados.

Abstract:

Introduction: Physiological deterioration of the elderly can be accelerated by disease, which increases the use of health services. In pursuit of customer satisfaction it is necessary to evaluate the quality of the services provided.

Objective: To analyze the level of satisfaction of older adults hospitalized regarding the care provided by nursing staff.

Methods: An analytical cross-sectional study was conducted, it included 191 older adults with hospital stay > 48 hours. CARE-Q instrument consisting of six dimensions was used. The satisfaction was classified as high with 184-139 points, medium with 138-93 points and low with 92 or less. Descriptive statistics and Spearman correlation coefficient were used.

Results: 37.7 % of participants were between 60-65 years of age, 61.8 % were male, 83.2 % had been hospitalized for two to eight days, 25.1 % was admitted with a diagnosis of cardiovascular disease; 50 % we re treated by internal medicine. Accessibility of nurses showed high satisfaction (77.5 %); in explanation and facilitation medium (47.6 %); ability to comfort, high (61.8 %); in anticipation, medium (75.4 %); regarding trust, high (73.8 %); in monitoring and tracking, high (81.2 %). The correlation of satisfaction with marital status was significant (p > 0.05).

Conclusions: The overall satisfaction was high in 61.8 % of respondents.

[Pregnancy and obesity: risk of developing gestational diabetes in the northern border area of Mexico]. / Embarazo y obesidad: riesgo para desarrollo de diabetes gestacional en la frontera norte de México.

INTRODUCTION: The United Sates-Mexico border area has the highest prevalence of overweight and obesity in women of reproductive age and family history of T2DM in the world, contributing to the risk of developing GDM. POPULATION AND METHODS: 58 pregnant women with GDM and 174 without GDM. Clinical records, O'Sullivan test and oral glucose tolerance test was used for diagnosis from 24 weeks of gestation. RESULTS: Average BMI 31.78 with GDM, 27.96 without GDM, O'Sullivan (GDM = 192.0 vs. 108.9 mg/dl), confirmatory test OGTT 100 g basal (88.4 vs. 82.5 mg/dl), at one hour (191. vs. 142.76 mg/dl), women with multiple births have 13 times the risk of overweight and obesity and 10.1 times of suffering GDM (p < 0.0001). Morbid obesity contributed 170% on display GDM. CONCLUSIONS: Women with GDM during pregnancy were overweight and obese. Multiparous and with overweight and obesity are at risk for the occurrence of GDM; as BMI increases the greater the occurrence of GDM.

Percepción de riesgo de contraer SIDA en adolescentes de Guadalajara Jalisco / Adolescent perceptions about the risk of contracting AIDS

Resumen

Objetivo: identificar la percepción del riesgo de contraer SIDA en adolescentes de Guadalajara, Jalisco.

Metodología: investigación cualitativa y análisis de texto tipo semiótico, con 49 estudiantes de 14 a 19 años. Información obtenida mediante entrevistas con grupos focales; se registró con audio grabación y observación participante; análisis centrado en narrativas desde perspectiva semántica y descripción temática; los ejes abordados son: ITS/SIDA, relaciones sexuales, embarazo, condón y fidelidad.

Resultados: la percepción de riesgo ante el SIDA es mucho menor que para embarazo, porque éste genera cambios inmediatos y hay una clara postura de rechazo familiar y social; ante el contagio de enfermedad no manifiestan preocupación latente, lo ven más como producto del azar o del destino: “si te toca te toca y aunque te cuides”, o enfocado a grupos de riesgo dentro del cual los adolescentes no se incluyen “jotos, drogos”, de aquellos que tienen relaciones con extraños o de gente promiscua. Ante el riesgo se distinguen seis posturas en las que los sujetos se mueven en función a la situación y a su interpretación; no hay una sola razón por la que pasen las cosas, concediéndole a otros la responsabilidad —e incluso— a la suerte.

Conclusiones: los adolescentes consideran al SIDA como un riesgo, pero no para ellos; tienen problemas con la información, comprensión y aceptación del problema. Respecto al uso del condón, las campañas deben ir encaminadas a reiterar las ventajas y utilidad de su uso (placer y protección) y en dar a conocer cómo usarlo. La educación sexual es un derecho y una alternativa de solución.

Summary

Objective: to know the perception of Adquired Immunodeficiecy Sindrome (AIDS) risk by adolescents.

Methodoly: a qualitative study with 49 students of 14 to 19 years old was carried out; a semiotic analysis of text was made. Information was obtained with focal groups recorded interviews. Participanting observation was also carried out; Analysis was centered in narrative since a semantic perspective and thematic description; the approached axes were Sexual Transmitted Diseases (STD) AIDS, sexual relationships, pregnancy, condom using and fidelity.

Results: high school perception of risk concerning AIDS was quite a lot less than students of becoming pregnant. Pregnancy brings immediate changes and there is a clear family and social position of rejection. They perceived it as a product of luck or fate; “If you are going to get it, you get it no matter whether you are careful or not.” Or the perception that it is focused on groups at risk and they do not consider them as part of on (“queers”, “junkies”). Six different stances are distinguished with regard to risk in function of the subjects’ situation and interpretation; there is not just one reason why these things happen and they assign the responsibility and even luck to others.

Conclusions: adolescents perceived AIDS as a risk. They have problems with information, understanding and accepting the problem. Regarding the use of condoms, campaigns should aim at repeating the advantages and usefulness of using them (pleasure and protection) and teach how to use them. Sex education is a right and an alternative solution.

[Disordered eating behaviors: prevalence among Mexican students aged 15-19]. / Conductas alimentarias de riesgo: prevalencia en estudiantes mexicanas de 15 a 19 años.

OBJECTIVE: To obtain the prevalence of disordered eating (DE) among student female adolescents from public high schools in 17 urban settings in the Mexican Republic, across age, setting and region. MATERIAL AND METHODS: The sample comprised 4358 female students 15 to 19 years of age. DE was evaluated with a validated and standardized questionnaire for Mexican adolescents with 2 cutoff points: moderate-DE and high-DE. RESULTS: The total prevalence of moderate-DE was 14.2% and 6.8% for high-DE. Significant statistical differences were found only for high-DE across settings, were the Estado de Mexico reached the highest score (12.1%) and Aguascalientes the lowest (2.1%). The north region obtained the highest scores for both moderate (17.2%) and high-DE (9.7%), whereas the center-west region obtained the second place for moderate-DE (15.1%) and the center region for high-DE (11.5%). The center region showed the lowest scores for moderate-DE (11.5%) and the south-southeast region the lowest for high-DE (4.5%). The analysis across age showed a positive relationship for both moderate and high-DE. CONCLUSIONS: The total prevalence of DE was 6.8%. Age, socioeconomic status and the place of residence seem to be variables that relate to disordered eating.

[Risk factors in cesarean section]. / Factores de riesgo en la operación cesárea.

BACKGROUND: Improvement of surgical techniques, innovation, and technological development have increased the frequency of cesarean section. OBJECTIVE: To identify the sociodemographics, obstetrical, attention and medical practice factors of risk most frequently associated to cesarean section. PATIENTS AND METHOD: From January to June 2007, we carried out a study of cases and controls with 222 cases of cesarean section and 358 controls of vaginal childbirth in Hospital General no. 6 of Ciudad Juárez. We compared frequency of sociodemographics, obstetrical, attention, and medical practice variables, by means of chi2 and Fisher exact tests; association among these variables and cesarean section was considered with odds ratio. In all cases chosen confidence interval was 95%. RESULTS: Risk factors associated with cesarean section were: maternal age over 28 years, previous cesarean section, complicated pregnancy, fetal suffering, cephalopelvic disproportion, deficient prenatal care; fetal podalic version, oxytocin administration, abnormal amniotic fluid, double- or triple-circle umbilical cord; patient attended by a gynecologist with more than 16 years of experience and by a resident; and medical care in evening shift. There was no association with age, menarche, beginning of sexual relationships, body mass index, smoking, or addictions. CONCLUSIONS: Risk factors associated with cesarean section were: previous cesarean section and patient attended by a gynecologist with more than 16 years of experience and by a resident.