Efectividad de un programa de automanejo para cuidadores familiares / Effectiveness of a self-management program for family caregivers

INTRODUCCIÓN: La carga de cuidado en los cuidadores familiares (CF), tiene un efecto en la salud física y mental, relaciones familiares, laborales y estado financiero, aumentando la necesidad de intervenciones efectivas para mejorar el automanejo de su condición y el cuidado al familiar en el hogar. OBJETIVO: evaluar la efectividad de un programa para promover el automanejo en CF. METODOLOGÍA: de diseño cuasi experimental con mediciones pre y post intervención, en una muestra no probabilística, intencionada de 19 CF de personas mayores con nivel de dependencia. El programa "Trabajando juntos en colaboración" (TJC), implementado por facilitadores entrenados y certificados, promueve el automanejo y habilidades para cuidar a su familiar en casa. Para evaluar el efecto de la intervención se aplicó pre y post-test el Instrumento de "Automanejo en Cuidadores Familiares", la prueba Shapiro-Wilks, el análisis de diferencias por la t-Student y test de Wilcoxon, se calculó el tamaño del efecto y la potencia estadística (1- ß). RESULTADOS: se encontró una diferencia estadísticamente significativa entre el pre y post intervención, observando un incremento en el resultado de la sumatoria global y en las tres dimensiones del automanejo. Estas diferencias muestran un efecto relevante a considerar (>,80) y una potencia alta (>,80). CONCLUSIÓN: El Programa TJC, muestra efectividad en mejorar el automanejo en CF, con una potencia adecuada que podría permitir generalizar resultados en poblaciones similares. Siendo este un programa genérico, podría ser aplicado en cualquier caso de CF, independiente a la enfermedad o condición de su familiar.

INTRODUCTION: The caregiving burden on family caregivers (FC) has an impact on physical and mental health, family relationships, work, and financial status, increasing the need for effective interventions to improve self-management of their condition and care for the family member at home. OBJECTIVE: to evaluate the effectiveness of a program to promote self-management in FC. METHODOLOGY: The study employed a quasi-experimental design with pre- and post-intervention measurements in a non-probabilistic, purposive sample of 19 FC of older individuals with a level of dependency. The "Trabajando Juntos en Colaboración" (TJC) program, implemented by trained and certified facilitators, promotes self-management and skills to care for their family member at home. To assess the intervention's effect, pre and post-tests were administered using the "Automanejo en Cuidadores Familiares" instrument, along with the Shapiro-Wilks test, t-Student analysis of differences, and Wilcoxon test. Effect size and statistical power (1- ß) were calculated. RESULTS: indicated statistically significant differences between the pre- and post-intervention periods, with an observed increase in the overall sum and in all three dimensions of self-management. These differences demonstrate a relevant effect (>0.80) and high statistical power (>0.80). CONCLUSION: the TJC program proves effective in enhancing self-management in CF, with sufficient power to potentially generalize results to similar populations. As a generic program, it could be applied in any FC case, regardless of the disease or condition of their family member.

Variables that predict informal caregiver overload

OBJECTIVE: to identify predictive variables of caregiver overload in the southern area of Tamaulipas. MATERIAL AND METHODS: the intentional sample was of 215 informal caregivers and/or relatives of people with chronic diseases, users of two General Hospitals of Tamaulipas, Mexico. The study design was transversal and explanatory. RESULTS: more than half of the sample presented problems of overload (53%) and family dysfunction (51.6%). Also, it was detected that just over half is perceived with medium and low level of caregiving competencies (45.6%) and in some category of depression (39.1%). In the regression model, four predictors of overload were identified: depression, caregiving competencies, dependence on the caregiver and time spent on caregiving. The adjusted R2 = .33, indicates that these 4 variables explain one third of the variance of overload. In addition, the family functionality and age variables were not significant for the model. CONCLUSIONS: the profile of informal caregivers in this study sample coincides with that reported in the international literature and that the model of predictors of caregiving overload allowed the identification of some variables that influence caregiver overload.

Situación socio familiar y nivel de autoestima de la madre adolescente / Socio-familiar situation and self-estimate level of the adolescent mother

El embarazo en la adolescencia se reconoce desde los 70' como un problema de salud pública, 25% de los embarazos son en adolescentes. Por lo que este estudio pretendió identificar las características socio-familiares, nivel de autoestima y conocimientos de este grupo en particular. Material y métodos: Estudio descriptivo, transversal, no ciego. Se incluyeron 267 adolescentes entre 12 y 20 años, excluyendo a quienes fueron violentadas sexualmente en sus embarazos, que rehusaron contestar el cuestionario, presentaron retraso mental o salud grave. Se aplicó la prueba psicológica. ¿Se estima lo suficiente? de la Lic. María Dueñas, y un cuestionario de 65 preguntas para las demás variables. Resultados: Inicio de vida sexual activa entre los 12 y 16 años, escolaridad máxima de primaria, dedicadas al hogar, católicas, no utilizan métodos anticonceptivos y padres casados, escolaridad máxima de primaria; padre empleado con ingreso de $1000.00 mensuales, 38% son alcohólicos, refiriendo una comunicación intrafamiliar armoniosa. Las adolescentes viven en unión libre con su pareja cuyas edades fluctúan entre los 15 y 52 años, empleados, con actitud de aceptación al embarazo, nivel de autoestima de la madre adolescente en 54% correcta y 46% narcisista; nivel de conocimientos sobre reproducción humana, métodos de planificación familiar y enfermedades de transmisión sexual, 45% deficientes y 23% nulos. Discusión: Se encontraron diferencias en lo reportado en otros estudios con respecto al nivel de autoestima. Hubo similitud con escolaridad y nivel socioeconómico bajos, así como en el nivel de conocimientos sobre sexualidad y reproducción.

The present descriptive, transverse study, not blind, it looked into determine the socio-family situation, the self-estimate level and the knowledge of adolescent mothers about human reproduction, family planning methods and sexual transmission illnesses. 267 adolescent mothers between the 12 and 20 years old were studied; they received childbirth attention and they were consulted in the adolescent module of the General Hospital of Tampico; being excluded those who were raped in their pregnancies and who refused to answer the questionnaire or those who presented mental retardation problems or critically state of health. To know the self-estimate level, it was applied the standard test "Do you estimate enough?" from the S.A. María Dueñas, and a questionnaire of 65 items of multiple option, for the other variables. It was founded that the beginning of the active sexual life in the adolescent mothers fluctuates between the 12 and 16 years old; they have as maximun education, the primary school level, they are housewives, they are catholic, with urban residence, they have a soon born by normal childbirth, with Apgar of 8-9, and without utilization of family planning methods. They're family married parents, with education of primary school, the father is an employee with an income of $1,000.00 monthly mexican pesos and a third part of them are alcoholic; with harmonious intrafamiliar communication the adolescent mothers live in free union with their couple, with High School education; in 39% their age fluctuates between the 25 and 26 years old; with initial acceptance of their pregnancy. The self-estimate level was normal in 54% and narcissist level in 45%, not existing null level of se If-estimate. Unknowledge about the process of human reproduction was obtained; an acceptable knowledge of family planning methods was obtained, identifying 30% with unknowledge about about prevention of sexual transmission illnesses.