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INTRODUCTION: Worldwide, because of the demographic transition, the proportion of older adults has increased, which has been reflected in an increase in the prevalence of major neurocognitive disorder (MND). This phenomenon is especially important in low- and middle-income countries such as Colombia, given the high economic and social costs it entails. The objective was to analyse the association between socioeconomic variables with the presence of cognitive impairment in Colombian older adults. METHODS: The records of 23,694 adults over 60 years-of-age surveyed for SABE Colombia 2015, that took a stratified sample by conglomerates and were representative of the adult population over 60 years-of-age. This instrument assessed cognitive impairment using the abbreviated version of the Minimental (AMMSE) and collected information on multiple socioeconomic variables. RESULTS: 19.7% of the older adults included in the survey were reviewed with cognitive impairment by presenting a score <13 in the AMMSE. There was a higher prevalence of cognitive impairment in women (21.5%) than in men (17.5%). The socioeconomic variables were shown to impact the prevalence of deterioration, especially being currently working (ORâ¯=â¯2.74; 95%CI, 2.43-3.09) as a risk factor and having attended primary school as a protective factor (ORâ¯=â¯0.30; 95%CI, 0.28-0.32), differentially according to gender. CONCLUSIONS: An association between socioeconomic and sociodemographic factors with cognitive impairment in Colombian older adults was evidenced. Despite the above, a differential impact dependent on sex is suggested.
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Introducción. La calidad de la alimentación es un derecho vinculado con la supervivencia, el crecimiento saludable, la prevención de enfermedades crónicas y malnutrición en todas sus formas. El objetivo de este trabajo fue analizar las prácticas de lactancia y de alimentación de menores de 2 años de áreas urbanas de la Argentina en 2018-19, según el nivel de ingreso de los hogares. Población y métodos. Estudio secundario con datos de la 2da. Encuesta Nacional de Nutrición y Salud 2018-19. Se analizaron indicadores de lactancia y alimentación complementaria, según metodología de la Organización Mundial de la Salud (OMS) y Unicef. Se estratificó según nivel de ingresos del hogar. Resultados. El análisis incluyó 5763 menores de 24 meses. Aunque el 97 % fue alguna vez amamantado, solo el 47 % de los menores de 6 meses tuvo lactancia exclusiva el día previo y el 48 % mantenía la lactancia luego del año, con mayor prevalencia en los niños/as de menores ingresos. En el día previo, el 23 % de los niños/as de 6 a 23 meses no consumió ninguna verdura o fruta; el 60 % consumió alimentos no saludables y el 50 %, bebidas dulces. Las bebidas dulces y la ausencia de frutas y verduras fueron mayores en aquellos de hogares de menores ingresos. Conclusión. La calidad de la alimentación de los niños/as dista de las recomendaciones y está condicionada por los ingresos. En los sectores empobrecidos, es menor el inicio temprano de la lactancia, la diversidad alimentaria mínima y el consumo de frutas y verduras, y es mayor el consumo de bebidas dulces.
Introduction. Diet quality is a right related to survival, healthy growth, prevention of chronic diseases, and malnutrition in all its forms. The objective of this study was to analyze breastfeeding and feeding practices in children younger than 2 years from urban areas of Argentina in 20182019 according to their household income level. Population and methods. Secondary analysis of data of the Second National Survey on Nutrition and Health (ENNyS2) of 20182019. Breastfeeding and complementary feeding indicators proposed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) were analized. Data were stratified by household income level. Results. The analysis included 5763 children younger than 24 months old. Although 97% was ever breastfed, only 47% of infants younger than 6 months were exclusively breastfed the previous day and 48% continued with breastfeeding after 1 year old, with a higher prevalence in low-income children. The previous day, 23% of children aged 6 to 23 months did not eat any fruit or vegetable, 60% consumed unhealthy foods, and 50% consumed sweet beverages. The consumption of sweet beverages and the absence of fruit and vegetables were higher in low-income households. Conclusion. The quality of children's diet is far from the recommendations and is conditioned by income. Early initiation of breastfeeding, minimum dietary diversity, fruit and vegetable consumption are lower and sweet beverage consumption is greater in impoverished sectors.
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Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Aleitamento Materno/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Argentina , Fatores Socioeconômicos , Dieta/estatística & dados numéricos , RendaRESUMO
OBJECTIVES: This study aims to assess the current state of childhood overweight and obesity in Spain, and its relationship with socioeconomic status and health-related behaviors. METHODS: Population-based cross-sectional observational study, based on the 2017 National Health Survey in minors in Spain. This study included all children surveyed who were aged 1-14 years. Childhood obesity was estimated from the z-score of the body mass index. RESULTS: The study included 4882 children aged 1-14 years (mean 7.5). The prevalence of obesity was 18.6% (95% confidence interval [CI] 18.5-18.7), while 13.5% (95% CI 13.4-13.6) were overweight. These figures represent over a million children in Spain who are obese and nearly 750,000 who are overweight. A north-south geographic gradient was apparent, with higher prevalence of unhealthy body weight in southern Spain. Factors associated with childhood obesity were low socioeconomic status, poor diet and sedentarism, among others. CONCLUSIONS: Childhood overweight in Spain is strongly associated with socioeconomic status and other factors such as diet and sedentarism. Multidisciplinary public health interventions are needed to reduce this serious health problem in children.
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Comportamentos Relacionados com a Saúde , Obesidade Infantil , Classe Social , Humanos , Espanha/epidemiologia , Estudos Transversais , Obesidade Infantil/epidemiologia , Criança , Masculino , Prevalência , Feminino , Pré-Escolar , Adolescente , Lactente , Comportamento Sedentário , Inquéritos Epidemiológicos , Índice de Massa CorporalRESUMO
RESUMEN Introducción. La leishmaniasis es una enfermedad zoonótica endémica con amplia distribución en Perú. Objetivo. Identificar los escenarios de transmisión de leishmaniasis y la población que reside en estos, e identificar las características de las poblaciones afectadas durante el periodo 2010 a 2022. Métodos. Estudio descriptivo, transversal, ecológico con unidad de análisis el nivel distrital. Se utilizó datos de fuentes secundarias de acceso público. Resultados. En el periodo de estudio se reportaron 85 117 casos, 7 374 007(22,08%) habitantes residían en 543 distritos con transmisión continua, 11 467 420 (34,33%) habitantes que residían en 454 distritos con reporte esporádico de casos y 14 558 983(43,59%) residían en 893 distritos libres de trasmisión. El 98,16% de los casos ocurrieron en distritos con trasmisión continua, el 1,84%, en distritos con reporte esporádico de casos. La incidencia acumulada media anual fue 3,48 casos/10 000 habitantes. 18 departamentos reportaban trasmisión continua, Madre de Dios (42,45 casos/10 000 habitantes) y Cusco (15,78 casos/10 000 habitantes) tuvieron las tasas más altas. Las poblaciones de mayor riesgo son: hombres, adolescentes y jóvenes; residentes de distritos: de selva, del quintil de mayor pobreza monetaria, del quintil con mayor porcentaje con al menos 1 NBI, y del quintil de menor índice de desarrollo humano. Conclusión. La leishmaniasis tiene amplia distribución en Perú, 56,41% de la población habita en distritos que reportan casos. Existen grupos poblacionales con mayor riesgo absoluto, los cuales pueden ser blanco de intervenciones diferenciadas de prevención y control.
ABSTRACT Introduction. Leishmaniasis is an endemic zoonotic disease widely distributed in Peru. Objectives. Identify transmission scenarios and the population residing in them and identify the characteristics of the affected populations during the period 2010-2022. Methods. Descriptive, cross-sectional, ecological study with district as analysis units. Publicly accessible secondary data sources were used. Results. During the study period, 85,117 cases were reported; 7,374,007 (22.08%) inhabitants live in 543 districts with continuous transmission; 1,146,7420 (34.33%) inhabitants reside in 454 districts with sporadic reports of cases; and 1,455,8983 (43.59%) reside in 893 transmission-free districts. 98.16% of the cases occurred in districts with continuous transmission; 1.84% occurred in districts with sporadic case reports. The mean annual incidence rate was 3.48 cases/10,000 inhabitants. 18 departments report continuous transmission; Madre de Dios (42.45 cases/10,000 inhabitants) and Cusco (15.78 cases/10,000 inhabitants) report the highest rates. The populations with higher absolute risk are men, adolescents, and young people; residents: from jungle districts; from the quintile with the highest monetary poverty; from the quintile with the highest percentage with at least 1 NBI; and from the quintile with the lowest human development index. Conclusion. Leishmaniasis is widely distributed in Peru, with 56.41% of the population living in districts reporting cases. There are population groups with a higher absolute risk, which can be the target of differentiated prevention and control interventions.
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Objetivo: el objetivo de esta revisión es estudiar el efecto que los determinantes sociales de la salud tienen sobre la prevalencia y pronóstico de la enfermedad pulmonar obstructiva crónica (EPOC). Métodos: se ha hecho una revisión exploratoria (scoping review) de los artículos publicados entre 2013 y 2023, y una búsqueda bibliográfica en Pubmed. Se encontraron 31 artículos que cumplieran los criterios de inclusión. Resultados: niveles educativos precarios, así como bajos ingresos económicos se relacionan con un aumento en el riesgo de EPOC, con incrementos del 44,9% y el 22,9% de los casos respectivamente. La dedicación a ciertos oficios, como la agricultura o los servicios de restauración, también aumenta la prevalencia de esta enfermedad y su impacto sobre la mortalidad. La soltería o viudez, el desempleo y vivir en áreas rurales con alta contaminación atmosférica son factores que se asocian a más hospitalizaciones, síntomas graves, menor productividad y mayor mortalidad. Las desigualdades sociales afectan el acceso a la atención médica y la adherencia al tratamiento. La EPOC es más común en hombres y en personas mayores, aunque algunos estudios muestran mayor riesgo en mujeres debido a su dedicación a las tareas domésticas y su exposición a sustancias contaminantes. Conclusiones: determinantes sociales de la salud como el bajo nivel socioeconómico, la ocupación laboral, la contaminación doméstica o ambiental, el estado civil, lugar de residencia o dificultad de acceso al sistema sanitario actúan como factores de riesgo de la EPOC e influyen desfavorablemente sobre ella.(AU)
Aim: the objective of this review is to study the impact of social determinants of health on the prevalence and prognosis of COPD.Methods: an exploratory scoping review of papers published between 2013 and 2023 was performed. A bibliographic search was conducted on pubmed, yielding 31 papers that met the inclusion criteria.Results: low educational levels and low incomes are linked to an increased risk of COPD with increments of 44.9% and 22.9% of cases respectively. Involvement in certain occupations such as agriculture or food services also increases the prevalence of the disease and its impact on mortality. Being single or widowhood, unemployment, and living in rural areas with high air pollution are associated with more hospitalizations, severe symptoms, reduced productivity and higher mortality. Social inequalities impact access to medical care and treatment adherence. COPD is more common in men and the elderly, although some studies reveal a higher risk in women due to household chores and exposure to pollutants.Conclusions: social determinants of health such as low socio-economic status, occupational status, household or environmental pollution, marital status, place of residence or difficulty accessing the healthcare system act as risk factors for COPD and have an unfavourable impact on this.(AU)
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Humanos , Masculino , Feminino , Determinantes Sociais da Saúde , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Fatores Socioeconômicos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/mortalidadeRESUMO
Distorção da imagem corporal é uma alteração da percepção do corpo que pode repercutir na saúde. Este estudo visa estimar, entre mulheres participantes do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil) residentes na Bahia, Brasil, a prevalência de acurácia e distorção da imagem corporal e investigar associações com características socioeconômicas, estilo de vida e procura de cuidados ginecológicos. Participaram 609 mulheres de 50-69 anos de idade que responderam, entre 2012-2014, questionários aplicados face a face. Foi utilizada a escala de silhuetas de Stunkard para investigar a percepção acurada ou distorcida para mais ou menos peso. A razão de risco relativo (RR) foi calculada por meio de regressão logística multinomial por meio do Stata 13. A maioria das participantes tem perspectiva acurada do próprio corpo (53,7%). Entre aquelas com percepção distorcida, há uma tendência à distorção para menos peso (38,1%). Na análise de regressão multinomial, permaneceram associadas à distorção para menos peso as variáveis raça/cor e escolaridade, sendo que a primeira foi positivamente associada à distorção para menos peso entre as pardas (RR = 1,89; IC95%: 1,13-3,16) e pretas (RR = 2,10; IC95%: 1,25-3,55), enquanto a segunda entre aquelas com escolaridade até o Ensino Médio (RR = 1,65; IC95%: 1,18-2,33). Não houve associações quanto às demais variáveis, nem com distorção para mais peso. Os resultados contribuem para a explicação das relações entre percepção da imagem corporal e fatores socioeconômicos, revelando que mulheres de raça/cor diferentes e variados níveis de escolaridade são influenciadas de formas distintas pelos discursos sociais, o que impacta a percepção da sua imagem corporal.
Body image distortion is an alteration in the perception of the body that can have repercussions on health. This study aims to estimate the prevalence of body image accuracy and distortion among women participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) living in Bahia State, Brazil, and to investigate associations with socioeconomic characteristics, lifestyle, and gynecological care seeking. A total of 609 women aged 50 to 69 years participated in the study, who answered face-to-face questionnaires from 2012 to 2014. The Stunkard silhouette scale was used to investigate accurate or distorted perception for more or less weight. The relative risk ratio (RR) was calculated by multinomial logistic regression using Stata 13. Most participants have an accurate perception of their own bodies (53.7%). Among those with distorted perception, there is a tendency to distort towards less weight (38.1%). In the multinomial regression analysis, the variables race/skin color and education remained associated with the distortion towards underweight. The race/skin color variable was positively associated with the distortion towards underweight among Mixed-race women (RR = 1.89; 95%CI: 1.13-3.16) and black (RR = 2.10; 95%CI: 1.25-3.55), while the education variable among those with up to high school education (RR = 1.65; 95%CI: 1.18-2.33). There were no associations with the other variables or with distortion for more weight. The results contribute to explaining the relationships between body image perception and socioeconomic factors, revealing that women of different races/skin colors and varying educational levels are influenced in different ways by social discourses, impacting the perception of their body image.
La distorsión de la imagen corporal es una alteración en la percepción del cuerpo que puede repercutir en la salud. Este estudio busca estimar, entre las mujeres participantes del Estudio Longitudinal de Salud del Adulto (ELSA-Brasil) que viven en Bahía, Brasil, la prevalencia de precisión y distorsión de la imagen corporal e investigar asociaciones con las características socioeconómicas, el estilo de vida y la busca de atención ginecológica. Participaron 609 mujeres que tenían entre 50 y 69 años que contestaron los cuestionarios aplicados cara a cara entre 2012 y 2014. Se utilizó la escala de siluetas de Stunkard para investigar la percepción precisa o distorsionada para más o menos peso. El cociente de riesgo relativo (RR) se calculó a través de regresión logística multinomial utilizando el Stata 13. La mayoría de los participantes tiene una perspectiva precisa del propio cuerpo (53,7%). Entre las personas con percepción distorsionada hay una tendencia a la distorsión para menos peso (38,1%). En el análisis de regresión multinomial, las variables raza/color y escolaridad permanecieron asociadas con la distorsión para menos peso, siendo la primera positivamente asociada con la distorsión para menos peso entre las mujeres pardas (RR = 1,89; IC95%: 1,13-3,16) y negras (RR = 2,10; IC95%: 1,25-3,55), mientras la segunda entre las mujeres que estudiaron hasta la enseñanza secundaria (RR = 1,65; IC95%: 1,18-2,33). No hubo asociaciones con las otras variables ni con la distorsión para más peso. Los resultados contribuyen para explicar las relaciones entre la percepción de la imagen corporal y los factores socioeconómicos, demostrando que mujeres de diferentes razas/colores y diferentes niveles de educación se influyen de distintas formas a través de discursos sociales, lo que impacta en la percepción de su imagen corporal.
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Resumen: Se sabe poco sobre cómo las fluctuaciones económicas afectan las desigualdades educativas en homicidios en países latinoamericanos. Los objetivos de este estudio fueron (a) analizar las variaciones temporales de las desigualdades relativas educacionales de la mortalidad por homicidio, y (b) comparar estas desigualdades entre años de crecimiento económico y años de recesión en ciudades del sur sudamericano durante el período 2000-2019. Se utilizaron datos de siete áreas urbanas, en tres países del Cono Sur Sudamericano: Mendoza y Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro y São Paulo (Brasil); y Santiago (Chile). Se estimaron modelos de Poisson, utilizando como variables explicativas la edad, sexo, año, ciudad de residencia, año de expansión o recesión económica y nivel educativo. Encontramos diferencias marcadas en la evolución temporal de las tasas de homicidio entre las siete ciudades, aunque siempre las poblaciones de nivel educativo bajo fueron las más vulnerables. Las cuatro ciudades de Brasil, analizadas en conjunto, tuvieron desigualdades educativas relativas de homicidios mayores en años de recesión económica, con respecto a años de crecimiento económico. Por un lado, el uso de la fuerza indiscriminado por parte del Estado enfocado hacia grupos criminales parece haber llevado a una creciente desigualdad social de la mortalidad por homicidio. Por el otro, en un contexto de fragmentación criminal y crisis económica se podrían agravar estas desigualdades a través de mayores disputas territoriales entre grupos criminales.
Abstract: Information on how economic fluctuations affect educational inequalities in homicides in Latin America is scarce. This study aimed to: (a) analyze the temporal variations of educational inequalities related to homicide mortality and (b) compare these inequalities between years of economic growth and recession in southern South America cities from 2000 to 2019. Data from seven urban areas in three countries in the Southern Cone of South America were used: Mendoza and Rosario (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro, and São Paulo (Brazil); and Santiago (Chile). Poisson models were estimated by using age, sex, city of residence, year of economic growth or recession, and schooling level as explanatory variables. Results showed significant differences in the temporal evolution of homicide rates in the seven cities, although populations with a low schooling level always showed the most vulnerability. The four Brazilian cities, analyzed together, showed greater educational inequalities related to homicides in years of economic recession when compared to those of economic growth. On the one hand, the indiscriminate use of force by the State against criminal groups seems to increase social inequality in homicide mortality. On the other hand, criminal fragmentation and economic crisis can exacerbate these inequalities by increasing territorial disputes between criminal groups.
Resumo: São escassas as informações sobre como as flutuações econômicas afetam as desigualdades educacionais em homicídios na América Latina. Os objetivos deste estudo foram: (a) analisar as variações temporais das desigualdades educacionais relacionadas à mortalidade por homicídio, e (b) comparar essas desigualdades entre os anos de crescimento econômico e os anos de recessão nas cidades do sul da América do Sul no período de 2000 a 2019. Foram utilizados dados de sete áreas urbanas, em três países do Cone Sul da América do Sul: Mendoza e Rosário (Argentina); Belo Horizonte, Curitiba, Rio de Janeiro e São Paulo (Brasil); e Santiago (Chile). Os modelos de Poisson foram estimados utilizando como variáveis explicativas a idade, sexo, ano, cidade de residência, ano de expansão ou recessão econômica e nível de escolaridade. Os resultados mostraram diferenças significativas na evolução temporal das taxas de homicídio entre as sete cidades, apesar de que as populações com baixo nível de escolaridade sempre foram as mais vulneráveis. As quatro cidades brasileiras, analisadas em conjunto, apresentaram maiores desigualdades educacionais relacionadas a homicídios em anos de recessão econômica em relação aos anos de crescimento econômico. Por um lado, o uso indiscriminado da força pelo Estado contra grupos criminosos parece ter levado ao aumento da desigualdade social na mortalidade por homicídio. Por outro lado, em um contexto de fragmentação criminal e crise econômica, essas desigualdades podem ser exacerbadas pelo aumento das disputas territoriais entre grupos criminosos.
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Abstract Objectives: identify the sociodemographic conditions of the community and determine the prevalence of the nutritional status of children under six years of age in the Nasa Paéz Indigenous Reserve, Rionegro-Huila, Colombia. Methods: cross-sectional descriptive study whose data was obtained from two databases, one of sociodemographic conditions and other anthropometric measurements of children under six years of age. The sample corresponded to the total population of less than six years. The data was analyzed using descriptive statistics using the R Studio 3.4 software. Results: 98.6% of the population is enrolled in the health system. Water consumption comes from 71.6% of non-potable sources. 25.5% of the population has access to wastewater disposal systems. Regarding nutritional status, the prevalence of delay in growth and risk of delay in growth is 43.3% in the population under six months and 69.4% in those aged between six months and six years. Furthermore, 34.3% of children under six months of age are at risk of being overweight. Conclusions: sociodemographic conditions are determined by different inequities, low education levels, inadequate housing, drinking water consumption, as well as a high prevalence of child malnutrition.
Resumen Objetivos: identificar las condiciones sociodemográficas de la comunidad y determinar la prevalencia del estado nutricional de niños menores de seis años en el Resguardo Indígena Nasa Paéz, Rionegro-Huila, Colombia. Métodos: estudio descriptivo transversal cuyos datos se obtuvieron de dos bases de datos, una de las condiciones sociodemográficas y otra de medidas antropométricas de niños menores de seis años. La muestra correspondió a la totalidad población menor seis años. Los datos se analizaron mediante estadística descriptiva utilizando el software R Studio 3.4. Resultados: el 98,6% de la población está inscrito en el sistema de salud. El consumo de agua proviene en un 71,6% de fuentes no potables. El 25,5% de la población tiene acceso a sistemas de eliminación de aguas residuales. En cuanto al estado nutricional, la prevalencia de retraso en el crecimiento y riesgo de retraso en el crecimiento es del 43,3% en la población menor de seis meses y del 69,4% en edad entre los seis meses a seis años. Además, el 34,3% de los niños menores de seis meses estaban en riesgo de tener sobrepeso. Conclusiones: las condiciones sociodemográficas están determinadas por diferentes inequidades, bajos niveles de educación, vivienda inadecuada, consumo de agua no potable, así como por una alta prevalencia de malnutrición infantil.
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Humanos , Recém-Nascido , Lactente , Pré-Escolar , Pesos e Medidas Corporais , Estado Nutricional , Desnutrição/epidemiologia , Determinantes Sociais da Saúde , Antropometria , Colômbia , Fatores Culturais , Povos Indígenas , Fatores SociodemográficosRESUMO
Introducción: El asma es una patología respiratoria caracterizada por inflamación cró-nica y reversible de las vías aéreas. Esta se asocia con factores de riesgo modificables y no modificables que influyen sobre su control y exacerbaciones. En países como Puer-to Rico y Cuba, la prevalencia del asma es significativamente mayor a la global (22,8%, 23% y 6,6%, respectivamente).
Introduction: Asthma is a respiratory pathology characterized by chronic and reversible airway inflammation. It is associated with modifiable and non-modifiable risk factors that influence its control and exacerbations. In countries such as Puerto Rico (22.8 %) and Cuba (23 %), the prevalence of asthma is significantly higher than the global prevalence (6.6 %).
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Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Asma/prevenção & controle , Terapêutica , Comorbidade , Fatores de Risco , República Dominicana , Absenteísmo , Exacerbação dos SintomasRESUMO
Resumen Objetivo: Evaluar los factores que influyen en la adherencia al tratamiento de los pacientes con enfermedad renal crónica, en el servicio de consulta externa de nefrología de un hospital de Tlaxcala. Material y Método: Se realizó un estudio descriptivo de corte transversal con una muestra de 80 pacientes que asisten al consultorio de nefrología. Mediante un cuestionario validado, se determinaron los factores que influyen en el paciente para mantenerse en la adherencia al tratamiento farmacológica y no farmacológica. Resultados: Se muestra un nivel de riesgo moderado de adherencia al tratamiento en la población estudiada, el 8.8% de los pacientes se adhieren al tratamiento, el 58.8% tienen un riesgo moderado de no adherirse al tratamiento, y el 32.5% tienen alto riesgo de no adherirse al tratamiento, siendo sus principales causas la carencia de recursos económicos (65%), no conocer cuál es su peso seco (61.3%), seguir un régimen dietético de alto costo (60%), dificultad para realizar un cambio en el estilo de vida (38.8%), y no recibir la información sobre los beneficios de los medicamentos (8.8%). Conclusiones: La falta de recursos económicos y la falta de información, son los principales factores que influyen en la no adherencia al tratamiento farmacológico y no farmacológico. El profesional de enfermería debe brindar información clara, completa y útil a fin de mejorar el apego al tratamiento y disminuir costos y complicaciones en la ERC. Es necesario buscar estrategias educativas, conductuales, y el apoyo social y familiar, debido a sus condiciones socioeconómicas, y el apego a hábitos que no son de beneficio para su estado de salud.
Abstract Objective: To evaluate the influencing factors that affect the adherence to the treatment in chronic kidney disease patients. Material and Methods: A descriptive cross-sectional study was carried out in a sample size of 80 patients in an external nephrology service from a hospital at Tlaxcala. A previously validated questionnaire divided in four dimensions was used to determine the factors that influence patients to maintain pharmacological and non-pharmacological adherence to their treatment. Results: A moderate risk level of adherence was present in this population, el 8.8% of the patients have adherence to the treatment, el 58.8% are in moderate risk of non-adherence, and 32.5% have a high risk of no adherence. The main factors by no adherence are lack of economic sources (65%), unknown their dry weight (61.3%), a highcost dietetic regime (60%), having difficulties to change their live style (38.8%), and do not get information about their medicine advantages (8.8%). Conclusions: Lack of moneyand information are the influencing factors because the patient do not have adherence to the pharmacologic and non-pharmacologic treatment. The nursing professional should provide clear, useful and complete information in order to improve the treatment adherence, to reduce complications and costs in CKD patients. It is necessary to look forward for educative and motivational strategies because their economic situation and arraigned habits, looking for social and family support to improve their health status.
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Objetivo: investigar los factores que influyen en la alfabetización en salud de los pacientes con enfermedad arterial coronaria. Método: estudio transversal, que incluyó 122 pacientes con enfermedades coronarias (60,7% del sexo masculino; 62,07±8,8 años); se evaluó la alfabetización en salud y el conocimiento específico sobre la enfermedad mediante entrevistas con los participantes, utilizando el Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Los datos fueron descritos por medidas de tendencia central y frecuencias. Los factores que influyen en la alfabetización en salud se determinaron mediante un modelo de regresión lineal. El nivel de significación adoptado fue del 5%. El estudio fue aprobado por el Comité de Ética e Investigación. Resultados: la edad y la hipertensión mostraron una relación inversa y significativa con la alfabetización en salud. Por otro lado, un mayor nivel educativo y tener empleo se asociaron con puntajes más altos en el instrumento de alfabetización en salud. El conocimiento específico sobre la enfermedad no influyó en la alfabetización en salud. Las variables del modelo de regresión explicaron el 55,3% de alfabetización inadecuada. Conclusión: en el presente estudio, se concluyó que el conocimiento sobre la enfermedad no influye en la alfabetización en salud, pero los profesionales deben considerar los factores sociodemográficos y clínicos para planificar las intervenciones.
Objective: to investigate the factors that exert an influence on health literacy in patients with coronary artery disease. Methods: a crosssectional study, including 122 patients with coronary diseases (60.7% male; 62.07 ± 8.8 years old). Health literacy and specific knowledge about the disease were evaluated through interviews with the participants by means of the Short Test of Functional Health Literacy in Adults and the Short version of the coronary artery disease education questionnaire. The data were described by means of central tendency measures and frequencies. The factors that exert an influence on health literacy were determined by means of a linear regression model. The significance level adopted was 5%. The study was approved by the Research Ethics Committee. Results: age and arterial hypertension presented an inverse and significant relationship with health literacy. On the other hand, higher schooling levels and having a job were associated with better scores in the health literacy instrument. Specific knowledge about the disease did not exert any influence on health literacy. The variables included in the regression model explained 55.3% of inadequate literacy. Conclusion: this study, knowledge about the disease exerts no influence on health literacy: however, the professionals should consider the sociodemographic and clinical factors to plan the interventions.
Objetivo: investigar os fatores que influenciam o letramento em saúde em pacientes com doença arterial coronariana. Método: estudo transversal, incluindo 122 pacientes com coronariopatias (60,7% do sexo masculino; 62,07±8,8 anos); letramento em saúde e conhecimento específico da doença foram avaliados por meio de entrevista com os participantes, pelo Short Test of Functional Health Literacy in Adults e Short version of the coronary artery disease education questionnaire. Os dados foram descritos por medidas de tendência central e frequências. Fatores que influenciam o letramento em saúde foram determinados por modelo de regressão linear. O nível de significância adotado foi de 5%. O estudo foi aprovado pelo Comitê de Ética e Pesquisa. Resultados: idade e hipertensão apresentaram uma relação inversa e significativa com letramento em saúde. Por outro lado, maior escolaridade e estar empregado associaram-se com maiores pontuações no instrumento de letramento em saúde. O conhecimento específico da doença não influenciou o letramento em saúde. As variáveis do modelo de regressão explicaram 55,3% do letramento inadequado. Conclusão: no presente estudo o conhecimento sobre a doença não influência o letramento em saúde, mas os profissionais devem considerar os fatores sociodemográficos e clínicos para planejar as intervenções.
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Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Autocuidado , Doença da Artéria Coronariana/terapia , Conhecimentos, Atitudes e Prática em Saúde , Inquéritos e Questionários , Letramento em Saúde , Fatores SociodemográficosRESUMO
RESUMEN Introducción: Más allá de los factores de riesgo (FR) tradicionales, hay determinantes no convencionales (DnoC) de la salud cardiovascular (CV) que operan en las mujeres como factores de riesgo adicional. Es por ello necesario explorarlos y establecer su prevalencia y vínculo con el género femenino. Objetivo: conocer la prevalencia de los DnoC socioeconómicos (SE) y psicosociales (PS) y su impacto en la salud CV de la mujer en Latinoamérica (LATAM). Material y métodos: estudio observacional, de corte transversal realizado a través de una encuesta anónima en mujeres de LATAM entre mayo y junio de 2022. Se recabaron datos sobre DnoC (SE y PS), FR convencionales y enfermedad cardiovascular (ECV). Resultados: participaron 4915 mujeres con edad media de 49 ± 13 años. El 49,6% residía en Argentina, el 55,8% en grandes ciudades, el 94,4% declaró acceso adecuado a la salud y el 89% tuvo acceso a algún nivel de educación. Si bien el 79,9% expresó tener trabajo remunerado, más de la mitad refirió percibir un salario no acorde (59,5%) y una exposición a la violencia en el ámbito laboral (26,7%). Los determinantes PS más prevalentes fueron el bajo a moderado nivel de satisfacción (68,3%), la ansiedad o irritabilidad (51,9%), el desinterés, los pensamientos negativos o la infelicidad (41,7%). El grupo de edad mayor de 45 años se asoció significativamente a más sobrepeso, obesidad, desempleo y violencia laboral. En el análisis multivariado se encontró asociación independiente con ECV para el trastorno del sueño (OR 1,7; p = 0,001), residir en una ciudad de baja densidad poblacional (OR 0,5; p <0,001), la violencia laboral (OR 1,8; p = 0,001), la ansiedad (OR 1,5; p = 0,001) y al haber padecido complicaciones del embarazo (OR 1,6; p = 0,022). Conclusión: se demostró una importante prevalencia de factores PS y SE que impactan en la salud CV de las mujeres en LATAM. Variables como la violencia laboral, la ansiedad o la irritabilidad, residir en ciudades de baja densidad poblacional, así como los trastornos del sueño y complicaciones del embarazo se asociaron de forma independiente con la ECV. Esta encuesta muestra el impacto de los DnoC SE y PS en la carga cardiometabólica (CCM) y la salud CV de las mujeres en LATAM, principalmente en aquellas mayores de 45 años.
ABSTRACT Background: Besides traditional risk factors (RF), non-conventional determinants (NCD) of cardiovascular (CV) health are additional risk factors in women. Therefore, they should be explored to establish their prevalence and association with the female gender. Objective: The aim of this study is to know the prevalence of socioeconomic (SE) and psychosocial (PS) factors as NCD in CV health in Latin American (LATAM) women. Methods: We conducted an observational, cross-sectional study using an anonymous survey distributed among LATAM women between May and June 2022. The information gathered included SE and PS NCD, traditional RF and cardiovascular disease (CVD). Results: A total of 4915 women participated; mean age was 49 ± 13 years. Most respondents (49.6%) lived in Argentina, 55.8% in large cities; 94.4% reported adequate access to healthcare services and 89% had access to some level of education. Although 79.9% had a paid job, more than half reported their salary was not commensurate (59.5%) and 26.7% reported exposure to violence at the workplace. The most prevalent PS factors were low to moderate level of satisfaction (68.3%), anxiety or irritability (51.9%), apathy, negative thoughts, or unhappiness (41.7%). Age >45 years was significantly associated with overweight, obesity, unemployment, and violence at the workplace. On multivariate analysis, sleep disorders (OR 1.7; p = 0.001), living in a city with low population density (OR 0.5; p <0.001), violence at the workplace (OR 1.8; p = 0.001), anxiety (OR 1.5; p = 0.001) and a history of pregnancy complications (OR 1.6; p = 0.022) were independently associated with CVD. Conclusion: The prevalence of PS and SE factors affecting the CV health of LATAM women was significant. Variables such as violence at the workplace, anxiety, or irritability, living in cities with low population density, sleep disorders and pregnancy complications were independently associated with CVD. This survey shows the impact of SE and PS factors as NCD on the cardiometabolic burden and CV health of women in LATAM, mainly in those > 45 years.
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Objetivo: Se propuso aplicar modelos basados en técnicas de aprendizaje automático como apoyo para el diagnóstico temprano de la diabetes mellitus, utilizando variables de datos ambientales, sociales, económicos y sanitarios, sin la dependencia de la toma de muestras clínicas. Metodología: Se utilizaron datos de 10 889 usuarios afiliados al régimen subsidiado de salud de la zona suroccidental en Colombia, diagnosticados con hipertensión y agrupados en usuarios sin (74,3 %) y con (25,7 %) diabetes mellitus. Se entrenaron modelos supervisados utilizando k vecinos más cercanos, árboles de decisión y bosques aleatorios, así como modelos basados en ensambles, aplicados a la base de datos antes y después de balancear el número de casos en cada grupo de diagnóstico. Se evalúo el rendimiento de los algoritmos mediante la división de la base de datos en datos de entreno y de prueba (70/30, respectivamente), y se utilizaron métricas de exactitud, sensibilidad, especificidad y área bajo la curva. Resultados: Los valores de sensibilidad aumentaron considerablemente al utilizar datos balanceados, pasando de valores máximos del 17,1 % (datos sin balancear) a valores de hasta 57,4 % (datos balanceados). El valor más alto de área bajo la curva (0,61) fue obtenido con los modelos de ensambles, al aplicar un balance en el número de datos por cada grupo y al codificar las variables categóricas. Las variables de mayor peso estuvieron asociadas con aspectos hereditarios (24,65 %) y con el grupo étnico (5.59 %), además de la dificultad visual, el bajo consumo de agua, una dieta baja en frutas y verduras, y el consumo de sal y azúcar. Conclusiones: Aunque los modelos predictivos, utilizando información socioeconómica y ambiental de las personas, surgen como una herramienta para el diagnóstico temprano de la diabetes mellitus, estos aún deben ser mejorados en su capacidad predictiva.
Objective: The objective was to apply models based on machine learning techniques to support the early diagnosis of diabetes mellitus, using environmental, social, economic and health data variables, without dependence on clinical sample collection. Methodology: Data from 10,889 users affiliated with the subsidized health system in the southwestern area of Colombia, diagnosed with hypertension and grouped into users without (74.3%) and with (25.7%) diabetes mellitus, were used. Supervised models were trained using k-nearest neighbors, decision trees, and random forests, as well as ensemble-based models, applied to the database before and after balancing the number of cases in each diagnostic group. The performance of the algorithms was evaluated by dividing the database into training and test data (70/30, respectively), and metrics of accuracy, sensitivity, specificity, and area under the curve were used. Results: Sensitivity values increased significantly when using balanced data, going from maximum values of 17.1% (unbalanced data) to values as high as 57.4% (balanced data). The highest value of area under the curve (0.61) was obtained with the ensemble models, by applying a balance in the amount of data for each group and by coding the categorical variables. The variables with the greatest weight were associated with hereditary aspects (24.65%) and with the ethnic group (5.59%), in addition to visual difficulty, low water consumption, a diet low in fruits and vegetables, and the consumption of salt and sugar. Conclusions: Although predictive models, using people's socioeconomic and environmental information, emerge as a tool for the early diagnosis of diabetes mellitus, their predictive capacity still needs to be improved.
Objetivo: Propôs-se aplicar modelos baseados em técnicas de aprendizagem automática como apoio para o diagnóstico precoce da diabetes mellitus, utilizando variáveis de dados ambientais, sociais, econômicos e sanitários, sem a dependência da coleta de amostras clínicas. Metodologia: Usaram-se dados de 10.889 usuários filiados ao regime subsidiado de saúde da zona sudoeste da Colômbia, diagnosticados com hipertensão e agrupados em usuários sem (74,3%) e com (25,7%) diabetes mellitus. Foram treinados modelos supervisionados utilizando k vizinhos mais próximos, árvores de decisão e florestas aleatórias, assim como modelos baseados em montagens, aplicados à base de dados antes de depois de equilibrar o número de casos em cada grupo de diagnóstico. Avaliou-se o desempenho dos algoritmos por meio da divisão da base de dados de treino e teste (70/30, respectivamente), e utilizaram-se métricas de exatidão, sensibilidade, especificidade e área sob a curva. Resultados: Os valores de sensibilidade aumentaram de maneira significativa ao utilizar dados equilibrados, passando de valores máximos de 17,1% (dados sem equilibrar) a valores de até 57,4% (dados equilibrados). O valor mais elevado de área sob a curva (0,61) foi obtido com os modelos de montagens, ao aplicar um balanço no número de dados por cada grupo e codificar as variáveis categóricas. As variáveis de maior peso estiveram associadas com fatores hereditários (24,65%) e com o grupo étnico (5,59%), além da dificuldade visual, o baixo consumo de água, um regime baixo em frutas e vegetais e o consumo de sal e açúcar. Conclusões: Embora os modelos preditivos, utilizando informação socioeconômica e ambiental das pessoas, surgem como uma ferramenta para o diagnóstico precoce da diabetes mellitus, ainda devem ser melhorados em sua capacidade preditiva.
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BACKGROUND: The aim of the study was to determine the socioeconomic and demographic factors associated with advanced colorectal cancer (CRC) presentation at our institution. METHODS: From January 2009 to January 2018, patients that underwent CRC surgery at our institution were included and retrospectively analyzed. Univariate and multivariate logistic regression were used to determine independent risk factors for presenting with advanced CRC. RESULTS: A total of 277 patients were included, 53.5% presented with advanced CRC. The multivariate analysis identified that living in a rural area (odds ratio [OR] = 5.25; 95% confidence interval [95% CI]: 2.27-12-10; p < 0.001), weight loss (OR = 2.33; 95% CI: 1.35-4.09; p = 0.002), needing emergency surgery (OR = 4.68; 95% CI: 1.25-17.49; p = 0.022), location in the rectum in comparison with colon (OR = 2.66; 95% CI: 1.44-4.91; p = 0.002), and location in the mid rectum (OR = 6.10; 95% CI: 2.31-16.12; p < 0.001) were associated with higher odds of advanced CRC stage at presentation. CONCLUSIONS: Patients with lower socioeconomic status, with symptoms, and needing emergency surgery were associated with advanced CRC stage at presentation. Special interventions to improve access to care in this population should be planned to enhance CRC outcomes.
INTRODUCCIÓN: El objetivo del presente estudio es determinar los factores socioeconómicos y demográficos asociados con la presentación de cáncer colorrectal (CCR) en etapas avanzadas en nuestra institución. MÉTODOS: De Enero 2009 a Enero 2018, aquellos pacientes operados por CCR fueron incluidos y analizados de forma retrospectiva. Se realizó análisis de regresión logística para determinar los factores de riesgo independientes para presentar CCR avanzado. RESULTADOS: Se incluyeron un total de 277 pacientes, de los cuales 53.5% se diagnosticaron con CCR avanzado. En el análisis multivariable: vivienda en zona rural (OR = 5.25; 95% CI: 2.27-12-10; p < 0.001), pérdida de peso (OR = 2.33; 95% CI: 1.35-4.09; p = 0.002), necesidad de cirugía de urgencia (OR = 4.68; 95% CI: 1.25-17.49; p = 0.022), tumores en recto (OR = 2.66; 95% CI: 1.44-4.91; p = 0.002), fueron factores asociados a mayor probabilidad de presentación avanzada del CCR. CONCLUSIONES: Pacientes con nivel socioeconómico bajo, aquellos que acuden sintomáticos, y los que requieren de inicio cirugía de urgencia, fueron factores asociados a presentaciones avanzadas de CCR. Se requieren intervenciones especiales para mejorar el acceso a un diagnóstico temprano y oportuno en estos grupos poblacionales.
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Neoplasias Colorretais , Humanos , Estudos Retrospectivos , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/cirurgia , Fatores Socioeconômicos , Reto , DemografiaRESUMO
OBJECTIVE: To synthesize the social inequalities related to mortality from traffic accidents reported in scientific publications. METHOD: A scoping review following the PRISMA-ScR guide was carried out. Using the MesH vocabulary, we systematically searched for articles in English, Portuguese and Spanish published in the EBSCO, Scielo, Scopus, Ovid, and PubMed databases. RESULTS: We identified 47,790 records in the initial search, of which 35 articles met the selection criteria. Nine out ten publications are in high-income countries; there is a greater interest in analyzing mortality in occupants and drivers of vehicles and motorcyclists. Half of the publications use race-ethnicity and geolocation as socioeconomic position variables. The articles included in this review indicate that groups of people with low socioeconomic positions have higher mortality due to traffic accidents. CONCLUSIONS: The highest mortality from traffic accidents occurs in people with low socioeconomic positions which suggests the development of road safety actions from a comprehensive, integrative perspective and linked to other political agendas to reduce their incidence by 2030. Although road traffic fatalities are higher in low and middle-income countries, few publications are available in these countries. It is necessary to strengthen the research capacities in these countries.
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Acidentes de Trânsito , Renda , Humanos , Bibliometria , Incidência , Fatores SocioeconômicosRESUMO
Objetivo: Identificar los determinantes sociales relacionados a la salud ocular en pobladores adultos de una comunidad de Ica 2022. Materiales y métodos: Se desarrolló una investigación con enfoque cuantitativo de corte transversal, correlacional, donde se incluyó una muestra de 108 pobladores adultos del sector de Santa Bárbara del distrito de Tinguiña en Ica, obtenida por muestreo probabilístico; utilizando dos instrumentos elaborados por las autoras, cada uno fue sometido a validación (p: 0.031) y prueba de confiabilidad (α=0.81; KR-20: 0.83). Resultados: Se identificó como factor biológico sexo femenino en 69.4%, la edad promedio fue de 51.84 ±15.56; el 75% no refiere antecedentes familiares, dentro de los estilos de vida el 94% se expone a una pantalla electrónica, el 65% consume alimentos que protegen la visión y el 62% no toma en cuenta la distancia e iluminación adecuada para la lectoescritura; el 91% refirió recibir una atención sanitaria inadecuada, el 71% afirma que su situación económica no les permite atender su salud, 80% no accede a una consulta oftalmológica, ni cubren su tratamiento; asimismo, el 94% de los pobladores no cuidan su salud ocular. Conclusión: Los determinantes sociales de la salud ocular identificados corresponden a la deficiente situación socioeconómica (rs = 0.212; p: 0.027); el ingreso familiar deficiente para la atención de salud (rs = 0.25; p: 0.009); no cubrir la consulta oftalmológica (rs = 0.24; p: 0.012); ni el tratamiento que esta genera (rs = 0.213; p: 0.02). (AU)
Objective: To identify the social determinants associated with eye health in adult residents of a community in Ica 2022. Materials and methods: An investigation with a cross-sectional quantitative approach was developed, correlational, which included a sample of 108adult residents of the Santa Bárbara sector of the Tinguiña district in Ica, obtained by probabilistic sampling; using two instruments developed by the authors, each one was subjected to validation (p: 0.031) and reliability test (α=0.81; KR-20: 0.83). Results: Female sex was identified as a biological factor in 69.4%, the average age was 51.84 ±15.56; 75% do not refer family history, within lifestyles, 94% are exposed to an electronic screen, 65% consume foods that protect vision; 65% consume foods that protect vision and 62% do not take into account the distance and adequate lighting for reading and writing; 91% reported receiving inadequate health care, 71% affirm that their economic situation does not allow them to take care of their health, 80% do not access an ophthalmological consultation, nor do they cover their treatment; Likewise, 94% of the inhabitants do not take care of their eye health. Conclusion: The social determinants of ocular health identified correspond to the deficient socioeconomic situation (rs = 0.212; p: 0.027); deficient family income for health care (rs = 0.25; p: 0.009) and does not cover ophthalmology consultation (rs = 0.24; p: 0.012); nor the treatment that it generates (rs = 0.213; p: 0.02). (AU)
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Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fatores Socioeconômicos , Saúde Ocular , Determinantes Sociais da Saúde , Estilo de Vida , Estudos TransversaisRESUMO
Objective. To identify socio-academic and family functionality factors communication, cohesion, and flexibility as predictive stimuli of adaptive coping of nursing university students in the post-COVID-19 pandemic. Methods. A cross-sectional descriptive study with stratified random sampling, with participation by 416 Nursing students from a private university in Pereira (Colombia), who answered a self-completed sociodemographic characterization survey, the Olson et al., communication scale, FACES III scale to assess family cohesion and flexibility, and the Calixta Roy CAPS scale to assess coping and adaptation capacity. Binary logistic regression and Hosmer-Lemeshow goodness-of-fit were performed to determine predictors of success, using SPSS v.26. Results. The profiles of the participants showed a higher proportion of women (78.4%), ages between 21 and 30 years (57.5%), young people who study and work (60.1%), and those who have an academic session on Friday and Saturday (67.5%). Nursing students perceive that their families communicate efficiently and satisfactorily (85.8%), have strong cohesion with a tendency towards attachment (73.6%) and flexibility, show a tendency towards chaos (70.7%) and have adaptive coping (48.5%). The success predictors for adaptive coping were female sex (p=0.007), academic session Friday and Saturday (p=0.042), occupation, study, and work (p=0.026), socioeconomic strata 4.5 and 6 (p=0.041), good or very good communication (p=0.001), balanced family cohesion (p = 0.048), and balanced family flexibility (p=0.039). Conclusion. This study found that good family functionality and having adequate socioeconomic conditions were predictors of higher coping and adaptation capacity during the COVID-19 pandemic in the nursing students who participated in the study
Objetivo. Identificar factores socio-académicos y de funcionalidad familiar -comunicación, cohesión y flexibilidad-, como estímulos predictores de afrontamiento adaptativo de estudiantes de Enfermería en postpandemia COVID-19. Métodos. Estudio descriptivo transversal con muestreo aleatorio estratificado. Participaron 416 estudiantes de Enfermería de una universidad privada de Pereira (Colombia) que respondieron una encuesta auto diligenciada de caracterización sociodemográfica y tres escalas validadas: de Comunicación de Olson et al., FACES III para valorar cohesión y flexibilidad familiar y escala CAPS de Calixta Roy para evaluar capacidad de afrontamiento y adaptación. Los factores predictores de éxito se analizaron con regresión logística binaria y bondad de ajuste de Hosmer-Lemeshow, utilizando SPSS v.26. Resultados. El perfil de los participantes mostró mayor proporción de mujeres(78.4%), edades entre 21 y 30 años (57.5%), jóvenes que estudian y trabajan (60.1%), y quienes cumplen jornada académica viernes y sábado (67.5%). Los estudiantes de enfermería perciben que sus familias se comunican en forma eficiente y satisfactoria (85.8%), tienen una fuerte cohesión con tendencia al apego (73.6%) y a la flexibilidad, muestran tendencia al caos (70.7%) y tienen afrontamiento adaptativo (48.5%). Los predictores de éxito para afrontamiento adaptativo fueron: sexo femenino (p=0.007), jornada académica viernes y sábado (p=0.042), ocupación estudia y trabajo (p=0.026), estratos socioeconómicos 4,5 y 6 (p=0.041), buena o muy buena comunicación (p=0.001), cohesión familiar equilibrada (p=0.048) y flexibilidad familiar equilibrada (p=0.039).Conclusión.En este estudio se encontró que la buena funcionalidad familiar y tener adecuadas condiciones socioeconómicas fueron predictores de mayor capacidad de afrontamiento y adaptación durante la pandemia COVID-19 en los estudiantes de enfermería que participaron en el estudio.
Objetivo. Identifico os fatores socioacadêmicos e a funcionalidade familiar -comunicação, coesão e flexibilidade-, como estímulos preditivos do enfrentamento adaptativo de estudantes de Enfermagem no pós-pandemia de COVID-19. Métodos. Estudo descritivo transversal com amostragem aleatória estratificada. Participaram 416 estudantes de enfermagem de uma universidade privada da cidade de Pereira (Colômbia), respondendo a uma pesquisa autopreenchida de caracterização sociodemográfica e três escalas validadas: Comunicação de Olson et al., FACES III para avaliar a coesão e flexibilidade familiar e a escala CAPS de Calixta Roy, para avaliar a capacidade de enfrentamento e adaptação. Os preditores de sucesso foram analisados com regressão logística binária e Hosmer-Lemeshow, usando SPSS v.26. Resultados. Os perfis dos participantes mostraram maior proporção de mulheres(78.4%), com idades compreendidas entre os 21 e os 30 anos (57.5%), jovens que estudam e trabalham (60.1%) e que cumprem o horário letivo de sexta-feira a sábado (67.5%). Os estudantes de enfermagem percebem que suas famílias se comunicam de forma eficiente e satisfatória (85.8%), têm forte coesão com tendência ao apego (73.6%) e flexibilidade, apresentam tendência ao caos (70.7%) e têm enfrentamento adaptativo (48.5%). Os preditores de sucesso para enfrentamento adaptativo foram: sexo feminino (p=0.007), jornada acadêmica sexta e sábado (p=0.042), ocupação, estudo e trabalho (p=0.026), estrato socioeconômico 4.5 e 6 (p=0.041), boa ou comunicação muito boa (p=0.001), coesão familiar equilibrada (p=0.048) e flexibilidade familiar equilibrada (p=0.039). Conclusão. Neste estudo, verificou-se que a boa funcionalidade familiar e ter condições socioeconômicas adequadas foram preditores de maior capacidade de enfrentamento e adaptação durante a pandemia de COVID-19 nos estudantes de enfermagem que participaram do estudo.
Assuntos
Humanos , Masculino , Feminino , Fatores Socioeconômicos , Estudantes de Enfermagem , Relações Familiares , COVID-19RESUMO
Introducción: La desigualdad socioeconómica (DSE) puede afectar negativamente al control del asma. El objetivo de este estudio fue identificar la relación de la DSE con el control del asma y la calidad de vida de los cuidadores. Métodos: El nivel socioeconómico se determinó por área de residencia, según la tasa de riesgo de pobreza (TRP). La población pediátrica de Castilla y León se estratificó en terciles de TRP, y se seleccionó una muestra mediante muestreo aleatorio estratificado, identificando a los niños (6-14 años) con asma activa en los registros clínicos de centros de atención primaria. La información se obtuvo mediante cuestionarios cumplimentados por los padres. Las variables primarias fueron el control del asma y la calidad de vida de los cuidadores. Se analizó su relación con la DSE, la calidad de la atención sanitaria y factores individuales (como el nivel educativo de los padres) mediante modelos multivariantes de regresión. Resultados: El tercil de TRP no se relacionó con ninguna medida de control del asma, calidad de vida ni calidad de la asistencia. El nivel educativo de la madre (educación media o superior) se asociaba a menor riesgo de consulta no programada/urgente (OR=0,50; IC 95%: 0,27-0,95; p=0,034) y el del padre a menor riesgo de asma mal controlada (OR=0,51; IC 95%: 0,28-0,94; p=0,030). Conclusión: En la población que hemos estudiado, no se encuentra asociación entre DSE, medida por área de residencia, y el control del asma en niños. Otros factores, como la educación de los padres, pueden ser factores protectores. (AU)
Introduction: Socioeconomic inequality (SEI) can adversely affect asthma control. The aim of this study was to establish the association of SEI with asthma control in children and caregiver quality of life. Methods: We assessed socioeconomic status based on the area of residence, according to the at risk of poverty rate (ARPR). After stratifying the paediatric population of Castilla y León (an autonomous community in Spain) in ARPR tertiles, we selected participants by stratified random sampling, and identified children with asthma aged 614 years from the health records of primary care centres. We collected data through questionnaires completed by parents. The primary outcomes were asthma control and caregiver quality of life. We assessed their association with SEI, health care quality measures and individual factors (such as parental educational attainment) by means of multivariate regression models. Result: The ARPR tertile was not associated with asthma control, quality of life or health care quality. A medium or high maternal educational attainment was associated with a lower risk of making an unscheduled or urgent visit (OR=.50; 95% CI: .27-.95; P=.034) and paternal educational attainment was associated with a lower risk of uncontrolled asthma (OR=.51; 95% CI: .28-.94; P=.030). Conclusion: In the sample under study, SEI assessed at the local level was not associated with asthma control in children. Other factors, such as parental educational attainment, may have a protective effect. (AU)
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Asma/prevenção & controle , Fatores Socioeconômicos , Estudos Transversais , Espanha , Disparidades nos Níveis de Saúde , Serviços de SaúdeRESUMO
INTRODUCTION: Socioeconomic inequality (SEI) can adversely affect asthma control. The aim of this study was to establish the association of SEI with asthma control in children and caregiver quality of life. METHODS: We assessed socioeconomic status based on the area of residence, according to the at risk of poverty rate (ARPR). After stratifying the paediatric population of Castilla y León (Spain) in ARPR tertiles, we selected participants by stratified random sampling, and identified children with asthma aged 6-14 years from the health records of primary care centres. We collected data through questionnaires completed by parents. The primary outcomes were asthma control and caregiver quality of life. We assessed their association with SEI, health care quality measures and individual factors (such as parental educational attainment) by means of multivariate regression models. RESULT: The ARPR tertile was not associated with asthma control, quality of life or health care quality. A medium or high maternal educational attainment was associated with a lower risk of making an unscheduled or urgent visit (ORâ¯=â¯.50; 95% CI, .27-.95; Pâ¯=â¯.034) and paternal educational attainment was associated with a lower risk of uncontrolled asthma (ORâ¯=â¯0.51; 95% CI, .28-.94; Pâ¯=â¯.030). CONCLUSION: In the sample under study, SEI assessed at the local level was not associated with asthma control in children. Other factors, such as parental educational attainment, may have a protective effect.
Assuntos
Asma , Qualidade de Vida , Humanos , Criança , Fatores Socioeconômicos , Classe Social , Asma/epidemiologia , Asma/terapia , Atenção à SaúdeRESUMO
At Lalonde we know that the determinants that most influence the health of the population are lifestyle, genetics and the environment. Health represents only 10% and is the determinant that consumes the most resources. It has been shown that a salutogenic approach focused on the social determinants of health and the support of public policies to improve the environment are more efficient in the long term than medicine focused on hospitals, technology and super-specialization. Primary Care (PC) that has an approach centered on the person and families with a community vision, is the ideal level to provide health care, and to influence lifestyles. However it is not invested in PC. In this article we review the socioeconomic and political factors that globally influence the lack of interest in the development of PC.