ABSTRACT
Se presenta la contribución del "Programa Habilidades para la Vida" a las prácticas de prevención de salud mental adolescente en escuelas de Chile. Se evalúa la intervención preventiva del programa, en particular observando si adolescentes que asistieron al taller preventivo (N = 212) muestran cambio en las variables desadaptación escolar (DE) y disfunción psicosocial (DP), según su asistencia y la de sus padres. El diseño fue expost facto, longitudinal prospectivo, con mediciones pre y post. El análisis consideró ANOVA de medidas repetidas y pruebas t para muestras relacionadas. Los resultados indican disminución en algunos factores de riesgo asociados a DE y la estabilidad de la DP de los adolescentes. Se discuten las implicancias de este estudio para la ciencia preventiva y las políticas públicas.
This paper shows the contribution of "Skills for Life Program" to prevention practices adolescent mental health in schools in Chile. Study included a sample of adolescents (N = 212) who participated in the preventive intervention of the program. The goal was to examine changes in variables of school maladjustment (SM) and psychosocial dysfunction (PD) based on their attendance and their parents to the preventive intervention. Design was ex-post-facto, longitudinal prospective, pre and post measurements. Analysis considered repeated measures ANOVA and t tests for related samples. Results indicate a decrease in risk factors associated with SM and PD stability of adolescents. Study implications will be discussed for preventive science and public policy.
Subject(s)
Adolescent , Mental Health , ChileABSTRACT
Factors associated with therapeutic lifestyle change (TLC) after myocardial infarction (MI) have not been fully investigated in Chile. This study aimed to provide a descriptive examination of facilitators and barriers to TLC after first MI. Methods: Qualitative study based on in-depth interviews and focus groups with cardiologists and patients who had first MI one-year±2 months before the begin-ning of the study. Grounded theory research methods were used to guide sampling and coding of data. Results: Twenty-one patients who had first myocardial infarction and 14 cardiologists participated in in-depth interviews and focus groups until the point of theoretical saturation. Facilitators for TLC included optimism, self-efficacy, faith-based life purpose, positive attitudes by family and friends, social participation, good patient-physician relationship, and positive medical advice. Barriers were: individual (older age, female sex, lower educational level, limiting beliefs, ambi val ence, depressive mood, lack of knowledge on strategies to achieve TLC, financial constraints), family (family crisis, overprotection, im-posing attitudes, unhealthy habits at home), work (work overload and competition between work recovery and TLC), socio-environmental (neighborhood unsafety), and health provider-related (poor patient-physician re-lationship, limiting beliefs among physicians, medical advice centered on restrictions or imprecise, medical training focused on pharmacological therapies and in-terventional procedures over preventive care, and orga-nizational issues). Conclusions: Reported facilitators and barriers enhance understanding of the process of lifestyle change after first myocardial infarction, and might be targets for optimization of secondary preventive strategies among Chilean patients.
Los factores asociados con el cambio terapéutico de estilos de vida (TLC) después de un infarto agudo al miocardio (IAM) no han sido suficientemente investigados en Chile. El objetivo de este estudio fue explorar y describir los facilitadores y barreras para la adopción de TLC en pacientes que han sufrido un primer IAM. Métodos: Estudio cualitativo basado en entrevistas en profundidad y grupos focales con cardiólogos y pacientes que tuvieron un primer IAM un año ± 2 meses antes del inicio del estudio. Se usó metodología de Teoría Fundada para guiar el muestreo y la codificación de los datos. Resultados: Veintiún pacientes con un primer IAM y 14 cardiólogos participaron en las entrevistas en profundidad y grupos focales, hasta el punto de saturación teórica. Facilitadores para TLC incluyeron optimismo, autoeficacia, propósito de vida basado en la fe, actitudes positivas por familiares y amigos, participación social, buena relación médico-paciente, y un consejo médico positivo. Las barreras fueron: individuales (edad avanzada, sexo femenino, bajo nivel educacional, creencias limitantes entre los pacientes, ambivalencia, estado de ánimo depresivo, falta de conocimiento sobre estrategias para lograr TLC, limitaciones financieras), a nivel familiar (crisis de la familia, sobreprotección, imposición de actitudes, hábitos no saludables en el hogar), a nivel laboral (sobrecarga de trabajo y competencia entre la recuperación del trabajo y la adopción de TLC), a nivel socio-ambiental (inseguridad del barrio), y a nivel del proveedor de salud (mala relación médico-paciente, creencias limitantes entre los médicos, consejo médico impreciso o basado en restricciones, formación médica centrada en aspectos farmacológicos e intervencionales por sobre lo preventivo, y problemas de organización). Conclusiones: Los facilitadores y barreras reportados mejoran la comprensión del proceso de cambio de estilos de vida después del primer infarto agudo al miocardio, y pueden contribuir a la optimización de estrategias de prevención cardiovascular secundaria en pacientes chilenos.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Life Style , Myocardial Infarction/prevention & control , Myocardial Infarction/psychology , Social Support , Chile , Interviews as Topic , Qualitative Research , Secondary Prevention , Interpersonal RelationsABSTRACT
Background: In medical education there has been increasing emphasis on faculty development programs aimed at the professionalization of teaching and increasing students' learning. However, these programs have been shown to have an impact beyond improvement in teaching skills. The medical school of the Pontificia Universidad Católica de Chile (EMUC) has been running a faculty development program (DEM) since 2000. Aim: To explore the perception of graduates on the effects of having participated in DEM on their development as teachers and clinicians. Material and Methods: Using an exploratory, descriptive and qualitative design, the 79 teachers who graduated from DEM from 2004-2008 were sent a questionnaire containing three open questions. Their answers were analyzed using the Constant Comparative Method of Qualitative Analysis of Glaser and Strauss by four researchers. Results: Faculty development, becoming a better clinician, personal development, appreciation of the value of teaching and strengthening of the academic community were the five categories that emerged from the answers. Graduates felt that, besides learning new educational skills, they changed their attitude towards teaching. DEM was perceived as facilitating self-awareness and refection about the graduates' role as doctors and teachers. The graduates also valued meeting other faculty. Conclusions: Faculty development programs can have an impact far beyond the learning objectives. The planning and design of programs contributes to their wider impact. This should be taken into consideration in the design, planning, and evaluation of faculty development programs. Care should be taken to protect time for participation, refection and for interaction with other academics.
Subject(s)
Female , Humans , Male , Education, Medical/standards , Faculty, Medical , Program Development/standards , Staff Development , Chile , Qualitative Research , Schools, MedicalABSTRACT
Background: Since 2000, the medical school of the Catholic University of Chile (EMUC) has offered courses for its faculty as part of a Diploma in Medical Education (DEM). However by 2009, 41% of faculty had never taken any courses. Aim: To explore the reasons why faculty choose not to participate in these courses. Material and Methods: Semi-structured interviews to seven faculty members, all of whom have an active role in teaching but who had not taken any DEM courses. The sampling was intentional and guided by theory. Based on Grounded theory, the data was analyzed using open, axial and selective coding. Results: Three categories emerged from the analysis. First, the characteristics of a "good teacher" and what it means to be a good teacher. Second, the current status of teaching. Third, the barriers to participate in courses of DEM. Non-attendance is multifactorial; teaching is seen as a natural skill that is difficult to be trained, teaching has a lower priority than other activities, and there are many barriers perceived for attendance. Conclusions: With these results we developed a model to explain the reasons why faculty choose not to participate in these courses. The lower value of teaching and the multiple roles that teachers have, are highlighted.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Education, Medical , Faculty, Medical/standards , Program Development/methods , Schools, Medical , Staff Development/standards , Chile , Qualitative ResearchABSTRACT
Background: Home visiting is effective for the promotion and prevention of mother-child health in other countries, especially in vulnerable populations such as pregnant teenagers. Aim: To evalúate the association between receiving a home visiting program duringpregnancy and child development during thefirstyear oflife, maternal mental health, perception of social support and school attendance. Material and Methods: Cross sectional assessment of 132 teenage mother-sibling pairs. Ofthese, 87 received home visits and 45 were randomly assigned to a control group. The assessed variables were maternal mental health, perception of social support, Ufe satisfaction, incorporation of mothers to school after delivery, child development and frequency of child abuse and neglect. Results: Mothers that received home visits had a better mental health and went back to school in a higherproportion. No significant differences between groups were observed on perception of social support or child development. Conclusions: These results suggest the effectiveness of domiciliary visits performed by non-professionals, to improve mental health and social integration of teenage mothers.