Validación de dos escalas utilizadas en la medición del cuidado humano transpersonal basadas en la Teoría de Jean Watson / Validation of Two Scales Used to Measure Transpersonal Human Caring, Based on Jean Watson's Theory

Objetivo: validar Caring Efficacy Scale y Nyberg's Caring Assessment, elementos basados en la Teoría Transpersonal del Cuidado Humano que se fundamenta en los aspectos humanos y éticos del cuidado. Método: los instrumentos fueron validados en una muestra de 360 enfermeras chilenas. Los coeficientes de alfa de Cronbach fueron de 0,76 para Caring Efficacy Scale, y de 0,82 para el Nyberg's Caring Assessment. En cuanto a la validez de constructo ambos instrumentos se correlacionan positiva y significativamente. Resultados: se pondera divergencia como estrategia de esta validez en ambos instrumentos y se utiliza una subescala que evalúa la falta de empatía con el sufrimiento del otro. Conclusión: la validación de estas escalas es un aporte al cuidado humano transpersonal, para conocer el significado que las enfermeras le otorgan, y cuán eficaces se sienten, así como remediar aspectos deficitarios en la enseñanza y práctica del cuidado.

Objective: Validate the Caring Efficacy Scale and Nyberg's Caring Assessment. Both these elements are based on the Theory of Transpersonal Human Caring, which is founded on the humanistic and ethical aspects of care. Method: These scales were validated in a sample comprised of 360 Chilean nurses. Cronbach's alpha was 0.76 for the Caring Efficacy Scale and 0.82 for Nyberg's Caring Assessment. In terms of construct validity, both instruments are correlated positively and significantly. Results: Divergence is weighted as a strategy or approach to this validity in both instruments, and a subscale was used to evaluate lack of empathy with the suffering of others. Conclusion: The validation of these scales is a contribution to transpersonal human caring in terms of knowing the significance nurses give to it and how effective they feel, as well as to remedy shortcomings in the teaching and practice of human care.

Objetivo: validar Caring Efficacy Scale e Nyberg's Caring Assessment, elementos baseados na Teoria Transpessoal do Cuidado Humano que se fundamenta nos aspectos humanos e éticos do cuidado. Método: os instrumentos foram validados em uma amostra de 360 enfermeiras chilenas. Os coeficientes de alfa de Cronbach foram de 0,76 para Caring Efficacy Scale, e de 0,82 para o Nyberg's Caring Assessment. Quanto à validade de construto, ambos os instrumentos se correlacionam positiva e significativamente. Resultados: considera-se divergência como estratégia desta validade em ambos os instrumentos e se utiliza uma subescala que avalia a falta de empatia com o sofrimento do outro. Conclusão: a validação dessas escalas é uma contribuição para o cuidado humano transpessoal, para conhecer o significado que as enfermeiras lhe outorgam, e quão eficazes se sentem, assim como remediar aspectos deficientes no ensino e prática do cuidado.

Identificación de factores de predicción del incumplimiento terapéutico en adultos mayores hipertensos de una comunidad del sur de Chile / Identifying predictive factors for therapy nonadherence among hypertensive, older adults from a community in southern Chile

Objetivo. Identificar factores de predicción del incumplimiento terapéutico en adultos mayores hipertensos a partir de su dependencia funcional, trastornos de memoria, percepción de bienestar, maltrato y depresión en una región del sur de Chile.Métodos. Estudio cuantitativo exploratorio en una muestra de 211 adultos mayores hipertensos (29,1% de los atendidos en el Programa Cardiovascular del Centro de Salud Familiar San Pedro, en la provincia de Concepción, Región del Bío Bío, Chile). Se aplicaron siete instrumentos: el cuestionario abreviado de Pfeiffer para el estado mental, la escala de Yesavagepara la depresión geriátrica, la escala de maltrato senil, la escala moral del Centro Geriátrico de Filadelfia, la escala de conductas en salud y las escalas de Lawton y Katz para medir la capacidadde realizar actividades instrumentales y básicas de la vida diaria, respectivamente. Mediante el análisis de componentes principales se definieron variables latentes. Resultados. Se determinaron dos variables latentes: vinculación con el medio —medida apartir de las variables depresión, maltrato y satisfacción con el medio— y autonomía —medida a partir de las variables estado mental y capacidad para realizar actividades instrumentales y básicas—. Estas variables latentes explicaron 39,7% y 20,7% del incumplimiento terapéutico, respectivamente. Conclusiones. Las variables latentes propuestas pueden emplearse como factores de prediccióndel incumplimiento terapéutico de los adultos mayores con hipertensión arterial. Las causas del incumplimiento terapéutico no pueden medirse solamente en los establecimientos desalud, es necesario conocer el entorno primario en el hogar y adecuar la atención sanitaria a partir de las necesidades que allí se detecten.

Objective. To identify the predictive factors associated with therapy nonadherence among hypertensive older adults, based on functional dependency, memory disorders, self-perceived wellbeing, abuse, and depression in an area of southern Chile. Methods. A quantitative, exploratory study of a sample of 211 hypertensive, olderadults (29.1% of those being treated by the cardiovascular program at the Centro de Salud Familiar San Pedro, in the province of Concepción, del Bío Bío region, Chile). Seven instruments were applied: Pfeiffer’s short mental status questionnaire, Yesavage’s geriatric depression scale, the elder abuse screening scale, the morale scale of thePhiladelphia Geriatric Center, the health behavior scale, the Lawton assessment of instrumental activities of daily living (ADL), and the Katz ADL index. Following an analysis of the important components, latent variables were identified. Results. Two latent variables were identified: social connectedness—measured by the variables depression, abuse, and social satisfaction—and autonomy—measured by the variables mental health and ability to perform basic and instrumental ADLs. These latent variables accounted for 39.7% and 20.7% of nonadherence to therapy,respectively. Conclusions. The latent variables proposed here can be used as predictive factors for therapy nonadherence in elderly adults with arterial hypertension. Causes of nonadherence to therapy cannot be assessed solely at health care centers; but rather, an understanding of the home environment is needed and treatment should be adapted according to the needs that exist there.

Burnout en profesionales de enfermería que trabajan en centros asistenciales de la Octava Región, Chile / Burnout in nursing professionals working in health centers at the Eighth Region of Chile

Investigación cuantitativa, descriptiva y correlacional cuyo objetivo fue determinar la presencia de estrés laboral crónico o burnout y su probable relación con factores sociales y laborales, en los profesionales de enfermería que trabajan en Unidades de Emergencias (UE) y Servicios de Atención Médica de Urgencia (SAMU) de la Octava Región, Chile. Se trabajó con el universo conformado por 91 enfermeras(os), siendo 57 de UE y 34 de SAMU. Se utilizaron dos instrumentos recolectores de datos; el primero elaborado por la autora, que recogió información sobre variables sociodemográficas y laborales. El segundo correspondió a la Escala de Maslach Burnout Inventory (MBI); que midió el desgaste profesional producto del estrés laboral crónico y los tres aspectos del síndrome de Burnout, que corresponden a cansancio emocional, despersonalización y realización profesional. Los resultados más relevantes del estudio mostraron que más del 50 por ciento de estos profesionales corresponden a adultos jóvenes, solteros(as) y sin hijos; presentando menos de 10 años de experiencia laboral, la mayoría realiza cuarto turno. El grupo de profesionales evidenció presentar burnout en una intensidad intermedia, que estaría principalmente influenciado por variables laborales como la percepción de recursos insuficientes y la realización de exceso de turnos, al mismo tiempo el grupo de mayor edad evidenció más cansancio emocional y los viudos o separados presentaron menos despersonalización que el resto de los encuestados.

This cross sectional study is a correlational research whose principal objective was determinating the presence of chronic labour stress or burnout and its probably relationships with labour and social factors of nursing professionals working in Emergency Rooms and UMAS (Urgency Medical Attention Service) at the Eighth Región of Chile. We work with the total universe constituted by ninety-one nursing professionals: fifty-seven nurses or male nurses of emergency unities and thirty-four of UMAS. We utilized two instruments to collect the information. The first one was made by the author, and their purposes were collecting information about socio-demographical, and labors variables. The second questionnaire correspond to the Maslach Burnout Inventory (MBI) that measures emotional tiredness, dispersonalization, and professional fullfiment between nursing professionals as an outcome of stress at the working conditions. The most outstanding results of this study showed that more than 50 percent of nursing professional working in the crash unity are single young-adults, without children, and having not more than 10 years of work experience; most of them often working on night-turn. These ER and UMAS group of nursing professionals displayed middle-intensity burnout; the principal influence acting on this illness coming from work variables, like the perception of insufficient resources in the unities and the excess of night turns; The older group showed more emotional tiredness while separated and widowers professional presented less depersonalization than the rest of these professionals.

Variables psicosociales asociadas a compensación metabólica de pacientes diabéticos de tipo 2 / Role of psychosocial variables in the metabolic control of type 2 diabetics

Background: Patients' cultural oríentations play an important role in chronic diseases. However, medical education research still does not emphasize these variables. Aim: To measure the influence of psychosocial dimensions on blood glucose control in type 2 diabetic patients. Subjects and methods: Case-control design. Data were collected from institutional records and structured interviews. Blood glucose control was tested using glycosylated hemoglobin A1C. Patients with a good metabolic proñle defined as a glycosylated hemoglobin of less than 7 percent were considered cases while those with a glycosylated hemoglobin >7 percent were labeled as controls. Sixty seven cases and 61 controls were randomly selected at a public health center located in Los Angeles, Chile. Socio-demographic, illness-related, and psychosocial variables were measured and múltiple modeling using logistic regression was performed. Results: Seventy per cent of patients were female, mean age was 61 years, 57 percent were housewives and most had a low income and educational level. The cultural predictors of metabolic control of diabetes were the perception of obstacles for blood glucose control, attribution of health benefits to a good control, family support and bonding quality with the health team. Conclusions: Cultural variables play a significant role in metabolic control of diabetic patients and must be born in mind in educational campaigns.

Efectos de la educación sobre la paridez / Effects of the education on the parturition

Keywords: Education, parity or number of children, contraceptive methods and ideal number of children A higher degree of education in women diminishes the number of children. Aim:To analyse the ways formal educationinfluences parity on fertile women. Descriptive and transversed design total universe fertile women of eighth region of Chile the Biobío Region. The sample was taken from 509 fertile age women living in urban and rural areas of this region. Aleatory and hierarchical selection of areas then it was determined an individual sample, gathering of information January 2001 according toDemographic and Health Survey Program Conceptual strategy based on Bongaarts model, including demographic socioeconomics and the access predictors together with fertility determinants. Dependant variable of the studywas parity or the total number of children per women Once data base was created on statistical univarying, bivarying and multivarying analysis was done with statistical analysis system (SAS) to know the effects of the variables on dependant. Results: The average scholarity and number of children were 10 and 1.8 respectively. When ordering hierarchically blocks of predictors variables with dependant variable. The best model on child bearing determinant includes education,age, marital status, number of children before using as contraceptive method, use of a modern contraceptive method and ideal number of children. Conclusion: The final model able to explain the percentage of variation is the one that included age and marital status and close determinants, number of children before the method, use ofmodern contraceptive method and ideal number of children. Education is an exogenous variable determining fertility of women.