ABSTRACT
La experiencia emocional de la mujer con embarazo de alto riesgo ante la maternidad es un tema poco estudiado, a pesar de la importancia que tiene preservar su salud emocional durante este proceso. Esta investigación analizó la experiencia de malestar psicológico en mujeres con embarazo de alto riesgo, según el riesgo médico diagnosticado, su vivencia de la maternidad y el papel que juegan la pareja, familia y redes de apoyo durante la gestación. Se realizó un estudio instrumental de casos múltiples. Se hicieron entrevistas semiestructuradas a 12 mujeres adultas con diagnóstico médico de embarazo de alto riesgo y se formaron tres grupos. Se realizó un análisis de significados de Kvale de los datos obtenidos. Los resultados mostraron que la vivencia de la maternidad y la manifestación de malestar psicológico en estas mujeres era diferente, dependiendo del riesgo médico diagnosticado. Además, podía ser de menor o mayor intensidad debido a la falta de planeación del embarazo, las experiencias obstétricas previas, no tener hijos vivos y contar con el apoyo de la pareja y la familia. Las mujeres con embarazo de alto riesgo vivían la maternidad como una experiencia dolorosa, con mucha angustia y miedo de perder el nuevo embarazo por complicaciones.
The emotional experience of maternity in high-risk pregnant women is a subject that has been seldom studied, despitethe importance of preserving the emotional health of women during this stage. This research analyzed the experience of psychological distress in women with high-risk pregnancy according to the medical risk diagnosed, their experience of maternity and the role of the partner, family and support networks during pregnancy. An instrumental multiple cases study was performed. By semi-structured interviews, we interviewed 12 adults women with medical diagnosis of high-risk pregnancy and three groups were formed. A Kvale analysis of meanings was performed on data. The results showed that the experience of motherhood and the manifestation of psychological distress in these women were different depending on the diagnosed medical risk; it may be of lower or higher intensity due to the lack of family planning, previous obstetric experiences, the lack of living children and also the support of the partner and the family. High-risk pregnant women lived mate I ty as a painful experience, with great anxiety and fear of losing the new pregnancy for medical complications.
Subject(s)
Female , Humans , Adult , Pregnancy , Mothers/psychology , Pregnancy, High-Risk/psychology , Stress, Psychological/psychology , Family Relations , Interpersonal Relations , Interviews as Topic , Social SupportABSTRACT
La pérdida de un hijo al inicio de la vida constituye uno de los estresores emocionales más intensos que puede experimentar una mujer. La evaluación de este proceso de duelo requiere contar con instrumentos confiables y válidos. El objetivo del presente trabajo fue determinar las características psicométricas de la Perinatal Grief Scale (Escala de Duelo Perinatal, EDP) en una muestra de mujeres mexicanas que habían experimentado pérdidas perinatales. La escala fue traducida, retraducida, piloteada y adaptada, para finalmente aplicarla a 200 mujeres que habían experimentado una o más pérdidas perinatales y que asistían a una clínica especializada. Los datos fueron sometidos a los procedimientos estadísticos usuales de validación (análisis de distribución de frecuencias, comparación de grupos extremos, análisis factorial exploratorio y análisis factorial confirmatorio, así como correlación entre subescalas) y de evaluación de consistencia interna, obteniendo índices adecuados de confiabilidad y validez. La EDP quedó conformada por 27 reactivos, agrupados en cuatro subescalas: duelo activo, depresión, culpa y aceptación. Se discute su utilización en la investigación y en la práctica clínica.
Losing a child at the beginning of life is one of the most intense emotional stressors that may experience a woman. The evaluation of this mourning process requires reliable and valid instruments. This study aimed to determine the psychometric characteristics of the Perinatal Grief Scale (PGS) in a sample of Mexican women who had experienced perinatal loss. The scale was translated, retranslated, tested and adapted to finally be applied to 200 women who had experienced one or more perinatal loss and were attending a clinic. Data were subjected to the usual statistical procedures of validation (analysis of frequency distribution, comparison of extreme groups, exploratory factor analysis and factor analysis confirming, as well as correlation between scales) and evaluation of internal consistency, obtaining appropriate indexes of reliability and validity. The Perinatal Grief Scale (EDP) was formed by 27 items, grouped in four scales: active grief, depression, guilt, and acceptance. Its use in research and clinical practice is discussed.
ABSTRACT
El objetivo de este trabajo es presentar una propuesta de intervención psicoterapéutica con mujeres con embarazo de alto riesgo atendidas en una institución de salud reproductiva Ciudad de México. Por llevarse a cabo dentro de una institución, se plantea un modelo de intervención breve, focalizado, basado en el enfoque integrador de la psicoterapia. Se describen las principales características del grupo, la conflictiva presentada por estas mujeres, los temas abordados, así como las técnicas empleadas más relevantes.
The aim of this work is to present a proposal for a psychotherapeutic intervention with women with high-risk pregnancies that are attending a reproductive health facility from México City. Because it was carried out within a health institution, this is a model of brief intervention, focused, and based on the integrative approach to psychotherapy. It describes the main features of the group, the conflict presented by these women, the topics that emerged, and the most relevant techniques used.
Subject(s)
Humans , Female , Pregnancy , Adolescent , Adult , Pregnancy, High-Risk/psychology , Psychotherapy, Group , Affective Symptoms/therapy , Adaptation, Psychological , Conflict, Psychological , Psychotherapy, BriefABSTRACT
El objetivo del estudio fue valorar a pacientes con pérdidas perinatales remitidas y no al Departamento de Psicología, para determinar si es eficiente el proceso de derivación a la psicoterapia de grupo. Se hizo un estudio con 140 pacientes; 95 pasaron a psicoterapia y 45 no. La validez estadística se determinó con la prueba no paramétrica de Wilcoxon. Se aplicó el CGS de Goldberg, el IDARE de Spielberger y la EAMD de Zung. De las pacientes caso valoradas con el Idare Rasgo-Estado, 70 por ciento son derivadas a grupo terapéutico; con el CGS 80 por ciento y con la EAMD, 62 por ciento). Un poco más de la mitad de aquellas detectadas como no caso a través del EAMD, y el IDARE, entran a psicoterapia; con el CGS, casi 90 por ciento>. Los resultados muestran una alta eficiencia en la captura de pacientes con problemática emocional significativa, siendo un poco menor en la depresión.
The objective of the study was to evaluate patients with perinatal losses referred and not referred to the Psychology Department to determine the efficiency of the referral process to group psychotherapy. Lhe study was carried out with 140 patients; 95 were referred to psychotherapy, while 45 were not. Statistical validity was determined using Wilcoxon's Matched Pairs Lest. Lhe instruments assessed were Goldberg's General Health Questionnaire (GHQ), Spielberger's State Lrait Anxiety Inventory (SLAI), and Zung's Self-Rating Depression Scale (SRDS). Lhe analysis showed that from the case patients, 70 percent> of those evaluated with the SLAI were referred to group therapy, as were 80 percent> of those evaluated with the GHQ, and 62 percent> of those evaluated with the SRDS. Slightly more than half of those detected as non-case patients with the SRDS and the SLAI entered psychotherapy; as did 90 percent> of those evaluated with the GHQ. Lhe Results show a high efficiency in the referral of patients with significant emotional problems, although with slightly inferior results in the case of depression.
Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Abortion, Habitual/psychology , Referral and Consultation , Psychiatric Department, Hospital , Surveys and Questionnaires , Depression/psychology , Retrospective Studies , Cross-Sectional Studies , Socioeconomic Factors , Perinatology/methods , Health Programs and Plans , Psychological Tests , Psychotherapy, Group , Patient Selection , Affective Symptoms/psychologyABSTRACT
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Summary Sexual dysfunctions are a high frequency problem that should be studied because of its significance for individual health. For that reason, approaches to sexuality, sexual dysfunctions prevalence among women and men of a population sample in Mexico City, and the particular frequency of each dysfunction, will convey the possibility of suggesting more precise and focused treatment strategies, as well as the generation of ground lines for the investigation of the specific factors that could be related to them. Based on researches conducted by many pioneers who have approached the study of human sexuality, Masters and Johnson built up, for the first time during the 1960s, the human sexual response and its dysfunctions. Also, they hold the hypothesis that the way to understand human sexuality must relay on the study of the human sexual response cycle. This consists of five phases: sexual urge phase, excitement phase, plateau phase, orgasmic phase and resolution phase. Masters and Johnson needed to define those phases, so they described and delimited inherent sexual dysfunctions, which may not always be present -but could be- in human sexuality. In order to give a precise and correct diagnosis, researchers have to define and classify sexual dysfunctions. In this sense, Rubio defines them as "a group of syndromes in which the erotical processes of sexual response are undesirable for the individual or for the social group, and occurs persistently and recurrently". Researchers of the Department of Psychology at the National Institute of Perinatology (Instituto Nacional de Perinatología, INPer) in Mexico City, which is a third level institution (specialties hospital) dedicated to people with reproduction problems, realized that investigation about sexual problems will lead to a broad and objective panorama (not hypothetical) of factors like prevalence, types, and gender comparisons of sexual problems among Mexican population. Main objective. This research seeks to state the prevalence, percentage, frequency, and types of both male and female sexual dysfunctions, as well as the differences between them, in a sample of Mexican population living in Mexico City. The research also intends to analyze some variables related to the sexual life of the population under study: sexual information they have previously received, traumatic sexual experiences and childhood trauma. Method (material and procedures): Researchers used the Clinical Record of Feminine Sexuality (Historia Clínica de la Sexualidad Femenina) and the Questionnaire of Sexuality, Male Version (Cuestionario de Sexualidad, Versión Hombres), both validated for Mexican population. The type of study that researchers conducted was populational, screening, descriptive, longitudinal, and retrospective. The study was performed using a non-experimental design with two samples drawn from INPer (patients and others); one of the samples consisted of 384 female participants and the other consisted of 363 male individuals (non partners of the patients included in the sample). Each participant was included into one of two groups: Group 1 comprised individuals without dysfunction and Group 2 included participants with sexual dysfunction. This classification was made when individuals were accepted at the INPer as patients, and before they were included in any medical treatment or intervention. Sample size was representative of the number of individuals accepted as patients of INPer that year. Inclusion criteria for men and women consisted of a level of education at least of elementary school -so they could understand the questionnaires- having a sexual partner for a year or more, without previous diagnostic of mental retardation or psychosis, nor medical conditions like neurological or endocrine syndromes, cardiopathies, vascular problems or genital infections, that could influence or determine sexual dysfunctions. Patients were included in Group 1 (control group) without sexual dysfunctions, or in Group 2 (experimental group) with sexual dysfunctions, based upon the results of the Clinical records in women as well as in men, which is intended to determine presence or absence of sexual dysfunctions and the kind of dysfunction that each individual has. The questionnaire, besides classifying sexual dysfunction, explores sexual life. The 10 types of sexual dysfunctions are: 1. sexual urge disorder (hypoactive sexual desire), 2. aversion to sex disorder, 3. female arousal disorder, 4, male erectile dysfunction, 5. female orgasm disorder, 6. male orgasm disorder, premature ejaculation, pain associated with intercourse disorder (dyspareunia), 9. vaginism (defined and classified following the Diagnostic and Statistical Manual of Mental Disorders-Text Revised (DSM-IV-TR), and 10. dysrythmia (as stated by Alvarez-Gayou, persistent and recurrent inability to obtain satisfaction in one of the partners due to the difference in sexual urge for sexual activity frequency, when conditions are adequate and the problem is not related to physical problems). Results: Prevalence in women was 52%; in men it was 38.8%. Mean in women with sexual dysfunctions was 2.52 dysfunctions by patient; mean in men with sexual dysfunctions was 1.48 by patient. Dysrythmia was the most frequent dysfunction both, in males and females. Concerning variables related to sexual activity, childhood trauma for women, masturbation for men and information about sexuality for both men and women, were the main ones. Conclusion: Prevalence of sexual dysfunctions and frequency by patient in individuals attending the INPer is lower in men's population. Having an effective and sound information about sexuality is essential for sexuality development. Another important topic are traumatic sexual experiences that are more frequent in female population and are also associated with sexual dysfunctions; men are less jeopardized for that kind of experiences. Masturbation practice is related to the absence of sexual dysfunctions in men. On the other hand, that practice is not significant for women. Results of this research led us to change attention strategies; this will have a repercussion in the effective treatments and decreased periods of time to solve the problem. Regarding the possibility to generalize the results, research could be directed to determine prevalence in populations with no reproduction risk and then compare them with the population of the study; hypothetically, results would not have a significant variability given the control of variables.
ABSTRACT
La resistencia del esmalte a la disolución ácida es un factor que influye en la susceptibilidad a la caries. Los propósitos del presente estudio fueron determinar la resistencia del esmalte a la disolución ácida a través de la técnica colorimétrica (RM) y correlacionar los datos obtenidos con la prevalencia de caries. Se seleccionaron 271 niños entre los siete y nueve años de edad, con los incisivos centrales superiores permanentes erupcionados, y se realizó el registro de los índices CPO-d y ceo-d y la prueba de resistencia del esmalte RM a través de un muestreo probabilístico de conveniencia en dos delegaciones, (seis escuelas públicas del Distrito Federal). De la muestra el 56.4 por ciento, registró esmalte muy resistente, el 27.3 por ciento menos resistente y el 16.2 por ciento poco resistente. El 57.9 por ciento se encontró libre de caries en la dentición permanente y el 10 por ciento en la dentición temporal; el promedio del índice CPO-D fue de 0.93 ñ 1.34 y del ceo-d 4.71 ñ 3.1. Los datos sugieren que la distribución de la resistencia del esmalte no es homogénea y que ésta aumenta proporcionalmente conforme al tercio de erupción (p< 0.05); el factor de correlación de Spearman fue negativo y estadísticamente significativo (p<0.05). La técnica RM demostró la existencia de individuos con diferente resistencia del esmalte a la disolución ácida