Conocimientos y riesgo ocupacional de VIH/SIDA en trabajadores de salud primaria chilenos / Conhecimentos e risco ocupacional de HIV/SIDA em trabalhadores de saúde primária chilenos / HIV/AIDS knowledge and occupational risk in primary care health workers from Chile

Objetivo. Explorar la relación entre nivel de conocimientos y riesgo de exposición ocupacional a VIH en trabajadores de salud de atención primaria. Metodología. Estudio analítico de corte transversal; 720 trabajadores de salud de Santiago respondieron un cuestionario acerca de VIH/SIDA, incluyendo conocimientos (inadecuado o adecuado), riesgo ocupacional (con o sin riesgo) y variables de control (edad, sexo, centro de salud, educación y estado civil). Se hicieron análisis descriptivos y de asociación. Se estimó la Odds Ratio (OR) mediante regresión logística simple y múltiple. Resultados. El 58.7% de los participantes reportó riesgo ocupacional de VIH. Un 63.8% del grupo con exposición presentó un nivel de conocimientos adecuado, versus el 36.1% del grupo sin exposición (OR ajustado de 3.1, IC95%OR: 2.0-4.8, p<0.0001). Los técnicos y el personal de aseo reportaron una proporción menor de nivel adecuado de conocimientos que el del personal con preparación universitario (p<0.0001). Conclusión. El nivel de riesgo ocupacional de VIH está asociado en forma directa con el nivel de conocimientos de esta enfermedad.

Objective. To explore the relationship between knowledge level and occupational risk exposure to HIV/AIDS in primary care health workers. Methodology. Analytical cross-sectional study. 720 health workers from Santiago answered a survey about HIV/AIDS that included: knowledge level (appropriate, inappropriate), occupational risk (with or without risk), and control variables (age, gender, health center, education and marital status). Descriptive and association analysis were performed. Odds Ratio (OR) was estimated through simple and multiple regressions logistics. Results. 58.7% of the participants reported HIV occupational risk. 63.8% of the participants from the exposed group reported an appropriate level of knowledge, versus 36.1% of the non-exposed group (Adjusted OR of 3.1, IC95%OR: 2.0-4.8, p<0.0001). Technicians and cleaning staff reported a lower proportion of appropriate level of knowledge compared to the employees with college education (p<0.0001). Conclusion. The level of HIV/AID occupational risk is directly associated with the level of knowledge of the disease.

Objetivo. Explorar a relação entre nível de conhecimentos e risco de exposição ocupacional a HIV/AIDS em trabalhadores de saúde de atendimento primário Metodologia. Estudo observacional analítico de corte transversal; 720 trabalhadores de saúde de Santiago responderam um questionário a respeito de HIV/AIDS, incluindo conhecimentos (inadequado ou adequado), risco ocupacional (com ou sem risco) e variáveis de controle (idade, sexo, centro de saúde, educação e estado civil). Fizeram-se análises descritivas e de associação. Estimou-se a Odds Ratio (OR) mediante regressão logística simples e múltipla. Resultados. O 58.7% dos participantes reportou risco ocupacional de HIV/AIDS. Um 63.8% do grupo com exposição apresentou um nível de conhecimentos adequado, contra o 36.1% do grupo sem exposição (OR ajustado de 3.1, IC95%OR: 2.0-4.8, p<0.0001). Os técnicos e o pessoal de lavabo reportaram uma proporção menor de nível adequado de conhecimentos do que o do pessoal com preparação universitário (p<0.0001). Conclusão. O nível de risco ocupacional de HIV está sócio em forma direta com o nível de conhecimentos desta doença.

Conocimientos y autoeficacia asociados a la prevención del VIH y SIDA en mujeres chilenas / Conhecimentos e autoeficacia sócios à prevenção do HIV e AIDS em mulheres chilenas / Knowledge and self efficacy associated to HIV and AIDS prevention in Chilean women

Objetivo. Evaluar la relación existente entre conocimientos y autoeficacia asociados al VIH/SIDA en mujeres chilenas en desventaja social. Metodología. Estudio correlacional, que utiliza la medición basal del estudio “Testeando una intervención en VIH y SIDA en mujeres chilenas”, realizada entre 2006 y 2008, que tiene una muestra de 496 mujeres entre 18 y 49 años residentes en dos comunas de Santiago de Chile. Las participantes respondieron un cuestionario estructurado aplicado por entrevistadoras entrenadas. Este cuestionario incluyó preguntas sobre datos sociodemográficos, escala de conocimientos de conductas de riesgo y autoeficacia, entre otros. Resultados. Edad promedio de 32.3+9.1 años, 72.2% vive con su pareja y 42.7% poseen educación media completa. La puntuación media de los conocimientos de la infección por el VIH fue de 8.9+2.5, mientras que para las tres escalas empleadas para medir autoeficacia fueron: “Normas de los pares” =9.8+3.6, “Intención de reducir conductas de riesgo” =12.2+3.6 y “Self Efficacy Form”=20.2+4.7. Los conocimientos tuvieron una correlación positiva débil con la “intención de reducir conductas de riesgo” (r=0.19; p<0.0001) y con la escala “Self Efficacy Form” (r=0.34; p<0.0001), pero no se relacionaron con las “normas de los pares en cuanto a relaciones sexuales seguras” (r=0.13; p=0.78). Conclusión. Existe una débil correlación positiva entre el nivel de conocimientos sobre el VIH/SIDA y la autoeficacia en mujeres chilenas en desventaja social.

Objetivo. Avaliar a relação existente entre conhecimentos e autoeficacia sócios ao HIV/AIDS em mulheres chilenas, em mulheres chilenas em desvantagem social. Metodologia. Estudo correlacional, que utiliza a medição basal do estudo “Testando uma intervenção em HIV e AIDS em mulheres chilenas”, realizada entre 2006 a 2008, que tem uma mostra de 496 mulheres entre 18 e 49 anos residentes em dois comunas de Santiago de Chile. As participantes responderam um questionário estruturado aplicado por entrevistadoras treinadas. Este questionário incluiu perguntas sobre dados sociodemográficos, escala de conhecimentos de condutas de risco e autoeficacia, entre outros. Resultados. Idade média de 32.3+9.1 anos, 72.2% vive com seu companheiro e 42.7% possuem educação média completa. A pontuação média dos conhecimentos da infecção pelo HIV foi de 8.9+2.5, enquanto para as três escalas empregadas para medir autoeficacia foram: “Normas dos pares” =9.8+3.6, “Intenção de reduzir condutas de risco” =12.2+3.6 e “Self Efficacy Form”=20.2+4.7. Os conhecimentos tiveram uma correlação positiva débil com a “intenção de reduzir condutas de risco” (r=0.19; p<0.0001) e com a escala “Self Efficacy Form” (r=0.34; p<0.0001), mas não se relacionaram com as “normas dos pares quanto a relações sexuais seguras” (r=0.13; p=0.78). Conclusão. Existe uma débil correlação positiva entre o nível de conhecimentos sobre o HIV/AIDS e a autoeficacia em mulheres chilenas em desvantagem social.

Objective. To assess the relationship between knowledge and self efficacy associated to HIV/AIDS in women from Chile with social disadvantages. Methodology. Correlation study that uses the baseline assessment of the “Testing an HIV and AIDS intervention in Chilean women” study, carried out between 2006 and 2008, with a sample of 496 women between 18 and 49 years old, in 2 neighborhoods of Santiago de Chile. Participants answered a structured survey conducted by trained interviewers. The survey included questions about sociodemographic information, risk behaviors and a self-efficacy knowledge scale among others. Results. The average age was 32.3+9.1 years, 72.2% live with their partner and 42.7% have completed high school education. The mean score of HIV infection knowledge was 8.9+2.5, while the mean score for the three scales used to measure self-efficacy were: “Peer rules” =9.8+3.6, “Risk reduction intentions =12.2+3.6 and “Self Efficacy Form”=20.2+4.7. HIV knowledge had a weak positive correlation with the “Risk reduction intentions” scale (r=0.19; p<0.0001) and the “Self Efficacy Form” scale (r=0.34; p<0.0001), however there was no correlation with the “Safe sex peer rules” (r=0.13;p=0.78). Conclusion. There is a weak positive correlation between the HIV/AIDS related knowledge and self-efficacy among Chilean with social disadvantages.

Eficacia de una intervención educativa sobre conocimientos de ley chilena de SIDA en trabajadores de salud primaria / Effectiveness of an educational program about the Chilean AIDS law in primary care health workers

Background: In Chile, members of the civil society and government achieved the passing of the HIV/AIDS Law (19.779). The level of knowledge of the law held by healthcare workers in Chile is not well known. Aim: To analyze the effect of an intervention on knowledge of the existence of the law and its application in clinical practice amongprimary healthcare workers in southeastern Santiago. Material and Methods: Healthcare workers of primary care centers were invited to participate in the study. One group received an educational intervention lasting a total of 16 hours, about AIDS physiopathology, sexually transmitted diseases, communication with patients and current legislation. A control group did not receive the educational intervention. Both groups answered a self-administered questionnaire about the HIV/AIDS law at baseline and three months after the intervention. Results: The intervention was carried out in 262 workers and 293 participated as controls. The initial evaluation revealed that only 16.3 percent (n = 89) had heard of the law, without any significant difference between intervention and control groups. The knowledge about the law improved by 65 percent in the intervention group and did not change in controls. At the end of the education period, the intervention and control groups improved their global knowledge by 29 and 3 percent, respectively (p < 0.05). Conclusions: The educational intervention was effective in improving knowledge of the HIV/AIDS Law among Chilean healthcare workers.

Análisis reflexivo del cuidado en reflexología y masoterapia centrado en la persona, por parte del profesional de enfermería / Reflexive analysis in reflexology and massotherapy client-centred care, by the nursing profession

Las terapias alternativas y complementarias (TAC) constituyen parte importante de las intervenciones desarrolladas en salud y solicitadas por quienes buscan resolver algún problema, mantener o mejorar su situación de salud y bienestar. El presente estado del arte tiene como propósito dar a conocer el análisis reflexivo del cuidado centrado en la persona e integral que surge de la realización de reflexología y masoterapia por parte del profesional de Enfermería. Primero, se desarrolla una descripción de diversas definiciones existentes en torno a TAC, luego se describe la conexión existente entre el cuidado alternativo y complementario y la ciencia de Enfermería, a continuación se desarrolla el proceso de cuidado en masoterapia y reflexología, posteriormente se exponen a través de una discusión los elementos centrales del cuidado centrado en la persona, pilar esencial de las TAC, y finalmente se establecen las conclusiones e implicancias para la práctica de Enfermería de estas terapias.

Complementary and alternative therapies (CAT) represent a relevant dimension of care in the nursing practice. They are requested by people who seek to resolve a particular health problem or condition, and to improve their wellness and health perception. This article is a state of the art and has the purpose of sharing the reflexive analysis of alternative and complementary person-centered care, which emerges from the practice of massage and reflexology for several years by nurse professionals. Primarily, it describes the various definitions existing for complementary and alternative therapies, and then describes the connection among alternative-complementary care and the nursing science. Afterwards, it develops the nursing process for massage and reflexology, then discusses the main aspects of person-centered care, most important factor in CAT, and finally establishes conclusions and suggestions for the nursing practice towards these therapies.

Intervención educativa efectiva en VIH para mujeres / Effective educational interventions in HIV for women

En Chile se estima que aproximadamente 38 mil personas viven con el Virus de Inmunodeficiencia Humana [VIH]. En el año 2001, 1.092 mujeres chilenas vivían con VIH, actualmente se cree que hay más de 7.600 mujeres con el virus. Frente a estas cifras surge la necesidad de crear estrategias de prevención dirigidas a mujeres chilenas. OBJETIVO: analizar los estudios ya realizados en la prevención de VIH para determinar qué aspectos se deben incluir en programas exitosos de prevención de VIH en mujeres. DISEÑO Y MÉTODO: se realizó una revisión de la literatura utilizando la base de datos Proquest, CINAHL, Pubmed y Scielo. Los límites comprendieron: textos completos, de los últimos 10 años, de acceso gratuito y escrito en español o inglés. Se seleccionaron 15 artículos para la revisión. RESULTADOS: todos los artículos comprenden la evaluación del efecto de una intervención sobre conocimiento y conductas relacionadas con VIH/SIDA. Catorce muestran resultados significativos en cambios positivos de conducta o conocimientos relacionados con la prevención de VIH. CONCLUSIONES: los programas de prevención de VIH en mujeres pueden ser efectivos para lograr cambios de conducta y de conocimiento. Las intervenciones exitosas son aquellas basadas en teorías o modelos de prevención y en cambios de conductas, todas adaptadas a la cultura de la población estudiada.

In Chile, it is estimated that over 38,000 people live with Human Immunodeficiency Virus [HIV]. In 2001, there were 1092 Chilean women living with HIV, and in 2006 there were 7,600, further affecting low income populations. These findings reveal the necessity to create prevention strategies directed towards Chilean women. OBJECTIVE: the purpose of this revision is to analyze studies of prevention programs in HIV in order to determine what aspects should be included in successful HIV prevention programs with women. DESIGN AND METHOD: a literature review was carried out using searches done in the databases Proquest and CINAHL, Pubmed and Scielo. The search was limited by the criteria of full text only, within the last ten years and free access, written in Spanish or English. Fifteen articles were selected for the following revision. RESULTS: all of the selected articles measured the effect of an intervention on knowledge and behaviours related to HIV/AIDS. Fourteen articles produced significant changes in positive behaviours or knowledge related to the prevention of HIV. CONCLUSIONS: prevention programs in HIV with socially disadvantaged women can be effective in provoking changes in behaviours and knowledge associated with HIV. Successful interventions were those based on prevention theories or models of behavior change and adapted to the culture of the sample.