Balance decisional sobre el uso del condón asociado a la conducta sexual de riesgo en universitarios / Decisional balance of condom use associated with risky sexual behavior in university students

Resumen La adquisición de alguna Infección de Transmisión Sexual (ITS) y los embarazos no planificados son riesgos a los que se enfrentan los jóvenes ante la decisión de no usar condón al tener relaciones sexuales. La aproximación del balance decisional enfatiza qué costos y beneficios están asociados a la conducta sexual de riesgo. Las decisiones acerca del uso del condón son un precursor de la conducta y este proceso puede estar influido por los beneficios que se perciban sobre él. El objetivo de la presente investigación es identificar la relación de las ganancias y pérdidas del uso del condón con la conducta sexual de riesgo. Se evaluó la conducta sexual de riesgo y el uso del condón masculino en sus relaciones sexuales. Se midieron las ganancias y las pérdidas del condón con una escala de medición, en una muestra de 257 universitarios, con una edad entre 18 y 39 años (. = 22.34; DE = 3.6) de Querétaro, México. La evaluación del balance decisional indica que las ganancias son mayores que las pérdidas (costos) del uso consistente del condón en las relaciones sexuales. Se encontraron asociaciones entre las ganancias y las pérdidas con indicadores de la conducta sexual de riesgo. Se observa que los universitarios que no utilizan condón manifiestan mayores pérdidas por utilizarlo. En las ganancias, se aprecia un aumento en las puntuaciones cuando se usa condón. Lo encontrado provee apoyo para el desarrollo de intervenciones que promuevan las ganancias o beneficios para incrementar el uso consistente del condón.

Abstract The acquisition of a Sexually Transmitted Infection (STI) and unplanned pregnancies are risks that young people deal when deciding not to use a condom when having sexual intercourse. During the decision-making process, individuals value the benefits (gains) and losses (costs) associated with a behavior. Cost-benefit analysis has been investigated to examine the differential impact of gains and losses on risky behaviours. The decisional balance approach emphasizes that costs and benefits are associated with risky sexual behavior. Decisions about condom use are a precursor to behavior, and this process may be influenced by perceived benefits. In the present study, it is proposed that the balance between the benefit and the loss of condom use contributes to consistent condom use. These factors as determinants of behaviour must be considered under the cultural context in which they are carried out. The objective of this research is to identify the relationship of gains and losses from condom use with risky sexual behaviour. It was hypothesized that: 1) Young people will evaluate the benefits (gains) with higher scores compared to the losses (costs) in deciding to use a condom in sexual intercourse. 2) The gains will be greater in those college students who use a condom more frequently and the losses will not be the same among those who use a condom. To evaluate risky sexual behavior and the use of the male condom in their sexual relations were considered. Condom gains and losses were measured with a measurement scale in a sample of 257 university students, aged between 18 and 39 years (. = 22.34; SD = 3.6) from Querétaro, México. With reference to sexual behavior, it was found that 89.1 % have started their sexual activity. The average age of initiation of sexual life is 15.41 years. The frequency of sexual activity is once or twice each month. The mean of sexual partners is 4.2, with a median of 3. The 68.5 % reported using some contraceptive method and regarding the use of condoms, 27.8 % always use it and 5.7 % never use it. To evaluate the decisional balance, subtracting the gain and loss factors created a net difference score. The gain factor was subtracted from its counterpart of the loss factor to indicate the preference for having sex with a condom. The decisional balance assessment indicates that the gains are greater than the losses (costs) of consistent condom use in sexual intercourse. Associations were found between gains and losses with indicators of risky sexual behavior. It is observed that university students who do not use a condom show greater losses from using it. In gains, there is an increase in scores when using a condom. Additionally, it is observed that university students, who sometimes use a condom, show greater losses for using it, unlike those who always use it, which show low scores in the losses of using it. In gains factor, there is an increase in the scores when using a condom, that is, those who never or almost never use a condom have the lowest scores and as the scores increase, the frequency of using a condom in their sexual relations also increases. In conclusion, gains and losses from male condom use are associated with risky sexual behavior (age of sexual activity, number of partners and condom use) in the university context. The findings provide support for the development of interventions that promote gains or benefits to increase consistent condom use. It is important to consider in specific interventions those young people who decide to continue having sex without using a condom despite the costs and possible consequences of not using it.

Cambio de conducta para insulinoterapia en personas que viven con diabetes tipo 2, Yucatán, México / Evaluation of the behavior stage and decisional balance of change of conduct for insulin therapy in diabetic patients at the health center of Ekmul, Yucatán in 2015

Resumen Introducción La Diabetes tipo 2 es la enfermedad endocrina más frecuente y una de las principales causas de morbi-mortalidad en nuestros días. Es una enfermedad compleja que requiere de un tratamiento integral, que implica cambios en el estilo de vida del paciente. Para el abordaje de este fenómeno se toma el modelo transteorético desarrollado por James O. Prochaska, el cual propone que las personas hagan cambios en etapas y que se muevan, en forma secuencial, a través de estadios mientras experimentan diferentes procesos de cambio. Objetivo Determinar el estadio y balance decisional de cambio de conducta en personas que viven con diabetes y criterios para insulinoterapia, que acuden a control al Centro de Salud de Ekmul, Yucatán, con base en el modelo transteorético y con enfoque cualitativo. Materiales y Métodos Se seleccionó cinco pacientes que contaban con criterios para insulinoterapia, pero renuentes. Se utilizaron como instrumentos los cuestionarios de datos generales y de etapas de cambio, un árbol de problemas y un diagrama causa-efecto. Resultados Cinco pacientes realizaron las actividades planteadas, identificándose tres (60%) en el estadio de precontemplación y dos (40%) en contemplación. Con el gráfico causa-efecto se obtuvieron en total 16 aseveraciones con respecto al uso de la insulina, 10 (62.5%) en contra y seis (37.5%) a favor. Conclusiones El balance decisional dentro de las etapas identificadas otorga un mayor peso a las desventajas del uso de insulina generando una oposición a un cambio conductual a corto plazo. La desinformación de la fisiología elemental de la enfermedad ocasiona que se adjudiquen falsos conceptos al uso de la insulina, lo que además es propiciado por los factores psicológicos, como el temor a lo desconocido, y sociales, como el estigma ya generado por los falsos conceptos. Esto forma un círculo vicioso que impide el inicio oportuno de la terapia con insulina.

Abstract Introduction Type II diabetes mellitus is the most common endocrine disease and one of the leading causes of morbidity and mortality of our days. It is a complex disease which requires an integral approach. Objective To determine the behavioral stage and the decisional balance of change of conduct in patients with type II diabetes who fulfill the insulin therapy criteria by using the transtheoretical model with a qualitative focus at Ekmul, Health Center in Yucatan Materials and Methods Eight patients, with dual oral hypoglycemic drug therapy, at a maximum dose and with no glycemic control, were chosen with a convenience sampling. In order to obtain Personal information and to know the stages of change we used questionnaires along with a cause-effect diagram and a problem tree. Results Five women completed the proposed activities, three (60%) of them where identified in the pre-contemplation stage and two in the contemplation stage. A total of 16 answers from the cause-effect diagram, related to insulin usage, showed that ten (62.5%) is against it and six (37.5%) in favor of it. Conclusions The decisional balance within the identified stages gives greater weight to the disadvantages of insulin therapy which generates resistance to short-term behavioral change. The misinformation of the elemental physiology of the disease causes false concepts of the insulin usage which is reinforced by psychological factors, such as the fear of the unknown and the social stigma. These contribute to form a vicious circle that prevents the timely initiation of insulin therapy.