Atención integral a gestantes vulnerables en hogar materno provincial de Pinar del Río / Comprehensive care to vulnerable pregnant women in a provincial Maternity Waiting Home in Pinar del Río

RESUMEN Introducción: las embarazadas comparten una experiencia común de gran valor simbólico y social, poseen características que las singularizan, deben ser tenidas en cuenta por las políticas sociales y, en particular las políticas de salud con alcance intersectorial. Objetivo: caracterizar la atención integral a gestantes internadas en el hogar materno Justo Legón Padilla de Pinar del Río. Métodos: se realizó un estudio observacional descriptivo con las gestantes ingresadas en el hogar materno Justo Legón Padilla de Pinar del Río durante el 2018. El universo de estudio quedó constituido por las gestantes ingresadas (U=2 536), la muestra por criterio de autoridad y conveniencia, por las residentes en el municipio Pinar del Río (n=2 128). Resultados: el 90,5 % de las gestantes tenían entre 20 y 34 años, predominaron las de nivel educacional preuniversitario (52,7 %) y las casadas con 50 %. Tuvieron mayor representación las primigestas (50,1 %) y las vinculadas laboralmente (49,7 %). Según valoración nutricional primaron las normopeso con 50,1 % y el tabaquismo fue el hábito tóxico más frecuente para 8,9 %. Los principales motivos de ingreso fueron: riesgo de prematuridad 25,9 %, embarazo en la adolescencia 9,3 % y anemia 5,4 %. Conclusiones: las gestantes internadas en el hogar materno provincial de Pinar del Río se caracterizaron por poseer nivel educacional pre universitario, estado civil, casadas; primigestas y vinculadas laboralmente. Predominaron las normopeso y el tabaquismo como hábito tóxico de mayor frecuencia. El riesgo de prematuridad, embarazo en adolescentes y la anemia, fueron los principales motivos de ingreso.

ABSTRACT Introduction: pregnant women share a common experience of great value which are both symbolic and social, having characteristics that make them unique, and must be taken into account by the social policies as well, in particular, healthcare policies with an intersectoral scope. Objective: to characterize the comprehensive care given to pregnant women admitted to Justo Legon Padilla Maternity Waiting Home (MWH) in Pinar del Río. Methods: a descriptive observational study was conducted with pregnant women admitted to Justo Legon Padilla MWH in Pinar del Río during 2018. The target group studied comprised pregnant women admitted (U=2,536), the sample was taken by authority and convenience criteria, that included those living in Pinar del Rio municipality (n=2,128). Results: 90,5 % of pregnant women were between 20 and 34 years old, with a predominance of those with pre-university educational level (52,7 %) and those who were married (50 %). Primigravid women (50,1 %) and those who were working (49,7 %) were more significantly represented. According to the nutritional assessment, normal weight (50,1 %) prevailed and smoking habit was the most frequent (8,9 %). The main reasons for admission were: risk of prematurity (25,9 %), adolescent pregnancy 9,3 % and anemia 5,4 %. Conclusions: pregnant women admitted to the provincial maternity waiting home in Pinar del Río were characterized by having pre-university educational level, most of them were married and workers. Normal weight and smoking habit prevailed. The risk of prematurity, adolescent pregnancy and anemia were the main reasons for admission.

Interventions to Reduce the Problems of Abused Children and Adolescents in Residential Facilities in South Korea: An Integrative Review

PURPOSE: The purpose of this study was to review the literature on intervention studies for abused children and adolescent in residential facilities in South Korea (ACARF-K). The goal was to understand the problems they experience, to evaluate the content and effectiveness of interventions applied to them, and to develop evidence-based nursing intervention programs. METHODS: We used four electronic databases to search for relevant articles. 18 studies according to Whittemore and Knafl's integrative review method to synthesize the literature. RESULTS: The ACARF-K experienced problems in biophysical, psychological, and sociocultural domains related to attachment impairment. Effective intervention strategies were building trust through empathy and fulfillment of needs, encouraging ACARF-K to express themselves and helping them to clarify emotions in an unthreatening environment, and improving their self-concept through activities in which they experienced achievement. CONCLUSION: Interventions are needed to help restore attachment damage among ACARF-K. The interventions in this study utilized emotional, cognitive, relational, and behavioral therapeutic tools to improve their psychological and social capacities. Future intervention programs for ACARF-K should include these key elements.

Alimentación y uso del complemento alimentario en hogares de beneficiarios de la Corporación Educativa Combos / Diet and Use of a Nutrition Supplement in Household Beneficiares of the Corporación Educativa Combos Program

Resumen Antecedentes: es importante que al indagar sobre temas de alimentación y hambre se haga desde la perspectiva de los sujetos que experimentan y vivencian dichas situaciones, para comprender de forma integral dicho asunto. Objetivo: describir la alimentación en los hogares de niñas y niños beneficiarios del Programa de Atención Integral a la Niñez Trabajadora de la Corporación Educativa Combos y la percepción que tienen del complemento alimentario. Materiales y métodos: investigación con enfoque cualitativo, metodología de etnografía focalizada, técnicas de entrevista a profundidad y grupos focales. Resultados: las familias participantes viven situaciones de hambre; omiten comidas principales por falta de recursos económicos; sus gustos alimentarios en el hogar tienden a ser tradicionales; prefieren alimentos rendidores, saciadores y económicos, ricos en grasas y carbohidratos. Fuera del hogar prefieren comidas rápidas porque están disponibles y son más económicas. Las y los participantes perciben el complemento alimentario como un protector del hambre de las y los menores, y el paquete de alimentos como una manera de disponer de alimentos para compartirlos en familia. Conclusiones: en poblaciones empobrecidas se prefieren alimentos rendidores, saciadores y económicos que les permita sentirse llenos por más tiempo. Los servicios que brinda la Corporación fueron apreciados y valorados por las y los beneficiarios, pues estos han contribuido a mejorar su calidad de vida, a configurar el comensalismo familiar y a restituir el derecho a la alimentación en los hogares.

Abstract Background: The theme of food and nutrition security, hunger and the meaning of food programs for vulnerable population has been investigated, however, from a qualitative and comprehensive perspective, trying to identify from the perspective of the subjects who experience the phenomenon. Objective: To describe the in-home diet of children who are beneficiaries of the Programa de Atención Integral a la Niñez Trabajadora (PAINIT) of the Corporación Educativa COMBOS and their perceptions of a nutrition supplement. Materials and Methods: Research was conducted using a qualitative approach, focused ethnography studies, in-depth interviews, and focus groups. Results: Participating families live in situations of hunger and often omit main meals for lack of economic resources. At-home food tends to be traditional, with preference for satiating and inexpensive foods rich in fats and carbohydrates. Outside the home they prefer fast foods due to accesability and affordability. Participants perceive the nutrition supplement as a protector against child hunger, and the food basket as a way to share meals with family on weekends. Conclusions: Impoverished populations prefer foods that are accesible, satiating and economic that allow them to feel full for longer, and tend towards collective or family meals. The services provided by the Corporation were appreciated and valued by the beneficiaries as they have contributed to improving quality of life, family togetherness, and restoration to food security in homes.

Estado de salud oral en discapacitados residentes en la Fundación Pequeño Cottolengo don Orione, Paraguay / Oral health status of disabled residents at the Fundación Pequeño Cottolengo don Orione, Paraguay

Viven con discapacidad aproximadamente 600 millones de individuos, cifra que va en aumento; de éstos el 80 % reside en países de bajos ingresos. En el Paraguay, se estima que aproximadamente el 15 % de la población presenta algún tipo de discapacidad. El objetivo fue describir el estado de salud oral de las personas con discapacidad que residen en la Fundación Pequeño Cottolengo Don Orione de Mariano Roque Alonso, Paraguay 2012. Se realizó un estudio observacional descriptivo de corte transversal en 37 niños, jóvenes y adultos en edades comprendidas entre 12 y 68 años. Fueron analizadas las lesiones de caried a través del índice CPO-D, lesiones no cariosas, lesiones de tejidos blandos y la presencia de factores de riesgo como nivel y frecuencia de higiene, placa microbiana, saliva y dieta. El índice CPO-D fue 16,24; se detectó presencia de lesiones no cariosas en 48,65 % y fluorosis en 2,70 %. Se encontraron fracturas a nivel de esmalte en 43,24 % y la higiene oral fue deficiente medido por medio del índice de Loë y Silness. El 24,32 % tenía saliva viscosa; el Índice de placa bacteriana fue de 2,04. Mientras que, en ninguno de los casos los momentos de azúcar superaron tres. El 100 % de la población se cepilla una vez al día por la mañana antes del desayuno. En la población de estudio existen valores elevados en cuanto a caries y dientes perdidos, por tanto, se deben aumentar los programas de concientización en los cuidadores para promover la preservación de los dientes y la salud oral.

Approximately 600 million people worldwide live with disabilities, a figure that is increasing; 80 % of these individuals live in low-income countries. In Paraguay, it is estimated that approximately 15 % of the population has some type of disability. The objective of this study was to describe the state of oral health of people with disabilities who reside in the Fundación Pequeño Cottolengo Don Orione de Mariano Roque Alonso, Paraguay 2012. A descriptive cross-sectional study was performed on 37 children, youth and adults aged between 12 and 68 years. We analyzed carious lesions thorough DMF-T index, lesions involving soft tissue and the presence of risk factors such as hygiene, microbial plaque, saliva and diet. The DMFT index was 16.24; presence of non-carious lesions was detected in 48.65 % and 2.70 % fluorosis. Level enamel fractures were found in 43.24 % and oral hygiene was poor by Loë and Silness index. Of the population studied, 24.32 % had viscous saliva and plaque index was 2.04. While they did not exceed sugar times three in any cases; 100 % of the population brushed once a day in the morning before breakfast. In the study population there are high values of missing and decayed teeth, therefore, awareness programs to promote the preservation of the teeth and oral health should be emphasized.

Factors Related to Care Workers’ Terminal Care Attitudes: Personal Attributes and Views on Life and Death

<p>Objective: This study aimed to reveal the relationship between the terminal care attitudes, personal attributes, and views on life and death of care workers in nursing and group homes. Method: An anonymous self-administered questionnaire survey was mailed to 772 staff members at nursing and group homes. We used the Frommelt Attitudes Toward Care of the Dying Scale Form B (Japanese version) and the Death Attitude Inventory, which is a scale of views on life and death, to form the questionnaire. Results: After excluding missing data, 338 staff responses were analyzed (valid response rate: 43.8%). The total terminal care attitude scores were significantly higher among managers compared to other staff members (β=0.182, p=0.001), and among those having provided end-of-life cared to 10 or more people (β=0.155, p=0.003). Additionally, the total terminal care attitude scores were significantly higher among those with lower scores in the “death avoidance” subscale (β=−0.183, p=0.001) and higher scores in the “afterlife beliefs” subscale (β=0.168, p=0.001) of the Death Attitude Inventory. Conclusion: Terminal care attitudes were influenced by job position, the number of persons provided with end-of-life care to, and views on life and death. We need to investigate factors that affect terminal care attitudes to ensure provision of high quality care in nursing homes.</p>

Adaptation Process to Group Home Living by Older Adults

PURPOSE: The purpose of the study was to explore and describe the adaptation process of older people to group homes. METHODS: Participants were twenty older adults aged 65 or older who were living in group homes. Data were collected from January to April, 2015. In-depth unstructured interviews were conducted with individual participants. Data were analyzed using Strauss and Corbin's grounded theory method. RESULTS: From open coding, 100 concepts, 38 sub-categories, and 14 categories were identified. Analysis showed that the central phenomenon of the adaptation process of older people to group homes was ‘gradually giving up’. Causal conditions were ‘good-for-nothing body’, contextual conditions were ‘pushed’, ‘beleaguered’. Intervening conditions were ‘reliable pillar: children’, ‘having affection (情) more than having it from family: facility workers’, ‘comfort - like feeling at home’, ‘relieved: system’. Action/interaction strategies were ‘facing the unfamiliar reality’, ‘building relationships with other people’, ‘accepting reality’. Consequences were ‘a good place, more than expected’, ‘hope for the remaining days’, ‘waiting for a peaceful death’. CONCLUSION: The results of this study provide an in-depth understanding of the experience of the adaptation process of older people to group homes. The findings from this study can be used as basic data to establish policies to increase the number of small scale facilities which can help older adults adapt easily to the facilities.