Percepción de los adolescentes y jóvenes sobre la atención en servicios de salud de El Salvador / Adolescents and Young People's Perception of Care in Health Services in El Salvador

Introducción. Los Servicios de Salud Amigables son espacios de atención integral y diferencial para personas adolescentes y jóvenes, que parten de sus necesidades biológicas, sociales y afectivas. Objetivo. Evaluar las percepciones de las juventudes sobre la calidad de atención que recibieron y su experiencia en las Unidades de Salud. Metodología. Se realizó un estudio mixto que recogió las percepciones de los participantes en dos etapas sucesivas. Primero, con un cuestionario se evaluó la calidad de atención y experiencia de los usuarios; luego, mediante entrevistas grupales e individuales se estimó el nivel de satisfacción. Resultados. El 68,2 % de los jóvenes y adolescentes desconocen los programas exclusivos para ellos. El servicio más utilizado es el de medicina general (76,6 %). En cuanto a la atención recibida, el respeto, la confianza y la privacidad brindada por los profesionales de salud fue calificada como excelente o muy buena (76 %). El 39,7 % reportó que el tiempo de espera fue de 30 a 60 minutos; el 17,6 % refirió esperar más de dos horas. Conclusión. Aunque la percepción de las unidades de salud por parte de los adolescentes y jóvenes en general es buena, los Servicios de Salud Amigables cuentan con barreras que interfieren en el acceso, oportunidad y aceptabilidad

Introduction. Friendly Health Services are spaces of comprehensive and differential care for adolescents and young people, which start from their biological, social and emotional. Objective. Evaluate the perceptions of youth about the quality of care they received and their experience in the Community Family Health Units. Methodology. A mixed study was carried out that collected the perceptions of the participants in two successive stages. First with a questionnaire that evaluated the quality of care and experience of users, then through group and individual interviews that estimated the level of satisfaction. Results. Youth consult health establishments, although 68.2 % are unaware of the exclusive programs for them (Friendly Health Services). The most used service was general medicine (76.6 %). Regarding the care received, the respect, trust and privacy provided by health professionals was rated as excellent or very good (76 %). 39.7 % reported that the waiting time was 30 to 60 minutes, 17.6 % reported waiting more than two hours. Conclusion. Currently, there is a need to improve access to services for adolescents and young people by socializing the offer to encourage their use, increase attention in preventive areas and implement their evaluation with methods different from current ones

Status and intervention strategy of adolescent health services / 中国学校卫生

Abstract@#By reviewing the advocacy framework and implementation path of global adolescent health promotion, summarizing the main health problems of adolescents worldwide and current status of adolescent health care services in China, an ecological model of adolescent health care was concluded according to the demands of adolescents towards health care services. A comprehensive intervention strategy, ie. multi sector cooperation, community participation and integration of hospital, school, community and family, etc, has been put forward to promote the health and sustainable development of adolescents.

Vulnerabilidad al estrés en adolescentes de instituciones deportivas / Vulnerability to stress in teenagers in sports institutions

Fundamento: Los trastornos temporomandibulares tienen origen multifactorial y el factor psicológico ocupa un papel importante en su desencadenamiento. Objetivo: Determinar la vulnerabilidad al estrés en adolescentes de instituciones deportivas. Metodología: Se realizó un estudio observacional descriptivo de corte transversal, en la EIDE provincial de Sancti Spíritus "Lino Salabarría Pupo" entre octubre de 2020 y marzo de 2021. Se seleccionaron 70 escolares de décimo, onceno y duodécimo grados mediante muestreo aleatorio simple. Se midió la variable: rango de vulnerabilidad al estrés. Se utilizaron métodos del nivel teórico, empírico y estadístico. Resultados: El 51.4 %.de los estudiantes fueron clasificados con vulnerabilidad al estrés, el 40 % no vulnerables, el 8.6 % seriamente vulnerables y ninguno extremadamente vulnerables. Conclusiones: Existe un predominio de adolescentes de instituciones deportivas con vulnerabilidad al estrés.

Background: Temporomandibular disorders have a multifactorial origin and the psychological factor plays an important role in their triggering. Objective: To determine the vulnerability to stress in teenagers from sports institutions. Methodology: A cross-sectional descriptive observational study was conducted at the Sancti Spíritus provincial EIDE "Lino Salabarría Pupo" between October 2020 and March 2021. Seventy schoolchildren from tenth, eleventh and twelfth grades were selected by simple random sampling. The variable range of vulnerability to stress was measured. Theoretical, empirical and statistical methods were used. Results: 51.4 % of the students were classified with vulnerability to stress, 40 % not vulnerable, 8.6 % seriously vulnerable and none extremely vulnerable. Conclusions: There is a predominance of teenagers from sports institutions with vulnerability to stress.

Tecnologias educacionais para abordagens de saúde com adolescentes: revisão integrativa / Tecnologías educativas para abordajes de salud con adolescentes: revisión integradora / Educational technologies for health approaches to adolescents: an integrative review

Resumo Objetivo Conhecer e sintetizar a produção científica sobre tecnologias educacionais para abordagens em saúde com adolescentes. Métodos Trata-se de uma revisão integrativa de literatura realizada nas bases de dados Pubmed, Web of Science, Scopus, Lilacs, SciELO e BVS, entre abril e julho de 2020. A disponibilidade completa e gratuita dos artigos em português, inglês e/ou espanhol e as publicações realizadas nos últimos cinco anos compuseram os critérios de inclusão. Realizou-se análise descritiva da caracterização dos estudos e do conteúdo. Resultados Foram selecionados 14 artigos, e destacaram-se cartilhas, jogos interativos e vídeos como tecnologias educacionais. A maioria dos estudos contemplou o VI nível de evidência - inclui estudos qualitativos e opiniões de especialistas, sete estudos estavam na língua inglesa e o delineamento predominante foi do tipo metodológico - com nove artigos. Conclusão O objetivo foi alcançado e as evidências apontaram que as tecnologias educacionais são fundamentais para a abordagem de saúde escolar com adolescentes, porém é necessário privilegiar espaços para o diálogo e para as considerações de suas necessidades a fim de aproximá-los dos serviços de saúde.

Resumen Objetivo Conocer y sintetizar la producción científica sobre tecnologías educativas para abordajes en salud con adolescentes. Métodos Se trata de una revisión integrativa de la literatura realizada en las bases de datos Pubmed, Web of Science, Scopus, Lilacs, SciELO y BVS, entre abril y julio de 2020. La disponibilidad completa y gratuita de los artículos en portugués, inglés o español y las publicaciones realizadas en los últimos cinco años compusieron los criterios de inclusión. Se realizó un análisis descriptivo de la caracterización de los estudios y del contenido. Resultados Se seleccionaron 14 artículos y se destacaron cartillas, juegos interactivos y videos como tecnologías educativas. La mayoría de los estudios contempló el VI nivel de evidencia - incluye estudios cualitativos y opiniones de especialistas, siete estudios estaban en lengua inglesa y la delineación predominante fue del tipo metodológico - con nueve artículos. Conclusión El objetivo fue alcanzado y las evidencias apuntaron a que las tecnologías educativas son fundamentales para el abordaje de la salud escolar con adolescentes, sin embargo existe la necesidad de privilegiar espacios para el diálogo y para las consideraciones de sus necesidades con la finalidad de aproximarlos a los servicios de salud.

Abstract Objective To know and synthesize scientific production on educational technologies for health approaches with adolescents. Methods This is an integrative literature review carried out on the PubMed, Web of Science, Scopus, LILACS, SciELO and Virtual Health Library databases, between April and July 2020. Full and free availability of articles in Portuguese, English and/or Spanish, and publications carried out in the last five years formed the inclusion criteria. A descriptive analysis of study and content characterization was carried out. Results A total of 14 articles were selected, and booklets, interactive games and videos were highlighted as educational technologies. Most studies contemplated the VI level of evidence, including qualitative studies and expert opinions, seven studies were in English and the predominant design was of the methodological type, with nine articles. Conclusion The objective was achieved and evidence showed that educational technologies are essential for addressing school health with adolescents; however, it is necessary to privilege spaces for dialogue and consideration of their needs in order to bring them closer to health services.

Perspective of pediatricians and adolescent patients on the transition process in a university hospital / Perspectivas de pediatras e pacientes adolescentes sobre o processo de transição em um serviço terciário

ABSTRACT Objective: To map the transition process from the perspective of pediatricians and their adolescent patients, and to suggest a transition protocol. Methods: This is a descriptive, cross-sectional study conducted in a pediatric outpatient clinic of a public tertiary hospital. Pediatricians answered a questionnaire about the transition process, and that was evaluated in a descriptive manner. The Transition Readiness Assessment Questionnaire (TRAQ) on health autonomy was answered by the adolescents and the analysis was performed using the χ2 and Mann-Whitney tests. p<0.05 were considered significant. Results: 31 pediatricians (16 residents, 15 supervisors) were enrolled, with a mean age of 40.1 (±16.9), 87% women, with years working in Pediatrics ranging from 2 to 45 years (median of 5 years). Most doctors agreed that there was no transition plan, but they stimulated the patient's autonomy and talked to the patient and family members about any existing chronic diseases. A total of 102 adolescent patients participated, with a median age of 15; 56% were female. The TRAQ median was 58, with similar scores between females and males, and higher scores in those older than 16 years of age (Mann-Whitney U test, p=0.01). The patients reported ease in face-to-face communication with their doctors, but great difficulty in talking about health issues over the phone. Conclusions: Even without a transition protocol, adolescents developed several self-care skills as they aged. The lack of a transitional protocol led to conflicting opinions, which reinforces the need for improvement. We suggest a flowchart and transition protocol.

Resumo Objetivo: Mapear o processo de transição na perspectiva de pediatras e de seus pacientes adolescentes bem como sugerir um protocolo de transição. Métodos: Estudo descritivo, transversal, realizado em um Ambulatório de Pediatria de um hospital público terciário. Pediatras responderam a um questionário sobre o processo de transição, que foi avaliado de forma qualitativa. O Questionário de Avaliação do Preparo para a Transição (TRACS) foi respondido pelos adolescentes, e a análise foi feita com testes do qui-quadrado e de Mann-Whitney. Valores p<0,05 foram considerados significantes. Resultados: Participaram do estudo 31 pediatras (16 residentes, 15 supervisores), com média de idade de 40,1 (±16,9) anos, 87% do sexo feminino, tempo de atuação na Pediatria variando de dois a 45 anos, com mediana de cinco anos. A maioria dos médicos concordava que não havia um plano de transição, mas eles estimulavam a autonomia do paciente e conversavam com pacientes e familiares sobre qualquer doença crônica presente. Participaram da pesquisa 102 pacientes adolescentes, com mediana de idade de 15 anos, 56% do sexo feminino. A mediana do TRACS foi de 58, com escores semelhantes entre os sexos feminino e masculino, e escores superiores nos maiores de 16 anos (teste U de Mann-Whitney, p=0,01). Os pacientes relataram facilidade na comunicação presencial com seus médicos, mas grande dificuldade para falar sobre questões de saúde por telefone. Conclusões: Mesmo sem protocolo de transição, os adolescentes desenvolveram várias habilidades de autocuidado com o avanço da idade. A falta de protocolo levou a opiniões conflitantes, reforçando a necessidade de melhor estruturação. Os autores sugerem a criação de um fluxograma e um protocolo de transição.

Evaluación del tratamiento de linfangiomas con bleomicina en población pediátrica de 0 a 18 años / Evaluation of the treatment of lymphangiomas with bleomycin in a pediatric population aged 0 to 18 years

INTRODUCCIÓN. Los linfangiomas son una malformación infrecuente a escala mundial y constituye una preocupación para los padres del infante; está asociado a problemas estéticos y a posibles efectos deletéreos debido a la obstrucción o compresión de órganos vitales. Se ha descrito a la escleroterapia como la mejor opción de tratamiento. OBJETIVO. Determinar la eficiencia del tratamiento con bleomicina en linfangiomas en la población pediátrica de 0 a 18 años. MATERIALES Y MÉTODOS. Estudio transversal analítico retrospectivo. Población y muestra conocida de 20 datos de Historias Clínicas electrónicas de pacientes diagnosticados con linfangiomas y tratados con bleomicina en el Hospital de Especialidades Carlos Andrade Marín, desde enero 2015 a enero 2018. Criterios de inclusión: pacientes de 0 a 18 años de edad con diagnóstico de linfangioma mediante ecografía y angiotomografía computarizada. Criterios de exclusión: pacientes mayores de 18 años de edad o sospecha diagnóstica de linfangioma sin estudios de imagen, y/o que no acudieron a la cita de control, pacientes diagnosticados de linfangioma que no recibieron bleomicina para su tratamiento, niños con otras malformaciones vasculares. El análisis de datos se realizó en el programa estadístico International Business Machines Statistical Package for the Social Sciences. RESULTADOS. La mediana de edad en mujeres fue de 6,25 años y 3,8 años en hombres. 10 pacientes fueron hombres. El promedio de seguimiento fue de 26,86 +/- 16,78 meses. El tamaño promedio de los linfangiomas fue de 5,77 +/- 3,73 cm. La localización más frecuente fue cervical con un 52,38%. La mayoría fueron macronodulares con un 85,71%. La respuesta fue buena o excelente en el 81,00% de los casos con la primera infiltración y subió al 95,00% con la segunda y tercera, según requerimiento. CONCLUSIÓN. El tratamiento de los linfangiomas con bleomicina fue muy efectivo en la población estudiada.

INTRODUCTION. Lymphatic malformation is a rare malformation worldwide and is a concern for the parents of the infant; it is associated with aesthetic problems and possible deleterious effects due to obstruction or compression of vital organs. Sclerotherapy has been described as the best treatment option. OBJECTIVE. To determine the efficiency of bleomycin treatment in lymphangiomas in the pediatric population aged 0 to 18 years. MATERIALS AND METHODS. Retrospective analytical cross-sectional study. Population and known sample of 20 data from Electronic Medical Records of patients diagnosed with lymphangiomas and treated with bleomycin at the Carlos Andrade Marín Specialties Hospital, from January 2015 to January 2018. Inclusion criteria: patients aged 0 to 18 years with diagnosis of lymphangioma by ultrasound and computed angiotomography. Exclusion criteria: patients older than 18 years of age or diagnostic suspicion of lymphangioma without imaging studies, and/or who did not attend the control appointment, patients diagnosed with lymphangioma who did not receive bleomycin for treatment, children with other vascular malformations. Data analysis was performed in the statistical program International Business Machines Statistical Package for the Social Sciences. RESULTS. The median age in women was 6,25 years and 3,8 years in men. Ten patients were men. The average follow-up was 26,86 +/- 16,78 months. The average size of the lymphatic malformations was 5,77 +/- 3,73 cm. The most frequent location was cervical with 52,38%. Most were macronodular with 85,71%. The response was good or excellent in 81,00% of cases with the first infiltration and rose to 95,00% with the second and third, as required. CONCLUSION. The treatment of lymphangiomas with bleomycin was very effective in the population studied.

Hipertensión arterial en adolescentes con exceso de peso y su resiliencia ante la enfermedad / Blood pressure in overweight adolescents and its resilience to the disease

RESUMEN Fundamento: la morbilidad por hipertensión arterial y el exceso de peso en la adolescencia constituyen un problema de salud, por lo que el equipo básico de salud y la familia juegan un papel importante para enfrentar este reto en la comunidad. Objetivo: diseñar un curso de superación a los Equipos Básicos de Salud (EBS) sobre la resiliencia ante la hipertensión arterial en adolescentes con exceso de peso. Metodos: se realizó un estudio de intervención en el periodo septiembre-diciembre de 2019 en el Policlínico Universitario "Chiqui Gómez Lubián" de Santa Clara. Villa Clara. Se emplearon métodos teóricos: análisis-síntesis e inductivo-deductivo; empíricos: análisis documental, grupo nominal y el criterio de especialistas para la valoración del producto diseñado. Resultados: la capacitación se diseñó en la modalidad presencial con cuatro semanas de duración, consta de cinco temas generales con algunos aspectos específicos y está concebido según necesidades de aprendizaje dependiendo de la actividad laboral de desempeño (médico o enfermera). Se aplicaron varios principios didácticos y diferentes modalidades evaluativas para comprobar la aprehensión de los contenidos, y se potencializó la vinculación de la teoría con la práctica como estrategia didáctica. Conclusiones: el curso diseñado cumple los requerimientos didácticos, es pertinente, factible y tiene un adecuado tratamiento científico y metodológico en sus temas según el criterio de los especialistas consultados.

ABSTRACT Background: morbidity due to hypertension and excess weight in adolescence constitute a health problem, so the basic health team and the family play an important role to face this challenge in the community. Objective: to design an upgrading course to improve Basic Health Teams (BHT) on resilience to hypertension in overweight adolescents. Methods: an intervention study was carried out from September to December 2019 at the Chiqui Gómez Lubián University polyclinic in Santa Clara. Villa Clara. Theoretical methods were used: analysis-synthesis and inductive-deductive; empirical ones: documentary analysis, nominal group and the criteria of specialists for the evaluation of the designed product. Results: the training was designed in the face-to-face modality with four weeks duration, it consists of five general topics with some specific aspects and it is conceived according to learning needs depending on the work activity of performance (doctor or nurse). Several didactic principles and different evaluative modalities were applied to verify the apprehension of the contents, and the linking of theory with practice as a didactic strategy was strengthened. Conclusions: the designed course meets the didactic requirements, it´s pertinent, feasible and has an adequate scientific and methodological treatment in its topics according to the criteria of the specialists consulted.

Buenas prácticas en la atención prenatal a adolescentes embarazadas: perspectivas de profesionales de la salud / Good prenatal care practices in teenage pregnancy from the perspective of healthcare professionals / Boas práticas no atendimento pré-natal para adolescentes grávidas: perspectivas de profissionais da saúde

Objetivo: sistematizar buenas prácticas de atención prenatal en un servicio de referencia para adolescentes embarazadas en Campinas, São Paulo, Brasil, desde la perspectiva de profesionales de la salud. Materiales y métodos: estudio cualitativo desarrollado entre junio y julio de 2017, se emplearon entrevistas semiestructuradas y se realizó un grupo focal con 10 profesionales de la salud que prestaban atención a adolescentes embarazadas en una unidad hospitalaria del sistema público de la región de Campinas, São Paulo, Brasil. Los datos fueron examinados mediante la técnica de análisis de contenido temático de donde surgieron nuevas categorías de análisis. Se hizo validación a través de triangulación de los resultados. Se identificó la aplicabilidad teórica y práctica de los principales hallazgos. Resultados: fueron elaboradas tres categorías emergentes del discurso de los profesionales y de las evidencias en la literatura: 1) análisis integral de las adolescentes en situación de embarazo; 2) experiencias profesionales en la atención a las adolescentes embarazadas que evidencian calidad en el servicio; 3) fortalezas y oportunidades del servicio con posibilidades de replicación como modelo asistencial. Son consideradas buenas prácticas durante el cuidado prenatal aquellas que priorizan la atención integral a las adolescentes embarazadas; estas son coordinadas por un equipo multidisciplinario, y consiguen tener un abordaje multidimensional, sobre todo, valorando la complejidad que supone la maternidad en la adolescencia. Conclusión: dentro de los servicios de salud sexual y reproductiva es recomendable el desarrollo de estrategias educativas, el fortalecimiento de la atención en grupos y la inclusión de la red de apoyo de las adolescentes en la atención, con el fin de favorecer una experiencia positiva durante el cuidado prenatal cuando el proceso de volverse madre acontece durante la adolescencia.

Objective: To systematize good prenatal care practices in a referral center for pregnant teenagers in Campinas, São Paulo, Brazil, from the perspective of healthcare professionals. Material and methods: Qualitative study conducted between June and July 2017 using semi-structured interviews and a focus group with 10 healthcare professionals providing care to pregnant teenagers in a public hospital in the region of Campinas, São Paulo, Brazil. Data were examined using the thematic content analysis technique, which gave rise to new analytical categories. Triangulation of the results was used for validation. The theoretical and practical applicability of the main findings was identified. Results: The study looked into three categories arising from the discourse of the professionals and the evidence found in the literature: 1) comprehensive analysis of pregnant teenagers; 2) professional experiences related to the care of pregnant teenagers reflecting service quality; and 3) strengths and improvement opportunities potentially replicable as a care model. Good practices in prenatal care are those which prioritize comprehensive care for pregnant teenagers, are coordinated by a multidisciplinary team and result in a multidimensional approach, valuing the complexity of motherhood in the teenage years. Conclusion: It is advisable to develop education strategies, strengthen group care and involve the teenager's support network as part of sexual and reproductive health services in order to promote a positive experience during prenatal care when the process of becoming a mother takes place during adolescence.

Objetivo: Sistematizar as boas práticas de atenção pré-natal em um serviço de referência para adolescentes grávidas em Campinas, São Paulo/Brasil desde a perspectiva dos professionais da saúde. Materiais e métodos: Estudo qualitativo desenvolvido entre junho e julho de 2017. Empregaram-se entrevistas semiestruturadas e grupo focal com 10 profissionais da saúde que prestavam atendimento à adolescentes grávidas em uma unidade hospitalar da rede pública da região de Campinas, São Paulo/Brasil. Os dados foram analisados por meio da técnica de análise de conteúdo temática onde surgiram as categorias de análise. Realizou-se validação através de triangulação dos resultados e foi identificada a aplicabilidade teórica e prática dos principais achados. Resultados: Foram elaboradas três categorias emergentes do discurso dos professionais e das evidências na literatura: 1) análise compreensiva das adolescentes em situação de gravidez; 2) vivências profissionais no cuidado de adolescentes grávidas que mostram a qualidade no atendimento; 3) potencialidades e oportunidades do serviço com possibilidades de replicação como modelo assistencial. No atendimento pré-natal, são consideradas como boas práticas aquelas que priorizam a atenção integral à gestante adolescente; as que são coordenadas por uma equipe multidisciplinar e conseguem ter uma abordagem multidimensional, sobretudo, avaliando a complexidade que supõe a maternidade durante a adolescência. Conclusões: Dentro dos serviços de saúde sexual e reprodutiva, é recomendável o desenvolvimento de estratégias educativas, o fortalecimento da atenção em grupos e a inclusão da rede de apoio das adolescentes na atenção para favorecer uma experiência positiva durante o cuidado pré-natal levando em consideração o processo de tornar-se mãe durante a adolescência.

Procura por serviços ou profissionais de saúde entre adolescentes: um estudo multinível / Demand for health services or professionals among adolescents: a multilevel study

Resumo O objetivo deste estudo foi analisar a procura por serviços ou profissionais de saúde pelos adolescentes com determinantes individuais e com variáveis contextuais, modalidade de ensino da escola e Índice de Vulnerabilidade Social. Os dados foram coletados no período de março a junho de 2018, em escolas públicas estaduais de Olinda, Pernambuco, através de um questionário estruturado com questões do Youth Risk Behavior Survey (YRBS) e da Pesquisa Nacional de Saúde do Escolar (PeNSE). Dentre os 2.454 adolescentes, a proporção daqueles que procuram por um serviço de saúde foi maior: no sexo feminino; em adolescentes cujas as mães tivessem escolaridade mínima de nove anos; naqueles fisicamente ativos; e cujos responsáveis não recebiam Bolsa Família. Observou-se que as variáveis contextuais não influenciaram a procura por serviços de saúde entre os adolescentes. No terceiro modelo da análise multinível, que analisou as variáveis individuais, observou-se que apenas o sexo feminino (OR=1,80), ter mãe com escolaridade maior ou igual a nove anos de estudo (OR=1,30), não receber Bolsa Família (OR=1,23) e ser ativo fisicamente (OR=1,32) foram associados a uma maior procura por serviços ou profissionais de saúde.

Abstract This study aimed to analyze the demand for health services or professionals by adolescents with individual determinants and contextual variables (school teaching modality and Social Vulnerability Index). Data were collected from March to June 2018, in state public schools in Olinda, Pernambuco, Brazil, through a structured questionnaire with questions from the Youth Risk Behavior Survey (YRBS) and the National School Health Survey (PeNSE). Among the 2,454 adolescents, the proportion of those looking for a health service was higher among women; in adolescents whose mothers had a minimum of nine schooling years; in the physically active; and whose parents did not receive a family aid (Bolsa Família). We observed that the contextual variables did not influence the demand for health services among adolescents. In the third model of the multilevel analysis, which analyzed the individual variables, we observed that only females (OR=1,80), having a mother with schooling greater than or equal to 9 years of study (OR=1,30), not receiving Bolsa Família (OR=1,23), and physically active (OR=1,32) were associated with an increased demand for health services or professionals.

Conocimientos, experiencias y actitudes sobre derechos sexuales y derechos reproductivos en adolescentes y jóvenes / Knowledge, experiences and attitudes about sexual rights and reproductive rights in adolescents and young people / Conhecimentos, experiências e atitudes sobre direitos sexuais e direitos reprodutivos em adolescentes e jovens

Resumen El Modelo de los Servicios de Salud Amigables para Adolescentes y Jóvenes (SSAAJ) corresponde a un proceso creado para garantizar que las instituciones de salud generen espacios y formas de atención integral y diferencial para la población entre 10 y 29 años, permitiendo que se garanticen los Derechos Sexuales y Derechos Reproductivos (DSDR) acorde a las necesidades y expectativas en salud que les afectan. Objetivo: indagar los conocimientos, actitudes y experiencias en DSDR en un grupo de adolescentes y jóvenes vinculados a los SSAAJ. Materiales y métodos: mediante un estudio cualitativo con diseño fenomenológico se realizaron 13 entrevistas semiestructuradas a los adolescentes y jóvenes entre los 13 y 21 años. Resultados: en conocimientos frente a los DSDR los adolescentes hombres tienen algunas nociones sobre derechos humanos, pero desconocen los diferentes DSDR que existen, en las mujeres predomina mayor conocimiento sobre los DSDR. Las actitudes de los adolescentes frente a los DSDR son favorables una vez identifican lo que representan en el abordaje de la sexualidad, sin embargo, consideran que sus experiencias sobre el ejercicio de los DSDR se ven limitadas para su exigibilidad y garantía por el desconocimiento que tienen de ellos. Conclusiones: se encontró que los conocimientos, actitudes y experiencias de los adolescentes y jóvenes sobre los DSDR están influenciados por factores familiares y culturales que impactan sus trayectorias de vida.

Abstract The Model of Friendly Health Services for Adolescents and Young People (SSAAJ for its acronym in Spanish) corresponds to a process created to guarantee that health institutions generate spaces and forms of comprehensive and differential care for the population between 10 and 29 years of age, allowing the Sexual Rights and Reproductive Rights (DSDR for its acronym in Spanish) according to the health needs and expectations that affect them. Objective: to investigate the knowledge, attitudes and experiences in DSDR in a group of adolescents and young people linked to the SSAAJ. Materials and methods: through a qualitative study with a phenomenological design, 13 semi-structured interviews were conducted with adolescents and young people between 13 and 21 years of age. Results: regarding knowledge about DSDR, male adolescents have some notions about human rights, but are unaware of the different DSDR that exist. In women there is more knowledge about DSDR. The attitudes of adolescents towards DSDR are favorable once they identify what they represent in the approach to sexuality. However, they consider that their experiences regarding the exercise of DSDR are limited for their enforceability and guarantee due to the lack of knowledge they have from them. Conclusions: it was found that the knowledge, attitudes and experiences of adolescents and young people about DSDR are influenced by family and cultural factors that impact their life trajectories.

Resumo O Modelo dos Serviços de Saúde Amigáveis para Adolescentes e Jovens (SSAAJ) corresponde a um processo criado para garantir que as instituições de saúde gerem espaços e formas de atenção integral e diferencial para a população entre 10 e 29 anos, permitindo que se garantam os Direitos Sexuais e Direitos Reprodutivos (DSDR) de acordo com as necessidades e expectativas em saúde que os afetam. Objetivo: indagar os conhecimentos, atitudes e experiências em DSDR em um grupo de adolescentes e jovens vinculados aos SSAAJ. Materiais e métodos: mediante um estudo qualitativo com desenho fenomenológico se realizaram 13 entrevistas semiestruturadas aos adolescentes e jovens entre os 13 e 21 anos. Resultados: em conhecimentos perante os DSDR os adolescentes homens têm algumas noções sobre direitos humanos, mas desconhecem os diferentes DSDR que existem, nas mulheres predomina maior conhecimento sobre os DSDR. As atitudes dos adolescentes frente aos DSDR são favoráveis assim que identificam o que representam na abordagem da sexualidade. No entanto, consideram que suas experiências sobre o exercício dos DSDR se veem limitadas para sua exigibilidade e garantia pelo desconhecimento que têm deles. Conclusões: Encontrou-se que os conhecimentos, atitudes e experiências dos adolescentes e jovens sobre os DSDR estão influenciados por fatores familiares e culturais que impactam suas trajetórias de vida.

Evaluation of Satisfaction of Adolescents Treated by Dental Students

ABSTRACT Objective: To evaluate the satisfaction of adolescents undergoing dental treatment between 2016 and 2018 at the Dental School of the Federal University of Minas Gerais (FAO UFMG). Material and Methods: A descriptive cross-sectional study using the Oral Health Services Satisfaction Assessment Questionnaire (QASSaB). The structured questionnaire has eleven questions divided among the dimensions: dentist / patient relationship, relationship with other professionals, effectiveness, accessibility/availability, technical-scientific quality, cleanliness and physical environment, acceptability, effectiveness/resolution, each with five response options. Descriptive data analysis was performed using absolute and relative frequencies. Results: A total of 145 adolescents participated in this study, 60 males and 85 females; 74.85% of adolescents rated dental treatment received as excellent, 76.7% reported having no symptoms after treatment, 46.2% considered it easy/very easy to get treatment, 65.6% reported that waiting time was short/very short, 90% considered dental equipment modern/very modern, 98% regarded the cleanliness of the waiting room and bathrooms as being excellent, 83.4% reported that they always received an explanation about the treatment, and 51.57% were totally satisfied with the appearance of the treated teeth and their chewing capacity. Conclusion: It was possible to observe that the adolescents, users of FAO UFMG, were satisfied with the service in the studied dimensions: human relations, effectiveness, accessibility/availability, technical-scientific quality, physical environment/cleanliness, acceptability and resolvability/effectiveness.

Cuidado às famílias no Centro de Atenção Psicossocial Infantojuvenil: uma pesquisa-intervenção com trabalhadores / Care for families in the Child and Adolescent Psychosocial Care Center: an intervention-research with workers

RESUMO O presente estudo aborda o modo como profissionais do Centro de Atenção Psicossocial Infantojuvenil (Capsi) compreendem as famílias, o cuidado que deve ser ofertado a elas e a sua expressão em indicadores de avaliação. Realizou-se uma avaliação de quarta geração, com embasamento teórico construtivista, que envolveu: a oferta de um curso de extensão para trabalhadores dos Capsi, a realização de Grupos de Apreciação Partilhada (GAP), com construção e validação de narrativas, culminando em oficinas de produção de consenso. Os participantes reconheceram a necessidade de realizar um registro sistemático de dados sobre as famílias - em aspectos como arranjo e dinâmica familiar, renda, raça/cor e divisão do trabalho -, a ser iniciado desde o momento do acolhimento para subsidiar a construção do Projeto Terapêutico Singular. A necessidade de construir relações mais horizontais e sensíveis às diferenças socioculturais foi considerada um importante desafio. Para caminhar nas direções apontadas, foram pactuados três indicadores quantitativos e um Guia de Boas Práticas. Trata-se de uma produção inédita no recorte da assistência a crianças e adolescentes, que atende a critérios de qualidade e dialoga com a literatura da área, e ainda poderá ser utilizada nos Capsi, com eventuais adaptações de acordo ao contexto.

ABSTRACT The present study addresses the way in which professionals from the Child and Adolescent Psychosocial Care Center (Capsi) understand families, the care that must be offered to them and their expression in evaluation indicators. We carried out a fourth generation assessment, based on a constructivist theoretical basis, which involved: offering an extension course for Capsi workers, holding Shared Appreciation Groups (GAP) with narrative construction and validation, culminating in production of consensus workshops. Participants recognized the need to carry out a systematic Record of data on the families ‒ in aspects such as family arrangement and dynamics, income, race/color, and division of labor ‒ that starts from the moment of reception to support the construction of the Singular Therapeutic Project. The need to build more horizontal and sensitive relationships to socio-cultural differences was considered an important challenge. To follow the indicated directions, three quantitative indicators and a Guide to Good Practices were agreed. This is an unprecedented production in the context of assistance to children and adolescents, which meets quality criteria and dialogues with the literature in the field and can be used in Capsi, with possible adaptations according to context.

Resiliencia en gestantes adolescentes del Caribe colombiano: evaluación con la escala de Wagnild y Young / Resilience in pregnant adolescents of the Colombian Caribbean, evaluation with the Wagnild and Young scale

RESUMEN Introducción: las adolescentes presentan cambios biológicos y reciben influencias sociales que las predisponen a quedar embarazadas a temprana edad. Objetivo: evaluar la resiliencia en un grupo de gestante adolescentes para estimar la frecuencia del NRB (nivel de resiliencia bajo) e identificar factores psicosociales asociados. Metodología: estudio transversal en gestantes adolescentes que acudieron a consulta prenatal en Cartagena, Colombia. Se aplicó un cuestionario de características sociodemográficas y es-calas sobre resiliencia, familismo, religiosidad, espiritualidad, funcionalidad familiar, violencia de pareja, felicidad y autoestima. Se compararon dos grupos: NRB y NRAM (nivel de resiliencia alto/moderado). Se realizó una regresión logística multivariada para identificar los factores asociados al NRB. Resultados: se estudiaron 499 gestantes adolescentes con una edad promedio de 17 años. La mitad de ellas pertenecían a familias disfuncionales. Sesenta y cuatro (12,8 %) tuvieron un NRB con factores asociados como bajo familismo OR: 4,736 (IC 95 %: 2,673-8,392), baja autoestima OR: 4,257 (IC 95 %: 1,363-13,295), disfunción familiar OR: 3,902 (IC 95 %: 2,052-7,422), violencia de pareja OR: 2,689 (IC 95 %: 1,082-6,678), deficiente espiritualidad OR: 2,503 (IC 95 %: 1,461-4,287) y reducida felicidad OR: 2,063 (IC 95 %: 1,214-3,506). Conclusión: en una ciudad del Caribe colombiano, en trece de cada cien gestantes adolescentes que acu-den a consulta prenatal, se encontró NRB; disfunción familiar, violencia de pareja en el embarazo, deficien-te perspectiva espiritual, reducida felicidad subjetiva, familismo y nivel de autoestima bajos se observaron asociados.

SUMMARY Introduction: Adolescents present biological changes and receive social influences which predispose them to pregnancies at early age. Objective: To evaluate resilience in a group of pregnant adolescents, to estimate the frequency of low resilience level and identify associated psychosocial factors. Methodoly: Cross-sectional study in pregnant adolescents who went to prenatal visit in Cartagena, Colombia. A sociodemographic characteristics questionnaire and validated scales on resilience, familism, religiosity, spirituality, family functionality, partner violence, happiness and selfesteem were applied. Two groups were compared: high/moderate resilience level (HMRL) and low resilience level (LRL). Multivariable logistic regression was performed to identify factors associated with LRL. Results: 499 pregnant adolescents were studied, average age 17 years, half belonging to dysfunctional families. Sixty four (12,8%) had LRL and were associated factors: low familism OR: 4,736 (IC95%: 2,673-8,392), low self-esteem OR: 4,257 (IC95%: 1,363-13,295), family dysfunction OR: 3,902 (IC95%: 2,052-7,422), partner violence OR:2,689 (IC95%: 1,082-6,678), poor spirituality OR: 2,503 (IC95%: 1,461-4,287) and reduced happiness OR: 2,063 (IC95%: 1,214-3,506). Conclusion: In a city of the Colombian Caribbean, in thirteen of every one hundred pregnant adolescents who attend to prenatal visit, LRL was found. Family dysfunction, partner violence in pregnancy, poor spirituality, reduced subjective happiness, low familism and low level of selfesteem, were associated with LRL.

Experiencia de cuidados de enfermería en centros de niños y adolescentes en riesgo / Nursing care experience in childrens and adolescents in risk centers

RESUMEN Fundamento: la labor de una enfermera/o es el cuidado, lo cual implica un trato directo con otros seres humanos, según tiempo, necesidades y ambiente en que se encuentren éstos. En este caso, en un campo diferente, como lo es una institución de protección de niños y adolescentes en riesgo. Objetivo: conocer la experiencia de cuidados de enfermería, develando las motivaciones y valores para cuidar niños, niñas y adolescentes en estos centros de la región de la Araucanía. Métodos: se realizó una investigación cualitativa de diseño fenomenológico. La población estuvo conformada por tres enfermeras/os, el tipo de muestra no probabilística, intencionada de casos por criterios y por conveniencia. Criterios de inclusión: enfermera/o que ejerza su labor en centros del SENAME. La técnica utilizada para la obtención de los datos fue una entrevista en profundidad. El análisis se logró, a través de reducción de éstos. La validez fue comprobada con criterios de rigor y, además, triangulada por investigadores. Se contemplaron los principios éticos de Ezequiel Emanuel. Resultados: del foco central, experiencia en cuidados de enfermería en centros de menores surgieron tres categorías: motivaciones para ejercer la Enfermería, cuidados de Enfermería y valores para otorgar cuidados de Enfermería. Para la primera, emergen como subcategoría: incentivo para trabajar en el centro; para la segunda, inicio y evolución de Cuidados de Enfermería, y para la tercera brotan subcategorías: identificación de valores, desempeño de valores institucionales o profesionales y por último, experiencia de valores profesionales en el cuidado. Conclusiones: las motivaciones para ingresar a trabajar en los centros: estabilidad laboral y seguridad económica. En el cuidado de Enfermería, se identificaron actividades asistenciales y administrativas. Los enfermeros/as evidencian valores como la ética, tolerancia, empatía y dedicación con propiedad profesional e institucional.

ABSTRACT Background: the work of a nurse is care, which implies a direct treatment with other human beings; according to time, needs and environment in which they are. In this case, in a different field, such as, an Institution for the Protection of Minors. Objective: to know the experience of nursing care, showing the motivations and values to care for children and adolescents in these centers, in the Araucanía Region. Methods: qualitative research of phenomenological design. The population is made up of three nurses, the type of sample: non-probabilistic, intentional of cases by criteria and by convenience. Inclusion criteria: a nurse who works at SENAME centers. The technique used to obtain the data was an in-depth interview. The analysis was achieved by reducing them. The validity was proved with strong criteria and, also, triangulated by researchers. The ethical principles of Ezequiel Emanuel were used. Results: related to the core of nursing care experience in juvenile centers, three categories were reported: motivations to practice Nursing; Nursing care and values ​​to grant nursing care. A subcategory appeared from the first one: incentive to work in the center, for the second one, beginning and evolution of Nursing Care and, for the third one, three subcategories appeared: identification of values, performance of institutional and/or professional values ​​and, finally, experience of professional values ​​in care. Conclusions: the motivations to enter the centers to work were job stability and economic security. In nursing care, assistance and administrative activities were identified. Nurses showed values, ​​such as, ethics, tolerance, empathy and dedication with professional and institutional property.

Fatores de risco aos desfechos obstétricos e neonatais de mães adolescentes / Factores de riesgo para los resultados obstétricos y neonatales de las madres adolescentes / Risk factors for obstetric and neonatal outcomes of adolescent mothers

Objetivo: comparar os desfechos obstétricos e neonatais entre mães adolescentes e adultas. Método: estudo transversal desenvolvido com base nos dados do Sistema de Informações de Nascidos Vivos, comparando variáveis sociodemográficas, obstétricas e neonatais de mães adolescentes e adultas do Rio Grande do Sul, no período de 2010-2016. O teste Qui-quadrado avaliou associação estatística e foi estimada a razão de prevalência. Resultados: houve diferenças significativas entre mães de 10-14 anos e as dos demais estratos: prevalência de raça/cor preta ou parda (RP=1,53; IC95% 1,46-1,60), pré-natal inadequado (RP=1,89; IC95% 1,84-1,94), prematuridade (RP=1,35; IC95% 1,27-1,43), baixo peso ao nascer (RP=1,34; IC95% 1,25-1,43) e desempenho inferior no Apgar do 1º minuto (RP=5,68; IC95% 5,49-5,88). Conclusão: a prevalência de fatores de risco aos desfechos obstétricos e neonatais de adolescentes de 10-14 anos demanda avaliação criteriosa da saúde. A gravidez precoce na adolescência requer o acionamento de equipes interdisciplinares, redes familiares, socioassistenciais e de proteção sociojurídica.

Objective: to compare obstetric and neonatal outcomes among adolescent and adult mothers. Method: cross-sectional study based on data from the Sistema de Informações de Nascidos Vivos (Live Birth Information System) comparing socio-demographic, obstetric, and neonatal variables of adolescent and adult mothers from Rio Grande do Sul in the period 2010-2016. The Chi-square test evaluated statistical association and the prevalence ratio was estimated. Results: there were significant differences between mothers aged 10-14 and those from other strata: prevalence of black or brown-skinned race/color (PR=1.53; CI95% 1.46-1.60), inadequate prenatal care (PR=1.89; IC95% 1.84-1.94), prematurity (PR=1.35; CI95% 1.27-1.43), low birth weight (PR=1.34; IC95% 1.25-1.43) and lower performance in the 1st minute Apgar score (PR=5.68; IC95% 5.49-5.88). Conclusion: prevalence of risk factors for obstetric and neonatal outcomes of adolescents aged 10-14 requires careful health evaluation. Early pregnancy in adolescence requires the activation of interdisciplinary teams, and family, social assistance and socio-legal protection networks.

Objetivo: comparar los resultados obstétricos y neonatales entre las madres adolescentes y adultas. Método: estudio transversal basado en datos del Sistema de Información de Nacimientos Vivos comparando las variables sociodemográficas, obstétricas y neonatales de madres adolescentes y adultas de Rio Grande do Sul en el período 2010-2016. Se estimó la prueba de Chi-cuadrado la asociación estadística y la relación de prevalencia. Resultados: hubo diferencias significativas entre las madres de 10 a 14 años y las de los otros estratos: prevalencia de raza/color negro o marrón (RP-1,53; IC95% 1,46-1,60), atención prenatal inadecuada (RP-1,89; IC95% 1,84-1,94), prematuridad (RP-1.35; IC95% 1,27-1,43), bajo peso al nacer (RP-1,34; IC95% 1,25-1,43) y menor rendimiento en el primer minuto de Apgar (RP-5.68; IC95% 5,49-5,88). Conclusión: la prevalencia de factores de riesgo para los resultados obstétricos y neonatales de adolescentes de 10 a 14 años requiere una evaluación cuidadosa de la salud. El embarazo precoz en la adolescencia requiere la activación de equipos interdisciplinarios y redes de familiares, de asistencia social y de protección socio-jurídica.

A constructing study on professional competency standards of school health education teachers / 中国学校卫生

Objective@#To construct a model of professional competency standard for school health education teachers in China, then to provide a framework for the professional development of health education teachers at primary and secondary schools.@*Methods@#Seventy-five indicators of professional competency of school health education teacher were identified through job task analysis, qualitative interview, expert consultation. A total of 282 school health administrators/researchers, school principals, health education teachers in Shanghai, and the first undergraduate students of health education progame in China were surveyed. Items analysis verified appropriateness, and exploratory factor analysis determined construct validity of the competency standards.@*Results@#The framework of competency standards consists of four major areas (general literacy, school health services, school health education, school health management), nine categories, and 70 competence standards. Nine categories include professional ethics, general literacy as teacher, assist to deal with emergency/accident health events and common diseases situation in school, assist vaccination and mental health assessment, monitoring/communication the health situation of students, knowledge of health education and teaching skills, implement health education activities effectively and continuously, deal with infectious diseases and environment/ water/food safety in school, monitor conditions of the school health and optimize health strategy continuously. Cronbach’s Alpha coefficient of total competence standards was 0.98, and those of the sub-dimensions ranged from 0.86 to 0.96 ; the split-half reliability of total system was 0.93 with sub-dimensions coefficient ranging from 0.83 to 0.95.@*Conclusion@#The model of competency standard developed in this study show good validity and reliability, which can provide theoretical framework for the training, using and evaluation of school health education teachers with the characteristics of combinating medicine and teaching.

Translation and validation of the Transition Readiness Assessment Questionnaire (TRAQ) / Tradução e validação do Questionário de Avaliação do Preparo para a Transição (TRAQ)

Abstract Objective: To translate and validate the Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire in a population of adolescents and young adults with chronic rheumatologic disorders. This questionnaire evaluates the patient's readiness for making the transition from the pediatric health service to adult care. Methods: The four-phase methodology for the translation and validation of generic questionnaires was followed, including translation, back-translation, pilot testing and clinical validation of the final tool. The confirmatory factor analysis was used for clinical validation and the Cronbach's alpha coefficient was used to assess the overall internal consistency of the final tool. Results: A total of 150 patients with a mean age of 17.0 years (SD = 2.2 years, range 14-21 years) were enrolled for the final tool validation. Of those, 71 patients had juvenile systemic lupus erythematosus (47.3%), 64 had juvenile idiopathic arthritis (42.7%), and 15 had juvenile dermatomyositis (10%). During the confirmatory factor analysis, the dimension "Talking with providers" consisting of two questions, was considered as not fitting the translated questionnaire due to a very high ceiling effect and was therefore excluded. All other translated items favorably contributed to the overall consistency of the final tool; removing that dimension did not result in a substantial increase in Cronbach's alpha, which was 0.776. Conclusions: The Brazilian Portuguese version of the Transition Readiness Assessment Questionnaire was validated in a population of transitional patients with chronic rheumatologic disorders, after one dimension from the original questionnaire was excluded. It is a non-specific disease questionnaire; thus, it can be used to evaluate the transition readiness of Brazilian patients with other chronic diseases.

Resumo Objetivo: Traduzir para o português brasileiro e validar o Questionário de Avaliação do Preparo para a Transição em uma população de adolescentes e adultos jovens com doenças reumáticas crônicas. Este questionário avalia o preparo do paciente para realizar a transição do serviço de saúde pediátrico para a assistência ao adulto. Métodos: Seguimos a metodologia de quatro etapas para a tradução e validação de questionários genéricos que inclui tradução, retrotradução, teste piloto e validação clínica do instrumento final. Utilizamos Análise Fatorial Confirmatória e Coeficiente Alfa de Cronbach para testar a validade do instrumento e sua consistência interna. Resultados: Responderam ao questionário traduzido e adaptado 150 pacientes. A média de idade foi de 17,0 anos (DP = 2,2 anos, variação 14-21 anos). Tinham o diagnóstico de lúpus eritematoso sistêmico juvenil 71 pacientes (47,3%), 64 (42,7%) artrite idiopática juvenil e 15 (10%) dermatomiosite juvenil. Durante a análise fatorial confirmatória, a dimensão "Falando com a Equipe Médica" contendo duas questões teve que ser removida devido à presença de expressivo efeito teto. Todas as outras questões restantes contribuíram favoravelmente para aumentar a consistência interna do questionário, obteve-se um Coeficiente Alfa de Cronbach de 0,776. Conclusões: O Questionário de Avaliação do Preparo para a Transição na sua versão em português brasileiro pode ser validado em uma população de pacientes com doenças reumáticas crônicas em transição, com a exclusão de uma dimensão do questionário original. Por ser um questionário não específico para doenças reumáticas, poderá ser utilizado para avaliar o preparo para a transição de outros pacientes brasileiros com doenças crônicas.

Consejería en Salud Sexual y Reproductiva, estrategia educativa de enfermería para reducir riesgos en adolescentes embarazadas / Sexual and Reproductive Health Counseling, educational nursing strategy to reduce risks in pregnant adolescents

Introducción: una de cada seis mujeres que se embarazan es adolescente, el riesgo de muerte materna es el doble en razón de las mujeres en edad fértil. Los riesgos y daños se pueden presentar en la gestación, el parto, posparto y en el recién nacido. Objetivo: evaluar el efecto de una intervención basada en "Consejería en Salud Sexual y Reproductiva" para reducir riesgos en las adolescentes embarazadas durante el parto, posparto y neonato. Métodos: diseño cuasiexperimental con 170 adolescentes embarazadas seleccionadas por conveniencia de un hospital público. Se seleccionó un grupo de intervención (85) y un grupo control (85). Intervención: I) capacitación de facilitadores por Ipas México, II) instrumento con base en las cédulas de riesgo perinatal PREVIGen IV, V, VI y VIII, III) elaboración de material educativo, IV) procedimiento de recolección de información en tres fases. Resultados: el promedio de edad de las adolescentes embarazadas fue de 16.2 ± 0.66 años, nivel socioeconómico bajo (87%), escolaridad primaria (77%), unión libre (80%). Las adolescentes al inicio del trabajo de parto, fue en Grupo control 25.8% y Grupo intervención 9.4% (p = 0.019). Durante el trabajo de parto, fue significativa en valoración de la respuesta fetal (p = 0.007). Conclusión: la intervención educativa de enfermería basada en la Consejería en Salud Sexual y Reproductiva demostró tener un efecto positivo en la reducción de riesgos de las adolescentes embarazadas durante el parto, posparto y neonato.

Introduction: One out of every six women who become pregnant is adolescent; the risk of maternal death is twice that of women of childbearing age. The risks and damages can occur in pregnancy, delivery, postpartum and newborn. Objective: To evalúate the effect of an intervention based on "Sexual and Reproductive Health Counseling" to reduce risks in pregnant adolescents during delivery, postpartum and neonate. Methods: Quasi-experimental design with 170 pregnant adolescents selected for the convenience of a public hospital. An intervention group (85) and a control group (85) were selected. Intervention: I) training of facilitators by Ipas México, II) instrument based on the perinatal risk cards PREVIGEN IV, V, VI and VIII, III) preparation of educational material, IV) information collection procedure in three phases. Results: The average age of pregnant adolescents was 16.2 ± 0.66 years, low socioeconomic levels (87%), primary schooling (77%), free unión (80%). Adolescents at the beginning of labor were 25.8% in the control group and 9.4% in the intervention group p = 0.019). During labor, it was significant in the evaluation of the fetal response (p = 0.007). Conclusión: The educational nursing intervention based on the Ministry of Sexual and Reproductive Health, demonstrated to have a positive effect in the reduction of risks of pregnant adolescents during childbirth, postpartum and neonate.

Real-life challenge: training program on drug use and adolescence in primary health care / Desafio na vida real: capacitação sobre uso de drogas e adolescência na atenção básica

ABSTRACT Guidelines emphasize the importance of approaching substance use by adolescents, particularly in primary health care. However, there are problems with its incorporation. The objective of this study was to present the training stages on the theme for professionals in primary health care. Researchers conducted logistic structuring, content elaboration and evaluation of difficulties before and after training. Sixty percent of professionals involved in the care of adolescents in a medium-sized city participated in the study. More than half of them stated having difficulties in the approach, mainly theoretical limitations and short consultations. After the training, the professionals informed whether they felt more prepared, but practical difficulties remained.

RESUMO Diretrizes ressaltam a importância da abordagem do uso de substâncias por adolescentes, particularmente na atenção básica. Todavia, observam-se problemas para sua incorporação. O objetivo deste estudo foi apresentar as etapas de capacitação no tema para profissionais da atenção básica. Realizou-se estruturação logística, elaboração do conteúdo e avaliação das dificuldades antes e após a capacitação. Participaram 60% dos profissionais envolvidos no atendimento de adolescentes em município de médio porte. Mais da metade afirmou ter dificuldades na abordagem, principalmente limitações teóricas e pouco tempo para atendimento. Após o treinamento, os profissionais informaram se sentir mais preparados, mas dificuldades práticas se mantiveram.