Modelo para capacitar sobre percepción de riesgo en VIH/sida a jóvenes del municipio Manicaragua / Model to train young people from the Manicaragua municipality, Cuba, on risk perception in HIV/AIDS

Fundamento: el VIH/sida es un problema de salud caracterizado por un severo compromiso de la inmunidad; esta entidad constituye factor de riesgo para el desarrollo de las principales causas de muerte a nivel mundial. Objetivo: proponer un modelo para capacitar sobre percepción de riesgo sobre el VIH/sida a jóvenes del Consultorio Médico 41 del área de salud Manicaragua. Métodos: se realizó un estudio observacional, descriptivo, transversal en el Consultorio Médico 41 del área de salud Manicaragua en la provincia de Villa Clara. Se aplicaron métodos teóricos: histórico-lógico, análisis síntesis, inducción-deducción, sistémico-estructural y modelación; empíricos: el cuestionario a jóvenes y la historieta de conflictos; matemáticos-estadísticos para el análisis de los datos. Resultados: las insuficiencias más frecuentes en la percepción de riesgo estuvieron relacionadas con las carencias en la información, la comprensión y la toma de decisiones para la prevención de salud. Se ofrece un modelo para la capacitación en percepción de riesgo ante el VIH/sida el cual fue valorado por criterios de especialistas. Conclusiones: el modelo posibilita la adquisición de conductas promotoras de la salud sexual, comprender y predecir cómo puede responderse a los peligros ante la enfermedad, contribuir al cambio de intención y comportamiento, y a asumir actitudes de protección. Fue valorado como aceptado por los especialistas consultados.

Background: HIV/AIDS is a health problem characterized by a severe compromise of immunity; this entity constitutes a risk factor for the development of the main causes of death worldwide. Objective: to propose a model to train young people from the Doctor´s office 41 in the Manicaragua health area on risk perception on HIV/AIDS. Methods: an observational, descriptive, cross-sectional study was carried out in the Doctor´s office 41 of the Manicaragua health area in the province of Villa Clara. Theoretical methods were applied: historical-logical, analysis synthesis, induction-deduction, systemic-structural and modeling; empirical ones: the questionnaire for young people and the conflict story; mathematical-statisticians for data analysis. Results: the most frequent deficiencies in risk perception were related to deficiencies in information, understanding and decision-making for health prevention. A model for training in risk perception to face HIV/AIDS is offered, which was assessed by specialist criteria. Conclusions: the model enables the acquisition of behaviors that promote sexual health, understanding and predicting how to respond to the dangers of the disease, contributing to the change of intention and behavior, and assuming protective attitudes. It was valued as accepted by the specialists consulted.

Rasgos de profesionalidad médica en el ámbito de la atención primaria: respeto por la autonomía / Traits of medical professionalism in the field of primary care: respect for autonomy

Fundamento: el respeto por la autonomía del paciente y una conducta respetuosa en general son rasgos centrales de la profesionalidad médica. Objetivo: indagar la presencia de los rasgos profesionales de respeto por la autonomía de los pacientes y de respeto en general en las expresiones verbales de profesionales del ámbito de atención primaria de la salud durante su interacción con pacientes y estudiantes del último año de la carrera de Medicina. Métodos: se efectuó una investigación cualitativa de carácter exploratorio en contextos de prácticas finales obligatorias en dos Centros de Atención Primaria de la Salud de la ciudad de Tandil, República de Argentina, durante el año 2019. Como métodos teóricos se emplearon: análisis-síntesis, inductivo-deductivo y método de revisión crítica de la literatura y empírico: se realizó el registro grabado de 28 encuentros entre expertos, estudiantes y pacientes. Las sesiones se analizaron mediante triangulación de investigadores. Resultados: las expresiones verbales de los expertos permitieron identificar enunciados relacionados con rasgos de respeto en general y respeto por la autonomía de los pacientes. Estos se evidenciaron en enunciados para construir un ambiente de confianza y confidencialidad, el esfuerzo por brindar explicaciones de forma clara y sencilla, la atención a las dudas de los pacientes y la formulación de explicaciones sobre cómo proceder, en un lenguaje accesible. Conclusiones: se identificó la presencia de los rasgos profesionales de respeto por la autonomía de los pacientes y de respeto en general, tanto en las interacciones con pacientes como con los estudiantes.

Background: respect for the autonomy of the patient and a respectful behavior in general are key features of medical professionalism. Objective: to investigate the presence of professional traits of respect for the autonomy of patients and of respect in general in the verbal expressions of professionals in the field of primary health care during their interaction with patients and students in the last year of the Medicine degree. Methods: a qualitative research of an exploratory nature was carried out in the context of mandatory final practices in two Primary Health Care Centers in the city of Tandil, Republic of Argentina, during the year 2019. The following theoretical methods were used: analysis-synthesis, inductive-deductive and method of critical review of the literature and empirical ones: the recorded record of 28 meetings between experts, students and patients was made. The sessions were analyzed by opposing sources of researchers. Results: the verbal expressions of the experts made it possible to identify statements related to traits of respect in general and respect for the autonomy of the patients. These were evidenced in statements to build an environment of trust and confidentiality, the effort to provide explanations in a clear and simple way, the attention to the patients' doubts and the formulation of explanations on how to proceed, in an accessible language. Conclusions: the presence of professional traits of respect for the autonomy of patients and respect in general was identified, both in interactions with patients and with students.

La expresión plástica como fortaleza de la pedagogía social en menores con trastornos de conducta / Plastic expression as strength of social pedagogy in adolescents with behavior disorders

Introducción: la pedagogía social es una oportunidad de abrir el pensamiento y las prácticas educativas a horizontes y destinos alternativos para la sociedad. Objetivo: describir una experiencia educativa relacionada con la expresión plástica como fortaleza de la pedagogía social en menores con trastornos de conducta. Métodos: se realizó una revisión bibliográfica sobre el contenido del artículo en las bases de datos SciELO, Google Académico y en textos impresos, entre octubre 2021-enero 2022; las palabras claves fueron: pedagogía social, educación artística, artes plásticas, trastornos de conducta. Se seleccionaron 20 textos: diez artículos de revistas extranjeras y cubanas, dos libros clásicos, tres documentos normativos, cuatro tesis, y el diccionario de pensamientos martianos compilados por Valdés Galarraga. Resultados: se analizaron aspectos relacionados con la pedagogía social como ciencia, la educación artística y su impronta en la pedagogía social, la expresión plástica como actividad educativa, el taller de expresión plástica: generador de educación y cultura, y como fortaleza para una educación social; por último, se describe la experiencia de la aplicación de varios de esos talleres, según sus etapas de realización. Conclusiones: la expresión plástica se posiciona como fortaleza de la pedagogía social porque su aplicación en la reducación de menores con trastornos de la conducta significó un logro, ya que modificaron sus modos de actuación de forma positiva, según se constató en la experiencia descrita; además se demostró la necesidad de establecer un sistema articulado de trabajo educativo desde la escuela, como el que se presenta.

Introduction: social pedagogy is an opportunity to open thought and educational practices to alternative horizons and destinations for society. Objective: to describe an educational experience related to plastic expression as strength of social pedagogy in adolescents with behavior disorders. Methods: a bibliographic review was carried out on the content of the article in the SciELO, Google Scholar databases and in printed texts, from October 2021 to January 2022; the keywords were: social pedagogy, artistic education, plastic arts, behavior disorders. Twenty texts were selected: ten articles from foreign and Cuban magazines, two classic books on pedagogy, three normative documents, three doctoral theses and one master's theses, and the dictionary of Marti's thoughts compiled by Ramiro Valdés Galarraga. Results: aspects related to social pedagogy as a science, artistic education and its imprint on social pedagogy, plastic expression as an educational activity, plastic expression workshop: generator of education and culture, and as a strength for social education were analyzed. Based on participation and opportunities for all; and finally, the experience of the application of several of these workshops is described, according to their stages of implementation. Conclusions: the plastic expression is positioned as strength of social pedagogy because its application in the reduction of adolescents with behavior disorders meant an achievement, since they modified their modes of action in a positive way, as verified in the described experience; In addition, the need to establish an articulated system of educational work from the school, such as the one presented, was demonstrated.

Programa educativo para el control de factores de riesgo modificables asociados al embarazo en adolescentes / Educational program for the control of modifiable risk factors associated with pregnancy in adolescents

Fundamento: el embarazo en adolescentes es una preocupación a nivel mundial, sobre todo para las naciones en desarrollo. Objetivo: determinar la efectividad de un programa educativo para el control de factores de riesgo modificables asociados al embarazo en la adolescencia, en el Consultorio Médico 5 de Esperanza entre febrero 2020-febrero de 2022. Métodos: se realizó un estudio de intervención de tipo cuasi experimental sin grupo de control. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético, inductivo-deductivo y abstracto-concreto. Del nivel empírico; revisión documental y encuesta. Resultados: se constató un predominio significativo de pacientes en etapa tardía de la adolescencia, 54,2 % con nivel preuniversitario, 79,2 % con primeras relaciones sexuales, de 15 años (45,8 %) y el vínculo de parejas de concubinato (29,2 %), sin abortos (58 %), como causa de los abortos forzados las dificultades económicas (17 %), no presencia de antecedentes familiares (54,1 %), la no presencia de infecciones de trasmisión sexual (75 %). Se modificaron los factores: consumo de alcohol, función familiar y uso de anticonceptivos. Se produjeron cambios muy significativos en el nivel de información de forma positiva. Conclusiones: se verificó la efectividad del programa educativo para el control de factores de riesgo modificables asociados al embarazo en la adolescencia.

Background: early pregnancy in adolescents is a global concern, especially for developing nations. Objective: determine the effectiveness of an educational program to control modifiable risk factors associated with teenage pregnancy, at the Esperanza 5 Medical Office from February 2020 to February 2022. Methods: a quasi-experimental intervention study was carried out without a control group. Theoretical methods were used: historical-logical, analytical-synthetic, inductive-deductive and abstract-concrete. From the empirical level; documentary review and survey. Results: a significant predominance of patients in late adolescence was found, 54.2% with pre-university level, 79.2% with first sexual relations, 15 years of age (45.8%) and the bond of cohabiting couples ( 29.2%), without abortions (58%), as the cause of forced abortions: economic difficulties (17%), no family history (54.1%), no presence of sexually transmitted infections (75% ). The factors were modified: alcohol consumption, family function and contraceptive use. There were very significant changes in the level of information in a positive way. Conclusions: the effectiveness of the educational program for the control of modifiable risk factors associated with pregnancy in adolescence was verified.

Medicina Conductual: Una revisión histórica / Behavioral Medicine: A historical review

RESUMEN La medicina conductual es un campo interdisciplinario que involucra a las ciencias del comportamiento y ciencias biomédicas orientadas al estudio de la conducta, con el objetivo de prevenir y tratar enfermedades físicas, mejorando así la salud del ser humano. En el desarrollo del manuscrito, se precisa la evolución de los conceptos de salud y enfermedad a lo largo del siglo pasado. En este proceso, se mencionan los eventos que contribuyeron al surgimiento de la medicina conductual y posteriormente los que le sucedieron en sus primeros años de consolidación. Se describe y explica su actual desarrollo en entornos físicos y digitales, basados en evidencias, y el interés e importancia de cómo utilizar estas evidencias en la formulación de políticas de salud pública. El propósito de esta revisión es extender los principios y la práctica de la medicina conductual en la comunidad de habla hispana y resaltar la relevancia de esta disciplina en el campo de la salud pública.

SUMMARY Behavioral medicine is an interdisciplinary field that involves behavioral and biomedical sciences towards the study of behavior, with the aim of preventing and treating physical illnesses and improve the human being's health levels. The manuscript examines the evolution of the concepts of health and disease throughout the last century is indicated in principle. In this process, the events that contributed to the emergence of behavioral medicine and those that happened during its first years of consolidation, are mentioned. Its current development, substantiated in evidence-based physical and digital environments, and the interest in and relevance of how to translate this evidence in the formulation of public health policies, are also explained. The purpose of this review is to extend the principles and practice of behavioral medicine in the Spanish-speaking community, exposing the relevance of this discipline in the public health field.

Desarrollar la comunicación en familias de niños con trastornos por déficit de atención con hiperactividad / Develop communication in families of children with attention deficit hyperactivity disorder

RESUMEN Fundamento: el trastorno por déficit de atención con hiperactividad es un desorden del neurodesarrollo con mayor prevalencia durante la etapa escolar. La comunicación afectiva en el proceso de formación y desarrollo de la personalidad del educando constituye una necesidad. Este es un tema de interés multidisciplinario incluidos los sistemas de salud y educación. Objetivo: diseñar un sistema de talleres para promover la comunicación afectiva entre padres e hijos con trastorno por déficit de atención con hiperactividad. Métodos: se realizó un estudio descriptivo de corte transversal en la Escuela Primaria "José Martí" del municipio Ranchuelo, provincia Villa Clara, entre octubre 2018-septiembre 2019. Se emplearon métodos teóricos: histórico-lógico, analítico-sintético, inductivo-deductivo y sistémico-estructural; empíricos: análisis documental, cuestionario y entrevista. Resultados: según el diagnóstico realizado, las habilidades comunicativas con mayores dificultades fueron: falta de escucha, lenguaje inapropiado (gritos, ofensas) muestras de rechazo y no respetar el turno de palabra. Se detectó el compromiso de las familias con sus hijos sobre mantener una comunicación afectiva, por lo que se diseñó un sistema de talleres, dirigido a orientarlas sobre cómo lograr una comunicación afectiva en ese contexto. Conclusiones: el sistema de talleres se caracterizó por aportar elementos metodológicos y prácticos para educar y orientar a la familia; posee flexibilidad, creatividad y enfoque interdisciplinario. Fue valorado de forma satisfactoria por las especialistas quienes reconocieron su adecuada pertinencia social y pedagógica, estructura lógica, factibilidad, originalidad y valor científico-pedagógico.

ABSTRACT Background: attention deficit hyperactivity disorder is a neurodevelopmental disorder with higher prevalence during the school stage. Affective communication in the process of formation and development of the learner's personality is a necessity. This is a topic of multidisciplinary interest, including health and education systems. Objective: to design a system of workshops to promote affective communication between parents and children with attention deficit hyperactivity disorder. Methods: a descriptive cross-sectional study was carried out at the "José Martí" Elementary School in the Ranchuelo municipality, Villa Clara province, from October 2018 to September 2019. Theoretical methods were used: historical-logical, analytical-synthetic, inductive-deductive and systemic-structural; Empirical ones: documentary analysis, questionnaire and interview. Results: according to the diagnosis made, the communication skills with the greatest difficulties were: lack of listening, inappropriate language (yelling, insults), signs of rejection and not respecting the speaking turn. The commitment of families with their children to maintain affective communication was detected, so a system of workshops was designed, aimed at guiding them on how to achieve affective communication in this context. Conclusions: the workshop system was characterized by providing methodological and practical elements to educate and guide the family; it has flexibility, creativity and an interdisciplinary approach. It was satisfactorily assessed by the specialists who recognized its adequate social and pedagogical relevance, logical structure, feasibility, originality and scientific-pedagogical value.

Programa de intervención educativa a cuidadores primarios de infantes con déficit de atención e hiperactividad / Educational intervention program for primary caregivers of infants with attention deficit hyperactivity disorder

RESUMEN Fundamento: el trastorno por déficit de atención e hiperactividad se caracteriza por patrones persistentes de hiperactividad, impulsividad y desatención. Las relaciones entre los infantes y sus cuidadores primarios suelen marcarse por el conflicto, lo que repercute en la adaptación, afrontamiento y calidad de vida de sus cuidadores. Objetivo: evaluar los resultados de la implementación de un programa de intervención educativa en la adaptación, afrontamiento, calidad de vida y satisfacción de los cuidadores primarios de infantes con déficit de atención e hiperactividad. Métodos: se realizó un estudio mixto de tipo triangulación concomitante, prexperimental (cuantitativo) y fenomenológico (cualitativo), en el Policlínico Universitario "Chiqui Gómez-Lubián" de Santa Clara, de 2016 a 2020. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético, sistematización, inductivo-deductivo, abstracción y sistémico-estructural. Del nivel empírico: escalas autoadministrables y entrevista abierta. Resultados: se elevó la capacidad de afrontamiento y adaptación de cuidadores primarios, con predominio de mediana capacidad antes de la intervención y alta luego de la intervención. Los cuidadores primarios incrementaron su índice de calidad de vida de predominio de nivel medio a alto, lo que produjo cambios significativos con valores asintóticos inferiores a 0,5. Conclusiones: los resultados de la implementación del programa de intervención educativa a cuidadores primarios de infantes con déficit de atención e hiperactividad se avaluaron de favorables, ya que permitió la mejora de su adaptación, afrontamiento, calidad de vida y satisfacción.

ABSTRACT Background: attention deficit hyperactivity disorder is characterized by persistent patterns of hyperactivity, impulsivity and inattention. Relationships between infants and their primary caregivers are often marked by conflict, which affects the adaptation, coping and quality of life of their caregivers. Objective: to evaluate the results of the implementation of an educational intervention program on adaptation, coping, quality of life and satisfaction of primary caregivers of infants with attention deficit hyperactivity disorder. Methods: a mixed study of concomitant triangulation type, pre-experimental (quantitative) and phenomenological (qualitative), was carried out at the "Chiqui Gómez-Lubián" University Polyclinic in Santa Clara, from 2016 to 2020. Theoretical methods were used: historical-logical, analytical-synthetic, systematization, inductive-deductive, abstraction and systemic-structural. From the empirical level: self-administered scales and open interview. Results: the coping and adaptation capacity of primary caregivers increased, with a predominance of average capacity before the intervention and high capacity after the intervention. Primary caregivers increased their quality of life index from average to high prevalence, which produced significant changes with asymptotic values less than 0.5. Conclusions: the results of the implementation of the educational intervention program for primary caregivers of infants with attention deficit hyperactivity disorder were evaluated as favorable, since it allowed the improvement of their adaptation, coping, quality of life and satisfaction.

Aprendizaje significativo en Psicología desde la educación a distancia en el contexto de la COVID-19 / Meaningful learning in Psychology from distance learning in the context of COVID-19

RESUMEN Fundamento: la enfermedad COVID-19 provocó la necesidad de realizar una serie de modificaciones importantes en el proceso docente-educativo en la educación médica superior, principalmente en las condiciones de educación a distancia. Objetivo: evaluar el logro de un aprendizaje significativo a partir del trabajo extraclase diseñado por el colectivo de la asignatura Psicología de la Universidad de Ciencias Médicas de Guantánamo en el contexto de la COVID-19. Métodos: se realizó una investigación cuanticualitativa de corte pedagógico, en el período de marzo a septiembre de 2020. Se emplearon métodos teóricos: analítico-sintético, tránsito de lo abstracto a lo concreto e inductivo-deductivo; empíricos: criterio de usuarios, mediante encuesta aplicada a los profesores de la asignatura, análisis de contenidos expresados en los trabajos extraclases y la técnica de lluvia de ideas, así como métodos matemáticos estadísticos para los valores absolutos y relativos. Resultados: la lluvia de ideas propició que en la tarea docente se integraran contenidos esenciales de la asignatura bajo el empleo de los métodos problémico y trabajo independiente. Se aprovecharon las potencialidades de los entornos virtuales de aprendizaje. Por criterio de especialistas, los profesores evaluaron en las escalas de muy de acuerdo y de acuerdo los parámetros considerados para la valoración del trabajo extraclase diseñado. El análisis de contenido a las respuestas elaboradas por los estudiantes evidenció la consecución del aprendizaje significativo. Conclusiones: el trabajo extraclase que se diseñó tributó a la adquisición de un aprendizaje significativo de los contenidos de Psicología vinculados a la experiencia de los estudiantes de segundo año de Medicina en el trabajo comunitario integrado.

ABSTRACT Background: the COVID-19 disease caused the need to carry out a series of important modifications in the teaching-learning process in higher medical education, mainly in the conditions of distance learning. Objective: to evaluate the achievement of meaningful learning from the extra class work designed by the group of the Psychology subject of Guantánamo University of Medical Sciences in the context of COVID-19. Methods: a pedagogical research within the quantitative-qualitative approach was carried out in the period from March to September 2020. Theoretical methods were used: analytical-synthetic, transition from the abstract to the concrete and inductive-deductive; empirical ones: criteria of users, by means of a survey applied to the teachers of the subject, analysis of contents expressed in the extra-class work and the brainstorming technique, as well as statistical mathematical methods for the absolute and relative values. Results: brainstorming led to the integration of essential contents of the subject into the teaching task under the use of problem-solving methods and independent work. The potentialities of virtual learning environments were exploited. Using the criteria of specialists, the teachers evaluated the parameters considered for the evaluation of the extra-class work designed on the scales of strong agreement and agreement. The content analysis of the responses made by the students evidenced the achievement of meaningful learning. Conclusions: the extra-class work that was designed contributed to the acquisition of a meaningful learning of the contents of Psychology linked to the experience of second-year Medicine students in integrated community work.

Superación sobre atención a cuidadores de infantes con déficit de atención e hiperactividad en enfermería / Upgrading on care for caregivers of infants with attention deficit and hyperactivity disorder in nursing

RESUMEN Fundamento: el trastorno por déficit de atención e hiperactividad en infantes afecta la adaptación y bienestar de sus cuidadores primarios, lo cual reclama la superación de los profesionales de la enfermería para su atención. Objetivo: determinar la efectividad de un curso de superación, dirigido a profesionales de enfermería sobre la atención a cuidadores primarios de infantes con déficit de atención e hiperactividad. Métodos: se realizó un estudio prexperimental, en el Policlínico Universitario "Chiqui Gómez Lubián" del municipio Santa Clara, en Villa Clara, de 2018 a 2020. Se utilizaron métodos teóricos: histórico-lógico, analítico-sintético, sistematización, inductivo-deductivo y sistémico-estructural; empíricos: análisis documental, cuestionario y entrevista abierta; y matemáticos-estadísticos. Resultados: se diseñó y aplicó el curso de superación dirigido a profesionales de la Enfermería, sustentado en la integración de fundamentos teóricos a partir de la identificación de necesidades de aprendizaje, y conformado por siete temas con sus objetivos, temáticas, materiales y medios de enseñanza y sistema de evaluación, el cual fue aprobado por el consejo científico de la Universidad de Ciencias Médicas de Villa Clara. Conclusiones: el curso de superación implementado sobre la atención a cuidadores primarios de infantes con déficit de atención e hiperactividad se considera efectivo al producir cambios significativos en el nivel de conocimientos de los profesionales y la satisfacción expresada por ellos.

ABSTRACT Background: attention deficit and hyperactivity disorder in infants affects the adaptation and well-being of their primary caregivers, which demands the upgrading of nursing professionals for their care. Objective: to determine the effectiveness of an upgrading course, aimed at nursing professionals on the care of primary caregivers of infants with attention deficit and hyperactivity disorder. Methods: a pre-experimental study was carried out at the "Chiqui Gómez Lubián" University Polyclinic of the Santa Clara municipality, in Villa Clara, from 2018 to 2020. Theoretical methods were used: historical-logical, analytical-synthetic, systematization, inductive-deductive and systemic-structural; empirical ones: documentary analysis, questionnaire and open interview; and mathematical-statistics. Results: an upgrading course aimed at nursing professionals was designed and applied, based on the integration of theoretical foundations from the identification of learning needs, and made up of seven topics with their objectives, topics, materials and teaching aids and evaluation system, which was approved by the scientific council of Villa Clara University of Medical Sciences. Conclusions: the upgrading course implemented on the care of primary caregivers of infants with attention deficit and hyperactivity disorder is considered effective as it produces meaningful changes in the level of knowledge of the professionals and the satisfaction expressed by them.

Trial of Online Clinical Practice for Obstetrics and Gynecology Including Behavioral Medicine / 医学教育

In order to conduct online clinical practice under the COVID-19 pandemic, we attempted to introduce behavioral medicine education in obstetrics and gynecology clinical practice. Forty fifth-year medical students were given Case Based Learning using scenarios in a two-week rotational clinical practice. The scenarios were obstetrics and gynecology cases based on the themes from the “Behavioral Medicine” textbook. The curriculum consisted of discussions during practical training using Zoom and independent study outside of the training time. After the practical training, we received comments from students suggesting there was a change in their awareness, such as “Behavioral medicine was previously classroom knowledge, but now I am able to be aware of it in subsequent practical training.”

Fatores associados à sonolência diurna em estudantes de medicina / Factors associated with daytime sleepiness in medical students / Fatores asociados a somnolencia diurna em estudiantes de medicina

Objetivo: Avaliar os fatores associados à sonolência diurna em graduandos do curso de medicina do Norte de Minas. Método: estudo transversal, realizado com 231 acadêmicos que estavam frequentando o primeiro, sétimo e décimo-primeiro períodos de graduação em medicina. A sonolência diurna foi avaliada pela Escala de Sonolência Diurna de Epworth. Realizou-se a análise de regressão de Poisson para verificar os fatores associados à sonolência diurna. Resultados: níveis patológicos e muito patológicos de sonolência diurna foram observados, respectivamente, em 34,6% e 6,9% dos estudantes. A prevalência de sonolência diurna foi maior nos estudantes com Transtornos Mentais Comuns, Exaustão Emocional e Ineficácia Profissional, e menor naqueles que residem com os pais. Conclusão: a prevalência de sonolência diurna patológica nos estudantes mostrou-se elevada, e teve relação com transtornos mentais comuns, percepção de exaustão emocional e profissional, além do contexto com quem o estudante residia

Objective:To analyze the factors associated with daytime sleepiness in undergraduate medical students in the north of Minas Gerais. Method: a cross-sectional study was performed, involving 231 students from the first, seventh and eleventh medical undergraduate periods. Daytime sleepiness was assessed by the Epworth Daytime Sleepiness Scale. Poisson regression analysis was performed to verify the factors associated with daytime sleepiness. Results: pathological and very pathological levels of daytime sleepiness were observed, respectively, in 34.6% and 6.9% of the students. The prevalence of daytime sleepiness was higher in students who suffered Common Mental Disorders, Emotional Exhaustion and Professional Ineffectiveness, and lower among those who lived with their parents. Conclusion: the prevalence of pathological daytime sleepiness among the students was high, and was related to common mental disorders, perception of emotional and professional exhaustion, and the context with whom the student lived with

Objetivo: Evaluar los factores asociados con la somnolencia diurna en estudiantes universitarios de medicina del norte de Minas Gerais. Método: estudio transversal, realizado con 231 estudiantes que asistieron al primer, séptimo y undécimo período en medicina. La Escala de somnolencia diurna de Epworth evaluó la somnolencia diurna. Se realizó un análisis de regresión de Poisson para verificar los factores asociados con la somnolencia diurna. Resultados: se observaron niveles patológicos y muy patológicos de somnolencia diurna, respectivamente, en 34,6% y 6,9% de los estudiantes. La prevalencia de somnolencia diurna fue mayor en los estudiantes con trastornos mentales comunes, agotamiento emocional e ineficacia profesional, y menor en los estudiantes que viven con sus padres. Conclusión: la prevalencia de somnolencia patológica durante el día en los estudiantes fue alta y se relacionó con trastornos mentales comunes, percepción de agotamiento emocional y profesional y el contexto en el que residía el estudiante

Cross-cultural adaptation and validation of the Self-efficacy Scale to Brush Teeth at Night / Adaptação transcultural e validação da escala de autoeficácia para a escovação dentária noturna

Abstract This study aims to perform cross-cultural adaptation and validation of the "Self-efficacy scale to brush teeth at night" with a Brazilian adult population. Translation and cross-cultural adaptation to the Brazilian-Portuguese language were done according to the stages recommended in the literature. Construct validity was carried out by mean of exploratory and confirmatory factorial analysis in a sample of 198 adult subjects. The reliability of the instrument was measured by Alpha and Omega indices. The model was observed to have been established as one-dimensional for all indicators, with explained variance of 85.7%; factorial loads between 0.85 and 0.91; and with communalities between 0.72 and 0.83. The goodness of fit of the model shown by the confirmatory model were between 0.98 and 0.99; with factorial loads between 0.85 and 0.93, and regression values between 0.69 and 0.84, all above the minimum indices established for instrument quality. For reliability, the Alpha and Omega values had identical indices of 0.95 showing high levels of reliability of the model. The G-H index replicability was 0.96, indicating the stability of solution in other contexts and samples. We concluded that all indicators represented excellent evidence of scale validity to measure self-efficacy to brush teeth at night.

Resumo O objetivo deste estudo foi realizar a adaptação transcultural e validação da "Escala de Autoeficácia para escovação dentária noturna" em uma população de adultos brasileiros. A tradução e a adaptação transcultural para a língua portuguesa foram realizadas de acordo com padrões recomendados na literatura. A validade de construto foi realizada por meio de análises fatoriais exploratória e confirmatória em uma amostra de 198 adultos. A confiabilidade do instrumento foi aferida pelos índices Alpha e Ômega. O modelo foi observado como unidimensional para todos os indicadores, com variância explicada de 85,7%, cargas fatoriais entre 0,85 e 0,91 e comunalidades entre 0,72 e 0,83. Os índices de ajuste do modelo apresentados pela análise confirmatória estiveram entre 0,98 e 0,99, com cargas fatoriais entre 0,85 e 0,93 e valores de regressão entre 0,69 e 0,84, indicando a qualidade do instrumento. Para a confiabilidade do instrumento, os valores de Alpha e Ômega apresentaram índices idênticos de 0,95, mostrando altos níveis de confiabilidade do modelo. O índice de replicabilidade G-H foi de 0,96, indicando a estabilidade da solução em outros contextos e amostras. Concluímos que todos os indicadores representaram excelentes evidências de validade da "Escala de Autoeficácia para Escovação Dentária Noturna".

Intervención educativa en la comunidad para cuidadores de infantes con déficit de atención e hiperactividad / Educational intervention in the community for caregivers of children with attention deficit / hyperactivity disorder

RESUMEN Fundamento: el Trastorno por Déficit de Atención con Hiperactividad (TDAH) es una perturbación del desarrollo neurológico frecuente en edades pediátricas. Afecta el comportamiento infantil y las relaciones con sus cuidadores primarios. Objetivo: diseñar acciones de intervención educativa en la comunidad para cuidadores primarios de infantes con TDAH. Métodos: se realizó un estudio mixto de tipo triangulación concomitante, en el Policlínico Universitario "Chiqui Gómez Lubián" de Santa Clara, de 2016 a 2019. Se utilizaron métodos teóricos: analítico-sintético, sistematización, inductivo-deductivo, modelación y sistémico-estructural; empíricos: escalas autoadministrables, entrevista abierta y cuestionario a expertos. Resultados: se constató un predominio de mediana capacidad de afrontamiento y adaptación en los cuidadores primarios. Las dimensiones más afectadas de calidad de vida fueron las emociones y conductas, descanso y sueño, y la preparación recibida para brindar cuidados a su familiar. Se diseñó un programa de intervención educativa en la comunidad, basado en la integración del modelo de la adaptación de Callista Roy y el sistema de apoyo educativo de Dorothea Orem; estructurado en cinco temas, con medios de enseñanza conformados con la aplicación de tecnologías educativas. Conclusiones: el programa fue valorado como muy adecuado por los expertos por su contribución a la adaptación, afrontamiento, calidad de vida y satisfacción de cuidadores primarios de infantes con TDAH, en modos adaptativos, con un enfoque grupal, interdisciplinario y sistémico.

ABSTRACT Basis: Attention Deficit /Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that is common in pediatric age. It can affect children's behavior and relationships with their primary caregivers. Objective: to design educational intervention actions in the community for primary caregivers of infants with ADHD. Methods: a mixed method study was conducted at the "Chiqui Gómez Lubian" University Polyclinic in Santa Clara, from 2016 to 2019. Theoretical methods were used: analytical-synthetic, systematization, inductive-deductive, modeling and systemic-structural; empirical methods: self-administered scales, open interview and questionnaire for experts. Results: a predominance of medium coping and adaptation capacity in primary caregivers was noted. The most affected indicators of quality of life were emotions and behaviors, rest and sleep, and readiness to provide care for his/her family member. An educational intervention program, based on the integration of Callista Roy's adaptation model and Dorothea Orem's educational support system, was designed in the community ; it was organized under five themes, with learning resources developed by using educational technologies. Conclusions: the program was evaluated by experts as very appropriate for its contribution to adaptation, coping, quality of life and satisfaction of primary caregivers of children with ADHD, in adaptive modes, with a focus group and interdisciplinary and systemic approach.

Estrutura representacional da microcefalia e autoimagem de mães de crianças com tal condição neurológica / Representational structure of microcephaly and self-image from mothers of children with the neurological affliction

Objetivou-se no presente estudo analisar a estrutura representacional da microcefalia, bem como da autoimagem que mães de crianças com tal condição neurológica possuem. Participaram da pesquisa 105 brasileiras com idades entre 20 e 50 anos (M=31; DP=7,32), que moram, maioritariamente, na região Sudeste do Brasil (39,0%). Para recolha de dados, em 2018, foi utilizado a Técnica de Associação Livre de Palavras. Análises prototípicas do material coletado demonstraram que as participantes constroem suas representações sobre a microcefalia com base no conhecimento científico, a descrevendo, ainda, através de signos que se referem à espiritualidade e ao amor. No que diz respeito à autoimagem dos participantes, foi possível perceber elementos que remetem-se a resiliência, além de outros fatores associados a características auto-transcendentes. As representações identificadas revelam processos adaptativos, a partir da alocação de recursos resilientes que permitem com que as participantes deste estudo ressignifiquem sua condição de mães de crianças com microcefalia.

This study aimed to analyze the representational structure of microcephaly, as well as the self-image that mothers of children with the illness possess. There were 105 Brazilian women, aged between 20 and 50 (M=31; SD=7.32), who live, mostly, in the south-eastern region of Brazil (39.0%). For data acquisition, in 2018, it was used the Free Word Association Technique. Prototypical analyses of the collected material demonstrated that the participants build their representations upon microcephaly based on scientific knowledge, also describing it using signs that refer to spirituality and love. When it comes to the participants' self-image, it was possible to notice elements that support the feature resilience and other factors that are associated with self transcending characteristics. The identified representations reveal adaptive processes, based on the allocation of resilient resources that allow the participants from this study to give a different meaning of being a mother of a child with microcephaly.

Características y factores asociados a trastornos de la esfera mental en estudiantes de medicina de la costa, sierra y selva peruana / Characteristics and factors associated with disorders of the mental sphere in medical students of the coast, mountains and Peruvian jungle

Resumen Introducción: Los trastornos de la esfera mental son cada vez más frecuentes, estos deben ser medidos en los estudiantes que están sometidos a gran presión y según el lugar de influencia. Objetivos: Determinar las características y factores asociados a trastornos de la esfera mental en estudiantes de medicina de la costa, sierra y selva peruana. Metodología: Se realizó un estudio transversal analítico preliminar, a través de la aplicación del Inventario Clínico Multiaxial de Millon (MCMI-II), a 105 estudiantes, dicha encuesta midió los distintos trastornos de la esfera mental; a los cuales se les asoció con variables socio-educativas. Resultados: Grandes porcentajes de encuestados tuvieron compulsividad (29%) y narcisismo elevado (28%). En el análisis multivariado se encontró que las mujeres tuvieron menor frecuencia de trastorno esquizoide (p=0,027); conforme aumentó la edad también hubo mayor frecuencia de trastornos evitativo (p=0,049) y ansiedad (p= 0,043); a mayor año académico se encontró menor frecuencia de trastorno dilusional (p=0,010); los estudiantes de la universidad de la sierra tuvieron más narcisismo (p=0,011), compulsividad (p=0,018) y paranoide (p=0,041); los estudiantes de la universidad de la selva tuvieron más agresividad-sádica (p=0,021), narcisismo (p=0,020) y compulsividad (p=0,005); estas dos últimas fueron comparados versus los que estudiaban en la costa. Conclusión: Se encontró gran frecuencia de algunos trastornos, así como algunos factores asociados, lo que puede ser útil como análisis situacional, lo que debería generar mayores trabajos en la materia.

Introduction: The disorders of the mental sphere are increasingly frequent, these should be measured in students who are under great pressure and according to the place of influence. Objectives: To determine the characteristics and factors associated with disorders of the mental sphere in medical students of the coast, mountains and Peruvian jungle. Methodology: A preliminary analytical cross-sectional study was carried out, through the application of the Millon Multiaxial Clinical Inventory (MCMI-II), to 105 students, said survey measured the different disorders of the mental sphere; to which they were associated with socio-educational variables. Results: Large percentages of respondents had compulsivity (29%) and high narcissism (28%). In the multivariate analysis it was found that women had a lower frequency of schizoid disorder (p = 0.027); as age increased there was also a higher frequency of avoidance disorders (p = 0.049) and anxiety (p = 0.043); the higher the academic year, the lower the frequency of dilution disorder (p = 0.010); the students of the Universidad de la Sierra had more narcissism (p = 0.011), compulsivity (p = 0.018) and paranoid (p = 0.041); the students of the jungle university had more aggressive-sadistic (p = 0.021), narcissism (p = 0.020) and compulsivity (p = 0.005); These last two were compared versus those studying on the coast. Conclussion: We found a high frequency of some disorders, as well as some associated factors, which can be useful as a situational analysis, which should generate more work in the field.

Reconsideration on the multiple value of Behavior determining Health: in the perspective of the situation of COVID-19 / 中华行为医学与脑科学杂志

Why has the concept of behavior determining health created more and more extensive and far-reaching influence ever since it was put forward? The reason lies in its multiple values. It is of great practical significance and has important implications for long-term health care to explore and analyze in the perspective of the situation of COVID-19 its philosophical values, cultural values, methodological values, social values and the national strategic value of "healthy China".

Rasgos de Personalidad y Niveles de Resiliencia en personas con quemaduras Unidad de Quemados de Hospital de Especialidades Carlos Andrade Marín / Personality Traits and Resilience Levels in people with burns Carlos Andrade Marín Specialty Hospital Burns Unit

INTRODUCCIÓN. Las quemaduras son lesiones traumáticas causadas por agentes térmicos, eléctricos, químicos o radiactivos con un largo y doloroso tratamiento donde los rasgos de personalidad y niveles de resiliencia forman parte importante de su rehabilitación. OBJETIVO. Analizar los rasgos de personalidad y niveles de resiliencia en pacientes con quemaduras de segundo y tercer grado, hospitalizados y de consulta externa en la Unidad de Quemados del Hospital de Especialidades Carlos Andrade Marín. MATERIALES Y MÉTODOS. Se realizó un estudio observacional, descriptivo, El universo fue: de 120 personas y una muestra de 20 pacientes con criterios de inclusión y exclusión, de la Unidad de Quemados del Hospital de Especialidades Carlos Andrade Marín, en el periodo Julio - Septiembre de 2018, los datos se obtuvieron durante los tres meses de investigación, a los pacientes se les aplicó una encuesta sociodemográfica, el Cuestionario de los Cinco Grandes Rasgos de la Personalidad y la Escala de Resiliencia de Wagnild y Young. Se aplicó el Método Clínico, el Método Estadístico y el Método Psicométrico, se analizó los datos con Microsoft Office Excel 2010. RESULTADOS. El factor de personalidad más puntuado correspondió a Tesón o Constancia con sub dimensiones de Escrupulosidad y Perseverancia y en cuanto a la resiliencia se presentó una escala alta siendo el factor más puntuado de confianza en sí mismo. CONCLUSIÓN. El rasgo de personalidad más representativo fue de Tesón o Constancia lo que reveló la capacidad del paciente para la atención y meticulosidad frente a diversos factores que son primordiales para la adaptación y continuidad del tratamiento hospitalario y de consulta externa; los niveles de resiliencia en la población estudiada son elevados, el factor más puntuado correspondió a confianza en sí mismo como habilidad para creer en las propias capacidades y enfrentarse a sucesos de alto estrés, superar condiciones adversas y salir fortalecido o transformado del proceso hospitalario.

INTRODUCTION. Burns are traumatic injuries caused by thermal, electrical, chemical or radioactive agents with a long and painful treatment where personality traits and resilience levels are an important part of their rehabilitation. OBJECTIVE. Analyze personality traits and levels of resilience in patients with second and third degree burns, hospitalized and outpatient at the Burns Unit of the Carlos Andrade Marín Specialty Hospital. MATERIALS AND METHODS. An observational, descriptive study was carried out. The universe was: 120 people and a sample of 20 patients with inclusion and exclusion criteria, from the Burns Unit of the Carlos Andrade Marín Specialties Hospital, in the period July - September 2018, the data were obtained during the three months of investigation, a sociodemographic survey was applied to the patients, the Questionnaire of the Five Great Personality Traits and the Wagnild and Young Resilience Scale. The Clinical Method, the Statistical Method and the Psychometric Method were applied, the data was analyzed with Microsoft Office Excel 2010. RESULTS. The most punctuated personality factor corresponds to Tesón or Constancia with sub-dimensions of Scrupulosity and Perseverance and in terms of resilience a high scale is presented, being the highest scoring factor in self-confidence. CONCLUSION. The most representative personality trait was Tesón or Constancia, which reveals the patient's capacity for attention and meticulousness in the face of various factors that are essential for the adaptation and continuity of hospital treatment and outpatient treatment; Resilience levels in the studied population are high, the most scoring factor corresponds to self-confidence as an ability to believe in one's own abilities and face high stress events, overcome adverse conditions and emerge strengthened or transformed from the hospital process.

Influence of retirement on health conditions and quality of life / Influência da aposentadoria nas condições de saúde e qualidade de vida

Introduction: Life expectancy is an important variable for retirement planning. The pension system and the importance of this period have lately been the focus of studies in Brazil. Objective: To evaluate the health conditions and quality of life (QoL) of retirees. Methods: Data collection was performed using the 36-item Short-Form Survey (SF-36), the Brazilian Economic Classification Criteria and a structured questionnaire. We verified the absence of normal data through the Shapiro-Wilk test, and then applied the Mann-Whitney U test in order to compare the groups (retirees who worked and those who did not). The significance level for the statistical tests was 5%. Results: Among the 205 retirees, we observed that the most prevalent diseases were hypertension (50.3%) and depression (37.0%). In addition, retirees who continued working after retirement had better health conditions and QoL. Conclusion: It is suggested that retirement planning may be an important alternative to minimize the development of psychosocial diseases and their aggravating factors.

Introdução: A expectativa de vida é uma variável essencial para o planejamento previdenciário. O sistema previdenciário e a importância desse período têm sido, ultimamente, foco de estudos no Brasil. Objetivo: Avaliar as condições de saúde e qualidade de vida (QV) dos aposentados. Métodos: Para a coleta de dados, aplicou-se o Questionário Genérico de Qualidade de Vida (SF-36), o questionário de Classificação Social Brasileira e um questionário estruturado. A partir do teste de Shapiro-Wilk, verificou-se a ausência de normalidade dos dados. Usou-se o teste U de Mann-Whitney para comparar os grupos (aposentados que trabalhavam e os que não trabalhavam), considerou-se nível de significância de p <0,05 para todas as análises. Resultados: Nos 205 aposentados, as doenças mais prevalentes foram hipertensão (50,3%) e depressão (37,0%). Além disso, os aposentados que trabalhavam após a aposentadoria apresentaram melhores condições de saúde e QV. Conclusão: Sugere-se que o planejamento da aposentadoria é uma importante alternativa para minimizar o desenvolvimento de doenças psicossociais e seus agravantes.

Current status of the research on psychosocial factors in patients with nonalcoholic fatty liver disease / 临床肝胆病杂志

Unhealthy dietary habits and a sedentary lifestyle have led to a significant increase in the prevalence rate of non-alcoholic fatty liver disease (NAFLD) in children, adolescents, and adults. In recent years, the biological-psychological-social medical pattern has attracted more and more attention, and internal psychosocial factors have become an important influencing factor for disease progression, treatment, and prognosis. Studies have shown that patients with NAFLD may experience psychosocial disorders, and this article summarizes the common psychosocial problems of these patients.

Behavioral medicine contributes to " Healthy China" / 中华行为医学与脑科学杂志

Health is the essential requirement of promoting the all-round development of human beings and the basic prerequisite of economic and social development. With the acceleration of industrialization, urbanization and population aging, the production mode and lifestyle, and disease spectrum of residents are constantly changing.Improper lifestyle and unhealthy behavior are closely related to residents' health. The development of behavioral medicine has played an important role in promoting the establishment of health living habits and healthy behavioral patterns of the people and improving the health level of the people, and will contribute to the construction of " Healthy China" through practical actions.