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.

Dr. Serafín Ruiz de Zárate Ruiz: aportes al ideal médico social desde su gestión ministerial / MD. Serafín Ruiz de Zárate Ruiz: contributions to the social medical ideal from his ministerial management

Fundamento: los años 1959 y 1960 fueron decisivos en las proyecciones y concreción del ideal médico social, como proceso iniciado, a establecerse en Cuba. Objetivo: identificar los aportes más relevantes del Dr. Serafín Ruiz de Zárate Ruiz, en su gestión como ministro de salud pública a la conformación del ideal médico social cubano en la década del sesenta del siglo XX. Métodos: se realizó una investigación documental de corte histórico en el año 2022. Se aplicaron métodos teóricos que permitieron analizar el objetivo de estudio, basado en la interacción de lo histórico y lo lógico y desde las dimensiones temporal y espacial; y empíricos: análisis de contenido y la consulta bibliográfica para procesar en conjunto el producto resultante, se empleó la triangulación para mejorar la validez y confiabilidad de los datos obtenidos. Resultados: la designación y actuación del Dr. Ruiz de Zárate frente al Ministerio de Salud Pública sentó las bases y logró avanzar, bajo una aguda lucha de clases, en el camino de modificar las condiciones higiénico-sanitarias de la población, posible solo por los cambios de concepciones médicas de lo asistencial curativo a lo social. Conclusiones: el Dr. Ruiz de Zárate en su gestión como ministro hizo relevantes aportes a la conformación del ideal médico social. Diversas y amplias fueron las acciones encaminadas para materializarlo, expresadas concretamente en políticas, leyes, planes, medidas, entre otras, que fueron superadas y fortalecidas con el mismo objetivo por el Dr. José Ramón Machado Ventura.

Background: the years 1959 and 1960 were decisive in the projections and concretion of the social medical ideal, as an initiated process, to be established in Cuba. Objective: to identify the most relevant contributions of MD. Serafín Ruiz de Zárate Ruiz, as Minister of Public Health, to the conformation of the Cuban social medical ideal in the sixties of the 20th century. Methods: a historical documentary research was carried out in the year 2022. Theoretical methods were applied that allowed us to analyze the objective of the study, based on the interaction of the historical and the logical and from the temporal and spatial dimensions; and empirical ones: content analysis and bibliographic consultation to jointly process the resulting product, sources contrasting was used to improve the validity and reliability of the data obtained. Results: the appointment and action of MD. Ruiz de Zárate in front of the Ministry of Public Health laid the foundations and managed to advance, under an acute class struggle, in the path of modifying the hygienic-sanitary conditions of the population, possible only because of the Changes in medical conceptions from curative care to social. Conclusions: MD. Ruiz de Zárate as minister of public health made relevant contributions to the conformation of the social medical ideal. Diverse and extensive were the actions aimed at materializing it, specifically expressed in policies, laws, plans, measures, among others, which were overcome and strengthened with the same objective by MD. José Ramón Machado Ventura.

Nivel de conocimientos sobre bioseguridad en estudiantes de Enfermería durante la pesquisa de COVID-19 / Level of knowledge about biosafety in Nursing students during the COVID-19 screening

Fundamento: la bioseguridad es considerada como una norma preventiva universal para reducir factores de riesgo, está orientada en el ámbito de la salud al fomento de la seguridad, y la protección de profesionales y estudiantes en contextos de riesgo. Objetivo: valorar el nivel de conocimientos en estudiantes de Enfermería sobre las medidas de bioseguridad durante la pesquisa de COVID-19. Métodos: se realizó un estudio descriptivo de corte transversal en el período comprendido de febrero a octubre 2021, en Camagüey, Cuba. Se aplicaron métodos teóricos para la fundamentación de la investigación, y empíricos: la observación participante y encuesta confeccionada por los autores. Se establecieron como variables: área de salud, cifra de estudiantes contagiados, posibles causas de contagio y nivel de conocimientos sobre bioseguridad. Resultados: hubo mayor representación de estudiantes del municipio Santa Cruz (15 %). El área de salud con más contagios fue Previsora con un 6,25 %. Las posibles causas de contagio identificadas se refieren a la conducta higiénico-sanitaria durante la pesquisa: dificultades en el uso de la mascarilla, la distancia física entre estudiantes y con la población objeto de pesquisa, y uso de desinfectante 91,25 %, 87,50 % y 82,50 % respectivamente. Conclusiones: se valoró que el nivel de conocimientos en estudiantes de Enfermería sobre las medidas de bioseguridad durante la pesquisa de COVID-19 fue bajo, a pesar de haber recibido un curso de capacitación previo a la actividad, y su presencia en los programas de estudio.

Background: biosafety is considered a universal preventive norm to reduce risk factors, it is oriented in the field of health to promote safety, and the protection of professionals and students in risk contexts. Objective: to assess the level of knowledge in Nursing students about biosafety measures during COVID-19 screening. Methods: a descriptive cross-sectional study was carried out in the period from February to October 2021, in Camagüey, Cuba. Theoretical methods were applied for the foundation of the research, and empirical ones: participant observation and survey made by the authors. The following variables were established: health area, number of infected students, possible causes of infection, and level of knowledge about biosafety. Results: there was a greater representation of students from the Santa Cruz municipality (15%). The health area with the most infections was Previsora ​​with 6.25%. The possible causes of contagion identified refer to hygienic-sanitary behavior during the investigation: difficulties in the use of the mask, the physical distance between students and with the population under investigation, and the use of disinfectant 91.25%, 87, 50% and 82.50% respectively. Conclusions: it was assessed that the level of knowledge in Nursing students about biosafety measures during the COVID-19 screening was low, despite having received a training course prior to the activity, and their presence in the study programs.

Competencias profesionales del Equipo Básico de Salud en prevención de violencia intrafamiliar / Professional competencies of the Basic Health Team in the prevention of intra-family violence

Fundamento: la violencia intrafamiliar representa un problema de salud y los profesionales de estas ciencias deben reconocer su existencia y estar debidamente preparados para prevenirla. Objetivo: identificar el nivel de competencia de los equipos básicos de salud en el manejo contra la violencia intrafamiliar en la edad pediátrica desde la atención primaria de salud. Métodos: se realizó un estudio descriptivo transversal en el Policlínico Universitario "Mártires del 10 de Abril", municipio Corralillo de enero a abril de 2021. Se utilizaron métodos teóricos y empíricos; para recogida de información se empleó el análisis de documentos y examen de competencia a profesionales de salud. Las variables en estudio fueron: categoría ocupacional, años de graduado, dimensiones cognitivas, procedimentales y actitudinales; y competencias profesionales en la prevención contra la violencia intrafamiliar. Resultados: El 52,94 % de los profesionales encuestados tenía más de 5 años de graduados, hubo predominio de residentes de MGI y licenciados en enfermería, respectivamente 44,12 % y 35,29 %. Las dimensiones de competencias en prevención contra la violencia intrafamiliar fueron evaluadas de medianamente adecuadas: la cognitiva en 18 (52,94 %), la procedimental en 21 (61,76 %) y la actitudinal en 24 (70,59 %). Conclusiones: el nivel de desarrollo de competencias profesionales resultó ser medianamente adecuado, como promedio. El diagnóstico realizado evidenció la necesidad de desarrollar competencias profesionales para la prevención contra la violencia intrafamiliar en edad pediátrica.

Background: intra-family violence represents a health problem and professionals in these sciences must recognize its existence and be properly prepared to prevent it. Objective: to identify the level of competence of the basic health team in the management of intra-family violence in the pediatric age. Methods: a cross-sectional descriptive study was carried out at the "Mártires del 10 de Abril" University Polyclinic, Corralillo municipality from January to April 2021. Theoretical and empirical methods were used; For the collection of information, the analysis of documents and the examination of the competence of health professionals were used. The variables under study were: occupational category, years of graduation, cognitive, procedural and attitudinal dimensions; and professional skills in the prevention of intra-family violence. Results: 52.94% of the surveyed professionals had more than 5 years working experience, there was a predominance of comprehensive General Medicine residents and nursing graduates, respectively 44.12% and 35.29%. The dimensions of competencies in intra-family violence prevention were evaluated as moderately adequate: cognitive in 18 (52.94%), procedural in 21 (61.76%), and attitudinal in 24 (70.59%). Conclusions: the level of development of professional skills turned out to be moderately adequate, on average. The diagnosis made showed the need to develop professional skills for the prevention of intra-family violence in children.

Concepción de la labor educativa desde el consultorio médico en el enfrentamiento a la COVID-19 / Conception of educational work from the doctor´s office while facing COVID-19

Fundamento: es necesario profundizar en los contenidos, formas y métodos de la labor educativa desde el consultorio médico de familia con los estudiantes de las ciencias médicas. Objetivo: caracterizar la concepción de la labor educativa asumida desde el consultorio médico de familia en el enfrentamiento a la COVID-19. Métodos: se realizó una investigación acción participativa, de corte transversal, en el período de marzo de 2020 a septiembre del 2021. El trabajo de campo se hizo con estudiantes de las carreras de Medicina, Enfermería y Estomatología, vinculados a los consultorios 17-17 y 17-37 pertenecientes al policlínico universitario "Chiqui Gómez-Lubián. Los métodos teóricos empleados fueron: analítico-sintético, inductivo-deductivo, histórico-lógico y enfoque de sistema; empíricos: análisis de documentos, observación de tipo participante, entrevista en profundidad y semiestructurada y análisis del producto de la actividad. Resultados: la concepción de la labor educativa empleada facilitó el trabajo de enfrentamiento a la pandemia de la COVID-19 desde el consultorio médico, la formación integral de los estudiantes y contribuyó al trabajo comunitario integrado. Conclusiones: el enfrentamiento a la COVID-19 permitió desplegar un sistema de acciones en la formación de los estudiantes que permitieron conformar una concepción acerca de la labor educativa desde el consultorio médico de familia.

Background: it is necessary to deepen the contents, forms and methods of the educational work from the family doctor's office with the students of medical sciences. Objective: to characterize the conception of the educational work assumed from the family doctor's office while facing COVID-19. Methods: a participatory, cross-sectional action research was carried out from March 2020 to September 2021. The field work was carried out with students from the Medicine, Nursing and Dentistry degrees, linked to clinics 17-17 and 17-37 belonging to the "Chiqui Gómez-Lubián" university polyclinic. Theoretical methods used were: analytical-synthetic, inductive-deductive, historical-logical and system approach; Empirical ones: document analysis, participatory observation and semi-structured interview and analysis of the product of the activity. Results: the conception of the educational work used facilitated the work to face COVID-19 pandemic from the doctor's office, the comprehensive training of students and contributed to integrated community work. Conclusions: the confrontation with COVID-19 allowed us to deploy a system of actions in the training of students that allowed us to form a conception about the educational work from the family doctor's office.

Ambiente escolar: una necesidad de aprendizaje por el médico de familia / School environment: a learning need for the family doctor

El Ministerio de Salud Pública cubano tiene orientada la realización de los controles médicos a los estudiantes y trabajadores que en su centro no cuentan con equipo básico de salud, en el consultorio médico de la comunidad. En el presente artículo los autores se proponen compartir con la comunidad científica los basamentos teóricos concernientes al proceso de superación, el cual responde a las necesidades de aprendizaje y constituye una vía primordial para que, gradualmente, los médicos de familia coadyuven a la solución de las insuficiencias académicas en determinados temas relacionados con el ambiente escolar y favorezcan el bienestar social desde su desempeño profesional y humano.

The Cuban Ministry of Public Health is oriented to carry out medical controls for students and workers who do not have basic health equipment in their center, in the community doctor's office. In this article the authors intend to share with the scientific community the theoretical foundations concerning the improvement process, which responds to the learning needs and constitutes a primary way for Gps to gradually contribute to the solution of the academic insufficiencies in certain topics related to the school environment and favor social well-being from their professional and human performance.

Programa educativo sobre cáncer de mama para mujeres del Consultorio Médico 028-2. Manicaragua / Educational program on breast cancer for women of the Doctor´s Office 028-2. Manicaragua, Cuba

Fundamento: el cáncer de mama representa un problema sanitario mundial por su alta incidencia; en la actualidad este es el de tipo de cáncer más frecuente en las mujeres. Objetivo: desarrollar un programa educativo sobre el cáncer de mama dirigido a las mujeres del Consultorio Médico 028-2, del Policlínico Docente "50 Aniversario", en Manicaragua. Métodos: se desarrolló un estudio prexperimental de intervención educativa evaluado por especialistas, en el Consultorio Médico 028-2, del Policlínico Docente "50 Aniversario" del municipio Manicaragua, entre enero 2021-enero 2022. Se utilizaron métodos teóricos: análisis-síntesis, inductivo-deductivo e histórico-lógico; empírico: análisis documental, encuesta y matemático-estadísticos para el análisis de los datos investigados. Resultados: predominaron las edades de 45 a 54 años, la mayoría no tenían antecedentes patológicos personales y sus conocimientos sobre cómo prevenir la enfermedad eran insuficientes, por lo que se diseñó un programa educativo, el cual fue valorado por criterios de especialistas. Conclusiones: después de ser valorado como adecuado, fue aplicado con muy buenos resultados entre las féminas; este programa se alerta sobre la necesidad de intensificar la labor educativa del médico y demás personal involucrado en la atención a las mujeres para que desarrollen conciencia sobre la importancia de la detección temprana de esta neoplasia.

Background: breast cancer represents a global health problem due to its high incidence; at present this is the most frequent type of cancer in women. Objective: to develop an educational program on breast cancer aimed at the women of the Doctor´Office 028-2, of the "50th Anniversary" Teaching Polyclinic, in Manicaragua. Methods: a pre-experimental study of educational intervention was developed, evaluated by specialists, in the Medical Office 028-2, of the "50 Aniversario" Teaching Polyclinic of the Manicaragua municipality, from January 2021 to January 2022. Theoretical methods were used: analysis-synthesis, inductive -deductive and historical-logical; Empirical ones: documentary, survey and mathematical-statistical for the analysis of the investigated data. Results: the ages of 45 to 54 years predominated, the majority had no past medical history and their knowledge on how to prevent the disease was insufficient, for which an educational program was designed, which was assessed by specialist criteria. Conclusions: after being evaluated as adequate, it was applied with very good results among the females; the need to intensify the educational work of the physician and other personnel involved in caring for women is alerted so that they develop awareness of the importance of early detection of this neoplasm.

Programa educativo para prevenir la leptospirosis en una zona rural de Jibacoa, Manicaragua, Cuba / Educational program to prevent leptospirosis in a rural area of Jibacoa, Manicaragua, Cuba

Fundamento: la leptospirosis es una zoonosis de distribución mundial que puede presentarse en zonas urbanas y rurales cuyo evidente resurgimiento se ilustra en los brotes recientes en todos los continentes. Objetivo: desarrollar un programa educativo sobre la leptospirosis en el Consultorio Médico 036-11, del poblado de Jibacoa, Manicaragua. Métodos: se desarrolló un estudio prexperimental de intervención educativa aprobado por especialistas, en el Consultorio Médico 036-11, de Jibacoa, Manicaragua entre marzo 2020-marzo 2022. Se utilizaron métodos teóricos: análisis-síntesis, inductivo-deductivo e histórico-lógico; empírico: análisis documental y cuestionario; y matemático-estadísticos para el análisis de los datos encontrados. Resultados: en el diagnóstico realizado predominaron los trabajadores del sexo masculino, la mayoría de ellos con riesgos para contraer la leptospirosis, la presencia de animales domésticos y roedores, e inadecuados conocimientos sobre la enfermedad. El análisis de situación de salud permitió caracterizar la comunidad rural con condiciones favorables para la proliferación de las leptospiras, por lo que se diseñó un programa educativo para capacitar a los habitantes del lugar sobre el tema, el cual valorado por criterios de especialistas. Conclusiones: después de valorado como adecuado se aplicó y demostró su efectividad al modificar positivamente los conocimientos de los habitantes en riesgo dentro de esa comunidad rural.

Background: leptospirosis is a zoonosis with worldwide distribution that can occur in urban and rural areas whose evident resurgence is illustrated in recent outbreaks on all continents. Objective: to develop an educational program on leptospirosis in the Doctor´s Office 036-11, in the town of Jibacoa, Manicaragua. Methods: a pre-experimental study of educational intervention approved by specialists was carried out at Doctor´s Office 036-11, in Jibacoa, Manicaragua from March 2020 to March 2022. Theoretical methods were used: analysis-synthesis, inductive-deductive and historical-logical; empirical: documentary analysis and questionnaire; and mathematical-statistical for the analysis of the data found. Results: male workers predominated in the diagnosis, most of them at risk of contracting leptospirosis, the presence of domestic animals and rodents, and inadequate knowledge about the disease. The analysis of the health situation allowed to characterize the rural community with favorable conditions for the proliferation of leptospirosis, for which an educational program was designed to train the inhabitants of the place on the subject, which was valued by specialist criteria. Conclusions: after being assessed as adequate, it was applied and demonstrated its effectiveness by positively modifying the knowledge of the inhabitants at risk within that rural community.

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.

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.

Superación del médico general para la atención integral a niños con necesidades educativas especiales / Knowledge improvement of the general practitioner for comprehensive care for children with special educational needs

Fundamento: la superación especializada del médico general integral debe de estar encaminada a elevar su nivel profesional en la atención primaria de salud, particularizando en las características individuales de cada paciente. Objetivo: diagnosticar el estado actual de preparación de los médicos generales de la atención primaria de salud en cuanto al conocimiento para brindar atención integral y especializada a los niños con necesidades educativas especiales, pertenecientes al Policlínico Universitario "Ignacio Agramonte", de Camagüey. Métodos: se realizó un estudio descriptivo transversal entre los meses septiembre-diciembre de 2021. Se aplicaron métodos teóricos: histórico-lógico, análisis-síntesis e inducción-deducción; y empíricos, revisión documental y cuestionario a los médicos que laboran en los consultorios médicos del área. Resultados: el diagnóstico realizado permitió identificar falencias en la formación profesional del médico general desde su programa de formación en la especialidad Medicina General Integral, las que dificultan el trabajo exitoso en cuanto a la atención integral a niños con necesidades especiales, en aras de promover su inclusión social y el beneficio de su desarrollo individual. Conclusiones: las deficiencias encontradas ratifican la necesidad de implementar una estrategia de superación en cuanto al tema para perfeccionar el distintivo trabajo comunitario del médico general integral.

Background: the specialized improvement of the comprehensive general practitioner must be aimed at raising their professional level in primary health care, particularizing the individual characteristics of each patient. Objective: to diagnose the current state of preparation of general practitioners in primary health care in terms of knowledge to provide comprehensive and specialized care to children with special educational needs, belonging to the "Ignacio Agramonte" University Polyclinic in Camagüey. Methods: a cross-sectional descriptive study was carried out between from September to December 2021. Theoretical methods were applied: historical-logical, analysis-synthesis and induction-deduction; and empirical ones, documentary review and questionnaire to the doctors who work in the doctor´s offices of the area. Results: the diagnosis made possible to identify shortcomings in the professional training of the general practitioner from his training program in the Comprehensive General Medicine specialty, which hinder successful work in terms of comprehensive care for children with special needs, in order to promote their social inclusion and the benefit of their individual development. Conclusions: the deficiencies found ratify the need to implement an improvement strategy regarding the subject to improve the distinctive community work of the comprehensive general practitioner.

A survey of public perception, knowledge and factors influencing COVID-19 vaccine acceptability in five communities in Ghana

Objective: The present study assessed the public's perception and Knowledge about COVID-19 and factors that could affect vaccine acceptability in Ghana. Design: We carried out a cross-sectional population-based study. A structured questionnaire was used to capture data on socio-demographic information, knowledge, and the public's perception of COVID-19 infection, as well as COVID-19 vaccine acceptability from consented participants. Factors affecting vaccine acceptability in Ghana were explored. Robust ordinary least square linear regression analysis was adopted to assess factors associated with vaccine acceptability. Setting: Five communities (Labone, Lartebiorkoshie, Old Fadama, Chorkor, and Ashiyie) in Accra in the Greater Accra district were selected. Participants: WHO modified cluster-sampling method was applied to select households of 997 participants in the five communities. Results: Most respondents were males (57.6%), and the median age of participants was 30 years. The study participants demonstrated a good knowledge of COVID-19 and had high perceptions of the COVID-19 pandemic. The results revealed that the highest educational level, marital status, self-rated Knowledge of COVID-19, Knowledge of COVID-19 definition, Knowledge of COVID-19 symptoms, and perception of the COVID-19 pandemic were significantly associated with vaccine acceptability. Self-reported impact of COVID-19 lockdown/movement restrictions on agriculture and job as a source of livelihood was associated with vaccine acceptability. Conclusion: Higher subjective and objective knowledge of COVID-19 increases vaccine acceptability scores significantly thus, education on COVID-19 and the vaccination against SARS-CoV-2 infection must be intensified to improve vaccine acceptability in Ghana, especially among those with lower educational backgrounds

Estágio de internato médico em medicina da família e comunidade no programa mais médicos: relato de experiência / Internship in family and community medicine within the more doctors program: experience report / Internado en medicina familiar y comunitaria dentro del programa más médicos: relato de experiencia

Um dos objetivos do Programa Mais Médicos (PMM) é proporcionar o provimento de médicos para o atendimento da população usuária do Sistema Único de Saúde (SUS) por meio do aumento da quantidade de vagas para a graduação em medicina, associado ao aumento da carga horária do graduando e atividades relacionadas ao ensino na comunidade. Este trabalho tem por objetivo descrever a experiência de estágio de estudantes de medicina nas unidades de saúde que atuam com estratégia de saúde da família (ESF) nas quais atuam médicos do PMM. Foram avaliados dados qualitativos referentes a aspectos objetivos e subjetivos envolvendo dimensões didáticas, cognitivas, comportamentais e assistenciais vivenciadas na relação estudante-médico-comunidade. Os estagiários não apresentaram dificuldade significativa quanto à adaptação ao modelo assistencial do PMM, relacionando-se de maneira harmoniosa com a equipe da unidade e com a comunidade atendida, alcançando, assim, os objetivos didáticos e formativos esperados. Nossa experiência do estágio de internato médico dentro do Programa Mais Médicos tem se mostrado exitosa.

One main objective of the More Doctors Program (PMM) is to supply physicians to serve the Brazilian Unified Health System (SUS) user population by increasing the number of vacancies for medical courses, associated with an increased course load and activities in the community. Given this context, this experience report focuses on internships developed in Family Health Strategy (ESF) units, served by PMM physicians. Data on objective and subjective aspects involving didactic, cognitive, behavioral and care dimensions experienced in the student ­ doctor ­ community relationship were qualitatively evaluated. The interns presented no significant difficulties in adapting to the PMM care model, establishing a harmonious relationship with the unit's team and the community served, thus achieving the expected didactic and training objectives. In conclusion, the medical internship within the More Doctors Program has been successful.

Uno de los objetivos del Programa Más Médicos (PMM) es proporcionar la provisión de médicos para la atención de la población usuaria del Sistema Único de Salud (SUS) mediante el aumento del número de vacantes para cursos de graduación en medicina, asociado al aumento de la carga de trabajo del estudiante en actividades relacionadas a la enseñanza en la comunidad. Este estudio tiene como objetivo describir la experiencia de la pasantía de estudiantes de medicina en una unidad de salud que actúan con estrategia de salud familiar (ESF), atendida por un médico del PMM. Los datos fueron evaluados cualitativamente, referidos a aspectos objetivos y subjetivos que involucran dimensiones didácticas, cognitivas, conductuales y asistenciales vivenciadas en la relación estudiante-médico-comunidad. Los internos no tuvieron dificultades significativas para adaptarse al modelo de atención del PMM, presentando una relación armoniosa con el equipo de la unidad y con la comunidad atendida, y logrando los objetivos didácticos y formativos esperados. Nuestra experiencia de la pasantía en el internado médico dentro del programa más médicos ha sido exitosa.

Avaliação do internato médico rural em Medicina de Família e Comunidade da Universidade de Caxias do Sul: reflexões para a educação médica e políticas de saúde / Evaluation of the rural medical internship in Family and Community Medicine at the Universidade de Caxias do Sul: reflections on medical education and health policies

A educação médica passou por transformações constantes ao longo da História e no Brasil assume características específicas. Recentemente, entre outros aspectos, têm-se debatido sobre a importância da variedade de cenários de ensino e de uma abordagem integral e generalista para o desenho de um perfil de egresso mais próximo às necessidades de saúde da população. Este estudo apresenta uma avaliação qualitativa e quantitativa da experiência de acadêmicos de Medicina, professores e profissionais de saúde envolvidos no internato médico rural em Medicina de Família e Comunidade da Universidade de Caxias do Sul, estado do Rio Grande do Sul, Brasil. Perfis dos participantes, motivadores de estágio, influências sobre opções de trabalho futuro, impacto nas equipes de saúde e aspectos positivos e negativos da experiência são apresentados e discutidos à luz da literatura internacional no tema. O internato rural aparece como uma experiência positiva na formação médica, com potencial agregador qualitativo para os envolvidos e influência na opção futura de trabalho, ajudando a reduzir a defasagem de recursos humanos em áreas rurais. O diálogo entre as comunidades, equipes de saúde, universidade e gestores locais é essencial para a superação dos desafios cotidianos e para a manutenção das atividades, assim como o suporte institucional aos alunos e qualificação do corpo docente. Sugestões de futuras linhas de pesquisa na área são apresentadas.

Medical education has undergone constant transformations throughout history and in Brazil it takes on specific characteristics. Recently, among other aspects, there has been debate about the importance of the variety of teaching scenarios and of an integral and generalist approach to the design of an egress profile closer to the population's health needs. This study presents a qualitative and quantitative evaluation of the experience of medical students, professors and health professionals involved in the rural medical internship in Family and Community Medicine at the Universidade de Caxias do Sul, Rio Grande do Sul state, Brazil. Profile of participants, internship motivators, influences on work options future, impact on health teams and positive and negative aspects of the experience are presented and discussed in the light of international literature on the subject. The rural internship appears as a positive experience in medical training, with qualitative aggregating potential for those involved and influence on the future work option, helping to reduce the gap in human resources in rural areas. Dialogue between communities, health teams, universities and local managers is essential to overcome daily challenges and to maintain activities, as well as institutional support for students and qualification of the teaching staff. Suggestions for future lines of research in the area are presented.

Programa de intervención educativa para prevenir cáncer cervicouterino en jóvenes del Policlínico Norte Placetas / Educational intervention program to prevent cervical cancer in young people from the North Placetas Polyclinic

Fundamento: el cáncer es una enfermedad que representa un problema de salud pública a nivel mundial. Objetivo: determinar la efectividad de un programa de intervención educativa sobre prevención del cáncer cervicouterino en jóvenes pertenecientes al Policlínico Docente Norte de Placetas. Métodos: se realizó un estudio de intervención prexperimental con enfoque mixto en el Policlínico Docente Norte de Placetas durante el año 2018. Se utilizaron métodos teóricos: histórico-lógico, inductivo-deductivo, sistémico- estructural-funcional y modelación; empíricos: análisis documental, cuestionario, grupo focal y nominal y la triangulación de fuentes y estadísticos. Resultados: las relaciones sexuales tempranas fueron la condición prevalente. El 40% de las féminas presentaban 1 o 2 factores de riesgo; antes de aplicar el programa de intervención educativa, a pesar de predominar la escolaridad preuniversitaria, el nivel de información era insuficiente (66,66 %), por lo que se elaboró una intervención educativa. Posterior a su aplicación se pudo constatar que hubo cambios muy significativos en el nivel de información sobre cáncer cervicouterino. Conclusiones: el programa de intervención educativa diseñado fue valorado por los especialistas como adecuado y efectivo al elevar el nivel de información sobre la prevención del cáncer cervicouterino en la población estudiada.

Background: cancer is a disease that represents a public health problem worldwide. Objective: to determine the effectiveness of an educational intervention program on the prevention of cervical cancer in young people belonging to the North Placetas Teaching Polyclinic. Methods: a pre-experimental intervention study with a mixed approach was carried out at the North Placetas Teaching Polyclinic during 2018. Theoretical methods were used: historical-logical, inductive-deductive, systemic-structural-functional and modeling; Empirical: documentary analysis, questionnaire, nominal and focal group and the review of sources and statistics. Results: early sexual relations were the prevalent condition. 40% of the females presented 1 or 2 risk factors; Before applying the educational intervention program, despite the predominance of pre-university education, the level of information was insufficient (66.66%), so an educational intervention was developed. After its implementation, it was possible to verify that there were very significant changes in the level of information on cervical cancer. Conclusions: the designed educational intervention program was valued by the specialists as adequate and effective in raising the level of information on the prevention of cervical cancer in the population studied.

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.

José María Bengoa de Sanare para el mundo de la nutrición social / José María Bengoa de Sanare for the world of social nutrition

José María Bengoa, hijo ilustre de Sanare, inicia su estadía en ese poblado rural en 1936, allí como el mismo lo expresó se forma en la Universidad de Sanare, donde con su acuciosa observación, reconoce los determinantes sociales de la desnutrición, allí descubrió que la desnutrición y el hambre, eran el denominador común de las enfermedades. Propone atender al niño y educar a la madre, y así surge el primer centro de recuperación nutricional. En medio de esa soledad recoge su experiencia, reflexiones, observaciones y soluciones prácticas las cuales publica en el libro "Medicina Social en el Medio Rural Venezolano" (1940). Logró extenderlo al resto de América, Asia y África desde su trabajo en Naciones Unidas. En 1941 dirige la Sección de Nutrición en el Ministerio de Sanidad y Asistencia Social, y contribuye con la creación del Instituto Nacional de Nutrición, la Escuela de Nutricionistas y Dietistas de la Universidad Central de Venezuela (1940 a 1950).En 1955 se incorpora a la Organización Mundial de la Salud (OMS) en Ginebra, de esta experiencia comentaba "cuando comencé mis actividades en la OMS, había un hiato evidente entre investigación en nutrición y la salud pública", dirigió la Unidad de Nutrición(1964 ­ 1974). Dirige a la Fundación Cavendes y logra convertir a Caracas en la Capital Latinoamericana de la Nutrición gracias a su capacidad para integrar alianzas, con instituciones nacionales y con organismos internacionales. Trabajó intensamente para fortalecer las instituciones existentes y promover nuevas instituciones(AU)

Jose María Bengoa, illustrious son of Sanare, began his stay in that rural town in 1936, there, as he himself expressed it, he trained at the University of Sanare, where with his careful observation, he recognized the social determinants of malnutrition, there he discovered that malnutrition and hunger were the common denominator of diseases. He proposes caring for the child and educating the mother, and thus the first nutritional recovery center arises. In the midst of that loneliness he collects his experience, reflections, observations and practical solutions of his published in the book "Social Medicine in the Venezuelan Rural Environment" (1940). He managed to spread it to the rest of America, Asia and Africa from his work at the United Nations. In 1941 he directed the Nutrition Section in the Ministry of Health and Social Assistance, and contributed to the creation of the National Institute of Nutrition, the School of Nutritionists and Dieticians of the Central University of Venezuela (1940 to 1950). In 1955 he joined the World Health Organization (WHO) in Geneva, commented on this experience "when I began my activities at WHO, there was an evident hiatus between research in nutrition and public health", he directed the Nutrition Unit (1964 - 1974). He directs the Cavendes Foundation and manages to turn Caracas into the Latin American Capital of Nutrition thanks to his ability to form alliances with national institutions and international organizations. He worked hard to strengthen existing institutions and promote new institutions(AU)

Building the foundation for universal healthcare: Academic family medicine's ability to train family medicine practitioners to meet the needs of their community across the globe

Background: The Declaration of Astana marked a revived global interest in investing in primary care as a means to achieve universal healthcare. Family medicine clinicians are uniquely trained to provide high-quality, comprehensive primary care throughout the lifespan. Yet little focus has been placed on understanding the needs of family medicine training programs. Aim: This study aims to assess broad patterns of strengths and resource challenges faced by academic programs that train family medicine clinicians. Methods: An anonymous online survey was sent to family medicine faculty using World Organization of Family Doctors (WONCA) listservs. Results: Twenty-nine representatives of academic family medicine programs from around the globe answered the survey. Respondents cited funding for the program and/or individual trainees as one of either their greatest resources or greatest limitations. Frequently available resources included quality and quantity of faculty and reliable clinical training sites. Frequently noted limitations included recruitment capacity and social capital. Over half of respondents reported their program had at some point faced a disruption or gap in its ability to recruit or train, most often because of loss of government recognition. Reflecting on these patterns, respondents expressed strong interest in partnerships focusing on faculty development and research collaboration. Lessons learnt: This study provides a better understanding of the challenges family medicine training programs face and how to contribute to their sustainability and growth, particularly in terms of areas for investment, opportunities for government policy and action and areas of collaboration.

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.

Residência em Medicina de Família e Comunidade para a formação de recursos humanos: o que pensam gestores municipais? / Family and Community Medicine Residency Programs for training the health workforce: what do municipal health managers think?

Resumo Treinamento especializado, provimento e fixação de profissionais na Atenção Primária à Saúde são desafios prementes no Brasil. A recente expansão dos Programas de Residência em Medicina de Família e Comunidade coexiste com lacunas na literatura sobre o efeito deste processo. O objetivo do trabalho é explorar a perspectiva do gestor municipal de saúde acerca das estratégias para o fortalecimento das residências e do papel destas na formação profissional e na qualificação da atenção. Trata-se de um estudo de análise quantitativa e qualitativa, com aplicação de questionário a gestores de municípios cenários destes programas. As respostas de 48 sujeitos foram submetidas a estatística descritiva e análise de conteúdo. Os resultados revelam um esforço em incorporar o Médico de Família e Comunidade na rede de atenção à saúde, uma percepção do potencial das residências no incremento da qualidade da atenção e da formação profissional e fragilidades nas ações para melhoria da estrutura e organização dos serviços com residentes. Vislumbra-se assim o potencial das residências para a superação de problemas históricos da Atenção Primária à Saúde brasileira, se atrelada a ações de fortalecimento do serviço, dos recursos humanos e do próprio programa.

Abstract The training, recruitment and retention of primary care professionals is a constant challenge in Brazil. The recent expansion of family and community medicine residency programs in the country coexists with gaps in the literature on the effects of this process. This article explores municipal health managers' understanding of these programs and the role they play in professional training and improving the quality of health care. We conducted a quantitative and qualitative analysis of the responses to questionnaires answered by 48 health managers working in municipal health services affiliated to residency programs. A descriptive statistical analysis of the quantitative data was performed and the qualitative data were analyzed using thematic analysis. The findings show that efforts were made to incorporate family and community doctors into the health care network and that managers recognized the potential residency program have to improve the quality of care and enhance professional training. Weaknesses were found in actions to improve infrastructure and facilities and the organization of the services affiliated to the programs. This study highlights the potential of residency programs for addressing longstanding problems in primary health care in Brazil when combined with actions to strengthen services, human resources and the programs.