Efecto del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado: Estudio cuasiexperimental / The effect of Problem-Based Learning on Care Management skills: A quasi-experimental study / O efeito da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado: Estudo quase-experimental

Objetivo: evaluar el efecto preliminar del Aprendizaje Basado en Problemas en habilidades de Gestión del Cuidado. Método: cuasiexperimental pretest-postest, con alumnos de la carrera de Licenciatura en Enfermería de una institución educativa. Muestra de 29 alumnos (Grupo Experimental) y 74 (Grupo Control). El Grupo Experimental solucionó cuatro escenarios bajo el método de Aprendizaje Basado en Problemas con los 7 pasos propuestos por la Universidad de McMaster, en un programa de Gestión del Cuidado en modalidad a distancia. El instrumento autoinformado evaluó las habilidades de Gestión del Cuidado pretesty postesten ambos grupos. Se obtuvieron valores medios y se realizó estadística descriptiva e inferencial (t de Student, t pareada, regresión lineal). Resultados: el Grupo Experimental obtuvo puntuaciones más elevadas en habilidades analíticas, de acción y globales que el Grupo Control (p<0,05). No se registraron diferencias en las habilidades interpersonales ni en el uso de la información. El Grupo Control no presentó diferencias significativas antes y después de la enseñanza habitual, mientras que en el Grupo Experimental sí se reportaron diferencias (p<0,05). Conclusión: a pesar de que existe poca evidencia en el desarrollo de habilidades de Gestión del Cuidado en Enfermería, el presente estudio demuestra que el Aprendizaje Basado en Problemas es un método efectivo y significativo en educación a distancia.

Objective: to assess the preliminary effect of Problem-Based Learning on Care Management skills. Method: a quasi-experimental pre- and post-test conducted with students attending the Bachelor's Degree in Nursing offered by an educational institution. The sample was comprised by 29 (Experimental Group) and 74 (Control Group) students. The Experimental Group solved four scenarios under the Problem-Based Learning method with the 7 steps proposed by McMaster University, in a Care Management program in distance mode. The self-reporting instrument assessed the pre- and post-test Care Management skills in both groups. Mean values were obtained and descriptive and inferential statistics were performed (Student's t, paired t, linear regression). Results: the Experimental Group obtained higher scores in analytical, action-related and global skills than the Control Group (p<0.05). No differences were recorded in interpersonal skills or in use of the information. The Control presented no significant differences before and after usual teaching, whereas differences were in fact reported in the Experimental Group (p<0.05). Conclusion: despite the fact that there is little evidence on the development of Nursing Care Management skills, the current study shows that Problem-Based Learning is an effective and significant method in remote education.

Objetivo: avaliar o efeito preliminar da Aprendizagem Baseada em Problemas nas habilidades de Gestão do Cuidado. Método: pré e pós-teste quase experimental, realizado com alunos do curso de Bacharelado em Enfermagem de uma instituição de ensino. A amostra foi composta por 29 (Grupo Experimental) e 74 (Grupo Controle). O Grupo Experimental resolveu quatro cenários sob o método de Aprendizagem Baseada em Problemas com os 7 passos propostos pela McMaster University, em um programa de Gestão do Cuidado na modalidade à distância. O instrumento de autorrelato avaliou as habilidades de Gestão do Cuidado pré e pós-teste em ambos os grupos. Valores médios foram obtidos e estatísticas descritivas e inferenciais foram realizadas (t de Student, t pareado, regressão linear). Resultados: o Grupo Experimental obteve escores mais elevados em habilidades analíticas, de ação e globais do que o Grupo Controle (p<0,05). Não foram registradas diferenças nas habilidades interpessoais ou no uso da informação. O Grupo Controle não apresentou diferenças significativas antes e depois do ensino usual, enquanto as diferenças foram de fato relatadas no Grupo Experimental (p<0,05). Conclusão: apesar de haver poucas evidências sobre o desenvolvimento de habilidades de Gestão do Cuidado de Enfermagem, o presente estudo mostra que a Aprendizagem Baseada em Problemas é um método eficaz e significativo na educação à distância.

Safety and effectiveness of adding fentanyl or sufentanil to spinal anesthesia: systematic review and meta-analysis of randomized controlled trials

Abstract Introduction Spinal infusions of either fentanyl or sufentanil have been reported in international reports, articles, and scientific events worldwide. This study aimed to determine whether intrathecal fentanyl or sufentanil offers safety in mortality and perioperative adverse events. Methods MEDLINE (via PubMed), EMBASE, CENTRAL (Cochrane library databases), gray literature, hand-searching, and clinicaltrials.gov were systematically searched. Randomized controlled trials with no language, data, or status restrictions were included, comparing the effectiveness and safety of adding spinal lipophilic opioid to local anesthetics (LAs). Data were pooled using the random-effects models or fixed-effect models based on heterogeneity. Results The initial search retrieved 4469 records; 3241 records were eligible, and 3152 articles were excluded after reading titles and abstracts, with a high agreement rate (98.6%). After reading the full texts, 76 articles remained. Spinal fentanyl and sufentanil significantly reduced postoperative pain and opioid consumption, increased analgesia and pruritus. Fentanyl, but not sufentanil, significantly reduced both postoperative nausea and vomiting, and postoperative shivering; compared to LAs alone. The analyzed studies did not report any case of in-hospital mortality related to spinal lipophilic opioids. The rate of respiratory depression was 0.7% and 0.8% when spinal fentanyl or sufentanil was added and when it was not, respectively. Episodes of respiratory depression were rare, uneventful, occurred intraoperatively, and were easily manageable. Conclusion There is moderate to high quality certainty that there is evidence regarding the safety and effectiveness of adding lipophilic opioids to LAs in spinal anesthesia.

Desenvolvimento da competência clínica por estudantes graduandos no ensino baseado em simulação: estudo quase experimental / Development of clinical competence by undergraduate students in simulation-based teaching: quasi-experimental study

OBJETIVO: Avaliar o ensino baseado em simulação no desenvolvimento da competência clínica de estudantes. MÉTODO: Estudo quase experimental realizado em uma universidade pública que participaram 62 estudantes. Para coleta de dados utilizou-se um Teste de Conhecimento e um Checklist. Os dados foram apresentados em percentual e comparados com a ANOVA. RESULTADOS: A média do percentual do conhecimento, antes, durante e após as estratégias teóricas (estudo de caso e aula teórica dialogada), foi 67,6%, 76,7% e 88,1% respectivamente e 87,6% após 30 dias. Na simulação, a habilidade "comunicou-se com fala nítida e tom de voz controlado" obteve 93,5% de acertos; "acoplou oxímetro de pulso" e "administrou o antiagregante plaquetário" 100%; 75% dos estudantes classificaram o paciente em um dos três grupos de síndrome coronariana e 83,7% relacionaram com o melhor tratamento. CONCLUSÃO: O ensino baseado em simulação possibilitou o desenvolvimento da competência clínica dos estudantes no atendimento de síndrome coronariana.

OBJECTIVE: To evaluate simulation-based teaching in the development of students' clinical competence. METHOD: Quasi-experimental study carried out at a public university with the participation of 62 students. A Knowledge Test and a Checklist were used for data collection. Data were presented as percentages and compared using ANOVA. RESULTS: The average percentage of knowledge, before, during and after the theoretical strategies (case study and dialogued theoretical class), was 67.6%, 76.7% and 88.1% respectively and 87.6% after 30 days. In the simulation, the skill "communicated with clear speech and controlled tone of voice" obtained 93.5% of correct answers; "attached pulse oximeter" and "administered platelet antiaggregant" 100%; 75% of the students classified the patient in one of the three groups of coronary syndrome and 83.7% related it to the best treatment. CONCLUSION: Simulation-based teaching enabled the development of students' clinical competence in treating coronary syndromes.

Efectividad de Intervención en enfermería para fortalecer la cooperación al tratamiento en pacientes con falla cardiaca / Effectiveness of nursing intervention to strengthen treatment cooperationinpatients with heart failure

Introducción: La falla cardiaca (FC) afecta a más de 23 millones de personas en el mundo. Se ha demostrado que las intervenciones de enfermería mejoran el conocimiento, comportamientos y reingresos hospitalarios. Objetivo: Determinar la efectividad de intervención de enfermería para fortalecer la cooperación al tratamiento en pacientes con FC. Métodos: Estudio pretest y postest cuasi experimental en una muestra conveniente de 70 pacientes con FC, grupo control (n=35) que recibió atención habitual y grupo experimental (n=35) tuvo la IE. Se utilizaron dos instrumentos: Escala Europea de Autocuidado EHFScB y la nueva escala de cooperación ECOOPFRGv1 previo proceso de validación por expertos. El estudio contó con el aval de comité de ética institucional y consentimiento informado de pacientes. Resultados: Se evaluó el efecto de la intervención de enfermería, los hallazgos evidenciaron que existió diferencia estadísticamente significativa (p=<0,001) en el grupo experimental con respecto a las mediciones obtenidas en el grupo control. Conclusiones: Se comprueba la efectividad de la intervención de enfermería para fortalecer la cooperación al tratamiento en los pacientes con FC. Los hallazgos sugieren la importancia de desarrollar programas de educación que se centren en mejorar la cooperación al tratamiento y los comportamientos de gestión del cuidado. (AU)

Introduction: Heart failure (HR) affects more than 23 million people worldwide. Nursing interventions have been shown to improve hospital knowledge, behaviors, and readmissions. Objective: To determine the effectiveness of nursing intervention to strengthen treatment cooperation in patients with CF. Methods: Pretest and quasi- experimental posttest study in a suitable sample of 70 patients with CF, control group(n=35) who received usual care and experimental group (n=35) had EI. Two instruments were used: European Self-Care Scale EHFScB and the new ECOOPFRGv1 cooperation scale after validation process by experts. The study was endorsed by the institutional ethics committee and informed consent of patients. Results: The effect of the nursing intervention was evaluated, the findings showed that there was a statistically significant difference (p = < 0.001) in the experimental group with respect to the measurements obtained in the control group. Conclusions: The effectiveness of nursing intervention to strengthen treatment cooperation in patients with CF was verified. The findings suggest the importance of developing education programs that focus on improving treatment cooperation and care management behaviors. (AU)

Estudio cuasi experimental: analgesia intratecal Clonidina vs Morfina para manejo del dolor postoperatorio inmediato en cirugías de columna / QUASI-EXPERIMENTAL STUDY: CLONIDINE INTRATHECAL ANESTHESIA VS. MORPHINE FOR IMMEDIATE POSTOPERATIVE PAIN MANAGEMENT IN SPINE SURGERY

Introducción: El manejo inmediato del dolor postoperatorio es esencial para una comodidad y rehabilitación temprana del paciente Este estudio busca evaluar el efecto analgésico postoperatorio inmediato en cirugías de columna lumbosacra por vía posterior, como los efectos adversos con la administración de analgesia intratecal, usando Clonidina contra Morfina. Material y métodos: Es un estudio analítico de intervención, cuasi experimental, prospectivo, longitudinal, comparativo, doble ciego. Para comparar la eficacia de la analgesia intratecal post operatoria inmediata en cirugías de columna lumbosacra primarias por vía posterior y los efectos adversos. Los pacientes se distribuyeron en dos grupos previamente designados, a un grupo se le administro Clonidina 0.5 microgramos/kg/peso y a otro grupo Morfina 5 microgramos/Kg/Peso. intratecal, intraoperatorio. Resultados: Existió diferencia estadísticamente significativa con mejor manejo del dolor postoperatorio en las primeras horas y menor presencia de vómitos en el grupo de pacientes que se utilizó Clonidina intratecal. No existió diferencia estadísticamente significativa de ambas medicaciones intratecales en la valoración de otros efectos adversos. Discusión: El uso de la analgesia intratecal ha ido ganando relevancia en el tiempo y se fueron sumando estudios para ver la eficacia de diferentes medicamentos, diferentes dosis, menor presencia de efectos adversos. El estudio analiza estas variables buscando una mejor opción terapéutica. Tenemos a favor una muestra representativa a pesar de no ser aleatoria, estricto seguimiento, y análisis estadístico adecuado. Conclusión: La Clonidina intratecal es más efectiva para manejo del dolor post operatorio inmediato de cirugías de columna lumbosacra por vía posterior y con menor presencia de efectos adversos

Introduction: Immediate postoperative pain management is essential for the patient's greater comfort and early rehabilitation. Te goal of this study is to evaluate the immediate analgesic postoperative effect in posterior lumbosacral spine surgery, as well as the adverse effects of the administration of intrathecal analgesia, using Clonidine versus Morphine. Material and methods: An analytical, quasi-experimental, prospective, longitudinal, comparative, double-blinded intervention study was conducted to compare the efficacy of immediate postoperative intrathecal analgesia in primary posterior lumbosacral spine surgery, and the adverse effects. Te patients were divided into two previously designated groups. One group received Clonidine 0.5 microgramos/kg and the other group received Morphine 5 microgramos/kg. Intrathecal, intraoperative. Results: Tere was a statistically significant difference with better postoperative pain management in the first hours and less vomiting in the group of patients who received intrathecal Clonidine. Tere was no statistically significant difference between both intrathecal medications in the evaluation of other adverse effects. Discussion: Te use of intrathecal analgesia, has been on the rise over time and more studies have been conducted to see the efficacy of different drugs, different doses, with fewer adverse effects. Tis study to analyze these variables with a view to finding a better therapeutic option. Te advantage is having a representative if not random sample, strict follow-up, and appropriate statistical analysis Conclusion: Intrathecal Clonidine proved to be more effective in immediate postoperative pain management after posterior lumbosacral spine surgery and with fewer adverse effects

Resultados a largo plazo de la rehabilitación del piso pélvico en pacientes con incontinencia fecal / Long-term results of pelvic floor rehabilitation in patients with fecal incontinence

Resumen Introducción: La rehabilitación del piso pélvico es frecuentemente indicada a los pacientes con incontinencia fecal. Su efectividad a corto plazo ha sido demostrada. Sin embargo, sus resultados en el largo plazo son controversiales. Objetivo: Nuestro objetivo es evaluar los resultados funcionales y calidad de vida a largo plazo de los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico. Materiales y Método: Estudio cuasi-experimental. Se incluyeron los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico entre 2007-2014 en nuestro centro, sin necesidad de cirugía. Se midió el puntaje funcional de Wexner y de calidad de vida (FIQLS) antes (T1) y después del tratamiento (T2). Se realizó encuesta vía correo electrónico para obtener dichos puntajes entre 3-10 años posterior al tratamiento (T3). Resultados: De 215 pacientes, 182 cumplían criterios de inclusión. 96 (52,8%) de ellos respondieron la encuesta en T3. La mediana de seguimiento fue de 4,5 (3-10) años. La edad promedio al tiempo del estudio fue de 60,8 ±13,1 años. 88,4% fueron mujeres. La mediana del puntaje funcional fue 16 (6-20) en T1 y 7 (0-18) en T2, p = 0,000. La calidad de vida mejoró significativamente en sus 4 dimensiones entre T1 y T2. En T3, ambos puntajes presentaron mejores promedios que en T1, p = 0,000. No hubo asociación entre el tiempo de seguimiento y el resultado funcional en T3. Conclusión: Los pacientes con incontinencia fecal tratados mediante rehabilitación del piso pélvico mejoran significativamente su funcionalidad y calidad de vida. El beneficio disminuye en el tiempo, pero persiste mejor que previo al tratamiento.

Introduction: Pelvic floor rehabilitation is often indicated as first-line therapy for patients with fecal incontinence. Its short-term effectiveness has been demonstrated in these patients. However, long-term results are controversial. Aim: Our objective is to evalúate long-term functionality and quality of life in patients with fecal incontinence treated with pelvic floor rehabilitation. Materials and Method: Quasi- experimental study conducted at a single tertiary care center. We included patients with fecal incontinence treated by pelvic floor rehabilitation at our center between 2007-2014 who did not require surgery. Wexner functional score and quality of life using FIQLS were measured pre (T1) and post-treatment (T2). Poste - riorly, an-e-mail survey was conducted to retrieve scores three to 10 years after treatment (T3). Results: Of the 215 patients, 182 met the inclusion criteria. 96 (52.8%) patients responded at T3 and were therefore included. The median follow-up period was of 4.5 years (3-10). The mean age at the time of the study was 60.8 ± 13.1 years and 88.4% were women. The median Wexner score was 16 (6-20) in T1 and 7 (0-18) in T2, (p = 0.000). Quality of life improved significantly in its four dimensions when comparing T1 and T2. In T3, Wexner and the quality of life scores were significantly lower than T2. However, in T3, both scales had better means than T1, (p = 0.000). There was no association between the follow-up time and the functional result in T3. Conclusions: Patients with fecal incontinence treated by pelvic floor rehabilitation improve their functionality and quality of life significantly. This benefit decreases over time but remains above its baseline.

Efecto del uso de mensajes de texto en dispositivos de telefonía móvil en la adherencia al tratamiento de hipertensión arterial / Effect of mobile phone text messaging on adherence to hypertension treatment

La hipertensión arterial es una de las enfermedades crónicas de mayor incidencia a nivel mundial, produce una importante mortalidad y discapacidad. Este trabajo tuvo por objetivo evaluar el efecto del uso de mensajes de texto en dispositivos de telefonía móvil en la adherencia al tratamiento de hipertensión arterial. Se efectuó un estudio de intervención cuasiexperimental, de antes y después, en el cual se entrevistó a pacientes que pertenecían a un programa ambulatorio de enfermedades crónicas. Se formaron 4 grupos, uno de ellos, el grupo control. A los grupos intervenidos se les remitieron mensajes de texto (educativos/motivadores), con diferentes frecuencias de envío, por un período de 2 meses. Al término de la intervención, se pidió llenar el cuestionario Martín-Bayarre-Grau para determinar su adherencia al tratamiento antihipertensivo antes y después de la intervención. Se realizó un análisis bivariado, en el cual se comparó la variable adherencia al tratamiento, antes y después de la intervención, de los cuatro grupos del estudio. Se encontró solo una diferencia significativa en el grupo 3 (p = 0,011), al cual se le enviaron 8 mensajes al mes (2 por semana). También se comparó, después de los 2 meses, a los grupos sometidos a intervención versus el grupo control; se halló una diferencia significativa en el grupo 3 (p = 0,022). La intervención ha demostrado ser útil para mejorar la adherencia en esta población de estudio. Se obtuvo una respuesta positiva en el grupo 3, que recibió 8 mensajes al mes(AU)

Hypertension is one of the chronic diseases with the highest incidence worldwide and a cause of considerable mortality and disability. This paper aims to evaluate the effect of mobile phone text messaging on adherence to hypertension treatment. A quasi-experimental before-after intervention was conducted based on interviews with patients from a chronic disease outpatient program. Four groups were formed, one of which was the control group. The groups intervened were sent encouraging educational text messages at varying frequencies for a period of two months. At the close of the intervention, participants were asked to fill in the Martín Bayarre Grau questionnaire to determine their adherence to antihypertensive treatment before and after the intervention. A bivariate analysis was performed comparing the variable adherence to treatment before and after the intervention in the four study groups. A significant difference was only found in Group 3 (p = 0.011). This group was sent eight messages per month (two messages per week). Additionally, a comparison between the intervention groups and the control group conducted at two months found a significant difference in Group 3 (p = 0.022). The intervention proved was useful to improve adherence in the study population. A positive response was obtained in Group 3, who received eight messages per month(AU)

Masaje de Field para la ganancia de peso en prematuros extremos. Estudio de viabilidad y aceptabilidad / Field massage for weight gain in extremely premature babies. Feasibility and acceptability study

Introducción: Una de las principales problemáticas del prematuro extremo es la limitación en su ganancia de peso debido a factores propios de su inmadurez (2,4); el desconocimiento acerca del tipo, el tiempo y la cantidad de estimulación que debe recibir, rescata la necesidad de indagar en nuevas intervenciones desde el cuidado de enfermería (4,11). Objetivo: Determinar la viabilidad y aceptabilidad de la terapia de masaje de Field, en prematuros extremos en una Unidad Neonatal de una institución de IV nivel, y los efectos en relación con la ganancia de peso. Metodología: Estudio cuantitativo, cuasi experimental, realizado en 15 prematuros extremos, que comparó el peso pre y post intervención, y un análisis para la estimación del efecto; se determinó la viabilidad del estudio mediante tasas de selección, reclutamiento y seguimiento y la aceptabilidad de la intervención en términos de satisfacción de los padres. El proceso de selección y reclutamiento se efectuó por más de 4 meses; la terapia se realizó 3 veces al día, durante 15 minutos, por 5 días consecutivos; posteriormente, se aplicó un cuestionario de aceptabilidad a las madres de los neonatos masajeados. Resultados: Se presentó una ganancia de peso significativa, lo cual podría ser atribuido al masaje, sin embargo, debe ser evaluado en futuras investigaciones frente a un grupo control. El estudio se hace menos viable en cuanto a la tasa de selección, si la muestra es captada durante poco tiempo, reduciendo la posibilidad de aplicar la intervención en una muestra significativa; en cuanto a reclutamiento y seguimiento, es totalmente viable. Es una terapia muy aceptada por las madres en términos de idoneidad, conveniencia y efectividad; sin embargo, se debe fortalecer desde sus riesgos y adherencia.

Introduction: One of the main problems of the extreme premature infants is the limitation in their weight gain due to factors inherent to their immaturity (2,4), the lack of knowledge about the type, the time, and the amount of stimulation they should receive, it also highlights the need to investigate new interventions in nursing care (4,11). Objective: To determine the feasibility and acceptability of Field's massage therapy in extreme premature infants in a Neonatal Unit of a level IV institution, and the effects in relation to weight gain. Methodology: Quantitative, quasi-experimental study, carried out in 15 extreme preterm infants, where pre and post intervention weight was compared, a analysis for effect estimation; the feasibility of the study was determined by selection, recruitment and followup rates and the acceptability of the intervention in terms of parental satisfaction. The selection and recruitment process were carried out for more than 4 months; the therapy was performed 3 times a day, for 15 minutes per session, for 5 consecutive days; subsequently, an acceptability survey was applied to the mothers of the massaged neonates who completed the intervention days. Results: here was a significant weight gain, which could be attributed to the massage, however, it should be evaluated in future research against a control group. The study becomes less viable in terms of the selection rate, if the sample is captured for a short time, reducing the possibility of applying the intervention in a significant sample; in terms of recruitment and follow-up, it is totally feasible. It is a therapy that is highly accepted by mothers in terms of suitability, convenience and effectiveness; however, it must be strengthened from its risks and adherence.

Jogo de tabuleiro sobre drogas psicoativas para pessoas com deficiência visual / Juego de tablero sobre drogas psicoactivas para personas con discapacidad visual / Board game about psychoactive drugs for visually disabled people

Resumo Objetivo Avaliar o aprendizado de pessoas com deficiência visual após participação em jogo educativo sobre drogas psicoativas. Métodos Pesquisa quase-experimental, realizada em uma associação de cegos e em laboratório experimental de ensino de saúde de uma universidade, com 60 cegos maiores de 18 anos, com cegueira ou baixa visão, alfabetizados em Braille ou capazes de ler textos com letras ampliadas. Foi aplicado o jogo educativo de tabuleiro "Drogas: jogando limpo", que contempla conteúdo sobre o conceito, tipos de drogas, prejuízos, fatores de risco, situações envolvendo o uso das drogas e fatores de proteção/prevenção. Aprendizagem foi avaliada em entrevista individual, antes e após aplicação do jogo com questões organizadas por níveis de complexidades. Comparação do número de acertos avaliados pelo teste McNemar. Resultados Questões de baixa complexidade apresentaram diferença significativa (p=0,0001) nos acertos após uso do jogo e elevado índice de acertos antes e após (81,7% e 98,3%). Não houve diferença estatística nas questões de média e alta complexidade. Conclusão O jogo Drogas: jogando limpo, contribuiu, de forma significativa, para a aprendizagem das pessoas com deficiência visual, representando estratégia de inclusão de individuos com deficiência no acesso à informação.

Resumen Objetivo Evaluar el aprendizaje de personas con discapacidad visual después de la participación en juego educativo sobre drogas psicoactivas. Métodos Investigación cuasi experimental, realizada en una asociación de ciegos y en un laboratorio experimental de enseñanza de salud de una universidad, con 60 ciegos de más de 18 años, con ceguera o con baja visión, alfabetizados en Braille con capacidad para leer textos con letras ampliadas. Se aplicó un juego educativo de tablero "Drogas: jugando limpio", que contempla contenidos sobre el concepto, tipos de drogas, perjuicios, factores de riesgo, situaciones que involucran el uso de drogas y factores de protección/prevención. El aprendizaje fue evaluado en entrevista individual, antes y después de la aplicación del juego con preguntas organizadas por niveles de complejidad. Comparación del número de aciertos evaluados por la prueba McNemar. Resultados Preguntas de baja complejidad presentaron diferencias significativas (p=0,0001) en los aciertos después del uso del juego y elevado índice de aciertos antes y después (81,7 % y 98,3 %). No hubo diferencia estadística en las preguntas de mediana y alta complejidad. Conclusión El juego Drogas: jugando limpio, contribuyó, de forma significativa, para el aprendizaje de las personas con discapacidad visual, lo que representa una estrategia de inclusión de personas con discapacidad para el acceso a la información.

Abstract Objective Evaluate the learning of visually disabled people after participating in an educational game about psychoactive drugs. Methods Quasi-experimental research, conducted in an association of the blind and in an experimental laboratory of health teaching at a university, involving 60 blind people over the age of 18, blind or with low vision, literate in Braille or able to read texts with enlarged letters. The educational board game "Drugs: playing fair" was applied, which covers content on the concept, types of drugs, harms, risk factors, situations involving the use of drugs and protection/prevention factors. Learning was evaluated in an individual interview, before and after the application of the game, with questions organized by levels of complexity. Comparison of the number of hits evaluated using the McNemar test. Results Questions of low complexity presented a significant difference (p=0.0001) in the hits after using the game and a high index of hits before and after (81.7% and 98.3%). There was no statistical difference in the medium and high complexity questions. Conclusion The game Drugs: playing fair, significantly contributed to the learning of people with visual disabilities, representing a strategy to include individuals with disabilities in the access to information.

Aprendizaje basado en juegos: propuesta de técnica-enseñanza en médicos becarios / Game-based learning: proposal of teaching technique in medical fellows

Introducción: los juegos son una técnica de aprendizaje de alto valor educativo que contribuye al desarrollo del sistema cognitivo, emocional y psicológico. El Semáforo es un instrumento que evalúa la percepción del aprendizaje y el nivel de diversión del alumno. Objetivo: proponer una técnica de enseñanza-aprendizaje basada en juegos en personal médico becario. Material y métodos: estudio cuasi experimental, muestra no probabilística consecutiva, en 42 médicos becarios (residentes de Medicina Familiar, pasantes de servicio social y en internado de pregrado). Se hizo un tablero de identificación de imágenes de patologías dermatológicas. Se otorgó consentimiento informado y se formaron equipos de dos integrantes. A cada uno se le dio un tablero y se hicieron preguntas entre ellos, referentes a la patología dermatológica que tenía esos signos y por medio de discriminación llegaron al diagnóstico. El tablero se basó en el juego ¿Adivina Quién? Se aplicó el instrumento Semáforo. Para la estadística, se usaron medidas de tendencia central, desviaciones estándar, rangos y chi cuadrada. Resultados: fueron 47 médicos becarios (61.7% mujeres); la mayoría (40.4%) tuvo de 31 a 40 años. Fueron residentes 74.5%, pasantes 14.9% e internos 10.6%. En el instrumento Semáforo en ambas preguntas (¿Cuánto crees que has aprendido en clase?, ¿Cuánto te has divertido en clase?) la respuesta fue mucho en 76.6%. Hubo chi cuadrada significativa para la edad y el sexo. Conclusiones: el juego es una opción muy viable para ser aplicada al proceso enseñanza-aprendizaje

Background: Games are a learning technique of high educational value that contributes to the development of cognitive, emotional and psychological systems. The Traffic Light is an instrument that evaluates the perception of learning and the student's level of fun. Objective: To propose a game-based learning teaching technique in fellow medical personnel. Material and methods: Quasi experimental, consecutive non-probabilistic sample, in 42 medical interns (residents from Family Medicine, social work interns, and undergraduate fellow students). A board was made to identify images of dermatological pathologies. Informed consent was given, teams of 2 people were formed. Each one was given a board, they began to ask each other about the dermopathology described by these signs and through discrimination they reached the diagnosis. This board is based on the board game Guess Who. The Traffic Light instrument was applied. For the statistical analysis it was used measures of central tendency, standard deviations, ranges, and chi-squared. Results: 47 male medical interns (female 61.7%). 40.4% were 31 to 40 years. 74.5% were medical residents, 14.9% social work interns, and 10.6% undergraduate fellow students. In the Traffic Light instrument in both questions (How much do you think you have learned in class? and How much fun did you have in class?), the answer was a lot in 76.6%. There was significant chi-squared for age and sex. Conclusions: The game is a very viable option to be applied to the teaching-learning process

Efetividade de tecnologia educacional para prevenção de quedas em ambiente hospitalar / Efectividad de tecnología educativa para la prevención de caídas en el ambiente hospitalario / Effectiveness of educational technology for preventing falls in a hospital environment

Resumo Objetivo Avaliar a efetividade de intervenção educativa mediada por tecnologia impressa no conhecimento sobre prevenção de quedas em pacientes hospitalizados. Método Estudo quase-experimental, do tipo antes e depois, aplicou uma intervenção educativa mediada por cartilha. O estudo incluiu 86 pacientes hospitalizados em clínica médica-cirúrgica. Utilizou-se teste de conhecimento sobre prevenção de quedas contendo 12 questões, o qual, foi previamente validado por profissionais com expertise em segurança do paciente. O teste de McNemar foi aplicado, para avaliar de forma pareada, as respostas do teste antes e após a intervenção educativa. Resultados Observou-se que, antes da intervenção, todas as questões do instrumento tiveram menos acertos. Houve associação entre mudança de conhecimento com: percepção sobre causas de quedas durante a internação (p=0,008); eventos considerados como queda (p=0,000); utilização de meios de apoio à mobilidade (p=0,000); dificuldade de visão e audição como fator de risco (p=0,000); o uso de medicamentos (p=0,000); importância de informar o profissional sobre o histórico de quedas (p=0,007); práticas gerais de prevenção (p=0,000); cuidados relacionados ao ambiente (p=0,000) e a prática de exercícios durante a hospitalização (p=0,000). Conclusão A intervenção educativa com uso da cartilha foi efetiva quanto a orientação sobre riscos de quedas em pacientes adultos hospitalizados.

Resumen Objetivo Evaluar la efectividad de una intervención educativa mediada por tecnología impresa sobre os conocimientos en prevención de caídas de pacientes hospitalizados. Método Estudio cuasi experimental, tipo antes y después, donde se aplicó una intervención educativa mediante una cartilla. El estudio incluyó 86 pacientes hospitalizados en una clínica médica quirúrgica. Se utilizó una prueba de conocimientos sobre prevención de caídas con 12 preguntas, que fue previamente validada por profesionales especialistas en la seguridad del paciente. Se aplicó la prueba de McNemar para evaluar de forma controlada las respuestas de la prueba antes y después de la intervención educativa. Resultados Se observó que, antes de la intervención, todas las respuestas del instrumento tuvieron menos aciertos. Se encontró una relación entre cambios de conocimientos y la percepción sobre causas de caídas durante la internación (p=0,008), los eventos considerados como caída (p=0,000), la utilización de medios de apoyo a la movilidad (p=0,000), las dificultades de visión y audición como factor de riesgo (p=0,000), el uso de medicamentos (p=0,000), la importancia de informar al profesional sobre el historial de caídas (p=0,007), las prácticas generales de prevención (p=0,000), los cuidados relacionados con el ambiente (p=0,000) y la práctica de ejercicios durante la hospitalización (p=0,000). Conclusión La intervención educativa con uso de la cartilla fue efectiva respecto a las instrucciones sobre riesgos de caídas en pacientes adultos hospitalizados.

Abstract Objective To evaluate the effectiveness of an educational intervention mediated by printed technology on knowledge about fall prevention in hospitalized patients. Method This is a quasi-experimental study, of before and after type, applied an educational intervention mediated by a booklet. The study included 86 patients hospitalized in a medical-surgical clinic. A knowledge test on fall prevention was used, containing 12 questions, which was previously validated by professionals with expertise in patient safety. McNemar test was applied to assess, in a paired fashion, test responses before and after the educational intervention. Results It was observed that, before the intervention, all questions of the instrument had less success. There was an association between change in knowledge with: perception of causes of falls during hospitalization (p=0.008); events considered as fall (p=0.000); use of means to support mobility (p=0.000); difficulty in seeing and hearing as a risk factor (p=0.000); the use of medications (p=0.000); importance of informing the professional about the history of falls (p=0.007); general prevention practices (p=0.000); care related to the environment (p=0.000) and the practice of exercises during hospitalization (p=0.000). Conclusion Educational intervention using the booklet was effective in providing guidance on the risk of falls in hospitalized adult patients.

Terapia floral na evolução do parto e na tríade dor-ansiedade-estresse: estudo quase-experimental / Terapia floral en la evolución del parto y en la tríada dolor-ansiedad-estrés: estudio cuasi experimental / Flower therapy in the evolution of childbirth and in the pain-anxiety-stress triad: quasi-experimental study

Resumo Objetivo Avaliar o efeito da Terapia floral na evolução do trabalho de parto e na tríade dor-ansiedade-estresse das mulheres durante o nascimento. Métodos Estudo quase-experimental realizado no período de maio a julho de 2018 no centro-obstétrico de um hospital referência para a assistência ao nascimento de baixo risco na Região Sul do Brasil, com 60 participantes (30 no Grupo Controle e 30 no Grupo Floral). A intervenção consistiu na administração dos Florais de Bach durante o trabalho de parto combinados por compostos capazes de regatar o equilíbrio emocional em situações de dor, ansiedade e estresse com a adição de 99,75% de conhaque orgânico Francês à 30% para 0,25% da tintura mãe. O grupo placebo recebeu uma mistura combinada de água com adição de 99,75% de conhaque orgânico Francês à 30% para 0,25% da tintura mãe. Ambos foram acondicionados em frascos conta gotas de 30 ml de igual tamanho, formato e característica. Para análise foi utilizado o teste t a fim de comparar as variáveis estudadas antes e após a intervenção e entre os grupos. Resultados As variáveis analisadas como dilatação cervical, contrações uterinas, ocitocina, cortisol e tempo do trabalho de parto apresentaram diferenças significativas para o Grupo Floral quando comparado com o placebo. Conclusão A Terapia floral pode ser uma alternativa para a mulher durante o trabalho de parto por auxiliar na progressão do parto sem trazer prejuízos ao recém-nascido.

Resumen Objetivo Analizar el efecto de la terapia floral en la evolución del trabajo de parto y en la tríada dolor-ansiedad-estrés de mujeres durante el nacimiento. Métodos Estudio cuasi experimental realizado en el período de mayo a julio de 2018 en el centro obstétrico de un hospital de referencia en la atención al nacimiento de bajo riesgo en la región sur de Brasil, con 60 participantes (30 en el grupo de control y 30 en el grupo floral). La intervención consistió en la administración de Flores de Bach durante el trabajo de parto combinadas con compuestos capaces de rescatar el equilibrio emocional en situaciones de dolor, ansiedad y estrés con la adición de 99,75 % de coñac orgánico francés al 30 % en 0,25 % de tintura madre. El grupo placebo recibió una mezcla combinada de agua con la adición de 99,75 % de coñac orgánico francés al 30 % en 0,25 % de tintura madre. Ambas fueron colocadas en frascos con cuentagotas de 30 ml de igual tamaño, formato y características. Para el análisis se utilizó el test-T a fin de comparar las variables estudiadas antes y después de la intervención y entre los grupos. Resultados Las variables analizadas, como dilatación cervical, contracciones uterinas, oxitocina, cortisol y tiempo de trabajo de parto presentaron diferencias significativas en el Grupo Floral en comparación con el de placebo. Conclusión La terapia floral puede ser una alternativa para la mujer durante el trabajo de parto porque ayuda a la evolución del parto sin perjuicios para el recién nacido.

Abstract Objective To evaluate the effect of flower therapy on the evolution of labor and on the pain-anxiety-stress triad of women during birth. Methods Quasi-experimental study conducted from May to July 2018 in the obstetric center of a reference hospital for low-risk birth care in southern Brazil with 60 participants (30 in the control group and 30 in the floral group). The intervention consisted of administering Bach Flower Remedies during labor combined with compounds capable of restoring emotional balance in situations of pain, anxiety and stress with the addition of 99.75% organic French brandy at 30% to 0.25% of the mother tincture. The placebo group received a combined water mix with added 99.75% organic French brandy at 30% to 0.25% of the mother tincture. Both were put in 30 ml dropper bottles of the same size, shape and characteristic. In the analysis, the t test was used to compare the variables studied before and after the intervention, and between groups. Results Variables analyzed such as cervical dilation, uterine contractions, oxytocin, cortisol and duration of labor showed significant differences for the floral group compared to placebo. Conclusion Flower therapy can be an alternative for women during labor, as it helps in the progression of labor without harming the newborn.

Prevalence of responders of a school intervention at physical fitness and mental health of children: a quasi-experimental study

Abstract Aim: to verify the effect of a physical education program at school on physical fitness and mental health in children and to determine the individual prevalence of responders. Methods: This is a quasi-experimental study, developed with 67 children aged between 6 and 11 years old. (8.09 ± 1.81). A 21-week intervention was performed, that intervention condition (IC) consisted of sports and circuit training, and nutritional education. For the control condition (CC) classes followed to the Common Curricular National Base. The following variables were evaluated at baseline and post-intervention: physical fitness and mental health through the strength and difficulties questionnaire. Mixed analysis of variance and the prevalence of responders were used for statistical analysis. Results: The main results indicate that there were improvements in the IC in the components of physical fitness (cardiorespiratory fitness, speed, and agility) and mental health indicators (total difficulties, emotional symptoms, problems with peers, and prosocial behavior) after a school physical education program in comparison with the CC. Concerning the prevalence of responders between groups, it was found differences in cardiorespiratory fitness (CC: 33.33%; IC: 65.38%), agility (CC: 36.66%; IC: 73.07%), speed (CC: 43.33%; IC: 79.16%), emotional symptoms (CC: 28.57%; IC: 50.00%), and prosocial behavior (CC: 17.14%; IC: 46.87%). Conclusion: It is reinforced that well-planned physical education classes and simple intervention programs can be adopted at the school level and are capable of promoting children's physical and mental health.

The execution order of the concurrent training and its effects on static and dynamic balance, and muscle strength of elderly people

Abstract Aim: Assess the effect of the performance order in the Concurrent Training (CT), Aerobic-Strength (AS), and Strength-Aerobic (SA), in the static balance, dynamic balance, and muscle strength in elderly people. Methods: The study involved 38 elderly people (men and women) aged 60 to 75 years old, divided into SA (n = 19) and AS (n = 19). Within 12 weeks, the aerobic training consisted of walking with intensity prescribed by the Borg's Rating of Perceived Exertion (6-20) and the strength training consisted of six exercises, with intensity controlled by Repetition Maximum training zones. Static balance (plantar pressure center area and displacement in bipedal support with eyes closed and open), dynamic balance (Timed Up and Go and Tandem Gait), and maximum dynamic strength of knee extension and bench press have been evaluated. For data analysis, Generalized Estimating Equations with Bonferroni's complimentary test have been used (α = 0.05). Results: For static and dynamic balance there hasn't been an effect on the 12 weeks of combined training, regardless of the performance order. Both groups maintained the balance variables within the intervention period. When it comes to strength, there has been a noticeable improvement in lower limbs (SA: 16%; AS: 11%; p < 0,001) and upper (SA: 22.0%; AS: 8.7%; p < 0.001), without any differences between the groups. Conclusion: So there is no difference between the order of performance of the CT in the variables of static and dynamic balance and strength of upper and lower limbs. Furthermore, after training, there have been significant improvements in the variables of strength and maintenance of static and dynamic balance.

Periodized combined training in physically active overweight women over 50 years

Abstract Aim: This quasi-experimental study, analyzes if periodized combined training's influence on plasma cytokine levels, muscle strength, and cardiorespiratory fitness in physically active women with overweight and/or obesity over 50 years. Methods: The sample was composed of 33 physically active women who were randomly allocated to three groups: Non-Periodized (NP) (n = 11); Undulating Periodization (UP) (n = 9); and Flexible Undulating Periodization (FUP) (n = 13). This study was conducted for 17 weeks, which included adaptation (weeks 1-3), baseline testing (week 4), training program (weeks 5-16), and post-evaluation (week 17). The training frequency comprised of three weekly sessions, with 30 min of aerobic exercise and 45 min of strength exercises. The data were analyzed using descriptive statistics and analysis of variance. The level of significance was p ≤ 0.05. Results: No differences were observed in weight parameters, plasma levels of cytokines, and biochemical parameters in any group, before and after the completion of the training period. Participants demonstrated increase in strength of the upper limbs in the UP (p = 0.032) and FUP (p = 0.021) groups, an increase in aerobic fitness in the NP (p = 0.041) and UP (p = 0.005) groups, and an increase in the amount of time of vigorous activity per week in the NP group (p = 0.019). Conclusion: This study shows that periodized combined training in physically active women with overweight and/or obesity over 50 years proved to be beneficial for all groups; although, the UP group exhibited better performance.

Efectividad del tratamiento con acupuntura en la urgencia hipertensiva / Effectiveness of acupuncture treatment in hypertensive emergency

Introducción: La hipertensión arterial constituye un problema de salud, tanto a nivel mundial como en Cuba, por las complicaciones e implicaciones que tiene en la morbilidad de la población mayor de 15 años. Una mayor y mejor asistencia sanitaria no consiste tan solo en la práctica de costosos tratamientos, sino ante todo en educar, sanitariamente, a la población en la utilización de los recursos de la naturaleza, así como en el empleo de técnicas y la búsqueda de terapias menos invasivas y sin efectos secundarios. Objetivo: Evaluar la efectividad del tratamiento acupuntural en la urgencia hipertensiva. Métodos: Se realizó un estudio cuasi-experimental en el Policlínico Fray Benito, municipio Rafael Freyre, en el período comprendido enero de 2019 y mayo de 2020. El universo lo conformaron todos los pacientes que acudieron al cuerpo de guardia de dicho policlínico, remitidos del consultorio médico de familia con diagnóstico de urgencia hipertensiva. La muestra de estudio se escogió de forma aleatoria y quedó constituida por aquellos pacientes con diagnóstico de urgencia hipertensiva, que cumplieron con los criterios de inclusión y los criterios de exclusión. Las principales variables utilizadas fueron edad, sexo, resultados del tratamiento, presencia de reacciones adversas o no. Conclusiones: Se demostró la efectividad del tratamiento acupuntural en la urgencia hipertensiva en el Policlínico Fray Benito(AU)

Introduction: Hypertension constitutes a health problem, both worldwide and in Cuba, due to the complications and implications it has on the morbidity of the population over 15 years of age. More and better health care does not consist only in the practice of expensive treatments, but above all in educating the population in health, in the use of natural resources, as well as in the use of techniques and the search for less invasive therapies and without side effects. Objectives: To evaluate the effectiveness of acupuncture treatment in hypertensive emergency. Methods: A quasi-experimental study was carried out at Fray Benito Community Clinic, Rafael Freyre municipality, from January 2019 to May 2020. The universe was made up of all the patients who attended the emergency room of said polyclinic, referred from their family doctor's office with emergency hypertensive diagnosis. The study sample was chosen randomly with those patients with a hypertensive emergency diagnosis, who met the inclusion and exclusion criteria. The main variables used were age, sex, treatment results, presence of adverse reactions or not. Conclusions: The effectiveness of acupuncture treatment in hypertensive emergencies was demonstrated at Fray Benito Community Clinic(AU)

¿Es el electrocardiograma correctamente interpretado por médicos residentes de Pediatría? Experiencia previa y posterior a una intervención educacional en un hospital universitario / Are electrocardiograms correctly interpreted by pediatric residents? Experience before and after an educational intervention in a teaching hospital

La incidencia del paro cardíaco pediátrico es desconocida; sus principales etiologías son cardiopatías congénitas, miocardiopatías y arritmias ventriculares. El electrocardiograma es un método diagnóstico que podría detectarlas precozmente y disminuir la morbimortalidad. El objetivo del estudio fue describir las habilidades de residentes de Pediatría para reconocer si un electrocardiograma era normal o anormal y realizar un diagnóstico electrocardiográfico preciso, antes y después de una intervención educativa. Participaron médicos residentes de primer año de Pediatría. Se tomó una evaluación con 12 trazados de electrocardiogramas, antes y después de un módulo educativo, y se compararon los puntajes mediante la prueba de "t" para datos pareados. No se halló diferencia entre ambas evaluaciones para la interpretación de electrocardiogramas como normales o anormales (p: 0,42). Sin embargo, hubo una diferencia estadísticamente significativa en cuanto a los diagnósticos de certeza (p < 0,002). Los diagnósticos de certeza electrocardiográficos mejoraron luego de implementar un módulo educacional

The incidence of pediatric cardiac arrest is unknown; its main etiologies are congenital heart diseases, cardiomyopathies, and ventricular arrhythmias. An electrocardiogram (ECG) is a diagnostic method that may allow to detect them in an early manner and reduce morbidity and mortality.The objective of this study was to describe pediatric residents' skills to determine if an ECG was normal or abnormal and make an accurate electrocardiographic diagnosis before and after an educational intervention. First-year pediatric residents participated in this study. An assessment including 12 ECG tracings was done before and after an educational module, and scores were compared using the t-test for paired data. No differences were observed between both assessments regarding the interpretation of ECG as normal or abnormal (p: 0.42). However, a statistically significant difference was observed in definitive diagnoses (p < 0.002). Definitive electrocardiographic diagnoses improved after the implementation of an educational module.

Intervención educativa en pacientes mayores de 60 años sobre fractura de cadera / Educational Intervention about Hip Fracture in Patients Older Than 60 Years

Introducción: La fractura de cadera es una entidad prevalente en el grupo etario de edad avanzada, y constituye una de las causas más frecuentes de ingreso hospitalario en personas mayores de 65 años. Objetivo: Evaluar el impacto de una intervención educativa sobre el conocimiento que poseen los adultos mayores sobre fractura de cadera en el Policlínico Docente Universitario Chiqui Gómez Lubián, de Santa Clara, durante el año 2019. Métodos: Se realizó una intervención educativa cuasi-experimental, sin grupo control en adultos mayores pertenecientes a un círculo de abuelos. Se evaluó el conocimiento que estos tenían sobre fractura de cadera antes y después de la intervención educativa durante el año 2019 en el Policlínico Chiqui Gómez de Santa Clara. La investigación tuvo como muestra 18 adultos mayores los cuales fueron seleccionados por el método no probabilístico. Resultados: Como consecuencia de la aplicación de la intervención educativa, el 100 por ciento de los encuestados demostró conocimientos adecuados acerca de las fracturas de cadera. Conclusiones: La intervención educativa fue efectiva pues demostró un incremento en el nivel de conocimientos en el adulto mayor sobre fractura de cadera(AU)

Introduction: Hip fracture is a prevalent entity in the elderly age group, and it constitutes one of the most frequent causes of hospital admission in persons over 65 years of age. Objective: To evaluate the impact of an educational intervention on the knowledge that older adults have about hip fracture at Chiqui Gómez Lubián University Teaching Polyclinic, Santa Clara, during 2019. Methods: A quasi-experimental educational intervention with no control group was carried out in older adults from a grandparents´ s club, to assess their knowledge about hip fracture. This assessment was conducted before and after the educational intervention during 2019 at Chiqui Gómez Polyclinic in Santa Clara. Eighteen aged adults made up the research sampled, who were selected by the non-probabilistic method. Results: As a result of the educational intervention, 100 percent of the respondents showed adequate knowledge about hip fractures. Conclusions: The educational intervention was effective as it showed growth in the level of knowledge in the elderly about hip fracture(AU)

Programa educativo para favorecer la adherencia terapéutica en pacientes hipertensos de Manzanillo / Educative program to promote therapeutic adherence in patients with hypertension from Manzanillo / Programa educativo para promoção da adesão terapêutica em hipertensos de Manzanillo

RESUMEN Introducción: En investigaciones realizadas en el contexto cubano, se han puesto en evidencia las dificultades que presentan los pacientes hipertensos con la adherencia a los tratamientos. Objetivo: Evaluar la efectividad de un programa educativo, basado en el Modelo de Creencias de Salud, para favorecer la adherencia terapéutica en los pacientes hipertensos del Consultorio Médico de Familia No. 6, del Policlínico Universitario "Ángel Alfonso Ortiz Vázquez", del municipio Manzanillo, Granma. Método: Se realizó un estudio de intervención, cuasi experimental, en el período septiembre 2018 - abril 2019. El universo estuvo constituido por los 80 pacientes hipertensos que se encontraban en la adultez media. La muestra quedó conformada por 18 pacientes. En el proceso investigativo se emplearon el cuestionario MBG (Martín-Bayarre-Grau) y una encuesta elaborada por las autoras. El procesamiento estadístico se realizó mediante números absolutos y porcientos, y la prueba de hipótesis de homogeneidad haciendo uso del test de Chi-cuadrado. Los resultados se presentan resumidos en tablas. Resultados: Después de aplicar el programa, predominaron los pacientes con una adherencia parcial con un 55,6 %. El 83,3 % poseía una susceptibilidad percibida alta y el 94,4 % una severidad percibida alta. El 100 % percibió muchos beneficios tanto del tratamiento farmacológico como del higiénico-dietético y el 77,8 % notó pocas barreras. Conclusiones: El programa educativo fue efectivo pues se incrementa la adherencia terapéutica en los pacientes hipertensos, se eleva la susceptibilidad y severidad percibidas acerca de las complicaciones de la hipertensión y los beneficios percibidos con respecto al tratamiento superan las barreras.

ABSTRACT Introduction: Various research approach conducted in Cuba have revealed all difficulties experienced by hypertensive patients related to their adherence to treatment. Objective: To assess the effectiveness of the educative program. The program was based on the Health Belief Model, aimed to promote therapeutic adherence in patients with hypertension registered at the No. 6 family doctor´s office associated to the Policlínico Universitario "Ángel Alfonso Ortiz Vázquez", in Manzanillo, Granma. Method: A study which included a quasi-experimental and an exercise intervention was carried out from September 2018 through April 2019. The universe of study consisted of 80 middle - age adults with hypertension. The sample included 18 patients. In the research process was used the Martín Bayarre Grau questionnaire, including in addition an enquiry performed by the authors. The statistic process was performed using absolute numbers and percentages, and was used the Chi-square test for homogeneity hypothesis test. The results are summarized in tables. Results: After program applied, patients with partial adherence, a 55.6%, were predominant. The 83.3% had a high perceived susceptibility and 94.4% had a high perceived severity. The 100% perceived many benefits from both pharmacological and hygienic-dietary treatment and 77.8% noted few barriers. Conclusions: The educative program was successfully effective, increasing therapeutic adherence in hypertensive patients, increasing the perceived susceptibility and severity of hypertensive complications, and the perceived benefits concerning treatment overcame the barriers.

RESUMO Introdução: Em investigações realizadas no contexto cubano, foram destacadas as dificuldades que os hipertensos apresentam para adesão aos tratamentos. Objetivo: Avaliar a eficácia de um programa educativo, baseado no Modelo de Crenças em Saúde, para promover a adesão terapêutica em hipertensos da Clínica Médica de Família nº 6, da Policlínica Universitária "Ángel Alfonso Ortiz Vázquez", do município de Manzanillo, Granma. Método: Foi realizado um estudo quase experimental de intervenção no período de setembro de 2018 a abril de 2019. O universo foi constituído por 80 hipertensos que se encontravam na metade da idade adulta. A amostra foi composta por 18 pacientes. No processo investigativo, foram utilizados o questionário MBG (Martín-Bayarre-Grau) e um questionário elaborado pelos autores. O processamento estatístico foi realizado por meio de números absolutos e percentuais e o teste de hipótese de homogeneidade pelo teste do Qui-quadrado. Os resultados estão resumidos em tabelas. Resultados: Após a aplicação do programa, houve predomínio de pacientes com adesão parcial com 55,6%. 83,3% tinham uma sensibilidade percebida alta e 94,4% uma severidade percebida alta. 100% perceberam muitos benefícios do tratamento farmacológico e higiênico-dietético e 77,8% perceberam poucas barreiras. Conclusões: O programa educativo foi eficaz, pois a adesão terapêutica em hipertensos aumentou, a suscetibilidade percebida e a gravidade das complicações da hipertensão aumentaram e os benefícios percebidos com relação ao tratamento ultrapassaram as barreiras.

Intervención educativa sobre succión digital en escolares. San Antonio de los Baños. 2019 / Educational intervention on digital suction in scholars. San Antonio de los Baños, 2019

Introducción: La succión digital se ha descrito como un hábito común en la infancia, pero su persistencia, acompañada de un patrón esqueletal desfavorable ocasiona diversas anomalías. Objetivo: Evaluar los resultados de un programa de intervención educativa en niños de 6 a 11 años con hábito de succión digital, pertenecientes a las escuelas primarias Julio Pérez y Domingo Lence del municipio San Antonio de los Baños. Material y Métodos: Se realizó un estudio cuasi-experimental. De un universo de 107 niños que practicaban hábitos deletéreos, se seleccionó una muestra de 42 teniendo en cuenta los criterios de inclusión. Las variables analizadas fueron: edad, sexo, nivel de conocimiento, anomalías dentomaxilofaciales y abandono del hábito. Los datos se tomaron de los resultados de la aplicación de un cuestionario. En el análisis de la información se utilizó el porcentaje y se confeccionaron tablas estadísticas y gráfico. Se usaron métodos teóricos, empíricos, estadísticos y el análisis documental. Resultados: Los niños entre 6 y 7 años fueron 47,6 por ciento y el sexo femenino, 73,8 por ciento. Dentro de las anomalías dentomaxilofaciales, la disfunción labial se presentó en 95,2 por ciento y el resalte aumentado en 92,8 por ciento. El 83.3 por ciento de los niños finalizaron con un conocimiento adecuado. El 78,6 por ciento abandonó el hábito. Conclusiones: Predominaron las hembras y el grupo de edad de 6 a 7 años. Las anomalías dentomaxilofaciales más frecuentes fueron la disfunción labial seguido del resalte aumentado. Aumentó el nivel de conocimientos y el abandono del hábito fue elevado(AU)

Introduction: Digital suction has been described as a common habit in childhood, but it can cause several anomalies if it is persistent and accompanied by an unfavorable skeletal pattern. Objective: To evaluate the results of an educational intervention program performed in children aged 6 -11 years with the habit of digital suction who belong to Julio Pérez and Domingo Lence elementary schools, San Antonio de los Baños municipality. Material and Methods: A quasi-experimental study was conducted. A sample of 42 children was selected from a universe that was made up of 107 children with deleterious habits, keeping in mind inclusion criteria. The variables analyzed included: age, sex, level of knowledge, dental and maxillofacial anomalies and cessation of the habit. The data were taken from the results of the application of a questionnaire. Percentages were used for the analysis of the information and statistical tables and figures were developed. Theoretical, empirical, and statistical methods were used; documentary analysis was also carried out. Results: The condition predominated in children aged 6 - 7 years (47,6 percent) and the female sex (73,8 percent). Among dental and maxillofacial anomalies, labial dysfunction was identified in 95,2 percent of children and augmentation of projection was present in 92,8 percent of the cases. Also, 83.3 percent of children developed an appropriate knowledge and 78,6 percent eradicated the habit. Conclusions: Female children and the age group between 6 and 7 years of age predominated in the study. The most frequent dental and maxillofacial anomalies were labial dysfunction followed by augmentation of projection. The level of knowledge increased and the cessation of the habit was high(AU)