Correlatos psicosociales y familiares de la conducta sexual en adolescentes indígenas y urbanos de Chiapas (México) / Psychosocial and family correlates of sexual behavior in indigenous and urban adolescents from Chiapas (México)

Resumen La adolescencia es una etapa de cambios a nivel fisiológico y emocional. Este tránsito hacia la adultez implica la exposición a riesgos que pueden tener consecuencias personales, familiares y escolares. Algunos de estos se asocian con el inicio de la vida sexual activa, por ejemplo, embarazos no deseados o el contagio de enfermedades de transmisión sexual. Este trabajo analiza la relación entre las conductas sexuales respecto a variables psicosociales y familiares en adolescentes de zonas rurales y urbanas de Chiapas (México). El estudio, de corte cuantitativo, se realizó con una muestra de 4952 adolescentes estudiantes de nivel secundaria y bachillerato de Chiapas. Se aplicó un cuestionario para valorar conductas sexuales y seis escalas para medir ideación suicida, sintomatología depresiva, impulsividad, autoestima y relación con los padres. Los resultados indican diferencias significativas entre los puntajes promedios de las escalas aplicadas y la edad de iniciación sexual, el uso del preservativo, la frecuencia de los encuentros sexuales y el número de distintas parejas sexuales. Resultados relevantes en el contexto de estudio, debido a que Chiapas es una demarcación multicultural y diversa étnicamente, en donde las investigaciones en torno a conductas sexuales con adolescentes de zonas rurales y urbanas son escasas.

Abstract Adolescence is a stage of physiological and emotional changes. This transition to adulthood involves exposure to risks that can have personal, familar and schoolar consequences. Some of these are associated with the beginning of an active sexual life, for example, unwanted pregnancies or the spread of sexually transmitted diseases. This paper analyzes the relationship between sexual behaviors regarding psychosocial and familiar variables in adolescents from rural and urban areas of Chiapas, Mexico. The study, of quantitative type, was made with a sample of 4,952 adolescents students from secondary and high school level from Chiapas, México. The data collection instruments consisted on a questionnaire about sexual behaviors and six scales to measure suicidal ideation, depressive symptomatology, impulsivity, self-esteem and relationship with parents. The results indicate significant differences between the average scores of the scales applied and the age of sexual initiation, the use of condoms in the first and subsequent sexual intercourse, the frequency of sexual encounters and the number of different sexual partners. The results are relevant in the context of the study because Chiapas is a multicultural area and ethnically di-versed, where research on sexual behavior with adolescents in rural and urban areas is scarce.

A cross-sectional study of health and psychosocial problems among elderly people living in old-age homes of Ahmedabad and Gandhinagar districts, Gujarat, India

Background: Old age is a big challenge to human life with respect to health needs as well as psychosocial needs. This study has explored the very important aspects of old age. Very few studies have been conducted in Ahmedabad and Gandhinagar districts on the same aspects. The present study was an attempt to fill the gap in knowledge about the existing health-related and psychosocial problems faced by elderly population. Objectives: To study the health profile, socio-demographic factors, and psychosocial aspects of the elderly in old-age homes. Materials and Methods: A cross-sectional study on the public health aspects and psychosocial problems of old-age persons (60 years and above) was carried out in old-age homes in Ahmedabad and Gandhinagar districts, Gujarat, India. Results: A total of 500 elderly people, living in nine old-age homes in Ahmedabad district, were interviewed and examined. In the study population, 42.20% were male and 57.80% were female. Majority of the elderly were residing in old-age home for 3–10 years (59.60%). Moreover, the most frequent reason of shifting to old-age home among them was family conflicts (45.60%). Majority of the elderly were having body mass index in normal and overweight ranges. And, more number of females had shown overweight pattern as compared to males. This study revealed the five common presenting symptoms of the elderly to be joint pain (47.40%), impaired vision (39.20%), insomnia (28.00%), weakness (23.20%), and impaired memory (23.20%). Health problems of elderly population are of much concern as per this study. The major health problems found in the elderly were cancer, anemia, diabetes, cataract, hypertension, coronary heart disease, asthma, and osteoarthritis. Conclusion: Majority of the elderly people felt neglected by their family members. Two-thirds of old-age homes were having facility for regular health checkup. Majority of the elderly were having hypertension and joint pain as the most common presenting complaints among all.

A Study To Compare The Health Status And Psychosocial Problems Among Hiv Positive And Hiv Negative Children Of Hiv Positive Mothers In Salem District

A survey and descriptive correlational study was undertaken to find out the current health status and psychosocial problems among HIV positive and HIV negative children of HIV positive mothers in Salem District. 300 samples were selected between the age group of 8-12 years. An observational check list was used to assess health status and PedQLinterview schedule questioner was used to assess psychosocial problems. HIV positive children 107(71.3%) had moderate health problems, 43(28.7%) had intense health problems among HIV negative children 106 (70.7%) had normal health 44 (29.3%) had moderate health problems and HIV positive children had more psychosocial problems than HIV negative children. Conclusion of the study shows HIV positive and HIV negative children had health and psychosocial problems at different level, whereas, HIVpositive children had more problems compared to HIVnegative children

Physician Impairment: Exploring the Health Issues and Determinants

Physician impairment is a critical issue in health care setting. Physicians have an exaggerated risk of psychosocial problems. The most common psychiatric problems in the physician can be isolated psychiatric conditions or substance abuse. Physician impairment due to psychosocial problems, substance abuse, burnout or accidental health care hazards can result in adverse personal, social and professional consequences. Due to the nature of the work, physician impairment can result in significant compromise in patients’ health. It is absolute necessary to have a definitive set of programs within each health care facility to target physician impairment preserving the functionality and optimal health output of health care provider and the receiver.

The Korean Version of the Pediatric Symptom Checklist: Psychometric Properties in Korean School-aged Children

Psychosocial problems increase the risk for mental health problems and increase the need for health care services in children and adolescents. Primary care practice is a valuable avenue for identifying the need for more specialized mental health care. We hypothesized that Korean version of the pediatric symptom checklist (PSC) would be a useful tool for early detection of psychosocial problems in children and adolescents in Korea and we aimed to suggest cut-off scores for detecting meaningful psychosocial problems. A total of 397 children with their parents and 97 child patients with their parents were asked to complete the PSC Korean version and the child behavior checklist (CBCL). The internal reliability and test-retest reliability of the PSC as well as the cut-off score of the PSC was determined via receiver operating characteristic analysis of the CBCL score, clinical group scores and non-clinical group scores. The internal consistency of the PSC-Korean version was excellent (Cronbach's alpha = 0.95). The test-retest reliability was r = 0.73 (P or = 60) and presence of clinical diagnosis, the recommended cut-off score of the PSC was 14. Using 494 Korean children aged 7-12 yr, the current study assessed the reliability and validity of a Korean version of the PSC and suggested a cut-off for recommending further clinical assessment. The present results suggest that the Korean version of the PSC has good internal consistency and validity using the standard of CBCL scores.

Distribution Pattern of the Psychosocial Problems according to the Academic Assessment of Adolescent Male Students.

Background: Many studies have reported psychosocial problems among adolescents. Methodology: A study of distribution pattern of psychosocial problems was conducted according to academic assessment among the adolescent males aged 10 – 19 years students selected from all rural and urban schools situated within 1 KM of urban and rural health training centers of the department of Community Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh. The study population comprised of 2347 students out of which 410 students were selected for study out which 390 students cooperated in the study. Semi-structured schedule for the record of psychosocial history, 35 items pediatric symptoms check list (YPSC) to screen psychosocial problems where applied and class teacher was requested for academic assessment of the student to grade according to 4 – points Likert scale that graded each student as (1) Excellent (2) Very Good (3) Average (4) Poor. Diagnosis was made as per criteria of ICD-10 (1999). Results: 17.9% students showed psychosocial problems. The problems were mere in students graded as poor in studies.

Mudança permanente: fonte de penosidade no trabalho? / Perpetual change: source of penibility at work?

Este artigo se propõe a examinar as possíveis condições para a melhoria duradoura da saúde psíquica dos trabalhadores. Para fazê-lo, após ter sintetizado as principais causas imediatas dos problemas psicossociais, recolocamo-los no contexto contemporâneo caracterizado pela renovação incessante dos dispositivos técnicos e de gestão. Assim, compreender os fenômenos dos problemas psicossociais no trabalho implica em se interessar pelos efeitos da mudança permanente. Precisamente, para considerarmos, de forma geral, estes efeitos sobre a saúde, elaboramos uma grade de análise a partir da herança da sociologia do trabalho e da noção de trabalho instituição (proposta por Lallement). Esta grade de análise é, em seguida, utilizada em situações empíricas variadas (hospitais, universidades, empresas multinacionais) para demonstrarmos que a mudança permanente engendra uma polarização dos indivíduos. Certos trabalhadores perdem seu vínculo com o trabalho e assim iniciam um processo de degradação de sua saúde, enquanto outros tiram proveito do movimento e permanecem em boa saúde. Enfim, a mudança perpétua é explicada como resultado de dinâmicas próprias ao campo da gestão e de uma postura reificante específica da abordagem racionalizadora. Assim, a fim de melhorar de forma duradoura a saúde psíquica no trabalho, é necessário intervir no coração das relações sociais.

The purpose of this article is to examine possible circumstances for a long lasting improvement of workers psychological health. After having synthesized the main immediate causes of psychosocial problems, those problems were placed in the contemporary context which is characterized by the incessant renewal of technical and managerial apparatus. To understand the phenomena of psychosocial problems at work one has to be aware of the effects of perpetual change. To analyze these effects on workers health, an analysis grid is presented, which was built based on the heritage of sociology of work and the notion of work institution (proposed by Lallement). This analysis grid is then applied in several empirical situations (hospitals, universities, multinational companies) to demonstrate that permanent changes lead to a polarization of individuals. Some workers loose their connection to work and, as a consequence, develop a process of degradation of their health, while others take advantage of the movement and remain in good health. Finally, perpetual change is explained as a result of typical dynamics of the management and of a reification posture which is emblematic to therationalizing approach. Therefore, it is necessary to intervene in the core of social relations to be able to improve workers psychological health in a long lasting way.

Quality of life and psychosocial functioning of HIV infected children.

Objective. To assess the quality of life (QOL) and the psychosocial problems of HIV infected children. Methods. The present study was a comparative, cross-sectional survey conducted in the clinic of a tertiary care hospital in north India from July- December 2007. Children suffering from cystic fibrosis (CF) were chosen as a comparison group. Children ≥ 6 yr of age with HIV infection or Cystic Fibrosis, with no acute illness at the time of survey were included in the study. Quality of life of the enrolled children was assessed by using the Pediatric Quality of Life InventoryTM (PedsQLTM). Pediatric Symptom Checklist (PSC) was used for assessing the psychosocial problems in the enrolled children. Results. Forty one HIV infected and 30 children with cystic fibrosis were enrolled. According to child self -report in the PedsQLTM 4.0, the difference of perceived physical health status between the two study groups was statistically significant (p=0.04), with HIV infected children demonstrating a better QOL in this domain. A significantly greater number of children with cystic fibrosis (8/30 or 26.67%) suffered from psychosocial problems as compared to HIV children (3/41 or 7.32%) [p=0.026]. Conclusions. The quality of life and psychosocial functioning is reasonably good in children with HIV infection. Thus, we should strive to maintain and optimize the overall quality of life of these children so that they can have a productive and meaningful future.

The Role of Medical Social Worker for Burn Patients and Family

During the long treatment period (from the treatment of early stage to rehabilitation), burn patients have experienced many problems that they cannot handle it. It is very important as to overcome psychosocial problems of burn patient as to get treatment. The social work intervention for burn patients is so necessary for psychosocial problems solving; this intervention require to support by family. Depending on burn treatment procedure, and patient's social status, each burn patients have different symptom of psychosocial problems. Medical social workers work through different method of intervention that included casework, group work, connecting community resource and etc.

Percepción sobre el acceso a los servicios de salud mental que tienen los residentes de tres municipios de Antioquia, 2004-2006 / Perceived access to mental health services in three municipalities of Antioquia, 2004-2006

OBJETIVO: Conocer la percepción de usuarios, familiares, prestadores de servicios de salud y funcionarios sobre los servicios de salud mental y las condiciones de acceso en tres municipios. METODOLOGÍA: la información parte de usuarios, familiares, prestadores y funcionarios. Incluye una mirada médica y social desde un enfoque etnográfico. Se entrevistaron 29 ciudadanos en los sectores de la salud, educativo, social y judicial. RESULTADOS: la descripción del problema de salud mental es diferente en los tres municipios, tanto en su dimensión patológica como en las explicaciones causales, ya que se atribuye causalidad a la violencia social y a las condiciones laborales. Se evidenciaron dificultades en la prestación de los servicios, como también sobresalieron algunos aspectos positivos. El trauma posterior a la violencia es común en los municipios, pero los desencadenantes son particulares a las personas. DISCUSIÓN: además de los trastornos mentales, los problemas psicosociales también se relacionan con la salud mental. Entre las dificultades de acceso, se encontró la afiliación al Sistema de Seguridad Social, recursos económicos y escaso personal calificado.

OBJECTIVE: To know the perception of users, family, health providers and staff on mental health services and access conditions in three municipalities. METHODOLOGY: The information was extracted from users, family members, providers and officials. It includes medical and social gaze from an ethnographic approach. We interviewed 29 citizens in the sectors of health, educational, social and judicial. RESULTS: the description of mental health problem is different in the three municipalities, both in its pathological dimension as causal explanations, because causation is attributed to social violence and working conditions. The results showed that difficulties in providing services, but also highlights some positive aspects. Post-Trauma Violence is common in the municipalities but the triggers are specific to humans. DISCUSION: In addition to mental disorders, psychosocial problems are also related to mental health. Among the difficulties of access, it was found affiliation to the Social Security System, financial resources and scarce qualified personnel.

How a social worker could alleviate psychosocial problems of families accessing a child development clinic in Colombo.

Objectives To describe psychosocial issues faced and the services available to children accessing the child development clinic and how a social worker could help extend services provided through the clinic. Design A cross sectional descriptive qualitative study. Method All children attending the weekly clinic were seen by a social work researcher and medical officer, over a period of seven months and in-depth interviews conducted on twenty five selected patients with significant psychosocial problems. The parent or accompanying care giver was enrolled through a volunteer process and subjected to an open ended consultation on problems faced, services available and accessed, and reasons for not accessing same. A study was made of disability services in the community. Results All patients had psychosocial problems of varying degree. Twenty five children in whom social problems caused a significant adverse impact on the capacity of care givers in providing care and therapy included a broad range of complex issues. Financial concerns, poor utilization of government and non governmental support schemes, inadequacy of suitable transport, dearth of facilities for appropriate schooling, social isolation, lack of respite for caregivers and siblings, family disharmony, alcoholism, and absence of counseling services were among these. Viable options for solving identified problems and the ways in which a social services officer could assist in each situation are described. Conclusion Families of children with disabilities face several difficulties in accessing services. Even when relevant services are available they are not competent to obtain these and are in need of extra help. A hospital based social services officer working within the team of the CDC could fulfill this role, effectively connecting government policy with the people it targets.

A Development of Psychosocial Problems Assessment Scale for Patients with Mental Disorders / 신경정신의학

OBJECTIVES: There have been no consistent reliable and valid tool for examining the psychosocial problems for the patients with mental disorders in Korea. The purpose of the present study is to develop a scale that examine the psychosocial problems for the patients with mental disorders and to test its reliability and validity. METHODS: To identify the psychosocial problems for 1,100 patients with mental disorders were selected in university hospitals and professional training institutes. And the items of the psychosocial problems were taken from them and divided them into individual and environmental categories. The representative items were established among these items of psychosocial problems and a questionnaire for a pilot study was made based on the representative items. The pilot study was done for 306 patients with mental disorders using the questionnaire to investigate reliability of the questionnaire. After the pilot study items and format of the questionnaire were revised and complemented. The revised questionnaire was given to 600 patients with mental disorders to test its validity and reliability and new scale for psychosocial problems was developed. RESULTS: At the pilot study, which was performed with 1,100 patients, 3,200 items of psychosocial problems of 205 types were selected. Among these items 78 representative psychosocial problems items were withdrawn. Fifty-eight psychosocial problem items were finally set for the questionnaire after discussing them with the expert groups and examining its content reliability. Forty-seven psychosocial problems items were finally selected and given to 306 subjects at the pilot study. At the main study in which 600 subjects were tested inner-reliability. Correlation between items and scale was relevant and correlation coefficient between test and retest was high. The finally developed psychosocial problems testing scales were consisted of 46 testing items into 9 areas. CONCLUSION: The Psychosocial Problems Assessment Scale, which were developed at this study is proved to be valid and reliable and it will be able to be used to examine overall psychosocial problems for the patients with mental disorders in Korea.