Automedicación en usuarios del programa de salud cardiovascular en una comuna de Chile / Self-medication in patients of cardiovascular health program in a commune in Chile

ResumenLa automedicación es un fenómeno creciente y que en la actualidad ha sido considerada como un problema de salud pública.Objetivo:Describir la automedicación con productos medicinales en usuarios del programa de salud cardiovascular de atención primaria, comuna de San Pedro de la Paz, región del BíoBío, Chile.Materiales y métodos: Estudio cuantitativo y transversal (n=257). El instrumento recolector de datos fue un cuestionario. Se utilizó análisis descriptivo univariante apoyado en SPSS.Resultados: El 98,7% de los participantes manifestó auto medicarse con algún producto medicinal. El 89,2% indicó no informar esta práctica al personal sanitario. Se destaca que el 52,9% de los participantes se auto medicaba para tratar o controlar la diabetes, hipertensión y el colesterol elevado.Discusión:La elevada frecuencia de automedicación encontrada en la muestra permite verificar que esta práctica se encuentra incorporada en el cotidiano de los cuidados de la salud de los pacientes del programa de salud cardiovascular. Se desprende la importancia de informar, aconsejar y educar a los usuarios a través de programas educativos que se orienten hacia la práctica responsable de la automedicación.

AbstractSelf-medication is increasing phenomenon that at present has been considered a public health problem.Objective:To describe the self-medication in users to cardiovascular health program in primary care, community of San Pedro de la Paz, Bio Bio region, Chile.Materials and Methods:The study was quantitative and transverse (n = 257). The data collection tools were a questionnaire and the review of medical record. Was used univariate descriptive analysis supported by SPSS.Results:98.7% of participants reported consuming some medicinal product without indication. 89.2% indicated not inform the practice to health team. It is highlighted that 52.9% of participants were self-medication to treat or control diabetes, hypertension and high cholesterol.Discussion:The high frequency of self-medication found in the sample verifies that this practice is incorporated in the routine of health care of patients in cardiovascular health program. Emerges the importance of informing, advising and educating users through educational programs that are geared towards the responsible self-medication.

Autoconsumo de hierbas medicinales en usuarios con enfermedades cardio-vasculares en una comuna de Chile / Consumption of herbal medicinal in users with cardiovascular disease in a commune of Chile)

Objetivo: Caracterizar el autoconsumo de hierbas medicinales en usuarios con enfermedades cardiovasculares. Metodología: Estudio de tipo cuantitativo y transversal, con una muestra de 257 personas. Los instrumentos recolectores de datos fueron un cuestionario y la revisión de la ficha clínica. Se utilizó un análisis descriptivo univariante apoyado en SPSS. Resultados: El 80,80% de los encuestados usó hierbas medicinales, y el 72,76% señaló no informar esta práctica al equipo de salud. Las hierbas medicinales más utilizadas para el control de la enfermedad cardiovascular fueron: el limón (20,6%) para bajar la presión arterial, la pata de vaca (7%) para reducir la glicemia y la alcachofa (3,5%) para controlar el colesterol. Conclusiones: La mayoría de los participantes recurrieron a las hierbas medicinales, pese a ser una práctica de autocuidado prevalente, no es informada al equipo de salud. Algunas hierbas utilizadas por la muestra para controlar la enfermedad cardiovascular, están descritas sus usos para otras causas. Esta situación podría reflejar el desconocimiento sobre su utilización. Se sugiere el desarrollo de estrategias para el adecuado uso de las hierbas medicinales en atención primaria, enfocado en la integralidad en salud

Objective: Characterize the consumption of plants medicinal in users with cardiovascular disease. Methods: Quantitative and transversal study, with a sample of 257 people. The instruments include a questionnaire and review of the record clinic. Were used univariate descriptive analysis in SPSS. Results: The 80.80% of participants used plants medicinal, the 72.76% said not report this practice the healthcare team. The medicinal herbs used for controlling cardiovascular disease were: lemon (20.62%) to lower blood pressure, cow leg (7.0%) to reduce glycemia and artichoke (3.50%) to control cholesterol. Conclusions: Most of the participants resorted to plants medicinal, despite being a prevalent practice of self-care is not reported the healthcare team. Some herbs that participants used to control cardiovascular disease, its uses for other causes. This may reflect the lack of knowledge about their use. Suggested to developing strategies for the appropriate use of plants medicinal herbal in primary care, focused on integrality health

Validez y confiabilidad de una escala de apoyo social percibido en población adolescente / Validity and reliability of a scale of perceived social support in adolescent population

El apoyo social percibido por los/as adolescentes, puede influir positiva o negativamente en su salud, lo que hace necesario contar con instrumentos que permitan su medición. Esto podrá orientar el desarrollo de estrategias promotoras de salud más efectivas. Objetivo: Determinar la confiabilidad y validez de la Escala Multidimensional de Apoyo Social Percibido, en población adolescente chilena. Material y Método: Estudio psicométrico, el instrumento fue aplicado a 247 estudiantes de educación secundaria, previo consentimiento informado de un adulto responsable y asentimiento de los adolescentes. Se estableció confiabilidad a través de evaluación de consistencia interna mediante alpha de Cronbach, validez de criterio concurrente a través de correlación con escala de autoeficacia y validez de constructo mediante análisis factorial. Resultados: La confiabilidad es adecuada para la escala total (=0,88) y para cada subescala (= >0,76), la estructura de la escala demostró ser tridimensional al igual que la escala original y positivamente relacionada con autoeficacia. Conclusión: Este instrumento es confiable y válido para ser utilizado en población adolescente chilena (AU)

The perceived social support in adolescents can have a positive or negative influence in their health; therefore it is necessary to have the instruments to measure it. This could guide the development of health promoter strategies. Objective: To determine the reliability and validity of the Multidimensional Scale of Perceived Social Support in Chilean adolescents. Materials and Method: Psychometric study, the instrument was applied to 247 high school students, with previous informed consent of the duty-bearer adult and the adolescent approval. Reliability was established through internal consistency evaluation by Cronbach’s alpha; concurrent criterion validity was established through the correlation with auto efficiency scale; and construct validity was established through factorial analysis. Results: Reliability is adequate for the total scale (=0,88) and for each subscale (= >0,76). Scale structure showed to be tridimensional as the original scale and positively related with auto efficiency. Conclusion: This instrument is reliable and valid to be used in the Chilean adolescent population (AU)

[Therapeutic adherence in users of a cardiovascular health program in primary care in Chile]. / Adherencia terapéutica en usuarios de un programa de salud cardiovascular de atención primaria en Chile.

OBJECTIVES: To analyze therapeutic adherence in users of a cardiovascular health program in primary care in the community of San Pedro de la Paz in the region of Bío Bío, Chile. MATERIALS AND METHODS: Cross-sectional and correlational study with a sample of 257 people aged 18-60 years. A questionnaire that included the Miller´s health behavior scale to measure adherence, and review of medical records was performed. Descriptive univariate and bivariate analyses supported in SPSS were performed. RESULTS: Of the total participants, 157 (61.1%) were women. The health behavior scale reflected non-adherence of participants, as only 4 (1.5%) indicated that they always followed the instructions provided by the health team. The subscale monitoring stress management had the highest average, indicating that in this aspect there was greater adherence of the participants. Associations between therapeutic adherence and doing paid work (p=0.025) and with participation in social activities (p=0.005) were found. CONCLUSIONS: Therapeutic adherence in users of the cardiovascular health program was low. It is important to develop strategies that favor therapeutic adherence from the perspective of equity and social determinants of health.

Adherencia terapéutica en usuarios de un programa de salud cardiovascular de atención primaria en Chile / Therapeutic adherence in users of a cardiovascular health program in primary care in Chile

Objetivos. Analizar la adherencia terapéutica en usuarios de un programa de salud cardiovascular de atención primaria de la comuna de San Pedro de la Paz en la región del Bío Bío, Chile. Materiales y métodos. Estudio de transversal y correlacional, con una muestra de 257 personas de 18 a 60 años. Se utilizó un cuestionario que incluía la escala de conductas en salud de Miller para medir adherencia terapéutica, y la revisión de la ficha clínica. Se utilizó un análisis descriptivo univariante y bivariado apoyado en SPSS. Resultados. Del total de participantes 157 (61,1%) fueron mujeres. La Escala de conductas en salud reflejó la no adherencia de los participantes, ya que solo 4 (1,5%) personas indicaron que siempre seguían las indicaciones entregadas por el equipo de salud. La subescala seguimiento en el manejo del estrés tuvo la media más alta, lo que indica que en este aspecto existió una mayor adherencia en los participantes. Se encontraron asociaciones entre la adherencia terapéutica con la realización de un trabajo remunerado (p=0,025) y con la participación de actividades sociales (p=0,005).Conclusiones. La adherencia terapéutica en los usuarios del programa de salud cardiovascular fue baja. Es importante desarrollar estrategias que favorezcan la adherencia terapéutica desde la perspectiva de equidad y de los determinantes sociales de la salud.

Objectives. To analyze therapeutic adherence in users of a cardiovascular health program in primary care in the community of San Pedro de la Paz in the region of Bío Bío, Chile. Materials and methods. Cross-sectional and correlational study with a sample of 257 people aged 18-60 years. A questionnaire that included the Miller´s health behavior scale to measure adherence, and review of medical records was performed. Descriptive univariate and bivariate analyses supported in SPSS were performed. Results. Of the total participants, 157 (61.1%) were women. The health behavior scale reflected non-adherence of participants, as only 4 (1.5%) indicated that they always followed the instructions provided by the health team. The subscale monitoring stress management had the highest average, indicating that in this aspect there was greater adherence of the participants. Associations between therapeutic adherence and doing paid work (p=0.025) and with participation in social activities (p=0.005) were found. Conclusions. Therapeutic adherence in users of the cardiovascular health program was low. It is important to develop strategies that favor therapeutic adherence from the perspective of equity and social determinants of health.

Percepción de los hombres y sus parejas sobre la calidad de vida en el climaterio masculino / Perception of men and their partners about the quality of life in the male climacteric

OBJETIVO: Determinar si existen diferencias entre la percepción de los hombres y de sus parejas sobre la calidad de vida relacionada con salud en la etapa de climaterio masculino. MÉTODO: Diseño descriptivo y correlacional. Población del estudio integrada por 49 parejas, formadas por hombres entre 40-65 años y sus parejas mujeres entre 40-60 años de un Centro de Salud de Concepción, Chile. Las parejas fueron entrevistadas en sus hogares previo consentimiento informado. Ambos respondieron de forma independiente la escala Aging Males' Symptoms. Se utilizó estadística descriptiva, Indice de Kappa y t de Student. RESULTADOS: La edad promedio fue 53,2 años para los hombres y 50,7 años para las mujeres. El 54,8% de los hombres mostró alguna alteración de la calidad de vida, mostrando mayor alteración en las sub-escalas somatovege-tativa y sexual. Al comparar los puntajes de los hombres en las tres sub-escalas, con la percepción de sus parejas, hubo diferencias significativas sólo en la sub-escala psicológica (p<0,01). CONCLUSIÓN: No existen diferencias significativas en la percepción que los hombres y sus parejas tienen respecto de calidad de vida relacionada con salud de los hombres durante esta etapa, en los aspectos somatovegetativo y sexual, sólo existe diferencia en el aspecto psicológico.

OBJECTIVE: To determine if there are differences between men's and their couples' perception of health related quality of life during the male climacteric period. METHOD: Cross-sectional and correlational design. The studied sample consisted of 49 couples, made up of men in a range of 40 to 65 years of age and women in a range of 40 to 60 years of age, enrolled in a Community Health Center in Concepción, Chile. Couples were interviewed in their homes after providing informed consent. Both members answered the Aging Males' Symptoms independently. Descriptive statistics, Kappa and Student-t tests were used. RESULTS: The average age was 53.2 years and 50.7 for men and women, respectively. 58.4% of the men showed any kind of alteration of their quality of life, having more deterioration in the somato-vegetative and sexual subscale. By comparing men scores in three sub-scales to their couples' perception, only psychological sub-scale (p<0.01) presented a significant difference. CONCLUSION: Men's perception of quality of life related to health during the male climacteric period is not different from their couples' in somato-vegetative and sexual sub-scales. The psychological subscale is the only exception.

Percepción de las mujeres y sus parejas sobre la calidad de vida en el climaterio / Perceptions of women and their partners about the quality of life in climacteric period

Objetivo: Determinar si existen diferencias entre la percepción de las mujeres y de sus parejas sobre la calidad de vida relacionada con salud en la etapa de climaterio. Método: Diseño descriptivo y correlacional. Población del estudio integrada por 49 parejas, formadas por mujeres entre 40-60 años y hombres entre 40-65 años de un Centro de Salud de Concepción, Chile. Las parejas fueron entrevistadas en sus hogares previo consentimiento informado. Ambos respondieron de forma independiente el Cuestionario Específico de Calidad de Vida en la Menopausia. Se utilizó estadística descriptiva, índice de Kappa y t de Student. Se consideró como significativo valores de p<0,05. Resultados: La edad promedio fue 50,7 años para las mujeres y 53,2 para los hombres. La mayoría de las mujeres percibieron una moderada alteración de la calidad de vida en los dominios psicosocial, físico y sexual, percibiendo mayor deterioro en los dominios físico y sexual. Al comparar los puntajes de las mujeres, en los cuatro dominios, con la percepción de sus parejas, hubo diferencias significativas en los dominios vasomotor (p<0,05), psicosocial (p<0,01) y físico (p<0,05). El dominio sexual fue el único en el que no hubo diferencias significativas entre la percepción de ambos miembros de la pareja. Conclusión: Existen diferencias en la percepción que la mujer tiene respecto de su calidad de vida relacionada con salud durante la etapa climaterio y la percepción que sus esposos tienen, con excepción del dominio sexual.

Objective: To determine if there are differences between women's and their couples' perception of health related quality of life during the climacteric period. Method: Cross-sectional and correlational design. The studied sample consisted of 49 couples, made up of women in a range of 40 to 60 years of age and men in a range of 40 to 65 years of age, enrolled in a Community Health Center in Concepción, Chile. Couples were interviewed in their homes after providing informed consent. Both members answered the Menopause-Specific Quality of Life Questionnaire independently. Descriptive statistics, Kappa and Student-t tests were used, considering p<0.05 as statistically significant. Results: The average age was 50.7 years and 53.2 for women and men, respectively. Most women presented a moderate alteration in their quality of life specifically in their sexual, physical and psychosocial domains, having more deterioration in the sexual and physical domains. Comparing women's scores in the four domains of the Menopause-Specific Quality of Life Questionnaire to their couples' scores, important differences were found in the vasomotor (p<0.05), psycosocial (p<0.01) and physical (p<0.05) domains. The sexual domain was the only one that did not present significant differences between women's and men's perceptions. Conclusion: Women's perception of quality of life related to health during the climacteric period is different from their husband's. The sexual domain is the only exception.

[Identifying predictive factors for therapy nonadherence among hypertensive, older adults from a community in southern Chile]. / Identificación de factores de predicción del incumplimiento terapéutico en adultos mayores hipertensos de una comunidad del sur de Chile.

OBJECTIVE: To identify the predictive factors associated with therapy nonadherence among hypertensive older adults, based on functional dependency, memory disorders, self-perceived wellbeing, abuse, and depression in an area of southern Chile. METHODS: A quantitative, exploratory study of a sample of 211 hypertensive, older adults (29.1% of those being treated by the cardiovascular program at the Centro de Salud Familiar San Pedro, in the province of Concepción, del Bío Bío region, Chile). Seven instruments were applied: Pfeiffer's short mental status questionnaire, Yesavage's geriatric depression scale, the elder abuse screening scale, the morale scale of the Philadelphia Geriatric Center, the health behavior scale, the Lawton assessment of instrumental activities of daily living (ADL), and the Katz ADL index. Following an analysis of the important components, latent variables were identified. RESULTS: Two latent variables were identified: social connectedness-measured by the variables depression, abuse, and social satisfaction-and autonomy-measured by the variables mental health and ability to perform basic and instrumental ADLs. These latent variables accounted for 39.7% and 20.7% of nonadherence to therapy, respectively. CONCLUSIONS: The latent variables proposed here can be used as predictive factors for therapy nonadherence in elderly adults with arterial hypertension. Causes of nonadherence to therapy cannot be assessed solely at health care centers; but rather, an understanding of the home environment is needed and treatment should be adapted according to the needs that exist there.

Visibility of Latin American nursing research (1959-2005).

OBJECTIVES: To analyze scientific activity in Latin American nursing using bibliometric indicators. MATERIALS AND METHODS: This is a quantitative, descriptive study of the universe of Latin American nursing journals (119) and scientific documents (13,208) published according to current library databases including: the Web of Science (WOS), Medline, LILACS, Periodica, Cuiden, and SciELO. A database was prepared using ProCite. RESULTS: The PAHO (Pan American Health Organization) Open-access Directory of Latin American Nursing Journals includes the greatest number of the 119 journal titles (60%). The average journal longevity is 11.3 years and Brazil produces the greatest percentage (31.9%) of journals. Of the current journals, 55% do not have international readership. The non-Latin American countries that contribute most to document diffusion are Spain, the United States, and England. The doubling time of scientific production of documents is 7.3 years and the annual growth rate is 10%; 2% of researchers form the most productive group of authors. Only in recent years has the number of contributions to the ISI nursing category begun to stabilize. CONCLUSIONS: Latin American scientific nursing production is still growing exponentially and Latin American nursing contributions to knowledge being disseminated through databases of recognized scientific quality seem to be increasing. The current scientific task is to organize and improve the publication processes. CLINICAL RELEVANCE: We describe the conditions in which Latin American nursing research has become institutionalized, the challenges that it has faced, and the gradual incorporation of such research into international science.

Identificación de factores de predicción del incumplimiento terapéutico en adultos mayores hipertensos de una comunidad del sur de Chile / Identifying predictive factors for therapy nonadherence among hypertensive, older adults from a community in southern Chile

Objetivo. Identificar factores de predicción del incumplimiento terapéutico en adultos mayores hipertensos a partir de su dependencia funcional, trastornos de memoria, percepción de bienestar, maltrato y depresión en una región del sur de Chile.Métodos. Estudio cuantitativo exploratorio en una muestra de 211 adultos mayores hipertensos (29,1% de los atendidos en el Programa Cardiovascular del Centro de Salud Familiar San Pedro, en la provincia de Concepción, Región del Bío Bío, Chile). Se aplicaron siete instrumentos: el cuestionario abreviado de Pfeiffer para el estado mental, la escala de Yesavagepara la depresión geriátrica, la escala de maltrato senil, la escala moral del Centro Geriátrico de Filadelfia, la escala de conductas en salud y las escalas de Lawton y Katz para medir la capacidadde realizar actividades instrumentales y básicas de la vida diaria, respectivamente. Mediante el análisis de componentes principales se definieron variables latentes. Resultados. Se determinaron dos variables latentes: vinculación con el medio —medida apartir de las variables depresión, maltrato y satisfacción con el medio— y autonomía —medida a partir de las variables estado mental y capacidad para realizar actividades instrumentales y básicas—. Estas variables latentes explicaron 39,7% y 20,7% del incumplimiento terapéutico, respectivamente. Conclusiones. Las variables latentes propuestas pueden emplearse como factores de prediccióndel incumplimiento terapéutico de los adultos mayores con hipertensión arterial. Las causas del incumplimiento terapéutico no pueden medirse solamente en los establecimientos desalud, es necesario conocer el entorno primario en el hogar y adecuar la atención sanitaria a partir de las necesidades que allí se detecten.

Objective. To identify the predictive factors associated with therapy nonadherence among hypertensive older adults, based on functional dependency, memory disorders, self-perceived wellbeing, abuse, and depression in an area of southern Chile. Methods. A quantitative, exploratory study of a sample of 211 hypertensive, olderadults (29.1% of those being treated by the cardiovascular program at the Centro de Salud Familiar San Pedro, in the province of Concepción, del Bío Bío region, Chile). Seven instruments were applied: Pfeiffer’s short mental status questionnaire, Yesavage’s geriatric depression scale, the elder abuse screening scale, the morale scale of thePhiladelphia Geriatric Center, the health behavior scale, the Lawton assessment of instrumental activities of daily living (ADL), and the Katz ADL index. Following an analysis of the important components, latent variables were identified. Results. Two latent variables were identified: social connectedness—measured by the variables depression, abuse, and social satisfaction—and autonomy—measured by the variables mental health and ability to perform basic and instrumental ADLs. These latent variables accounted for 39.7% and 20.7% of nonadherence to therapy,respectively. Conclusions. The latent variables proposed here can be used as predictive factors for therapy nonadherence in elderly adults with arterial hypertension. Causes of nonadherence to therapy cannot be assessed solely at health care centers; but rather, an understanding of the home environment is needed and treatment should be adapted according to the needs that exist there.

Efecto de un taller vivencial de orientación humanista en la auto-actualización de adolescentes de nivel socioeconomico bajo / Life based-workshop effect, with an humanistic orientation, in low income teenagers self-actualization

Este trabajo tiene como objetivo determinar el efecto de un taller vivencial de orientación humanista en el nivel de auto-actualización de los adolescentes que cursan enseñanza media. Para ello se utiliza un diseño experimental clásico de pre-test y post-test con grupo control. La muestra es no probabilística y se toma en dos colegios de nivel socioeconómico bajo de la Octava Región, Chile, con alumnos que cursan tercero y cuarto de la enseñanza media cuyas edades fluctúan entre 17 y 19 años, a quienes se les realizará una medición con el instrumento Personal Orientation Inventory (P.O.I.) validado para la población chilena. De acuerdo a los resultados obtenidos, se demuestra que es posible aumentar el nivel de auto-actualización en los adolescentes que participaron en el taller vivencial, siendo estadísticamente significativo (p< 0.05) en 8 de 12 dimensiones que son autonomía, vivir existencial, sensibilidad organísmica, auto-aprecio, auto-aceptación, naturaleza constructiva del hombre, sinergia y capacidad de contacto íntimo, por lo que el taller vivencial de orientación humanista es una modalidad eficaz y recomendable para favorecer un desarrollo integral de los adolescentes.

[Determinant factors of therapeutic compliance in elderly hypertensive patients]. / Factores determinantes de cumplimiento terapéutico en adultos mayores hipertensos.

BACKGROUND: In Chile, less than 30% of treated hypertensive patients achieve normal blood pressure values. Lack of compliance with treatment may influence the lack of success of treatments. AIM: To identify determinant treatment compliance factors, according to the Health Belief Model, in elderly hypertensive patients. MATERIAL AND METHODS: A stratified and randomized sample with 245 elderly hypertensive patients, participating in the Cardiovascular Program of the San Pedro de la Paz Health Center in Chile, was studied. Modified Miller's Health Behavior Scale to measure therapeutic compliance and Health Belief Questionnaire to measure independent factors influencing compliance, were applied. Data analysis was done with Student's, test ANOVA and linear regression. RESULTS: Eight of 23 factors were predictors of compliance: gender, occupational activity, smoking, modification of health behaviors, difficulties to take medications, perception of treatment effectiveness, knowledge and perception about hypertension. CONCLUSIONS: Knowledge about factors that influence therapeutic compliance allows to modify health care programs and improve their effectiveness.

Factores determinantes de cumplimiento terapéutico en adultos mayores hipertensos / Determinant factors of therapeutic compliance in elderly hypertensive patients

Background: In Chile, less than 30% of treated hypertensive patients achieve normal blood pressure values. Lack of compliance with treatment may influence the lack of success of treatments. Aim: To identify determinant treatment compliance factors, according to the Health Belief Model, in elderly hypertensive patients. Material and methods: A stratified and randomized sample with 245 elderly hypertensive patients, participating in the Cardiovascular Program of the San Pedro de la Paz Health Center in Chile, was studied. Modified Miller's Health Behavior Scale to measure therapeutic compliance and Health Belief Questionnaire to measure independent factors influencing compliance, were applied. Data analysis was done with Student's, test ANOVA and linear regression. Results: Eight of 23 factors were predictors of compliance: gender, occupational activity, smoking, modification of health behaviors, difficulties to take medications, perception of treatment effectiveness, knowledge and perception about hypertension. Conclusions: Knowledge about factors that influence therapeutic compliance allows to modify health care programs and improve their effectiveness.