Test de conocimientos sobre el climaterio: proceso de construcción y validación / Test of knowledge about the menopause: process of construction and validation

Objetivo. Construir y validar un test de conocimientos sobre el climaterio. Emplazamiento. El ámbito de aplicación de este instrumento es la Comunidad Autónoma de Andalucía. Método. 1. Construcción del universo teórico mediante técnica Delphi. 2. Ponderación de cada una de las dimensiones del universo teórico. 3. Formulación y selección de los elementos conceptuales a introducir en el cuestionario y formulación de sus correspondientes ítems. 4. Selección de ítems y análisis de la consistencia interna, homogeneidad, estabilidad y equivalencia tras pilotaje. Participantes. El pilotaje del cuestionario se ha realizado en 150 mujeres andaluzas, seleccionadas a través de un muestreo por cuotas de edad, hábitat y nivel de instrucción. Mediciones y resultados. Obtención de un cuestionario de 56 ítems de verdadero y falso (V/F) agrupados en 4 dimensiones: aspectos biológicos (14 ítems), aspectos psicosociales (14), riesgos de salud asociados al climaterio (6), cuidados y actividades preventivas y de mejora de la salud en el climaterio (22). Su validez y fiabilidad vienen determinadas por los siguientes resultados: nivel de consistencia interna y homogeneidad global: alfa de Cronbach, 0,86; estabilidad o ausencia de diferencias significativas respecto al momento en que se realiza la encuesta (t de Student, 1,09; p = 0,28), coeficiente de correlación intraclase (CCI), 0,753; equivalencia o ausencia de influencia de los encuestadores (t de Student, 1,09; p = 0,28), CCI = 0,761. Conclusiones. A tenor de los resultados, podemos concluir que se ha obtenido un instrumento estable teniendo en cuenta la independencia de la variable tiempo y la variable encuestador, un buen nivel de consistencia interna y una buena representatividad de los elementos conceptuales que conforman el universo teórico (AU)

Valoración de conocimientos sobre el climaterio en mujeres andaluzas / Evaluation of knowledge of the menopause among andalusian women

Objetivos. Valorar el nivel de conocimientos sobre el climaterio que poseen las mujeres andaluzas de 30-60 años, y determinar su posible relación con variables sociodemográficas, de utilización de servicios sanitarios y con su situación respecto al climaterio. Diseño. Estudio transversal. Participantes. Se ha seleccionado una muestra de 770 mujeres andaluzas de 30-60 años, para un error muestral de ñ 5 por ciento y un nivel de confianza del 95 por ciento, elegidas mediante un muestreo multietápico: aleatorio proporcional por provincia y tamaño de hábitat, y un muestreo por cuotas de edad y nivel de instrucción. Mediciones. La variable principal de estudio es el nivel de conocimiento de la mujer sobre el climaterio, valorado a través de un test validado de 56 preguntas dicotómicas. En el análisis descriptivo se ha obtenido la media, desviación estándar e intervalos de confianza del 95 por ciento (IC del 95 por ciento); y en el análisis relacional se ha aplicado test de homogeneidad de medias, análisis de variancia y regresión. Resultados. En un escala de 0-56 puntos, la media obtenida en la muestra es de 18,17 con una desviación estándar de 14,37, (IC del 95 por ciento, 17,15-19,17). Un 57,9 por ciento de la muestra encuestada obtiene valores de bajo o muy bajo nivel de conocimientos. En el análisis relacional, y según los datos del análisis de variancia, encontramos que el nivel de conocimientos está relacionado para una p < 0,001 con edad (F = 64,21), nivel de instrucción (F = 131,19), tipo de menopausia (F = 8,94) y haber recibido información sobre el climaterio (F = 7,57). De estas 4 variables es el nivel de instrucción el que en mayor medida explica la variabilidad del nivel de conocimiento (r = 0,52; p < 0,001). Sin embargo, la experiencia de la menopausia, o la utilización de los servicios sanitarios en relación a ésta no parece influir en el conocimiento sobre la etapa climatérica y sus cuidados. Conclusiones. El escaso conocimiento sobre el climaterio que posee la población de estudio pone de manifiesto la necesidad de educación para la salud sobre esta etapa de la vida. Del análisis relacional podemos concluir que el perfil de la mujer estudiada con mayor nivel de conocimientos parece ser el relacionado con un nivel de instrucción medio/alto, edad (30-40 años), que ha tenido una menopausia quirúrgica y recibido información sobre el climaterio (AU)

[Test on knowledge about climacteric: development and validation process]. / Test de conocimientos sobre el climaterio: proceso de construcción y validación.

OBJECTIVE: To construct and validate a test of knowledge about the menopause. SETTING: The context for use of this test is the Autonomous Community of Andalusia. METHOD: 1. Construction of the theoretical universe through the Delphi Technique. 2. Weighting of each of the dimensions of the theoretical universe. 3. Formulation and selection of the conceptual elements to introduce into the questionnaire and formulation of the corresponding items. 4. Selection of items and analysis of their internal consistency, homogeneity, stability and equivalence after a pilot study. PARTICIPANTS: The questionnaire's pilot study was run with 150 Andalusian women, chosen through sampling by quotas of age, habitat and educational background. MEASUREMENTS AND RESULTS: A questionnaire with 56 true and false (T/F) items grouped in four dimensions was obtained: biological aspects (14 items), psychological and social aspects (14), health risks linked to the menopause (6), care and preventive and health-improvement activities at the menopause (22). Its validity and reliability were determined by the following results: internal consistency and overall homogeneity (Cronbach's alpha = 0.86); stability or absence of significant differences at the moment the questionnaire is run (Student's t = 1.09; p = 0.28); intra-class correlation coefficient (ICC) = 0.753; equivalence or absence of bias of the questioners (Student's t = 1.09; p = 0.28), ICC = 0.761. CONCLUSIONS: The results lead us to conclude that the instrument is stable, allowing for the independence of the time and questioner variables, with high internal consistency and representing well the conceptual elements that shape the theoretical universe.

[Evaluation of knowledge about climacteric in Andalusian women]. / Valoración de conocimientos sobre el climaterio en mujeres andaluzas.

OBJECTIVES: To evaluate the level of knowledge about the menopause of Andalusian women between 30 and 60 years old; and to determine their knowledge's relationship with social and demographic variables, health service use and their position as regards the climacteric. DESIGN: Cross-sectional study. PARTICIPANTS: A sample of 770 Andalusian women between 30 and 60 was chosen, for a sample error of +/- 5% and 95% confidence interval, chosen through multi-stage sampling: at random with proportionality for province and size of habitat, and sampling by age quotas and educational background. MEASUREMENTS: The principal study variable was women's level of knowledge about the menopause, evaluated through a validated test of 56 dichotomous questions. In the descriptive analysis, the mean, standard deviation and 95% CIs were obtained; in the analysis of relationships, the test of homogeneity of means, and variance and regression analysis were used. RESULTS: On a scale of 0-56, the mean on the sample was 18.17 with a standard deviation of 14.37 (95% CI: 17.15-19.17). 57.9% of the sample polled had values of low or very low level of knowledge. In the analysis of relationships, and according to the variance analysis data, we found that the level of understanding is related (p < 0.001) to age (F = 64.21), educational background (F = 131.19), type of menopause (F = 8.94), and having received information on the menopause (F = 7.57). Of these four variables it is educational background which most explains the variability in knowledge (r = 0.52, p < 0.001). However, experience of the menopause or use of the health services for the menopause do not seem to affect knowledge about the climacteric period and its treatment. CONCLUSIONS: The lack of knowledge of the menopause shown by the population studied demonstrates the need for Health Education on this stage of life. The relationships analysis leads us to conclude that the profile of women studied who knew most was someone with middle/high educational background, aged 30-40, who had had a surgical menopause, and had received information about the menopause.

[Health education on menopause: consensus on its contents]. / Educación para la salud sobre el climaterio: un consenso sobre sus contenidos.

OBJECTIVE: To define the standard knowledge women should have about the menopause in order to confront this stage successfully. DESIGN: Use of the Delphi technique to reach consensus with experts at a national level. PARTICIPANTS: 43 professionals were chosen from the biological, psychological and social health fields, who had professional experience in women's problems at this stage of their lives, and/or authors of books, articles, doctoral theses and other documents on the menopause. MEASUREMENTS AND MAIN RESULTS: Through three mailings, we obtained the views of 37 (86.04%) of the experts about the knowledge a woman should have of the menopause and the importance attached to each facet of this knowledge. Combining both criteria enabled us to classify the 266 Conceptual Elements (CE) that were expressed into three categories according to their relevance to women's knowledge. CONCLUSION: The Conceptual Framework on the Menopause is made up of a total of 173 CE, structured in 4 dimensions: biological aspects (23.12%), psychological and social aspects (24.8%), health risks (10.98%), and care, prevention and health promotion activities concerning the menopause (41.4%). This last dimension contained the highest percentage of specially relevant material (47.88% Level I CE).

[Evaluation of the quality of care at a nursing station in a health center]. / Evaluación de la calidad de la consulta de enfermería en un centro de salud.

OBJECTIVE: To analyse the procedures in the care of patients who attend the nursing station (NS), identify possible faults and evaluate the effect of these procedures on the patients. DESIGN: Descriptive and retrospective study concerning the quality of the NS. SITE. Primary Care. At the Molino de la Vega Health Centre, Huelva. PATIENTS OR OTHER PARTICIPANTS: The 602 people who attended the NS: patients with Hypertension, Diabetic, Obesity and osteoarticular problems. MAIN MEASUREMENTS AND RESULTS: 54.4% of the procedures show a high level of control: in the case of Hypertension, the percentage reaches 62.7% (C.I. 95%: 57.8-68%). 87.3% of diabetics treated with insulin managed to give themselves their injections. 45.4% of patients suffered more than one chronic illness. The analytical tests envisaged were carried out on 62% of those with light Hypertension and on 41.4% of those with severe Hypertension. 71.3% of patients with light Hypertension had a high rate of attendance at the station, which was correct in 93.8% of the severe cases. All categories of patients with diabetes attended with excessive frequency. CONCLUSIONS: The high level of control attained clearly shows the NS's usefulness. The high percentage of self-injection achieved means that the majority of our diabetics who are treated with insulin are responsible for their own health. A fair number of patients present varied pathologies. Over-use of the NS by the large proportion of those patients with light Hypertension and diabetes implies inadequate care for other groups of patients, for example those suffering severe Hypertension.