Ejercicio tradicional de la partería frente a su profesionalización: estudio de caso en Jalisco, México / The traditional practice of midwifery and its professionalization: a case study in Jalisco, México / Exercício tradicional do partejo frente a sua profissionalização: estudo de caso em Jalisco, México

RESUMEN Objetivo: analizar el estado de la partería en Jalisco, México, frente al proceso de profesionalización. Metodología: Estudio de caso, realizado desde junio de 2011 a julio de 2013 en tres momentos: I. Entrevistas a profundidad con 20 parteras, II. Cuatro asambleas regionales con 44 parteras, III. Una asamblea estatal con 136 parteras, personal de salud y otros actores sociales, retomando técnicas educativas populares. Los datos cualitativos fueron analizados bajo el modelo actancial semiótico y los datos sociodemográficos de parteras en Epi Info 7, realizando una meta-inferencia con ambos hallazgos. Resultados: 180 parteras informantes, 89% de zona rural, media de edad 56 años, 73% con estudios de secundaria o menos, 95% son parteras tradicionales, adoptando esta práctica desde la adolescencia, capacitándose en instituciones de salud y entre las mismas parteras; 16.7% estudiaron enfermería buscando posicionamiento institucional, sin dejar de ser parteras. Actualmente otorgan atención materno-infantil y a nosologías tradicionales, aludiendo abandono institucional. Existen posturas de rechazo y aceptación de su incorporación al sector salud en médicos y enfermeras, mientras que otros actores sociales, piden su reconocimiento. Conclusiones: la partería en Jalisco, México, es una práctica tradicional vital, con o sin reconocimiento institucional, transformándose en respuesta a necesidades de atención, teniendo que considerar el perfil sociodemográfico de las parteras, su papel actual, la perspectiva del personal de salud y otros actores sociales, junto con la estrecha relación sociocultural y económica del país, frente a su profesionalización.

ABSTRACT Objective: to analyze the status of midwifery in Jalisco, Mexico and its professionalization process. Methodology: a case study conducted from June 2011 to July 2013 in three stages: I. in-depth interviews with 20 midwives, II. four regional assemblies with 44 midwives, and III. a state assembly with 136 midwives, health care staff and other social actors. The three stages employed popular educational techniques. In addition, qualitative data were analyzed using the actantial semiotic model, and the midwives' sociodemographic data were processed in Epi Info 7. Finally, a meta-inference was performed with the findings from both datasets. Results: a total of 180 midwives participated in the study, 89% of which operate in rural areas. The average age was 56, and 73% of the midwives had secondary education or less. Moreover, 95% of them were traditional midwives who adopted this practice since their adolescence and received training from health care providing institutions and from other midwives. In addition, 16.7% studied nursing in order to obtain positions in institutions while remaining midwives. They currently provide care for mothers and children as well as for patients with traditional nosologies. They also mention that they suffer institutional neglect. Among doctors and nurses, there are positions of rejection and acceptance regarding their inclusion in the health sector, while other social actors request their acknowledgement. Conclusions: midwifery in Jalisco, Mexico, is a traditional and vital practice with or without institutional recognition. It is an answer to the need for health care. Likewise, it is necessary to consider the socio-demographic profile of midwives, their current role, the views of the health care staff and other social actors and the close cultural and economic relationship of the Country regarding its professionalization.

RESUMO Objetivo: analisar o estado do partejamento em Jalisco, México, frente ao processo de profissionalização. Métodos: Estudo de caso, realizado desde junho 2011 ao julho 2013 em três momentos: I. Entrevistas em profundidade com 20 parteiras, II. Quatro assembleias regionais com 44 parteiras, III. Uma assembléia estadual com 136 parteiras, funcionários da saúde e outros atores sociais, na retomada das técnicas educacionais populares. Os dados qualitativos foram analisados sob o padrão actancial semiótico e os dados sociais demográficos de parteiras em Epi Info 7, realizando uma meta-inferência com ambos achados. Resultados: 180 parteiras informantes, 89% de zona rural, media de idade 56 anos, 73% com estudos da secundaria ou menos, 95% são parteiras tradicionais, adotando esta prática desde a adolescência, capacitando-se em instituições de saúde e entre as mesmas parteiras; 16.7% estudaram enfermagem procurando posicionamento institucional, sem deixar de ser parteiras. Atualmente outorgam atenção materno-infantil e as nosologías tradicionais, aludindo abandono institucional. Existem posições de rejeito e aceitação da sua incorporação ao setor saúde nos médicos e enfermeiras, entanto que outros atores sociais, pedem o seu reconhecimento. Conclusões: O partejo em Jalisco, México, é uma prática tradicional vital, com ou sem reconhecimento institucional, transformando-se em resposta as necessidades de atenção, tendo que considerar o perfil social demográfico das parteiras, o seu papel atual, a perspectiva dos funcionários da saúde e outros atores sociais, junto com a estreita relação sociocultural e financeira do país, frente a sua profissionalização.

[Perceptions of adolescents Jalisco campaign on breast cancer]. / Percepción de los adolescentes jaliscienses de las campañas sobre cáncer de mama.

BACKGROUND: Breast cancer campaigns and awareness strategies with limited evidence of their effectiveness in youth. Behavioral model of perception that shows how individuals choose, organize and interpret information. This study shows the perceptions of youth from Jalisco regarding breast cancer campaigns. METHODS: Cross-sectional qualitative exploratory study based on constructionist and associationist theories of perception. Informed consent interviews with 13 focus groups, 129 men and women between 12 and 19 years old, enrolled students, residents of 6 regions of Jalisco. The sampling consisted in snowball technique. Interviews transcribed and processed with Atlas Ti version 4.1, open coding analysis. RESULTS: 10 campaigns were identified and the perceptions about them showed 3 processes: 1) SELECTION: permeated by the campaign design elements; 2) ORGANIZATION: influenced by pre-structured meanings of the color pink, scope and limitations of the campaigns; and 3) INTERPRETATION: showed judgments about the visibility of breast cancer, accessibility of knowledge and resources, permeability of positive ads and cultural codes and the lack of coverage meeting expectations. CONCLUSIONS: A high awareness of breast cancer among teenagers was evident as well as the extensive need of information and services. We recommend creating strategies for formal education about breast cancer during adolescence.

Introducción: las campañas sobre cáncer de mama (CaMa) y las estrategias de sensibilización tienen limitada evidencia sobre su efectividad en jóvenes. La percepción referente conductual que da cuenta cómo individuos seleccionan, organizan e interpretan información. Este estudio muestra la percepción de adolescentes jaliscienses sobre campañas de CaMa. Métodos: estudio cualitativo, exploratorio, transversal, basado en las teorías construccionista y asociacionista de la percepción. Entrevista con consentimiento informado a 13 grupos focales, 129 hombres y mujeres de 12 a 19 años, escolarizados, residentes de 6 regiones de Jalisco, muestreo: técnica bola de nieve. Entrevistas transcritas y procesadas en Atlas Ti 4.1, análisis por codificación abierta. Resultados: se identificaron 10 campañas, la percepción de ellas mostró 3 procesos: 1) Selección: permeada por elementos del diseño de las campañas; 2) Organización: influenciada por significados pre estructurados sobre el color rosa, alcances y limitaciones de las campañas, y 3) Interpretación: mostró juicios referentes a visibilización del CaMa, accesibilidad al conocimiento y recursos, permeabilización de pautas y códigos culturales positivos y no cobertura a expectativas. Conclusiones: se evidenció alta sensibilización de adolescentes ante el CaMa y amplia necesidad de información y servicios. Recomendamos generar estrategias en educación formal en la adolescencia sobre salud mamaria.

Representación social que los adolescentes de Jalisco, México, tienen de la detección precoz del cáncer de mama / The social representation that adolescents from Jalisco, Mexico have of early detection of breast cancer

OBJETIVO: Mostrar la representación social que tienen de la detección precoz del cáncer de mama los adolescentes de Jalisco, México. DISEÑO: Cualitativo transversal, tipo analítico-interpretativo y fundamentado en la teoría de las representaciones sociales. Muestreo no probabilístico. Emplazamiento: Contacto con escuelas de nivel educativo básico de 7 municipios del Estado de Jalisco, México, a través de diversas instituciones gubernamentales y educativas. Participantes: Ciento treinta y cinco adolescentes, hombres y mujeres, escolarizados. MÉTODO: Entrevista a 13 grupos focales: 12 de 8-12 participantes y uno de 18 participantes. Transcripción de entrevistas y análisis de tipo semiótico en programa Atlas Ti versión 4.1. para la identificación de componentes de la representación social. RESULTADOS: Se vinculó la detección precoz a la disminución de muertes por cáncer de mama, tratamientos prolongados y mastectomía, pero se percibió poca cobertura a la salud mamaria del adolescente. Se refirieron como elementos limitadores de la detección precoz los aspectos de género, psicológicos y de acceso a la información y servicios de salud; como facilitadores, se mencionó la transición de los elementos limitadores a variantes positivas. CONCLUSIONES: Se muestra un panorama favorable sobre el nivel de sensibilización de los adolescentes sobre su salud mamaria, identificándose como un sector altamente sensible a la información sobre cáncer de mama y con disposición para efectuar acciones de detección precoz. Se identifica como reto importante la generación de campañas, materiales educativos y espacios de salud enfocados al adolescente

PURPOSE: To describe the social representation that adolescents from Jalisco, Mexico, have of early detection of breast cancer. DESIGN: Qualitative cross, analytical interpretative and based on the theory of social representations. Non-probability sampling. Location: Contact schools in basic education level of 7 municipalities of the State of Jalisco, Mexico, through various government and educational institutions. Participants: A hundred thirty five schooled adolescents, men and women. METHOD: Interview with 12 focus group 8-12 participants and 1 with 18 participants. The interviews were transcribed in Atlas Ti program version 4.1 for a semiotic analysis to identify components of social representation. RESULTS: The precocious detection linked itself to the decrease of deaths for cancer of breast, long treatments and mastectomy, but little coverage was perceived to the mammary health of the teenager. They refer as limiter elements of the precocious detection the aspects of kind, psychological and of access to the information and services of health; since facilitators there was mentioned the transition of the limiter elements to facilitators. CONCLUSIONS: A favorable panorama appears on the level of awareness of the teenagers on his mammary health, identifying as a sector highly sensitive to the information about cancer of breast and with disposition to effect actions of early detection; there are identified as important challenge the generation of campaigns, educational materials and spaces of health focused on the teenager

[The social representation that adolescents from Jalisco, Mexico have of early detection of breast cancer]. / Representación social que los adolescentes de Jalisco, México, tienen de la detección precoz del cáncer de mama.

PURPOSE: To describe the social representation that adolescents from Jalisco, Mexico, have of early detection of breast cancer. DESIGN: Qualitative cross, analytical interpretative and based on the theory of social representations. Non-probability sampling. LOCATION: Contact schools in basic education level of 7municipalities of the State of Jalisco, Mexico, through various government and educational institutions. PARTICIPANTS: A hundred thirty five schooled adolescents, men and women. METHOD: Interview with 12 focus group 8-12participants and 1 with 18participants. The interviews were transcribed in Atlas Ti program version 4.1 for a semiotic analysis to identify components of social representation. RESULTS: The precocious detection linked itself to the decrease of deaths for cancer of breast, long treatments and mastectomy, but little coverage was perceived to the mammary health of the teenager. They refer as limiter elements of the precocious detection the aspects of kind, psychological and of access to the information and services of health; since facilitators there was mentioned the transition of the limiter elements to facilitators. CONCLUSIONS: A favorable panorama appears on the level of awareness of the teenagers on his mammary health, identifying as a sector highly sensitive to the information about cancer of breast and with disposition to effect actions of early detection; there are identified as important challenge the generation of campaigns, educational materials and spaces of health focused on the teenager.

Estado nutricional y carencias de micronutrientes en la dieta de adolescentes escolarizados de la Zona Metropolitana de Guadalajara, Jalisco

Las deficiencias de micronutrientes son una parte importante, del más amplio y serio problema de la malnutrición. La adolescencia constituye una etapa de gran riesgo nutricional debido al aumento de necesidades, cambios de hábitos alimentarios y posibles situaciones de riesgo. Existe evidencia documentada de deficiencia de micro nutrimentos entre la población de México. El objetivo del trabajo fue determinar el estado nutricional del adolescente escolarizado y la ingestión de micronutrientes en su dieta. La muestra estuvo conformada por 307 adolescentes. Se analizó la composición corporal a través de indicadores antropométricos. Para determinar la ingestión de micro nutrimentos se utilizó el recordatorio de 24 horas y el software Mexfoods. Los porcentajes que indican una ingestión adecuada se clasificaron según los siguientes puntos de corte: debajo de los requerimientos mínimos, cuando la ingesta fue <50%; cubren requerimientos mínimos ≥50% y <75%; y exceden requerimientos mínimos cuando fue ≥75%. El IMC indicó que el 21.8 % de estudiantes de ambos sexos presentaron desnutrición mientras que la prevalencia de sobrepeso y obesidad fue del 27.9%. Los resultados de la ingestión de micro nutrimentos indicaron deficiencias significativas en hierro (p = 0.002), zinc (p= 0.000) y calcio (p = 0.002). Las vitaminas del complejo B fueron las que presentaron menores porcentajes de insuficiencias. Se identificó que la dieta de los adolescentes presenta carencias significativas de micro nutrimentos y siendo las mujeres las que resultaron con mayores deficiencias. Urge establecer estrategias destinadas a reducir los problemas derivados del déficit en la alimentación de los adolescentes.

Nutritional state and shortcoming of micronutrients on schooled youth's diet on the metropolitan zone of Guadalajara Jalisco. The adolescence is a stage of high nutritional risk due to the increased requirements, changes in eating habits and potential risk. There are documented evidence of micronutrient deficiency among the population of Mexico.To evaluate the nutritional status and micronutrient deficiencies in the diet of adolescents. The sample consisted of 307 adolescents. We analyzed the body composition by using anthropometric indicators. To determine the intake of micronutrients, the 24 hours reminder and software Mexfoods were used. The percentages that indicate adequate intake were classified according to the following breakpoints: Below minimum requirements, when intake was <50%; minimum requirements covered ≥ 50% and <75%; and exceed minimum requirements when it was ≥ 75 %. The BMI indicated that 21.8% of students of both sexes showed malnutrition and the prevalence of overweight and obesity was 27.9%. The micronutrient intake results indicated significant deficiencies in iron (p = 0.002), zinc (p = 0.000) and calcium (p = 0.002). The B-complex vitamins were those that had lower failure rates. We identified that the diet of adolescents has significant micronutrient deficiencies and that adolescent girls resulted with the major deficiencies. It is urgent to develop strategies, to reduce the problems of food deficit in adolescents.

[Nutritional state and shortcoming of micronutrients on schooled youth's diet on the metropolitan zone of Guadalajara Jalisco]. / Estado nutricional y carencias de micronutrientes en la dieta de adolescentes escolarizados de la Zona Metropolitana de Guadalajara, Jalisco.

The adolescence is a stage of high nutritional risk due to the increased requirements, changes in eating habits and potential risk. There are documented evidence of micronutrient deficiency among the population of Mexico. To evaluate the nutritional status and micronutrient deficiencies in the diet of adolescents. The sample consisted of 307 adolescents. We analyzed the body composition by using anthropometric indicators. To determine the intake of micronutrients, the 24 hours reminder and software Mexfoods were used. The percentages that indicate adequate intake were classified according to the following breakpoints: Below minimum requirements, when intake was < 50%; minimum requirements covered > or = 50% and < 75%; and exceed minimum requirements when it was > or = 75%. The BMI indicated that 21.8% of students of both sexes showed malnutrition and the prevalence of overweight and obesity was 27.9%. The micronutrient intake results indicated significant deficiencies in iron (p = 0.002), zinc (p = 0.000) and calcium (p = 0.002). The B-complex vitamins were those that had lower failure rates. We identified that the diet of adolescents has significant micronutrient deficiencies and that adolescent girls resulted with the major deficiencies. It is urgent to develop strategies, to reduce the problems of food deficit in adolescents.

Percepción de riesgo de contraer SIDA en adolescentes de Guadalajara Jalisco / Adolescent perceptions about the risk of contracting AIDS

Resumen

Objetivo: identificar la percepción del riesgo de contraer SIDA en adolescentes de Guadalajara, Jalisco.

Metodología: investigación cualitativa y análisis de texto tipo semiótico, con 49 estudiantes de 14 a 19 años. Información obtenida mediante entrevistas con grupos focales; se registró con audio grabación y observación participante; análisis centrado en narrativas desde perspectiva semántica y descripción temática; los ejes abordados son: ITS/SIDA, relaciones sexuales, embarazo, condón y fidelidad.

Resultados: la percepción de riesgo ante el SIDA es mucho menor que para embarazo, porque éste genera cambios inmediatos y hay una clara postura de rechazo familiar y social; ante el contagio de enfermedad no manifiestan preocupación latente, lo ven más como producto del azar o del destino: “si te toca te toca y aunque te cuides”, o enfocado a grupos de riesgo dentro del cual los adolescentes no se incluyen “jotos, drogos”, de aquellos que tienen relaciones con extraños o de gente promiscua. Ante el riesgo se distinguen seis posturas en las que los sujetos se mueven en función a la situación y a su interpretación; no hay una sola razón por la que pasen las cosas, concediéndole a otros la responsabilidad —e incluso— a la suerte.

Conclusiones: los adolescentes consideran al SIDA como un riesgo, pero no para ellos; tienen problemas con la información, comprensión y aceptación del problema. Respecto al uso del condón, las campañas deben ir encaminadas a reiterar las ventajas y utilidad de su uso (placer y protección) y en dar a conocer cómo usarlo. La educación sexual es un derecho y una alternativa de solución.

Summary

Objective: to know the perception of Adquired Immunodeficiecy Sindrome (AIDS) risk by adolescents.

Methodoly: a qualitative study with 49 students of 14 to 19 years old was carried out; a semiotic analysis of text was made. Information was obtained with focal groups recorded interviews. Participanting observation was also carried out; Analysis was centered in narrative since a semantic perspective and thematic description; the approached axes were Sexual Transmitted Diseases (STD) AIDS, sexual relationships, pregnancy, condom using and fidelity.

Results: high school perception of risk concerning AIDS was quite a lot less than students of becoming pregnant. Pregnancy brings immediate changes and there is a clear family and social position of rejection. They perceived it as a product of luck or fate; “If you are going to get it, you get it no matter whether you are careful or not.” Or the perception that it is focused on groups at risk and they do not consider them as part of on (“queers”, “junkies”). Six different stances are distinguished with regard to risk in function of the subjects’ situation and interpretation; there is not just one reason why these things happen and they assign the responsibility and even luck to others.

Conclusions: adolescents perceived AIDS as a risk. They have problems with information, understanding and accepting the problem. Regarding the use of condoms, campaigns should aim at repeating the advantages and usefulness of using them (pleasure and protection) and teach how to use them. Sex education is a right and an alternative solution.

[Knowledge and attitudes about using emergency contraceptives among young college students]. / Conocimientos y actitudes hacia el use de la anticoncepción de emergencia en jóvenes universitarios.

OBJECTIVE: to identify the knowledge and attitudes regarding the use of emergency contraceptives (the day-after pill) with a gender viewpoint, among young college students affiliated to Instituto Mexicano del Seguro Social. METHOD: a cross-sectional survey was applied to 583 freshmen college students at the Health Sciences University Center of the University of Guadalajara. The quantitative probe included: knowledge about emergency contraceptives (EC) and attitudes concerning the use of EC. The qualitative probe included reasons for taking or not taking EC. RESULTS: 95 % of the population had heard about EC, and 80 % considered it as a useful contraceptive method. The knowledge about the correct use of EC as well as its acceptance was greater in men than in women. Women proved to be more reflexive when mentioning a number of reasons to justify the need for further information about EC. The reasons not to take EC were linked to moral criteria aspects. Men were more knowledgeable and more prone to using it. CONCLUSIONS: the knowledge and attitudes concerning the use of EC were different among men and women. Almost all had heard about EC, half of them knew how to use it correctly and 25% showed unfavorable attitudes about taking it due to ethical and moral concerns.

[The meanings of masculinity, sexuality, power and violence among adolescents]. / Masculinidad, sexualidad, poder y violencia: análisis de significados en adolescentes.

OBJECTIVE: To analyze perceived meanings of masculinity and power related to sexual violence among adolescents. MATERIAL AND METHODS: A qualitative study was carried out between 1998 and 2000 in the metropolitan area of Guadalajara, Mexico, among 155 junior high and high school male/female students. Information was collected from 12 focal groups in two-hour sessions. Data collection instruments included: interviews, observation, and instruction guides. Data were recorded using notes and tape recordings. Oral and written information was transcribed, categorized, and coded, in order to construct matrixes and interpret results. RESULTS: Symbolic explanatory concepts related with rape included: constructivism vs. naturalism, heteronomous moral posture, and early exchange towards respect and human rights. Females were perceived as the real and potential victims. Males were perceived as violent by nature or under challenge, and prone to be victimized only if they were children, unmanly, or homosexual. Analysis objects included motives, power, female refusal, accusation, consequences, management, and prevention. CONCLUSIONS: Sexual violence is symbolized within the realm of explanatory and moral controversy. The ideological values of masculinity legitimate both legal and judiciary impunity. Social meanings and adolescent participation should be considered in research and interventions.

Masculinidad, sexualidad, poder y violencia: análisis de significados en adolescentes / The meanings of masculinity, sexuality, power, and violence among adolescents

OBJETIVO: Analizar, en relación con esquemas de masculinidad y poder, significados que en torno a violencia sexual tienen adolescentes escolares de la zona metropolitana de Guadalajara, México. MATERIAL Y MÉTODOS: Estudio cualitativo hecho en la Zona Metropolitana de Guadalajara, Jalisco, México, entre 1998 y 2000 con 155 informantes alumnos/as de secundaria y preparatoria; indagación: entrevistas grupofocales (12 grupos), dos sesiones de dos horas; instrumentos: guías, entrevista y observación; registro: notas y audiograbación; análisis: transcripción, categorización, codificación, construcción matricial e interpretación. RESULTADOS: Conceptualización simbólica explicativa: constructivista vs naturalista, postura moral heterónoma y de intercambio inicipiente hacia respeto y derechos humanos. Asociada más con violación. Ellas, víctimas reales y potenciales, ellos violentos por naturaleza o provocación, victimas sólo si: niños, poco hombres u homosexuales. Se analizan motivos, poder, negativa femenina, denuncia, consecuencias, manejo y prevención. CONCLUSIONES: Violencia sexual simbolizada dentro de controversia explicativa y moral. Valores ideológicos de masculinidad legitiman, legal y judicialmente, algo impune. Importante considerar significación social y participación adolescente en investigaciones e intervenciones

[Vaccination messages foster mobilization and high coverage in Mexico]. / Los mensajes de vacunación favorecen la movilización y altas coberturas en México.

OBJECTIVE: To understand the perceptions of the effect of vaccination messages aired during the Second National Health Week in 1996 on the predisposition to vaccinate children among mothers from a lower class neighbourhood in Mexico City. METHODS: 120 mothers of children between the ages of 0 and 7 years who were exposed to the campaign messages participated. They were divided into 8 focus groups based on the age of the children and level of schooling attained by the mothers. A content analysis was conducted using open-ended coding and categorization based on shared concepts. RESULTS: The mothers had a positive image of vaccines for the health of their children. They perceived that the messages reminded them that they needed to vaccinate their children and contributed to the mobilization of their social network in support of vaccination. The authors inferred of mother 5 narratives that some components of messages generated inaccurate interpretations and knowledge and reinforced negative attitudes and cultural and organizational barriers to vaccination in some mothers. CONCLUSIONS: The messages prompted the use of vaccination services during the health campaign. In the production, the form and content should be modified to overcome misunderstandings and barriers to vaccination.

Los mensajes de vacunación favorecen la movilización y altas coberturas en México / Vaccination messages foster mobilization and high coverage in Mexico

OBJECTIVE: To understand the perceptions of the effect of vaccination messages aired during the Second National Health Week in 1996 on the predisposition to vaccinate children among mothers from a lower class neighbourhood in Mexico City. METHODS: 120 mothers of children between the ages of 0 and 7 years who were exposed to the campaign messages participated. They were divided into 8 focus groups based on the age of the children and level of schooling attained by the mothers. A content analysis was conducted using open-ended coding and categorization based on shared concepts. RESULTS: The mothers had a positive image of vaccines for the health of their children. They perceived that the messages reminded them that they needed to vaccinate their children and contributed to the mobilization of their social network in support of vaccination. The authors inferred of mother 5 narratives that some components of messages generated inaccurate interpretations and knowledge and reinforced negative attitudes and cultural and organizational barriers to vaccination in some mothers. CONCLUSIONS: The messages prompted the use of vaccination services during the health campaign. In the production, the form and content should be modified to overcome misunderstandings and barriers to vaccination.

Etica en investigación y educación sexual: reflexiones desde la práctica con adolescentes / Ethics in research and sexual education: reflections from the experience with adolescents

La ética es en sí, una construcción social que responde a una cultura, un momento y un espacio determinados. No se puede hablar de una sola postura ética auténtica y verdadera. Comúnmente la salud es abordada desde la bioética y la ética médica, las cuales resultan insuficientes y limitantes para la investigación social. El análisis de las cuestiones éticas resulta restringido y confuso, lo que se traduce en injusticia social para muchos sectores. Además existe un profundo rezago en reflexiones ético educativas en adolescentes, que propician una mala educación capaz de decrementar la calidad de vida o ponerla en riesgo. Sobre la adolescencia se discute si por su edad y características poseen el estatus de persona integra y autónoma, de ahí que su participación en investigaciones represente dilemas por resolver sobre todo en principios éticos que tienen que ver con el respeto a la persona, el consentimiento informado y la confidencialidad, así como en educación con su derecho a la información y al ejercicio libre y autónomo de su sexualidad. Sería conveniente establecer códigos socioéticos de investigación y educación desde una perspectiva multi y transdiciplinaria y no sólo médica de la salud sexual y reproductiva de los y las adolescentes y que con base en los principios de respeto, beneficencia, justicia y tolerancia se reconozcan los derechos y potencialidades de los y las adolescentes

Análisis de texto de áreas críticas relatadas por adolescentes en servicio de orientación / Text analysis of the critical areas narrated by the adolescent users of an orientation service

Caracterizar, no espaço discursivo de 27 usuários do "Consultório Juvenil", suas áreas críticas em relaçäo à temática, aos atores, açöes, valores e esquemas de percepçäo situacional. Estudo qualitativo através de análise semiótica, realizada pelas: descriçäo da estrutura do texto, codificaçäo para a localizaçäo de isotopias e análise de organizaçäo interna. Existe uma clara diferenciaçäo temática e de significado por gênero: as meninas estäo vinculadas a espaços familiares, enquanto que os meninos a extrafamiliares. O namoro sério é um tema central para as meninas; a sexualidade para os meninos. As decisöes säo tomadas pelas meninas baseadas em uma moral situacional, e pelos meninos em uma ética individualista. Em ambos, o problema é percebido como externo, alheio e destinado a outros. As áreas críticas encontram-se influenciadas pela formaçäo social de gênero, que mitifica e estereotipa os comportamentos. A tendência de expor o problema como imposto pode significar risco para o adolescente

Motivos y expectativas de los adolescentes sobre la utilización de servicios de salud / Motives and expectations related by adolescents for using health services

El objetivo de este trabajo fue identificar los motivos y expectativas que refirieron los adolescentes de una escuela preparatoria de Guadalajara para utilizar servicios de salud. Se realizó un estudio cualitativo mediante entrevistas a grupos focales, El análisis de los datos constó de la transcripción de la grabación relectura, identificación de elementos claves para la construcción de categorías y análisis interpretativo. La utilización de los servicios de salud se asocia con el diagnóstico y pronóstico de los adolescentes y su red de apoyo les asignan. Los motivos referidos para utilizarlos varian según su sexo: para no hacerlo se relacionan con timidez, verguenza, no asertividad y distorciones del pensamiento. El grupo de pares juega roles contradictorios (facilitador/oponente) para que acudan a los servicios. Se concluye que la utilización de los servicios de salud esta influida por características de la personalidad, por la percepción de género y por la red de apoyo (familiares, amigos, maestros)

Consideraciones éticas para la investigación médica con adolescentes: editorial / Ethical considerations for medical research among adolescents

El rápido avance de los conocimientos científicos en las últimas décadas no ha ido a la par con el desarrollo de las normas legales y éticas que deben regirlos, por lo que a veces se establecen normas, com implicaciones dudosas, sobre hechos ya consumados. La tecnología actual permite acceder a estructuras tan microscópicas que pareciera que ya nada queda fuera de la observación y el conocimiento humano. Ahora, es posible moverse con relativa facilidad al tener la posibilidad de manipular gametos, influir cromosomas, intentar clonaciones, fecundar a mujeres estériles, experimentar con injertos, prolongar la vida con medios artificiales, o bien, terminarla cuando el paciente así lo solicita. Esto hace pensar que se están rebasando los límites impuestos por la naturaleza, y que se está atentando contra las leyes que ha regido siempre sobre aspectos como la vida, la salud o el patrimonio genético de la humanidad. Por esto, el actuar médico y científico debe analizarse desde una escala de valores construida sobre el respeto a la dignidad de la persona y mantenerse dentro de estos límites. En este sentido, la ética propone una serie de normas racionales que orientan el quehacer de los profesionistas de la salud.