Caracterización de los determinantes sociales de la salud del envejecimiento activo en estudios enfocados a la calidad de vida: mapeo sistemático / Characterization of the social determinants of health in active aging in studies focused on quality of life: systematic mapping

Resumen El aumento demográfico de adultos mayores se está presentando acompañado de condiciones socioeconómicas y de salud desfavorables, que afectan su calidad de vida. Esta situación puede paliarse a través del marco del envejecimiento activo, el cual aporta lineamientos alternativos que pueden resultar eficaces para contrarrestarlos. La Organización Mundial de la Salud establece que el envejecimiento activo tiene seis Determinantes Sociales de la Salud (DSS) que han sido abordados desde diferentes áreas por la comunidad científica. El objetivo del presente trabajo fue identificar y caracterizar el tipo de estudios enfocados a la calidad de vida, desde el envejecimiento activo, y clasificarlos de acuerdo con los DSS. Se revisaron las bases de datos Ebscohost, Scopus, Oxford, Redalyc y Sage Journals. Los descriptores utilizados fueron "envejecimiento activo" y "calidad de vida", en inglés y español. La búsqueda del mapeo sistemático comprendió enero 2015 a marzo 2022. Se localizaron 91 artículos en los que se evaluó la calidad de vida, desde la perspectiva del envejecimiento activo y la mayoría (81.3 %) fueron estudios transversales. Se identificaron 3 intervenciones psicológicas, con evaluación antes y después de las sesiones, abordando los DSS relacionados con los factores personales, como salud psicológica, percepción positiva con la actividad física y función cognitiva. Así mismo, los factores conductuales, como estilos de vida para la prevención de riesgo de caídas y mejora de la vida en general, que podrían condicionar la calidad de vida. El principal alcance temático de los estudios fue la vinculación existente entre la calidad de vida y los DSS relacionados con los factores personales y con el entorno social. Se requieren más estudios interdisciplinarios que ayuden a generar políticas públicas que impacten favorablemente en este sector poblacional.

Abstract The demographic increase of elderly people is taking place along with unfavorable socioeconomic and health conditions, which affect their quality of life. This situation can be alleviated through an active aging framework, which provides alternative guidelines that can be effective in counteracting them. The World Health Organization establishes that active aging has six Social Determinants of Health (SDH) that have been approached from different areas by the scientific community. The objective of this work was to identify and characterize the type of studies focused on quality of life, from active aging, and classify them according to the SDH. Ebscohost, Scopus, Oxford, Redalyc and Sage Journals databases were reviewed. The descriptors used were "active aging" and "quality of life", in English and Spanish. The systematic mapping search comprised from January 2015 to March 2022. 91 articles were located where quality of life was evaluated from the perspective of active aging and the majority (81.3 %) were cross-sectional studies. Three psychological interventions were identified, with an evaluation before and after the sessions, comprising the SDH related to personal factors, such as psychological health, positive perception with physical activity and cognitive function. Likewise, behavioral factors such as lifestyles for the prevention of risk of falls and general life improvement which could condition the quality of life. The main thematic scope of the analyzed studies was the existing relationship between quality of life and the SDH related to personal factors and the social environment. Further interdisciplinary studies are required to contribute to the creation of public policy that impacts favorably this sector of the population.

Validation of a Spanish-Language Questionnaire on Adolescent Eating Behavior Based on Social Cognitive Theory.

OBJECTIVE: To validate a Spanish-language questionnaire on adolescent eating behavior based on Social Cognitive Theory. DESIGN: The validity (reliability and construct validity) of a self-administered questionnaire containing 28 questions with Likert scale-type response options was evaluated. SETTING: School located in Tonala, Jalisco, Mexico (a peri-urban area) with approximately 1,400 students enrolled. PARTICIPANTS: One hundred fifty-two adolescents enrolled in the second year of a middle school in Tonalá, Jalisco, Mexico (mean age, 13.7 years; SD, 0.5 years; 64% female). The retest was completed by 70 adolescents chosen at random. OUTCOME MEASURES AND ANALYSIS: The questionnaire's reliability was measured through internal consistency (Cronbach α) and reproducibility (intraclass correlation coefficient [ICC]). Construct validity was assessed using exploratory factor analysis. RESULTS: Five questions were eliminated from the questionnaire because of a lack of temporal stability (ICC ≤0.4). The exploratory factor analysis was satisfactory for 3 factors (41.89% of variance): environmental facilitators and social support, self-efficacy and self-regulation, and outcome expectations and outcome expectations value. The questionnaire had good internal consistency (α = 0.824) and excellent temporal stability (ICC = 0.849). CONCLUSIONS AND IMPLICATIONS: The results substantiate the reliability and construct validity of this questionnaire. The questionnaire has the potential to use the assessment of Social Cognitive Theory constructs in clinical practice or in nutrition interventions aimed at modifying the eating habits of Spanish-speaking adolescents.

Prevalence of Pica in Patients on Dialysis and its Association With Nutritional Status.

OBJECTIVE: Pica could be strongly implicated in nutritional status of patients on dialysis; however, very scarce data are currently available. The objective of this study was to evaluate the prevalence of pica and its association with nutritional status in dialysis patients. DESIGN AND METHODS: This is a cross-sectional study in a tertiary care teaching hospital. Four-hundred patients on dialysis, without previous pica diagnosis or transplant, pregnancy, mental illness, or infection, were included in the study. Pica, according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, was classified as no pica, ice pica, or hard pica. Dialysis Malnutrition Score, 24-hour dietary recall, and biochemical measurements were obtained from patients. As part of statistical analysis, point prevalence and 95% confidence interval of pica were calculated. Comparisons between groups were performed by means of analysis of variance, Kruskal-Wallis test, χ2, or Fisher exact tests, as appropriate. A multivariate analysis was performed by multinomial logistic regression. RESULTS: Prevalence of pica was 42% (ice pica, 46%; soil, 29%; two substances, 14%; red brick, 5%; paper, 3%; soap, 2%; and cattle pasture, 1%). Comparing patients with pica (hard pica and ice pica) versus no pica, subjects with pica were of younger age (25 ± 7, 27 ± 9, 30 ± 11 years, respectively), were more frequently educated <9 years (57%, 46%, 30%, respectively), and had longer dialysis duration (36 ± 19, 32 ± 18, 27 ± 16 months, respectively). Patients with pica achieved the recommended calorie and macronutrients intake target less frequently than those without pica (40-64% vs. 66-77%, P <.05). Malnutrition was present in 74% of the whole sample: (1) 67% in no pica group, (2) 80% in ice pica group, and (3) 89% in hard pica group (P = .001). In the multivariate analysis (R2, 0.27; P < .0001), malnutrition, C-reactive protein, and lower educational level significantly predicted both ice and hard pica. CONCLUSIONS: A worse nutritional status was observed in patients with pica, who additionally were younger, had lower educational level, longer dialysis duration, and worse macronutrient intake routine than patients without pica. Malnutrition, C-reactive protein, and lower educational level significantly predicted both ice and hard pica.

Competencia y compartimiento emocional en usuarios de cocaína: Psicometría y relación con variables sociodemográficas y clínicas / Emotional competence and magazine in cocaine users: Psychometrics and relationship with sociodemographic and clinical variables

INTRODUCCIÓN: Existe evidencia de relación entre factores emocionales y el consumo de drogas. Sin embargo, al menos la competencia emocional y el compartimiento social de las emociones en usuarios de cocaína no han sido estudiados con anterioridad, en parte debido a la reciente generación de las herramientas para su medición. OBJETIVO: Evaluar las características psicométricas de la Escala de Alexitimia de Toronto (EAT), el Cuestionario de Competencias Emocionales (CEMO), y el Cuestionario de Creencias sobre los efectos de Compartimiento Social de Emociones (CCSE) en pacientes mexicanos usuarios de cocaína, así como establecer su relación con variables socio-demográficas y clínicas. MÉTODO: Los instrumentos fueron completados junto con las Escalas de Afectividad Positiva (AP) y Negativa (AN) en dos ocasiones por 158 pacientes usuarios de cocaína. RESULTADOS: Las tres escalas mostraron coeficientes alpha superiores a .70. La EAT y el CEMO presentaron alta estabilidad temporal a quince días. La AN se asoció positivamente con la EAT y negativamente con el CEMO. La AP se correlacionó negativamente con la EAT y positivamente con el CEMO y el CCSE. El 50.9% de los pacientes presentaron una dificultad relevante en la identificación y la expresión de sus emociones, que se relacionó de forma negativa con la escolaridad. DISCUSIÓN Y CONCLUSIÓN: Se sugiere necesaria la sistematización de la evaluación y el tratamiento de las dificultades en la expresión emocional de usuarios de cocaína. Las versiones en español de las escalas evaluadas en este estudio resultaron válidas y confiables para su uso clínico y de investigación en pacientes mexicanos usuarios de cocaína.

INTRODUCTION: Current evidence suggests a relationship between emotional factors and drugs consumption, although at least both emotional competence and social magazine of emotions have not been studied in cocaine users, in part due to the recent generation of tools for their measure. OBJECTIVE: To evaluate the psychometric properties of the Toronto Alexithymia Scale (TAS), Emotional Competence Questionnaire (ECQ), and the Questionnaire about Beliefs in the effects of the Social Magazine of Emotions (QSME) in Mexican cocaine users, and to establish its relationship with socio-demographic and clinical variables. METHOD: All instruments, as well as the Positive Affectivity (PA) and Negative Affectivity (NA) Scales, were completed twice by 158 cocaine users. RESULTS: All scales showed alpha coefficients greater than .70. The TAS and ECQ presented high temporal stability. NA was positively associated with TAS, and negatively with ESQ. PA showed a negative correlation with TAS, and a positive relation with ECQ and QSME. 50.9% of the patients had a relevant difficulty in identifying and expressing their emotions, which was negatively correlated with schooling. DISCUSSION AND CONCLUSION: A systematic evaluation and treatment of difficulties in the expression of emotions in cocaine users seems to be necessary. The Spanish versions of the scales are valid and reliable for their use with clinical and research purposes in Mexican cocaine users.