Fibromialgia y empatía: un camino hacia el bienestar / Fibromyalgia and empathy: A path towards well-being

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Experiencia de colaboración entre atención primaria y salud mental en el Departamento de Salud La Ribera, 7 años después / An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)

Pese a la gran frecuencia de problemas de salud mental entre los consultantes de atención primaria, persiste el problema de unos inadecuados diagnóstico y tratamiento. Se necesita una buena capacitación de los médicos de familia para el manejo de estos trastornos, a fin de minimizar su impacto sanitario, económico y social. Entre otros elementos, se considera relevante la cooperación con los servicios de salud mental, para la cual existen diferentes modelos. Nuestro departamento de salud inició en 2006 una colaboración estable según el modelo de enlace. Se han obtenido resultados positivos en términos de reducción de demora para las primeras visitas al especialista y de aumento de la satisfacción de los profesionales, aunque deben interpretarse con cautela. Recientemente se han acumulado evidencias sobre la utilidad del modelo colaborativo, aunque su evaluación y extrapolación son complejas. Nos proponemos ahondar en la evaluación de nuestro modelo, de manera análoga a otras iniciativas de nuestro entorno (AU)

Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment (AU)

[An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)]. / Experiencia de colaboración entre atención primaria y salud mental en el Departamento de Salud La Ribera, 7 años después.

Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment.

Inmigrantes magrebíes gestantes en Atención Primaria: características sociofamiliares / Immigrant Maghrebian pregnant in primary health care: social and family characteristics

Objetivo. Describir demografía, tipología familiar, apoyo social, estresores y función familiar en gestantes magrebíes de una Zona Básica de Salud. Diseño. Estudio transversal. Emplazamiento: ZBS 5 del Departamento de Salud La Ribera (Valencia). Participantes. Gestantes magrebíes, captadas mediante muestreo consecutivo durante un año, que acepten ser encuestadas. Mediciones Principales. Variables sociodemográficas (edad, años en España, nº de hijos, nº de convivientes, nivel de estudios, trabajo remunerado y tipo familiar), acontecimientos vitales estresantes, apoyo social y función familiar. Instrumentos: encuesta sociodemográfica, genograma, escala de reajuste social (SRRS), escala Duke.UNC-11 y cuestionario APGAR familiar. RESULTADOS. Se entrevistaron 45 mujeres (medias de 28,42 años de edad y 3,44 años en España). La mediana de número de hijos fue 1, y la de convivientes en el domicilio 3. Destaca un 26,7% con trabajo remunerado y 28,9% sin estudios; sólo 8,9% tenían estudios superiores. El 68,9% son familias nucleares íntegras y 26,7% nucleares ampliadas. En 36 pacientes se obtuvo el SRRS (media: 179,64) y la escala Duke-UNC-11 (33,22) y en 35 el APGAR familiar (8,09). Se observó una asociación estadísticamente significativa entre: años en España y APGAR familiar; tipo familiar y apoyo social, y número de convivientes y apoyo social afectivo. CONCLUSIONES. Destaca un alto porcentaje de personas sin estudios y predominio de familias nucleares. Se observa un grado de estrés potencialmente patógeno, apoyo social deficiente y normofunción familiar. Se precisan estudios más amplios y cuestionarios culturalmente adaptados(AU)

Objective. To describe demography, family typology, social support, stressors and family function in immigrant Maghrebian pregnant in a basic health care area. Design. Cross sectional study. Location. ZBS 5 of La Ribera (Valencia) health department. Participants. Pregnant Maghrebian women, recruited by means of consecutive sampling over a year, and who agree to being surveyed. Measures. Sociodemographic variables (age, years in Spain, nº of children, nº of cohabitants, academic level, paid work and family type), stressful life events, social support and family function. Procedures: population survey, genogram, social reorganization scale (SRRS), Duke-UNC-11 scale and APGAR family questionnaire. Results. 45 women were interviewed (average 28.42 years of age and 3.44 years’ residence in Spain). The median number of children was 1, and 3 cohabitants in the home. Figures of 26,7% with paid work and 28,9% without formal eduction stand out. Only 8,9% had received higher education. 68,9% are full nuclear families and 26,7%, extended. En 36 patients, the SRRS (average: 179,64) and the Duke-UNC-11 scale (33,22) were obtained and in 35, the family APGAR (8,09). A statistically significant association was seen between: years of residence in Spain and family APGAR; family type and social support, number of cohabitants, and emotional social support. Conclusions. A high percentage of uneducated people and a predominance of nuclear families stand out. A degree of potentially pathogenic stress, lack of social support and a normal functioning family. Broader studies are needed, as well as culturally adapted questionnaires(AU)