RESUMO
La colocación de una sonda de alimentación a través de una gastrostomía endoscópica percutánea es un método seguro y efectivo para proveer nutrición enteral prolongada en pacientes que no pueden deglutir y ofrece claras ventajas respecto a la alimentación por sonda nasogástrica. Esta técnica de alimentación es relativamente desconocida en Atención Primaria. Revisamos las indicaciones de dicha técnica y los cuidados que estos pacientes requieren desde el punto de vista de los profesionales de Atención Primaria. La gastrostomía endoscópica percutánea se ha convertido en el método de elección para facilitar una nutrición enteral prolongada en pacientes atendidos a domicilio (AU)
Assuntos
Humanos , Gastrostomia/métodos , Endoscopia do Sistema Digestório/métodos , Nutrição Enteral/métodos , Atenção Primária à Saúde , Serviços de Assistência Domiciliar , Gastrostomia/efeitos adversos , Endoscopia do Sistema Digestório/efeitos adversosRESUMO
OBJECTIVE: To find the present state of postgraduate teaching in Family and Community Medicine, (FCM) in rural areas, according to the view of teaching unit (TU) coordinators. DESIGN: A descriptive cross-sectional study using a mail questionnaire. SETTING: The 75 TUs of FCM in Spain. PARTICIPANTS: TU coordinators. INTERVENTIONS: In January 1996 a questionnaire with 29 questions was sent to the TU coordinators. In May 1996 it was sent again to those who had not replied. MEASUREMENTS AND MAIN RESULTS: 68 (90.66%) of the TUs replied, which covered all the Spanish provinces except four. Out of the TUs who replied, 42 (61.76%) had a rural Health District (RHD) or local practice (LP) in their area, and 37 (54.4%) had some RHD/LP doctor accredited as a tutor. Of the 1,894 tutors in all, 1,675 (88.43%) worked in urban areas and 219 (11.56%) in rural areas. Before 1989 there had been only three RHD/LP tutors. CONCLUSIONS: There are few RHD/LP tutors. Teaching in rural areas should be strengthened, both because of these areas' specific requirements and because they could be the future workplaces of many of our present Residents.
