RESUMO
Objetivo: Analizar según variables sociodemográficas el control mamográfico que realizan las mujeres españolas de 45 a 69 años de edad y describir el papel que desempeñan los programas poblacionales de cribado del cáncer de mama en cuanto a la variabilidad de los controles mamográficos. Métodos: Estudio transversal a partir de la Encuesta Nacional de Salud de 2011. La población de estudio son las mujeres residentes en España entre finales de 2011 y principios de 2012. La muestra ponderada analizada corresponde a 3.086 mujeres de 45 a 69 años de edad. Las variables dependientes fueron la realización de mamografías, la última mamografía y el motivo de su realización. Las variables independientes fueron la edad, la clase social, la situación laboral, el país de origen, el ámbito de procedencia, la cobertura sanitaria y los años de implantación del programa. Se realizaron modelos de regresión logística, obteniendo odds ratio (OR) ajustadas por edad y sus intervalos de confianza del 95% (IC95%). Resultados: Un 91,9% indicó que se había realizado una mamografía alguna vez. Las mujeres que se habían realizado el último control mamográfico entre 1 y 2 años antes se asociaron a la clase social más alta (OR: 1,69; IC95%: 1,03-2,75). El motivo de realizar la última mamografía periódica por un programa poblacional se asoció a las mujeres cuya edad era de 60-69 años (OR: 1,51; IC95%: 1,04-2,19). Conclusión: Los resultados indican que existen desigualdades sociales en la realización de prácticas preventivas. Debemos identificar posibles grupos de riesgo con el fin de impulsar la implementación de acciones específicas (AU)
Objective: To analyse mammography screening in Spanish women aged 45 to 69 according sociodemographic variables and to describe the role of population-based breast cancer screening programmes in terms of variability of said screening. Methods: Cross-sectional study of the 2011 National Health Survey. The study population includes women living in Spain between late 2011 and early 2012. The weighted sample analysed corresponds to 3,086 women aged 45 to 69. The dependent variables were mammograms and when the last mammogram was performed and why. Independent variables were age, social class, occupational status, country of origin, area of origin (rural/urban), health cover and years the programme had been in place. Logistic regression models were performed, with odds ratio (OR) adjusted according to age and 95% confidence intervals (95% CI). Results: Approximately 91.9% indicated that they had had a mammogram before. The women who had had their last mammography screening in the previous 1 to 2 years were associated with the highest social class (OR: 1.69; 95% CI: 1.03-2.75). The reason for performing the last periodic mammogram via a population-based programme was associated with women aged between 60 and 69 years (OR: 1.51; 95% CI: 1.04-2.19). Conclusions: The results show that there are still inequalities in preventive practices. Possible risk groups need to be identified in order to promote the implementation of specific actions (AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Disparidades nos Níveis de Saúde , Mamografia/métodos , Mamografia/tendências , Serviços de Saúde , 24436 , Programas de Rastreamento/métodos , Modelos Logísticos , Estudos Transversais/métodos , 28599 , Intervalos de ConfiançaRESUMO
OBJECTIVE: To analyse mammography screening in Spanish women aged 45 to 69 according sociodemographic variables and to describe the role of population-based breast cancer screening programmes in terms of variability of said screening. METHODS: Cross-sectional study of the 2011 National Health Survey. The study population includes women living in Spain between late 2011 and early 2012. The weighted sample analysed corresponds to 3,086 women aged 45 to 69. The dependent variables were mammograms and when the last mammogram was performed and why. Independent variables were age, social class, occupational status, country of origin, area of origin (rural/urban), health cover and years the programme had been in place. Logistic regression models were performed, with odds ratio (OR) adjusted according to age and 95% confidence intervals (95% CI). RESULTS: Approximately 91.9% indicated that they had had a mammogram before. The women who had had their last mammography screening in the previous 1 to 2 years were associated with the highest social class (OR: 1.69; 95% CI: 1.03-2.75). The reason for performing the last periodic mammogram via a population-based programme was associated with women aged between 60 and 69 years (OR: 1.51; 95% CI: 1.04-2.19). CONCLUSIONS: The results show that there are still inequalities in preventive practices. Possible risk groups need to be identified in order to promote the implementation of specific actions.
Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Mamografia , Fatores Socioeconômicos , Fatores Etários , Idoso , Intervalos de Confiança , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Emprego/estatística & dados numéricos , Feminino , Humanos , Seguro Saúde/estatística & dados numéricos , Modelos Logísticos , Mamografia/estatística & dados numéricos , Pessoa de Meia-Idade , Motivação , Razão de Chances , Classe Social , EspanhaRESUMO
PURPOSE: While there has been systematic research on the experiences of immigrant patients in mental health services within certain European countries, little research has explored the experiences of mental health professionals in the delivery of services to immigrants across Europe. This study sought to explore professionals' experiences of delivering care to immigrants in districts densely populated with immigrants across Europe. METHODS: Forty-eight semi-structured interviews were conducted with mental health care professionals working in 16 European countries. Professionals in each country were recruited from three areas with the highest proportion of immigrants. For the purpose of this study, immigrants were defined as first-generation immigrants born outside the country of current residence, including regular immigrants, irregular immigrants, asylum seekers, refugees and victims of human trafficking. Interviews were transcribed and analysed using thematic analysis. RESULTS: The interviews highlighted specific challenges to treating immigrants in mental health services across all 16 countries including complications with diagnosis, difficulty in developing trust and increased risk of marginalisation. CONCLUSIONS: Although mental health service delivery varies between and within European countries, consistent challenges exist in the experiences of mental health professionals delivering services in communities with high proportions of immigrants. Improvements to practice should include training in reaching appropriate diagnoses, a focus on building trusting relationships and measures to counter marginalisation.
Assuntos
Atitude do Pessoal de Saúde , Emigrantes e Imigrantes/psicologia , Pessoal de Saúde/psicologia , Transtornos Mentais/etnologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/organização & administração , Adulto , Barreiras de Comunicação , Competência Cultural , Cultura , Emigrantes e Imigrantes/estatística & dados numéricos , Europa (Continente)/epidemiologia , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Relações Profissional-Paciente , Pesquisa Qualitativa , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos , ConfiançaRESUMO
BACKGROUND: Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries. RESULTS: Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this. CONCLUSIONS: The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways.
Assuntos
Serviço Hospitalar de Emergência/organização & administração , Pessoal de Saúde/psicologia , Serviços de Saúde Mental/organização & administração , Atenção Primária à Saúde/organização & administração , Migrantes/legislação & jurisprudência , Adulto , Atitude do Pessoal de Saúde , Comunicação , Serviço Hospitalar de Emergência/ética , Europa (Continente) , Humanos , Serviços de Saúde Mental/ética , Atenção Primária à Saúde/éticaRESUMO
Fundamentos: Con el fin de mejorar las estrategias de comunicación y aumentar la participación en el programa de cribado, se plantea describir las características sociodemográficas de las mujeres según su participación o no en el Programa de Detección Precoz de Cáncer de Mama (PDPCM) en Barcelona (2007), analizar su grado de satisfacción y conocimientos del programa y conocer las expectativas de las no participantes respecto al programa. Métodos: Estudio transversal en una muestra de 600 mujeres de 50 a 69 años empadronadas en Barcelona. Se realizó una entrevista telefónica con un cuestionario de 35 preguntas agrupadas en: conocimientos de la enfermedad y del programa, satisfacción con respecto al programa, expectativas (características que incentiven a la participación) y características sociodemográficas. La asociación entre los conocimientos y la satisfacción con las características sociodemográficas se analizaron mediante análisis bivariante y multivariante (modelos de poisson robusta). Se llevó a cabo un análisis descriptivo de las expectativas de las no participantes en el programa. Resultados: De las 244 (40,7%) mujeres entrevistadas que no participaron en el PDPCM, 160 (65,6%) tenían estudios medios o superiores y 163 (66,8%) eran de clase social aventajada. De las 356 que indicaron ser participantes en el PDPCM 340 (95,5%) estaban satisfechas con el PDPCM en su conjunto. Conclusiones: El grado de satisfacción y el conocimiento respecto al programa es muy elevado. Las expectativas expresadas sugieren que las mujeres reciben mensajes contradictorios en cuanto a la periodiciad del cribado (anual respecto bianual) y rango de edad (40-69 respecto 50-69)(AU)
Background In order to improve the strategies of communication and to increase the participation in the screening program, one considers to describe the sociodemographic characteristics of participants and nonparticipants of the Breast Cancer Screening Program (BCSP) in Barcelona (2007), to analyse the degree of satisfaction and knowledge with the programme, and to know the expectations of nonparticipants with respect to the programme. Methods: Cross-sectional study in a sample of 600 women between 50 and 69 years of age registered in Barcelona. A telephone interview was carried out using a questionnaire composed of 35 questions, grouped in: knowledge of the disease and the programme, satisfaction with the programme, expectations (characteristics which might increase participation) and sociodemographic characteristics. The association between knowledge and satisfaction with the sociodemographic characteristics was analysed by means of bivariate and multivariate analysis (robust poisson models). A descriptive analysis of the expectations of nonparticipants was carried out. Results: Among the 244 nonparticipants interviewed, 160 (65,6%) had middle or superior studies, and 163 (66,8%) were of a privileged social class. Of 356 women that indicated to be participants in the PDPCM 340 (95,5 %) were satisfied with the PDPCM in global. Conclusions: The degree of satisfaction and knowledge with the programme is very high. The expectations indicated suggest that women receive contradictory messages with regard to periodicity (annual respect biannual) and age range (40-69 respect 50-69)(AU)
Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Diagnóstico Precoce , Neoplasias da Mama/epidemiologia , Programas de Rastreamento/métodos , Programas de Rastreamento/estatística & dados numéricos , Satisfação do Paciente , Mamografia/estatística & dados numéricos , Mamografia , Estudos Transversais , Inquéritos e Questionários , Telefone , Análise Multivariada , Distribuição de Poisson , Análise de DadosRESUMO
BACKGROUND: In order to improve the strategies of communication and to increase the participation in the screening program, one considers to describe the sociodemographic characteristics of participants and nonparticipants of the Breast Cancer Screening Program (BCSP) in Barcelona (2007), to analyse the degree of satisfaction and knowledge with the programme, and to know the expectations of nonparticipants with respect to the programme. METHODS: Cross-sectional study in a sample of 600 women between 50 and 69 years of age registered in Barcelona. A telephone interview was carried out using a questionnaire composed of 35 questions, grouped in: knowledge of the disease and the programme, satisfaction with the programme, expectations (characteristics which might increase participation) and sociodemographic characteristics. The association between knowledge and satisfaction with the sociodemographic characteristics was analysed by means of bivariate and multivariate analysis (robust poisson models). A descriptive analysis of the expectations of nonparticipants was carried out. RESULTS: Among the 244 nonparticipants interviewed, 160 (65,6%) had middle or superior studies, and 163 (66,8%) were of a privileged social class. Of 356 women that indicated to be participants in the PDPCM 340 (95,5 %) were satisfied with the PDPCM in global. CONCLUSIONS: The degree of satisfaction and knowledge with the programme is very high. The expectations indicated suggest that women receive contradictory messages with regard to periodicity (annual respect biannual) and age range (40-69 respect 50-69).