Estudio comparativo de estresores y apoyo psicosocial en adolescentes embarazadas en cinco ciudades de la República Mexicana / Comparative study of stressors and psychosocial support in pregnant adolescents in five cities of the Mexican Republique

El embarazo en la adolescencia es un evento que en los últimos años se ha estudiado de manera prioritaria desde diferentes enfoques y perspectivas. El propósito de este estudio, fue generar información acerca de la percepción que tienen las adolescentes durante su embarazo, referente tanto a estresores como al apoyo psicosocial. Comparandose dos grupos de adolescentes embarazadas en cinco ciudades de la República Mexicana (Durango, Fresnillo, Zacatecas, Ciudad de México y Morelia). Uno de ellos formado por 114 casos de adolescentes con el diagnóstico de hipertensión inducida por el embarazo (HIE), y otro constituido por 223 cualificadas como "sanas" (grupo control); se establecieron comparaciones en lo referente a la percepción tanto de experiencias estresantes como de eventos gratificantes en relación a la red familiar y social. El trabajo aporta algunos elementos conceptuales que permiten describir, la percepción que tiene la adolescente embarazada de su entorno psicosocial identificando aspectos que tentativamente se proponen como factores que influyen en el desencadenamiento de problemas de salud

Pregnancy in the adolescente has beenstudied on a high-priority way from different approachesand perspectives in the last years. Theaim of this study, was to explore information onthe perception of the adolescents during her pregnancy,both referred to stressors and to psychosocialsupport. Two groups of pregnant adolescentsin five cities of the Mexican Republic (Durango,Fresnillo, Zacatecas, Morelia and Mexico City)were compared. One of them forrned by 114 adolescentcases with the diagnosis of pregnancy inducedhypertension (PIH), and other one constitutedby 223 qualified as "healthy" (controlgroup). Comparisons of stress fui experiences andgrateful events in relation to the familiar and socialnet were conducted. This work contributes todescribe several factors of the psychosocial environmentthat tentatively intluence the triggeringproblem ofhealth in the pregnant adolescent

Hipertensión inducida por el embarzo en adolescents: un studio multicéntrico / Pregnancy-induced hipertensión in young women: a multicenter study

Se evaluó la situación psicosocial percibida durante el proceso gestacional por dos grupos de adolescentes, un grupo se formó por 114 mujeres en quienes se estableció el diagnóstico de hipertensión inducida por el embarazo (HIE) y el otro por mujeres que fueron cualificadas como "sanas" (n=223). Fueron entrevistadas 337 mujeres adolescentes de las ciudades de Durango, Zacatecas, Fresnillo, Morelia y ciudad de México, que acudieron a instituciones hospitalarias de la Secretaría de Salud (SSA), y del Instituto Mexicano del Seguro Social (IMSS), de septiembre de 1998 a enero del 2000. Se aplicó a todas las participantes un cuestionario, para la identificación de estresores psicosociales y apoyo psicosocial. Se emplearon estadísticos descriptivos; X2 y estimación logarítmica media de razón de momios con IC. a 95%. Se observó una percepción más favorable de la situación psicosocial en las integrantes del grupo control. La situación psicosocial desfavorable identificada en el grupo de casos, sugiere su vinculación con los mecanismos biológicos responsables de la expresión de la HIE

To evaluate the psychosocial condition during pregnancy, as seen by two groups of young pregnant women from five cities in Mexico, women suffering from pregnancy-induced hypertension (PIH) were gathered into a group (n=l14). While women with a normal pregnancy formed another group (n=223). 337 young women from Durango, Zacatecas, Fresnillo, Morelia and Mexico City, were interviewed. They were submitted for obstetric care into hospitals belonging to the Mexican Ministry of Health (SSA) and the Mexican Social Security Institute (IMSS), between September 1998, and January 2000. All of the participating women answered a questionnaire, in order to identify psychosocial stressors and psychosocial support. Descriptive statistics, X2 and estimated mean log-odds ratio with 95% confidence intervals were used. A more favorable perception of psychosocial condition with figures statistically significative in the members of the control group were observed. The unfavorable psychosocial condition of the cases group, suggests its vinculation with the biologic process of the PIH

Diferencias en ansiedad estado-rasgo entre adolescentes con hipertension inducida por el embarazo y adolescentes embarazadas sanas / Differences in state-trait anxiety between adolescents with pregnancy induced hypertension and healthy pregnant adolescents

Se establecen y comparan los niveles de ansiedad percibidos por dos grupos de adolescentes, uno de ellos con el diagnóstico de hipertensión inducida por el embarazo (HIE), y el otro grupo conformado por adolescentes cualificadas como sanas. Es un estudio colaborativo de casos y controles, en el cual fueron escogidas 128 adolescentes embarazadas, que acudieron al servicio de gineco-obstetricia en hospitales de la Secretaría de Salud en las ciudades de Durango y México. El grupo de casos se integró por 46 adolescentes en quienes se estableció el diagnóstico de HIE por personal médico hospitalario, el grupo control se conformó por 82 adolescentes, que fueron cualificadas como sanas de acuerdo con criterios explícitos del estudio; tanto el grupo de casos como el de controles se integraron por adolescentes de ambas ciudades. Las participantes accedieron a responder el Inventario de Ansiedad EstadoRasgo (IDARE). Percepciones de ansiedad estado y rasgo difieren significativamente entre adolescentes con HIE y el grupo control. Los resultados muestran que el grupo de adolescentes con hipertensión inducida por el embarazo, presentan niveles de ansiedad significativamente más altos que el grupo control. (AU)

[Psychosocial status of adolescents and pregnancy toxemia]. / Situación psicosocial de las adolescentes y toxemias del embarazo.

OBJECTIVE: To compare the perception of psychosocial conditions (during pregnancy) between two groups of adolescents; one group was integrated by young women diagnosed with pregnancy induced-hypertension and the other group by clinically healthy women. MATERIAL AND METHODS: A case-control study design where 39 cases and 88 controls were chosen from pregnant adolescents seeking care at the General Hospital of Durango City, México, from July 1996 to February 1997, and from September 1998 to January 1999. Participants agreed to answer a semi-structured questionnaire to collect data on psychosocial support; psychosocial source of stress; coping responses; intention, desire and acceptance of pregnancy; and attitude and quality of socialization during pregnancy. Data analysis consisted of descriptive statistics, chi 2 and odds ratios with 95% confidence intervals. RESULTS: The two groups' sociodemographic and gyneco-obstetric characteristics were similar. Perception of stressors was higher among cases; sources of support were greater among controls. Positive attitudes and satisfactory socialization during pregnancy were more frequently reported by controls, with statistically significant differences between groups. CONCLUSIONS: We found qualitative differences in the perception of psychosocial conditions among study participants, with statistically significant favorable perceptions among controls.

[Prevalence of domestic violence in the city of Durango]. / Prevalencia de violencia doméstica en la ciudad de Durango.

OBJECTIVE: To characterize and determine the prevalence of the different types of gender-associated violence in the city of Durango, Mexico. MATERIAL AND METHODS: With a transversal design, 384 women residents of the city of Durango, either living with or having lived with someone before, were interviewed. The sample was proportionately distributed in 6 city sectors which were randomly chosen and representative of the high middle and low socioeconomic levels. Sixty-four interviews were conducted in each city sector. The questionnaire consisted of 184 closed and 22 open questions, including identification, sociodemographic and reproductive data, as well as specific questions on physical, emotional and sexual violence. RESULTS: Median age of the studied group was 41.5 years, ranging from 12 to 48 years. Prevalence of domestic violence was: sexual 42%; physical 40%; emotional 39%. CONCLUSIONS: The problem of violence, in its different forms, is a highly prevalent factor which jeopardizes the welfare of the family nucleus. Higher prevalence values of domestic violence were detected in the presence of factors such as violence antecedents, alcoholism and/or drug consumption by some member of the family.

[Epidemiology of nosocomial infections in a second level hospital]. / Epidemiología de las infecciones nosocomiales en un hospital de segundo nivel.

OBJECTIVE: To determine the incidence, specific rates, areas of greatest risk and causal agents of nosocomial infections at the Hospital General de Durango, of the Secretaría de Salud, Mexico. MATERIAL AND METHODS: Prospective study of nosocomial infection vigilance during one year including all patients discharged during this period. RESULTS: An overall rate of 9 infections per 100 discharged patients was found, the higher specific rates were in the areas of intensive pediatric care and births and the lowest were in the surgery, pediatric and gynecology and obstetrics departments. Infections were most frequent in urinary tract and surgical wounds as well as pneumonia among adults; among children, the most frequent were bacteremias and an epidemic outbreak with predominating Serratia marscecens was observed. Most patients presented one only infectious process and E coli, Klebsiello and Enterobacter sp. were the most frequently isolated microorganisms. CONCLUSIONS: The nosocomial infection rate observed in this study is higher than the average in Mexico for similar institutions. The most affected areas were those of critical patients and new births with urinary tract and surgical wound infections, and pneumonia, and the most frequent causal agents were enteric Gram-negative bacilli. These findings suggest guide lines for the design of a nosocomial infection control program, adjusted to the particular features of each institution.

[Nosocomial urinary tract infections at a second-level hospital]. / Infecciones nosocomiales de vías urinarias en un hospital de segundo nivel.

In order to investigate the incidence, etiologic agents and number of episodes of nosocomial urinary tract infections, a prospective study was carried on at the General Hospital in Durango, Mexico. All the patients admitted to the hospital during the period of March to June, 1991, and whose hospital stay was longer than 48 hours, were included. The infection rate in 962 patients was 12.9 episodes per hundred. The service of Internal Medicine had the highest rate and Pediatrics the lowest. The infection rate was higher among older patients and there was no significant difference between genders. 73% of the patients had only one episode of infection and the presence of a permanent urinary-catheter was the main clinical condition associated with infection. Escherichia coli and Klebsiella sp. were the most frequently isolated microorganisms. Nosocomial urinary tract infections have a very high incidence in a general hospital, therefore there is a pressing need to implement effective control programs.