The impact of managed care on psychiatric hospitalizations and length of stay in Puerto Rico.

The objective of this paper is to estimate the impact of managed care on psychiatric hospitalizations and length of stay of medically indigent residents in Puerto Rico. A quasi-experimental design and three waves of data from a random community sample were used. Results indicate that, after 2 years, managed care had minimal impact on the number of psychiatric hospitalizations; while the mean length of hospitalization decreased after implementation of managed care, this change was not significant. Based on the data in this study, the managed care initiative developed as part of health reform in Puerto Rico did not appear to affect rates of psychiatric hospitalization and produced only a nonsignificant reduction in the average length of psychiatric hospital stays. Additional research is needed to determine trends in mental health care provision in Puerto Rico based on more recent data.

Attitudes towards homosexual and lesbians among Puerto Rican Public Health graduate students.

The objective of this study is to identify the attitude toward the homosexuals and lesbians among graduate students of General Public Health and Health Education Program at School of Public Health, Medical Sciences Campus of the University of Puerto Rico. A descriptive-92 graduate students of the correlational design was used to carry out the study participated in the study General Public Health and Health Education programs. The data collection was collected through a self-administered questionnaire. Descriptive and inferential statistics (Chi-square and t-test student) were used to data analysis. The 82.6% of the participants had a prejudiced attitude toward the homosexuals and the lesbians. The 79.3% presented a low distance level. There is a significant association among the social distance, homosexual and lesbian educational exposure and the years of studies. To develop appropriate strategies to foment the acceptance and eliminate the prejudice toward the homosexuals and lesbians in the participants, what will impact in a better way of providing quality health services.

Physicians and nurses: knowledge of clinical management of sexual aggression in children based on the sexual aggression survivors manual in Puerto Rico.

OBJECTIVE: To evaluate the knowledge of health professionals about clinical the management of sexual aggression in children based on the sexual aggression survivors manual in Puerto Rico. METHOD: The study population was composed of 150 health professionals (physicians and nurses). For the collected data, a self-administered questionnaire was used. The response rate was 88.7% (n=133). Descriptive statistics, crosstabs tables and Chi-Square were used for the data analysis. RESULTS: 75.9% of the participants were unaware of physical indicators related to sexual aggression in children. Nevertheless, 66.2% of the participants recognized emotional indicators of sexual aggression. 82.7% of the participants think sexual aggression victims should be referred to the physician and nurse, followed by 20.4% that indicated the social worker. 94.7% of the participants were unaware of the correct steps to carry out in a crisis intervention with sexual aggression victims and 91.7% recognized that all information topics should be offered during the intervention. CONCLUSION: The results of this study confirm the necessity of intervention strategies to increase the knowledge of the participants about the correct clinical management of sexual aggression survivors.

Knowledge about breastfeeding in mothers of infants with gastroesophageal reflux

Infants with gastroesophageal reflux disease (GERD) who are breastfed have significantly shorter clinical episodes of the condition than artificially fed infants. The purpose of this study was to identify the knowledge about the benefits of breastfeeding in mothers of babies 0-12 months of age with gastroesophageal reflux. A non-probabilistic sample was taken among patients from various private radiological centers. Sixty mothers completed a self-administered questionnaire, with a median age of 26 years and an educational level of 14 years. Seventy one percent breastfed their last baby, but only 18.6 practiced exclusive breastfeeding. The pediatrician suggested formula to 53.3 of the mothers, and 64 of the mothers were told to combine breast milk with vegetables as treatment for the GERD. Inadequate knowledge about the benefits of breastfeeding was exhibited by 27 of the mothers. Mothers of infants with GERD need education on the importance of breastfeeding. Further research is necessary on the factors which impact the duration of breastfeeding in this population.

Factores Asociados al Nivel de Ansiedad del Personal de Enfermería al Ofrecer Cuidado al Paciente VIH Positivo / Factors associated with the level of anxiety of nursing personnel taking care of HIV positive patients

The objective of the study was to measure the level of HIV/AIDS related anxiety among hospital nursing staff and identify its determinants. Data were obtained through anonymous self administered questionnaire distributed to 222 nurses. The rasge anxiety and the HIV/AIDS attitudes were the most determinants of the anxiety level in the participants. Specifically, negative HIV/AIDS attitudes was associated with raise in state anxiety level, as well as high level of rasge anxiety was associated with high level of state anxiety. In conclusion, it is necessary to provide to the participants update trainings that included different aspects of HIV infection, as well as, anxiety management when caring for persons with HIV/AIDS.

Pacientes Renales: aspectos relacionados con el Cumplimiento del Tratamiento Renal / Kidney patients: aspects related to compliance with renal treatment

The Objective of this study was identify the aspects related with the adherence of medical treatment recommended to the patients that received hemodialysis in the tertiary public hospital. A non experimental transectional correlation design was utilized in this study. Fifty-three patients constituted the population study. A structure interview was utilized to gathered the data. Descriptive statistics and Chi-square tests were utilized to analysis. The response rate was 91.0. The 75.0 of patients not compliance with the medical treatment. Significant association between compliance variable and educational level was encountered (p < or = 0.05). This study provides important findings to will develops educative intervention in the Renal Unit, directed to improve the adherence of the patient with medical treatment.

Conocimiento en sexualidad y prácticas sexuales en estudiantes universitarios con impedimentos visuales: necesidad de materiales educativos / Knowledge about sexuality and sex behavior in university students with visual impairment: need of educational materials

The objective of this study was to identify the knowledge about sexuality (including STD/HIV/AIDS), the sexual practices more frequents and sexuality education sources in a group of students with visual impairments. A self administered questionnaire was utilized in 50 students with visual impairment. Descriptive statistics were utilized. Seventy six percent (76.0) of the participants presented a high knowledge about sexuality and 22.0 presented moderated knowledge. The no penetrative sexual practice more frequent was corporal caress (82.0) and the penetrative was penis-vagina (74.0). The source of sexuality education most common was the conferences (83.9). Although, in general, the knowledge about sexuality was high, there are "gaps" in them. There is the need to develop educational materials adapted to the needs of the studied population.

Reliability and validity of a breastfeeding attitudes instrument for nursing staff

An instrument was designed and validated with the purpose of identifying attitudes towards breastfeeding among nursing professionals. The preliminary instrument contained 19 items which were submitted to experts in the field of human lactation and breastfeeding for content validity. The construct validity was measured through factor analysis and matrix correlation. Four factors were identified in the analysis. Overall internal consistency of the instrument was 0.83, with a subscale's range fluctuating from 0.64 to 0.73. The instrument is valid and reliable, and it is the first of its nature in Puerto Rico.

Introspección hacia su condición de un grupo de pacientes puertorriqueños con trastornos mentales / Introspection into the condition of the group of puertorican patients with mental disorders

The purpose of this study was to explore the degree of insight towards their condition of a group of Puerto Rican mental patients. A non-probabilistic (n = 51) sample was used for convenience and availability from the total patient population with mental conditions who received treatment, during June 1997, in a Diagnostic and Treatment Center (DTC) of the Puerto Rico Department of Health. Descriptive statistics were used, as well as the Cramer chi-square and the Mann Whitney t-test. Fifty two percent of the participants had a high level of insight and the participant's gender (t = 1.92, p = 0.05). Males obtained a higher average grading in the insight scale than females. It was expected that the studied population would be stable in their conditions since they were being treated at the outpatient level. Even so, almost half of the patients had a low level of insight towards their conditions. Implications of these results are very important for health education efforts, since almost half of the patients do not understand that they suffer a serious mental disturbance.

Perceptions assessment of a group of Puerto Rican pregnant adolescents regarding the susceptibility, severity, benefits and barriers of teenage pregnancy

OBJECTIVE: This assessment was aimed at describing the perceptions of a group of Puerto Rican pregnant adolescents regarding the susceptibility, severity, benefits and barriers of adolescents pregnancy. METHOD: A non probabilistic sample of 71 adolescents that receive prenatal services at a hospital in the greater metropolitan area of San Juan, Puerto Rico. Descriptive statistics were utilized to describe the population. RESULTS: A 50.7 per cent of the participants had a moderated high susceptibility perception and 53.5 per cent had a high severity perception. In general, 70.4 per cent of the participants perceived that the prenatal care during the adolescent pregnancy is highly beneficial and 60.0 per cent had a low barriers perceptions. CONCLUSION: The assessment specifically demonstrated the need to create permanent educational programs in hospitals and schools. It is important that the health professionals develop basic educational strategies to procure effective behavior modification in adolescents.

Obstetras y pediatras: Experiencia con la lactancia materna en sus programas de residencia / Obstetricians and pediatricians: experience with breastfeeding in their residency programs

A prior study had the objective of identifying knowledge and experience on breastfeeding of obstetricians and pediatricians in two private hospitals of the Metropolitan Area of San Juan, Puerto Rico. This study presents the experience of those physicians regarding breastfeeding education during their residency training. An exploratory research design was used, the sample was non-probabilistic and was selected according to availability for participation among the physicians who visited those hospitals during June, 1997. The studied sample included 29 pediatricians and 26 obstetricians. Descriptive statistics and crosstab tables were used to describe the results. It was found that participating physicians had little or no exposition to breastfeeding related topics during their respective residency programs. They are aware of the importance of their role in the achievement of successful breastfeeding. They perceive themselves as effective in stimulating breastfeeding although they recognize that they should have received better training on the subject. This attitude is worrisome in face of the fact that this same group presented significant deficiencies in a previous study with regards to knowledge in the management of breastfeeding.