[Healthy walks, beyond physical exercise: evaluation of an experience in older population from Gipuzkoa (Spain)]. / Rutas saludables, más allá del ejercicio físico: evaluación de una experiencia en población mayor de Gipuzkoa.

INTRODUCTION: In 2011 the Tipi-Tapa initiative was endorsed by the Public Health Department of Gipuzkoa to promote physical exercise through healthy walks in community-dwelling older adults, in collaboration with municipalities, citizens associations and primary care. OBJECTIVE: To evaluate, from the participants' perspective, the Tipi-Tapa experience during 2012-2017 to identify the main successes and failures and share proposals of continuity and improvement. METHOD: Mixed methods design with a qualitative core component and a supplementary questionnaire to all participants from 13 municipalities. The Chi-squared test was used to compare percentages. In the qualitative study, a purposive sampling was applied considering participants' profiles through nine focus groups and 10 individual interviews. The interviews were audio recorded with previous consent. A thematic analysis was performed using conceptual maps and the MAXQDA software. Triangulation among researchers was done in a research-learning context. RESULTS: We analysed 464 questionnaires; 64% from women and 36% from men. The participants' mean age was 69.8 years; 75% were older than 65 years. The general satisfaction was 9.05/10 with significant differences in favour of women, older age groups and widows. In the qualitative study, 43 women and 37 men participated. Three main thematic areas were identified based on category coding and overlap: a) it is not just walking; b) organization, values and persons; and c) collaborative keystones and future challenges. CONCLUSIONS: The health benefits perceived by participants go beyond physical exercise, with important implications for social interaction and cohesion. The complexity of the processes assessed entails methodological, organizational and collaborative requirements.

Educational activities in the Program for Education through Work for Health / Actividades educativas en el Programa de Educación por el Trabajo para la Salud / Atividades educativas no Programa de Educação pelo Trabalho para Saúde

Abstract Objective: To describe the educational activities of the Program for Education through Work for Health (PET-Health) developed in family health units of a municipality in the Northeast of Brazil. Method: Qualitative study with 16 preceptors interviewed in the months of March and April 2016. Inclusion criterion was adopted: preceptors who worked in family health units linked to the program, for at least two years. Were excluded workers on vacations, maternity leave or on leave for various reasons. The data were interpreted according with Bardin's content analysis method. Results: It was evidenced that the PET-Health involves users in health education actions in the formation of educational groups, recreational activities and income generation workshops, and permanent education activities for health service workers through training, collective actions and induction of changes in daily work. Conclusion and implications for practice: Educational activities of the PET-Health, according to the reality and needs of health services, is a differential that qualifies the training process of students and workers, while promoting education for the health of users through integrated and intersectoral actions.

Resumen Objetivo: Describir las actividades educativas del Programa de Educación por el Trabajo para la Salud (PET-Salud) desarrolladas en unidades de salud de la familia de un municipio del Nordeste brasileño. Método: Estudio cualitativo con 16 preceptores entrevistados entre marzo y abril de 2016. Se adoptó criterio de inclusión: preceptores que actuaron en unidades de salud de la familia vinculadas al programa, por período mínimo de dos años. Se excluyeron los trabajadores de vacaciones, en licencia por maternidad o alejados por razones diversas. Los datos fueron interpretados según el análisis de contenido de Bardin. Resultados: Se evidenció que el PET-Salud involucra a los usuarios en las acciones de educación en salud en la formación de grupos educativos, actividades lúdicas y talleres de generación de renta, y actividades de educación permanente a los trabajadores de salud por medio de capacitaciones, acciones colectivas e inducción de cambios en el cotidiano de trabajo. Conclusión e implicaciones para la práctica: Actividades educativas del PET-Salud, según la realidad y necesidades de los servicios, es un diferencial que califica el proceso de formación de estudiantes y trabajadores, al tiempo que promueve educación para la salud de los usuarios a través de acciones integradas e intersectoriales.

Resumo Objetivo: Descrever as atividades educativas do Programa de Educação pelo Trabalho para Saúde desenvolvidas em unidades de saúde da família de um município do Nordeste brasileiro. Método: Estudo qualitativo com 16 preceptores entrevistados nos meses março e abril 2016. Adotou-se critério de inclusão: preceptores que atuaram em unidades de saúde da família vinculadas ao programa, pelo período mínimo de dois anos. Foram excluídos trabalhadores em férias, licença-maternidade ou afastados por razões diversas. Os dados foram interpretados segundo método análise de conteúdo de Bardin. Resultados: Evidenciou-se que o Programa de Educação pelo Trabalho para Saúde envolve usuários nas ações de educação em saúde na formação de grupos educativos, atividades lúdicas e oficinas de geração de renda, e atividades de educação permanente aos trabalhadores de saúde do serviço por meio de capacitações, ações coletivas e indução de mudanças no cotidiano de trabalho. Conclusão e implicações para a prática: As atividades educativas do Programa de Educação pelo Trabalho para Saúde, consoante com a realidade e necessidades dos serviços de saúde, é um diferencial que qualifica o processo formativo de estudantes e trabalhadores, ao mesmo tempo em que promove educação para a saúde dos usuários por meio de ações integradas e intersetoriais.

Adherence predicts symptomatic and psychosocial remission in schizophrenia: Naturalistic study of patient integration in the community. / La adherencia predice la remisión sintomática y psicosocial en esquizofrenia: estudio naturalístico de la integración de los pacientes en la comunidad.

INTRODUCTION: Psychosocial functioning in patients with schizophrenia attended in daily practice is an understudied aspect. The aim of this study was to assess the relationship between symptomatic and psychosocial remission and adherence to treatment in schizophrenia. METHODS: This cross-sectional, non-interventional, and multicenter study assessed symptomatic and psychosocial remission and community integration of 1,787 outpatients with schizophrenia attended in Spanish mental health services. Adherence to antipsychotic medication in the previous year was categorized as≥80% vs.<80%. RESULTS: Symptomatic remission was achieved in 28.5% of patients, and psychosocial remission in 26.1%. A total of 60.5% of patients were classified as adherent to antipsychotic treatment and 41% as adherent to non-pharmacological treatment. During the index visit, treatment was changed in 28.4% of patients, in 31.1% of them because of low adherence (8.8% of the total population). Adherent patients showed higher percentages of symptomatic and psychosocial remission than non-adherent patients (30.5 vs. 25.4%, P<.05; and 32 vs. 17%, P<.001, respectively). Only 3.5% of the patients showed an adequate level of community integration, which was also higher among adherent patients (73.0 vs. 60.1%, P<.05). CONCLUSIONS: Adherence to antipsychotic medication was associated with symptomatic and psychosocial remission as well as with community integration.

Estigma y comunidad: el desafío de la integración comunitaria de sujetos internados en instituciones psiquiátricas o de salud mental / Stigma and community: the challenge of the community integration of persons interned in psychiatric or mental health institutions

El presente trabajo intenta dar cuenta de los desafíos que implica el trabajo de integración comunitaria de sujetos con padecimiento o discapacidad mental que han estado internados en instituciones psiquiátricas, de salud y/o discapacidad mental. Los abordajes llamados “especiales”, la internación y el dignóstico psiquiátricos, y las figuras jurídicas de insanía e inhabilitación, tienen efectos estigmatizantes para el sujeto que obstaculizan el camino a desandar a la hora de reintegrarse a la comunidad. En este sentido, se proponen prácticas “antiestigma” y como orientación del trabajo un doble movimiento: desde la comunidad para tolerar y vérselas con lo diferente y desde el sujeto, para que ceda algo de lo que lo excluye de la “comunidad de los comunes”.

SUMMARYThe present articule focus on the challenge implied in community integration of persons that had been interned in mental or disability institutions. The “special” treatments, the psychiatric internment and diagnosis, and the juridic figures of insannity and disqualification, has stigmatizing effects that obstruct the way back to the community. “Anti-stigma” practices and a double movement are proposed: the community has to tolerate and deal with the difference and the individual has to give in the aspects that exclude him from “the community of the commons”.

Días de Radio. el esfuerzo hacia la recuperación: la radio como integración / Radio Days. the effort to recovery: the radio as integration

Desde el Centro de Rehabilitación Psicosocial ("CRPS") Los Cármenes (inscrito dentro de la Red Pública de Atención Social para Personas con Enfermedad Mental Grave y Duradera, dependiente de la Consejería de Familia y Asuntos Sociales de la Comunidad de Madrid (www.comunidad.org); gestionado por Instituto de Trabajo Social y Servicios Sociales (INTRESS), se desarrolla desde el 2004 un proyecto que consiste en la realización del programa de radio comunitaria "Ábrete Camino". La metodología, basada en los valores clave de la recuperación, permite que los/as participantes sean cada vez más protagonistas, tanto en el programa como en sus vidas. Ellos/as mismos/as nos cuentan su experiencia a través de un debate en directo en una de sus emisiones. Valoran la experiencia como muy positiva, siendo una actividad significativa en su proyecto vital.(AU)

From the Center for Psychosocial Rehabilitation ("CRPS") Los Cármenes (registered in the Public Network of Social Care for People with Severe and Enduring Mental Illness, under the Ministry of Family and Social Affairs of the Community of Madrid, operated by Intress ), developed since 2004 a project that consists in making community radio program " Ábrete Camino". The methodology, based on the core values of the recovery, allowing the participants to be increasingly more players in both the program and in their lives. They have experience through a live debate in one of their broadcasts.(AU)

Días de Radio. el esfuerzo hacia la recuperación: la radio como integración / Radio Days. the effort to recovery: the radio as integration

Desde el Centro de Rehabilitación Psicosocial ("CRPS") Los Cármenes (inscrito dentro de la Red Pública de Atención Social para Personas con Enfermedad Mental Grave y Duradera, dependiente de la Consejería de Familia y Asuntos Sociales de la Comunidad de Madrid (www.comunidad.org); gestionado por Instituto de Trabajo Social y Servicios Sociales (INTRESS), se desarrolla desde el 2004 un proyecto que consiste en la realización del programa de radio comunitaria "Ábrete Camino". La metodología, basada en los valores clave de la recuperación, permite que los/as participantes sean cada vez más protagonistas, tanto en el programa como en sus vidas. Ellos/as mismos/as nos cuentan su experiencia a través de un debate en directo en una de sus emisiones. Valoran la experiencia como muy positiva, siendo una actividad significativa en su proyecto vital.

From the Center for Psychosocial Rehabilitation ("CRPS") Los Cármenes (registered in the Public Network of Social Care for People with Severe and Enduring Mental Illness, under the Ministry of Family and Social Affairs of the Community of Madrid, operated by Intress ), developed since 2004 a project that consists in making community radio program " Ábrete Camino". The methodology, based on the core values of the recovery, allowing the participants to be increasingly more players in both the program and in their lives. They have experience through a live debate in one of their broadcasts.