RESUMEN
INTRODUCTION: Metabolic control of patients with diabetes is determined by several factors, among others competence level, performance, and attitudes of primary-care physicians. OBJECTIVE: On objective was to determinate family physician factors associated with glycemic control in subjects with diabetes in two Family Medicine Units (FMU). DESIGN: Cross-sectional comparative study. SETTING: Two Family Medicine Units of the Mexican Institute Social Security. INTERVENTIONS: Family physician demographic factors were measured (age, sex, job seniority, time of university graduation, and had to have studied a specialty residence studied). Two validated instruments were applied to measure attitude level and handling competence of DM 2, and we determined glycemic level in the previous months of five diabetic patients by consulting room. RESULTS: Forty family physicians were evaluated, mean age 43.9 years, 57.5% with a residence in Family Medicine. Better glycemic control was associated with job seniority, OR 2.49 (CI 0.96-6.6), time of university graduation > 10 years with OR 2.11 (CI 1.4-2.9), to have at least one course related with diabetes in the previous year with OR 4.8 (IC 0.39-22), and competence level OR 2.02 (CI 0.36-11.3) CONCLUSIONS: There association between better glycemic control and more professional experience and training on diabetes in the previous year.
Asunto(s)
Glucemia/efectos de los fármacos , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Médicos de Familia/estadística & datos numéricos , Adulto , Factores de Edad , Glucemia/metabolismo , Estudios Transversales , Diabetes Mellitus Tipo 2/sangre , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Hipoglucemiantes/uso terapéutico , Masculino , Medicina/estadística & datos numéricos , México/epidemiología , Factores Sexuales , EspecializaciónRESUMEN
Objetivo. Evaluar la validez y fiabilidad del instrumento 'FANTASTIC', al aplicarse a una muestra de pacientes mexicanos con hipertensión arterial. Diseño. Observacional, prospectivo, longitudinal y descriptivo. Emplazamiento. Unidad de Medicina Familiar N.º 91 del Instituto Mexicano del Seguro Social. Pacientes. Un total de 103 adultos hipertensos con tratamiento farmacológico, no diabéticos, que supieran leer y escribir. Intervenciones. Se aplicó el instrumento 'FANTASTIC' que consta de 25 ítems cerrados sobre el estilo de vida, traducido al español en las versiones de 3 y 5 opciones de respuesta, con un intervalo test-retest de 14-21 días. Se calculó el promedio de la tensión arterial sistólica (TAS), diastólica (TAD) y media (TAM) de los 3 últimos registros del expediente clínico, se midió índice de masa corporal (IMC), índice cintura/cadera (ICC). Mediciones y resultados. Un 66 por ciento de los pacientes fueron mujeres. El coeficiente de correlación test-retest en la versión de 5 opciones de respuesta fue de 0,81 (p = 0,01) y entre ambas versiones de 0,91 (p = 0,01). No se encontraron diferencias en la calificación total según el sexo. A mayor edad, se encontró mayor calificación y menor IMC. Se observó correlación negativa débil y no significativa entre mayor calificación total y menor TAD. Hubo correlación negativa entre mayor calificación en el dominio de nutrición y menor IMC (p = 0,01), entre mayor calificación en el dominio de tabaco (menor consumo) con menor TAD (p = 0,05) y menor TAM (p = 0,05). Conclusiones. La consistencia del instrumento es muy buena. Su contenido no se correlaciona específicamente con los indicadores clínicos de control en hipertensos (AU)
Asunto(s)
Persona de Mediana Edad , Niño , Adolescente , Adulto , Anciano , Masculino , Femenino , Humanos , Infecciones Estreptocócicas , Encuestas y Cuestionarios , Hipertensión , Estilo de Vida , Streptococcus pyogenes , Factores Sexuales , Sensibilidad y Especificidad , Tonsilitis , Reproducibilidad de los Resultados , México , Faringitis , Personalidad , Estudios Prospectivos , Bacterias , Peso Corporal , Antihipertensivos , beta-Lactamasas , Presión Sanguínea , Estudios Transversales , Factores de Edad , Análisis de Varianza , Índice de Masa Corporal , Pruebas de Sensibilidad MicrobianaRESUMEN
OBJECTIVE: To evaluate the reliability and validity of the instrument "FANTASTIC", when being applied to a sample of Mexican patients with high blood pressure. DESIGN: Observational, prospective, longitudinal, descriptive. SETTING: Unit of Family Medicine No. 91 Instituto Mexicano del Seguro Social. PATIENTS: 103 patients with hypertension on treatment, adults, non diabetics that knew to read and to write. INTERVENTIONS: Was applied "FANTASTIC" instrument (that consists of 25 closed items on the lifestyle), translated to Spanish in versions of 3 and 5 answers, with an interval test-retest of 14 to 21 days. The average of the systolic arterial tension (SAT), diastolic (DAT) and half arterial tension (HAT) was calculated of the last 3 registrations of the clinical file, mass corporal index (MCI), waist/hip ratio (WHR), and fast glucaemia (FG) was measured. MEASUREMENT AND RESULTS: 66% was women. The correlation test-retest, in the version of five answer options was of 0.81 (p = 0.01) and among both versions of 0.91 (p = 0.01). They were not differences in the total qualification according to the sex. To more age, it was bigger qualification and smaller MCI and FG. Weak correlation was observed (not significant) among more total qualification and smaller DAT. There was negative correlation among more qualification in the nutrition domain and smaller MCI (p = 0.01), among more qualification in the domain of tobacco (smaller consumption) with smaller DAT (p = 0.05) and smaller HAT (p = 0.05). CONCLUSIONS: The consistency of the instrument is very good. Their content doesn't correlate specifically with the control indicators in hypertension.