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1.
Cir Cir ; 88(3): 354-360, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32539002

RESUMO

BACKGROUND: Medical surgeons specialists are exposed to risk factors, the most frequent being those of the psychosocial type, where burnout syndrome is included due to the type of exposure and diversification of their activities as a member of the health team and the legal and socio-labor repercussions. OBJECTIVE: To determine the prevalence and risk factors of burnout in medical surgeons. METHOD: Observational, descriptive and cross-sectional study in 296 specialists. The data was processed descriptively and inferentially with the support of the SPSS 15.0 and Epi-infoV6.1 program. RESULTS: There was a response in 92.5% of the interviewees and the burnout was found in 40.2%. Significant differences were detected in age under 40 years, not having a stable partner, and < 15 years with your partner, being a medical oncologist, having < 10 years of professional seniority and in the workplace. CONCLUSIONS: Burnout is frequent (40.2%), as risk factors are, being: woman; under 40 years old; not having a stable partner, under 15 years with her and not working this, without children; surgical medical oncologist; < 10 years of professional seniority and job position, night shift; definitive hiring; not having another job and more than 4 h in it. The involvement of the subscales behaves like the syndrome. There was a negative correlation with burnout between emotional exhaustion and depersonalization, and positive with lack of personal fulfillment at work.


ANTECEDENTES: Los médicos cirujanos especialistas están expuestos a factores de riesgo, siendo los más frecuentes los de tipo psicosocial, incluyendo el síndrome de desgaste profesional (burnout) por el tipo de exposición y la diversificación de sus actividades como miembros del equipo de salud, y las repercusiones jurídicas y sociolaborales. OBJETIVO: Determinar la prevalencia y los factores de riesgo del burnout en médicos cirujanos especialistas. MÉTODO: Estudio observacional, descriptivo y transversal, en 296 especialistas. Los datos se procesaron descriptivamente y de manera inferencial con apoyo de los programas SPSS 15.0 y Epi-infoV6.1. RESULTADOS: Hubo respuesta en el 92.5% de los entrevistados y el burnout se encontró en el 40.2%. Se detectaron diferencias significativas en edad menor de 40 años, no tener pareja estable o menos de 15 años con pareja, ser médico oncólogo quirúrgico, y tener menos de 10 años de antigüedad profesional o en puesto de trabajo. CONCLUSIONES: El burnout es frecuente (40.2%) y como factores de riesgo están ser mujer, ser menor de 40 años, no tener pareja estable o menos de 15 años con pareja y que esta no trabaje, no tener hijos, ser médico oncólogo quirúrgico, tener menos de 10 años de antigüedad profesional o en puesto de trabajo, trabajar en turno nocturno, tener contratación definitiva, no tener otro trabajo y trabajar más de 4 horas en él. La afectación de las subescalas se comporta como el síndrome. Hubo correlación negativa con el burnout entre agotamiento emocional y despersonalización, y positiva con falta de realización personal en el trabajo.


Assuntos
Esgotamento Profissional/epidemiologia , Cirurgiões/psicologia , Adulto , Atitude do Pessoal de Saúde , Esgotamento Profissional/prevenção & controle , Esgotamento Profissional/psicologia , Estudos Transversais , Emoções , Características da Família , Feminino , Humanos , Masculino , Casamento , Oncologia , México/epidemiologia , Pessoa de Meia-Idade , Médicos/psicologia , Prevalência , Fatores de Risco , Autorrelato , Jornada de Trabalho em Turnos/psicologia , Equilíbrio Trabalho-Vida , Local de Trabalho/psicologia
2.
Salud trab. (Maracay) ; 28(1): 7-21, jun. 2020. ilus
Artigo em Espanhol | LILACS, LIVECS | ID: biblio-1104315

RESUMO

Objetivo: Determinar prevalencia y factores asociados al riesgo del síndrome de desgaste profesional (burnout) en médicos especialistas. Material y métodos: Estudio observacional, descriptivo y transversal, participaron 182 médicos especialistas. Se realizaron estadísticas descriptivas e inferenciales con SPSS 15.0 y Epi-infoV6.1. Resultados: Respuesta del 81,3%. Se detectó burnout en 49,5%. Diferencias significativas: edad menor de 40 años; Menos de 15 años con pareja estable; Que trabajara la pareja; Antigüedad profesional menor a 10 años. Se mostró una correlación negativa entre agotamiento emocional y despersonalización; positiva con la falta de realización personal en el trabajo en presencia del síndrome. Conclusión: el burnout es frecuente (49,5%), perfil de riesgo: ser mujer; <40 años de edad; sin pareja estable y <15 años con ella; que trabaja la pareja; sin hijos; especialidad quirúrgica; <10 años de antigüedad profesional y en el puesto actual de trabajo; laborar en jornada acumulada; con tipo de contratación definitiva, no tener otro trabajo; jornada mayor a 4 horas. Las subescalas en promedio están cerca de la normalidad. Agotamiento emocional y despersonalización, se comportan como el síndrome. Correlación negativa entre agotamiento emocional y despersonalización y positiva con la falta de realización personal con burnout(AU)


Objective: To determine the prevalence and risk factors associated with burnout syndrome in medical specialists. Material and methods: An observational, descriptive and cross-sectional study was conducted among 182 participating medical specialists. Descriptive and inferential statistics were performed using SPSS 15.0 and EpiinfoV6.1. Results: We obtained a 81.3% response. Burnout was detected in 49.5% of respondents. Significant findings: respondents under 40 years of age; less than 15 years with a stable partner; had a working spouse; length of professional employment less than 10 years. We found a negative correlation between emotional exhaustion and depersonalization was evident, on the other hand, a positive correlation was evident between the lack of personal fulfillment at work and the presence of burnout. Conclusion: Burnout is frequent (49.5%).Risk factors include being a woman; being less than40 years old; having no stable partner and being together for less than15 years; that the couple works; childless; surgical specialty; less than 10 years of professional seniority and in the current job position; has a cumulative work day; having permanent recruitment, not having another job; and a work day greater than 4 hours. The subscales on average were close to normal. Emotional exhaustion and depersonalization mimic burnout. A negative correlation was evident between emotional exhaustion and depersonalization. A positive correlation was evident between the lack of personal fulfillment and burnout(AU)


Assuntos
Humanos , Esgotamento Profissional/prevenção & controle , Estudos Transversais , Fatores de Risco , Despersonalização , Esgotamento Psicológico/prevenção & controle , México , Categorias de Trabalhadores
3.
Rev Med Inst Mex Seguro Soc ; 56(3): 261-272, 2018 Oct 25.
Artigo em Espanhol | MEDLINE | ID: mdl-30376623

RESUMO

Background: The life table is a useful instrument to measure the impact of health care in a population. In this case we report the situation of the population that use the medical services of the Instituto Mexicano del Seguro Social in the state of Jalisco. Methods: We used the abridged Reed-Merrell method, which shows the life expectancy in five-year age groups. Results: In 2015 life expectancy for people with hospital insurance was 80.51 for women and 77.93 for men. For the total of insured women and men, life expectancy was 77.65 and 73.73 years, respectively. Conclusion: Compared with previous calculations, we observed a deceleration of the gain of life expectancy in both sexes, even though women keep more life expectancy than men.


Introducción: La tabla de vida es un valioso instrumento para medir el impacto de la atención médica en una población. En este caso reportamos la situación de la población usuaria de los servicios de salud del Instituto Mexicano del Seguro Social en el estado de Jalisco, México. Métodos: Se utilizó el método abreviado de Reed-Merrell, que muestra la esperanza de vida en grupos quinquenales de edad. Resultados: En 2015 la esperanza de vida en asegurados hospitalizados hombres fue de 77.93 años y en mujeres, de 80.51 años. Para el total de asegurados mujeres y hombres fue de 77.65 y 73.73, respectivamente. Conclusiones: Si se compara con cálculos previos, se observa una desaceleración en la ganancia de expectativa de vida en pacientes hospitalizados de ambos sexos, aunque se conserva una mayor esperanza para las mujeres.


Assuntos
Expectativa de Vida , Tábuas de Vida , Academias e Institutos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , México , Pessoa de Meia-Idade , Previdência Social , Adulto Jovem
5.
Rev Med Inst Mex Seguro Soc ; 53(3): 308-15, 2015.
Artigo em Espanhol | MEDLINE | ID: mdl-25984616

RESUMO

BACKGROUND: The growing prevalence of diabetes must be confronted in several ways. Establishing the generational transmission of cultural knowledge offers some guidelines to prevent and control the disease. Once we identify and compare the semantic structures of shared knowledge we lay the foundations of a culturally comprehensive care. The objective was to characterize the main elements about cultural domain of the causes of diabetes in a population of grandparents, parents and children belonging to popular strata in Guadalajara, Jalisco, Mexico. METHODS: A cognitive anthropological study performed in 104 subjects selected randomly in Guadalajara. We applied the free listing technique in order to obtain the semantic model and the average of cultural knowledge on the causes of the disease through a consensus analysis.A cognitive anthropological study performed in 104 subjects selected randomly in Guadalajara. We applied the free listing technique in order to obtain the semantic model and the average of cultural knowledge on the causes of the disease through a consensus analysis. RESULTS: The studied groups were divided by generation: grandparents, parents and children. The data evidences intergenerational transmission, in form of a basic semantic structure, and a significant consensus around a single model. CONCLUSIONS: The semantic structure on the causes of the diabetes includes: a) the emotions, as traditional dimension; b) certain behaviours related with the lifestyle, as everyday dimension; c) some biomedical concepts, like an emergent dimension.


Introducción: la creciente prevalencia de diabetes se debe afrontar de diversas maneras. Determinar la transmisión generacional del conocimiento cultural ofrece pautas para la prevención y el control de la enfermedad. Al identificar y comparar las estructuras semánticas del conocimiento compartido, sentamos las bases de una atención culturalmente comprensiva. El objetivo es caracterizar los principales elementos relacionados con el dominio cultural sobre las causas de la diabetes en una población de abuelos, padres e hijos pertenecientes a estratos populares en Guadalajara, México. Métodos: estudio antropológico cognitivo en 104 personas seleccionadas al azar en el sector Libertad de Guadalajara, Jalisco, México. Se aplicaron técnicas de listas libres para obtener el modelo semántico y el promedio de conocimiento cultural sobre las causas del padecimiento por análisis de consenso. Resultados: los grupos estudiados se dividieron por generación de abuelos, padres e hijos. Se evidenció transmisión intergeneracional al presentar el conocimiento cultural una estructura semántica básica y un consenso significativo. Conclusiones: la estructura semántica sobre causas de la diabetes incluye como elementos: a) las emociones, como dimensión tradicional; b) conductas relacionadas al estilo de vida, como dimensión cotidiana; c) algunos conceptos biomédicos, como dimensión emergente.


Assuntos
Características Culturais , Diabetes Mellitus Tipo 2/etiologia , Conhecimentos, Atitudes e Prática em Saúde , Relação entre Gerações , Semântica , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Diabetes Mellitus Tipo 2/psicologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Modelos Psicológicos
7.
Salud pública Méx ; 56(3): 236-237, may.-jun. 2014.
Artigo em Espanhol | LILACS | ID: lil-723393
9.
Rev. colomb. psiquiatr ; 42(2): 182-190, abr.-jun. 2013. ilus, tab
Artigo em Espanhol | LILACS, COLNAL | ID: lil-698804

RESUMO

Objetivo: Determinar la prevalencia del síndrome de agotamiento profesional (burnout) en odontólogos y analizar los posibles factores de riesgos sociodemográficos y laborales. Métodos: Estudio observacional, descriptivo y transversal, mediante el censo del personal odontológico de la Zona Metropolitana de Guadalajara, México, del Instituto Mexicano del Seguro Social, de la Universidad de Guadalajara y de los que ejercen la práctica privada, en el que participaron 203. Se les aplicó una ficha de identificación y el Maslach Burnout Inventory-Human Services Survey en formulario autoaplicable. Las estadísticas descriptivas y el análisis inferencial se realizaron mediante SPSS 15.0 y EpiInfo V6.1. Resultados: Se logró el 88,3 % de respuesta. La frecuencia del síndrome de agotamiento profesional (burnout) detectada es del 52,2 %. Se obtuvieron diferencias significativas en función de la contratación definitiva. Se observó correlación negativa entre las subescalas agotamiento emocional y despersonalización y correlación positiva con la falta de realización personal en el trabajo. Conclusiones: El síndrome de agotamiento profesional (burnout) es frecuente (52,2 %) entre los odontólogos. Sus posibles factores de riesgo: laborar en una institución pública, ser varón mayor de 40 años sin pareja estable o con más de 15 años en pareja, no tener hijos, ser especialista con 10 años o más de antigüedad laboral y en el puesto actual de trabajo, turno matutino, contratación definitiva y tener otro trabajo. La afectación del agotamiento emocional se comporta como el síndrome. Los niveles medios de las subescalas se encuentran en general cerca de la normalidad. Se encontró una correlación negativa entre las subescalas agotamiento emocional y despersonalización y positiva entre la falta de realización personal en el trabajo con la presencia del síndrome. Lo anterior nos lleva a considerar la necesidad de establecer medidas preventivas en el ámbito laboral y personal o realizar programas de intervención individuales, sociales u organizacionales para reducir la prevalencia encontrada.


Objectives:To determine the prevalence of professional exhaustion syndrome (burnout) in dentists and to analyze possible sociodemographic and occupational risk factors. Methods: An observational, descriptive and cross-sectional survey of 203 dental staff of the Metropolitan Zone of Guadalajara, Mexico, from the Mexican Social Security Institute, University of Guadalajara, and those in private practice. A self-reported identification form and the Maslach Burnout Inventory-Human Services Survey were used to gather data. Descriptive statistics and inferential analyzes were performed using SPSS 15.0 support and EpiInfo V6.1. Results: There was an 88.3 % response. Professional exhaustion syndrome (burnout) was detected in 52.2 % of them. Significant differences were obtained depending on the employment contract. A negative correlation was observed between the subscales emotional exhaustion and depersonalization, and a positive one between the lack of personal accomplishment at work. Conclusions: Professional exhaustion syndrome (burnout) is common (52.2 %) for dentists, their possible risk factors: working in a public institution, being male, over 40 years, without a regular partner, and with more than 15 years with a partner, not having children, being a specialist with 10 years or more in an institution and the current job, morning shift, permanent recruitment, and having another job. The involvement of emotional exhaustion behaves like the syndrome. Average levels of the subscales are generally near normal. A negative correlation was found between the subscales emotional exhaustion and depersonalization, and positive between the lack of personal fulfillment at work with the presence of the syndrome. This leads us to consider the need for preventive measures in the workplace and personnel, as well as intervention programs at an individual, social or organizational level to reduce the prevalence found.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Riscos Ocupacionais , Esgotamento Profissional , Demografia/tendências , Odontólogos , Pessoal de Saúde , Estudos Observacionais como Assunto , México
10.
Rev Colomb Psiquiatr ; 42(2): 182-90, 2013 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-26572813

RESUMO

OBJECTIVES: To determine the prevalence of professional exhaustion syndrome (burnout) in dentists and to analyze possible sociodemographic and occupational risk factors . METHODS: An observational, descriptive and cross-sectional survey of 203 dental staff of the Metropolitan Zone of Guadalajara, Mexico, from the Mexican Social Security Institute, University of Guadalajara, and those in private practice. A self-reported identification form and the Maslach Burnout Inventory-Human Services Survey were used to gather data. Descriptive statistics and inferential analyzes were performed using SPSS 15.0 support and EpiInfo V6.1. RESULTS: There was an 88.3% response. Professional exhaustion syndrome (burnout) was detected in 52.2% of them. Significant differences were obtained depending on the employment contract. A negative correlation was observed between the subscales emotional exhaustion and depersonalization, and a positive one between the lack of personal accomplishment at work. CONCLUSIONS: Professional exhaustion syndrome (burnout) is common (52.2%) for dentists, their possible risk factors: working in a public institution, being male, over 40 years, without a regular partner, and with more than 15 years with a partner, not having children, being a specialist with 10 years or more in an institution and the current job, morning shift, permanent recruitment, and having another job. The involvement of emotional exhaustion behaves like the syndrome. Average levels of the subscales are generally near normal. A negative correlation was found between the subscales emotional exhaustion and depersonalization, and positive between the lack of personal fulfillment at work with the presence of the syndrome. This leads us to consider the need for preventive measures in the workplace and personnel, as well as intervention programs at an individual, social or organizational level to reduce the prevalence found.

11.
Desacatos ; 39: 29-44, 2012. ilus, tab
Artigo em Espanhol | LILACS, MOSAICO - Saúde integrativa | ID: biblio-911475

RESUMO

Se destaca el conocimiento popular de "herbolarios, hierberos, yerberos o yerbateros" sobre las plantas medicinales utilizadas en mercados de la Zona Metropolitana de Guadalajara (zmg), en comparación con estudios fitoquímicos. Se rescatan datos sobre la práctica médica herbolaria con técnicas de antropología cognitiva. Las especies más utilizadas son: árnica, cuachalalate, tila, gordolobo, salvia, cola de caballo y boldo. Los resultados demuestran que existe consenso sobre las plantas medicinales que se usan, su efectividad y la conveniencia económica en contraste con las medicinas de patente. Se enfatiza la importancia de la comprensión del uso y significado de la enfermedad, y de la adquisición del conocimiento a través de generaciones por parte de los hierberos como un patrón de conocimiento cultural.


Assuntos
Compostos Fitoquímicos , Plantas Medicinais , Produtos Vegetais , Características Culturais , México , Fitoterapia
12.
Rev. colomb. psiquiatr ; 40(3): 420-432, jul.-set. 2011. tab
Artigo em Espanhol | LILACS | ID: lil-636512

RESUMO

Objetivo: Determinar la prevalencia de depresión en el personal sanitario femenino y analizar los factores de riesgo socio demográficos y laborales. Métodos: Estudio observacional, descriptivo y transversal, con 190 mujeres del Instituto Mexicano del Seguro Social, a quienes se les aplicó una ficha de identificación y el cuestionario clínico de diagnóstico para cuadros depresivos. Resultados: La tasa de respuesta fue del 86,0 %. El 52,2 % tenía más de 40 años de edad; el 61,0 %, pareja estable; el 75,3 %, hijos, y el 51,5 %, nivel de escolaridad mayor a 12 años. El 71,0 % mostró una antigüedad institucional mayor de 10 años y el 56,3% reveló una antigüedad en el puesto de actual menor a 10 años; predominaron el turno vespertino en el 52,1 %, la contratación de base en el 90,0 % y el no tener otro trabajo en el 8,6 %. Se detectó depresión en 18,9 %; 9,5 % presentó reacción de ansiedad; 8,4 %, depresión moderada, y 1,1 %, depresión severa. No hubo diferencias significativas en la variable socio-demográficas y laboral, a excepción de tener pareja estable, antigüedad institucional mayor de 10 años, trabajar solamente en la institución, tabaquismo y alcoholismo negativos. Conclusiones: La depresión presentó una prevalencia del 18,9 %. Los factores de riesgo fueron: ser trabajadora social, mayor de 40 años, con pareja estable y con menos de 15 años con ella, tener hijos, escolaridad mayor de 12 años, con más de 10 años de antigüedad institucional y en el puesto actual de trabajo, turno matutino, contratación de base y no tener otro trabajo aparte del institucional...


Objective: To determine the prevalence of depression in women healthcare workers and to Analyze the socio-demographic and work-related risk factors. Material and methods: This is an observational, descriptive, and transversal study. 190 female healthcare workers of the Mexican Social Security Institute were assessed by an identification form and a self-administered diagnostic clinical questionnaire of depressive symptoms. Results: The response rate was 86.0 %. All were women, 52.2 % were over 40 years old, 61.0 % had a steady partner, and 75.3 % reported having children. 51.5 % had more than 12 years of schooling 71.0 % had been at the institution over 10 years, and 56.3 % had been at their current position for less than 10 years. 52.1 % had the afternoon shift, 90.0 % were hired directly, and 8.6 % had no other job outside the institution. Depression was detected in 18.9 % of the women. 9.5 % had anxiety reactions, 8.4 % moderate depression, and 1.1 % severe depression. There were no significant differences according to socio-demographic and work-related variables, except for having a stable partner, being at the institution for more than 10 years, working only at the institution, and non-use of tobacco and alcohol. Conclusions: Depression showed a prevalence of 18.9 %. Risk factors were being a social worker, being more than 40 years old, having a stable partner for less than 15 years, having children, having over 12 years of schooling, working for more than 10 years at the institution in the current position, having the morning shift, being a direct hire employee, and not having another job outside the institution...


Assuntos
Depressão , Fatores de Risco , Mulheres
14.
Arch Latinoam Nutr ; 58(1): 19-26, 2008 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-18589568

RESUMO

The purpose of this study was to identify the food habits of pregnant adolescents and their perception about which, of her cultural concepts, have higher influence. 54 subjects between 12 and 19 years old from Guadalajara City were included and socioeconomic, dietetic data, as food frequency consumption and cultural concepts about feeding were also explored. Chi square was used for identifying association between variables. The fat intake was lower in late vs. Early and middle stage of adolescence (57 vs. 71 g/d, p = 0.05). The iron, calcium and zinc intake was also deficient in the early/middle stage; meanwhile, the folic acid consumption was very low in the late stage of adolescence. Corn tortillas were the most consumed cereal and food (93-96%); junk food and sodas (62 and 55%) prevailed in the early/middle stage. About local costumes, "tacos", "pozole" and burgers were the most referred (74.1%). They also mentioned that fat (36.7%), junk food (30%), chili (26.7%), sodas (23.3%), processed meals (26.7%) and salt (10%) were harmful. They also believed that vegetables (77%), fruits (60 %), milk (21%), broths (17%), and meat (12.5%) were beneficial; and, 96% considered that chicken and bean broths were nutritious (myth). There were some prohibited foods (taboos) during pregnancy: chili (48%), junk food (20%), and salt (16%). Prejudices were more common among later adolescents (60.9%) (p = 0.03). The erratic food habits and the conceptual confusion of these adolescents cause a low intake of nutrients and place them in a nutritional risk.


Assuntos
Características Culturais , Dieta/etnologia , Comportamento Alimentar/etnologia , Conhecimentos, Atitudes e Prática em Saúde , Gravidez na Adolescência/etnologia , Gravidez , Adolescente , Adulto , Criança , Estudos Transversais , Dieta/classificação , Dieta/estatística & dados numéricos , Registros de Dieta , Inquéritos sobre Dietas , Feminino , Humanos , México , Fatores Socioeconômicos
15.
Rev Med Inst Mex Seguro Soc ; 46(1): 73-81, 2008.
Artigo em Espanhol | MEDLINE | ID: mdl-18647576

RESUMO

INTRODUCTION: removing the biological perspective of the sexual differences and understanding the asymmetries related to diabetes, lead to define situations of benefit or deterioration of the population's health. OBJECTIVE: to analyze gender situations related to self-care and control of type 2 diabetes in primary care patients. METHODS: we conducted a descriptive observational study in 620 patients with diabetes at the family medicine clinic number 3 of Instituto Mexicano del Seguro Social in Guadalajara, Mexico. Three groups each with 79 women and 54 men were integrated. Gender situation was valued by means of questionnaires. Data were tested using the multiple correspondences analysis in seven situations of susceptibility. The comparison included the analysis with Snedecor's F distribution and chi2. RESULTS: women have several social disadvantages, deterioration of healthy life, poor self-care and lack of solidarity that increases their vulnerability to reach glycemic control successfully to avert complications. CONCLUSIONS: continuing investigating about the gender situation as the main driver to design specific actions to provide integrated care, should focus to supporting women's self care in general and glycemic control of diabetic women in particular.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Composição Corporal/fisiologia , Constituição Corporal/fisiologia , Diabetes Mellitus Tipo 2/sangue , Feminino , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/sangue , Hiperglicemia/terapia , Masculino , Atenção Primária à Saúde , Autocuidado , Fatores Sexuais
17.
Chronic Illn ; 2(2): 77-85, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17175651

RESUMO

OBJECTIVE: In this study, we examined the relative impact of self-management activities on glycaemic control in a population at high risk for developing complications. METHODS: Patients diagnosed with diabetes mellitus of at least 1 year in duration at 30 years of age or older were sampled from the Instituto de Mexico Seguro Social (IMSS) Family Medicine Clinics in Guadalajara, Mexico (n=800). Demographic, clinical and health behaviour variables were used to predict good/poor glycaemic control, as measured by haemoglobin Alc (A1C). RESULTS: Most (72.24%) patients had poor control (A1C > or = 7.0). Hyperglycaemia was significantly associated with factors not under patient control, such as having diabetes for a longer time [odds ratio (OR) = 2.40, 95% confidence interval (CI) 1.39, 4.14], having a first-degree relative with diabetes (OR= 1.52; 95% CI 1.06, 2.19), and being prescribed anti-diabetic medications, e.g. insulin (OR = 7.88, 95% CI 2.42, 25.63). After controlling for these variables, the only self-management variable that reduced the likelihood of hyperglycaemia was following a special diet (OR=0.49; 95% CI 0.32, 0.76). Furthermore, depression had an important effect on self-management, as those with lower levels of depressive symptoms were more likely to follow a diet and exercise. DISCUSSION: While patients in this population have little control over many factors associated with glycaemic control, an important exception is diet. However, because of the adverse effect of depression on dieting, both depression management and dietary education are important for this population.


Assuntos
Diabetes Mellitus Tipo 2/terapia , Autocuidado , Adulto , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Humanos , Hiperglicemia/terapia , Modelos Logísticos , México , Razão de Chances
18.
Ginecol Obstet Mex ; 74(6): 300-5, 2006 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-16970115

RESUMO

BACKGROUND: Female urinary and anal incontinence are common entities in pelvic floor dysfunction. The most frequently age affected range from 45 to 69 years. Previous studies performed in the United States report a prevalence of 24-62% for urinary incontinence and 3-60% for anal incontinence. OBJECTIVE: To determine the prevalence of these disorders in the Guadalajara metropolitan area because we do not know it. PARTICIPANTS AND METHODS: A transversal and various stage study was performed recollecting blocks first, then houses, finally interviewing women and applying a structured questionnaire with somatometric and social-demographic data and also clinical-pathological antecedents. The data obtained was registered and processed first manually then using Excel and Epi-Info software. RESULTS: The group of women interviewed (n = 352) were between 15-85 years. The majority were married, housewives, 33% with grammar school, 23% finished high school, 25% professionists and 19% did not finish school; with an average of three pregnancies and with a body mass index (BMI) positive for overweight and obesity. The prevalence for urinary incontinence was 27.8% and anal incontinence of 3.4%. These are results compatible with those reported in the United States. CONCLUSIONS: Women living in Guadalajara have the same behavior that European and American women about prevalence of urinary incontinence. We recommend the performance of this type of studies in other states of this country in order to enrich the present information.


Assuntos
Incontinência Fecal/epidemiologia , Incontinência Urinária/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , México , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , População Urbana
19.
Rev Med Inst Mex Seguro Soc ; 44(2): 113-20, 2006.
Artigo em Espanhol | MEDLINE | ID: mdl-16674857

RESUMO

INTRODUCTION: Medical anthropology considers the sociocultural aspects of illnesses, from the biomedical definition of the experience of the one who suffers the illness. This is what makes the difference between a disease and an illness, in other words, an explanatory model of illness. OBJECTIVES: To show the cultural consensus elaborated and shared by a group of diabetics through personal experience, of the causes, symptoms, treatment and complications of type 2 diabetes mellitus; to highlight the importance this has in the daily medical practice, and to understand the meaning of type 2 diabetes from the patient's perspective. MATERIAL AND METHODS: 88 patients were studied in an interactive process, with an interview outline that was applied in an open form at the waiting rooms for outpatients at two family medicine units of the Mexican Institute of Social Security (IMSS) in Guadalajara, Jalisco. RESULTS: The way in which patients construct a definition and an explanation of their illness is a syncretism of lived experiences done in a procedural manner. In this reconciliation, patients with diabetes integrate biomedical elements, alternative medicines, deities and even sorcery. CONCLUSIONS: These previously mentioned factors should be considered when in contact with the patient if one thinks that the influence of a doctor or institutional health care provider has the objective of achieving a greater effectiveness in the long-term handling of these patients.


Assuntos
Diabetes Mellitus Tipo 2/psicologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/diagnóstico , Diabetes Mellitus Tipo 2/etiologia , Diabetes Mellitus Tipo 2/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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