RESUMO
Introducción. La pandemia por COVID-19 ha tenido un impacto profundo en la salud de la población joven de todo el mundo y especialmente en personas con trastornos de la conducta alimentaria (TCA) por situaciones de estrés, ansiedad y cambios en el acceso a la atención médica. Objetivo. Explorar las percepciones de adolescentes sobre los cambios en sus vínculos sociales y modalidades de atención en pacientes con TCA. Población y métodos. Se realizó un estudio cualitativo a través de entrevistas en profundidad a adolescentes con TCA en un hospital universitario durante la pandemia por COVID-19. Resultados. Se entrevistó a 15 adolescentes; el 93 % fueron mujeres y la mediana de edad fue 18 años. El 86,6 % tuvo anorexia nerviosa. Los aspectos negativos percibidos más importantes fueron los malestares en la convivencia familiar (80 %) y la disconformidad con los contenidos de las redes sociales sobre la imagen corporal y dietas (73 %). Los aspectos percibidos positivos fueron la ayuda de los pares (66 %) y mejoras en relación con la alimentación (66 %). El principal cambio identificado en comparación con el tratamiento recibido previo a la pandemia por COVID-19 fue el seguimiento virtual por salud mental (73 %). Conclusión. La población adolescente con TCA durante el ASPO manifestó malestar en la convivencia familiar y disconformidad en los contenidos en redes sociales sobre imagen corporal y dietas. Aunque resaltaron como aspectos positivos la ayuda de los pares y mejoras en su alimentación
Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects.
Assuntos
Humanos , Feminino , Adolescente , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , COVID-19/psicologia , COVID-19/epidemiologia , Isolamento Social/psicologia , Apoio Social , Imagem Corporal/psicologia , Pesquisa Qualitativa , Pandemias , Mídias SociaisRESUMO
Introduction. The COVID-19 pandemic has had a profound impact on the health of young people worldwide, especially on people with eating disorders (EDs) due to the stress, anxiety, and changes experienced in access to health care. Objective. To explore adolescents' perceptions on changes in their social ties and the modalities of health care for patients with EDs. Population and methods. Qualitative study using in-depth interviews with adolescents with EDs seen at a teaching hospital during the COVID-19 pandemic. Results. Fifteen adolescents were interviewed; their mean age was 18 years; 93% were girls. Anorexia nervosa was observed in 86.6%. The most relevant negative aspects perceived were discomfort with family life (80%) and dissatisfaction with social media content regarding body image and dieting (73%). The aspects perceived as positive were peer support (66%) and improvements in eating habits (66%). The main change identified regarding the management before the COVID-19 pandemic was online followup by the mental healthcare team (73%). Conclusion. The adolescent population with EDs during the mandatory social isolation period reported discomfort with family life and dissatisfaction with social media content regarding body image and dieting. Notwithstanding this, adolescents highlighted peer support and improvements in their eating habits as positive aspects.
Introducción. La pandemia por COVID-19 ha tenido un impacto profundo en la salud de la población joven de todo el mundo y especialmente en personas con trastornos de la conducta alimentaria (TCA) por situaciones de estrés, ansiedad y cambios en el acceso a la atención médica. Objetivo. Explorar las percepciones de adolescentes sobre los cambios en sus vínculos sociales y modalidades de atención en pacientes con TCA. Población y métodos. Se realizó un estudio cualitativo a través de entrevistas en profundidad a adolescentes con TCA en un hospital universitario durante la pandemia por COVID-19. Resultados. Se entrevistó a 15 adolescentes; el 93 % fueron mujeres y la mediana de edad fue 18 años. El 86,6 % tuvo anorexia nerviosa. Los aspectos negativos percibidos más importantes fueron los malestares en la convivencia familiar (80 %) y la disconformidad con los contenidos de las redes sociales sobre la imagen corporal y dietas (73 %). Los aspectos percibidos positivos fueron la ayuda de los pares (66 %) y mejoras en relación con la alimentación (66 %). El principal cambio identificado en comparación con el tratamiento recibido previo a la pandemia por COVID-19 fue el seguimiento virtual por salud mental (73 %). Conclusión. La población adolescente con TCA durante el ASPO manifestó malestar en la convivencia familiar y disconformidad en los contenidos en redes sociales sobre imagen corporal y dietas. Aunque resaltaron como aspectos positivos la ayuda de los pares y mejoras en su alimentación.
Assuntos
COVID-19 , Transtornos da Alimentação e da Ingestão de Alimentos , Humanos , COVID-19/epidemiologia , COVID-19/psicologia , Adolescente , Feminino , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Masculino , Mídias Sociais , Isolamento Social/psicologia , Pesquisa Qualitativa , Apoio Social , Imagem Corporal/psicologia , PandemiasRESUMO
Los trastornos de la conducta alimentaria son enfermedades de elevada prevalencia en la adolescencia y tienen repercusión en la salud integral. El objetivo fue describir su evolución y tratamiento en un grupo de adolescentes. Se estudiaron adolescentes menores de 18 años con al menos 6 meses de seguimiento y tratados por un equipo interdisciplinario. Se incluyeron 41 adolescentes: 23 presentaron anorexia nerviosa; 9, trastornos alimentarios no especificados; 7, bulimia nerviosa y 2, trastorno por atracones. El 35 % de pacientes con anorexia nerviosa requirió internación por complicaciones de la desnutrición. El 69 % de las pacientes con anorexia nerviosa, el 57 % de quienes tenían bulimia nerviosa y el 78 % de quienes tenían un trastorno alimentario no especificado presentaron remisión total o parcial, y no hubo pacientes fallecidos. La mayoría presentó una evolución favorable con el tratamiento.
Eating disorders are highly prevalent diseases in adolescence and have an impact on overall health. The objective was to describe the evolution and treatment of eating disorders in adolescents. Adolescents under 18 years of age with at least 6 months of follow-up and treated by an interdisciplinary team were studied. Forty one adolescents were included, 23 presented anorexia nervosa, 9 unspecified eating disorders, 7 bulimia nervosa and 2 binge eating disorders. Thirty five percent of patients with anorexia nervosa required hospitalization for complications of malnutrition. Sixty nine percent of the patients with anorexia nervosa, 57 % with bulimia nervosa, and 78 % with unspecified eating disorders had total or partial remission and there were no deceased patients. The majority presented a favorable evolution with the treatment.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Anorexia Nervosa/diagnóstico , Anorexia Nervosa/terapia , Anorexia Nervosa/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Estudos Transversais , Seguimentos , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/terapia , Bulimia Nervosa/epidemiologia , Transtorno da Compulsão Alimentar/diagnóstico , Transtorno da Compulsão Alimentar/terapia , Transtorno da Compulsão Alimentar/epidemiologiaRESUMO
Eating disorders are highly prevalent diseases in adolescence and have an impact on overall health. The objective was to describe the evolution and treatment of eating disorders in adolescents. Adolescents under 18 years of age with at least 6 months of follow-up and treated by an interdisciplinary team were studied. Forty one adolescents were included, 23 presented anorexia nervosa, 9 unspecified eating disorders, 7 bulimia nervosa and 2 binge eating disorders. Thirty five percent of patients with anorexia nervosa required hospitalization for complications of malnutrition. Sixty nine percent of the patients with anorexia nervosa, 57 % with bulimia nervosa, and 78 % with unspecified eating disorders had total or partial remission and there were no deceased patients. The majority presented a favorable evolution with the treatment.
Los trastornos de la conducta alimentaria son enfermedades de elevada prevalencia en la adolescencia y tienen repercusión en la salud integral. El objetivo fue describir su evolución y tratamiento en un grupo de adolescentes. Se estudiaron adolescentes menores de 18 años con al menos 6 meses de seguimiento y tratados por un equipo interdisciplinario. Se incluyeron 41 adolescentes: 23 presentaron anorexia nerviosa; 9, trastornos alimentarios no especificados; 7, bulimia nerviosa y 2, trastorno por atracones. El 35 % de pacientes con anorexia nerviosa requirió internación por complicaciones de la desnutrición. El 69 % de las pacientes con anorexia nerviosa, el 57 % de quienes tenían bulimia nerviosa y el 78 % de quienes tenían un trastorno alimentario no especificado presentaron remisión total o parcial, y no hubo pacientes fallecidos. La mayoría presentó una evolución favorable con el tratamiento.
Assuntos
Anorexia Nervosa , Bulimia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos , Adolescente , Anorexia Nervosa/epidemiologia , Anorexia Nervosa/terapia , Bulimia Nervosa/diagnóstico , Bulimia Nervosa/epidemiologia , Bulimia Nervosa/terapia , Transtornos da Alimentação e da Ingestão de Alimentos/diagnóstico , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/terapia , Hospitalização , Humanos , Lactente , PesquisaAssuntos
Humanos , Masculino , Feminino , Criança , Nutrição da Criança , Obesidade/complicações , Obesidade/prevenção & controleAssuntos
Humanos , Masculino , Feminino , Criança , Obesidade/prevenção & controle , Obesidade/complicações , Nutrição da CriançaRESUMO
OBJECTIVE: Gender disparities in mental health highlight the need to include gender equity measures when planning, implementing, and evaluating mental health programs at national, state or provincial, and municipal levels. This study aimed to identify, select, and assess the feasibility of comparing gender-sensitive mental health indicators in a low- (Peru), middle- (Colombia), and high- (Canada) income country. METHODS: The indicators were selected by a multidisciplinary group of experts who used criteria and a framework proposed by the World Health Organization. Data from national, population-based databases from each country were used to measure the indicators. RESULTS: Seven indicators (12-month prevalence of the following: depression, psychological distress, generalized anxiety disorder, suicide attempts, alcohol dependence, mental health service use, and psychological impairment) were feasible for measurement in at least two countries. Only five indicators were comparable between two countries, and only one was comparable among all countries (suicide attempts). The indicators that showed the greatest inequities between men and women were depression, anxiety, suicide attempts, use of mental health services, and alcohol dependence. Female-to-male ratios for prevalence of mental illness ranged from .1 to 2.3, and ratios for service use ranged from 1.3 to 1.9. Significant trends were found when the indicators were considered by age, education, marital status, and income. CONCLUSIONS: Some of these indicators can be used to identify populations most vulnerable to gender inequities in mental health. The results from this study may provide useful information to program planners who aim to implement, improve, and monitor national mental health strategies that reduce gender inequities under different national conditions.
Assuntos
Disparidades nos Níveis de Saúde , Indicadores Básicos de Saúde , Transtornos Mentais/epidemiologia , Adulto , Canadá/epidemiologia , Estudos de Coortes , Colômbia/epidemiologia , Estudos de Viabilidade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Serviços de Saúde Mental , Pessoa de Meia-Idade , Peru/epidemiologia , Estudos Retrospectivos , Fatores SexuaisRESUMO
BACKGROUND: As gender is known to be a major determinant of health, monitoring gender equity in health systems remains a vital public health priority. Focusing on a low-income (Peru), middle-income (Colombia), and high-income (Canada) country in the Americas, this study aimed to (1) identify and select gender-sensitive health indicators and (2) assess the feasibility of measuring and comparing gender-sensitive health indicators among countries. METHODS: Gender-sensitive health indicators were selected by a multidisciplinary group of experts from each country. The most recent gender-sensitive health measures corresponding to selected indicators were identified through electronic databases (CINAHL, PsycINFO, MEDLINE, Embase, LILACS, LIPECS, Latindex, and BIREME) and expert consultation. Data from population-based studies were analyzed when indicator information was unavailable from reports. RESULTS: Twelve of the 17 selected gender-sensitive health indicators were feasible to measure in at least two countries, and 9 of these were comparable among all countries. Indicators that were available were not stratified or adjusted by age, education, marital status, or wealth. The largest between-country difference was maternal mortality, and the largest gender inequity was mortality from homicides. CONCLUSIONS: This study shows that gender inequities in health exist in all countries, regardless of income level. Economic development seemed to confer advantages in the availability of such indicators; however, this finding was not consistent and needs to be further explored. Future initiatives should include identifying health system factors and risk factors associated with disparities as well as assessing the cost-effectiveness of including the routine monitoring of gender inequities in health.
Assuntos
Identidade de Gênero , Indicadores Básicos de Saúde , Disparidades em Assistência à Saúde/normas , Saúde da Mulher , Direitos da Mulher , Canadá , Colômbia , Bases de Dados Bibliográficas , Etnicidade/classificação , Etnicidade/educação , Características da Família , Estudos de Viabilidade , Feminino , Acessibilidade aos Serviços de Saúde/normas , Habitação/classificação , Habitação/normas , Humanos , Masculino , Mortalidade/etnologia , Peru , Pobreza , Reprodutibilidade dos Testes , Fatores Sexuais , Fatores Socioeconômicos , População Urbana/classificaçãoRESUMO
Gender inequities in health prevail in most countries despite ongoing attempts to eliminate them. Assessment of gender-sensitive health policies can be used to identify country specific progress as well as gaps and issues that need to be addressed to meet health equity goals. This study selected and measured the existence of gender-sensitive health policies in a low- (Peru), middle- (Colombia), and high (Canada)-income country in the Americas. Investigators selected 10 of 20 gender-sensitive health policy indicators and found eight to be feasible to measure in all three countries, although the wording and scope varied. The results from this study inform policy makers and program planners who aim to develop, improve, implement, and monitor national gender-sensitive health policies. Future studies should assess the implementation of policy indicators within countries and assess their performance in increasing gender equity.