RESUMO
BACKGROUND: During the COVID-19 pandemic, reductions in healthcare utilization are reported in different contexts. Nevertheless, studies have not explored specifically gender disparities in access to healthcare in the context of COVID-19. METHODS: To evaluate gender disparities in access to medical in Chile we conducted an interrupted time series analysis using segmented regression. The outcome variable was the number of weekly confirmed cases of a set of oncologic and cardiovascular time-sensitive conditions at a national level. The series contained data from weeks 1 to 39 for 2017 to 2020. The intervention period started at week 12. We selected this period because preventive interventions, such as school closures or teleworking, were implemented at this point. We estimated the level effect using a dummy variable indicating the intervention period and slope effect using a continuous variable from weeks 12 to 39. To test heterogeneity by gender and age group, we conducted a stratified analysis. RESULTS: We observed a sizable reduction in access to care with a slowly recovery for oncologic (level effect 0.323; 95% CI 0.291-0.359; slope effect 1.022; 95% CI 1.016-1.028) and cardiovascular diseases (level effect 0.586; 95% CI 0.564-0.609; slope effect 1.009; 95% CI 1.007-1.011). Greater reduction occurred in women compared to men, particularly marked on myocardial infarction (level effect 0.595; 95% CI 0.566-0.627 versus 0.532; 95% CI 0.502-0.564) and colorectal cancer (level effect 0.295; 95% CI 0.248-0.35 versus 0.19; 95% CI 0.159-0.228). Compared to men, a greater absolute reduction was observed in women for oncologic diseases, excluding sex-specific cancer, (1352; 95% CI 743-1961) and cardiovascular diseases (1268; 95% CI 946-1590). CONCLUSION: We confirmed a large drop in new diagnoses for time-sensitive conditions during the COVID-19 pandemic in Chile. This reduction was greater for women. Our findings should alert policy-makers about the urgent need to integrate a gender perspective into the pandemic response.
Assuntos
COVID-19 , Infarto do Miocárdio , Chile/epidemiologia , Feminino , Acessibilidade aos Serviços de Saúde , Humanos , Masculino , Pandemias , SARS-CoV-2RESUMO
Breastfeeding is the most beneficial feeding practice for infants. However, it is not always the first choice for mothers and their encouragement and support from health professionals is variable. OBJECTIVE: To understand the experience of mothers who had difficulties with their breastfeeding process. PATIENTS AND METHOD: A phenomenological study was conducted in a University Health center. Twelve breastfeeding women were included. Data collection technique was in depth interviews, taped recorded with participants consent. Phenomenological analysis of data followed Streubert´s method. The rigor of the study was guarded by criteria for qualitative research and the research process. Ethical aspects were sheltered through the informed consent process, confidentiality and methodological rigor. RESULTS: The experience of living difficulties in the breastfeeding process is revealed in five comprehensive categories: recognizing the difficulties with breastfeeding; emotional impact when unable to breastfeed; motivation to overcome the difficulty and ask for help; support for breastfeeding recovery; and transition process from stress and anxiety to peace, gratification and empowerment. CONCLUSION: The understanding of this experience is qualitative evidence that contributes to a comprehensive understanding of the situation of each mother and child, allowing to improve support care interventions in health.
Assuntos
Aleitamento Materno/psicologia , Mães/psicologia , Adolescente , Adulto , Ansiedade/etiologia , Feminino , Humanos , Entrevistas como Assunto , Motivação , Poder Psicológico , Pesquisa Qualitativa , Apoio Social , Estresse Psicológico/etiologia , Adulto JovemRESUMO
La lactancia materna es el método de elección para alimentar a los niños pequeños por sus múltiples y reportados beneficios. Sin embargo, es una práctica que no siempre es de primera elección para las madres y su estímulo y apoyo por parte de los profesionales de la salud es variable. OBJETIVO: Comprender la experiencia vivida por madres que presentaron dificultades durante su proceso de amamantamiento. PACIENTES Y MÉTODO: Estudio fenomenológico realizado en centro de salud universitario, participantes 12 mujeres. Se utilizó la entrevista en profundidad, grabada con consentimiento de las participantes. Análisis fenomenológico de los datos según método de Streubert. Se cauteló el rigor del estudio a través de criterios de investigación cualitativa y del proceso de investigación. Aspectos éticos resguardados a través de proceso de consentimiento informado, confidencialidad y rigor metodológico. RESULTADOS: La experiencia de vivir dificultades en el proceso de amamantamiento se reveló en cinco categorías comprensivas: reconociendo las dificultades con el amamantamiento; impacto emocional al no poder amamantar; motivación para superar la dificultad y pedir ayuda; apoyo en la recuperación de la lactancia; y proceso de transición desde el estrés y angustia a la tranquilidad, gratificación y empoderamiento. CONCLUSIÓN: La comprensión de esta experiencia constituye evidencia cualitativa que contribuye al conocimiento integral de la situación de cada madre con su hijo, permitiendo mejorar las intervenciones de apoyo en salud.
Breastfeeding is the most beneficial feeding practice for infants. However, it is not always the first choice for mothers and their encouragement and support from health professionals is variable. OBJECTIVE: To understand the experience of mothers who had difficulties with their breastfeeding process. PATIENTS AND METHOD: A phenomenological study was conducted in a University Health center. Twelve breastfeeding women were included. Data collection technique was in depth interviews, taped recorded with participants consent. Phenomenological analysis of data followed Streubert´s method. The rigor of the study was guarded by criteria for qualitative research and the research process. Ethical aspects were sheltered through the informed consent process, confidentiality and methodological rigor. RESULTS: The experience of living difficulties in the breastfeeding process is revealed in five comprehensive categories: recognizing the difficulties with breastfeeding; emotional impact when unable to breastfeed; motivation to overcome the difficulty and ask for help; support for breastfeeding recovery; and transition process from stress and anxiety to peace, gratification and empowerment. CONCLUSION: The understanding of this experience is qualitative evidence that contributes to a comprehensive understanding of the situation of each mother and child, allowing to improve support care interventions in health.
Assuntos
Humanos , Feminino , Adolescente , Adulto , Adulto Jovem , Aleitamento Materno/psicologia , Mães/psicologia , Ansiedade/etiologia , Apoio Social , Estresse Psicológico/etiologia , Poder Psicológico , Entrevistas como Assunto , Pesquisa Qualitativa , MotivaçãoRESUMO
El progresivo deterioro biológico y el aumento de problemas de salud derivados del envejecimiento pueden manifestarse de diversas formas, asociándose con una declinación de las capacidades funcionales y autonomía de las personas mayores. El cuidado de estas personas en situación de dependencia está a cargo de las familias, situación bastante estudiada, desde la perspectiva de los cuidadores, sin embargo, es escaso el conocimiento respecto a quien vive el fenómeno. OBJETIVO: develar el significado de la experiencia vivida por una PM chilena en condición de dependencia severa. MÉTODOS: Diseño estudio de caso con enfoque cualitativo fenomenológico. Se realizó una entrevista en profundidad a una PM chilena en situación de dependencia severa. El análisis se realizó aplicando el método propuesto por Streubert & Carpenter. RESULTADOS: la experiencia de esta persona se describe en tres categorías comprensivas: Valoración del apoyo social: Ser cuidado como una experiencia que brinda seguridad, protección y bienestar; Experiencia emocional ante la limitación funcional y Vivir y convivir con la enfermedad. CONCLUSIÓN: las intervenciones a realizar en las PM en condición de dependencia severa deben basarse en los significados que tiene dicha vivencia para ellas. Lo anterior sugiere poner énfasis en las dimensiones halladas en este estudio.
The progressive biological deterioration and increased health problems resulting from aging can manifest itself in various forms and are generally associated with a decline in functional capacity and autonomy of the elderly. Care for dependent eldery people is in charge of families, well-studied situation from the perspective of caregivers; however, there is little knowledge from the point of view of who bears the phenomenon. OBJECTIVE: To reveal the meaning of the experience of a chilean aged person in a condition of severe dependence. METHODS: Design phenomenological case study with qualitative approach. The method used was the interview in depth. The analysis was conducted using the method proposed by Streubert & Carpenter. RESULTS: the experience of this person is described in three comprehensive categories: 1. Social support: Be careful as an experience that provides security, safety and welfare; 2. Emotional experience to the functional limitation and 3. Live with the disease. CONCLUSION: perform interventions in older people living in severe dependence should be based on the meanings that have this experience for them. This suggests emphasizing the dimensions found in this study.
Assuntos
Humanos , Idoso de 80 Anos ou mais , Idoso/psicologia , Atividades Cotidianas/psicologia , Idoso Fragilizado/psicologia , EmoçõesRESUMO
OBJECTIVE: To review current evidence on the non-pharmacological (non-invasive) treatment of erectile dysfunction (ED). METHOD: We performed a systematic review of research articles that included adult men diagnosed with ED who had undergone some type of non-pharmacological and non-surgical intervention for this disorder. Free-access, complete texts with an available summary published between 2000 and 2006 were sought. Studies not published in English were excluded. RESULTS: A total for 124 articles were found, and after critical analysis only 8 matched the inclusion criteria (of the 8 articles, 2 were classified as showing quality criterion 1-B and none met the criterion for 1-A). Four types of non-pharmacological, non-surgical therapy were found, which could reverse or improve ED in patients with organic, psychological or mixed impairment and could be applied by nurses. Among these therapies were lifestyle changes (losing weight, pelvic musculature strengthening, psychotherapy and/or psychoeducation and the use of Internet and/or other multimedia devices. CONCLUSIONS: Alternative therapies are available for men with ED. These therapies help to improve or reverse ED and guarantee satisfactory and lasting Results. Nevertheless, we stress that our aim is not to compete with invasive and non-invasive therapies but rather to provide a greater number of treatment alternatives. The low quality of studies could be attributed to the lack of economic resources and the fact that ED is still an emerging subject in current medicine.
Assuntos
Disfunção Erétil/fisiopatologia , Disfunção Erétil/terapia , Meios de Comunicação de Massa , Força Muscular/fisiologia , Diafragma da Pelve/fisiologia , Estimulação Luminosa , Psicoterapia/métodos , Regeneração/fisiologia , Redução de Peso , Terapia Combinada , Humanos , Estilo de Vida , MasculinoRESUMO
Se presenta un estudio clínico de aplicación de una novedosa técnica no convencional de terapia breve, la terpsicoretranceterapia (T.T.T.) en el control del stress y las enfermedades asociadas, desarrollada durante un curso de control de stress, como parte del programa de extensión del bienestar del personal de la Universidad de Valparaíso. T.T.T. es una terapia grupal que utiliza trances hipnóticos cinéticos que ocurren sin intervención directa del terapeuta durante el desarrollo del proceso, y que se caracteriza por intensas catarsis emocionales y por la mobilización de recursos inconscientes para solucionar los problemas del paciente. Los resultados obtenidos son extraordinariamente buenos y alientan a continuar con la investigación y la práctica de T.T.T., no solamente en el control y tratamiento del stress, sino en varios campos de la conducta humana
Assuntos
Humanos , Masculino , Feminino , Estresse Psicológico/prevenção & controle , Hipnose , Transtornos Psicofisiológicos/terapia , Psicoterapia , Encaminhamento e Consulta , Transtornos Relacionados ao Uso de Substâncias/terapiaAssuntos
Humanos , Masculino , Feminino , Idoso , Saúde do Idoso , Terapia de Relaxamento , Envelhecimento/fisiologia , Ansiedade/terapia , Saúde Mental , Relaxamento MuscularAssuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Saúde do Adulto , Desenvolvimento Humano , Comportamento Sexual/psicologiaRESUMO
Se revisaron 100 casos de VHS muy elevada (>80 mm en la 1a hora) que se reunieron en un período de 23 meses, Se analiza la incidencia, un 3,30 por ciento de los egresos durante ese período; la causa resultando un 71 por ciento de origen infeccioso, un 13 por ciento de causa renal o enfermedad del colágeno, 8 por ciento de enfermedad neoplásica o hematológica y 5 por ciento de causas misceláneas. Se analizaron las características de cada grupo causal y cuando la causa era de origen infeccioso se trató de pacientes de menor edad, un Hb normal o disminuído y recuento de leucocitos, polimorfonucleares y baciliformes elevados. Cuando la causa fue renal o enfermedad colágeno se trató de pacientes de mayor edad con Hb normal o disminuída, con recuento de leucocitos y polimorfonucleares elevados; pero sin desviación izquierda. Cuando la causa fue una enfermedad neoplásica o hematológica fueron pacientes de edad escolar, con Hb disminuída, recuento de leucocitos y polimorfonucleares normales y no hubo desviación izquierda. Sólo existió mortalidad, 3 casos, en el grupo de enfermos neoplásicos o hematológicos y en general el pronóstico es favorable comparado con adultos