Suchergebnisse

Este artículo resume los resultados de una investigación cuyo objetivo fue poner a prueba una herramienta metodológica de análisis discursivo interaccional, que denominamos el método I-R-CR. El propósito del diseno y la aplicación de este método es el de estudiar la relación existente entre la interacción discursiva en el habla oral, real y concreta de los hablantes de espanol de Chile y los efectos interpersonales de dominación discursiva resultantes de dicha interacción. El método propuesto ha sido aplicado a muestras de diálogo dramático y de diálogo institucional. Los resultados obtenidos hasta el momento parecen indicar la existência de un vínculo entre el desarrollo temático de un intercâmbio verbal y los efectos de dominación, en término de patrones de secuencias interaccionales asociados sistemáticamente con la dominación de un participante de cada evento dialogai respecto a los demás.

Purpose
This paper aims to analyze how psychosocial support influences caring activities toward indigenous older adults.


Design/methodology/approach
A descriptive study with the participation of 229 informal indigenous caregivers. The study considered both sociodemographic and medical variables. It used the mini-mental test to determine the cognitive level in the elderly. It applied the Yesavage and Zarit scales to establish depressive symptomatology and caregiver burden. Finally, the study used the MOS psychosocial support and Apgar screening questionnaires to assess the psychosocial dimension and the patient's family functional state, respectively.


Findings
The study observed a low caregiver burden effect using the MOS questionnaire. This may be explained due to variability in the Zarit Scale Score product of other variables like years of care (−0.17 and −0.28), depressive symptoms (0.16 and 0.18), cognitive level (mini-mental) (−0.13 and −0.14) and comorbidity (0.26 and −0.27). The study obtained an incidence between (−0.02 and −0.12) when including all assessed dimensions into the model. The instrumental dimension in the social support questionnaire obtained the highest score.


Originality/value
Protective factors prevail in the group of indigenous caregivers allowing this activity to not trigger overload. Yet, variables such as the female gender, some comorbidities and the presence of depressive symptoms could be potential variables for dysfunction in this occupational role.

BACKGROUND: Eating disorders (ED) are associated with internalized problems (INTP), such as depression and anxiety. Evidence shows that ED and INTP are associated with comorbidities. The relationship between these variables has not been the focus of studies on young people from Northern Chile. Children and adolescents are considered as an at-risk group, since they have been found to experience greater vulnerability to psychological problems than other age groups within the population and given the scarcity of studies in Chile, it is necessary to study the relationship between these variables. METHODS: This study analyzed the relationship between ED and INTP in Chilean high school students aged 12 to 18 years using Pearson's correlation. This is a non-experimental and transactional correlational study. We included 2277 students belonging to the public, government-subsidized, and private educational establishments in Northern Chile. The Child and Adolescent Evaluation System [Sistema de Evaluación de Niños y Adolescentes (SENA)] was used to detect a range of INTP, as well as ED. The Brief Self-Control Scale was used in this study. RESULTS: A strong and direct correlation of the eating disorder variable with depression and anxiety was found. Additionally, significant differences were observed with sex, highlighting females with a higher presence of INTP and ED. CONCLUSIONS: There is a need to establish strategies in the school setting for detecting frequent symptomatology in adolescents with INTP and ED to achieve a timely and accessible intervention. PLAIN ENGLISH SUMMARY: Since the symptomatology of ED is more prevalent in adolescents, this research evaluated relationships between ED and INTP in young people from Northern Chile. This research is relevant because the evidence on this topic in Chile is scarce and the relationships found could be the first research on the subject and serve to design an intervention plan at the school level in the medium and long terms. It is a non-experimental and transactional ...

Purpose
The purpose of this study was to determine the factors associated with functionality, a clinical criterion that could predict frailty in the elderly people in a rural context.


Design/methodology/approach
This project is a cross-sectional descriptive analysis of 342 adults of age >60 years who are residents of Putumayo province in Colombia. Information regarding demographic characteristics, medical history, health perception and current illness was collected. The Mini-Mental State Examination (MMSE) protocol was used to perform cognitive evaluation; the Yesavage Geriatric Depression Scale was used to establish depressive symptoms; and the Hamilton Rating Scale was used to assess anxiety level. Questionnaire was used to evaluate performance on instrumental activities of daily living that lead to functional independence [daily life questionnaire (DLQ)]. The medical outcomes study scale was used to assess social parameters.


Findings
A moderate and negative correlation was found between the DLQ score and age (r = −0.49; 95% CI: −0.57 to −0.47), whereas a positive correlation was found with education (r = 0.17; 95% CI: 0.07–0.27). Older adults with economic independence achieved a higher score in functional performance than those with economic dependence (standardized mean difference = 0.55; 95% CI: 0.33–0.77). This study observed a moderate correlation a moderate correlation between the MMSE cognitive performance (r = 0.56; 95% CI: 0.48−0.63) and the depressive symptomatology of Yesavage Scale (r = −0.36, 95% CI: −0.44 to −0.26). Finally, the structural model determined that age (r = −0.37), economic dependence (r = −0.383) and cognitive state (r = 0.309) determine the functional component.


Research limitations/implications
This study provides empirical support about older adults living in rural contexts, around the functionality variable from a multidimensional approach, highlighting the sociodemographic and cognitive variables. Consequently, the policy of social support in older adults must be oriented toward the development of a range of divergent intervention strategies.


Originality/value
The study deals with the assessment of functionality in the elderly people from an interdisciplinary approach in the rural setting which presents a greater risk of physical and socioeconomic vulnerability. Therefore, the community, the health professionals and the government entities should help implement active aging programs for this population.

El método de la logogenia crea condiciones para posibilitar el proceso de adquisición del español en personas sordas, a través de su exposición al código escrito, para que estas puedan comunicarse. Debido a la utilidad de la logogenia en sordos jóvenes y adultos, es pertinente identificar su funcionalidad en niños, época de la vida en la que podría tener mayor impacto. El estudio tuvo como objetivo identificar si la aplicación de la logogenia permite que los sordos de 5 a 8 años activen tempranamente el proceso de adquisición de la competencia lingüística del español, en especial en cinco dimensiones: comprensión, expresión y uso de elementos de contenido, y comprensión, expresión y uso de elementos funcionales, reglas gramaticales, discriminación de gramaticalidad y conciencia gramatical; además se buscaba identificar si esta activación tenía incidencia en la participación en la comunidad a través de la lengua escrita. Los resultados, a través de pruebas de U Mann-Whitney, mostraron que los participantes del grupo experimental que fueron sometidos a la logogenia desarrollaron habilidades en los procesos sintácticos, que les permitió activar la adquisición de la lengua, a través del código escrito del español. Asimismo, esta activación lingüística propició una efectiva y eficiente participación en los contextos sociales, familiares y escolares, aspectos no evidenciados en el grupo control.

Introduction: Aging is a phenomenon that has increased worldwide as a result of a higher life expectancy, evidencing situations typical of this stage, which can impact the happiness of individuals, who deserve attention and approach from mental health and public health. Objective: To explore the association between sociodemographic characteristics, medical history and symptoms, emotional state, social support, cognitive performance, and functional dependence, in relation to happiness in older adults in a rural area of Túquerres, Nariño. Method: Cross-sectional study of association. Results: There were 252 records in total, corresponding to the data of rural older adults. A multivariate linear regression was performed, finding an association with happiness in the variables of age (βa = 0.41; CI95% 0.09–0.73), socioeconomic level (βa = -0.22; C95% -0.58 – 0, 13), education level (βa = 0.41; 95% CI -0.68 – 1.49), occupation (βa = 0.59; 95% CI -0.48 – 1.67), having chronic disease (βa = 0.42; 95% CI 0.12–0.73), breathing difficulties (βa = -0.25; 95% CI -0.51–0.02), joint pain (βa = 0, 55; 95% CI 0.26 – 0.83), depression symptoms (βa = -0.21; 95% CI -0.48 – 0.06]) or anxiety (βa = 0.40; 95% CI 0 .72 – 0.07), and social support (βa = -0.27; CI95% -0.52 – -0.02). Discussion: this population has unfavorable socioeconomic and health conditions that impact their perception of happiness. Conclusion: happiness is a multicausal phenomenon that in older adults is part of the result of the interaction of variables and historical decisions at a political, economic, and social level. ; Introducción: El envejecimiento es un fenómeno que ha aumentado a nivel mundial como consecuencia de una mayor esperanza de vida, evidenciando situaciones propias de esta etapa, que pueden impactar en la felicidad de los individuos, quienes merecen la atención y el abordaje desde la salud mental y la salud pública. Objetivo: explorar la asociación entre las características sociodemográficas, los antecedentes y síntomas médicos, el estado ...

INTRODUCTION: Clinical practice guidelines (CPGs) are designed to improve the quality of care and reduce unjustified individual variation in clinical practice. Knowledge of the barriers and facilitators that influence the implementation of the CPG recommendations is the first step in creating strategies to improve health outcomes. The present systematic meta-review sought to explore the barriers and facilitators for the implementation of CPGs. METHODS: A search was conducted in the PubMed, Embase, Cochrane, Health System Evidence and International Guideline Library (G-I-N) databases. Systematic reviews of qualitative, quantitative or mixed-methods studies that identified barriers or facilitators for the implementation of CPGs were included. The selection of the title and abstract, the evaluation of the full text, extraction of the data and the quality assessment were carried out by two independent reviewers. To summarise the evidence, we grouped the barriers and facilitators according to the following contexts: political and social, health organisational system, guidelines, health professionals and patients. RESULTS: Overall, 25 systematic reviews were selected. The relevant barriers in the social-political context were the absence of a leader, difficulties with teamwork and a lack of agreement with colleagues. Relevant barriers in the health system were a lack of time, financial problems and a lack of specialised personnel. Barriers of the CPGs included a lack of clarity and a lack of credibility in the evidence. Regarding the health professional, a lack of knowledge about the CPG and confidence in oneself were relevant. Regarding patients, a negative attitude towards implementation, a lack of knowledge about the CPG and sociocultural beliefs played a role. Some of the most frequent facilitators were consistent leadership, commitment of the members of the team, administrative support of the institution, existence of multidisciplinary teams, application of technology to improve the practice and education ...

BACKGROUND: The issue of lower extremity amputation has been in the Colombian political agenda for its relationship with the armed conflict and antipersonnel mines. In 2015 the Colombian Ministry of Health published a national clinical practice guideline (CPG) for amputee patients. However, there is a need to design implementation strategies that target end-users and the context in which the CPG will be used. This study aims to identify users' perceptions about the barriers and facilitators for implementing the guideline for the care of amputee patients in a middle-income country such as Colombia. METHODS: Semi-structured interviews were conducted with 38 users, including patients, health workers, and administrative staff of institutions of the health system in Colombia. Individuals were purposively selected to ensure different perspectives, allowing a balance of individual positions. RESULTS: According to participants' perceptions, barriers to implementation are classified as individual barriers (characteristics of the amputee patient and professionals), health system barriers (resource availability, timely care, information systems, service costs, and regulatory changes), and barriers related to clinical practice guidelines (utility, methodological rigour, implementation flexibility, and characteristics of the group developing the guidelines). CONCLUSIONS: Our study advances knowledge on the perceived individual and health system barriers and facilitators for the implementation of the CPG for amputee patients in Colombia. Importantly, the governance, financial, and service delivery arrangements of the Colombian health system are determining factors in implementing CPGs. For example, the financial arrangements between the insurance companies and the health care provider institutions were identified as barriers for the implementation of recommendations related to the continuity and opportunity of care of patients with amputations. The design of implementation strategies that successfully address the individual ...