ÍNDICE DE FUNCIÓN SEXUAL FEMENINA: UN TEST PARA EVALUAR LA SEXUALIDAD DE LA MUJER

Objetivo. Aplicar y validar en una población chilena el "Indice de Función Sexual Femenina" establecido en el International Consensus Development Conference on Female Sexual Dysfunctions. Material y método. 383 mujeres sanas de 20 a 59 años con actividad sexual, beneficiarias del Centro de Salud "Carol Urzúa". Instrumento: cuestionario de 19 preguntas, agrupadas en seis dominios: deseo, excitación, lubricación, orgasmo, satisfacción y dolor. Análisis estadístico: Se utilizó ANOVA, Kruskall-Wallis, Chi cuadrado, regresión logística y alpha de Cronbach. Resultados. Edad media: 35,3±10,9 años, casadas (50,4%) o conviviente (17,0%), con educación media (48,2%). La consistencia interna del test fue buena (&gt;0,70). La sexualidad logra su máxima expresión a los 35-40 años (puntaje: 29,1±4,9) para caer posteriormente (21,0±6,0), especialmente el deseo y excitación. Después de los 44 años se incrementa el riesgo de disfunción sexual (OR:3,6; IC: 2,1-6,3; p< 0,0001). La mayor educación y la estabilidad de pareja disminuyen el riesgo (OR: 0,45; IC:0,28-0,80; p< 0,005 y OR:0,58; IC:0,35-0,98; p< 0,05 respectivamente). Conclusiones. El Indice de Función Sexual Femenino es un instrumento sencillo de aplicar, con propiedades psicométricas adecuadas que permite evaluar la sexualidad en diferentes etapas de la vida. Es adecuado para estudios epidemiológicos y clínico

A metasynthesis of qualitative studies regarding opinions and perceptions about barriers and determinants of health services’ accessibility in economic migrants

Background: Access to health services is an important health determinant. New research in health equity is required, especially amongst economic migrants from developing countries. Studies conducted on the use of health services by migrant populations highlight existing gaps in understanding which factors affect access to these services from a qualitative perspective. We aim to describe the views of the migrants regarding barriers and determinants of access to health services in the international literature (1997–2011). Methods: A systematic review was conducted for Qualitative research papers (English/Spanish) published in 13 electronic databases. A selection of articles that accomplished the inclusion criteria and a quality evaluation of the studies were carried out. The findings of the selected studies were synthesised by means of metasynthesis using different analysis categories according to Andersen’s conceptual framework of access and use of health services and by incorporating other emergent categories. Results: We located 3,025 titles, 36 studies achieved the inclusion criteria. After quality evaluation, 28 articles were definitively synthesised. 12 studies (46.2%) were carried out in the U.S and 11 studies (42.3%) dealt with primary care services. The participating population varied depending mainly on type of host country. Barriers were described, such as the lack of communication between health services providers and migrants, due to idiomatic difficulties and cultural differences. Other barriers were linked to the economic system, the health service characteristics and the legislation in each country. This situation has consequences for the lack of health control by migrants and their social vulnerability. Conclusions: Economic migrants faced individual and structural barriers to the health services in host countries, especially those with undocumented situation and those experimented idiomatic difficulties. Strategies to improve the structures of health systems and social policies are needed.Carolina Foundation (Spain), Mario Benedetti Foundation of the University of Alicante, Regional Ministry of Education (Generalitat Valenciana) (BEST/2009/003). Healthcare Research Fund of the Spanish Ministry of Health and Social Policy (PI 0790470)

Global research priorities related to the World Health Organization Labour Care Guide : results of a global consultation

Background: The World Health Organization (WHO) published the WHO Labour Care Guide (LCG) in 2020 to support the implementation of its 2018 recommendations on intrapartum care. The WHO LCG promotes evidence-based labour monitoring and stimulates shared decision-making between maternity care providers and labouring women. There is a need to identify critical questions that will contribute to defining the research agenda relating to implementation of the WHO LCG. Methods: This mixed-methods prioritization exercise, adapted from the Child Health and Nutrition Research Initiative (CHNRI) and James Lind Alliance (JLA) methods, combined a metrics-based design with a qualitative, consensus-building consultation in three phases. The exercise followed the reporting guideline for priority setting of health research (REPRISE). First, 30 stakeholders were invited to submit online ideas or questions (generation of research ideas). Then, 220 stakeholders were invited to score "research avenues" (i.e., broad research ideas that could be answered through a set of research questions) against six independent and equally weighted criteria (scoring of research avenues). Finally, a technical working group (TWG) of 20 purposively selected stakeholders reviewed the scoring, and refined and ranked the research avenues (consensus-building meeting). Results: Initially, 24 stakeholders submitted 89 research ideas or questions. A list of 10 consolidated research avenues was scored by 75/220 stakeholders. During the virtual consensus-building meeting, research avenues were refined, and the top three priorities agreed upon were: (1) optimize implementation strategies of WHO LCG, (2) improve understanding of the effect of WHO LCG on maternal and perinatal outcomes, and the process and experience of labour and childbirth care, and (3) assess the effect of the WHO LCG in special situations or settings. Research avenues related to the organization of care and resource utilization ranked lowest during both the scoring and consensus-building process. Conclusion: This systematic and transparent process should encourage researchers, program implementers, and funders to support research aligned with the identified priorities related to WHO LCG. An international collaborative platform is recommended to implement prioritized research by using harmonized research tools, establishing a repository of research priorities studies, and scaling-up successful research results

Assistência à mulher climatérica: novos paradigmas Atención a la mujer climatérica: nuevos paradigmas Assistance to the climacteric woman: new paradigms

O envelhecimento populacional é uma realidade demográfica brasileira. Como conseqüência, espera-se, nos próximos anos, um aumento progressivo na procura dos serviços de saúde por mulheres com queixas relacionadas ao climatério. Paralelamente, a assistência ao climatério tem passado por uma modificação de paradigmas, impondo aos profissionais de saúde uma mudança de atitude. Reconhece-se que o climatério é influenciado tanto por fatores biológicos, como por fatores psicossociais e culturais, cujo conhecimento é fundamental para uma assistência mais qualificada e humanizada. Este artigo propõe refletir sobre as mudanças de paradigmas na assistência ao climatério, destacando a multidisciplinaridade e interdisciplinaridade, no sentido acolher melhor essa parcela da população e proporcionar-lhe um cuidado integral e individualizado, aproximando o saber da sensibilidade, voltado a uma melhor qualidade vida.<br>Envejecimiento poblacional es una realidad demográfica brazilian. Consecuentementese espera un aumento progresivo de la búsqueda en los servicios de salud del país por mujeres con quejas relacionadas al climaterio. La asistencia al climaterio ha pasado por un cambio de paradigmas que han impuesto a los profesionales de la salud. El climaterio es influenciado por factores biológicos, factores psicosociales y culturales, cuyo conocimiento es fundamental para la planificación de una asistencia. Artículo se propone reflexionar sobre los cambios de paradigmas, el abordaje multidisciplinario e interdisciplinario, en el sentido de recibir mejor esta parcela de la población y proporcionarle un cuidado integral e individualizado, aproximando el saber de la sensibilidad, y el tener como objetivo a una mejor calidad de vida.<br>Population aging is a demographic reality for Brazil. Consequently, in the next years it is expected a progressive increase in seeking health care services in the country by women with complaints related to climacterium. Parallel to it, assistance at this part of woman's life has been going through a paradigm shift which has imposed to health professionals a change of attitude in relation to this stage of woman's life. Today it is acknowledged that the climacterium is influenced by biological, psychosocial and cultural factors, whose knowledge is fundamental for planning a more qualified and humanized care. This article proposes a reflection on the paradigm shifts in assistance at climacterium, highlighting important aspects as multidisciplinarity and interdisciplinarity, so as to serve better this portion of population, and provide it with more integrated and individualized care, bringing together knowledge and sensitivity, and always aiming at a better quality of life