Caracterización de pacientes que reciben cuidados paliativos en una unidad privada no hospitalaria en El Salvador.

In El Salvador, access to palliative care is limited. In July 2013, he started a private support and symptom control unit in palliative care. They care for cancer and non-cancer patients at three levels: outpatient consultation, hospitalization in private centers and home care. The objective of this study is to describe the demographic and clinical characteristics of the population attended from January 2014 to December 2016 as the first experience of private palliative care in San Salvador.It is an observational, retrospective and descriptive study, using the population census and clinical records. Where sociodemographic and clinical variables of the patients were collected in an initial assessment by the palliative doctor.The total of patients was 125. Being 56.8% women with an average age of 72 years. 68% of patients live in San Salvador. 14.4% have private health insurance. 68% received a home consultation. 86.4% of the patients attended suffered from oncological diseases. The most frequent symptoms: weakness 90.4%, lack of appetite 88.8% and pain 76%. The most widely used opioid was morphine 28.8% followed by tramadol 17.6%, oxycodone 8% and fentanyl 8%. 12.8% required palliative sedation. The patients were referred by doctors in 52.8% and by relatives 47.2%.We present the characteristics of the patients cared for in the private unit and whose results show that when palliative care cares for its principles and basic elements of work, the results are similar to other units in the rest of the world.En El Salvador el acceso a los cuidados paliativos es limitado. En julio de 2013 inició una unidad privada de soporte y control de síntomas en cuidados paliativos. Atienden enfermos oncológicos y no oncológicos en tres niveles: consulta externa, hospitalización en centros privados y atención domiciliaria. El objetivo de este estudio es describir las características demográficas y clínicas de la población atendida desde enero de 2014 a diciembre de 2016 como primera experiencia de atención paliativa privada en San Salvador. Es un estudio observacional, retrospectivo y descriptivo, utilizando el censo poblacional y los expedientes clínicos. En donde se recogieron variables sociodemográficas y clínicas de los pacientes en una valoración inicial por el médico paliativista. El total de pacientes fue 125. Siendo 56.8% mujeres con promedio de edad 72 años.  El 68% de los pacientes viven en San Salvador. 14.4% tienen seguro médico privado. 68% recibieron consulta domiciliar. El 86.4% de los pacientes atendidos padecían de enfermedades oncológicas. Los síntomas más frecuentes: debilidad 90.4%, falta de apetito 88.8% y dolor 76%. El opioide más utilizado fue morfina 28.8% seguido de tramadol 17.6%, oxicodona 8% y fentanilo 8%.  Requirieron sedación paliativa 12.8%. Los pacientes fueron referidos por médicos en 52.8% y por familiares 47.2%. Presentamos las características de los pacientes atendidos en la unidad privada y cuyos resultados muestran que cuando los cuidados paliativos cuidan sus principios y elementos básicos de trabajo los resultados son similares a otras unidades en el resto del mundo

Social Networks Dynamics: Implications for Salvadoreans in San Francisco

The 1990 U.S. Census estimates that there are over half a million Salvadoreans in the U.S., which means that approximately one of every six Salvadoreans may now reside in the United States. The experience of Salvadoreans differs from that of Mexican immigrants, the largest Latino immigrant group, in that Salvadoreans left a war-torn country and their large-scale migration to the U.S. is relatively recent. In this paper, I analyze the centrality of social networks in Salvadorean migration to the United States. In contrast to most studies of immigrant social networks that emphasize the supportive and generally cohesive side of these social ties, I focus on instances where networks may weaken and even break down, and consequences of this situation for the lives of Salvadorean newcomers.This study is based on ethnographic fieldwork carried out in San Francisco, from late 1989 to 1992. Fifty Salvadorean men and women who had arrived in the U.S. within the previous five years were interviewed. In addition, important information was obtained through informal observations with the respondents and their families, as well as through interviews with community leaders and social services providers.The central findings of this study point out that the broader contexts of reception, such as policies of the receiving state with respect to the immigrant group in question, the local labor marker, and the organizations in the community of reception, together with a legacy of a war-ravaged country of origin manifested in traumatic disorders, affect kinship networks in important ways. In the case I analyzed here, the absence of an official reception by the government and a recessionary economic cycle have exacerbated the impoverished condition of Salvadorean newcomers. The scarcity of resources undermines the reciprocity inherent in social networks, often leading to a weakening and even a breakdown of kingship support networks

Social Networks Dynamics: Implications for Salvadoreans in San Francisco

The 1990 U.S. Census estimates that there are over half a million Salvadoreans in the U.S., which means that approximately one of every six Salvadoreans may now reside in the United States. The experience of Salvadoreans differs from that of Mexican immigrants, the largest Latino immigrant group, in that Salvadoreans left a war-torn country and their large-scale migration to the U.S. is relatively recent. In this paper, I analyze the centrality of social networks in Salvadorean migration to the United States. In contrast to most studies of immigrant social networks that emphasize the supportive and generally cohesive side of these social ties, I focus on instances where networks may weaken and even break down, and consequences of this situation for the lives of Salvadorean newcomers.This study is based on ethnographic fieldwork carried out in San Francisco, from late 1989 to 1992. Fifty Salvadorean men and women who had arrived in the U.S. within the previous five years were interviewed. In addition, important information was obtained through informal observations with the respondents and their families, as well as through interviews with community leaders and social services providers.The central findings of this study point out that the broader contexts of reception, such as policies of the receiving state with respect to the immigrant group in question, the local labor marker, and the organizations in the community of reception, together with a legacy of a war-ravaged country of origin manifested in traumatic disorders, affect kinship networks in important ways. In the case I analyzed here, the absence of an official reception by the government and a recessionary economic cycle have exacerbated the impoverished condition of Salvadorean newcomers. The scarcity of resources undermines the reciprocity inherent in social networks, often leading to a weakening and even a breakdown of kingship support networks