Afectaciones personales, familiares y productivas en el cuidador primario: un estudio predictivo

The objective of this research was to analyze the personal, family and productive affectations in caregivers. Methodology: Quantitative cross-sectional study with a predictive scope, 307 primary caregivers were included, with a non-probabilistic sample. Results: the predictive model explains that the effects on the health and emotional state depend on the level of dependency and gender of the patient, as well as on the gender, age, hours of care, food expenses, modified activities and reasons for caring for the caregiver. . In family affections; the relationship with children and partner depend on the patient's marital status, working caregivers, toilet expenses, modification of self-care and work activities. Finally, in the productive affectations; labor problems were more frequent, which depended on the age of the patients, caregivers who work, modification of various activities, being the sole caregiver or having two caregivers; in the same way, the economic affectations are explained from years of care, food expenses, and grooming, as well as reasons to care. Conclusion: It is observed that the affectations depend more on the characteristics of the caregiver than on the characteristics of the patient.El objetivo de esta investigación fue analizar las afectaciones personales, familiares y productivas de los cuidadores principales de personas dependientes. Metodología: Estudio cuantitativo de corte transversal y con alcance predictivo, se incluyeron 307 cuidadores primarios, con una muestra no probabilística. Resultados: el modelo predictivo explica que las afectaciones al estado de salud y emocional, dependen del nivel de dependencia y género del enfermo, así como, del género, edad, horas de cuidado, gastos de alimentación, actividades modificadas y razones para cuidar del cuidador.  En las afectaciones familiares; la relación con los hijos y pareja dependen del estado civil del enfermo, cuidadores que trabajan, gastos de aseos, modificación de actividades de autocuidado y laborales. Por último, en las afectaciones productivas; los problemas laborales fueron más frecuentes, los cuales dependieron de la edad de los enfermos, cuidadores que trabajan, modificación de diversas actividades, ser cuidador único o contar con dos cuidadores; del mismo modo, las afectaciones económicas se explican a partir de años de cuidado, gastos de alimentación, y aseo, así como, de razones para cuidar. Conclusión: Se observa que las afectaciones dependen más de las características del cuidador que de las características del enfermo

Prevalence and factors associated with violence and abuse of older adults in Mexico’s 2012 National Health and Nutrition Survey

Background: Factors associated with violence and the abuse of older adults are understudied and its prevalence in Mexico has not been reported. The aim of this study was to identify the prevalence and factors associated with violence and abuse of older adults in Mexico. Methods: We used Mexico’s 2012 National Health and Nutrition Survey, which included a sample of 8,894 individuals who are 60 years or older and who self-reported a negative health event related to robbery, aggression or violence in the previous 12 months. We used chi-squared test and Fisher’s exact test to analyze the variables related to violence. Adjusted estimates were completed with multiple logistic regression models for complex surveys. Results: The prevalence of violence was 1.7 % for both men and women. In 95 % of the cases, the aggression was from an unknown party. Verbal aggressions were the most prevalent (60 %). Among men, physical aggression was more common. Violence frequently occurred in the home (37.6 %); however, men were primarily assaulted in public places (42.4 %), in comparison to women (30.7 %). There were also differences in the risk factors for violence. Among men, risk was associated with younger age (60–64 years), higher education (secondary school or above) and higher socioeconomic status. Among women, risk was associated with depression, not being the head of the family, and region of the country. Conclusions: Violence against older adults presents differently for men and women, which means it is necessary to increase knowledge about the dynamics of the social determinants of violence, particularly in regards to the role of education among men. The relatively low prevalence found in this study may reflect the difficulty and fear of discussing the topic of violence. This may occur because of cultural factors, as well as by the perception of helplessness perpetuated by the scarce access to social programs that ensure protection and problem solving with regards to the complex social determinants of individual and family violence that this population group endures.publishedVersio

Development and validation of a Screening Questionnaire of Family Mistreatment against Older Adults for use in primary care settings in Mexico

The abuse of older adults is a serious public health issue that can be difficult to identify at the first level of care. Medical and nursing personnel are sometimes unable to identify older adults who suffer family mistreatment. This can occur when victims feel shame or as a result of cultural factors. In the light of this, healthcare personnel require a screening tool that can be used to identify signs of mistreatment. The aim of this study was to develop and validate a screening tool for detecting the familial mistreatment of older adults in primary care settings. A mixed method cross‐sectional study was carried out in three phases between 2009 and 2012 in Mexico. The formative phase involved using a qualitative methodology to identify terms that older adults use to identify practices defined as forms of mistreatment. On this basis, the second phase involved the design of a screening tool through the formation of items in collaboration with a panel of experts. These items were tested on older adults to ensure their intelligibility. Finally, validity and reliability levels were evaluated through the application of the screening tool to a sample of older adults at a primary care facility and at a legal centre. These findings were discussed with gerontologists, and the data were analysed through an exploratory factor analysis with orthogonal rotation and Cronbach's alpha using STATA v13. From the results, we generated a screening tool that is culturally and socially tailored to older adults in Mexico. The tool has a Cronbach's alpha of 0.89, a sensitivity value of 86% (p < .05) and a specificity value of 90% (p < .05) for positive answers to the tool's 15 items. Applying this tool at the first level of care could limit damage to older adults’ health and could lower the frequency of emergency room use in hospitals.publishedVersio

Looking at maternal health of Asháninka communities from the conceptual framework of the accessibility of care

Abstract Background Peru is one of the 20 countries that has significantly reduced maternal mortality before the pandemic due to implementing policies to strengthen maternal health care, mainly in rural areas with greater poverty. However, the implementation of these policies has been different across the territory; such is the case of the indigenous communities of the Peruvian Amazon that are characterized by the inaccessibility of their territory and continue to face severe problems in accessing maternity care in health services. Objective Analyze the main dimensions of accessibility for maternal care in public health services for women of the Asháninka community of Peru between 2016 and 2018. Methods Qualitative research was carried out in the Asháninka community of the Tambo River. Key informants involved in maternal health care were selected, and 60 in-depth interviews were conducted that explored geographical, financial, cultural, and organizational accessibility. The interviews were recorded and transcribed into a word processor; then, a content analysis was performed to classify the texts according to the dimensions of specified accessibility. Results Geographical accessibility: health units in the territory do not have the resolution capacity to attend maternal health problems. Financial accessibility: the programs implemented by the government have not been able to finance the indirect costs of care, such as transportation, which has high costs that a family cannot afford, given their subsistence economy. Cultural: there are efforts for cultural adaptation of maternal care, but its implementation needs to be improved, and the community cannot recognize it due to the lack of continuity of the model and the high personnel turnover. Organizational: health units are characterized by insufficient human resources, supplies, and medicines that fail to offer continuous and quality care. Conclusions The poor geographical, financial, cultural, and organizational accessibility that women from the Asháninka community face for maternal care in public health services are evident. So, the Peruvian government must review the implementation processes of its models of care and maternal health programs in these communities and propose strategies to improve the coverage, quality and continuity of maternal care

Significado de saúde: a vivência do idoso

The meaning of health during old age is based on achieving a state of well-being. Therefore, it is important to understand the factors that benefit or affect accomplishing that goal. Objective: analyze what health means to older adults, based on their experiences. Materials and methods: This is a qualitative study based on content analysis and semi-structured interviews. Twenty elderly adults who frequented a geriatric care center were selected intentionally and determined by means of a saturation index. Results: The meaning of health is manifest in the ability to do things. Accordingly, health is conceived as a useful means to obtain a benefit, be it material, moral or physical. Family ties are important and were even compared to health. The participants also equated health with the absence of pain and disease. Conclusion: Health is experienced by the elderly in a family context. Well-being is perceived as the ability to do things, even if pain and illness are present.Durante la vejez, el significado de salud se basa en alcanzar un estado de bienestar; por ello, es importante comprender los factores que benefician o afectan el logro de este propósito. Objetivo: analizar los significados de salud que los adultos mayores construyen a partir de sus vivencias y experiencias. Materiales y métodos: investigación cualitativa con técnica de análisis de contenido y entrevista semiestructurada. Participaron veinte adultos mayores, que acudieron a un centro de atención geriátrica, seleccionados de manera intencionada y determinada por índice de saturación. Resultados: el significado de salud se manifiesta en la capacidad de poder hacer cosas; así, la salud se concibe como un medio útil para obtener un beneficio, ya sea material, moral o físico. Los vínculos familiares son importantes, incluso los comparan con la salud; también, identifican la salud con la ausencia de dolor y enfermedad. Conclusión: la salud del adulto mayor es vivida en contexto familiar; el bienestar es percibido como la capacidad de hacer cosas, aunque el dolor y la enfermedad estén presentes.doi: 10.5294/aqui.2017.17.2.6Durante a velhice, o significado de saúde está baseado em atingir um estado de bem-estar; por isso, é importante compreender os fatores que beneficiam ou afetam conquistar esse propósito. Objetivo: analisar os significados de saúde que os idosos constroem a partir de suas vivências e experiências. Materiais e método: pesquisa qualitativa com técnica de análise de conteúdo e entrevista semiestruturada. Participaram vinte idosos que foram a um centro de atenção geriátrica, selecionados de maneira intencionada e determinada por índice de saturação. Resultados: o significado de saúde se manifesta na capacidade de poder fazer coisas; assim, a saúde é concebida como um meio útil para obter um benefício — material, moral ou físico. Os vínculos familiares são importantes, inclusive os comparam com a saúde; também identificam a saúde com a ausência de dor e doença. Conclusões: a saúde do idoso é vivida em contexto familiar; o bem-estar é percebido como a capacidade de fazer coisas, embora a dor e a doença estejam presentes

Significado de salud: la vivencia del adulto mayor

Durante la vejez, el significado de salud se basa en alcanzar un estado de bienestar; por ello, es importante comprender los factores que benefician o afectan el logro de este propósito. Objetivo: analizar los significados de salud que los adultos mayores construyen a partir de sus vivencias y experiencias. Materiales y métodos: investigación cualitativa con técnica de análisis de contenido y entrevista semiestructurada. Participaron veinte adultos mayores, que acudieron a un centro de atención geriátrica, seleccionados de manera intencionada y determinada por índice de saturación. Resultados: el significado de salud se manifiesta en la capacidad de poder hacer cosas; así, la salud se concibe como un medio útil para obtener un beneficio, ya sea material, moral o físico. Los vínculos familiares son importantes, incluso los comparan con la salud; también, identifican la salud con la ausencia de dolor y enfermedad. Conclusión: la salud del adulto mayor es vivida en contexto familiar; el bienestar es percibido como la capacidad de hacer cosas, aunque el dolor y la enfermedad estén presentes. doi: 10.5294/aqui.2017.17.2.

Self-Care behaviors in older adults: a cualitative study in a Mexican population

Background: Older adults perform self-care activities based on common knowledge, which should be valued by the nursing team. Objectives: To describe and analyze the self-care behaviors of older adults in a Mexican population. Methodology: Qualitative ethnographic study, using Leininger’s qualitative research method. Results: Seventeen older adults were interviewed. Te analysis resulted in 4 explanatory patterns: 1) I keep my peace of mind through what I think, feel, and believe; 2) I watch my diet and pay attention not only to what I eat but also how I eat it; 3) Staying busy is what keeps me going; 4) and Seeking help and helping myself. Te following risk behaviors were identifed: Postponing medical care; Self-medication; and Food-related beliefs. Conclusion: Identifying older adults’ reported behaviors would contribute to the planning of culturally-sensitive nursing interventions.Marco contextual: Los adultos mayores realizan prácticas de autocuidado con base en sus saberes populares, estas de- ben ser valoradas por el personal de enfermería. Objetivos: Describir y analizar las prácticas de autocuidado que llevan a cabo adultos mayores de una población mexicana. Metodología: Investigación cualitativa etnográfica, en la que se utilizó el método de análisis cualitativo de Leininger. Resultados: Se entrevistó a 17 adultos mayores. El análisis originó 4 patrones explicativos: 1) Conservo mi tranquilidad a través de lo que pienso, siento y creo; 2) Cuido mi alimentación porque no solo es lo que se come, sino cómo se come; 3) Mantenerme ocupado es lo que me tiene en pie; 4) Pidiendo ayuda y ayudándose uno mismo. Las prácticas de riesgo son posponer la atención médica, automedicarse y las creencias en la alimentación. Conclusión: La identificación de las prácticas expresadas por los adultos mayores aportaría una plusvalía en la planificación de las intervenciones de enfermería en el ámbito de los cuidados culturalmente sensibles

Prácticas de autocuidado en adultos mayores: un estudio cualitativo en una población mexicana

"Marco contextual: Los adultos mayores realizan prácticas de autocuidado con base en sus saberes populares, estas deben ser valoradas por el personal de enfermería. Objetivos: Describir y analizar las prácticas de autocuidado que llevan a cabo adultos ma