Satisfacción Laboral en Profesionales de Enfermería

Introducción: El objetivo principal de la investigación fue describir el grado de satisfacción laboral de las Enfermeras de Clínicas y Hospitales de Bucaramanga y área Metropolitana, para ello se identificaroncaracterísticas sociodemográficas, y características laborales del personal de enfermería. Materiales y Métodos : Se trato de un estudio descriptivo multicéntrico cuya muestra la conformaron 218 enfermeras que laboran en el sector público y privado de las Clínicas y Hospitales de Bucaramanga y su área Metropolitana. Se aplicó el cuestionario de satisfacción laboral S10/12 de J.L Meliá y J.M.Peiro (1998) modificado para incluir algunos aspectos descriptivos y factores intrínsecos de la teoría de Herzberg. Resultados: En cuanto al nivel educativo un gran porcentaje el 47.2% no ha realizado ningún tipo de estudio complementario al de su pregrado, el 25.7% ha realizado alguna especialización y el 24.8% diplomado; además solo el 1.8% ha realizado maestría y el 0.5% tiene doctorado. En el 67.9% la categoría laboral es general y el 27.5% es especialista. En cuanto a la jerarquía el 88.1% laboran como enfermeras de servicio y el 0.9% ejercen labores de supervisión. Los resultados también demuestran que los factores de ambiente y supervisión están dentro de una media del 5.2 y una desviación estándar de 1.3 lo que equivale a decir que las enfermeras están satisfechas; por otro lado el factor que genera mayor inconformidad es el de las prestaciones sociales con una media de 4.7 y una desviación estándar de 1.6. Discusión y Conclusiones: Los resultados del estudio en su mayoría de ítem demuestran que las personas están satisfechas, sin embargo a pesar de esto llama la atención que un porcentaje tan alto desee trabajar fuera del país. (Rev Cuid 2010;1(1):53-62).Palabras clave: satisfacción en el trabajo, personal de enfermería, motivación, condiciones de trabaj

Prevalencia del consumo de sustancias psicoactivas en estudiantes universitarios de la salud y ciencias sociales

Introducción: La prevalencia de vida de alguna sustancia psicoactiva ilícita o lícita de uso indebido en estudiantes universitarios de Colombia es del 29.3%. Materiales y Métodos: Se condujo un estudio descriptivo de corte transversal, el tamaño de la muestra fue calculado por programa académico con una frecuencia esperada del 2%, error estándar del 0.5% y una confianza del 95%. Se empleó el cuestionario “factores de riesgo y de protección para el consumo de drogas en jóvenes” desarrollado por Varela Arévalo M.T. y colaboradores, del Grupo de investigación Psicología, Salud y Calidad de Vida de la Pontificia Universidad Javeriana Cali. Resultados: Se evaluaron 995 estudiantes de la Facultad de Salud y de Ciencias Sociales, 76.71% eran mujeres, la mediana de edad fue de 21 años, el 93.90% de los estudiantes eran solteros. Las sustancias psicoactivas de mayor consumo dado la prevalencia de vida fueron en orden: el alcohol 83.73%, tabaco 34.08%, marihuana 11.87%, alucinógenos 4.59% y cocaína 2.33%; además, con una prevalencia actual del 61.69%, 16.40%, 3.05%, 1.60% y 0.42% para cada sustancia, respectivamente. Los hombres presentan mayor prevalencia de consumo en la vida y actual de cigarrillo, marihuana, cocaína y alucinógenos que las mujeres, (valor de p<0.01). Dentro de los problemas provocados por el consumo de sustancias psicoactivas se destacan los interpersonales, conflictos personales, económicos, académicos y/o laborales. Discusión y Conclusiones: Es necesario desarrollar e implementar programas o estrategias de promoción de la salud mental y prevención del consumo de sustancias psicoactivas en los estudiantes universitarios, vinculando a bienestar universitario, con el propósito de evitar que la prevalencia del consumo aumente, afecte el proyecto de vida de los estudiantes y problemas biopsicosociales. (Rev Cuid 2012; 3(3):334-41).Palabras clave: Agentes Psicoactivos, Prevalencia, Estudiantes. (Fuente: DeCS BIREME)

Concepciones del embarazo en adolescentes gestantes de la ciudad de Bucaramanga

Introducción: El embarazo adolescente es una problemática que tiene consecuencias en la vida de las adolescentes y sus familias. Conocer las concepciones y representaciones que tienen las adolescentes gestantes es una herramienta fundamental para fortalecer la toma de decisiones y las redes de apoyo social. Objetivo: Identificar las concepciones sobre el embarazo, las características sociales, económicas y de redes de apoyo en un grupo de adolescentes gestantes de Bucaramanga. Materiales y Métodos: Se realizó un estudio cualitativo (estudio de caso) mediante las técnicas de grupo focal, observación participante y elaboración de diario de campo. Se incluyeron 15 participantes de las 100 adolescentes beneficiadas por el Programa Plan Padrino de la Secretaría de Salud y Ambiente de Bucaramanga durante el año 2014. Resultados: La mayoría de las participantes refirieron que, aunque el embarazo fue no deseado lo han aceptado y asumido con grandes cambios en sus vidas, especialmente la relación con sus amigos y con su familia. Identificaron como red de apoyo fundamental la familia. Discusión: Las concepciones sobre embarazo en las adolescentes coinciden con los estudios reportados en Colombia en el sentido que lo asumieron con responsabilidad, pero les representó un doble reto en especial para continuar con sus estudios. Conclusiones: Fortalecer la red de apoyo de las adolescentes en especial la relacionada con procesos educativos y de familia.Cómo citar este artículo: Niño BAP, Ortíz SP, Solano S, Amaya CM, Serrano L. Concepciones del embarazo en adolescentes gestantes de la ciudad de Bucaramanga. Rev Cuid. 2017; 8(3): 1875-86. http://dx.doi.org/10.15649/cuidarte.v8i3.448 

Voices of the academy and decision-makers from the East of Colombia regarding the implementation of the Integral Health care Model

Introducción: En Colombia, a partir del año 2011 ha resurgido el interés por la incorporación de la Estrategia de Atención Primaria en Salud (APS) en los servicios de salud y en los debates académicos. A partir de la promulgación del nuevo Modelo Integral de Atención en Salud en el año 2016, este interés es explícito por los distintos actores del Sistema General de Seguridad Social en Salud. En el marco de la Alianza por la Atención Primaria en Salud para Colombia, se promovieron encuentros regionales que permitieran identificar potencialidades y limitaciones para la implementación de la estrategia de APS en el marco de la nueva política de atención. Objetivo: Socializar las reflexiones que tomadores de decisiones y representantes de la academia realizaron frente a la implementación de la nueva política de atención en el oriente del país. Metodología: Se realizaron tres mesas de trabajo con 30 actores de 11 Instituciones de Educación Superior y 17 tomadores de decisiones de cuatro departamentos del oriente del país. Se utilizó la estrategia de investigación de grupos de discusión. Resultados:Tanto la academia como los tomadores de decisiones identificaron desafíos relacionados con la comprensión de los aspectos conceptuales del enfoque poblacional del modelo, así como la necesidad de hacer una mirada crítica a las competencias y currículos de los nuevos profesionales. Conclusión: Los distintos temas que emergieron del debate incluyen aspectos estructurales y de funcionamiento del sistema de seguridad social en Salud que le plantean a la autoridad sanitaria retos que superan la mera instrumentalización del modelo.Introduction: Since 2011, there has been an increasing interest to re-incorporate primary health care (PHC) strategy in healthcare services and academic debates. After the promulgation of the new healthcare model (MIAS) in 2016, this interest has been made explicit by all actors involved in the health benefits program of the Social Security System (SGSSS). According to the guidelines proposed by the Colombian PHC Alliance, regional meetings have been held to identify potentialities and limitations for implementing the PHC strategy within the framework of the new healthcare policy. Objective: To socialize the analysis carried out by decision-makers and academics related to the implementation of the new healthcare policy in the east of the country. Methodology: Three workshops were held with the participation of 30 representatives of 11 higher-education institutions and 17 decision makers from four departments of the east of the country. Qualitative research methodology based on focus groups was applied. Results: Academics and decision-makers identified challenges related to understanding the conceptual aspects of the Model’s population focus and raised awareness about the need of a critical assessment of curricula and professional competencies of health professionals. Conclusion: The discussion topics emerged from the debate included structural and functional aspects of the Health System that represent challenges to health authorities beyond the mere operationalization of the model

Costos derivados de la atención a pacientes con enfermedad crónica no transmisible

 Antecedentes: Las enfermedades crónicas no transmisibles, son la principal causa de morbimortalidad a nivel mundial. Comportamiento similar se presenta en Colombia al igual que en Santander. Las patologías cardiovasculares en el 2010 cobraron la vida de 1527 mujeres y 1634 hombres; seguido de las neoplasias, en especial las de localización de tumores malignos que causaron la muerte a 727 mujeres y 755 hombres, estos resultados se ven reflejados en los altos costos requeridos para la atención hospitalaria, ambulatoria y domiciliaria por lo que requiere dedicación, educación y cuidado individualizado. Métodos: Se realizó una búsqueda de artículos teniendo en cuenta tiempo de publicación y las palabras claves; en las bases de datos: MEDLINE, IME, LILACS, Centro Cochrane Iberoamericano, EMBASE, CINAHL, BDIE, en el primer semestre de 2013. Identificando 55 estudios potenciales, de los cuales se seleccionaron seis artículos del comportamiento de los costos de la atención a pacientes con enfermedades crónicas no transmisibles; cabe incluir que se obtuvo información directa por parte de algunas instituciones de Bucaramanga, la cual demuestra el comportamiento de los costos frente al cuidado de enfermería y a nivel interno de cada entidad no solo del sistema de salud sino de los pacientes y cuidadores familiares. Resultados: la enfermedad crónica genera la mayor parte de los costos al Sistema de Salud, situación a tener en cuenta; así como el cuidado efectivo para la atención de pacientes que ya han sido afectados. Conclusiones: el Sistema de Salud debe implementar estrategias preventivas para la aparición de las Enfermedades Crónicas No Trasmisibles (ECNT) y las complicaciones derivadas de ellas, que contemple un cuidado efectivo para la atención de los individuos.Palabras claves: Costos, Cuidado, Enfermedad Crónica no transmisible.  Abstract  Background: Chronic noncommunicable diseases are the leading cause of morbidity and mortality worldwide. Similar behavior occurs in Colombia as in Santander. Cardiovascular diseases in 2010 claimed the lives of 1527 women and 1634 men ; followed by neoplasms, especially the localization of malignant tumors that killed 727 women and 755 men, these results are reflected in the high cost required for inpatient , outpatient and home care so requires dedication , education and individualized care. Methods: A search of articles were given at time of publication and keyword; in databases: MEDLINE, IME, LILACS, Iberoamerican Cochrane Centre, EMBASE, CINAHL, BDIE in the first half of 2013. By identifying 55 potential studies, of which six articles of behavior of costs of care were selected patients with chronic non- communicable diseases; it should include direct information was obtained by some institutions Bucaramanga, which shows the behavior of costs compared to nursing care and internally each institution not only the health system but patients and family caregivers. Results: Chronic illness generates most of the costs the health system, a situation to consider; and effective care for the care of patients who have already been affected. Conclusions: Health System must implement preventive strategies for the appearance of Chronic Non Communicable (ECNT) and complications arising from them, by providing effective care for the care of individuals.Keywords: Costs, Care, Chronic Non-Communicable Disease

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

COPPADIS Study Group.[Introduction] We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson's disease (PD) without dementia.[Methods] The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models.[Results] Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r = 0.37, p < 0.001), and this association remained significant after controlling for several potential confounding variables (p = 0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p = 0.02).[Conclusions] Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition-relevant changes in non-demented PD.This work was supported by the Alzheimer Forschung Initiative e.V. (AFI International Training Grant to MJG), the Instituto de Salud Carlos III-Fondo Europeo de Desarrollo Regional (ISCIII-FEDER) [PI14/01823, PI16/01575, PI18/01898, PI19/01576, PI20/00613], the Consejería de Economía, Innovación, Ciencia y Empleo de la Junta de Andalucía [CVI-02526, CTS-7685], the Consejería de Salud y Bienestar Social de la Junta de Andalucía [PI-0471-2013, PE-0210-2018, PI-0459-2018, PE-0186-2019], the Fundación Alicia Koplowitz and the Fundación “Curemos el Parkinson” (https://www.curemoselparkinson.org). MJG is supported by the “Miguel Servet” program [CP19/00031], MALE by the University of Seville [USE-20046-J], JFM by the “Sara Borrell” program [CD13/00229] and VI-PPIT-US from the University of Seville [USE-18817-A], SJ by the “Acción B-Clínicos-Investigadores” program [B-0007-2019], and DMG by the “Río Hortega” program [CM18/00142].Peer reviewe

In vivo cholinergic basal forebrain degeneration and cognition in Parkinson's disease: Imaging results from the COPPADIS study

Introduction: We aimed to assess associations between multimodal neuroimaging measures of cholinergic basal forebrain (CBF) integrity and cognition in Parkinson’s disease (PD) without dementia. Methods: The study included a total of 180 non-demented PD patients and 45 healthy controls, who underwent structural MRI acquisitions and standardized neurocognitive assessment through the PD-Cognitive Rating Scale (PD-CRS) within the multicentric COPPADIS-2015 study. A subset of 73 patients also had Diffusion Tensor Imaging (DTI) acquisitions. Volumetric and microstructural (mean diffusivity, MD) indices of CBF degeneration were automatically extracted using a stereotactic CBF atlas. For comparison, we also assessed multimodal indices of hippocampal degeneration. Associations between imaging measures and cognitive performance were assessed using linear models. Results: Compared to controls, CBF volume was not significantly reduced in PD patients as a group. However, across PD patients lower CBF volume was significantly associated with lower global cognition (PD-CRStotal: r =0.37, p <0.001), and this association remained significant after controlling for several potential confounding variables (p =0.004). Analysis of individual item scores showed that this association spanned executive and memory domains. No analogue cognition associations were observed for CBF MD. In covariate-controlled models, hippocampal volume was not associated with cognition in PD, but there was a significant association for hippocampal MD (p =0.02). Conclusions: Early cognitive deficits in PD without dementia are more closely related to structural MRI measures of CBF degeneration than hippocampal degeneration. In our multicentric imaging acquisitions, DTI-based diffusion measures in the CBF were inferior to standard volumetric assessments for capturing cognition- relevant changes in non-demented PD

Clinical and structural brain correlates of hypomimia in early-stage Parkinson's disease

Altres ajuts: acord transformatiu CRUE-CSICBackground and purpose: Reduced facial expression of emotions is a very frequent symptom of Parkinson's disease (PD) and has been considered part of the motor features of the disease. However, the neural correlates of hypomimia and the relationship between hypomimia and other non-motor symptoms of PD are poorly understood. Methods: The clinical and structural brain correlates of hypomimia were studied. For this purpose, cross-sectional data from the COPPADIS study database were used. Age, disease duration, levodopa equivalent daily dose, Unified Parkinson's Disease Rating Scale part III (UPDRS-III), severity of apathy and depression and global cognitive status were collected. At the imaging level, analyses based on gray matter volume and cortical thickness were used. Results: After controlling for multiple confounding variables such as age or disease duration, the severity of hypomimia was shown to be indissociable from the UPDRS-III speech and bradykinesia items and was significantly related to the severity of apathy (β = 0.595; p < 0.0001). At the level of neural correlates, hypomimia was related to motor regions brodmann area 8 (BA 8) and to multiple fronto-temporo-parietal regions involved in the decoding, recognition and production of facial expression of emotions. Conclusion: Reduced facial expressivity in PD is related to the severity of symptoms of apathy and is mediated by the dysfunction of brain systems involved in motor control and in the recognition, integration and expression of emotions. Therefore, hypomimia in PD may be conceptualized not exclusively as a motor symptom but as a consequence of a multidimensional deficit leading to a symptom where motor and non-motor aspects converge

Predictors of Global Non-Motor Symptoms Burden Progression in Parkinson’s Disease. Results from the COPPADIS Cohort at 2-Year Follow-Up

Background and Objective: Non-motor symptoms (NMS) progress in different ways between Parkinson's disease (PD) patients. The aim of the present study was to (1) analyze the change in global NMS burden in a PD cohort after a 2-year follow-up, (2) to compare the changes with a control group, and (3) to identify predictors of global NMS burden progression in the PD group. Material and Methods: PD patients and controls, recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017, were followed-up with after 2 years. The Non-Motor Symptoms Scale (NMSS) was administered at baseline (V0) and at 24 months ± 1 month (V2). Linear regression models were used for determining predictive factors of global NMS burden progression (NMSS total score change from V0 to V2 as dependent variable). Results: After the 2-year follow-up, the mean NMS burden (NMSS total score) significantly increased in PD patients by 18.8% (from 45.08 ± 37.62 to 53.55 ± 42.28; p < 0.0001; N = 501; 60.2% males, mean age 62.59 ± 8.91) compared to no change observed in controls (from 14.74 ± 18.72 to 14.65 ± 21.82; p = 0.428; N = 122; 49.5% males, mean age 60.99 ± 8.32) (p < 0.0001). NMSS total score at baseline (β = -0.52), change from V0 to V2 in PDSS (Parkinson's Disease Sleep Scale) (β = -0.34), and change from V0 to V2 in NPI (Neuropsychiatric Inventory) (β = 0.25) provided the highest contributions to the model (adjusted R-squared 0.41; Durbin-Watson test = 1.865). Conclusions: Global NMS burden demonstrates short-term progression in PD patients but not in controls and identifies worsening sleep problems and neuropsychiatric symptoms as significant independent predictors of this NMS progression

Predictors of Loss of Functional Independence in Parkinson’s Disease: Results from the COPPADIS Cohort at 2-Year Follow-Up and Comparison with a Control Group

COPPADIS Study Group.[Background and objective] The aim of this study was to compare the progression of independence in activities of daily living (ADL) in Parkinson’s disease (PD) patients versus a control group, as well as to identify predictors of disability progression and functional dependency (FD).[Patients and Methods] PD patients and control subjects, who were recruited from 35 centers of Spain from the COPPADIS cohort between January 2016 and November 2017 (V0), were included. Patients and subjects were then evaluated again at the 2-year follow-up (V2). Disability was assessed with the Schwab & England Activities of Daily Living Scale (S&E-ADLS) at V0 and V2. FD was defined as an S&E-ADLS score less than 80%.[Results] In the PD group, a significant decrease in the S&E-ADLS score from V0 to V2 (N = 507; from 88.58 ± 10.19 to 84.26 ± 13.38; p < 0.0001; Cohen’s effect size = −0.519) was observed but not in controls (N = 124; from 98.87 ± 6.52 to 99.52 ± 2.15; p = 0.238). When only patients considered functional independent at baseline were included, 55 out of 463 (11.9%) converted to functional dependent at V2. To be a female (OR = 2.908; p = 0.009), have longer disease duration (OR = 1.152; p = 0.002), have a non-tremoric motor phenotype at baseline (OR = 3.574; p = 0.004), have a higher score at baseline in FOGQ (OR = 1.244; p < 0.0001) and BDI-II (OR = 1.080; p = 0.008), have a lower score at baseline in PD-CRS (OR = 0.963; p = 0.008), and have a greater increase in the score from V0 to V2 in UPDRS-IV (OR = 1.168; p = 0.0.29), FOGQ (OR = 1.348; p < 0.0001) and VAFS-Mental (OR = 1.177; p = 0.013) (adjusted R-squared 0.52; Hosmer and Lemeshow test = 0.94) were all found to be independent predictors of FD at V2.[Conclusions] In conclusion, autonomy for ADL worsens in PD patients compared to controls. Cognitive impairment, gait problems, fatigue, depressive symptoms, more advanced disease, and a non-tremor phenotype are independent predictors of FD in the short-term.Fundación Curemos el Parkinson (www.curemoselparkinson.org).Peer reviewe