Factores que influyen en el cumplimiento y adherencia al tratamiento odontológico: una revisión exploratoria

Introducción: según la Organización Mundial de la Salud (OMS), las enfermedades bucodentales constituyen unaimportante carga para el sector salud en muchos países, ya que afecta a las personas durante toda su vida y causadolor, molestias, desfiguración e incluso la muerte. El 50 % de los pacientes con enfermedades bucales crónicaspresentan adherencia a las intervenciones en salud. Objetivo: analizar los factores que influyen en el cumplimiento y adherencia al tratamiento odontológico de los usuarios. Metodología: se realizó una scoping review basada en seis etapas. Se utilizaron las bases de datos bibliográficas de PubMed, Web of Science (WOS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Google Scholar. La pregunta fue elaborada por medio del acrónimo PCC (Población, Concepto y Contexto). Fueron incluidos estudios empíricos y literatura gris, publicados entre los años 2015 a 2020. Todas las citas fueron importadas a través del gestor de referencia  EndNote. Para la evaluación de la calidad metodológica de estudios primarios fue utilizado el checklist Mixed Methods Appraisal Tool (MMAT) y Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) para literatura gris.Fue realizado un análisis temático de acuerdo con seis etapas y basado en el modelo de proceso de la teoría de laautodeterminación (TAD). Para el reporte de la scoping review se utilizó PRISMA-ScR. Resultados: de un total de282 estudios recuperados se incluyeron nueve artículos, uno cualitativo, seis de tipo cuantitativo, un análisis críticoy una tesis. Los factores que influyen en el cumplimiento y adherencia al tratamiento dental fueron categorizados según la calidad de vida relacionada con la salud oral y la salud oral autoevaluada. Conclusiones: la presente revisión analizó los factores que influyen en el cumplimiento y adherencia al tratamiento odontológico de los usuarios. La calidad de vida relacionada con la salud oral se caracterizó por el bajo nivel socioeconómico y baja alfabetización en salud oral, y la salud oral autoevaluada se caracterizó por el miedo o ansiedad dental y los perfiles de personalidad de cada paciente. Introducción: según la Organización Mundial de la Salud (OMS), las enfermedades bucodentales constituyen unaimportante carga para el sector salud en muchos países, ya que afecta a las personas durante toda su vida y causadolor, molestias, desfiguración e incluso la muerte. El 50 % de los pacientes con enfermedades bucales crónicaspresentan adherencia a las intervenciones en salud. Objetivo: analizar los factores que influyen en el cumplimiento y adherencia al tratamiento odontológico de los usuarios. Metodología: se realizó una scoping review basada en seis etapas. Se utilizaron las bases de datos bibliográficas de PubMed, Web of Science (WOS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) y Google Scholar. La pregunta fue elaborada por medio del acrónimo PCC (Población, Concepto y Contexto). Fueron incluidos estudios empíricos y literatura gris, publicados entre los años 2015 a 2020. Todas las citas fueron importadas a través del gestor de referencia  EndNote. Para la evaluación de la calidad metodológica de estudios primarios fue utilizado el checklist Mixed Methods Appraisal Tool (MMAT) y Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) para literatura gris.Fue realizado un análisis temático de acuerdo con seis etapas y basado en el modelo de proceso de la teoría de laautodeterminación (TAD). Para el reporte de la scoping review se utilizó PRISMA-ScR. Resultados: de un total de282 estudios recuperados se incluyeron nueve artículos, uno cualitativo, seis de tipo cuantitativo, un análisis críticoy una tesis. Los factores que influyen en el cumplimiento y adherencia al tratamiento dental fueron categorizados según la calidad de vida relacionada con la salud oral y la salud oral autoevaluada. Conclusiones: la presente revisión analizó los factores que influyen en el cumplimiento y adherencia al tratamiento odontológico de los usuarios. La calidad de vida relacionada con la salud oral se caracterizó por el bajo nivel socioeconómico y baja alfabetización en salud oral, y la salud oral autoevaluada se caracterizó por el miedo o ansiedad dental y los perfiles de personalidad de cada paciente. Introduction: According to the World Health Organization (WHO), oral diseases constitute a major burden on thehealth sector in many countries, affecting people throughout their entire lives, causing pain, discomfort, disfigurement and even death. Fifty percent of patients with chronic oral diseases are adherent to health interventions. Objective: To analyze the factors that influence compliance and adherence to dental treatment of users. Methodology: A sixstage scoping review was carried out. The electronic databases PubMed, Web of Science (WOS), Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Google Scholar were used. The question was elaboratedusing the acronym PCC (Population, Concept and Context). Empirical studies and grey literature, published betweenthe years 2015 to 2020, were included. All citations were imported through the EndNote reference manager. TheMixed Methods Appraisal Tool (MMAT) and Authority, Accuracy, Coverage, Objectivity, Date, Significance (AACODS) checklist for gray literature were used to assess the methodological quality of primary studies. Thematic analysis was performed according to six stages and based on the process model of Self-Determination Theory (SDT). PRISMA-ScR was used for the scoping review report.  Results: From a total of 282 studies retrieved, nine articles were included, being one qualitative study, six quantitative, one critical analysis and one thesis. The factors that influence compliance and adherence to dental treatment were categorized according to oral health-related quality of life and self-assessed oral health. Conclusion: The present review analyzed the factors that influence compliance and adherence to dental treatment among users. Oral health-related quality of life was characterized by low socioeconomic status and low oral health literacy, and self-rated oral health was characterized by dental fear or anxiety and individual patient personality profiles

INTERVENCIONES BASADAS EN INTERNET PARA LA ATENCIÓN DE TRASTORNOS MENTALES EN PANDEMIA: UNA REVISIÓN SISTEMÁTICA

Objective: : To describe Internet-based interventions for the care of mental disorders during the pandemic. Material and method: This was a systematic review. The databases PubMed, CINAHL, Web of Science, Scopus, and Virtual Health Library were used. The search strategy used MeSH descriptors, CINAHL Subjects, DeCS: "Adults", "Internet-Based Intervention", and "Mental Disorders" in combination with keywords and Boolean operators. Primary studies were included, in Spanish, English, and Portuguese, between 2019 to 2021, in the context of COVID-19, SARS-CoV-2, and/ or the pandemic. References were imported into EndNote. Methodological quality was assessed according to the Mixed Methods Appraisal Tool (MMAT). Data were analyzed based on thematic analysis. Results: From a total of 303 articles, six duplicates were eliminated, 295 were eligible and five were included. Two studies showed a positive attitude and disposition towards mobile app interventions, two showed significant decreases in anxiety scores, depression, and increased use of text messaging (mHealth) versus this type of intervention and one showed a greater number of telemedicine visits than conventional visits in patients with severe mental illness. Conclusion: he study found that the predominant internet-based interventions were by text messaging and mobile apps.Objetivo: Describir las intervenciones basadas en internet para la atención de trastornos mentales en pandemia. Material y método: Se trató de una revisión sistemática. Fueron utilizadas las bases PubMed, CINAHL, Web of Science, Scopus y Biblioteca Virtual en Salud. La estrategia de búsqueda utilizó descriptores MeSH, Subjects CINAHL, DeCS: “Adults”, “Internet-Based Intervention”, “Mental Disorders” en combinación a palabras claves y operadores booleanos. Fueron incluidos estudios primarios, en español, inglés y portugués, entre 2019 a 2021, en contexto de COVID-19, SARS-CoV-2 y/o pandemia. Las referencias fueron importadas a EndNote. Se evaluó la calidad metodológica según Mixed Methods Appraisal Tool (MMAT). Los datos fueron analizados basado en el análisis temático. Resultados: De un total de 303 artículos, seis duplicados fueron eliminados, 295 elegibles y cinco fueron incluidos. Dos estudios mostraron una actitud positiva y disposición frente a intervenciones por aplicativo móvil, dos evidenciaron disminución significativa en las puntuaciones de ansiedad, depresión y mayor utilización de la mensajería de texto (mHealth) frente a este tipo de intervención y uno mostró mayor número de visitas por telemedicina que visitas convencionales en pacientes con enfermedad mental grave. Conclusiones: El estudio encontró que las intervenciones basadas en internet predominantes fueron por mensajería de texto y aplicativos móviles

Survival time among patients who were diagnosed with tuberculosis, the precocious deaths and associated factors in southern Brazil

Background: A diagnosis of tuberculosis (TB) does not mean that the disease will be treated successfully, since death may occur even among those who are known to the health services. Here, we aimed to analyze patient survival time from the diagnosis of TB to death, precocious deaths, and associated factors in southern Brazil. Methods: We conducted a longitudinal study with patients who were diagnosed with TB and who died due to the disease between 2008 and 2015 in southern Brazil. The starting point for measuring survival time was the patient’s diagnosis date. Techniques for survival analysis were employed, including the Kaplan-Meier test and Cox’s regression. A mixed-effect model was applied for identifying the associated factors to precocious deaths. Hazard ratio (HR) and odds ratio (OR) with 95% confidence intervals (95% CI) were estimated. We defined p value <0.05 as statistically significant for all statistics applied. Results: One hundred forty-six patients were included in the survival analysis, observing a median survival time of 23.5 days. We observed that alcoholism (HR=1.55, 95% CI=1.04-2.30) and being male (HR=6.49, 95% CI=1.03-2.68) were associated with death. The chance of precocious death within 60 days was 10.48 times greater than the chance of early death within 30 days. Conclusion: Most of the deaths occurred within 2 months after the diagnosis, during the intensive phase of the treatment. The use of alcohol and gender were associated with death, revealing inequality between men and women. This study advanced knowledge regarding the vulnerability associated with mortality. These findings must be addressed to fill a gap in the care cascades for active TB and ensure equity in health.publishersversionpublishe

Determinantes Sociales de la Salud que influyen en la incidencia/prevalencia de las enfermedades cardiovasculares

Introduction: Germany, the United States and Brazil are the countries with the highest mortality rates due to cardiovascular disease (CVD). In Chile, they represent the leading cause of death in adults. There are structural and intermediate determinants that interfere in the incidence and prevalence of CVD. Objective: To describe the influence of social determinants of health (SDH) on the incidence and prevalence of CVD in adults. Methods: This was a systematic review. The question was elaborated according to the PICO acronym. The PubMed and Virtual Health Library (VHL) databases were used. For PubMed, the search was constructed using the descriptors MeSH, Adult, Cardiovascular Disease, Social Determinants of Health. For VHL, by means of DeCS, Cardiovascular Disease, Social Determinants of Health, Adult in Spanish, English and Portuguese. For both searches, in combination with keywords and Boolean operators AND and OR. All references were imported into EndNote. The methodological quality of the studies was evaluated according to JBI Critical Appraisal tools. Deductive thematic analysis of the data was performed. Results: A total of 834 articles were identified and 31 included. The structural determinants identified were race, sex, socioeconomic level and educational level. The intermediate determinants identified were rurality, comorbidities, mental health factors and the presence of unhealthy habits. Conclusions: Low socioeconomic and educational level were the structural DSS identified. Poor mental health and the presence of unhealthy habits were intermediate DSS that influenced the incidence and prevalence of CVD.Introducción: Alemania, Estados Unidos y Brasil, son los países con las tasas más altas de mortalidad por enfermedades cardiovasculares (ECV). En Chile, representan la primera causa de muerte en adultos. Existen determinantes estructurales e intermedios que interfieren en la incidencia y prevalencia de ECV. Objetivo: Describir la influencia de los determinantes sociales de la salud (DSS) en la incidencia y prevalencia de ECV en adultos. Métodos: Se trató de una revisión sistemática. Fue elaborada la pregunta según acrónimo PICO. Fueron utilizadas las bases PubMed y Biblioteca Virtual de la Salud (BVS). Para PubMed, la búsqueda fue construida con descriptores MeSH, Adult, Cardiovascular Disease, Social Determinants of Health. Para BVS, por medio de los DeCS, Enfermedades Cardiovasculares, Determinantes Sociales en Salud, Adulto en español, inglés y portugués. Para ambas búsquedas, en combinación a palabras claves y operadores booleanos AND y OR. Todas las referencias fueron importadas a EndNote. Fue evaluada la calidad metodológica de los estudios según JBI Critical Apraisal tools. Fue realizado análisis temático deductivo de los datos. Resultados: De un total de 834 artículos identificados y 31 incluidos. Los determinantes estructurales identificados fueron la raza, sexo, nivel socioeconómico y nivel educacional. Los determinantes intermedios identificados fueron la ruralidad, comorbilidades, factores de salud mental y la presencia de hábitos no saludables. Conclusiones: El nivel socioeconómico y educacional bajo fueron los DSS estructurales identificados. La salud mental deficiente y la presencia de hábitos no saludables, fueron DSS intermedios que influyeron en la incidencia y prevalencia de las ECV

Lesiones por presión de origen hospitalario y factores que afectan su desarrollo: estudio multicéntrico

Introduction: Hospital-acquired pressure ulcers (HAPU) represent a significant public health challenge. Understanding their main characteristics and related factors is essential for effective prevention. This article aims to analyse the main characteristics of HAPUs in four high-complexity hospital centres in Chile.Methods: Secondary, analytical observational study. The sample (n=1000) included paediatric and adult patients. The study variables were the presence of HAPU, age, sex, dermatitis, risk of HAPU, change of position, pressure relief surface, immobilisation and speed of onset. Measurement of variables included physical examination and chart review. Descriptive statistics and multivariate logistic regression models were performed, accepting 95%CI, p&lt;0.05.Results: A crude prevalence of 18.7% was estimated. Most patients with HAPU were male (56.1%), aged 18-59 years (39.6%) and 60-80 years (39.0%). On average, ten days elapsed from patient admission to the development of HAPU The most common stage was stage I (50%), and the sacral region was the most frequent site of occurrence (30.1%). The factor with the strongest association with having HAPU was having a high ulceration risk classification (OR 2.6, 95%CI1.5-4.4).Conclusions: This is the first study in Chile that showed the characterization of HAPU in a relevant sample of hospitalized patients. The relevant representative aspects for monitoring and preventing HAPU as its prevalence, location and factors associated with its appearance.Introducción: Las Lesiones por presión de origen hospitalario (LPPH) representan un desafío significativo en salud pública. Comprender sus principales características y factores relacionados es esencial para contribuir a su prevención efectiva. El objetivo de esta investigación es analizar las características principales de LPPH en cuatro centros hospitalarios de alta complejidad en Chile. Metodología: Estudio secundario, observacional analítico. La muestra (n=1000) incluyó pacientes pediátricos y adultos. Las variables de estudio fueron: presencia de LPPH, estadio, edad, sexo, dermatitis, riesgo de LPPH, cambio de posición, superficie de alivio de presión, inmovilización y velocidad de aparición. La medición de variables incluyó examen físico y revisión de ficha clínica. Se realizó estadística descriptiva y modelos de regresión logística multivariada, aceptando IC95%, p&lt;0,05.Resultados: Se estimó una prevalencia cruda de 18,7%. La mayoría de los pacientes con LPPH eran hombres (56,1%), con edades entre 18 a 59 años (39,6%) y 60 a 80 años (39,0%). En promedio, transcurrieron 10 días desde el ingreso del paciente hasta el desarrollo de las LPPH. El estadio I fue el más frecuente (50%), predominantemente en la región sacra (30,1%). El factor con mayor fuerza de asociación a la aparición de LPPH fue contar con clasificación de riesgo alto de ulceración (OR 2,6, IC95%1,5-4,4). Conclusiones: Este es el primer estudio en Chile que permitió caracterizar las LPPH en una muestra relevante de pacientes hospitalizados. Los hallazgos reflejan aspectos relevantes para el monitoreo y prevención de LPHH, como su prevalencia, ubicación y factores asociados a su aparición

Resultados de tratamiento de la e-Health en personas mayores: Una revisión sistemática

Since the SARS-Cov-2 pandemic, e-Health has become an alternative for patient care; however, few studies have shown the treatment results of this tool in the elderly. The aim of this study was to analyze the results of telemedicine treatment in the elderly. A systematic review was carried out according to the formulation of the question, literature search, selection of eligibility criteria, selection of articles, evaluation of the methodological quality of the studies, synthesis and levels of evidence. The PubMed, CINAHL and Science Direct databases were used. The search strategy was constructed according to the combination of MeSH descriptors, CINAHL Subjects, keywords, Boolean operators AND and OR. Experimental studies between 2017 and 2022 were included. All references were exported to the EndNote manager. Methodological quality was analyzed using the Mixed Method Appraisal Tools (MMAT) checklist. The deductive thematic analysis of the data was based on the Model for Assessment of Telemedicine Applications (MAST). Of a total of 2,628 articles identified, 15 duplicates were eliminated and 10 included. Telephone follow-up is a clinically effective tool that was evidenced by psychosocial changes in the elderly.La e-Health, es una prestación de servicios relevante desde la pandemia por SARS-Cov-2, se transformó en una alternativa de atención de pacientes, sin embargo, escasos estudios han evidenciado los resultados de tratamiento de esta herramienta en personas mayores. Por lo que se pretende, analizar los resultados de tratamiento de la telemedicina en personas mayores. Se realizó una revisión sistemática de acuerdo con la formulación de la pregunta, búsqueda de la literatura, selección de los criterios de elegibilidad, selección de los artículos, evaluación de la calidad metodológica de los estudios, síntesis y niveles de evidencia. Fueron utilizadas las bases PubMed, CINAHL y Science Direct. La estrategia de búsqueda fue construida según la combinación de descriptores MeSH, CINAHL Subjects, palabras claves, operadores booleanos AND y OR. Fueron incluidos estudios experimentales entre los años 2017 y 2022. Todas las referencias fueron exportadas al gestor EndNote. Fue analizada la calidad metodológica utilizando la lista de verificación Mixed Method Appraisal Tools (MMAT). El análisis temático deductivo de los datos fue basado según Model for Assessment of Telemedicine Applications (MAST). De un total de 2,628 artículos identificados, 15 duplicados fueron eliminados y 10 incluidos. El seguimiento telefónico, es una herramienta con efectividad clínica que fue evidenciado por cambios psicosociales en el adulto mayor

Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review

Abstract Background Among the treatments for type 1 diabetes mellitus (T1DM), Continuous Subcutaneous Insulin Infusion (CSII) is a device that infuses insulin through the subcutaneous tissue in an uninterrupted manner and that comes closest to the physiological secretion of insulin. The use of CSII can provide the family with greater security and children and adolescents have more autonomy in relation to the treatment of T1DM. There is a lack of reviews that systematically gather the mounting evidence about the use of CSII in children and adolescents with T1DM. Therefore, the aim of this review was to group and describe primary and secondary studies on the use of CSII in children and adolescents with T1DM. Methods A systematic mapping review was performed based on searches in the following databases: PubMed, Embase, CINAHL, Lilacs and PsycINFO, using a combination of descriptors and keywords. The screening of the studies was carried out with the aid of the Rayyan software and reading in full was conducted independently by two reviewers. The data extraction of the studies was performed using an extraction tool adapted and validated by researchers specialized in diabetes. The data were analyzed according to the content analysis technique. The map from geocoding of the studies was produced using the ArcGis 10.5 software. Results A total of 113 studies were included in the review, including primary studies, literature reviews and gray literature publications. The content analysis of the results of the studies allowed for the identification of four categories: 1) metabolic control; 2) support networks; 3) benefits of using CSII; and 4) challenges of using CSII, each category having its respective subcategories. The review also made it possible to conduct a rigorous mapping of the literature on the use of CSII considering the location of development and the design of the studies. Conclusions The use of CSII should be indicated by health professionals able to prepare children, adolescents, and their families for the treatment of T1DM, and, despite being a technological device, it may not be suitable for the entire pediatric population

Magnitude of social determinants in the risk of death from tuberculosis in Central-west Brazil

Objective: To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city. Method: Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests. Results: A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR = 2.09 (95%CI: 1.48-2.94; p = 0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%. Conclusions: The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem.publishersversionpublishe

Crianças em seguimento ambulatorial: perspectivas do atendimento evidenciadas por entrevista com fantoche

Resumo OBJETIVO Analisar a perspectiva da criança sobre a própria condição de saúde, suas experiências relacionadas ao atendimento ambulatorial hospitalar e ao uso de fantoches como estratégia lúdica para a coleta de dados. MÉTODO Estudo qualitativo, incluiu 16 crianças diagnosticadas com doenças crônicas, recrutadas em um ambulatório pediátrico do interior paulista. Os dados foram coletados em outubro de 2016 mediante entrevista semiestruturada e utilizou-se o fantoche como recurso facilitador na comunicação. As entrevistas foram analisadas por meio da análise temática indutiva. RESULTADOS Foram construídos quatro temas: “criança em seguimento ambulatorial: o que elas sabem?”; “emoções que perpassam o seguimento ambulatorial”; “o ambulatório dos meus sonhos”; e “a utilização dos fantoches e o universo lúdico da entrevista”. CONSIDERAÇÕES FINAIS Foi possível identificar o motivo e os principais sentimentos vivenciados durante o atendimento ambulatorial, assim como as preferências das crianças acerca dos aspectos físicos e estruturais do ambulatório

Crianças em seguimento ambulatorial: perspectivas do atendimento evidenciadas por entrevista com fantoche

Objetivo: Analisar a perspectiva da criança sobre a própria condição de saúde, suas experiênciasrelacionadas ao atendimento ambulatorial hospitalar e ao uso de fantoches como estratégia lúdicapara a coleta de dados.Método: Estudo qualitativo, incluiu 16 crianças diagnosticadas com doenças crônicas, recrutadasem um ambulatório pediátrico do interior paulista. Os dados foram coletados em outubro de 2016mediante entrevista semiestruturada e utilizou-se o fantoche como recurso facilitador nacomunicação. As entrevistas foram analisadas por meio da análise temática indutiva.Resultados: Foram construídos quatro temas: “criança em seguimento ambulatorial: o que elassabem?”; “emoções que perpassam o seguimento ambulatorial”; “o ambulatório dos meus sonhos”;e “a utilização dos fantoches e o universo lúdico da entrevista”.Considerações finais: Foi possível identificar o motivo e os principais sentimentos vivenciadosdurante o atendimento ambulatorial, assim como as preferências das crianças acerca dos aspectosfísicos e estruturais do ambulatório.Palavras-chave: Enfermagem pediátrica. Assistência ambulatorial. Doença crônica. Criança. Jogose brinquedos