Atencion Primaria最新文献

英文中文

Relationship between physical activity and the sense of coherence in healthy adults 健康成年人的体育锻炼与协调感之间的关系。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-11 DOI: 10.1016/j.aprim.2024.103106

Miguel Jose Soares-Santeugini , Indira Enith Rodriguez-Prieto , Margareth Lorena Alfonso-Mora , Carolina Sandoval-Cuellar

Objective

This study seeks to stablish a relation between the level of physical activity and the sense of coherence in young adults.

Design

Cross sectional and analytical study in healthy young participants.

Site

Web form application.

Participants

191 active or inactive adult men or women between the ages of 18 and 45 without cognitive alterations. Professional or amateur athletes were excluded.

Main measurements

Correlation between the sense of coherence instrument (SOC-13) and Inventory of Physical Activity Questionnaire (IPAQ) were applied.

Results

The physical activity levels in the sample were distributed as: high level 34%, medium level 52%, and low level 13%. The mean of SOC-13 was 52.4. No difference was found when comparing between SOC-13 for each group of physical activity (high: 55, medium: 54, low: 58, p > 0.05), no correlation between SOC-13, age, and MET's reported by participants was found.

Conclusions

In healthy individuals, the IPAQ measure of physical activity levels showed no correlation with the sense of coherence in healthy young adults. Apparently, a sedentary lifestyle does not correlate with an individual's self-directed pursuit of health. It is possible that being physically active or sedentary is related to extrinsic variables associated with culture or family environment.

研究目的本研究旨在确定年轻人的体育锻炼水平与协调感之间的关系：设计：对健康青年参与者进行横断面分析研究。网站：网络表格应用：191名年龄在18至45岁之间、无认知障碍的成年男性或女性。职业或业余运动员除外：主要测量指标：连贯感工具（SOC-13）与体力活动调查表（IPAQ）之间的相关性：结果：样本的体力活动水平分布为：高水平 34%，中等水平 52%，低水平 13%。SOC-13 的平均值为 52.4。比较各组体力活动的 SOC-13 没有发现差异（高：55，中：54，低：58，P>0.05），也没有发现 SOC-13、年龄和参与者报告的 MET 之间的相关性：结论：在健康人中，IPAQ 测量的体力活动水平与健康年轻人的协调感没有相关性。显然，久坐不动的生活方式与个人对健康的自我追求并不相关。体力活动或久坐不动可能与文化或家庭环境相关的外在变量有关。

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引用次数: 0

Los ahogamientos y la gestión de espacios acuáticos: un problema de salud pública [溺水与水生空间管理：一个公共卫生问题]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-09 DOI: 10.1016/j.aprim.2024.103137

Javier Fagundo-Rivera , Juan Gómez-Salgado

引用次数: 0

Prevalence and factors associated with female genital mutilation among daughters using Somalia Demographic Health Survey Data, SDHS 2020 利用索马里 2020 年人口与健康调查数据，研究切割女性生殖器在女儿中的流行率和相关因素

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-05 DOI: 10.1016/j.aprim.2024.103113

Omer Adam Farih , Abdirahman Omer Ali , Abdirizak Hassan Abokor , Mustafe Abdillahi Ali , Abdisalam Hassan Muse , Ahmed Abdi Aw Egge

Objective

To determine the prevalence and associated factors of female genital mutilation (FGM) among daughters of women aged 15–49 in Somalia using data from the 2020 Somaliland Demographic and Health Survey (SDHS).

Design

A cross-sectional study utilizing data from the 2020 SDHS.

Setting

Data was collected across Somalia, including urban, rural, and nomadic areas.

Main measurements

FGM prevalence was presented as percentages. Logistic regression analysis was used to identify associated factors, presented as odds ratios with 95% confidence intervals.

Results

The prevalence of FGM among daughters was 24%. Factors significantly associated with FGM included age, region, residence, education, and wealth index. Younger daughters were more likely to be circumcised (p = 0.000, 95% CI: 0.066–0.274). Rural residence increased the likelihood of FGM (OR = 1.436, CI = 1.257–1.64). Primary education increased the odds of FGM (OR = 1.334, CI = 1.127–1.58). Mothers who believed FGM should continue were more likely to have circumcised daughters (OR = 1.464, CI = 1.305–1.642).

Conclusions

FGM prevalence among daughters in Somalia is influenced by age, region, rural residency, and education. The findings highlight the need for targeted educational and intervention programs, particularly in rural areas, to effectively reduce FGM practices.

目标利用 2020 年索马里兰人口与健康调查 (SDHS) 的数据，确定索马里 15-49 岁妇女的女儿中切割女性生殖器官 (FGM) 的流行率和相关因素。采用逻辑回归分析确定相关因素，以几率和 95% 的置信区间表示。结果女性生殖器切割在女儿中的流行率为 24%。与切割女性生殖器官明显相关的因素包括年龄、地区、居住地、教育程度和财富指数。年龄较小的女儿更有可能接受割礼（p = 0.000，95% CI：0.066-0.274）。居住在农村会增加切割女性生殖器的几率（OR = 1.436，CI = 1.257-1.64）。小学文化程度会增加切割女性生殖器的几率（OR = 1.334，CI = 1.127-1.58）。认为女性生殖器切割应继续下去的母亲更有可能为女儿实施割礼（OR = 1.464，CI = 1.305-1.642）。研究结果表明，有必要开展有针对性的教育和干预计划，尤其是在农村地区，以有效减少切割女性生殖器官的做法。

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引用次数: 0

Violencia de género: situación actual, avances y desafíos pendientes en la respuesta del Sistema Sanitario 基于性别的暴力：卫生系统应对措施的现状、进展和有待应对的挑战

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2023.102767

引用次数: 0

Aspectos éticos y legales de la violencia sobre la mujer [暴力侵害妇女行为的伦理与法律问题]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2023.102857

Caring for female victims of violence presents health professionals with situations that require careful consideration due to the conflicts raised between the fundamental principles of bioethics. During this process, intermediate courses of action should be adopted in which none of the affected principles is totally compromised, yet always take into account due compliance with legal and deontological regulations.

Within these conflicts, the possible impact on the autonomy of the victim must be taken into consideration, conditioned by the relationship of dominance with respect to their aggressor, a fundamental characteristic of gender violence. However, the fact that there is a legal obligation to issue an injury report or to communicate a well-founded suspicion of abuse is not enough to ignore the fact that the person, in this case the victim, must be a participant in the process. As such, the doctor has the obligation to inform his or her patient about this legal requirement, dedicating all the time and attention necessary to ensure that the victim understands the purpose and benefits of complying with this.

In any case, and beyond the appropriate adaptation of the professional's conduct to current precepts, the ethical principle of care must be adhered to, by which the best thing the professional can do is to provide the victim with the means to avoid the repetition of new attacks, implementing prevention measures that have their origin in the accurate diagnosis of the situation of violence and in the communication of this to the authorities.

由于生命伦理学基本原则之间的冲突，医护人员在照顾女性暴力受害者时需要慎重考虑。在这一过程中，应采取中间行动方案，既不能完全损害任何受影响的原则，又要始终考虑到适当遵守法律和道义上的规定。在这些冲突中，必须考虑到对受害者自主权可能造成的影响，这种影响取决于受害者与施暴者之间的支配关系，这也是性别暴力的一个基本特征。然而，尽管法律规定了发布伤害报告或通报有充分理由怀疑的虐待行为的义务，但这并不足以忽视一个事实，即当事人（此处指受害人）必须是这一过程的参与者。因此，医生有义务将这一法律要求告知其病人，并投入一切必要的时间和精力，确保受害人理解遵守这一要求的目的和好处。在任何情况下，除了使专业人员的行为符合当前的规定之外，还必须遵守关爱的道德原则，根据这一原则，专业人员所能做的最好的事情就是向受害者提供避免再次发生新的攻击的手段，实施预防措施，这些措施源于对暴力情况的准确诊断以及向当局通报这一情况。

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引用次数: 0

Contextos de especial vulnerabilidad para la violencia de género. Interseccionalidad: adaptando la respuesta a la diversidad de contextos y situaciones [基于性别的暴力极易发生。交叉性：适应环境和情况多样性的对策]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2023.102834

Addressing gender violence from the health system effectively, still involves addressing numerous challenges. If gender violence is suffered by women with one or more situations of personal and social vulnerability, intervention is surrounded by formidable difficulties.

In these heterogeneous situations, early detection is urgent, as well as professional support adapted to each woman with her particular context. The intersectional approach to gender violence provides useful tools for actions in these complex scenarios, full of suffering and fragility.

This article mentions the common and specific needs of the most vulnerable women. Recommendations are offered to improve the intervention to be developed from the health system — a privileged space for this — to understand and accompany these women in their diversity, with the most effective services and resources, in coordination with the rest of the social protection systems and entities.

从卫生系统有效解决性别暴力问题，仍然需要应对众多挑战。如果遭受性别暴力的妇女有一种或多种个人和社会脆弱性，那么干预工作就会面临巨大的困难。在这些不同的情况下，当务之急是及早发现，并根据每位妇女的具体情况提供专业支持。应对性别暴力的交叉方法为在这些充满痛苦和脆弱的复杂情况下采取行动提供了有用的工具。本文提到了最弱势妇女的共同需求和特殊需求。本文提出了一些建议，以改进卫生系统（这是一个得天独厚的空间）制定的干预措施，以便与其他社会保护系统和实体协调，利用最有效的服务和资源，了解和陪伴这些妇女的多样性。

引用次数: 0

La violencia sexual y su abordaje en el sistema de salud [解决医疗服务中的性暴力问题]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2023.102837

Sexual violence is a very underdetected public health problem, with important short and long-term consequences on physical, mental, social, sexual and reproductive health, which must be taken into account by health services.

Health systems are part of the set of resources necessary for a comprehensive approach from the ecological model: prevention and promotion of healthy sexuality with equality, adequate and coordinated care in the event of sexual assault and subsequent support to prevent sequelae.

All sexual violence has health consequences, even those that may seem less serious such as sexual harassment or sexual cyberviolence.

We must know the needs of the victim and their possible emotional reactions. A risk assessment will be carried out, the victim will be referred to a hospital if necessary and comprehensive and integrated care will be provided.

Care and follow-up must focus on the survivor and with professionals trained in trauma to understand the consequences of sexual violence, offer a safe and trusting environment and know how to reinforce their qualities and support.

性暴力是一个极少被发现的公共卫生问题，对身体、精神、社会、性和生殖健康都有重要的短期和长期影响，卫生服务部门必须考虑到这一点。卫生系统是生态模式综合方法所需的一系列资源的一部分：预防和促进平等的健康性行为，在发生性侵犯时提供充分和协调的护理，以及为防止后遗症提供后续支持。所有性暴力都会对健康造成影响，即使是那些看起来不太严重的性暴力，如性骚扰或网络性暴力。我们必须了解受害者的需求及其可能的情绪反应。我们将进行风险评估，必要时将受害者转到医院，并提供全面综合的护理。护理和后续工作必须以幸存者为重点，并由受过创伤培训的专业人员进行，以了解性暴力的后果，提供一个安全和信任的环境，并知道如何加强他们的素质和支持。

引用次数: 0

Consecuencias para la salud de la violencia contra la mujer por la pareja [夫妻暴力侵害妇女的健康后果]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.102903

Intimate partner violence against women (IPV) has devastating effects on the healthcare and well-being of women and their children. Physical, psychological, and social consequences, a worse perception of their own health, and loss of quality of life are well-documented, while aftereffects persist in time even after the end of abuse. Psychological consequences of abuse last longer and are more serious. IPV also affects sons and daughters, disabled people, family, and the attacker himself.

Many health problems, both physical and mental, that lead women to go to healthcare services in search of help have an origin in the violence they experience. Treatment of the symptoms without awareness of its relation to such violence favours medicalization, iatrogenesis, and chronification.

Psychological violence poses a threat that is invisible, subtle, cumulative, and difficult to detect; it is, however, the most destructive.

亲密伴侣对妇女的暴力行为（IPV）对妇女及其子女的保健和福祉具有破坏性影响。身体、心理和社会方面的后果、对自身健康状况的更糟糕看法以及生活质量的下降都是有据可查的，而即使在虐待行为结束后，后遗症也会长期存在。虐待的心理后果持续时间更长，也更严重。IPV 还会影响儿女、残疾人、家人和施暴者本人。许多导致妇女前往医疗服务机构寻求帮助的身心健康问题都源于她们所遭受的暴力。在治疗症状时，如果没有意识到这些症状与暴力的关系，就会助长医疗化、人为化和慢性化。心理暴力造成的威胁是无形的、微妙的、累积的、难以察觉的，但却是最具破坏性的。

引用次数: 0

La respuesta necesaria de los servicios de salud ante la violencia de género. Atención integral y prestación de servicios integrados [医疗服务对性别暴力的必要反应。全面护理和提供综合服务]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2023.102858

Gender violence has multiple and serious consequences for the health of victims and their families, hence the reason for the important role that the health system plays in addressing it. Health professionals have a key role in the response, which must include early detection, care, and follow-up; actions in which primary care, because of its privileged position in the system, can play a fundamental part. This article establishes the necessary characteristics for the intervention to be effective: comprehensive care, multidisciplinary approach, intersectoral coordination, and integrated service provision; all of it community-oriented, person-centered, and adapted to its context (social factors and vulnerabilities) with an intersectional approach. The woman, her sons and daughters, and other cohabitants, as well as the perpetrator, are considered the object of intervention in the response, and specific guidelines for action are provided for detection, care, and follow-up. Reorientation of interventions, with emphasis on a community approach, is also proposed.

性别暴力会对受害者及其家人的健康造成多重严重后果，因此卫生系统在应对性别暴力方面发挥着重要作用。卫生专业人员在应对措施中发挥着关键作用，其中必须包括早期发现、护理和后续行动；初级保健因其在系统中的特殊地位，可以在这些行动中发挥重要作用。本文确定了有效干预的必要特征：全面护理、多学科方法、跨部门协调和提供综合服务；所有这些都以社区为导向，以人为本，并以交叉方法适应其背景（社会因素和脆弱性）。在应对措施中，妇女、其子女、其他同居者以及施暴者都被视为干预对象，并为侦查、护理和后续行动提供了具体的行动指南。还建议调整干预措施的方向，重点放在社区方法上。

引用次数: 0

Impacto de la violencia de género en las niñas y las adolescentes [性别暴力对女童和青少年的影响]。

IF 1.8 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

Atencion Primaria

Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.102972

Gender is an important determinant of health. Its relationship with inequality and violence allows us to consider being a woman as a risk factor for health. Girls and teenager girls are not exempt from this circumstance, which conditions their lives from before birth and can determine their health status throughout life. It can vary according to social contexts, as various factors intersect with gender, adding risk and vulnerability to being a woman. Gender-based violence is often identified as a problem for adult women; however, the experience of discriminatory gender-based violence is constructed throughout women's lives, producing serious individual and social consequences from childhood. Accepting this violence as a «private or domestic matter» often prevents seeing the true dimension of the problem, its consequences, and the need to address it as a global issue.

性别是健康的一个重要决定因素。它与不平等和暴力之间的关系使我们能够将身为女性视为影响健康的一个风险因素。女孩和少女也不能幸免于这种情况，这种情况从出生前就开始影响她们的生活，并可能决定她们一生的健康状况。由于各种因素与性别交织在一起，身为女性的风险和脆弱性因社会环境而异。性别暴力通常被认为是成年妇女面临的问题；然而，歧视性性别暴力的经历贯穿了妇女的一生，从童年开始就造成了严重的个人和社会后果。将这种暴力视为 "私人或家庭事务"，往往会妨碍人们看到问题的真正层面、其后果以及将其作为一个全球性问题加以解决的必要性。

引用次数: 0

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