Pub Date : 2024-11-01DOI: 10.1016/j.aprim.2023.102767
{"title":"Violencia de género: situación actual, avances y desafíos pendientes en la respuesta del Sistema Sanitario","authors":"","doi":"10.1016/j.aprim.2023.102767","DOIUrl":"10.1016/j.aprim.2023.102767","url":null,"abstract":"","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 11","pages":"Article 102767"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139455139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.aprim.2024.103133
Rodrigo Córdoba García , Francisco Camarelles Guillem , Elena Muñoz Seco , Juana M. Gómez Puente , Joaquín San José Arango , Jose Ignacio Ramírez Manent , Carlos Martín Cantera , María del Campo Giménez , Juan Revenga Frauca , Ana Egea Ronda , Raquel Cervigón Portaencasa , Laura Rodriguez Benito
We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.
{"title":"Recomendaciones sobre el estilo de vida. Actualización PAPPS 2024","authors":"Rodrigo Córdoba García , Francisco Camarelles Guillem , Elena Muñoz Seco , Juana M. Gómez Puente , Joaquín San José Arango , Jose Ignacio Ramírez Manent , Carlos Martín Cantera , María del Campo Giménez , Juan Revenga Frauca , Ana Egea Ronda , Raquel Cervigón Portaencasa , Laura Rodriguez Benito","doi":"10.1016/j.aprim.2024.103133","DOIUrl":"10.1016/j.aprim.2024.103133","url":null,"abstract":"<div><div>We present the recommendations of the Preventive Activities and Health Promotion Programme (PAPPS) of the semFYC (Spanish Society of Family and Community Medicine) to promote healthy lifestyles using intervention methodology, and preventive actions against tobacco and alcohol use, healthy eating, physical activity in leisure time, prevention of traffic accidents, and child restraint systems. The recommendations have been updated, and new aspects highlighted, such as the definition of low-risk alcohol consumption, and the references have been updated. For the main recommendations, we include specific tables showing the quality of the evidence and the strength of the recommendation.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 ","pages":"Article 103133"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 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.
{"title":"Aspectos éticos y legales de la violencia sobre la mujer","authors":"","doi":"10.1016/j.aprim.2023.102857","DOIUrl":"10.1016/j.aprim.2023.102857","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 11","pages":"Article 102857"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139503128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 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.
{"title":"Contextos de especial vulnerabilidad para la violencia de género. Interseccionalidad: adaptando la respuesta a la diversidad de contextos y situaciones","authors":"","doi":"10.1016/j.aprim.2023.102834","DOIUrl":"10.1016/j.aprim.2023.102834","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>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.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 11","pages":"Article 102834"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139032907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 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.
{"title":"La violencia sexual y su abordaje en el sistema de salud","authors":"","doi":"10.1016/j.aprim.2023.102837","DOIUrl":"10.1016/j.aprim.2023.102837","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>All sexual violence has health consequences, even those that may seem less serious such as sexual harassment or sexual cyberviolence.</div><div>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.</div><div>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.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 11","pages":"Article 102837"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139426159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 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.
{"title":"Consecuencias para la salud de la violencia contra la mujer por la pareja","authors":"","doi":"10.1016/j.aprim.2024.102903","DOIUrl":"10.1016/j.aprim.2024.102903","url":null,"abstract":"<div><div>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.</div><div>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.</div><div>Psychological violence poses a threat that is invisible, subtle, cumulative, and difficult to detect; it is, however, the most destructive.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 11","pages":"Article 102903"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140307935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/j.aprim.2024.103127
Francisco Buitrago Ramírez , Ramon Ciurana Misol , María del Carmen Fernández Alonso , Pablo González García , Lydia Salvador Sánchez , Jorge Luis Tizón García , Nuria Villamor Sagredo , Grupo de Salud Mental del PAPPS. Actualización PAPPS 2024
Childhood and adolescent abuse (MTIA) is a serious and complex global public health problem with potentially devastating effects on the physical and mental health and well-being of people throughout their lives. This is a health issue that, although it was not recognized until a few decades ago, has very serious consequences on the lives of these future adult children and their families. By adopting various forms and modalities (violence, abuse, neglect and others), it is highly prevalent and has serious repercussions on personal development and both mental and physical morbidity. PHC professionals can play a key role in the detection of MTIA, in its exploration, in the adoption of the first therapeutic or mitigating measures, in the implementation of the care network for these cases, and in the follow-up in the medium and long term of abuse situations. This PAPPS subprogram, for attention to abuse of children and adolescents, attempts to provide some basic lines on each of these sections.
{"title":"Prevención de los trastornos de la salud mental. Maltrato hacia la infancia y la adolescencia","authors":"Francisco Buitrago Ramírez , Ramon Ciurana Misol , María del Carmen Fernández Alonso , Pablo González García , Lydia Salvador Sánchez , Jorge Luis Tizón García , Nuria Villamor Sagredo , Grupo de Salud Mental del PAPPS. Actualización PAPPS 2024","doi":"10.1016/j.aprim.2024.103127","DOIUrl":"10.1016/j.aprim.2024.103127","url":null,"abstract":"<div><div>Childhood and adolescent abuse (MTIA) is a serious and complex global public health problem with potentially devastating effects on the physical and mental health and well-being of people throughout their lives. This is a health issue that, although it was not recognized until a few decades ago, has very serious consequences on the lives of these future adult children and their families. By adopting various forms and modalities (violence, abuse, neglect and others), it is highly prevalent and has serious repercussions on personal development and both mental and physical morbidity. PHC professionals can play a key role in the detection of MTIA, in its exploration, in the adoption of the first therapeutic or mitigating measures, in the implementation of the care network for these cases, and in the follow-up in the medium and long term of abuse situations. This PAPPS subprogram, for attention to abuse of children and adolescents, attempts to provide some basic lines on each of these sections.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 ","pages":"Article 103127"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 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.
{"title":"La respuesta necesaria de los servicios de salud ante la violencia de género. Atención integral y prestación de servicios integrados","authors":"","doi":"10.1016/j.aprim.2023.102858","DOIUrl":"10.1016/j.aprim.2023.102858","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55435,"journal":{"name":"Atencion Primaria","volume":"56 11","pages":"Article 102858"},"PeriodicalIF":1.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139564876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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