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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 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。
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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 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。
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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 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。
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引用次数: 0
Red Europea de Prevención (EUROPREV) 欧洲预防网
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.103130
Carlos Brotons , John Brodersen
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引用次数: 0
Prevención de los trastornos de la salud mental. Maltrato hacia la infancia y la adolescencia 预防精神卫生障碍。虐待儿童和青少年
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 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.
儿童和青少年虐待是一个严重和复杂的全球公共卫生问题,可能对人们一生的身心健康和福祉产生破坏性影响。这是一个健康问题,虽然直到几十年前才被认识到,但对这些未来成年子女及其家庭的生活产生了非常严重的后果。通过采取各种形式和方式(暴力、虐待、忽视和其他),它非常普遍,并对个人发展和身心疾病产生严重影响。初级保健专业人员可以在以下方面发挥关键作用:发现MTIA、探索MTIA、采取最初的治疗或缓解措施、为这些案件实施护理网络,以及对虐待情况进行中长期随访。这个关注虐待儿童和青少年问题的PAPPS子方案,试图对这些部分提供一些基本的线索。
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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 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。
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引用次数: 0
Prevención de los trastornos de la salud mental. Antecedentes de psicopatología en los padres y cuidadores 预防精神卫生障碍。父母和照护者的精神病理背景
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.103126
Francisco Buitrago Ramírez Coordinador del Grupo , 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
The upbringing and psychosocial development of children who live with parents with serious mental disorders (schizophrenia and delusional disorders, major depression, manic episode, suicide attempts, severe personality disorders, alcoholism or abuse of other drugs and other disorders) can be more difficult, and your quality of life, relationships, and mental health may be seriously affected. Achieving a certain knowledge in clinical practice that facilitates the collection and investigation of parents’ psychiatric history and the identification of risk factors and basic warning signs in children, represents an improvement in the capabilities of Primary Health Care (PHC) teams to integrate mental health elements into your daily practice. It is also an essential preliminary step to implement preventive interventions, at least elementary, necessary to protect the mental health of these children and future adults: that is the core of this PAPPS subprogram for the care of the mental health of children and adolescents in the case of a history of psychopathology in parents or caregivers.
与患有严重精神障碍(精神分裂症和妄想障碍、重度抑郁症、躁狂发作、自杀未遂、严重人格障碍、酗酒或滥用其他药物和其他疾病)的父母一起生活的儿童的抚养和心理社会发展可能会更加困难,您的生活质量、人际关系和心理健康可能会受到严重影响。在临床实践中获得一定的知识,有助于收集和调查父母的精神病史,识别儿童的风险因素和基本警告信号,这代表了初级卫生保健(PHC)团队将精神健康因素纳入日常实践的能力的提高。这也是实施预防性干预的必要初步步骤,至少是基本的,以保护这些儿童和未来的成年人的心理健康:这是PAPPS次级方案的核心,该方案旨在照顾父母或照顾者有精神病理史的儿童和青少年的心理健康。
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引用次数: 0
Resumen PAPPS Infancia y Adolescencia 2024 PAPPS摘要2024年儿童和青少年
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.103125
Olga Cortés Rico, María Jesús Esparza Olcina, José Galbe Sánchez-Ventura, Ana Gallego Iborra, Ana Garach Gómez, Laura García Soto, Juan Hidalgo Sanz, Leyre Martí Martí, Carmen Rosa Pallás Alonso, Julia Colomer Revuelta, José María Mengual Gil
In this document we present two important topics in childhood, one completely new, the promotion of reading in the first years of life, and the other is an update that continues to generate doubts and questions from Parents, caregivers and health professionals: Is it necessary to screen for iron deficiency in children under 5 years of age?
在本文中,我们提出了儿童的两个重要主题,一个是全新的,即在生命的最初几年促进阅读,另一个是更新的,它继续引起父母、照顾者和卫生专业人员的怀疑和问题:是否有必要对5岁以下儿童进行缺铁筛查?
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引用次数: 0
Recomendaciones preventivas vasculares. Actualización PAPPS 2024 预防血管疾病。PAPPS 2024更新
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.103123
Domingo Orozco-Beltrán , Carlos Brotons-Cuixart , José R. Banegas , Vicente F. Gil-Guillen , Ana M. Cebrián-Cuenca , Enrique Martín-Rioboó , Ariana Jordá-Baldó , Johanna Vicuña , Jorge Navarro-Pérez
The recommendations of the semFYC's Program for Preventive Activities and Health Promotion (PAPPS) for the prevention of vascular diseases (VD) are presented. New in this edition are new sections such as obesity, chronic kidney disease and metabolic hepatic steatosis, as well as a ‘Don’t Do’ section in the different pathologies treated. The sections have been updated: epidemiological review, where the current morbidity and mortality of CVD in Spain and its evolution as well as the main risk factors are described; vascular risk (VR) and recommendations for the calculation of CV risk; main risk factors such as arterial hypertension, dyslipidemia and diabetes mellitus, describing the method for their diagnosis, therapeutic objectives and recommendations for lifestyle measures and pharmacological treatment; indications for antiplatelet therapy, and recommendations for screening of atrial fibrillation, and recommendations for management of chronic conditions. The quality of testing and the strength of the recommendation are included in the main recommendations.
介绍了半fyc预防活动和健康促进方案(PAPPS)关于预防血管疾病(VD)的建议。新在这个版本是新的部分,如肥胖,慢性肾脏疾病和代谢性肝脂肪变性,以及“不做”部分在不同的病理治疗。这些章节已经更新:流行病学审查,其中描述了西班牙目前心血管疾病的发病率和死亡率及其演变以及主要危险因素;血管风险(VR)和心血管风险计算的建议;动脉高血压、血脂异常、糖尿病等主要危险因素,描述其诊断方法、治疗目标、生活方式措施和药物治疗建议;抗血小板治疗的适应症,房颤筛查的建议,慢性疾病管理的建议。测试的质量和建议的强度包括在主要建议中。
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引用次数: 0
Prevención de las enfermedades infecciosas. Actualización en vacunas PAPPS 2024 预防传染病。PAPPS 2024年疫苗更新
IF 1.8 4区 医学 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-11-01 DOI: 10.1016/j.aprim.2024.103129
Ana Pilar Javierre Miranda , Coro Sánchez Hernández , Susana Martín Martín , Pablo Aldaz Herce , José Javier Gómez Marco , Germán Schwarz Chavarri , Cristina García Iglesias , M. Isabel Gutiérrez Pérez , M. Luisa Morató Agustí , Grupo de Prevención de Enfermedades Infecciosas del PAPPS
Vaccination throughout life is the best way to prevent infectious diseases and improve people's quality of life. As health professionals we must know the vaccine indications and guidelines as if they were any other treatment.
In the updates for this year 2024, we continue to focus on the most relevant developments in terms of indications, changes in vaccination guidelines, new vaccines incorporated into the adult calendar and even anticipating the next vaccines to be incorporated in a short period of time. We continue to insist on remembering the specific indications in risk groups, whether due to chronic diseases or immunocompromise. They are very relevant groups in which to review and complete their vaccination schedule. Nor should we forget about vaccination during pregnancy and for health workers, we must protect ourselves to protect. We have extended the chapter of vaccination for travelers, due to increasing numbers in our Primary Care consultations. And we have added a few touches of the «One Health» approach, focusing on vaccination as a tool to improve population health and contribute to the reduced use of antibiotics and thereby avoid bacterial resistance.
We have tried to summarize a large part of the document in the form of tables so that it is an agile and easy-to-consult instrument in our daily care work and we do not forget to review and complete, if necessary, the vaccination schedule of all our patients.
Although we focus on adults, due to the novelty and relevance in terms of reducing the burden of disease in infants, we have included a section on immunoprevention against respiratory syncytial virus with monoclonal antibodies and its indications for the next 2024-2025 season.
终生接种疫苗是预防传染病和提高人们生活质量的最佳途径。作为卫生专业人员,我们必须了解疫苗的适应症和指南,就像它们是任何其他治疗一样。在今年2024年的更新中,我们继续关注适应症、疫苗接种指南的变化、纳入成人接种日程的新疫苗,甚至预测在短时间内将纳入下一种疫苗等方面最相关的发展。我们继续坚持记住风险群体的具体适应症,无论是由于慢性疾病还是免疫功能低下。他们是审查和完成其疫苗接种计划的非常相关的群体。我们也不应该忘记怀孕期间的疫苗接种,对于卫生工作者来说,我们必须保护自己才能保护自己。由于我们初级保健咨询的人数不断增加,我们延长了旅行者接种疫苗的章节。我们还增加了“同一个健康”方法的一些内容,重点是将疫苗接种作为一种工具,以改善人口健康,并有助于减少抗生素的使用,从而避免细菌耐药性。我们试图以表格的形式总结该文件的大部分内容,以便它成为我们日常护理工作中一个灵活和易于查阅的工具,我们不忘记在必要时审查和完成所有患者的疫苗接种时间表。虽然我们的重点是成人,但由于在减轻婴儿疾病负担方面的新颖性和相关性,我们已经包括了一个关于呼吸道合胞病毒单克隆抗体的免疫预防及其下一个2024-2025季节的适应症的部分。
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引用次数: 0
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Atencion Primaria
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