Descreve-se uma experiência do projeto chileno-canadense, intitulado "Promover a saúde mental de ... more Descreve-se uma experiência do projeto chileno-canadense, intitulado "Promover a saúde mental de mulheres chilenas em desvantagem social: os Segredos de Maruja". Apresentam-se os objetivos, as etapas das intervenções e as avaliações preliminares. Com a participação das mulheres usuárias dos Centros de Saúde, profissionais de saúde e autoridades da comunidade de La Pintana, foi construído, aplicado e avaliado um projeto de intervenção para apoiar as mulheres na tomada de decisões que favorecessem sua saúde mental, pessoal, familiar e social. A intervenção contemplou o desenho, a produção, a distribuição e a avaliação de 12 cartilhas educativas tipo calendários, cada uma referente a três temas de saúde mental considerado importante pelas mesmas mulheres: identidade e auto-estima; vínculos e comunicação; e autocuidado. Cada cartilha tem um teste de autodiagnóstico e endereços dos recursos sociais comunitários. Ademais, comprometeu as enfermeiras que trabalham nos Centros de Saúde que incorporaram esta estratégia no seu atendimento habitual e avaliaram seu impacto tanto na sua identidade e autonomia profissional quanto na melhoria da qualidade do cuidado brindado às mulheres.
ABSTRACT The purpose of this study is to determinate whether a multicomponent remote care model i... more ABSTRACT The purpose of this study is to determinate whether a multicomponent remote care model is effective to achieve the modification of unhealthy eating practices and increase physical activity in adults who have pre-diabetes and over-weight/obesity. The remote care model is composed by four components: 1. counseling intervention (by telephone) is the core of the multicomponent model. These counseling calls are made by professionals working at primary health centers who have been trained to apply theories on behavioral change and decisionmaking; 2. Short Message Service (SMS) counseling is aimed at providing information and encouraging the patient to change his/her behavior in terms of nutrition and physical activity. SMS are sent weekly and are related to counseling sessions; 3. educational material; and4. self-monitoring equipment, pedometers and measuring tape for patients to check their waist circumference. A randomized clinical study (RCT) is being developed (November 2011–January 2013). A total sample of 70 Chilean people (20–64 years) diagnosed with pre-diabetes, BMI (25–34) and mobile phones were recruited. Pre intervention measurement was applied. No statistical differences were found for Prediabetes knowledge, physical activity, eating habits, BMI, Weight, waist circumference and clinical parameters (Glucose, Triglycerides and Total Cholesterol) between both groups in basal measurement. The control group received the usual care from health centers. In the study group, the intervention was developed during 6 months per patient (received usual care plus remote care model′s components). The RCT will end at January 2013, and the final results will be presented.
Este estudio da a conocer el interes y las principales dificultades para realizar estudios de pos... more Este estudio da a conocer el interes y las principales dificultades para realizar estudios de post-grado en Enfermeras docentes y asistenciales pertenecientes a 18 Escuelas de Enfermeria, que representan siete paises de America Latina. Sus resultados no pueden generalizarse a la realidad de Enfermeria de America Latina ya que la seleccion de los participantes fue intencionada, considerando su potencial como polo de desarrollo(AU)
Se describe el proyecto de promocion de la salud "UC Saludable: Vive tu Equilibrio", cu... more Se describe el proyecto de promocion de la salud "UC Saludable: Vive tu Equilibrio", cuyo proposito es "desarrollar una cultura en la Pontificia Universidad Catolica de Chile que contribuya a que esta sea un lugar seguro, libre de humo de tabaco y otras toxinas; un ambiente fisico y psicologico positivo para el aprendizaje; donde se fomenten el derecho al desarrollo humano sano y las relaciones constructivas entre los integrantes de su comunidad" El grupo objetivo es la comunidad universitaria constituida por los estudiantes, academicos y personal administrativo. Hacia ellos van dirigidas las acciones que facilitan la promocion de estilos de vida saludables y que se ordenan en funcion de dos ejes principales: el cambio de conductas daninas para la salud por otras mas saludables; y el cambio o desarrollo de politicas y normas institucionales que favorezcan estilos de vida sanos Actualmente el proyecto es coordinado en forma conjunta por la Escuela de Enfermeria y ...
The School of Nursing at the Catholic University of Chile (PUC) has been implementing, since 1983... more The School of Nursing at the Catholic University of Chile (PUC) has been implementing, since 1983 a health care model based on selfcare. (Lange I., Jaimovich S.1996). This work has been enriched with the Ottawa Health Decision Support framework developed in the nineties, in Canada, by O’Connor, A. et al. With the support of the Canadian team and the financial support of the Canadian International Development Agency (CIDA) the project “Making Choices, Making Decisions: A Client/Provider Partnership in Canadian/Chilean Technology Transfer” (DECIDE) was carried out in Chile between 1999 and 2003. The dissemination phase of this project included collaboration with other schools of nursing to promote the incorporation of the Ottawa Decision Support Framework and tool kits for decision support into the nursing curriculum. This experience generated a networking model among the Schools, which enriched and strengthened the DECIDE project, regarding iden# Trabajo realizado con el apoyo financ...
Se propone una reflexion sobre el desafio que representa el cuidado de personas con condiciones c... more Se propone una reflexion sobre el desafio que representa el cuidado de personas con condiciones cronicas de salud (CC) en la atencion de salud y la incorporacion del constructo "Apoyo al Automanejo" como parte de la formacion profesional y a su vez, como este desafio ha sido asumido por la Escuela de Enfermeria UC. Se apoya esta propuesta, en el escenario epidemiologico actual de las condiciones cronicas de salud, especialmente de las enfermedades no transmisibles y los limitados resultados alcanzados con el modelo actual de atencion, con los consecuentes efectos en las personas y familias. Se discute sobre el deficit de preparacion en el equipo de salud para afrontar la complejidad de la situacion. Se revisa la trayectoria de la Escuela de Enfermeria en el ambito de formacion e investigacion en autocuidado de la salud y su relacion y evolucion hacia el apoyo al automanejo como parte integral del Modelo de Cuidados Cronicos que es la estrategia definida por el Ministerio d...
Antecedentes: la prediabetes es una condición reversible y su tratamiento una oportunidad para mo... more Antecedentes: la prediabetes es una condición reversible y su tratamiento una oportunidad para modificar prácticas no saludables. Objetivo: evaluar la efectividad del Modelo Multi-componente de Telecuidado para apoyo a personas con prediabetes y obesidad en Chile. Método: ensayo clínico controlado en centros de atención primaria, Santiago, Chile. Se realizó un muestreo y asignación aleatoria en cada uno de los 5 centros de salud participantes. Participantes: 70 adultos con pre-diabetes, IMC: 25-34 y acceso a telefonía móvil. GI (n = 33), recibió modelo: consejerías telefónicas, envío de SMS, material educativo y equipos auto-monitoreo; y GC (n = 32) atención habitual atención habitual y equipos de automonitoreo. Medición pre y post intervención de los conocimientos sobre Prediabetes, alimentación no saludable, actividad física, peso, circunferencia de cintura, Glicemia, Triglicéridos y Colesterol Total. Resultados: en el GI, la intervención fue efectiva en mantener estable el nivel ...
The purpose of this study is to determinate whether a multicomponent remote care model is effecti... more The purpose of this study is to determinate whether a multicomponent remote care model is effective to achieve the modification of unhealthy eating practices and increase physical activity in adults who have pre-diabetes and over-weight/obesity. The remote care model is composed by four components: 1. counseling intervention (by telephone) is the core of the multicomponent model. These counseling calls are made by professionals working at primary health centers who have been trained to apply theories on behavioral change and decisionmaking; 2. Short Message Service (SMS) counseling is aimed at providing information and encouraging the patient to change his/her behavior in terms of nutrition and physical activity. SMS are sent weekly and are related to counseling sessions; 3. educational material; and4. self-monitoring equipment, pedometers and measuring tape for patients to check their waist circumference. A randomized clinical study (RCT) is being developed (November 2011–January 2...
A new role has emerged within the current demographic context of an aging population; namely, tha... more A new role has emerged within the current demographic context of an aging population; namely, that of the worker-caregiver. The person who works and also cares for a disabled family member has personal and work-related problems and is less committed to their own self-care. Improving the perception of social support can be an effective intervention in this respect. The article describes an interdisciplinary program initiated in 2009 to support family workers-caregivers. Its purpose is to promote health and prevent disease risk factors by strengthening self-care skills and the development of institutional policies that facilitate efficient and healthy compliance with both roles. Some of the health promotion strategies that have been used include education for self-care, strengthening family and social support networks, professional counseling and a community of peers. Sixty workers took part in the last three annual cohorts: 83.4% were women, with an average age of fifty. The program ...
Revista panamericana de salud pública = Pan American journal of public health
mHealth is a practical, useful, and available tool for one-way or two-way communication between h... more mHealth is a practical, useful, and available tool for one-way or two-way communication between health professionals and patients. It is especially promising in countries such as Chile, with widespread and growing mobile telephone coverage that is very well accepted by the public. Our objective is to demonstrate the process for designing a mobile communication and monitoring model, aimed at providing communication between professionals in primary healthcare centers and their patients, to facilitate timely diagnosis and initiation of treatment for type 2 diabetes. This model's characteristics include use of mobile telephones as a communication tool, a one-way method (from health centers to patients), integration into in-person care delivered at health centers, use of different communication strategies (voice and written), and integrated functioning using open-source software. The system includes personalized communication, automated voice communication, and automated written comm...
Telephone based self-management support may improve the metabolic control of patients with type2 ... more Telephone based self-management support may improve the metabolic control of patients with type2 (DM2) diabetes if it is coordinated with primary care centers, if telephone protocols and clinical guidelines are used and if it is provided by nurses trained in motivational interviewing. To assess the efficacy of a tele-care self-management support model (ATAS) on metabolic control of patients with DM2 attending primary care centers in a low income area in Santiago, Chile. Two primary care centers were randomly assigned to continue with usual care (control group, CG) or to receive additionally 6 telecare self-management support interventions (IG) during a 15 month period. Glycosylated hemoglobin (HbA1c) was used to measure metabolic control of DM2; the "Summary of Diabetes Self-care Activities Measure" and the "Spanish Diabetes Self-efficacy" scale were used to measure self-management and self efficacy, respectively. Changes in the use of health services were also e...
Despite cultural differences the countries of Latin America and the Caribbean have been marked by... more Despite cultural differences the countries of Latin America and the Caribbean have been marked by the same historical factors in their development: loss of cultural background through colonization, high economic dependence on the colonizing and then developed countries and periods of strong, anti-democratic governments. The result has been unstable economic, social and political structures. The current tendency, however, is toward a new social order in which civil institutions are being strengthened and the role of the state is being redefined. In this context, health stands out as one of the emerging priorities. And in this maelstrom of change, Latin American nurses are vying for their rightful position in the health care hierarchy. To understand their needs, INR begins its first installment of an analysis of nursing in Latin America.
The following is the last of a three-part analysis of nursing in Latin America. The first two ins... more The following is the last of a three-part analysis of nursing in Latin America. The first two installments dealt with education and practice. Below, a look at current policies and their repercussions for nursing.
Nursing informatics ... : proceedings of the ... International Congress on Nursing Informatics, 2012
Chronic disease management is highly complex because multiple interventions are required to impro... more Chronic disease management is highly complex because multiple interventions are required to improve clinical outcomes. From the patient's perspective, his main problems are dealing with self-management without support and feeling isolated between clinical visits. A strategy for providing continuous self-management support is the use of communication technologies, such as the telephone. However, to be efficient and effective, an information system is required for telecare planning and follows up. The use of electronic clinical records facilitates the implementation of telecare, but those systems often do not allow to combine usual care (visits to the health clinics) with telecare. This paper presents the experience of developing an application called SIGSAC (Software de Información, Gestión y Seguimiento para el Autocuidado Crónico) for Chronic Disease Management and Telecare follow up.
Proceedings of the 4th International Symposium on Applied Sciences in Biomedical and Communication Technologies - ISABEL '11, 2011
... Ilta Lange School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile ... Q... more ... Ilta Lange School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile ... Qualitative data regarding provider satisfaction and the system's perceived clinical utility will be collected via semi-structured interviews. ...
Descreve-se uma experiência do projeto chileno-canadense, intitulado "Promover a saúde mental de ... more Descreve-se uma experiência do projeto chileno-canadense, intitulado "Promover a saúde mental de mulheres chilenas em desvantagem social: os Segredos de Maruja". Apresentam-se os objetivos, as etapas das intervenções e as avaliações preliminares. Com a participação das mulheres usuárias dos Centros de Saúde, profissionais de saúde e autoridades da comunidade de La Pintana, foi construído, aplicado e avaliado um projeto de intervenção para apoiar as mulheres na tomada de decisões que favorecessem sua saúde mental, pessoal, familiar e social. A intervenção contemplou o desenho, a produção, a distribuição e a avaliação de 12 cartilhas educativas tipo calendários, cada uma referente a três temas de saúde mental considerado importante pelas mesmas mulheres: identidade e auto-estima; vínculos e comunicação; e autocuidado. Cada cartilha tem um teste de autodiagnóstico e endereços dos recursos sociais comunitários. Ademais, comprometeu as enfermeiras que trabalham nos Centros de Saúde que incorporaram esta estratégia no seu atendimento habitual e avaliaram seu impacto tanto na sua identidade e autonomia profissional quanto na melhoria da qualidade do cuidado brindado às mulheres.
ABSTRACT The purpose of this study is to determinate whether a multicomponent remote care model i... more ABSTRACT The purpose of this study is to determinate whether a multicomponent remote care model is effective to achieve the modification of unhealthy eating practices and increase physical activity in adults who have pre-diabetes and over-weight/obesity. The remote care model is composed by four components: 1. counseling intervention (by telephone) is the core of the multicomponent model. These counseling calls are made by professionals working at primary health centers who have been trained to apply theories on behavioral change and decisionmaking; 2. Short Message Service (SMS) counseling is aimed at providing information and encouraging the patient to change his/her behavior in terms of nutrition and physical activity. SMS are sent weekly and are related to counseling sessions; 3. educational material; and4. self-monitoring equipment, pedometers and measuring tape for patients to check their waist circumference. A randomized clinical study (RCT) is being developed (November 2011–January 2013). A total sample of 70 Chilean people (20–64 years) diagnosed with pre-diabetes, BMI (25–34) and mobile phones were recruited. Pre intervention measurement was applied. No statistical differences were found for Prediabetes knowledge, physical activity, eating habits, BMI, Weight, waist circumference and clinical parameters (Glucose, Triglycerides and Total Cholesterol) between both groups in basal measurement. The control group received the usual care from health centers. In the study group, the intervention was developed during 6 months per patient (received usual care plus remote care model′s components). The RCT will end at January 2013, and the final results will be presented.
Este estudio da a conocer el interes y las principales dificultades para realizar estudios de pos... more Este estudio da a conocer el interes y las principales dificultades para realizar estudios de post-grado en Enfermeras docentes y asistenciales pertenecientes a 18 Escuelas de Enfermeria, que representan siete paises de America Latina. Sus resultados no pueden generalizarse a la realidad de Enfermeria de America Latina ya que la seleccion de los participantes fue intencionada, considerando su potencial como polo de desarrollo(AU)
Se describe el proyecto de promocion de la salud "UC Saludable: Vive tu Equilibrio", cu... more Se describe el proyecto de promocion de la salud "UC Saludable: Vive tu Equilibrio", cuyo proposito es "desarrollar una cultura en la Pontificia Universidad Catolica de Chile que contribuya a que esta sea un lugar seguro, libre de humo de tabaco y otras toxinas; un ambiente fisico y psicologico positivo para el aprendizaje; donde se fomenten el derecho al desarrollo humano sano y las relaciones constructivas entre los integrantes de su comunidad" El grupo objetivo es la comunidad universitaria constituida por los estudiantes, academicos y personal administrativo. Hacia ellos van dirigidas las acciones que facilitan la promocion de estilos de vida saludables y que se ordenan en funcion de dos ejes principales: el cambio de conductas daninas para la salud por otras mas saludables; y el cambio o desarrollo de politicas y normas institucionales que favorezcan estilos de vida sanos Actualmente el proyecto es coordinado en forma conjunta por la Escuela de Enfermeria y ...
The School of Nursing at the Catholic University of Chile (PUC) has been implementing, since 1983... more The School of Nursing at the Catholic University of Chile (PUC) has been implementing, since 1983 a health care model based on selfcare. (Lange I., Jaimovich S.1996). This work has been enriched with the Ottawa Health Decision Support framework developed in the nineties, in Canada, by O’Connor, A. et al. With the support of the Canadian team and the financial support of the Canadian International Development Agency (CIDA) the project “Making Choices, Making Decisions: A Client/Provider Partnership in Canadian/Chilean Technology Transfer” (DECIDE) was carried out in Chile between 1999 and 2003. The dissemination phase of this project included collaboration with other schools of nursing to promote the incorporation of the Ottawa Decision Support Framework and tool kits for decision support into the nursing curriculum. This experience generated a networking model among the Schools, which enriched and strengthened the DECIDE project, regarding iden# Trabajo realizado con el apoyo financ...
Se propone una reflexion sobre el desafio que representa el cuidado de personas con condiciones c... more Se propone una reflexion sobre el desafio que representa el cuidado de personas con condiciones cronicas de salud (CC) en la atencion de salud y la incorporacion del constructo "Apoyo al Automanejo" como parte de la formacion profesional y a su vez, como este desafio ha sido asumido por la Escuela de Enfermeria UC. Se apoya esta propuesta, en el escenario epidemiologico actual de las condiciones cronicas de salud, especialmente de las enfermedades no transmisibles y los limitados resultados alcanzados con el modelo actual de atencion, con los consecuentes efectos en las personas y familias. Se discute sobre el deficit de preparacion en el equipo de salud para afrontar la complejidad de la situacion. Se revisa la trayectoria de la Escuela de Enfermeria en el ambito de formacion e investigacion en autocuidado de la salud y su relacion y evolucion hacia el apoyo al automanejo como parte integral del Modelo de Cuidados Cronicos que es la estrategia definida por el Ministerio d...
Antecedentes: la prediabetes es una condición reversible y su tratamiento una oportunidad para mo... more Antecedentes: la prediabetes es una condición reversible y su tratamiento una oportunidad para modificar prácticas no saludables. Objetivo: evaluar la efectividad del Modelo Multi-componente de Telecuidado para apoyo a personas con prediabetes y obesidad en Chile. Método: ensayo clínico controlado en centros de atención primaria, Santiago, Chile. Se realizó un muestreo y asignación aleatoria en cada uno de los 5 centros de salud participantes. Participantes: 70 adultos con pre-diabetes, IMC: 25-34 y acceso a telefonía móvil. GI (n = 33), recibió modelo: consejerías telefónicas, envío de SMS, material educativo y equipos auto-monitoreo; y GC (n = 32) atención habitual atención habitual y equipos de automonitoreo. Medición pre y post intervención de los conocimientos sobre Prediabetes, alimentación no saludable, actividad física, peso, circunferencia de cintura, Glicemia, Triglicéridos y Colesterol Total. Resultados: en el GI, la intervención fue efectiva en mantener estable el nivel ...
The purpose of this study is to determinate whether a multicomponent remote care model is effecti... more The purpose of this study is to determinate whether a multicomponent remote care model is effective to achieve the modification of unhealthy eating practices and increase physical activity in adults who have pre-diabetes and over-weight/obesity. The remote care model is composed by four components: 1. counseling intervention (by telephone) is the core of the multicomponent model. These counseling calls are made by professionals working at primary health centers who have been trained to apply theories on behavioral change and decisionmaking; 2. Short Message Service (SMS) counseling is aimed at providing information and encouraging the patient to change his/her behavior in terms of nutrition and physical activity. SMS are sent weekly and are related to counseling sessions; 3. educational material; and4. self-monitoring equipment, pedometers and measuring tape for patients to check their waist circumference. A randomized clinical study (RCT) is being developed (November 2011–January 2...
A new role has emerged within the current demographic context of an aging population; namely, tha... more A new role has emerged within the current demographic context of an aging population; namely, that of the worker-caregiver. The person who works and also cares for a disabled family member has personal and work-related problems and is less committed to their own self-care. Improving the perception of social support can be an effective intervention in this respect. The article describes an interdisciplinary program initiated in 2009 to support family workers-caregivers. Its purpose is to promote health and prevent disease risk factors by strengthening self-care skills and the development of institutional policies that facilitate efficient and healthy compliance with both roles. Some of the health promotion strategies that have been used include education for self-care, strengthening family and social support networks, professional counseling and a community of peers. Sixty workers took part in the last three annual cohorts: 83.4% were women, with an average age of fifty. The program ...
Revista panamericana de salud pública = Pan American journal of public health
mHealth is a practical, useful, and available tool for one-way or two-way communication between h... more mHealth is a practical, useful, and available tool for one-way or two-way communication between health professionals and patients. It is especially promising in countries such as Chile, with widespread and growing mobile telephone coverage that is very well accepted by the public. Our objective is to demonstrate the process for designing a mobile communication and monitoring model, aimed at providing communication between professionals in primary healthcare centers and their patients, to facilitate timely diagnosis and initiation of treatment for type 2 diabetes. This model's characteristics include use of mobile telephones as a communication tool, a one-way method (from health centers to patients), integration into in-person care delivered at health centers, use of different communication strategies (voice and written), and integrated functioning using open-source software. The system includes personalized communication, automated voice communication, and automated written comm...
Telephone based self-management support may improve the metabolic control of patients with type2 ... more Telephone based self-management support may improve the metabolic control of patients with type2 (DM2) diabetes if it is coordinated with primary care centers, if telephone protocols and clinical guidelines are used and if it is provided by nurses trained in motivational interviewing. To assess the efficacy of a tele-care self-management support model (ATAS) on metabolic control of patients with DM2 attending primary care centers in a low income area in Santiago, Chile. Two primary care centers were randomly assigned to continue with usual care (control group, CG) or to receive additionally 6 telecare self-management support interventions (IG) during a 15 month period. Glycosylated hemoglobin (HbA1c) was used to measure metabolic control of DM2; the "Summary of Diabetes Self-care Activities Measure" and the "Spanish Diabetes Self-efficacy" scale were used to measure self-management and self efficacy, respectively. Changes in the use of health services were also e...
Despite cultural differences the countries of Latin America and the Caribbean have been marked by... more Despite cultural differences the countries of Latin America and the Caribbean have been marked by the same historical factors in their development: loss of cultural background through colonization, high economic dependence on the colonizing and then developed countries and periods of strong, anti-democratic governments. The result has been unstable economic, social and political structures. The current tendency, however, is toward a new social order in which civil institutions are being strengthened and the role of the state is being redefined. In this context, health stands out as one of the emerging priorities. And in this maelstrom of change, Latin American nurses are vying for their rightful position in the health care hierarchy. To understand their needs, INR begins its first installment of an analysis of nursing in Latin America.
The following is the last of a three-part analysis of nursing in Latin America. The first two ins... more The following is the last of a three-part analysis of nursing in Latin America. The first two installments dealt with education and practice. Below, a look at current policies and their repercussions for nursing.
Nursing informatics ... : proceedings of the ... International Congress on Nursing Informatics, 2012
Chronic disease management is highly complex because multiple interventions are required to impro... more Chronic disease management is highly complex because multiple interventions are required to improve clinical outcomes. From the patient's perspective, his main problems are dealing with self-management without support and feeling isolated between clinical visits. A strategy for providing continuous self-management support is the use of communication technologies, such as the telephone. However, to be efficient and effective, an information system is required for telecare planning and follows up. The use of electronic clinical records facilitates the implementation of telecare, but those systems often do not allow to combine usual care (visits to the health clinics) with telecare. This paper presents the experience of developing an application called SIGSAC (Software de Información, Gestión y Seguimiento para el Autocuidado Crónico) for Chronic Disease Management and Telecare follow up.
Proceedings of the 4th International Symposium on Applied Sciences in Biomedical and Communication Technologies - ISABEL '11, 2011
... Ilta Lange School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile ... Q... more ... Ilta Lange School of Nursing, Pontificia Universidad Católica de Chile, Santiago, Chile ... Qualitative data regarding provider satisfaction and the system's perceived clinical utility will be collected via semi-structured interviews. ...
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