Factores asociados a síndrome bronquial obstructivo y/o neumonía adquirida en la comunidad en el lactante, desde un enfoque de cuidado de la salud
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Fecha
2010
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Facultad/escuela
Idioma
es
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Universidad Andrés Bello
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Licencia CC
Licencia CC
Resumen
La investigación aborda la prevención de daños en salud, expresado a
través del Cuidado de la Salud. El estudio se centra en la Atención Primaria en Salud (APS)
y estudia la relación entre las Condiciones-Biológico-Sociales y la presencia de Síndrome
Bronquial Obstructivo y/o Neumonía Adquirida en la Comunidad (Sbo y NAC) desde los 12 a
18 meses, en forma retrospectiva. Su objetivo fue determinar la magnitud y fuerza de
asociación entre el Síndrome Bronquial Obstructivo y/o Neumonía AC y las CondicionesBiológico-
Sociales, desde un enfoque del "Cuidado de la Salud".
Se presenta como un estudio cuantitativo, diseño analítico de casos y
controles, donde la muestra se constituyó por 139 casos y 130 controles, eliminándose los
sesgos de selección y de medición. La medida utilizada para cuantificar la asociación entre la
exposición y la presencia de enfermedad fue "odds ratio" (OR) con un 95% de Intervalo de
Confianza para confirmar o rechazar la asociación de la exposición con la enfermedad.
Los resultados del estudio asocian el Sbo a la etnia y "Conducta de
Cuidado". Las madres y/o cuidadoras revelaron carencia en la "Conducta de Cuidado" hacia
su hijo o lactante a su cuidado, en las conductas: calefaccionar, ventilar y evitar fuentes de
contagio en su hogar, lo que reafirma la necesidad de fortalecer el mensaje educativo a
través de consejerías familiares dirigidas a madres y/o cuidadoras de lactantes con factores
de riesgo para Sbo y/o Neumonía Adquirida en la Comunidad. Estrategias apoyadas
conjuntamente con el desarrollo de campañas educativas, que incorporen metodología
innovada.
Se confirma el efecto negativo del Tabaquismo en la población general, 15,2
%, situación que obliga a replantear prácticas educativas tendientes a controlar su consumo,
substancialmente importante en familias con antecedentes de Asma y Alergias donde los
riesgos se potencian.
Los riesgos para Sbo se dirigieron hacia peso de nacimiento menor de 2500
grs., "Conducta de Cuidado" en la madre y/o cuidadora, hospitalización del lactante en
período de recién nacido, antecedentes de Asma y Alergia en los padres de los lactantes,
presencia de animales dentro del hogar, (gatos, perros) precariedad de la vivienda,
asistencia a guarderías, estado sanitario deficiente de la vivienda, ingreso económico
mínimo, ruralidad, género masculino y embarazo no deseado.
La Neumonía AC en el lactante, se asoció a parto prematuro y peso de
nacimiento menor de 2500 grs., el riesgo se expresó en peso menor a 2500 grs., parto
prematuro, etnia Mapuche, asistencia a guarderías, sexo masculino, saneamiento de la
vivienda, embarazo no deseado e ingreso económico mínimo.
El conocer las asociaciones y factores de riesgo para Sbo y/o Neumonía AC
permite mayor cautela a la hora de tomar decisiones diagnósticas y terapéuticas. De acuerdo
al conocimiento actual la conducta más adecuada para prevenir las patologías en estudio es
fomentar la educación en la madre y/o cuidadora, respecto del cuidado de su hijo y promover estilos de vida saludable incluyendo el control de Tabaquismo y de patologías como Alergias
y Asma.
Se pudo constatar una razón de riesgo (OR) superior a 5 en peso de
nacimiento menor a 2500 grs., significando que el lactante tiene 5 veces mas posibilidades
de desarrollar Sbo y/o Neumonía AC; (OR) superior a 2 en déficit de "Conducta de Cuidado"
materno, riesgo superior a 1 en antecedentes de Alergia para Sbo y riesgo superior a 1 en
asistencia a guarderías, para Sbo y/o Neumonía AC.
Se espera que el conocer las Condiciones-Biológico-Sociales asociadas a
Síndrome Bronquial Obstructivo y/o Neumonía AC, contribuirá en la generación e
implementación de políticas que favorezcan un enfoque de "Cuidado de la Salud', con
conductas de prevención en la madre y/o cuidadora y favorecer un óptimo crecimiento y
desarrollo de los lactantes.
The research deals with the prevention of damage caused by health problems, expressed through Health Caring. The study is focused on Primary Health Care (PHC) and studies the relation between the Social Biological Conditions and the presence of the Obstructed Bronchial Syndrome or Community-acquired Pneumonia from birth until 18 months old on a retrospective look. lts objective was to determine the importance and strength of the association between the Obstructed Bronchial Syndrome or Communityacquired Pneumonia and the Social Biological Conditions from a Health Caring approach. This research is a quantitative study, analytical design of cases and controls design, where the sample was constituted by 139 cases and 130 controls, where the selection biases were eliminated. The measure used to quantify the association between the exposition and presence of the disease was the "odds ratio" (OR) with a 95% of confidence interval in order to confirm or reject the association of the exposure with the disease. The results of the study associate the Obstructed Bronchial Syndrome to the ethnic group and the caring behavior. The mothers revealed a lack of caring behavior towards their children (behaviors as heating, ventilate, avoiding infection sources at home), which reasserts the need for strengthening the educational message through family counseling, address to mothers or childcare providers with risk factors for Obstructed Bronchial Syndrome or Community-acquired Pneumonia and strategies supported along with the development of educational campaigns that include innovative methodology. The negative effect of smoking in the population is also shown, 15.2% this situation forces to change the education aimed to control the tobacco consumption; highly important in families with asthma and allergy history, where risks are increased Risks for the Obstructed Bronchial Syndrome were present on infants with a birth weight lower than 2500 gr., Caring Behavior of the mother or childcare providers, infant hospitalization, asthma and allergy history of the infants' parents, presence of animals inside their house (cats, dogs), a house in bad conditions, attending day care, deplorable sanitary conditions of the house, minimum wage, rural area, male gender and unwanted pregnancy. Community-acquired Pneumonia was associated to a premature delivery and with a birth weight of 2500 gr. in infants; the risk was shown in a weight lower than 2500 gr., premature delivery, Mapuche people, attendance to day care, male gender, bad sanitary conditions of the house, unwanted pregnancy and minimum wage. Knowing the associations and risk factors for the Obstructive Bronchial Syndrome or Community-acquired Pneumonia allows to be cautious when making diagnostic and treatment decisions. According to the current knowledge, the more proper behavior to prevent the O8S or CAP is to encourage education in the mother or childcare provider, regarding to the child care and to foster healthy life styles, including the smoking and pathology control such as allergies and asthma. A risk indicator (OR) higher of 5 in infants with birth weight lower tan 2500 gr could be verified, which means that the infant has 5 times more possibilities of developing OBS or CAP; a OR higher than 2 in mother Caring Behavior, with a risk higher than 1 in allergy history for OBS and a risk higher than 1 in attendance to day care for OBS or/and CAP. lt is expected that knowing the Biological and Social Conditions associated to the Obstructed Bronchial Syndrome or/and the Community-acquired Pneumonia, will contribute to the generation and implementation of policies that help in the approach of the Health Care with prevention behaviors of the mother to favor an ideal growth and development of the infants.
The research deals with the prevention of damage caused by health problems, expressed through Health Caring. The study is focused on Primary Health Care (PHC) and studies the relation between the Social Biological Conditions and the presence of the Obstructed Bronchial Syndrome or Community-acquired Pneumonia from birth until 18 months old on a retrospective look. lts objective was to determine the importance and strength of the association between the Obstructed Bronchial Syndrome or Communityacquired Pneumonia and the Social Biological Conditions from a Health Caring approach. This research is a quantitative study, analytical design of cases and controls design, where the sample was constituted by 139 cases and 130 controls, where the selection biases were eliminated. The measure used to quantify the association between the exposition and presence of the disease was the "odds ratio" (OR) with a 95% of confidence interval in order to confirm or reject the association of the exposure with the disease. The results of the study associate the Obstructed Bronchial Syndrome to the ethnic group and the caring behavior. The mothers revealed a lack of caring behavior towards their children (behaviors as heating, ventilate, avoiding infection sources at home), which reasserts the need for strengthening the educational message through family counseling, address to mothers or childcare providers with risk factors for Obstructed Bronchial Syndrome or Community-acquired Pneumonia and strategies supported along with the development of educational campaigns that include innovative methodology. The negative effect of smoking in the population is also shown, 15.2% this situation forces to change the education aimed to control the tobacco consumption; highly important in families with asthma and allergy history, where risks are increased Risks for the Obstructed Bronchial Syndrome were present on infants with a birth weight lower than 2500 gr., Caring Behavior of the mother or childcare providers, infant hospitalization, asthma and allergy history of the infants' parents, presence of animals inside their house (cats, dogs), a house in bad conditions, attending day care, deplorable sanitary conditions of the house, minimum wage, rural area, male gender and unwanted pregnancy. Community-acquired Pneumonia was associated to a premature delivery and with a birth weight of 2500 gr. in infants; the risk was shown in a weight lower than 2500 gr., premature delivery, Mapuche people, attendance to day care, male gender, bad sanitary conditions of the house, unwanted pregnancy and minimum wage. Knowing the associations and risk factors for the Obstructive Bronchial Syndrome or Community-acquired Pneumonia allows to be cautious when making diagnostic and treatment decisions. According to the current knowledge, the more proper behavior to prevent the O8S or CAP is to encourage education in the mother or childcare provider, regarding to the child care and to foster healthy life styles, including the smoking and pathology control such as allergies and asthma. A risk indicator (OR) higher of 5 in infants with birth weight lower tan 2500 gr could be verified, which means that the infant has 5 times more possibilities of developing OBS or CAP; a OR higher than 2 in mother Caring Behavior, with a risk higher than 1 in allergy history for OBS and a risk higher than 1 in attendance to day care for OBS or/and CAP. lt is expected that knowing the Biological and Social Conditions associated to the Obstructed Bronchial Syndrome or/and the Community-acquired Pneumonia, will contribute to the generation and implementation of policies that help in the approach of the Health Care with prevention behaviors of the mother to favor an ideal growth and development of the infants.
Notas
Tesis (Doctor en Enfermería)
Palabras clave
Cuidados del lactante, Enfermedades respiratorias, Síndrome Bronquial Obstructivo, Neumonía AC, Prevención y Control de Enfermedades, Chile