Atención Familiar

Clinical Instruments Validation: Key Aspects

Haydee Alejandra Martini-Blanquel — Wed, 26 Jun 2024 00:00:00 -0500

This study explores some key aspects of the validation of instruments used in clinical data collection, which is part of a critical process for diagnosis and treatment in the medical field. Clinimetrics underscores the importance of validity, and reliability in the use of instruments for the accurate identification, and measurement of signs and symptoms. Validity ensures that the instrument effectively measures the variable of interest, while reliability indicates that repeated use of the same instrument will produce consistent results. The article addresses aspects related to instrument construction and validation, including theoretical and empirical foundations, validation by expert judges, pre-sampling tests, as well as construct and criterion evaluations. In addition, the application of exploratory and confirmatory factor analysis to validate the internal structure of the instruments is addressed. This work highlights the importance of accuracy in clinical practice and provides a detailed framework for ensuring the efficacy and relevance of instruments in different population contexts.

Clinical Instruments Validation: Key Aspects

Haydee Alejandra Martini-Blanquel — Wed, 26 Jun 2024 00:00:00 -0500

Urinary Incontinence in the Elderly: a Primary Care Approach

Wed, 26 Jun 2024 00:00:00 -0500

The world is undergoing an accelerated demographic transition, with an increase in the geriatric population, and a corresponding increase in the prevalence of geriatric syndromes such as urinary incontinence. This article presents a general context and a practical algorithm for approaching urinary incontinence in the geriatric patient, which facilitates the classification of the different types of incontinence, and also provides criteria for referring patients from primary care to other specialties. This updated and synthesized document, based on the evidence and practice of experts in the various medical specialties involved, is a valuable tool to improve the understanding, and clinical approach of professionals caring for adults over 60 years, with urinary incontinence, especially in primary care.

Instructions for Authors

Atención Familiar UNAM — Wed, 26 Jun 2024 00:00:00 -0500

Portada, contraportada y hoja legal

Atención Familiar UNAM — Wed, 26 Jun 2024 00:00:00 -0500

Aten. Fam. Volumen 31 no. 3 julio-septiembre, 2024 (PDF completo)

Atención Familiar UNAM — Wed, 26 Jun 2024 00:00:00 -0500

Stress Fracture of the Third Metatarsal in a Marathon Runner

Luis Gerardo Domínguez-Carrillo, Luis Gerardo Domínguez-Gasca — Wed, 26 Jun 2024 00:00:00 -0500

Identify a Case

Advances and Challenges in Primary Prevention of Stroke: Perspectives from Undergraduate Medical Students

Karla P. Meneses-León, Alma Daniela Méndez-Álvarez — Wed, 26 Jun 2024 00:00:00 -0500

Journal Club

Conflicts Experienced by Women Who Have Had Breast Cancer and Are in the Recovery Phase

Andrea Díaz-García, Alan Sepúlveda-Hernández — Wed, 26 Jun 2024 00:00:00 -0500

Journal Club

Why Should I Lose Weight if I have Diabetes or Hypertension?

Wed, 26 Jun 2024 00:00:00 -0500

Communication with the patient

Toward a Greater Representation of Family Medicine in the National System of Researchers in Mexico

Geovani López Ortiz — Wed, 26 Jun 2024 00:00:00 -0500

Editorial

Toward a Greater Representation of Family Medicine in the National System of Researchers in Mexico

Geovani López Ortiz — Wed, 26 Jun 2024 00:00:00 -0500

Editorial

Journal Club as a Teaching and Learning Strategy in Medical Education

Raúl Sampieri Cabrera — Wed, 26 Jun 2024 00:00:00 -0500

Editorial

Sleep Quality and Frailty Association in the Elderly

Wed, 26 Jun 2024 00:00:00 -0500

Objective: To analyze the association between sleep quality and frailty syndrome in the elderly who are attending a general hospital. Methods: Cross-sectional analytical study conducted at the General Hospital of the Zone No. 27 of the Mexican Institute of Social Security from November 2022 to April 2023, in Mexico City, Mexico; 170 adults ≥ 60 years of age attending geriatric consultation participated, non-probability sampling was used. The Pittsburgh Sleep Quality and frail for frailty questionnaires were used; to exclude other factors that could influence the development of frailty, the Geriatric Depression Scale, and the Mini Nutritional Assessment were used. Descriptive statistics, X² test to evaluate significant differences between groups, prevalence ratio (pr) to evaluate the likelihood of frailty with poor sleep quality, and binary linear regression to explore the influence of other variables on frailty were performed. Results: The mean age was 79.6 ± 8 years, women represented 71.2% (n= 121) of the sample. It was reported that 48.2% (n= 82) of the patients showed frailty, and 68.8% (n= 117) poor sleep quality, regarding the evaluation of confounding variables, 55.8% (n=95) showed depression, and 3.5% (n= 6) malnutrition. An association was found between sleep quality and frailty (p < 0.001), the pr for frailty was 14.52 (ci 5.72-36.83). The linear regression model for sleep quality was 10.33 (95% ci: 3.92-27.25), and for depression 2.34 (95% ci: 1.10-4.94). Conclusion: an association was found between poor sleep quality and frailty, with a 14.52-fold increase in the probability of presenting frailty in those with poor sleep quality.

Sleep Quality and Frailty Association in the Elderly

Wed, 26 Jun 2024 00:00:00 -0500

Objective: To analyze the association between sleep quality and frailty syndrome in the elderly who are attending a general hospital. Methods: Cross-sectional analytical study conducted at the General Hospital of the Zone No. 27 of the Mexican Institute of Social Security from November 2022 to April 2023, in Mexico City, Mexico; 170 adults ≥ 60 years of age attending geriatric consultation participated, non-probability sampling was used. The Pittsburgh Sleep Quality and frail for frailty questionnaires were used; to exclude other factors that could influence the development of frailty, the Geriatric Depression Scale, and the Mini Nutritional Assessment were used. Descriptive statistics, X² test to evaluate significant differences between groups, prevalence ratio (pr) to evaluate the likelihood of frailty with poor sleep quality, and binary linear regression to explore the influence of other variables on frailty were performed. Results: The mean age was 79.6 ± 8 years, women represented 71.2% (n= 121) of the sample. It was reported that 48.2% (n= 82) of the patients showed frailty, and 68.8% (n= 117) poor sleep quality, regarding the evaluation of confounding variables, 55.8% (n= 95) showed depression, and 3.5% (n= 6) malnutrition. An association was found between sleep quality and frailty (p < 0.001), the pr for frailty was 14.52 (ci 5.72-36.83). The linear regression model for sleep quality was 10.33 (95% ci: 3.92-27.25), and for depression 2.34 (95% ci: 1.10-4.94). Conclusion: an association was found between poor sleep quality and frailty, with a 14.52-fold increase in the probability of presenting frailty in those with poor sleep quality.

Quality of Life in the Elderly with Hearing Impairment

Wed, 26 Jun 2024 00:00:00 -0500

Objective: to characterize the quality of life in the elderly with hearing impairment attending a family medicine unit. Methods: cross-sectional analytical study carried out at the Family Medicine Unit No. 9 in Mexico City; 60 patients over 60 years of age were included by non-probabilistic sampling. Questionnaires were applied, and sociodemographic data and associated comorbidities were collected; the Hearing Impairment Scale for the Elderly (hhie) was used for hearing impairment, and the sf-12 health questionnaire was used to assess quality of life. Relevant characteristics were compared by gender using bivariate analysis and Fisher’s exact test; linear regression models were constructed. Results: a higher prevalence of hearing loss was identified in men; severe hearing limitation was higher in men than in women (40% vs. 17.14%), regarding characteristics related to quality of life, the prevalence of retired men was higher than in women (68% vs. 40%, p= 0.039), in contrast, women were ten times more represented in housework (40% vs. 4%, p= 0.001). The mean smoking rate was significantly higher in men than in women (6.24 vs. 2.28, p= 0.033), especially in those with a history of diabetes, where the difference was even more pronounced (7.81 in men vs. 1.07 in women). Among participants with a history of hypertension, men also had twice the rate of women (7.5 vs 3.3). On the other hand, women reported higher quality of life scores in both physical (46.16 vs 42.17, p= 0.042), and mental (48.36 vs 43.15, p= 0.45) dimensions. Conclusion: The degree of impairment was negatively related to quality of life, so it is necessary to make an early diagnosis and implement preventive strategies from the primary level.

Effectiveness of a Cognitive Rehabilitation Program in Geriatric Patients

Wed, 26 Jun 2024 00:00:00 -0500

Objective: To evaluate the efficacy of a cognitive rehabilitation program in geriatric patients using the Montreal Cognitive Assessment (MoCA) test as a measurement tool. Methods: A quasi-experimental study was conducted at the Physical Medicine and Rehabilitation Unit of the Mexican Institute of Social Security Siglo XXI, in Mexico City, from January to May 2023. The sample size was calculated, and the type of sampling was probabilistic. Forty-seven participants of both genders, over 60 years of age, with no history of neurological pathology were included, to whom the MoCA test was applied, then six institutional cognitive rehabilitation sessions of 40 minutes were performed, and at the end of the sessions the measurement instrument was applied again. Interferential statistics were performed using the Wilcoxon test, and Student’s t-test, both with an estimate of p< 0.05. Results: The initial MoCA score was 21.9±4.8 points, and the final score was 26.3±1.9, which corresponds to a normal score, with a difference of 4.4 points (p<0.05). Most of the MoCA test sections had p<0.05, with the exception of identification, sentence repetition and orientation domains, the best results also corresponded to the sections of visuoconstruction (clock), abstraction, and memory. Conclusión: the use of cognitive rehabilitation programs, and strategies applied to the geriatric population have a significant impact on the improvement of attention and memory.

Prevalence of Neuropathy Associated with Frailty in Geriatric Patients

Aimee C. Morales-Servin, Teresa Alvarado-Gutiérrez, Juan L. Vega-Blancas — Wed, 26 Jun 2024 00:00:00 -0500

Objetivo: analizar la prevalencia de neuropatía asociada a fragilidad en pacientes geriátricos atendidos en la Unidad de Medicina Familiar (umf) No. 31. Métodos: se realizó un estudio transversal analítico, se obtuvo una muestra de 368 pacientes mediante la fórmula de poblaciones finitas, posteriormente se realizó un muestreo no probabilístico por cuotas. Se evaluaron a pacientes derechohabientes mayores de 65 años de edad de la umf No. 31 del Instituto Mexicano del Seguro Social, se analizó presencia de dolor neuropático y el síndrome de fragilidad mediante los cuestionarios dn 4 y Fried, respectivamente; se evaluó su asociación mediante estadística inferencial. Resultados: se identificó neuropatía en 69.56% de los pacientes y fragilidad en 77.4%. En 64.40% existió concurrencia de las dos entidades. Conclusión: existe una alta prevalencia de pacientes que padecen síndrome de fragilidad y neuropatía. Estos hallazgos sugieren una asociación significativa entre la neuropatía y la fragilidad en esta población, lo que subraya la importancia de considerar ambos aspectos en la atención de este grupo etario.

Association Between Social Support Network and Adolescent Pregnancy in a Family Medicine Unit

Wendy A. Avilés-Aguilar, María Y. Rocha-Rodríguez, Francisco Hernández-Pérez — Wed, 26 Jun 2024 00:00:00 -0500

Objective: To evaluate the degree of association between the social support network and pregnancy among adolescents in a primary care unit. Methods: Case-control design. A total of 159 adolescents of childbearing age were selected from January 1, 2022, to March 31, 2023, attending the Family Medicine Unit No. 15 in Mexico City; 53 were pregnant (cases), and 106 were not (control). The mos questionnaire was used to evaluate the global index of perceived social support and its domains. Student’s t-test was used to compare means, and X² to compare percentages; odds ratios (or) between cases and controls, and confidence intervals were determined, considering p<0.05 statistically significant. Results: Of the 65 participants (40.9%) with maximum support, 37.7% were pregnant, and 42.5% were not; of the 94 participants (59.1%) with less than maximum support, 62.3% were pregnant and 57.5% were not. When calculating the degree of association, an or of 0.82 (95% ci 0.41-1.61) was identified; there was no risk association between adolescent pregnancy, and the global index of social support network (p= 0.56). Conclusion: The variables evaluated were associated in a protective manner in pregnant adolescents, although most of them were not statistically significant.