Tesis Especializaciones (Ciencias Médicas)

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Afectación psicológica en adolescentes expuestos a violencia intrafamiliar de la parroquia Ricaurte. Cantón Cuenca. 2015-2016
(Universidad de Cuenca, 2017-11-11) Moscoso Pineda, Blanca Luzmila; Ortiz Segarra, José Ignacio
Introduction: Violence as a social problem at a global, national and local level results from the use of physical force or power, causing injury, death or psychological damage, affecting the psychological sphere of adolescents, with negative repercussions on their future. Objective: To determine the different types of psychological affection in adolescents exposed to intrafamily violence. Materials and Methods: A cross - sectional, analytical study was carried out on the psychological involvement of adolescents exposed to intrafamily violence, Ricaurte parish, Cuenca canton. With structured questionnaires to 255 participants, collecting information on sociodemographic, family characteristics, violence, detecting psychological affection analyzing prevalences, a bivariate and multivariate analysis determining association by OR and 95% CI. Considering significant results at p <0.05. Results: The prevalence of psychological affection was for moderate anxiety 22.35%, severe depression 14.90%, medium-low self-esteem 25.88% and verbal aggressiveness 52.16%. The type of psychological violence showed 45.1%. The bivariate analysis showed a statistically significant association between anxiety OR = 2.16 (95% CI: 1.18-3.95) (p = 0.011), depression OR = 1.91 (95% CI = 1.11-3.29 ) (P = 0.018), verbal aggressiveness OR = 5.29 (95% CI = 1.16-24.17) (p = 0.01) and rage OR = 2.15 (95% CI = 1.26-3, 68) (p = 0.005), with types of violence. The multivariate analysis found an association between family functionality and adolescent psychological distress OR = 2.68 -2.80, (95% CI = 1.459 - 5.260) (p <0.05). CONCLUSIONS: Exposure to intrafamily violence triggers in the adolescents psychological consequences determined the functionality of the family, which makes it necessary to address this significant social problem
Disfuncionalidad familiar y problemas de salud mental en los adolescentes: una revisión sistemática
(Universidad de Cuenca, 2022-02-11) Astudillo Ñauta, Johanna Paulina; Ortiz Segarra, José Ignacio
Background: 16% of adolescent illnesses are associated with mental health, half of them starting around the age of 14, often going unnoticed, generating individual and family consequences. General Objective: To analyze the relationship between family dysfunctionality and mental health problems in adolescents, based on the analysis of research conducted during the period 2016-2020. Methodology: A systematic review was conducted of observational studies published in the last 5 years, in English and Spanish, in Scopus, Pubmed, Elsevier, ResearchGate, ScienceDirect, Dialnet, Springer, Scielo and Redalyc databases. For the bibliographic search we used keywords described in the methodology combined with Boléan operators such as OR, AND, NOT (in Spanish) and OR, AND, NOT (in English), considering the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: 19 studies were analyzed, which identified the following mental health problems: depression, anxiety, substance use and eating disorders; there was a higher prevalence of mental health problems in adolescents belonging to dysfunctional families compared to functional ones, with family factors influencing the appearance of these problems such as: neglect, abuse, violence, maternal overprotection, difficulties in family communication and abandonment by the father. Conclusion: Mental disorders in adolescents maintain a direct relationship with dysfunctional family systems in comparison to functional ones and with variable prevalences worldwide.
Embarazo en adolescentes y factores asociados individuales, familiares y sociales: una revisión sistemática
(Universidad de Cuenca, 2022-02-09) Ramón Granda, César Fernando; Mogrovejo Guzmán, Marilupe Josefina
Background: worldwide, adolescent pregnancy rates are on the rise, especially in developing countries, leading to negative effects on the biopsychosocial sphere of adolescents and their family environment. Objective: to determine the association between adolescent pregnancy and individual, family and social factors. Methodology: a systematic review was conducted, the search was performed in five electronic databases: Pubmed, Sciencie Direct, Scielo, Redalyc and Latindex, and the MeSH (Medical Subject Headings) terms "Teen pregnancy" or "pregnant teen" and the Health Sciences Descriptors (DeCS) "teen pregnancy" or "pregnant teen" were used. Nineteen studies were included, published from 2015 to 2020, with quartiles of the (Scimago Journal & Country Ranking) from 1 to 4, in English, Spanish and Portuguese. Results: It was found that risk factors such as family dysfunction and household poverty were statistically significantly associated with adolescent pregnancy. Other factors that were associated were early initiation of sexual relations, lack of knowledge of contraceptive methods, low level of education, being a resident of rural areas, and low level of education of the parents. Conclusion: This review emphasizes that individual, family and social factors are associated with adolescent pregnancy. Limitations: most of the publications required subscription and prior payment, so we opted for other databases, such as Pub Med and Scielo.
Factores asociados al inicio de relaciones sexuales tempranas en adolescentes escolarizados de la parroquia Tarqui, Cuenca 2015-2016
(Universidad de Cuenca, 2017-11-11) Durán Ochoa, Andrea Gabriela; Abril Matute, Cumandá Patricia
Background: For the World Health Organization, the beginning of the early sexual relations is a health problem due to the various consequences for young people, his family and the society. Several studies show that adolescents each time set romantic relationships and initiate sexual activity at younger ages. Objectives: To determine the factors associated with the initiation of early sexual relations in adolescent students of the parish Tarqui, Cuenca 2015. Materials and Methods: We conducted an observational, analytical cross-sectional study with a sample of 211 adolescent students of the Tarqui in the city of Cuenca. A validated questionnaire was applied to determine the prevalence of sexual intercourse, the characteristics of the same and the associated factors. There was a descriptive analysis using frequencies, percentages, graphics and is reported average and standard for the deviation numerical variables. The association was determined using the prevalence ratio and its confidence interval of 95%. It was considered statistically significant results to the values of p<0.05. Results: The prevalence of sexual intercourse is of 17.1% CI95%: 12.2 - 22.18. The mean age was 17.4 years. In its most 80.6% the frequency is occasional, with a couple 33.3% defined as stable by 58.3%. The activity valued by the scale of Peeting that prevailed is the kisses 28.0%, the main reasons for initiating sexual activity were the curiosity 9.0%. It was low condom use 15.2% and the main source of sexual information were the parents 82.5%. Association was found with the Family Apgar RP 0.36 CI95%: 0.15-0.87, p=0.020; with the have a partner or in love or 8,510 CI95%: 3.64-19.9, p=0.000; be grade repeater RP 3.30 CI95%: 1.45-7.50, p=0.003; with the consumption of alcohol RP 4.98 CI95%: 2.34-10.6, p=0.000 and with the family structure RP 2.66 CI95%: 1.27-5.57, p=0.008. Conclusions: The prevalence of sexual intercourse is less than the reported in other national and international studies and is associated with the family Apgar, have a partner or lover, be grade repeater, consume alcohol and the family structure
Funcionalidad familiar y factores asociados al consumo de alcohol en adolescentes escolarizados de la parroquia Cumbe 2015
(Universidad de Cuenca, 2017-11-11) Mogrovejo Guzmán, Marilupe Josefina; Siguencia Astudillo, Héctor Fabián
Objective: To determine the relationship between family functionality and factors associated with alcohol consumption among on teenagers enrolled in the Cumbe Parish 2015. Methodology: It was a cross-sectional analytical study on alcohol consumption on 170 teenagers enrolled in the middle and high school. Demographic variables and associated factors were evaluate by validated forms base on family functionality with the family functioning scale and alcohol consumption by the Identification Test base on disorders due to alcohol consumption. These results were tabulated and analyzed in SPSS version 20, qualitative variables (frequencies and percentages); quantitative variables (median, interquartile range) and statistical association (prevalence ratio, 95% confidence interval and p value <0.05). Results: 53.5% of respondents were female, with a median of 16 years; 57.5% to average adolescence; 55.3% to unstructured families; 69.4% dysfunctional, 58,2 % have high self-esteem and 68.2% have friends' influence. The prevalence was 37.6%, higher in males. The risk factors were male gender (RP 3.19, CI 1.671-6.09 p <0.05), late adolescence (RP 4.31, CI 2.229-8.346 p <0.05), family dysfunction (RP 3 , 03, CI 1.424-6.485, p <0.05) and social influence of friends (RP 2.96, CI 2,385-3,681, p <0,05); The factors without statistical association were family structure (RP1.06, CI 0.570-1.987, p> 0.05) and low self-esteem (RP 0.836; CI 0.44-1.573; p> 0.05). Conclusions: The statistically significant risk factors for alcohol consumption in school-aged adolescents were male sex, late adolescence, dysfunctional families and social influence of friends
El machismo en la conducta sexual y reproductiva de los adolescentes varones escolarizados de la parroquia de Nulti-Azuay 2015
(Universidad de Cuenca, 2017-11-11) Zhañay Condo, Wilson Esteban; Vega Crespo, Bernardo José
Background: Machismo or sexist attitudes in adolescence can be precursors of behavior of superiority or violence against women in adult life, so its identification becomes important in the adolescence. Objective: To determine factors associated with machismo in the sexual behavior of adolescent students in Nulti Parish. Azuay 2015 Methods and materials: We conducted a quantitative, cross-sectional and analytical study in 160 male students in the parish of Nulti, Azuay 2015. The EMS-Sexism-12 instrument was applied to determine the machismo scale. Quantitative variables with normal distribution were expressed as mean and standard deviation, while those with non-normal distribution were expressed as medians and interquartile range. Quantitative ones were represented as absolute and relative frequencies, bivariate analysis was performed to determine risk factors for high machismo. Results: The average machismo scale was 25, 48±6, 68 points. We found a greater scale of machismo in adolescents with relationships, and a greater number of them in those who referred the use of condoms. In the same way it is associated the person with whom their first sexual intercourse took place, and the familiar functionality with a machismo level. According to the evaluated factors, the presence of a relationship, and the presence of a non-functional family were the factors that showed a significant risk for high machismo. Conclusions: The presence of relationships is a factor related to a higher machismo in male adolescents. The presence of a relationship, the person with whom their first sexual intercourse took place, and the belief that condoms prevent sexually transmitted diseases, were associated
Perfil epidemiológico y clínico de soporte nutricional en pacientes menores de 16 años ingresados en el departamento de Pediatría del Hospital Vicente Corral Moscoso enero – noviembre 2020
(Universidad de Cuenca, 2022-02-17) Semanate Bautista, Sandra Daniela; Tinoco Ochoa, Ana Cristina
Background: Nutritional support is an important therapeutic strategy in both hospitalized and critically ill pediatric patients. General objective: To determine the epidemiological and clinical profile of nutritional support in patients under 16 years of age admitted to the pediatric department of the Vicente Corral Moscoso Hospital in the January-November 2020 period. Methodology: This research is descriptive, quantitative, it was carried out in 105 patients admitted to the pediatric department of the Vicente Corral Moscoso Hospital, who required nutritional support and who met the inclusion criteria. The information was obtained through a survey and review of the medical history and the data entered in a form. The data were tabulated and analyzed in the SPSS program. 18. Descriptive analysis was carried out. Results: Younger infants (43.8%), female sex (60%) predominated in the study group; respiratory pathology was the most frequent (38%) followed by neurological (11.4%); the most frequent comorbidity was genetic diseases (7.6%); 31.4% presented malnutrition, predominantly severe malnutrition (16.2%); 86.6% of the patients received enteral nutrition, and 13.3% parenteral nutrition. The formula was used in 50% of the patients who required enteral nutrition; in 61.15 of the patients, feeding was started in the first 72 hours. Enteral nutrition was more frequent in young infants (22.8%), parenteral nutrition was more frequent in adolescents. Conclusion: The most frequent nutritional support was enteral, predominantly in young infants, with adequate initial caloric intake.
Prevalencia de autolesiones no suicidas y conducta suicida en adolescentes de la consulta externa de psiquiatría infantojuvenil del Hospital Vicente Corral Moscoso, y factores asociados. Mayo 2018 – abril 2019
(Universidad de Cuenca, 2020-03-09) Escobar Carrión, Marcia Alfonsina; Tapia Peralta, Roberto Stalin
INTRODUCTION: Suicide constitutes a health problem in many countries. According to the WHO, it is the second cause of death among young people aged 15-29, and the sixth cause of death between the ages of 5-14 years. OBJECTIVE: To determine the prevalence of non-suicidal self-harm, suicidal behavior and associated factors in adolescents of the outpatient clinic of child and adolescent psychiatry at Vicente Corral Moscoso Hospital. May 2018 - April 2019. METHODOLOGY: Analytical cross-sectional descriptive study, the sample was randomized, consisting of 157 adolescents aged 10 to 18 years. For the bivariate analysis, chi square was used and to determine the intensity of RP association with 95% CI, significant p <0.005. RESULTS: It was determined that there is a statistically significant relationship between non-suicidal self-harm with: parenteral migration (RP 3.5, CI 1.5-8.4 p 0.002), depression (RP 8 CI 2.9-22.15 p 0.000) , be a victim of violence (RP 5,3,2, CI 2,3-12,6 p 0.000), and relationship between suicidal behavior with: parental migration (RP 4.38, CI 1.8-10.28 p 0.000 ), depression (RP 7.8 CI 3.8-16.2 p 0.000), consumption of psychoactive substances (RP 4.46, CI 1.6-12 p 0.002), being a victim of violence (RP 11.2, IC 5.2-23.3 p 0.000). They behaved as protective factors: to come from a functional family for non-suicidal self-harm and suicidal behavior and to belong to a social group only for non-suicidal self-harm. CONCLUSIONS: It is concluded that suicide is a preventable event in adolescents when protective factors are reinforced and risk factors are adequately treated.
Prevalencia de embarazo en adolescentes y factores asociados en el Hospital Luis F. Martínez - Cañar 2017
(Universidad de Cuenca, 2019-11-11) Vázquez Bustos, Wilson Patricio; Sempértegui Cárdenas, Pablo Xavier
Objective: To determine the prevalence of pregnancy in adolescents and associated factors in the Hospital Luis F Martínez in the province of Cañar in the year 2017. Method and materials: A cross-sectional prevalence study was carried out, with the sample calculation being made based on the pregnancy prevalence percentage (11.6%) obtained from previous results, giving a total of 200 female adolescents. Data were collected by survey and clinical history data and tabulated in the database in the SPSS 22.0 program. Results: Among the factors that predispose to pregnancy in adolescence are: late adolescence (92%), mestizo ethnic self-identification (52.5%), low academic level (41%), free union (51.5%), being a housewife (51.5%) %), low and low average socioeconomic status (p value: 0.0065%), living distant from the health center (p value: 0.0041), consumption of psychoactive substances (p value: 0.0053), migration of one of parents (p value: 0.0025), school dropout (p value: 0.0000) and family dysfunction (p value: 0.0000). The prevalence of pregnancy in adolescents is 18 %. Conclusions: The following factors are associated with adolescent pregnancy: low or medium low socioeconomic status (p 0.0065), living distant from the health center (p 0.0041), consumption of psychoactive substances (p 0, 0053), parental migration (p 0.0025), school dropout (p 0.0000) and antecedent of previous pregnancies (p 0.0000), while age under 15 was a protective factor (p 0, 0000). The rest of the variables studied, although they showed associations, these were not statistically significant.
Prevalencia de sobrepeso, obesidad y factores asociados en adolescentes hospitalizados en Hospital Vicente Corral Moscoso año 2017
(Universidad de Cuenca, 2019-11-11) Rodríguez Pacheco, Paola Alejandra; Santacruz Pérez, Paola Daniela
Background: According to the last records obtained in the opinion poll of National of Health and Nutrition, Ecuador books in 8.6 % of children under five years with excess of weight, while in the ages between 5 and 11 years, get to the 29.9 % and in the case of the teens, to the 26 %. General objective: Determining the prevalence of overweight, obesity and factors once 2017 were correlated in teens hospitalized in the Hospital “Vicente Corral Moscoso” year. Methodology: I study observational, quantitative, analytical of transverse guy, it had total success with 143 teens attended in 2017, in the Hospital “Vicente Corral Moscoso”. SPSS checked case histories, by means of tie of frequencies and percentages. He used him the reason of prevalence and the stadigraph Chi-Square, in order to evaluate the relation with the risk factors. Results: Of the 143 studied teens the 55.2 % have between 10 and 12 years. He predominates the feminine sex, the rural procedence 60 % and the socioeconomic status is essentially Low or Half-Way Low. The prevalence of teens with overweight and obesity belonged to the 16.8 %. The analyzed risk factors do not evidence a statistically significant relation with overweight or obesity. The paternal overweight happened to be the one of bigger incidence. Findings: Overweight or obesity in the population do not have very high levels, a single factor does not separately evidence significant relation with the nutritional state, the conjugation of varied of these risk factors bear overweight and the obesity in these subjects.
Prevalencia del consumo de sustancias psicoactivas en adolescentes (15-19 años) en colegios urbanos de la ciudad Cuenca y factores asociados. 2017.
(Universidad de Cuenca, 2019-11-11) Moreno Morejón, Adriana Elizabeth; Sempértegui Cárdenas, Pablo Xavier
Background: most of the research carried out in Ecuador on the subject was carried out in adolescents in night schools, centers or shelters, among others, our study was conducted in urban schools in the city of Cuenca. Objective: To determine the prevalence of the consumption of psychoactive substancies in adolescents (15-19 years) in urban schools in the city of Cuenca and the associated factors. Methodology: A cross-sectional, descriptive study was carried out, the sample was calculated with an expected prevalence of 56%, with 10% of losses, leaving 371. Adolescents aged 15 to 19 years of either sex who regularly visit establishments were included. randomized education, adolescents with coexisting psychiatric illnesses or incomplete data were excluded. A form designed by the author and submitted to validation by means of a pilot plan and the validated FFSIL scale was used to collect the information. Results: 65% of the sample were men and 35% women, the average age was 15.91 years. A consumption prevalence of 68% was found, being the most frequent: alcohol 85%, Marijuana 9.1%, Tobacco 3.6%, Cocaine and "H" with 0.8% respectively. A positive association was found with consumption in some family member (p 0.0018), consumption in the social environment (p 0.0032) and family economic income greater than $ 1500 monthly (p 0.0000). Conclusions: it was demonstrated that family factors have a great weight in the beginning of consumption of psychoactive substances. Social influence, especially friends, leads to a significant increase in consumption, and in addition, there is a higher ratio of consumption to higher economic income
Prevalencia y factores asociados al inicio de vida sexual activa en adolescentes de la parroquia Hermano Miguel, Cuenca, 2018
(Universidad de Cuenca, 2019-11-11) Reinoso Jaramillo, Karla Janneth; Tapia Cárdenas, Jeanneth Patricia
Introduction: The beginning of sexual life is a transcendental event; The response is more frequent in adolescents, the risk of unwanted pregnancies and STIs (sexually transmitted infections). Objective: to identify the prevalence and factors associated with the beginning of sexual life in the adolescents of the Hermano Miguel parish. Methodology: cross-sectional study; in 170 adolescents, in 2 educational institutions of the Hermano Miguel parish, the prevalence and factors such as family breakdown, family dysfunctionality and low socioeconomic status were reported. Frequencies, percentages, means, standard deviation, OR, 95% confidence interval, p-value were presented; The SPSS program version 23 was used for the analysis. Results: 60.6% belonged to the group of 14 to 16 years, 57.1% were women. 45.9% already started their sexual life; 10.4% have presented an STI. 23.4% have presented pregnancy. 84.4% had one of three couples. 26% do not apply any contraceptive method; 60.6% belong to a structured family; 67.1% at a low socioeconomic status; and 77.6% of a functional family. Existence of risk in the dysfunctional and dysfunctional family of the beginning of sexual life, however, was not significant. Conclusions: adolescents will initiate their sexual life in a high percentage and at an early age, there will be risk in dysfunctional and dysfunctional families but not in the socioeconomic condition.
Uso de métodos anticonceptivos en adolescentes y factores socio-familiares e individuales, una revisión sistemática
(Universidad de Cuenca, 2022-02-09) Paguay Saeteros, María Delfina; Orellana Díaz, Marisol Liliana
Background: there is currently a large gap regarding the satisfaction of contraceptive and family planning needs in adolescents. Objective: to establish the use of contraceptive methods in adolescents and associated socio- family and individual factors. Methodology: systematic review. The information search was carried out according to the PRISMA guide, electronic databases such as Pubmed, Scopus, Redalyc and Scielo were used, keywords specified in the DeCs and MesH and Boolean operators were applied. 19 quantitative studies were included, between quartiles one to four, language was not discriminated. The results were consolidated in tables, registering percentages, Odds Radius, confidence intervals and p value. Results: the male condom was the contraceptive method used in the highest percentage. The use of contraceptives was associated with the following factors: higher economic and educational level, married or common-law marital status, good marital communication and peer relationships, greater age range, high self-esteem, and the adolescent's ability to manage stress. and to make your own decisions about your sexuality. Residency in rural areas, older age of the couple, initiation of sexual activity from peers, receipt of information on sexual issues from non-viable sources, and toxic habits reduced use. Conclusions: the condom was the most used contraceptive method; contraceptive protection is related to social, demographic, economic, school and individual factors. Limitations: scarce bibliography with adequate methodology in relation to the subject of study.

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