| 1. |
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| 2. |
- Briones-Vozmediano, Erica, et al.
(författare)
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Discursos profesionales sobre la violencia del compañero íntimo: implicación en la atención de las mujeres inmigrantes en España : [Professional discourses on intimate partner violence: implication for care of immigrant women in Spain]
- 2016
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Ingår i: Gaceta Sanitaria. - : Elsevier. - 0213-9111 .- 1578-1283. ; 30:5, s. 326-332
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Tidskriftsartikel (refereegranskat)abstract
- Objective: 1) to examine the discourses of professionals involved in the care of female victims of intimate partner violence (IPV), with emphasis on how they describe the immigrant women, the perpetrators and their own responsibility of care; and 2) to compare these discourses with the other professions involved in caring for these women (social services, associations and police and justice). Methods: Qualitative study based on semi-structured interviews with 43 professionals from social services, associations and the police and judicial systems. A discourse analysis was carried out to identify interpretive repertoires about IPV, immigrant women and their aggressors, their culture and professional practices. Results: Four interpretive repertoires emerged from professional discourses: "Cultural prototypes of women affected by IPV", "Perpetrators are similar regardless of their culture of origin", "Are victims credible and the perpetrators responsible?" and "Lack of cultural sensitivity of professionals in helping immigrant women in abusive situations". These repertoires correspond to preconceptions that professionals construct about affected women and their perpetrators, the credibility and responsibility they attribute to them and the interpretation of their professional roles. Conclusions: The employment of IPV-trained cultural mediators in the services responsible for caring for the female victims, together with cultural training for the professionals, will facilitate the provision of culturally sensitive care to immigrant female victims of intimate partner violence. (C) 2016 SESPAS. Published by Elsevier Espana, S.L.U.
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| 3. |
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| 4. |
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| 5. |
- Costa, Diogo, et al.
(författare)
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Intimate partner violence in Europe: design and methods of a multinational study. : La violencia de pareja en Europa: diseño y métodos de un estudio multinacional
- 2013
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 0213-9111 .- 1578-1283. ; 27:6, s. 558-561
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Tidskriftsartikel (refereegranskat)abstract
- Objective To describe the design, methods, procedures and characteristics of the population involved in a study designed to compare Intimate Partner Violence (IPV) in eight European countries.Methods Women and men aged 18–65, living in Ghent-Belgium (n = 245), Stuttgart-Germany (n = 546), Athens-Greece (n = 548), Budapest-Hungary (n = 604), Porto-Portugal (n = 635), Granada-Spain (n = 138), Östersund-Sweden (n = 592), London-United Kingdom (n = 571), were sampled and administered a common questionnaire. Chi-square goodness of fit and five-age strata population fractions ratios for sex and education were computed to evaluate samples' representativeness.Results Differences in the age distributions were found among women from Sweden and Portugal and among men from Belgium, Hungary, Portugal and Sweden. Over-recruitment of more educated respondents was noted in all sites.Conclusion The use of a common research protocol with the same structured questionnaire is likely to provide accurate estimates of the general population IPV frequency, despite limitations in probabilistic sampling and restrictions in methods of administration.
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| 6. |
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| 7. |
- Goicolea, Isabel, et al.
(författare)
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Applying the WHO recommendations on health-sector response to violence against women to assess the Spanish health system : a mixed methods approach
- 2014
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 0213-9111 .- 1578-1283. ; 28:3, s. 238-41
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Tidskriftsartikel (refereegranskat)abstract
- This methodological note describes the development and application of a mixed-methods protocol to assess the responsiveness of Spanish health systems to violence against women in Spain, based on the World Health Organization (WHO) recommendations.Five areas for exploration were identified based on the WHO recommendations: policy environment, protocols, training, accountability/monitoring, and prevention/promotion. Two data collection instruments were developed to assess the situation of 17 Spanish regional health systems (RHS) with respect to these areas: 1) a set of indicators to guide a systematic review of secondary sources, and 2) an interview guide to be used with 26 key informants at the regional and national levels.We found differences between RHSs in the five areas assessed. The progress of RHSs on the WHO recommendations was notable at the level of policies, moderate in terms of health service delivery, and very limited in terms of preventive actions. Using a mixed-methods approach was useful for triangulation and complementarity during instrument design, data collection and interpretation.
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| 8. |
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| 9. |
- Goicolea, Isabel, et al.
(författare)
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Primary health care attributes and responses to intimate partner violence in Spain
- 2017
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 0213-9111 .- 1578-1283. ; 31:3, s. 187-193
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: This study provides an overview of the perceptions of primary care professionals on how the current primary health care (PHC) attributes in Spain could influence health-related responses to intimate partner violence (IPV).METHODS: A qualitative study was conducted using semi-structured interviews with 160 health professionals working in 16 PHC centres in Spain. Data were analysed using a qualitative content analysis.RESULTS: Four categories emerged from the interview analysis: those committed to the PHC approach, but with difficulties implementing it; community work relying on voluntarism; multidisciplinary team work or professionals who work together?; and continuity of care hindered by heavy work load. Participants felt that person-centred care as well as other attributes of the PHC approach facilitated detecting IPV and a better response to the problem. However, they also pointed out that the current management of the health system (workload, weak supervision and little feedback, misdistribution of human and material resources, etc.) does not facilitate the sustainability of such an approach.CONCLUSION: There is a gap between the theoretical attributes of PHC and the "reality" of how these attributes are managed in everyday work, and how this influences IPV care.
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| 10. |
- Goicolea, Isabel, et al.
(författare)
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Using realist evaluation to assess primary healthcare teams' responses to intimate partner violence in Spain
- 2015
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 0213-9111 .- 1578-1283. ; 29:6, s. 431-436
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: Few evaluations have assessed the factors triggering an adequate health care response to intimate partner violence. This article aimed to: 1) describe a realist evaluation carried out in Spain to ascertain why, how and under what circumstances primary health care teams respond to intimate partner violence, and 2) discuss the strengths and challenges of its application.METHODS: We carried out a series of case studies in four steps. First, we developed an initial programme theory (PT1), based on interviews with managers. Second, we refined PT1 into PT2 by testing it in a primary healthcare team that was actively responding to violence. Third, we tested the refined PT2 by incorporating three other cases located in the same region. Qualitative and quantitative data were collected and thick descriptions were produced and analysed using a retroduction approach. Fourth, we analysed a total of 15 cases, and identified combinations of contextual factors and mechanisms that triggered an adequate response to violence by using qualitative comparative analysis.RESULTS: There were several key mechanisms -the teams' self-efficacy, perceived preparation, women-centred care-, and contextual factors -an enabling team environment and managerial style, the presence of motivated professionals, the use of the protocol and accumulated experience in primary health care- that should be considered to develop adequate primary health-care responses to violence.CONCLUSION: The full application of this realist evaluation was demanding, but also well suited to explore a complex intervention reflecting the situation in natural settings.
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| 11. |
- Goicolea, Isabel, et al.
(författare)
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Why do certain primary health care teams respond better to intimate partner violence than others? : A multiple case study
- 2019
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Ingår i: Gaceta Sanitaria. - Bridgewater : Elsevier. - 0213-9111 .- 1578-1283. ; 33:2, s. 169-176
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyse how team level conditions influenced health care professionals’ responses to intimate partner violence.Methods: We used a multiple embedded case study. The cases were four primary health care teams located in a southern region of Spain; two of them considered "good" and two s "average". The two teams considered good had scored highest in practice issues for intimate partner violence, measured via a questionnaire (PREMIS - Physicians Readiness to Respond to Intimate Partner Violence Survey) applied to professionals working in the four primary health care teams. In each case quantitative and qualitative data were collected using a social network questionnaire, interviews and observations.Results: The two "good" cases showed dynamics and structures that promoted team working and team learning on intimate partner violence, had committed social workers and an enabling environment for their work, and had put into practice explicit strategies to implement a women-centred approach.Conclusions: Better individual responses to intimate partner violence were implemented in the teams which: 1) had social workers who were knowledgeable and motivated to engage with others; 2) sustained a structure of regular meetings during which issues of violence were discussed; 3) encouraged a friendly team climate; and 4) implemented concrete actions towards women-centred care.
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| 12. |
- Hoffmann, Rasmus, et al.
(författare)
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Amenable mortality revisited : the AMIEHS study
- 2013
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 0213-9111 .- 1578-1283. ; 27:3, s. 199-206
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Tidskriftsartikel (refereegranskat)abstract
- ObjectivesThere is a renewed interest in health system indicators. In 1976 a measure of quality of healthcare, amenable mortality, was introduced by Rutstein. This indicator is based on the concept that deaths from certain causes should not occur in the presence of timely and effective healthcare. In the project “Amenable mortality in the European Union: toward better indicators for the effectiveness of health systems” (AMIEHS), we introduce a new approach to the selection of indicators of amenable mortality.MethodsBased on predefined selection criteria and a broad review of the literature on the effectiveness of medical interventions, a first set of potential indicators of amenable mortality (causes of death) was selected. The timing of the introduction of medical innovations was established through reviews and questionnaires sent to national experts from seven participating European countries. The preselected indicators were then validated by a trend analysis that identified associations between the timing of innovations and cause-specific mortality trends and by a Delphi-procedure.ResultsAfter a short review of previous lists of amenable mortality indicators and a detailed description of the innovative procedure in the AMIEHS project we present a list of 14 causes of death that passed our selection criteria. We illustrate our empirical validation of these indicators using the examples of peptic ulcer and renal failure.ConclusionsThe innovation developed in the AMIEHS study is a rigorous new approach to the concept of amenable mortality that includes empirical validation. Only validated indicators can be successfully used to assess the quality of healthcare systems in international comparisons.
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| 13. |
- Jesus Rodriguez, Gabriel, et al.
(författare)
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Trends in socioeconomic inequalities in general mortality in the city of Cadiz, Spain (1992-2007)
- 2014
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Ingår i: Gaceta Sanitaria. - : Elsevier. - 0213-9111 .- 1578-1283. ; 28:4, s. 313-315
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To analyze trends in socioeconomic inequality in mortality in the city of Cadiz (Spain) from 1992 to 2007. Methods: An ecological study was performed of trends over 3 cross-sections, with the census tract as the unit of analysis. Deaths were grouped into three periods: 1992-1996, 1997-2001 and 2002-2007 and were then classified according to a deprivation index of the census tract. We calculated adjusted rates by the direct method and three measures of health inequality. Results: Of 18,586 deaths, 96.7% was geocoded to a census tract. The population-attributable risk decreased in men and women, respectively, from 15.4% and 12.2% in 1992-1996 to 9.3% and 5.6% in 2002-2007. The other measures, slope index and the relative index also showed a decline in inequality but only among women. Conclusions: Despite a decreasing trend, social inequalities are a substantial component in the distribution of overall mortality in the city of Cadiz.
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| 14. |
- Juarez, Sol Pia
(författare)
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Notas acerca del movimiento natural de la población para el estudio de la salud perinatal.
- 2014
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 1578-1283 .- 0213-9111. ; 28:6, s. 505-507
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Tidskriftsartikel (refereegranskat)abstract
- Vital statistics, published by the National Statistics Institute in Spain, are a highly important source for the study of perinatal health nationwide. However, the process of data collection is not well-known and has implications both for the quality and interpretation of the epidemiological results derived from this source. The aim of this study was to present how the information is collected and some of the associated problems. This study is the result of an analysis of the methodological notes from the National Statistics Institute and first-hand information obtained from hospitals, the Central Civil Registry of Madrid, and the Madrid Institute for Statistics. Greater integration between these institutions is required to improve the quality of birth and stillbirth statistics.
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| 15. |
- Juarez, Sol Pia, et al.
(författare)
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Revisiting the 'Low BirthWeight paradox' using a model-based definition.
- 2014
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 1578-1283 .- 0213-9111. ; 28:2, s. 160-162
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Tidskriftsartikel (refereegranskat)abstract
- Immigrant mothers in Spain have a lower risk of delivering Low BirthWeight (LBW) babies in comparison to Spaniards (LBW paradox). This study aimed at revisiting this finding by applying a model-based threshold as an alternative to the conventional definition of LBW.
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| 16. |
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| 17. |
- Murillo, Pilar, et al.
(författare)
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Factores asociados a la respuesta a la violencia del compañero íntimo en atención primaria de salud en España
- 2018
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Ingår i: Gaceta Sanitaria. - : Elsevier. - 0213-9111 .- 1578-1283. ; 32:5, s. 433-438
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Tidskriftsartikel (refereegranskat)abstract
- Objetivo: Analizar la capacidad de respuesta a la violencia del compañero íntimo (VCI) de profesionales sanitarios/as españoles/as en atención primaria e identificar posibles determinantes que puedan favorecer una mejor respuesta.Método: Estudio transversal con muestreo no probabilístico y por conveniencia en profesionales sanitarios/as de 15 centros de atención primaria españoles. El instrumento Physician Readiness to Manage Intimate Partner Violence Survey (PREMIS), en su versión validada y traducida al español, permitió recolectar información sobre conocimientos, opiniones y prácticas sobre VCI. Se realizaron análisis estadísticos descriptivo y de regresión lineal bivariada y multivariada.Resultados: Se recibieron 265 cuestionarios diligenciados, con una tasa de respuesta del 80,3%. Se observó un efecto exposición-respuesta, en el que a más horas de formación, mayor puntuación en las escalas del cuestionario (p <0,05). La edad, el tipo de profesión, los años de experiencia en atención primaria, las horas de formación en VCI y la lectura del protocolo mostraron asociación positiva con conocimientos (preparación percibida, conocimiento percibido, conocimiento real), opiniones (preparación del equipo, requerimientos legales, autoeficacia, disponibilidad de recursos en el lugar de trabajo, barreras, entendimiento de la víctima) y prácticas del personal sanitario.Conclusiones: Leer el protocolo de actuación regional/nacional y recibir formación en VCI fueron las intervenciones más importantes asociadas a una mejor capacidad de respuesta a la VCI de los/las profesionales sanitarios/as en atención primaria.
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| 18. |
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| 19. |
- Rodríguez-Blanes, Gloria M., et al.
(författare)
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Detección de violencia de compañero íntimo en atención primaria de salud y sus factores asociados
- 2017
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Ingår i: Gaceta Sanitaria. - : Elsevier. - 0213-9111 .- 1578-1283. ; 31:5, s. 410-415
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Tidskriftsartikel (refereegranskat)abstract
- Objetivo: La violencia de compañero íntimo (VCI) contra las mujeres es un importante problema de salud pública y de derechos humanos. Los profesionales de atención primaria tienen un papel clave en su detección y abordaje. El objetivo de este estudio es determinar la frecuencia y los factores asociados a la realización de preguntas de detección de VCI en atención primaria, y describir las principales acciones desarrolladas en los casos identificados.Métodos: Estudio transversal en 15 centros de salud de cuatro comunidades autónomas, con 265 profesionales sanitarios. Recogida de información mediante el cuestionario PREMIS (Physician Readiness to Manage Intimate Partner Violence Survey) autocumplimentado, que incluye variables sobre realización de preguntas para detección, sociodemográficas, nivel de formación/conocimientos en VCI, percepciones y acciones. Se realizó un análisis descriptivo y analítico.Resultados: El 67,2% de los participantes señalan que preguntan sobre VCI en la consulta, siendo las acciones más frecuentes referir/derivar a otros servicios, consejo individual y entrega de información. Se asociaron a mayor probabilidad de indagar sobre VCI tener ≥21 de horas de formación, nivel formativo avanzado, conocer políticas y programas, y disponer de protocolo y recursos apropiados de referencia. La realización de preguntas aumenta a medida que los/las profesionales se sienten formados en VCI y provistos/as de un protocolo de manejo de casos.Conclusiones: Dos terceras partes de los/las profesionales sanitarios/as encuestados/as refirieron indagar sobre VCI. Dada la influencia de la formación en VCI y el conocimiento sobre los recursos para su abordaje, resulta imprescindible continuar invirtiendo en la formación en VCI del personal sanitario.
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| 20. |
- Rodríguez Eguizabal, Eva, et al.
(författare)
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Capacidad de respuesta del sistema de salud en atención primaria valorada por pacientes con enfermedades crónicas : [Evaluation of health center's primary care responsiveness by patients with chronic illnesses]
- 2022
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Ingår i: Gaceta Sanitaria. - : Elsevier. - 0213-9111 .- 1578-1283. ; 36:3, s. 232-239
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Tidskriftsartikel (refereegranskat)abstract
- Objetivo: Evaluar la capacidad de respuesta del sistema de salud percibida por pacientes crónicos de atención primaria, así como los factores asociados a esa percepción.Método: Estudio transversal basado en entrevistas a pacientes mayores de 18 años diagnosticados de al menos una enfermedad crónica que visitaron los centros de atención primaria durante junio y julio de 2015 en una zona básica de Salud de La Rioja. El resultado fue el índice de respuesta y los factores potencialmente relacionados incluyeron características sociodemográficas y de salud. Entrevistadores capacitados realizaron el cuestionario breve en español de la encuesta multipaís de la Organización Mundial de la Salud con 403 participantes. Se realizaron estadística descriptiva y regresión logística bivariable y multivariable.Resultados: El 87,10% de los participantes consideró buena la respuesta general. Los dominios que obtuvieron las puntuaciones más altas fueron confidencialidad (99,3%), dignidad (98,3%) y comunicación (97,3%). Los peor evaluados fueron atención rápida (38,6%) y calidad de los servicios básicos (31,8%). La clase social baja fue el factor más importante asociado a la capacidad de respuesta, concretamente con la autonomía y la atención rápida. Sexo, educación y ocupación estuvieron relacionados con comunicación, y los pacientes con peor salud percibida valoraron peor la respuesta general. Los dominios considerados más importantes fueron dignidad (33,5%) y atención rápida (30,5%).Conclusiones: Los dominios mejor evaluados fueron los relacionados con el respeto a las personas. La atención rápida tiene una baja valoración, pero una gran importancia, y por lo tanto requiere una acción prioritaria.
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| 21. |
- Ruiz-Ramos, Miguel, et al.
(författare)
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Crisis económica al inicio del siglo xxi y mortalidad en España. Tendencia e impacto sobre las desigualdades sociales. Informe SESPAS 2014.
- 2014
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 1578-1283 .- 0213-9111.
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed to assess the impact of the current economic crisis on mortality trends in Spain and its effect on social inequalities in mortality in Andalusia. We used data from vital statistics and the Population Register for 1999 to 2011, as provided by the Spanish Institute of Statistics, to estimate general and sex- and age-specific mortality rates. The Longitudinal Database of the Andalusian Population (2001 census cohort) was used to estimate general mortality rates and ratios by educational level. The annual percentages of change and trends were calculated using Joinpoint regressions. No significant change in the mortality trend was observed in Spain from 2008 onward. A downward trend after 1999 was confirmed for all causes and both sexes, with the exception of nervous system-related diseases. The reduction in mortality due to traffic accidents accelerated after 2003, while the negative trend in suicide was unchanged throughout the period studied. In Andalusia, social inequalities in mortality have increased among men since the beginning of the crisis, mainly due to a more intense reduction in mortality among persons with a higher educational level. Among women, no changes were observed in the pattern of inequality.
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| 22. |
- Ruiz-Ramos, Miguel, et al.
(författare)
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Crisis económica al inicio del siglo xxi y mortalidad en Espana. ˜ Tendencia e impacto sobre las desigualdades sociales. Informe SESPAS 2014 [The economic crisis at the beginning of the XXI century and mortality in Spain. Trend and impact on social inequalities. SESPAS Report 2014].
- 2014
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 0213-9111 .- 1578-1283. ; 28 (Suppl 1), s. 89-96
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Tidskriftsartikel (refereegranskat)abstract
- El objetivo de este estudio es analizar el impacto de la actual crisis económica en la evolución de la mortalidad en Espana˜ y sus efectos sobre las desigualdades sociales en la mortalidad en Andalucía. Se han utilizado las defunciones procedentes de las estadísticas vitales del Instituto Nacional de Estadística para los anos ˜ 1999 a 2011, así como la población correspondiente del padrón municipal de habitantes. Se calcularon tasas ajustadas de mortalidad general y específica por sexo y edad. Para estimar las tasas de mortalidad general y las razones de tasas según el nivel de estudios, entre 2002 y 2010 se utilizó la Base de Datos Longitudinal de Población de Andalucía (cohorte censal del 2001). Los porcentajes de cambio anuales y las tendencias se calcularon mediante regresión joinpoint. En Espana˜ no se observa ningún cambio de tendencia significativo en la mortalidad a partir de 2008. Desde 1999 se mantiene una tendencia descendente, en ambos sexos y por todas las causas, excepto en las enfermedades del sistema nervioso. La mortalidad por accidentes de tráfico acelera su decrecimiento desde 2003. Los suicidios no modifican su tendencia negativa a lo largo del periodo. En Andalucía, las desigualdades sociales en la mortalidad general aumentaron en los hombres desde el inicio de la crisis, en el ano˜ 2008, fundamentalmente por un mayor descenso en la mortalidad en los de mayor nivel de estudios que en el resto, en un contexto de descenso de la mortalidad. En las mujeres no se observan cambios en el patrón de desigualdad.
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| 23. |
- Ruiz-Ramos, Miguel, et al.
(författare)
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Mortalidad general y por causas en la población autóctona e inmigante en Andalucía
- 2013
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Ingår i: Gaceta Sanitaria. - : Elsevier BV. - 1578-1283 .- 0213-9111. ; 27:2, s. 116-122
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To compare mortality rates between immigrant and native-born residents of Andalusia between 2006 and 2010, and to characterize mortality by cause. Material and methods: The data consisted of deaths from mortality statistics by cause, and the aggregated populations registered in the lists of inhabitants by country of birth in the case of native-born individuals and immigrants (with immigrants grouped into six geographical areas of origin). Crude rates and age-standardized mortality rates (0-39, 40-65 and 65 years and above) were calculated by cause of death separately for men and women. Results: In the group aged 0-39 years, mortality due to external causes was higher in immigrants than in the native-born population, especially in African immigrants, with standardized rates of 142 and 145 deaths per 100,000 persons/year in women and men, respectively. Deaths due to maternal-related factors were particularly high among Africans. In the group aged 40-64 years, mortality rates were higher in immigrant women than in native-born women but were lower in immigrant men than in native-born men; in this age group, mortality was particularly high in African women and men from Europe and North America. In the group aged 65 years and over, mortality was higher in the native-born population of both genders than in immigrants due to cancer and cardiovascular disease. Conclusions: The differences in mortality between immigrants and native-born residents varied depending on age, gender, cause of death and birthplace. Notable findings were the higher mortality among elderly native-born residents, due to chronic degenerative diseases, and the high mortality in the Sub-Saharan population at younger ages due to accidents. (C) 2012 SESPAS. Published by Elsevier Espana, S.L. All rights reserved.
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