Objetivo. Identificar las barreras socio-culturales, psicológicas, del sistema de salud y de acceso que impiden el diagnóstico oportuno del cáncer cervical en mujeres Colombianas según la literatura existente.Métodos. Una revisión entre enero de 2003 y junio de 2014. La búsqueda se realizó en las fuentes de información: Pubmed, LILACS, The Cochrane Library, Cancer Library, CANCERMondial, Ministerio de Salud y Protección Social y Repositorios.Resultados. De 40 publicaciones, se incluyeron 22 resultados de investigación en Colombia. Finalmente se incluyeron 10 estudios correspondientes a barreras socioculturales, 1 a barreras psicológicas, 12 barreras de los sistemas de salud y acceso.Conclusiones. Se encontraron pocos estudios que demuestran la existencia de barreras relacionadas con la oportunidad de decisión y acción, de acceso a la atención y de calidad de la atención del cáncer cervicouterino en Colombia.
Introducción. Para evaluar la efectividad de los programas de prevención aplictitudes y prácticas (CAP). Por ello, surgió la necesidad de evidenciar la literatura existente sobre los conocimientos, actitudes y prácticas del dengue en escolares.Métodos. Se presenta una revisión de literatura utilizando como fuentes Pubmed, ScienceDirect y Scielo. Se incluyen 16 artículos publicados entre 2001-2014.Resultados. La mayoría de los estudios revelaron que los conocimientos, actitudes y estrategias de prevención de los escolares frente al dengue son insuficientes, contradictoriamente, la implementación de estrategias educativas promovían un cambio positivo en ellos.Conclusión. Los estudios CAP han demostrado que las estrategias de prevención del dengue funcionan, sin embargo el impacto positivo solo es tangible en la medida que estas acciones tienen continuidad
Background: Although cervical cancer is preventable through early detection and appropriate treatment, it is still one of the most common cancers in the developing word. In Colombia approximately half of the women diagnosed with cervical cancer die. The purpose of our study was to determine factors associated with delay in the diagnosis of cervical cancer (CC) and to establish strategies for its control in three border regions of Colombia with high number of indigenous and impoverished population.Methods: We conducted a mixed study with convergent triangulation. The study was developed in two stages, first the quantitative component comprising a case-control study, followed by the qualitative component that included interviews and focus groups to healthcare personnel, members of women’s associations, indigenous communities, and quantitative phase´participants. We used the three-delay model as our theoretical framework; this has helped understanding the delay in decision-making by women regarding seeking care (delay 1: individual), arriving at the healthcare institution (delay 2: access), and receiving the appropriate treatment at the institution (delay 3: care and quality).Results: Fifty-five women participated in the quantitative phase, and we conducted 64 interviews and 9 focus groups. Time between the first appointment or Pap smear and final diagnosis was more than two months in 76% of the participants. Delay one was most common among women in La Guajira (higher concentration of indigenous population), and delay two and three in Nariño. Pap smear after 25 years of age (p= 0.002), and more than 3 years apart, once in a lifetime, or never (p< 0.001) were associated with invasive CC. Barriers to undergo a Pap smear were negative experiences with the healthcare system, lack of symptoms, lack of an active sexual life, having only one partner or their partner not having other sexual partners, and fear of the test being painful. The main strategies proposed to prevent and control CC were education, improve actions to promote Pap smear, and human talent strengthening.Conclusion: Even though individual factors played an important role in a delay diagnosis, they are closely influenced by actions of health care services, insurers, and public health actions.
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