Self-medication (SM) is a global and growing phenomenon. It represents a public health problem due to antibiotic resistance, risk of adverse drug reactions, drug–drug interactions, disease masking, and increased morbidity. There is not a consensus on the definition of SM. The definitions found in different studies make it difficult to address this problem from a theoretical perspective and therefore find an adequate solution to this public health problem. The aim of this article is to search the medical literature to characterize the current understanding of SM in the medical community. We conducted a scoping review of definitions of SM by searching on PubMed – Medline, Embase, and LILACS using the following combination of keywords: ‘self-prescription’ or ‘self prescription’, ‘self-medication’ or ‘self medication’, or ‘automedication’ and ‘definition’ or ‘explanation’. The search was limited to articles containing the definition of SM, with no limit on language or year. Duplicate studies and those that did not mention the definition of SM were excluded from the final review. A total of 65 studies were included in the final selection. We found a vast heterogeneity in the definition of SM. Most articles based their definition of SM on the process of obtaining the drug, the nonparticipation of a specific health professional, the source of the medication, and the reason for SM. Other interesting concepts such as self-care, nonadherence to a prescription, reuse of stored drugs, and sharing and lending medicines were also considered forms of SM by other authors, however. This study highlights the need to reach a consensus regarding the definition of SM to adequately propose strategies to address this global health problem. This study shows the diverse concepts that need to be included in a future definition of SM. Plain Language Summary Definition of self-medication: a review with systematic methodology Self-medication (SM) is a global and growing phenomenon that represents a public health problem due to antibiotic resistance, risk of dangerous side effects, interactions between drugs, and disease masking. Currently, there is not a consensus on the definition of SM, which makes it difficult to address this problem and therefore find an adequate solution. Making a standard definition would allow the development of programs focused on addressing drug-related problems associated with self-medication behavior. The purpose of this article is to search the medical literature to define the current understanding of SM in the medical community. We included a total of 65 studies and found a great variance in the definition of SM. Most articles based their definition of SM on the process of obtaining the drug, the nonparticipation of a specific health professional, the source of the medication, and the reason for SM. Other interesting concepts such as self-care, not following a prescription, reuse of stored drugs, and sharing and lending medicines were also considered forms of SM by other authors, however. Furthermore, this study highlights that SM is a wider concept that goes beyond aiming to promote and restore health, as aesthetic and recreational purposes are also reasons for SM that can put individuals at risk and compromise the correct and safe use of medications.
Abstractthe adaptation of a test from a language into that same language in another culture is common; however, there are no clear guidelines for this process. the objective was to adapt a protocol providing some guidelines for adapting questionnaires from one language to the same language. a total of eight experts supported the adaption process and 825 participants from spain and colombia were evaluated in this study. participants answered the brief version of the sexual assertiveness scale, the sexual opinion survey, the Massachusetts general Hospital-sexual Functioning Questionnaire and the sexuality scale. the adaptation was made following some guidelines which have already been published. the results showed a strong partial invariance between countries. DiF analysis also replied this partial invariant form and adequate psychometric properties; guidelines to adapt questionnaires into same language in other cultures are presented. therefore, the adaptation process -in the absence of further evidence -could be effective. Keywords: Sexual assertiveness, psychometry, guidelines, adaptation, same language scales. ResumenLa adaptación de test dentro de una misma lengua en varias culturas diferentes es común; sin embargo, no existen guías claras para realizar este proceso. El objetivo fue adaptar un protocolo generando unas guías para adaptar cuestionarios dentro de una misma lengua. Un total de ocho expertos realizaron el proceso de adaptación y 825 participantes de España y Colombia fueron evaluados en este estudio. Todos ellos contestaron a la versión breve de la Sexual Assertiveness Scale, la Sexual Opinion Survey, la Massachusetts General Hospital-Sexual Functioning Questionnaire y la Sexuality Scale. La adaptación se realizó siguiendo las directrices de algunas guías ya publicadas. Los resultados mostraron una invarianza fuerte entre los dos países. Estos hallazgos fueron replicados mediante DIF, además se observaron adecuadas propiedades psicométricas, finalmente las guías para el proceso de adaptación han sido presentadas. Por lo que concluimos que el proceso de adaptación -en ausencia de más evidencia-podría ser efectivo. Palabras clave: asertividad sexual, psicometría, guía, adaptación, escalas mismo idioma.
The Rosenberg Self-Esteem Scale is the most widely used instrument to assess self-esteem. In light of the absence of adaptations in Colombia, this study seeks to validate and adapt this scale in the Colombian population, and perform factorial equivalence with the Spanish version. A total of 1,139 seniors (633 Colombians and 506 Spaniards) were evaluated; the individuals answered the Rosenberg Self-Esteem Scale and sexual self-esteem scale. The average score of the items was similar to the questionnaire's theoretical average, and standard deviations were close to one. The psychometric properties of the items are generally adequate with alphas of .83 and .86 and significant (CI = .95) and correlations with the sexual self-esteem scale ranging from .31 and .41. Factorial equivalence was confirmed by means of a structural equation model (CFI = .912 and RMSEA = .079), thus showing a strong level of invariance.
Attitudes toward sexuality are a key variable for sexual health. It is really important for psychology and education to have adapted and validated questionnaires to evaluate these attitudes. Therefore, the objective of this research was to adapt, validate and calculate the equivalence of the Colombia Sexual Opinion Survey as compared to the same survey from Spain. To this end, a total of eight experts were consulted and 1,167 subjects from Colombia and Spain answered the Sexual Opinion Survey, the Sexual Assertiveness Scale, the Massachusetts General Hospital-Sexual Functioning Questionnaire, and the Sexuality Scale. The evaluation was conducted by online and the results show adequate qualitative and quantitative properties of the items, with adequate reliability and external validity and compliance with the strong invariance between the two countries. Consequently, the Colombia Sexual Opinion Survey is a valid and reliable scale and its scores can be compared with the ones from the Spain survey, with minimum bias.
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