This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries.
Las enfermedades crónicas han pasado a ser objeto de creciente atención por parte de investigadores con una orientación cualitativa. Pocos trabajos, sin embargo, han profundizado en las decisiones metodológicas empleadas en los estudios. El objetivo de este artículo es presentar algunas reflexiones sobre la metodología empleada en un estudio cualitativo multicéntrico centrado en las perspectivas sobre las enfermedades crónicas y su atención. Los temas objeto de reflexión son la orientación del estudio, la selección del área y la muestra, el empleo de los grupos focales y las relaciones entre los participantes. Concluimos sustentando que las opciones y estrategias metodológicas empleadas, más que ser un asunto de índole técnico, están íntimamente vinculadas al objeto de estudio, a las relaciones sociales establecidas entre los participantes y al contexto del estudio.
Objective: To evaluate the effectiveness of an educational intervention program on people with diabetes mellitus type 2 in a family medical unit of San Luis Potosi, Mexico. Methodology and material: This is a study of intervention, longitudinal and, comparative. A probabilistic sample and a randomized assignation was used. The variables of study were: level of knowledge in regard to the disease, self care and metabolic control of the patient. An educational intervention program was applied to the study group during nine months, thus a conventional assistance was given to the control group. Measurements of glucosidal hemoglobin were taken, so was the level of knowledge before and after the intervention. The data were processed and analyzed with the software SPSS 8.0. A test of differences of medians for independent samples was applied. Results: The findings show statistic evidence of the educational program effectiveness, thus the knowledge level was improved, and through the test of Friedman, it was showed that the average of glucosidal hemoglobin is lower in the study group. Conclusions: The evaluated program is effective because it increases knowledge increment with respect to the illness, and also ways of control and the therapeutic, such as the metabolic control of the patient.
This paper presents the results of the evaluation to analyse (from the teachers and students’ perspective) of the implementation process of a Licenciatura in Nursing in the Facultad de Enfermería, Universidad autónoma de San Luis Potosí México, since the programme that was radically restructured. Methodology: it was a qualitative evaluation with an ethnographic focus that lasted from January 2004 to August 2005. The informants were 36 teachers and 42 students who were selected through a convenience sample. Eleven central groups were formed for the collection of the information. The data was analysed through the examination of the content according to different topics. Results: the teachers and students referred to their perception of strengths and weaknesses in relation to the experiences, and the evaluation of the content and implementation of the theory and practice areas in the programme, the teaching and learning process and its elements; as well as the teaching strategies and the evaluation, the perspective of the main parties and the relation among them. Conclusion: it is evident that the strengths and weaknesses in the structure, and the processes of a formative programme that established ambitious objectives based on the pedagogical focuses that sustain them, required a practical transformation of those involved. The constructive and critical restructuring of the programme detonated changes in the existing education schemes and so the teachers and students faced the need to change these. The process has encouraged some people to discover themselves and to make decisions to improve their practices. However it has caused in others a bigger resistance to change.
Data are lacking on the extent and distribution of injuries in rural areas. This study aimed at comparing injury-related hospitalizations between 2002 and 2012 at a rural hospital of northern Mexico focusing on differences between indigenous (IP) and non-indigenous patients (NIP). A retrospective design based on the review of records of patients hospitalized with injury diagnoses was used. Information extracted included ethnicity, sex, age, hospital duration, surgical procedures, complications and discharge outcome. Injury data comprised of main diagnosis, mechanism and body part affected. Patterns were stratified by year and ethnicity. Logistic regression was used to determine the probability of being hospitalized for >1 day. Injury-related mortality increased from 0.4% in 2002 to 3.1% in 2012. The proportion of non-indigenous patients hospitalized also increased by 4.5%. Men accounted for two-thirds of all inpatients. Weapon involvement doubled from 16.6% to 33.6%. Almost half of the patients in 2012 were victims of interpersonal violence. Indigenous patients had a 2.7 higher adjusted odds ratios of being hospitalized for >1 day in 2002 (95% CI 1.2-5.7), though the gap was reduced to 1.9 (1.1-3.5) in 2012. While indigenous patients continue to be more disadvantaged than the non-indigenous, the gaps closed in 2012; the reasons behind these disparities need to be further investigated.
Características de pacientes con enfermedad coronaria egresados de un hospital de tercer nivel de atención en México RESUMEN El infarto agudo al miocardio es una enfermedad súbita; su desarrollo es particular en cada persona, y se ve influenciado por condiciones sociodemográficas y rasgos de la afección. El objetivo de este trabajo fue elaborar un perfil epidemiológico de pacientes con diagnóstico de infarto que fueron dados de alta de un hospital de tercer nivel en México, entre el 2008 y el 2013, e identificar el tipo de tratamiento y evolución de la mejora de salud. Se realizó un estudio descriptivo retrospectivo, obteniendo la información de los expedientes clínicos. Del total de personas atendidas (325), sobrevivieron el 46%, con mayor frecuencia en hombres (85.4%); la edad promedio fue de 59 años. El 92% presentaba su primer evento agudo, el 43.7% reportó un factor asociado a enfermedad cardiovascular, siendo la hipertensión arterial (57%) y la diabetes tipo II (39%) co-morbilidades. En la cirugía como tratamiento se encontró asociación en los días de estancia hospitalaria y una tendencia a complicaciones, sugiriendo evaluación en protocolo de elección quirúrgica.
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