La pandemia de la COVID ha enfrentado a Atención Primaria a un desafío excepcional, con escenarios inesperados. Aún acostumbrados a movernos en la incertidumbre, esta situación nos ha hecho replantearnos múltiples aspectos organizativos, asistenciales y competenciales, descubriéndonos debilidades, pero también fortalezas y oportunidades. Fue necesario reorganizarse, tomar decisiones rápidas, en un contexto de enorme estrés y preocupación. Aspectos esenciales en nuestra praxis son la comunicación y los principios de la bioética. Trasladamos a formato de guion cinematográfico situaciones vividas con los pacientes y con nuestros propios compañeros, en los centros de salud, en las consultas del médico de familia, en los domicilios, para reflexionar sobre el valor de la comunicación en el afrontamiento de las dificultades vividas en la pandemia COVID-19. Planteamos asimismo situaciones que nos enfrentaron a conflictos éticos ante la toma de decisiones de gran exigencia, en una situación de absoluta excepcionalidad.
The World Health Organization (WHO) estimated that physical inactivity (PI) is responsible for 20 to 30% of all non-communicable diseases. We aimed to analyze the effectiveness of a multiple health behavior change (MHBC) intervention to increase physical activity (PA) in patients 45 to 75 years old who had at least 2 of 3 unhealthy behaviors (tobacco use, reduced fruit and vegetable consumption, and insufficient PA). The MHBC intervention is based on the Transtheoretical Model and the conceptual framework of the “5 A’s” and includes an individually tailored intervention, group sessions, and the use of community resources. We included 3062 participants, 1481 in the intervention group and 1581 in the control group. After 12 months, there were no differences in PA intensity measured by metabolic_equivalent_of_task_minutes/week (adjusted mean difference: 284.093, 95% CI: −298.24, 866.42) nor in the proportion of participants who increased PA levels to moderate or high (OR: 1.02, 95% CI: 0.85, 1.23; p = 0.822), and no differences in blood pressure, weight loss, or waist circumference. We found an increased proportion of patients in the intervention group who followed the WHO recommendations for PA (OR: 1.29; 95% CI: 1.04, 1.60; p = 0.02). We concluded that the intervention did not lead to a significant increase in PA.
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