Tendencias y factores asociados a cesáreas en México: validación de un instrumento



Título del documento: Tendencias y factores asociados a cesáreas en México: validación de un instrumento
Revista: Perinatología y reproducción humana
Base de datos: PERIÓDICA
Número de sistema: 000360684
ISSN: 0187-5337
Autores: 1
2
2
3
Instituciones: 1Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar 7, México, Distrito Federal. México
2Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, México, Distrito Federal. México
3Universidad Nacional Autónoma de México, Facultad de Medicina, México, Distrito Federal. México
Año:
Periodo: Oct-Dic
Volumen: 25
Número: 4
Paginación: 212-218
País: México
Idioma: Español
Tipo de documento: Estadística o encuesta
Enfoque: Descriptivo
Resumen en español mostró a los médicos que realizan mayor porcentaje de cesáreas obteniendo un 80% de acierto y con la prueba de HosmerLemeshow mostró una capacidad predictiva de 0.862. Los médicos que obtuvieron una puntuación mayor de 42 tienen un riesgo de realizar el 50% de sus partos por cesárea (RR = 1.714, IC 95% = 1.004-2.926, p = 0.038). Conclusiones: Con este instrumento se evaluaron los factores relacionados a determinar la actitud del médico frente a la decisión de la vía de resolución del embarazo
Resumen en inglés The WHO determined an ideal rate of 15% of c-section deliveries, but in Mexico during 2009, the c-section was done in 41% of the deliveries. Objective: design and validate a survey to determine cesarean section tendencies and associated factors. Methods: A survey with 74 items including the following: sociodemographic characteristics, preferences, competence, and attitudes of Ob Gyns about the indications for c-section, was presented. It was validated in appearance, content, constructo and internal consistency. Eighteen Ob Gyns evaluated the appearance of the instrument, while the content was validated by a group of health professionals with doctor degree, master degree, and general practitioners. The internal consistency was evaluated by the application of the survey to 30 Ob Gyns, and Cronbach’s alpha and Hotelling’s T squared distribution, were used. The Hosmer-Lemeshow test was done, to determine those Ob Gyns who performed more percentage of c-section. Results: There were 13 items eliminated from the original survey, leaving 61; 16 for the sociodemographic aspects, 14 related with medical preferences of the pregnancy resolution, 11 items about the medical attitude related of c-section without clinical indication, 17 items about obstetrician’s willingness to perform a caesarean section on maternal request; and three about the rights of woman to decide about the way of birth. Twenty-two minutes was the mean time of response (range 12-45 minutes). With Cronbach’s alpha and the Hosmer-Lemeshow test, it was determined those Ob Gyns who performed more percentage of c-sections, with a success of 80% and a predictive capacity of 0.862. The risk of perform 50% or more c-sections was established when medical doctors obtained 42 points or more in the survey (RR = 1.714, IC 95% = 1.004-2.926, p = 0.038). Conclusions: The use of this validated survey allowed the knowledge of factors infl uence in elective caesarean s
Disciplinas: Medicina
Palabras clave: Cirugía,
Ginecología y obstetricia,
Cesárea,
Factores asociados,
Médicos,
Actitudes,
Preferencias
Keyword: Medicine,
Gynecology and obstetrics,
Surgery,
Cesarean section,
Associated factors,
Physicians,
Attitudes,
Preferences
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