Hernández-Alemán FR, Ornelas-Bernal LA, Apresa-García T, Sánchez-Garduño S, Martínez-Rodríguez OA, Hernández-Hernández DM

Idioma: Español
Referencias bibliográficas: 36
Paginas: 217-227
Archivo PDF: 91.68 Kb.

RESUMEN

Objetivo. Determinar factores asociados al abandono del proceso de atención de NIC. Material y métodos. Se realizó un estudio de casos y controles anidado en una cohorte de mujeres referidas a las clínicas de displasias de dos hospitales de tercer nivel. Casos: pacientes que abandonaron su atención médica. Controles: pacientes que cumplieron con sus citas médicas. Las pacientes contestaron una entrevista estructurada respecto a variables sociodemográficas y de atención médica al inicio y al final del seguimiento. Los datos clínicos se obtuvieron de la revisión de expedientes. Análisis: Medidas de frecuencia y asociación, ajustando variables con Regresión Logística no Condicionada. Resultados. La tasa de abandono fue de 108/525 = 20.7% (17.2-24.3); 60.2% ocurrieron en la fase diagnóstica, 17.7% durante el tratamiento y 23.1% en la fase de vigilancia y/o control. Un total de 108 casos y 417 controles fueron considerados para el análisis. Los factores de riesgo ajustados fueron: miedo a la muerte (ORa = 4.2, I.C._95% = 1.8-9.5), citas prolongadas (ORa = 6.6, I.C._95% = 3.4-13.0), falta de privacidad (ORa = 12.5, I.C._95% = 2.6-59.8), rechazo al tratamiento propuesto (ORa = 40.4, I.C._95% = 2.1-785.4) y falta de información (ORa = 41.9, I.C._95% = 14.2-124.1) entre otros. Conclusiones. Los factores relacionados con la percepción de gravedad de la enfermedad y las barreras al acceso de los servicios de salud fueron los de mayor importancia para abandonar la atención médica.

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