Browsing by Author "Castañeda Caro, Felipe"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Exploración de las barreras de acceso a tratamiento para pacientes con trastornos alimentarios en Chile
    (2023) Castañeda Caro, Felipe; Cerda, Jaime; Pontificia Universidad Católica de Chile. Escuela de Medicina
    Contexto: Los trastornos alimentarios (TAL) son enfermedades asociadas a alta morbimortalidad, que afectan predominantemente a jóvenes y mujeres. Un retraso en el inicio de tratamiento se ha asociado a un curso clínico crónico y más severo; no obstante, la evidencia sobre barreras y facilitadores de acceso en Chile es escasa. Objetivo: Se buscó identificar las barreras y facilitadores de acceso para el tratamiento de pacientes con TAL en Chile, desde la perspectiva de pacientes, familiares y profesionales tratantes. Metodología: Abordaje cualitativo a través de entrevistas semiestructuradas sobre pacientes, sus familiares y profesionales tratantes. Los grupos fueron reclutados desde dos centros de Santiago de Chile (uno público y uno privado). El análisis cualitativo estuvo basado en la Teoría Fundamentada, mediante el software MAXQDA. Resultados: Se realizaron 40 entrevistas (n = 22 pacientes, n = 10 familiares y n = 8 tratantes). La edad promedio del grupo de pacientes fue de 21.78 años, mientras que el tiempo promedio sin tratamiento fue de 91.41 meses (mediana 70 meses). Del análisis emergieron 5 grandes categorías con intersecciones entre ellas: paciente (P), entorno familiar y social (EFS), profesionales tratantes (T), sistema de salud (SS), y contexto social y cultural (CSC). Dentro de las categorías y sus intersecciones aparecieron importantes barreras, destacando, entre otros, la falta de conocimiento o expertise del profesional, el valor monetario del tratamiento, el desconocimiento cultural o desinformación sobre trastornos alimentarios, y los síntomas egosintónicos del paciente. A su vez, los principales facilitadores tuvieron relación con la psicoeducación al paciente y su familia, y los factores ligados a la interacción del paciente con su familia: el reconocimiento de síntomas por parte de la familia, la toma de acción de los padres hacia el tratamiento, y el entendimiento o apoyo del grupo familiar. Conclusiones: El presente estudio pudo aportar información valiosa en cuanto al acceso a tratamiento para pacientes con trastornos alimentarios en Chile. Un abordaje de salud pública eficaz debe considerar la multi-causalidad del retraso en el tratamiento, junto a favorecer la pesquisa temprana para evitar la cronicidad del trastorno.
  • Thumbnail Image
    Item
    Exploration of barriers to treatment for patients with eating disorders in Chile
    (2024) Castañeda Caro, Felipe; Cerda, Jaime; Jara Latorre, Raúl Hernán; Riestra, Francisca; Urrejola Noguera, Pascuala; Vogel, Melina; Gumucio, María E.; Irribarra Pastenes, Verónica; Álvarez, Jorge; Díaz, María A.; Kompatzki, Paula; Costa, Daniela
    Background Eating disorders (EDs) are associated with high morbidity and mortality, affecting predominantly young people and women. A delay in starting treatment is associated with chronic and more severe clinical courses; however, evidence on barriers and facilitators of access to care in Latin America is scarce. We aimed to identify barriers and facilitators of ED treatment in Chile from the perspective of patients, relatives, and health professionals. Methods Qualitative approach through semi-structured interviews with patients, their relatives, and health professionals. Participants were recruited from two ED centers in Santiago, Chile (one public and one private). Analysis was mainly based on Grounded Theory, using MAXQDA software. Results 40 interviews were conducted (n = 22 patients, 10 relatives, and 8 health professionals). The mean age of patients was 21.8 years, while the mean duration of untreated ED was 91.4 months (median 70 months). Five categories emerged with intersections between them: patient (P), family and social environment (FSE), health professionals (HP), healthcare system (HCS), and social and cultural context (SCC). Relevant barriers appeared within these categories and their intersections, highlighting a lack of professional knowledge or expertise, cultural ignorance or misinformation regarding EDs, and patient’s ego-syntonic behaviors. The main facilitators were patients’ and relatives’ psychoeducation, recognition of symptoms by family members, and parents taking the initiative to seek treatment. Conclusions This study provides information regarding access to treatment for patients living with EDs in Chile. A practical public health approach should consider the multi-causality of delay in treatment and promoting early interventions. Plain English Summary Eating disorders (EDs) may severely affect the daily functioning of people enduring them. A delay in starting treatment is associated with a disease that is more difficult to treat. To our knowledge, there are no published studies carried out in Latin America exploring factors influencing treatment initiation in EDs patients. This study aimed to identify facilitators of and barriers to treating patients with EDs in Chile. We interviewed patients (n = 22), their relatives (n = 10), and health professionals (n = 8) from a private and a public center in Santiago, Chile. Our analysis showed that the main barriers to starting treatment were the lack of professional knowledge in ED, the monetary cost of illness, and cultural misinformation. Facilitators were related to the role of the family in recognizing and addressing the disease while being educated in EDs by professionals. This study helps to provide data about treatment access in developing countries. While facilitators and barriers were similar to others reported in the literature, the untreated ED’s duration was longer. It is essential to address these barriers to provide access to treatment more efficiently and prevent severe and enduring forms of disease.