Percepciones de los médicos de atención primaria en la seguridad social hacia la prevención cuaternaria en Lima Perú

• Autor: Cuba Fuentes, María Sofía
• Formato: tesis doctoral
• Fecha de Publicación: 2021
• Institución: Universidad Peruana Cayetano Heredia
• Repositorio: UPCH-Institucional
• Lenguaje: español
• OAI Identifier: oai:repositorio.upch.edu.pe:20.500.12866/9069
• Enlace del recurso: https://hdl.handle.net/20.500.12866/9069
• Nivel de acceso: acceso abierto
• Materia: Prevención Cuaternaria; Atención Primaria; Sobrediagnóstico; Sobretratamiento; https://purl.org/pe-repo/ocde/ford#3.02.27; https://purl.org/pe-repo/ocde/ford#3.03.05

Quaternary prevention is the action taken to identify patients at risk of overtreatment, protect them from unnecessary new health actions, and suggest ethically acceptable interventions. The objective of this study is to describe the perceptions of actions that are drivers or barriers for the practice of quaternary prevention, in Primary care doctors of Rebagliati Health network at Social Security in Lima, Peru, on 2018. We carried out a mixed cross sectional study, using the Quantitative-Qualitative methodological triangulation. For the quantitative component, que conducted a survey among all primary care physicians of Rebagliati health Network. We measure the importance they assigned to the practice of quaternary prevention and relevance of Choosing Wisely recommendations (choosing wisely); We used a phenomenological approach in the qualitative component, seeking to reconstruct how the experience has been lived, interpreted by the actors themselves regarding the barriers and facilitators of the practice of quaternary prevention. Results: Most of the interviewees considered the practice of quaternary prevention important (94%) and consider relevant the Choosing Wisely recommendations (59.4%). In the in-depth interviews, the doctors stated that there was a possibility of causing harm with medical practice and identified barriers for quaternary prevention in the health system, the socio-health conditions of the patient and professional burnout; they identified as facilitators of quaternary prevention practice their communication skills and their permanent updating for clinical decision making.