Abstract
Objetivo
Analizar el valor del Cuestionario General de Salud de Goldberg de 28 ítems (GHQ-28) para identificar problemas psicosociales (PPS), relacionándolo con los acontecimientos vitales estresantes (AVE), la utilización de servicios y las variables individuales (edad, sexo, actividad, nivel socioeconómico y cultural)
Diseño
Estudio transversal
Emplazamiento
Centro de Salud de Almanjayar, Granada
Participantes
Un total de 314 pacientes mayores de 18 años seleccionados por muestreo sistemático en consulta a demanda
Mediciones principales
Cada paciente realizó una entrevista y cumplimentó el GHQ-28 (las puntuaciones ³ 8 se consideraron indicativas de problemas psicosociales), y se valoraron la Escala de Reajuste Social de Holmes y Rahe (acontecimientos vitales estresantes en el último año), el nivel socioeconómico, el nivel cultural, la actividad y la utilización de los servicios sanitarios (número de consultas en el último año). Se realizó un análisis descriptivo de cada variable y su asociación con el GHQ-28 mediante el test de la c2. Para determinar qué categorías se asociaban de manera independiente con las puntuaciones altas de GHQ se hizo un análisis multivariable
Resultados
Las variables estudiadas que se asocian con mayor probabilidad de presentar problemas psicosociales son el sexo femenino (odds ratio [OR] = 2,15; intervalo de confianza [IC] del 95%, 1,14–4,04) y la presencia de altos niveles de estrés (OR = 2,65; IC del 95%, 1,50–4,68), que mantendrían una relación estadísticamente significativa con las puntuaciones del GHQ una vez se han tenido en cuenta todas las variables
Conclusiones
GHQ puede ser un buen detector de problemas psicosociales en la consulta del médico de familia y ayudar a la posterior identificación y estudio cualitativo de los pacientes
Palabras clave: Problemas psicosociales, Acontecimientos vitales estresantes, Hiperutilización de servicios, Cuestionario General de Salud de Goldberg
Abstract
Objective
To analyze the usefulness of the 28-item Goldberg General Health Questionnaire (GHQ-28) in identifying psychosocial problems, and to determine how the questionnaire scores are related to stressful life events (SLE), use of health services, and individual variables (age, sex, employment status, socioeconomic group, and educational level)
Design
Cross-sectional study.
Setting
Almanjayar Health Center in the city of Granada, Southern Spain
Participants
314 patients more than 18 years of age, selected by systematic sampling at an on-demand health center
Main measures
Each patient completed the GHQ-28 during the course of a personal interview, and scores of 8 or higher were considered to indicate psychosocial problems. Score on the Social Readjustment Rating Scale of Holmes and Rahe (stressful life events during the previous year) was also recorded, as were socioeconomic group, educational level, employment status and use of services (number of visits to the doctor during the previous year). All variables were subjected to descriptive analysis and their associations with the GHQ-28 score were tested with the chi-squared test. Multivariate analysis was used to identify categories that showed an independent association with highscores on the GHQ-28
Results
The variables associated with a greater likelihood of psychosocial problems were female sex (OR, 2.15; CI, 1.14–4.04) and high levels of stress (OR, 2.65; CI, 1.50– 4.68). Both showed a statistically significant association with the GHQ-28 score after multivariate analysis
Conclusions
The GHQ-28 is a potentially useful instrument to detect psychosocial problems in the family physician's office, and can aid in the subsequent identification andqualitative evaluation of patients
Key words: Psychosocial problem, Stressful life events, Service overuse, Goldberg General Health Questionnaire
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