Descargar este archivo PDF

ÉOL[)RUHUR2UHMDUHQD0DUFHOD$UUHJRFpV6RODQR-XDQ&DUORVÉYLOD9HUD
(ODLQH2UWHJD+HUUHUD'LDQD3DROD2UWL]%XHQR*XLOOHUPR*yPH]0R\D
(VWXGLDQWHGHOD(VSHFLDOL]DFLyQHQ(QGRGRQFLD86DQWR7RPiV0pGLFR\&LUXMDQR'RFHQWH86DQWR7RPiV
3URIHVRU$VRFLDGR8,QGXVWULDOGH6DQWDQGHU
$XWRUUHVSRQVDEOHGHFRUUHVSRQGHQFLDÉOL[)RUHUR2UHMDUHQD
&RUUHRHOHFWUyQLFRDOL[RGRRQWR#KRWPDLOFRP
5(680(1
2EMHWLYR'HVFULELUORVKiELWRVGHXVRGHDQWLPLFURELDQRVVLVWpPLFRVSRUSDUWHGHRGRQWyORJRVJHQHUDOHVHQHOPDQHMRGHODVSDWRORJtDV
SXOSDUHV\SHULDSLFDOHVGHRULJHQSXOSDU
0DWHULDOHV\PpWRGRV(VWXGLRREVHUYDFLRQDOGHVFULSWLYRGHFRUWHWUDQVYHUVDOFRQSREODFLyQGHHVWXGLRFRQIRUPDGDSRURGRQWyORJRV
JHQHUDOHVUHVLGHQWHVHQODFLXGDGGH%XFDUDPDQJDDTXLHQHVPHGLDQWHHQWUHYLVWDGLUHFWDVHDSOLFyXQFXHVWLRQDULRSUHYLDPHQWHYDOL
GDGR6HREWXYRLQIRUPDFLyQGHGLIHUHQWHVYDULDEOHVGHLQWHUpVUHODFLRQDGDVFRQHOXVRGHDQWLPLFURELDQRVVLVWpPLFRVHQODVSDWRORJtDV
UHIHULGDV6HDSOLFDURQSUXHEDVGHHVWDGtVWLFDGHVFULSWLYD\GHDVRFLDFLyQHQWUHYDULDEOHV&KLW6WXGHQWFRQS 5HVXOWDGRV(QWUHHO\HOGHORVRGRQWyORJRVJHQHUDOHVXVDURQVLHPSUHDOJ~QDQWLPLFURELDQRSDUDSDWRORJtDVSXOSDUHVDVt
pVWRVQRHVWXYLHVHQLQGLFDGRV(QWUHHO\HOGHORVRGRQWyORJRVSUHVFULELHURQDOJ~QDQWLPLFURELDQRGHWLSRSURILOiFWLFRHQ
SDFLHQWHVFRQFRPSURPLVRVLVWpPLFR/DDPR[LFLOLQDIXHHODQWLPLFURELDQRPiVSUHVFULWRHQWRGRVORVFDVRV/RVHVTXHPDVGHDGPLQLV
WUDFLyQGHDQWLPLFURELDQRVDWHQGLHURQODVUHFRPHQGDFLRQHVHVWDEOHFLGDVSDUDORVFDVRVWUDWDGRV
&RQFOXVLyQ/RVDQWLPLFURELDQRVVLVWpPLFRVVRQDPSOLDPHQWHXWLOL]DGRVSRURGRQWyORJRVJHQHUDOHVHQODVSDWRORJtDVSXOSDUHV\SHULD
SLFDOHVGHRULJHQSXOSDULQFOXLGRVORVFDVRVHQTXHQRHVWiQLQGLFDGRV>)RUHUR$$UUHJRFHV0ÉYLOD-&2UWHJD(2UWL]'3*yPH]*
8VRGHDQWLPLFURELDQRVVLVWpPLFRVSRURGRQWyORJRVJHQHUDOHVSDUDHOPDQHMRGHSDWRORJtDVSXOSDUHV\SHULDSLFDOHVGHRULJHQSXOSDU
8VWDVDOXG@
3DODEUDVFODYH$QWLPLFURELDQRSDWRORJtDSXOSDUSDWRORJtDSHULDSLFDOHQGRGRQFLD
6<67(0,&$17,0,&52%,$/86(%<*(1(5$/'(17,676)257+(75($70(172)38/3
$1'3(5,$3,&$/3$7+2/2*,(62)38/3$/25,*,1
$%675$&7
2EMHFWLYH7RGHVFULEHWKHKDELWVRIV\VWHPLFDQWLPLFURELDOXVHE\JHQHUDOGHQWLVWVLQWKHWUHDWPHQWRISXOSDQGSHULDSLFDOSDWKRORJ\RI
SXOSDORULJLQV
0HWKRGV$QREVHUYDWLRQDOGHVFULSWLYHFURVVVHFWLRQDOVWXG\ZDVGRQHWKHVXUYH\HGSRSXODWLRQFRQVLVWHGRIJHQHUDOGHQWLVWVOLYLQJ
DW%XFDUDPDQJDFLW\ZKRWKURXJKDGLUHFWLQWHUYLHZDQVZHUHGDSUHYLRXVO\YDOLGDWHGTXHVWLRQQDLUH,QIRUPDWLRQZDVJDWKHUHGIURP
GLIIHUHQWYDULDEOHVRILQWHUHVWUHODWHGWRWKHXVHRIV\VWHPLFDQWLPLFURELDOVLQWKHSDWKRORJLHVLQTXHVWLRQ'HVFULSWLYHVWDWLVWLFVDQG
WHVWVRIDVVRFLDWLRQEHWZHHQYDULDEOHV&KLW6WXGHQWS ZHUHGHYHORSHGEDVHGRQWKHLQIRUPDWLRQUHFROOHFWHG
5HVXOWV%HWZHHQDQGRIWKHGHQWLVWVDOZD\VXVHVRPHDQWLPLFURELDOIRUSXOSSDWKRORJLHVZLWKRXWEHLQJLQGLFDWHG%HWZHHQ
DQGRIGHQWLVWVXVHVRPHW\SHRISURSK\ODFWLFDQWLPLFURELDOLQSDWLHQWVZLWKDV\VWHPLFFRQGLWLRQ$PR[LFLOOLQZDVWKHPRVW
FRPPRQO\XVHGDQWLELRWLFLQDOOFDVHV$GPLQLVWUDWLRQVFKHPHVRIDQWLPLFURELDOVDWWHQGHGWKHHVWDEOLVKHGUHFRPPHQGDWLRQVIRUWKH
WUHDWHGFDVHV
&RQFOXVLRQ$KLJKSURSRUWLRQRIJHQHUDOGHQWLVWVLQ%XFDUDPDQJDXVHV\VWHPLFDQWLPLFURELDOVLQWKHWUHDWPHQWRISXOSDQGSHULDSLFDO
SDWKRORJ\RISXOSDORULJLQVHYHQLIQRWLQGLFDWHG
.H\ZRUGV$QWLPLFURELDOSXOSDOSDWKRORJ\SHULDSLFDOSDWKRORJ\HQGRGRQWLFV
5HFLELGRSDUDSXEOLFDFLyQGHVHSWLHPEUHGH$FHSWDGRSDUDSXEOLFDFLyQGHIHEUHURGH
UstaSalud
Revista
862'($17,0,&52%,$1266,67e0,&263252'217Ð/2*26
*(1(5$/(63$5$(/75$7$0,(172'(3$72/2*Ì$638/3$5(6<
3(5,$3,&$/(6'(25,*(138/3$5
Revista
UstaSalud
ARTÍCULO ORIGINAL
,1752'8&&,Ð1
/DV LQIHFFLRQHV RGRQWRJpQLFDV GH RULJHQ SXOSDU
\ SHULDSLFDO VRQ PX\ IUHFXHQWHV HQ ODV FRQVXOWDV
RGRQWROyJLFDV\SDUDVXWUDWDPLHQWRSRUORJHQHUDO
QRVHLQGLFDHOXVRGHDQWLPLFURELDQRVVLVWpPLFRV
H[FHSWRFXDQGRKD\SUHVHQFLDGHSHULRGRQWLWLVDSL
FDODJXGDVXSXUDWLYDRXQDFRQGLFLyQFOtQLFDVLVWp
PLFDHQHOSDFLHQWH6LQHPEDUJRHQGLYHUVDVRFD
VLRQHVORVRGRQWyORJRVXVDQDQWLPLFURELDQRVSDUD
HO WUDWDPLHQWR GH WRGDV ODV SDWRORJtDV SXOSDUHV
([LVWHQSXEOLFDFLRQHVTXHUHILHUHQODVREUHPHGLFD
FLyQ DQWLPLFURELDQD FRPR SRU HMHPSOR GRQGH HO
GHORVRGRQWyORJRVSUHVFULEHQDQWLPLFURELDQRV
HQWUDWDPLHQWRVHQGRGyQWLFRV\HQUHWUDWDPLHQWRV
6HKDUHSRUWDGRTXHHOGHORVHQGRGRQFLVWDV
SUHVFULEHDQWLPLFURELDQRVSDUDWUDWDUSHULRGRQWLWLV
DSLFDODJXGDVLQLQIODPDFLyQHOORVSUHVFUL
EHSDUDSXOSLWLVLUUHYHUVLEOH\HOSDUDSHULRGRQ
WLWLVDSLFDOFUyQLFD
(QRWURHVWXGLRVHREVHUYyTXHHOGHORVSD
FLHQWHVVHDXWRPHGLFDURQFRQDQWLPLFURELDQRV\HO
HUDQ SUHVFULWRV SRU ORV RGRQWyORJRV 7DP
ELpQVHKDHQFRQWUDGRTXHHOGHORVRGRQWy
ORJRV SUHVFULEHQ DQWLPLFURELDQRV HQ SHULRGRQWLWLV
DSLFDOFUyQLFDQRVXSXUDWLYD\HOHQSHULR
GRQWLWLVDSLFDOFUyQLFDVXSXUDWLYD
3RURWUDSDUWHODUHVLVWHQFLDEDFWHULDQDKDDXPHQ
WDGRHQORV~OWLPRVDxRVSRUHOXVRLQDGHFXDGRGH
DQWLPLFURELDQRV SRU YtD VLVWpPLFD XQLGD DO OHQWR
DYDQFHHQODFUHDFLyQGHQXHYRVPHGLFDPHQWRVDQWL
LQIHFFLRVRV\ODE~VTXHGDGHHVWUDWHJLDVTXHSHUPL
WDQVXFRQWURO(Q&RORPELDODVWDVDVGHUHVLVWHQ
FLDDDQWLPLFURELDQRVHQFRQWUDGDVVRQVXSHULRUHVD
ODVPRVWUDGDVSRUHVWXGLRVGHYLJLODQFLDHQ(VWDGRV
8QLGRV (XURSD \ RWURV SDtVHV GH $PpULFD /DWLQD
/RVSRUFHQWDMHVGHUHVLVWHQFLDEDFWHULDQDRVFLODURQ
SDUDHVWRVHVWXGLRVHQWUHXQ\
/RVDQWLPLFURELDQRVFRQILQHVVLVWpPLFRVHQODVSD
WRORJtDVSXOSDUHVVHSXHGHQXWLOL]DUFRQILQHVSURIL
OiFWLFRVRFXUDWLYRV\VHLQGLFDQFXDQGRKD\FHUWH]D
GHXQSURFHVRLQIHFFLRVRFXDQGRVHFRQVLGHUDTXH
KD\DUHVSXHVWDDODQWLPLFURELDQR\FXDQGRVHDXQD
LQIHFFLyQJUDYH/RVDQWLPLFURELDQRVVHGHEHQDG
PLQLVWUDUSDUDWUDWDULQIHFFLRQHVFRQSRVLELOLGDGGH
GLVHPLQDFLyQVLVWpPLFD\FXDQGRORVKDOOD]JRVFOtQL
FRVQRLQGLFDQXQDSRVLEOHUHVROXFLyQHVSRQWiQHD
/RVVLJQRV\VtQWRPDVTXHVXJLHUHQHOFRPSURPLVR
VLVWpPLFRVRQODILHEUHHOHGHPD\ODLQIODPDFLyQ
FRPRSRUHMHPSORHQODSHULRGRQWLWLVDSLFDODJXGD
VXSXUDWLYDTXHHVOD~QLFDSDWRORJtDGHRULJHQSXO
SDU\SHULDSLFDOTXHUHTXLHUHPHGLFDFLyQDQWLPLFUR
ELDQD(QSDFLHQWHVFRQFRPSURPLVRVLVWpPLFRVH
LQGLFDQHQIRUPDSURILOiFWLFDSDUDWRGDVODVSDWROR
JtDVSXOSDUHV
/DVSDWRORJtDVSXOSDUHVTXHRULJLQDQXQDOHVLyQHQ
GRGyQWLFDSHULDSLFDOSURGXFHQVDOLGDGHVXVWDQFLDV
LUULWDQWHVKDFLDORVWHMLGRVSHULUUDGLFXODUHVORVTXH
VXIUHQGLIHUHQWHJUDGRGHHIHFWRDVXH[SRVLFLyQ\
SUHVHQWDQ GLYHUVRV FDPELRV WLVXODUHV /DV SDWROR
JtDV SHULDSLFDOHV GH RULJHQ SXOSDU VH FODVLILFDURQ
FRPRSHULRGRQWLWLVDSLFDODJXGDQRVXSXUDWLYDSH
ULRGRQWLWLV DSLFDO DJXGD VXSXUDWLYD SHULRGRQWLWLV
DSLFDOFUyQLFDQRVXSXUDWLYD\SHULRGRQWLWLVDSLFDO
FUyQLFDVXSXUDWLYD/DVSDWRORJtDVSXOSDUHVVHFOD
VLILFDURQFRPRSXOSLWLVLUUHYHUVLEOHDJXGD\SXOSLWLV
LUUHYHUVLEOHFUyQLFD
(OSURSyVLWRGHHVWHHVWXGLRIXHGHVFULELUHOXVRGH
DQWLPLFURELDQRVVLVWpPLFRVSRUSDUWHGHRGRQWyOR
JRV JHQHUDOHV HQ HO WUDWDPLHQWR GH ODV SDWRORJtDV
SXOSDUHV\SHULDSLFDOHVGHRULJHQSXOSDU
0$7(5,$/(6<0e72'26
6H UHDOL]y XQ HVWXGLR REVHUYDFLRQDO GHVFULSWLYR GH
FRUWH WUDQVYHUVDO FRQ XQD SREODFLyQ GH HVWXGLR
FRQIRUPDGD SRU RGRQWyORJRV JHQHUDOHV UHVL
GHQWHVHQODFLXGDGGH%XFDUDPDQJD(OWDPDxRGH
ODPXHVWUDIXHFDOFXODGRGHDFXHUGRDODSUHYDOHQFLD
GHOXVRGHDQWLPLFURELDQRVHQSDWRORJtDVSXOSDUHV\
SHULDSLFDOHVGHRULJHQSXOSDUHQFRQWUDGDHQODOLWH
UDWXUDUHYLVDGDTXHYDULyHQWUHHO\HO
FRQXQQLYHOGHFRQILDQ]DGHXQSRGHUGH
\XQQLYHOGHVLJQLILFDQFLDGHO3URJUDPD(SLLQIR
YHUVLyQ
3UHYLR DO LQLFLR GHO HVWXGLR VH UHDOL]y XQD SUXHED
SLORWR FRQ OD SDUWLFLSDFLyQ GH RGRQWyORJRV JH
QHUDOHV VHOHFFLRQDGRV GH PDQHUD DOHDWRULD TXH
FXPSOtDQORVUHTXLVLWRVGHHOHJLELOLGDGHVWDEOHFLGRV
SDUD HVWH HVWXGLR RGRQWyORJRV JHQHUDOHV KRPEUHV
RPXMHUHVJUDGXDGRVTXHHMHUFLHUDQHQODFLXGDGGH
%XFDUDPDQJDGHFXDOTXLHUHGDG\TXHH[SUHVDUDQ
YROXQWDULDPHQWHVXSDUWLFLSDFLyQHQHOHVWXGLR(VWD
SUXHEDSHUPLWLyYDOLGDUHOFXHVWLRQDULRDSOLFDGRHQ
ODHQWUHYLVWDSHUVRQDOHVWDQGDUL]DUSURFHGLPLHQWRV
GHQWURGHOJUXSRGHWUDEDMRFRPRWDPELpQLGHQWLIL
FDU\UHVROYHUDVSHFWRVGHWLSRORJtVWLFR
/RVRGRQWyORJRVJHQHUDOHVSDUWLFLSDQWHVHQHOHVWX
GLRVHVHOHFFLRQDURQGHPDQHUDDOHDWRULDPHGLDQWH
XQ OLVWDGR FRQIRUPDGR D SDUWLU GHO UHJLVWUR GLVSR
QLEOH HQ OD 6HFUHWDUtD GH 6DOXG 'HSDUWDPHQWDO GH
ODLQIRUPDFLyQH[LVWHQWHHQHOGLUHFWRULRWHOHIyQLFR
GHODFLXGDG\GHXQOLVWDGRVXPLQLVWUDGRSRUDOJX
QDVGHODVFDVDVFRPHUFLDOHVTXHSURYHHQSURGXFWRV
RGRQWROyJLFRV
$ ORV RGRQWyORJRV JHQHUDOHV VHOHFFLRQDGRV VH OHV
FRQWDFWy WHOHIyQLFDPHQWH \ VH OHV LQYLWy D SDUWLFL
SDUHQHOHVWXGLRTXLHQHVH[SUHVDURQVXDFHSWDFLyQ
HQ IRUPD YROXQWDULD 6H REWXYR HO FRQVHQWLPLHQWR
LQIRUPDGRRUDOGHFDGDXQRGHORVSDUWLFLSDQWHV\
8VWDVDOXG
)RUHUR$\FRO
/D YDULDEOH GHSHQGLHQWH PiV LPSRUWDQWH IXH HO
XVRGHDQWLPLFURELDQRVVLVWpPLFRVSRUSDUWHGHORV
RGRQWyORJRVJHQHUDOHVHQSDWRORJtDVSXOSDUHV\SH
ULDSLFDOHVGHRULJHQSXOSDU2WUDVYDULDEOHVIXHURQ
HOWLSRGHDQWLPLFURELDQRSUHVFULWRODGRVLILFDFLyQ
HPSOHDGD HO LQWHUYDOR GH DGPLQLVWUDFLyQ OD IUH
FXHQFLDGHXVR\ODIUHFXHQFLDGHVROLFLWXGGHXQDQ
WLPLFURELDQRSRUSDUWHGHORVSDFLHQWHV
/DV YDULDEOHV LQGHSHQGLHQWHV WHQLGDV HQ FXHQWD
UHODFLRQDGDVFRQODSREODFLyQGHHVWXGLRIXHURQHO
JpQHURODHGDGHOWLHPSRGHHMHUFLFLRSURIHVLRQDO
ODDVLVWHQFLDDFDSDFLWDFLyQHQHOiUHDRGRQWROyJLFD
FOtQLFDHOWLHPSRSURPHGLRGHGXUDFLyQGHODFRQ
VXOWDRGRQWROyJLFD
$GHPiV VH WXYLHURQ HQ FXHQWD YDULDEOHV UHODFLR
QDGDV FRQ OD DXVHQFLD R SUHVHQFLD GH FRPSURPLVR
VLVWpPLFRHQORVSDFLHQWHVDWHQGLGRVLQFOXLGDVHQ
GRFDUGLWLVEDFWHULDQDGLDEHWHVPHOOLWXVKHPRILOLD
ILHEUHUHXPiWLFD\XVRGHDQWLFRDJXODQWHVRUDOHV6H
LQGDJyVREUHVLHOSURSyVLWRGHXVRGHORVDQWLPLFUR
ELDQRVWHQtDILQHVSURILOiFWLFRVRFXUDWLYRV
/RV DVSHFWRV pWLFRV VH DFRJLHURQ D OD 5HVROXFLyQ
GHO0LQLVWHULRGH6DOXGDOWHQHUHQFXHQWD
ORVSULQFLSLRVUHODFLRQDGRVFRQHOUHVSHWRDODGLJ
QLGDGODSURWHFFLyQGHORVGHUHFKRV\ODSULYDFLGDG
GHORVVXMHWRV(OSURWRFRORGHLQYHVWLJDFLyQUHFLELy
FRQFHSWR IDYRUDEOH GHO &RPLWp GH ,QYHVWLJDFLRQHV
GH OD )DFXOWDG GH 2GRQWRORJtD GH OD 8QLYHUVLGDG
6DQWR7RPiV
3DUDHOSURFHVDPLHQWRGHODLQIRUPDFLyQVHUHD
OL]yXQDQiOLVLVHVWDGtVWLFRGHVFULSWLYRXQLYDULD
GRVHFRQVLGHUDURQODVYDULDEOHVGHDFXHUGRFRQ
VX QDWXUDOH]D QLYHO GH FODVLILFDFLyQ \ HVFDODV
GHPHGLFLyQ6HDSOLFDURQPHGLGDVGHWHQGHQFLD
FHQWUDO\PHGLGDVGHGLVSHUVLyQ6HOOHYyDFDER
XQDQiOLVLVELYDULDGRSDUDGHWHUPLQDUODUHODFLyQ
GHODVYDULDEOHVLQGHSHQGLHQWHVGHLQWHUpVFRQHO
XVRGHDQWLPLFURELDQRVVLVWpPLFRVHQSDWRORJtDV
SXOSDUHV \ SHULDSLFDOHV \ VH DSOLFDURQ SUXHEDV
GH VLJQLILFDQFLD HVWDGtVWLFD W GH 6WXGHQW &KL
S 5(68/7$'26
(QWUH ORV RGRQWyORJRV JHQHUDOHV SDUWLFLSDQWHV
KXERSUHGRPLQLRGHOJpQHURIHPHQLQRFRQ
(O SURPHGLR GH HGDG GH ORV SDUWLFLSDQWHV
IXH “ DxRV FRQ UDQJR HQWUH \ DxRV(OSURPHGLRGHOWLHPSRGHHMHUFLFLRSURIH
VLRQDOIXH“DxRV'HOWRWDOGHHQFXHV
WDGRVHOKDEtDUHFLELGRFDSDFLWDFLyQ
HQ iUHDV FOtQLFDV GH OD RGRQWRORJtD GLIHUHQWHV D
ODHVSHFLDOLGDGHQHQGRGRQFLDGXUDQWHHO~OWLPR
DxR(OWLHPSRSURPHGLRGHGXUDFLyQGHODFRQ
VXOWDRGRQWROyJLFDIXH“PLQXWRV
(Q UHODFLyQ FRQ HO HMHUFLFLR SURIHVLRQDO SUHGR
PLQyODSUiFWLFDSULYDGDXELFDGDHQVXJUDQPD
\RUtDHQHVWUDWRVRFLRHFRQyPLFR7DEOD
(OXVRGHDQWLPLFURELDQRVVLVWpPLFRVSRUORV
RGRQWyORJRVJHQHUDOHVHQODVSDWRORJtDVSXOSD
UHV \ SHULDSLFDOHV GH RULJHQ SXOSDU VH GHVFULEH
HQOD7DEOD
7DEOD'LVWULEXFLyQGHORVRGRQWyORJRVJHQHUDOHVSRUHVWUDWRVRFLRHFRQyPLFRGHOVLWLRGHWUDEDMR%XFDUDPDQJD
(675$7262&,2(&21Ð0,&2
1Ô0(52
325&(17$-(
7DEOD8VRGHDQWLPLFURELDQRVHQSDWRORJtDVSXOSDUHV\SHULDSLFDOHVSRURGRQWyORJRVJHQHUDOHV%XFDUDPDQJD
3$72/2*Ì$
3HULRGRQWLWLVDSLFDODJXGDVXSXUDWLYD
3HULRGRQWLWLVDSLFDOFUyQLFDVXSXUDWLYD
3HULRGRQWLWLVDSLFDODJXGDQRVXSXUDWLYD
3HULRGRQWLWLVDSLFDOFUyQLFDQRVXSXUDWLYD
1HFURVLVSXOSDU
3XOSLWLVLUUHYHUVLEOHDJXGD
3XOSLWLVLUUHYHUVLEOHFUyQLFD
862$17,0,&52%,$12
Q
)RUHUR$\FRO
8VWDVDOXG
Revista
SRVWHULRUPHQWHVHDSOLFyHOFXHVWLRQDULRPHGLDQWH
HQWUHYLVWDSHUVRQDO
UstaSalud
ARTÍCULO ORIGINAL
Revista
UstaSalud
ARTÍCULO ORIGINAL
(OXVRGHDQWLPLFURELDQRVHQODVSDWRORJtDVSXOSD
UHV\SHULDSLFDOHVFRQILQHVFXUDWLYRVHVDFHSWDEOH
VyORSDUDFDVRVGHSHULRGRQWLWLVDSLFDODJXGDVXSX
UDWLYD\ORVUHVXOWDGRVLQGLFDQTXHORVRGRQWyORJRV
JHQHUDOHVORVSUHVFULELHURQHQ
/DIUHFXHQFLDGHXVRGHDQWLPLFURELDQRVVLVWpPLFRV
SRU ORV RGRQWyORJRV JHQHUDOHV HQ ODV SDWRORJtDV
SXOSDUHV \ SHULDSLFDOHV GH RULJHQ SXOSDU VH GHV
FULEHHQOD7DEOD(QODTXHVyORHOGHORV
RGRQWyORJRVHQWUHYLVWDGRVVLHPSUHSUHVFULEtDDQWL
PLFURELDQRVHQFDVRGHSHULRGRQWLWLVDSLFDODJXGD
VXSXUDWLYD(VIUHFXHQWHHOXVRGHDQWLPLFURELDQRV
VLVWpPLFRVQRLQGLFDGRVHQRWURVFDVRVGHHVWHWLSR
GH SDWRORJtDV (O WLSR GH DQWLPLFURELDQR VLVWpPLFR
SUHVFULWR \ VX IUHFXHQFLD GH XVR VH H[SUHVDQ HQ OD
7DEOD
/DDPR[LFLOLQDIXHHODQWLPLFURELDQRGHPD\RUXVR
HQWRGDVODVSDWRORJtDVSXOSDUHV\SHULDSLFDOHVFRQ
XQDIUHFXHQFLDGHGHORVFDVRV
(O XVR GH ORV DQWLPLFURELDQRV HQ ODV SDWRORJtDV
SXOSDUHV \ SHULDSLFDOHV LQFOXLGR HO WLSR GH WUDWD
PLHQWR SURILOiFWLFR R FXUDWLYR HQ DTXHOORV SD
FLHQWHVFRQFRPSURPLVRVLVWpPLFRVHGHVFULEHHQ
OD7DEOD1R
7DEOD)UHFXHQFLDGHXVRDQWLPLFURELDQRHQSDWRORJtDSXOSDU\SHULDSLFDOSRURGRQWyORJRVJHQHUDOHV%XFDUD
PDQJD
3$72/2*Ì$
6,(035(
)5(&8(1&,$
/$0$<25Ì$'(
/$69(&(6
2&$6,21$/
3HULRGRQWLWLVDSLFDODJXGDVXSXUDWLYD
3HULRGRQWLWLVDSLFDOFUyQLFDVXSXUDWLYD
3HULRGRQWLWLVDSLFDODJXGDQRVXSXUDWLYD
3HULRGRQWLWLVDSLFDOFUyQLFDQRVXSXUDWLYD
1HFURVLVSXOSDU
3XOSLWLVLUUHYHUVLEOHDJXGD
3XOSLWLVLUUHYHUVLEOHFUyQLFD
7DEOD $QWLPLFURELDQRV GH PD\RU XVR HQ SDWRORJtDV SXOSDUHV \ SHULRGRQWDOHV SRU RGRQWyORJRV JHQHUDOHV
%XFDUDPDQJD
$17,0,&52%,$12
)5(&8(1&,$862
Q
3XOSLWLVLUUHYHUVLEOHDJXGD
$PR[LFLOLQD
&HIDOH[LQD
3HULRGRQWLWLVDSLFDOFUyQLFDQRVXSXUDWLYD
$PR[LFLOLQD
'LFOR[DFLOLQD
1HFURVLVSXOSDU
$PR[DFLOLQD
'LFOR[DFLOLQD
3HULRGRQWLWLVDSLFDOFUyQLFDVXSXUDWLYD
$PR[DFLOLQD
'LFOR[DFLOLQD
3XOSLWLVLUUHYHUVLEOHFUyQLFD
$PR[LFLOLQD
$]LWURPLFLQD
3HULRGRQWLWLVDSLFDODJXGDQRVXSXUDWLYD
$PR[DFLOLQD
'LFOR[DFLOLQD
3HULRGRQWLWLVDSLFDODJXGDVXSXUDWLYD
$PR[DFLOLQD
'LFOR[DFLOLQD
3$72/2*Ì$
8VWDVDOXG
)RUHUR$\FRO
VLVWpPLFRHOXVRGHDQWLPLFURELDQRVVHGHEHUHDOL]DU
FRQILQHVSURILOiFWLFRV
/DDVRFLDFLyQGHOXVRGHDQWLPLFURELDQRVVLVWpPLFRV
HQSDWRORJtDVSXOSDUHV\SHULDSLFDOHV\VXUHODFLyQ
FRQYDULDEOHVLQGHSHQGLHQWHVGHLQWHUpVVHGHVFULEH
HQOD7DEOD
7DEOD)UHFXHQFLDGHXVRDQWLPLFURELDQRHQSDFLHQWHVFRQFRPSURPLVRVLVWpPLFRSRURGRQWyORJRVJHQHUDOHV
%XFDUDPDQJD
862'($17,0,&52%,$126
3523Ð6,72'(/75$7$0,(172
6,
1
12
1
352),/É&7,&2
1
&85$7,92
1
352),/É&7,&2<
&85$7,92
1
1,1*812
1
(QGRFDUGLWLVEDFWHULDQD
'LDEHWHVPHOOLWXV
+HPRILOLD
$QWLFRDJXODFLyQ
)LHEUHUHXPiWLFD
3$72/2*Ì$
7DEOD8VRGHDQWLPLFURELDQRVHQSDWRORJtDVSXOSDUHV\SHULDSLFDOHVVHJ~QYDULDEOHVLQGHSHQGLHQWHV%XFD
UDPDQJD
862$17,0,&52%,$126
3$72/2*Ì$
3XOSLWLVLUUHYHUVLEOHDJXGD
3XOSLWLVLUUHYHUVLEOHFUyQLFD
3HULRGRQWLWLVDSLFDODJXGD
VXSXUDWLYD
3HULRGRQWLWLVDSLFDODJXGDQR
VXSXUDWLYD
9$5,$%/(6,1'(3(1',(17(6
9$/253
6,
Q
12
Q
*pQHUR
)HPHQLQR
0DVFXOLQR
7UDEDMDLQVWSDUWLFXODUHV
6L
1R
(GDG
DxRVRPiV
0HQRVGHDxRV
$xRVGHHJUHVDGR
RPiVDxRV
0HQRVGHDxRV
7UDEDMDHQLQVWSDUWLFXODU
6L
1R
'XUDFLyQGHODFRQVXOWD
0D\RUGHPLQXWRV
PLQXWRVRPHQRV
(VWUDWRVRFLRHFRQyPLFR
\
\
&KLWGH6WXGHQW
)RUHUR$\FRO
8VWDVDOXG
Revista
/D IUHFXHQFLD GH XVR GH DQWLPLFURELDQRV FRQ ILQHV
SURILOiFWLFRVHQSDWRORJtDVSXOSDUHV\SHULDSLFDOHV
SDUDSDFLHQWHVFRQFRPSURPLVRVLVWpPLFRHVEDMDOD
IUHFXHQFLDHVGHXVRDFHSWDEOHVyORHQFDVRVGHHQ
GRFDUGLWLVEDFWHULDQD(QFXDOTXLHUSDWRORJtD
SXOSDU\SHULDSLFDOSDUDSDFLHQWHVFRQFRPSURPLVR
UstaSalud
ARTÍCULO ORIGINAL
Revista
UstaSalud
ARTÍCULO ORIGINAL
3DUD OD SXOSLWLV LUUHYHUVLEOH DJXGD QR VH KDOODURQ
GLIHUHQFLDVHVWDGtVWLFDPHQWHVLJQLILFDWLYDVVHJ~QHO
HVWUDWRVRFLRHFRQyPLFRHVGHVWDFDGRTXHHOGH
ORV RGRQWyORJRV TXH XVDURQ DQWLPLFURELDQRV SDUD
HVWDSDWRORJtDWUDEDMDODPD\RUSDUWHGHVXWLHPSR
HQLQVWLWXFLRQHVTXHVHHQFXHQWUDQHQHVWUDWRV
\S (Q OD SXOSLWLV LUUHYHUVLEOH DJXGD OD PD\RUtD GH
RGRQWyORJRVTXHXVDQDQWLPLFURELDQRVVRQGHOJp
QHURIHPHQLQRORFXDOHYLGHQFLDPHQRUSRU
FHQWDMHGHQRXVRSRUSDUWHGHORVKRPEUHV
S 'HLJXDOPDQHUDVHHQFRQWUyGLIHUHQFLD
HVWDGtVWLFDSDUDXVRGHDQWLPLFURELDQRVHQUHODFLyQ
FRQHOKHFKRGHWUDEDMDUHQLQVWLWXFLRQHVSDUWLFXOD
UHVLQFOXLGDODFRQVXOWDSULYDGDS 3DUD OD SXOSLWLV LUUHYHUVLEOH FUyQLFD VH GHWHFWDURQ
GLIHUHQFLDVVLJQLILFDWLYDVFXDQGRVHWXYRHQFXHQWD
HOVLWLRGRQGHHORGRQWyORJRODERUDS &RQ
UHVSHFWRDODSHULRGRQWLWLVDSLFDODJXGDVXSXUDWLYD
HOXVRGHDQWLPLFURELDQRVVHGHPRVWUyDVRFLDGRFRQ
ODHGDGGHORVSDUWLFLSDQWHVS \FRQHOWLHP
SRTXHOOHYDGHHJUHVDGRFRPRSURIHVLRQDOGHRGRQ
WRORJtDS (Q FXDQWR D OD SHULRGRQWLWLV DSLFDO DJXGD QR VX
SXUDWLYD VH HQFRQWUDURQ GLIHUHQFLDV HVWDGtVWLFDV
UHODFLRQDGDV FRQ HO HMHUFLFLR SURIHVLRQDO HQ LQVWL
WXFLRQHVSDUWLFXODUHVS \DTXHHOWRWDOGH
SURIHVLRQDOHV TXH XVDQ DQWLPLFURELDQRV HQ HVWD
SDWRORJtD ODERUD HQ HVWH WLSR GH LQVWLWXFLRQHV
'HPDQHUDVLPLODUVHHQFRQWUDURQUHVXO
WDGRVHVWDGtVWLFRVVLJQLILFDWLYRVSDUDHOXVRGHDQ
WLPLFURELDQRV VLVWpPLFRV VHJ~Q HO WLHPSR GH GX
UDFLyQGHODFRQVXOWDS SXHVHOGH
ODV FRQVXOWDV RGRQWROyJLFDV WHQtDQ XQD GXUDFLyQ
PHQRUGHPLQXWRV
',6&86,Ð1
FDOFUyQLFDVXSXUDWLYDHQXQ\SDUDODSHULR
GRQWLWLVDSLFDOFUyQLFDQRVXSXUDWLYDHQXQ
3DUD OD SHULRGRQWLWLV DSLFDO DJXGD QR VXSXUDWLYD
VHHQFRQWUyXQGHXVRGHDQWLPLFURELDQRV
PLHQWUDV HVWXGLRV UHDOL]DGRV SRU HO &RPLWp $PH
ULFDQRGH(QGRGRQFLD\SRU:KLWWHQ\FRODER
UDGRUHVHQFRQWUDURQXQ\XQUHVSHFWL
YDPHQWHGHSUHVFULSFLyQSDUDHVWDDOWHUDFLyQSH
ULDSLFDO7DPELpQVHREVHUYyXQGHXVRGH
DQWLPLFURELDQRV HQ FDVR GH QHFURVLV SXOSDU pVWD
HVXQDSURSRUFLyQVLPLODUDODKDOODGDSRU<LQJOLQJ
\FRODERUDGRUHV\PD\RUDODUHSRUWDGDHQ
RWURVHVWXGLRV
(VWHHVWXGLRPRVWUyTXHVHXVDQDQWLPLFURELDQRV
SDUD OD SHULRGRQWLWLV DSLFDO DJXGD VXSXUDWLYD HQ
XQ VLPLODU D RWURV HVWXGLRV FRQ XQ \/RVRGRQWyORJRVJHQHUDOHVTXHHMHUFHQ
HQ LQVWLWXFLRQHV SDUWLFXODUHV WLHQGHQ D XVDU PiV
DQWLPLFURELDQRV VLVWpPLFRV \ HQ ORV HVWUDWRV VR
FLRHFRQyPLFRV\SRVLEOHPHQWHSDUDSUHYH
QLUDOJXQDFRPSOLFDFLyQGHVSXpVGHODDWHQFLyQDO
SDFLHQWH
(VHVHQFLDOWHQHUHQFXHQWDTXHQRKD\LQGLFDFLyQ
SDUDHOXVRGHDQWLPLFURELDQRVVLVWpPLFRVHQFDVR
GH SDWRORJtDV SXOSDUHV \ SHULDSLFDOHV GH RULJHQ
SXOSDUFRQILQHVWHUDSpXWLFRVRSURILOiFWLFRVH[
FHSWRHQODSHULRGRQWLWLVDSLFDODJXGDVXSXUDWLYD
HQSDFLHQWHVFRQFRPSURPLVRVLVWpPLFR(VWiGH
PRVWUDGRPHGLDQWHGLYHUVRVHVWXGLRVTXHVXXVR
QR GLVPLQX\H HO GRORU SXOSDU QL OD VHQVLELOLGDG
D OD SHUFXVLyQ VLQ WUDWDU HO GLHQWH HQGRGyQWLFD
PHQWH
(QHVWHHVWXGLRVHHQFRQWUyTXHHODQWLPLFURELDQR
PiVXVDGRHQODSHULRGRQWLWLVDSLFDODJXGDVXSXUD
WLYDIXHODDPR[LFLOLQDHQXQHVWDSURSRUFLyQ
HVPD\RUDODHQFRQWUDGDHQXQHVWXGLRHQ&XED
GH
(VWHHVWXGLRPXHVWUDXQDIUHFXHQFLDGHXVRGHDQ
WLPLFURELDQRVHQODSXOSLWLVLUUHYHUVLEOHDJXGDGH
XQPLHQWUDVXQHVWXGLRHQ(VWDGRV8QLGRV
HVWDEOHFLySUHVFULSFLyQGHHVWRVPHGLFDPHQWRVGH
SDUD OD PLVPD SDWRORJtD (O UHVXOWDGR GHO
XVR GH DQWLPLFURELDQRV HQ SXOSLWLV LUUHYHUVLEOH
DJXGDSRURGRQWyORJRVJHQHUDOHVHQHVWHHVWXGLR
IXHPD\RUFRPSDUDGRFRQRWURHVWXGLRHQHOTXHVH
HQFRQWUyXQFRQXQDPXHVWUDGHRGRQ
WyORJRVJHQHUDOHVHQFXHVWDGRV
6HJ~QORVHVWXGLRVUHYLVDGRVHQHOWUDWDPLHQWRGH
ODVSXOSLWLVLUUHYHUVLEOHVDJXGDV\FUyQLFDVQRKD\
LQGLFDFLyQSDUDHOXVRGHDQWLPLFURELDQRVVyORVH
HOLPLQDHOWHMLGRSXOSDU\SRVWHULRUPHQWHVHUHD
OL]D HO WUDWDPLHQWR GHO FRQGXFWR UDGLFXODU
2WURV HVWXGLRV GHPRVWUDEDQ TXH HQ OD QHFURVLV
SXOSDUQRKD\LQGLFDFLyQSDUDHOXVRGHDQWLPLFUR
ELDQRV\HOWUDWDPLHQWRGHEHVHUODWHUDSLDHQGR
GyQWLFD
(O SUHVHQWH HVWXGLR PRVWUy XQ GH XVR GH
DQWLPLFURELDQRVSDUDODSHULRGRQWLWLVDSLFDOFUyQL
FDVXSXUDWLYDPLHQWUDVTXHSDUDODSHULRGRQWLWLV
DSLFDO FUyQLFD QR VXSXUDWLYD IXH GH (VWRV
UHVXOWDGRV VRQ FRPSDUDWLYDPHQWH PD\RUHV D XQ
HVWXGLRUHDOL]DGRHQ$UJHQWLQDHQHOTXHVHSUHV
FULEtDQDQWLPLFURELDQRVSDUDODSHULRGRQWLWLVDSL
(Q HO WUDWDPLHQWR GH OD SHULRGRQWLWLV DSLFDO FUy
QLFD VXSXUDWLYD QR VH KD LQFOXLGR HO XVR GH DQWL
PLFURELDQRV SDUD FRQWURODU OD LQIHFFLyQ FDXVDGD
SRUPLFURRUJDQLVPRVVyORVHLQGLFDODWHUDSLDHQ
GRGyQWLFD FRPR WDO FRQ VyOR UHDOL]DU OD DSHUWXUD
GHO FRQGXFWR VH URPSH OD DQDHURELRVLV (VWXGLRV
GHPXHVWUDQ TXH HVWD SDWRORJtD HV PDQHMDGD SRU
8VWDVDOXG
)RUHUR$\FRO
(OXVRGHDQWLPLFURELDQRVVyORHVWiLQGLFDGRHQFDVR
GHSHULRGRQWLWLVDSLFDODJXGDVXSXUDWLYDHQODFXDO
H[LVWHXQHGHPDGLIXVRTXHSXHGHLUGHVGHOD]RQD
DG\DFHQWH DO GLHQWH DIHFWDGR KDVWD LQYDGLU ORV HV
SDFLRVDSRQHXUyWLFRVFRQODSRVLELOLGDGGHFRPSUR
PHWHUODYLGDGHOSDFLHQWH$OSULQFLSLRGHOSURFHVR
HVGLItFLOORFDOL]DUHOGLHQWHDIHFWDGRSUHVHQWDFLHUWD
PRYLOLGDG \ HVWi OLJHUDPHQWH H[WUXLGR $OJXQRV
HVWXGLRV UHSRUWDQ TXH GHQWUR GH ORV DQWLPLFURELD
QRVGHHOHFFLyQHQHVWDSDWRORJtDHVWiODSHQLFLOLQD
9TXHHVODGHHOHFFLyQOXHJRODDPR[LFLOLQDGH
PJ\ODDPR[LFLOLQDPiVHOiFLGRFODYXOyQLFR\DTXH
FRQVHUYD VX DFWLYLGDG FRQWUD ODV EHWDODFWDPDVDV
SURGXFLGDVSRURUJDQLVPRVTXHVHDVRFLDQDLQIHF
FLRQHV RGRQWRJpQLFDV /D GXUDFLyQ LGHDO GH OD
WHUDSLD DQWLPLFURELDQD GHEH VHU GH D GtDV (Q
FDVRGHOSDFLHQWHDOpUJLFRDODVSHQLFLOLQDVVHXVDOD
FOLQGDPLFLQD
(VWH HVWXGLR PXHVWUD TXH HO DQWLPLFURELDQR TXH
PiV XVDQ ORV RGRQWyORJRV JHQHUDOHV HQFXHVWDGRV
SDUD ODV SDWRORJtDV SXOSDUHV \ SHULDSLFDOHV GH RUL
JHQSXOSDU\SHULDSLFDOIXHODDPR[LFLOLQDFRQGRVLV
GHPJGHDGtDVFRQXQLQWHUYDORGHD
KRUDV
6LPLODUDRWURVHVWXGLRVUHYLVDGRVHQORVTXHVHHQ
FRQWUy TXH HO HVTXHPD WHUDSpXWLFR GH ORV DQWLPL
FURELDQRVVLVWpPLFRVHQFDVRGHSHULRGRQWLWLVDSL
FDODJXGDVXSXUDWLYDHVODSHQLFLOLQD8,
XQDDPSROODFDGDKRUDVSRUGRVGtDVDPR[LFLOLQD
PJ YtD RUDO XQD FDGD KRUDV SRU D GtDV
FOLQGDPLFLQDPJYtDRUDOXQDFDGDKRUDVSRU
DGtDVHQFDVRGHSHUVRQDVDOpUJLFDVDODVSHQL
FLOLQDV
(VWXGLRVUHYLVDGRVPXHVWUDQTXHSDUDHOWUDWDPLHQ
WRGHWRGDVODVSDWRORJtDVSXOSDUHV\SHULDSLFDOHVGH
RULJHQSXOSDUHQSDFLHQWHVFRQFRPSURPLVRVLVWpPL
FRFRPRHQGRFDUGLWLVEDFWHULDQDGLDEHWHVPHOOLWXV
KHPRILOLDSDFLHQWHVFRQPHGLFDFLyQDQWLFRDJXODQWH
\ILHEUHUHXPiWLFDVHXVDQVLHPSUHDQWLPLFURELDQRV
VLVWpPLFRVFRQILQHVSURILOiFWLFRVODDPR[LFLOLQDHV
ODSULPHUDHOHFFLyQ(QRWURVHVWXGLRVVHREVHU
YDURQORVHVTXHPDVSURILOiFWLFRVGHHOHFFLyQHQWUH
HOORVODDPR[LFLOLQDJUYtDRUDOXQDKRUDDQWHV
GHOSURFHGLPLHQWRHQSDFLHQWHVDOpUJLFRVFOLQGDPL
FLQD PJ YtD RUDO XQD KRUD DQWHV GHO SURFHGL
PLHQWR
(Q HVWH HVWXGLR VH HQFRQWUy TXH ORV RGRQWyORJRV
JHQHUDOHV XVDQ HQ EDMD SURSRUFLyQ DQWLPLFURELD
QRV FRQ ILQHV SURILOiFWLFRV HQ SDFLHQWHV FRQ FRP
SURPLVRVLVWpPLFR8QDSRVLEOHH[SOLFDFLyQDHVWRV
UHVXOWDGRVHVODIDOWDGHFDSDFLWDFLyQSRUSDUWHGH
ORV RGRQWyORJRV JHQHUDOHV HQ WHPDV UHODFLRQDGRV
FRQ HQGRGRQFLD GLDJQyVWLFR \ WHUDSpXWLFD DQWLPL
FURELDQDVLQHPEDUJRVHSHUFLELyXQPD\RULQWHUpV
SRUODDFWXDOL]DFLyQHQRWUDViUHDVGHODRGRQWROR
JtDXQDH[SOLFDFLyQVLPLODUIXHVXJHULGDSRU=DULN\
/HYLQ3RURWUDSDUWHHOSRFRWLHPSRGHGXUDFLyQ
GHODFRQVXOWDRGRQWROyJLFDQRSHUPLWHTXHHORGRQ
WyORJRJHQHUDOUHDOLFHXQGLDJQyVWLFRDGHFXDGROR
FXDO SXHGH LQIOXLU HQ OD WHUDSLD IDUPDFROyJLFD TXH
VHUHFRPLHQGD
2WUDSRVLEOHLQWHUSUHWDFLyQGHORVKDOOD]JRVDQWHULR
UHVVHEDVDHQHOVXSXHVWRTXHORVRGRQWyORJRVJH
QHUDOHVGHFLGHQUHDOL]DUHOWUDWDPLHQWRHQGRGyQWLFR
SHUR SULPHUR UHFXUUHQ DO XVR GH DQWLPLFURELDQRV
SDUD UHVROYHU HO SUREOHPD LQIHFFLRVR LQLFLDO \ SRV
WHULRUPHQWHOOHYDUDFDERODHQGRGRQFLD(VLPSRU
WDQWHTXHFXDQGRHORGRQWyORJRJHQHUDOUHDOLFHXQ
GLDJQyVWLFRGHXQDHQIHUPHGDGSXOSDURSHULDSLFDO
GHRULJHQSXOSDUVHYDORUHGHIRUPDLQWHJUDOODFRQ
GLFLyQFOtQLFD\VHFRQVLGHUHODUHPLVLyQDOHQGRGRQ
FLVWDFXDQGRHOFDVRORDPHULWH
8QDIRUWDOH]DGHHVWHHVWXGLRFRQVLVWHHQODIRUPD
FLyQ DFDGpPLFD GHO SHUVRQDO HQFDUJDGR GH OD DSOL
FDFLyQGHOFXHVWLRQDULRGXUDQWHODVHQWUHYLVWDVSHU
VRQDOHV\ODUHFROHFFLyQGHODLQIRUPDFLyQTXLHQHV
HUDQRGRQWyORJRVUHVLGHQWHVGHO~OWLPRDxRGHOD(V
SHFLDOL]DFLyQHQ(QGRGRQFLDGHELGDPHQWHHQWUHQD
GRV\FDSDFLWDGRVSDUDHOGLDJQyVWLFR\WUDWDPLHQWR
UHODFLRQDGRFRQODVSDWRORJtDVSXOSDUHVHVWHDVSHF
WRSHUPLWLyWDPELpQUHVROYHUGHPDQHUDDGHFXDGD
ODVSUHJXQWDVGHORVRGRQWyORJRVJHQHUDOHVHQFXHV
WDGRV \ GDUOHV RULHQWDFLyQ VREUH HO PDQHMR GH ODV
SDWRORJtDVSXOSDUHV\SHULDSLFDOHVGHRULJHQSXOSDU
2WURDVSHFWRLPSRUWDQWHFRQVLVWHHQHOPHFDQLVPR
GHDSOLFDFLyQGHODHQFXHVWDODFXDOQRIXHDXWRGL
OLJHQFLDGD VLQR TXH VH UHDOL]y PHGLDQWH HQWUHYLVWD
GLUHFWD\DGPLQLVWUDGD'HHVWDPDQHUDVHFRQWUR
Oy HQ EXHQD PHGLGD OD FDOLGDG GH ODV UHVSXHVWDV
REWHQLGDV 7DPELpQ FDEH GHVWDFDU HO DOWR QLYHO GH
LQWHUpV SRU SDUWH GH ORV RGRQWyORJRV HQFXHVWDGRV
ORVFXDOHVH[SUHVDURQVXVLQTXLHWXGHV\GXGDVTXH
IXHURQDWHQGLGDVSRUORVLQWHJUDQWHVGHOHTXLSRGH
LQYHVWLJDFLyQ
)LQDOPHQWHVHSXHGHFRQFOXLUTXHXQDDOWDSURSRU
FLyQGHRGRQWyORJRVJHQHUDOHVXVDURQDQWLPLFURELD
QRVVLVWpPLFRVHQSDWRORJtDVSXOSDUHV\SHULDSLFDOHV
GH RULJHQ SXOSDU D~Q FXDQGR QR HVWpQ LQGLFDGRV
(O DQWLPLFURELDQR PiV SUHVFULWR IXH OD DPR[LFLOL
QD 8QD EDMD SURSRUFLyQ GH RGRQWyORJRV XVDQ DQ
WLPLFURELDQRVVLVWpPLFRVFRQILQHVSURILOiFWLFRV(V
HVHQFLDOSURPRYHUPHGLDQWHDFWLYLGDGHVHGXFDWLYDV
GLULJLGDVDORGRQWyORJRJHQHUDOHOXVRFRUUHFWRGH
DQWLPLFURELDQRVHQFXDQWRDODLQGLFDFLyQHOHFFLyQ
)RUHUR$\FRO
8VWDVDOXG
Revista
ORV RGRQWyORJRV JHQHUDOHV FRQ DQWLPLFURELDQRV
PHGLDQWHXVRLQGLVFULPLQDGRHQFXDQWRDHOHFFLyQ
GRVLV\IUHFXHQFLDGHDGPLQLVWUDFLyQ
UstaSalud
ARTÍCULO ORIGINAL
Revista
UstaSalud
ARTÍCULO ORIGINAL
GRVLVIUHFXHQFLDGHDGPLQLVWUDFLyQ\GXUDFLyQGHOD
WHUDSLDDVtFRPRUHFRPHQGDUODUHPLVLyQDOHVSHFLD
OLVWDHQHQGRGRQFLDFXDQGRHOFDVRORDPHULWH$Vt
PLVPRVHUHTXLHUHDPSOLDUHOWLHPSRGHODFRQVXOWD
RGRQWROyJLFDSDUDSRGHUUHDOL]DUGLDJQyVWLFRVDGH
FXDGRV\WUDWDPLHQWRVySWLPRV
%,%/,2*5$)Ì$
:DOWRQ5(7RUDELQHMDG0(QGRGRQFLD3ULQFLSLRV\3UiF
WLFD &OtQLFD GD (GLFLyQ 3KLODGHOSKLD ,QWHUDPHULFDQD
0F*UDZ+LOO
=DGLN < /HYLQ / &OLQLFDO GHFLVLRQ PDNLQJ LQ UHVWRUDWL
YH GHQWLVWU\ HQGRGRQWLFV DQG DQWLELRWLF SUHVFULSWLRQ -
'HQW (GXF >HQ OtQHD@ -DQ >)HFKD GH DFFHVR PDU]R
GH @ 85/ GLVSRQLEOH HQ KWWSZZZ
MGHQWDOHGRUJFJLFRQWHQWIXOO
<LQJOLQJ10%\UQH%(+DUWZHOO*5$QWLELRWLFXVHE\
PHPEHUVRIWKH$PHULFDQ$VVRFLDWLRQRI(QGRGRQWLVWVLQ
WKH\HDU5HSRUWRID1DWLRQDO6XUYH\-(QGRG
5RGUtJXH]+6RODU28VRLQGLVFULPLQDGRGHWHWUDFLFOLQD
HQ DIHFFLRQHV EXFDOHV GH RULJHQ RGRQWROyJLFR 5HY &XE
(VWRPDWRO >HQ OtQHD@ >)HFKD GH DFFHVR PDU]R GH
@85/GLVSRQLEOHHQKWWSVFLHORVOGFXVFLH
ORSKS"
(QVLQDV3$QiOLVLVGHORVKiELWRVGHPHGLFDFLyQDQWLELy
WLFDSRUSDUWHGHRGRQWyORJRVJHQHUDOHVDQWHGLIHUHQWHV
SDWRORJtDV SXOSDUHV >HQ OtQHD@ >)HFKD GH DFFHVR
PDU]R GH @ 85/ GLVSRQLEOH HQ KWWSZZZFDU
ORVERYHGDFRPHQJOLVKVLWHGHQWDOJXHVWKWP
7REyQ)(VWXGLRVREUHDXWRPHGLFDFLyQHQOD8QLYHUVLGDGGH
$QWLRTXLD/DWUHLD0HGHOOtQ'LFLHPEUH
3pUH]+)DUPDFRORJtD\7HUDSpXWLFD2GRQWROyJLFDGD
(G%RJRWi&HOVXV
&DYLHGHV-(VWpYH]0&5RMDV3$$QWLELyWLFRVHQHOPDQHMR
GHODVLQIHFFLRQHVRGRQWRJpQLFDVGHRULJHQHQGRGyQWLFR
>HQOtQHD@>)HFKDGHDFFHVRDEULOGH@$UWtFXORV
GH5HYLVLyQ3RVJUDGRGH(QGRGRQFLD85/GLVSRQLEOHHQ
KWWSZZZMDYHULDQDHGXFRDFDGHPLDSJHQGRGRQFLD
LBDBUHYLVLRQKWPO
&DEUHUD&(*yPH]5)=~xLJD$(/DUHVLVWHQFLDGHEDF
WHULDV D DQWLELyWLFRV DQWLVpSWLFRV \ GHVLQIHFWDQWHV XQD
PDQLIHVWDFLyQ GH ORV PHFDQLVPRV GH VXSHUYLYHQFLD \
DGDSWDFLyQ&RORPELD0HG
,QJOH-(QGRGRQFLDWD(G0p[LFR0F*UDZ+LOO
6LJXUGVVRQ $ 3XOSDO GLDJQRVLV (QGRG 7RSLFV ²
*DWHZRRG56+LPHO97'RUQ627UHDWPHQWRIWKHHQGRGRQ
WLFHPHUJHQF\DGHFDGHODWHU-(QGRG
:KLWWHQ%+*DUGLQHU'/-HDQVRQQH%*/HPRQ55&X
UUHQWWUHQGVLQHQGRGRQWLFVWUHDWPHQWUHSRUWRIDQDWLR
QDOVXUYH\-$P'HQW$VVRF
0LOLDQ9304XLURV(0%R]D0'6DQWRV310DUWtQ$&
&DUDFWHUL]DFLyQGHOXVRGHDQWLPLFURELDQRVHQODVLQIHF
FLRQHVHVWRPDWROyJLFDVHQXQiUHDGHVDOXGGH&XED,QW-
2GRQWRVWRPDW
$EERW 39 +XPH : 3HDUPDQ -: $QWLELRWLFV DQG HQGR
GRQWLFV$XVW'HQW-
6XWKHUODQG6$QWLELRWLFVGRQRWUHGXFHWRRWKDFKHFDXVHG
E\LUUHYHUVLEOHSXOSLWLV$UHV\VWHPDWLFDQWLELRWLFVHIIHFWL
YHLQSURYLGLQJSDLQUHOLHILQSHRSOHZKRKDYHLUUHYHUVL
EOHSXOSLWLV"(YLG%DVHG'HQW
)LFD$0DQHMRGHODIDULQJRDPLJGDOLWLVHVWUHSWRFyFLFDHQ
SDFLHQWHV DGXOWRV R DGROHVFHQWHV 5HY &KLO ,QIHFW )RXDG$)$UHDQWLELRWLFVHIIHFWLYHIRUHQGRGRQWLFSDLQ"
$QHYLGHQFHEDVHGUHYLHZ(QGRG7RSLFV
)D\DG , 3UHVHQFLD GH PLFURRUJDQLVPRV SURGXFWRUHV GH
%HWDODFWDPDVDHQGLHQWHVFRQSHULRGRQWLWLVDSLFDOFUyQL
FDVXSXUDWLYD5HYLVWD)HGHUDFLyQ2GRQWROyJLFD&RORP
ELDQD
'XPVKD7*XWPDQQ-3UREOHPVLQ0DQDJLQJ(QGRGRQ
WLF (PHUJHQFLHV (Q *XWPDQQ - 'XPVKD 7 /RYGDKO 3
+RYODQG(3UREOHP6ROYLQJLQ(QGRGRQWLFV3UHYHQWLRQ
,GHQWLILFDWLRQDQG0DQDJHPHQWGD(G6W/RXLV0RVE\
SS
3ODQHOOVGHO3R]R3%DUUD6RWR0-$QWLELRWLFSURSK\OD[LV
LQSHGLDWULFRGRQWRORJ\$QXSGDWH0HGLFLQD2UDO3DWR
ORJtD2UDO\&LUXJtD%XFDO²
5HWDQD $* 3URWRFROR GH DWHQFLyQ RGRQWROyJLFD HQ SD
FLHQWHVFRQWUDVWRUQRVKHPDWROyJLFRV5HYLVWD5KRPEXV
%ULQFDW06DYDUULR/6DXQGHUV:(QGRGRQWLFVDQGLQ
IHFWLYHHQGRFDUGLWLVLVDQWLPLFURELDOFKHPRSURSK\OD[LV
UHTXLUHG",QW(QGRG-
:LOVRQ:7DXEHUW.$*HZLW]0/RFNKDUW3%%DGGRXU
/0/HYLVRQ0HWDO3UHYHQWLRQRILQIHFWLYHHQGRFDUGL
WLV*XLGHOLQHVIURPWKH$PHULFDQ+HDUW$VVRFLDWLRQD
JXLGHOLQHIURPWKH$PHULFDQ+HDUW$VVRFLDWLRQ5KHXPD
WLF)HYHU(QGRFDUGLWLVDQG.DZDVDNL'LVHDVH&RPPLWWHH
&RXQFLORQ&DUGLRYDVFXODU'LVHDVHLQWKH<RXQJDQGWKH
&RXQFLO RQ &OLQLFDO &DUGLRORJ\ &RXQFLO RQ &DUGLRYDVFX
ODU6XUJHU\DQG$QHVWKHVLDDQGWKH4XDOLW\RI&DUHDQG
2XWFRPHV 5HVHDUFK ,QWHUGLVFLSOLQDU\ :RUNLQJ *URXS -
$P'HQW$VVRF²
6LQJK-$QWLELRWLFSURSK\OD[LVIRUHQGRFDUGLWLVWLPHWR
UHFRQVLGHU $XVW 'HQW - 0HGLFDWLRQV 6XSSOHPHQW 8VWDVDOXG
)RUHUR$\FRO