Tesis doctorales, maestría y licenciatura http://speiro.usma.ac.pa/handle/123456789/22 2026-04-17T10:40:49Z 2026-04-17T10:40:49Z Pauli-Quirós, Elianne http://speiro.usma.ac.pa/handle/123456789/629 2026-01-06T19:03:33Z 2024-01-01T00:00:00Z

EVALUACIÓN DE UN PROGRAMA DE INTERVENCIONES COGNITIVAS Y FÍSICAS EN ADULTOS MAYORES EN LA CIUDAD DE PANAMÁ DURANTE 2023 Y 2024 Pauli-Quirós, Elianne Introduction: Dementia, as the most severe form of cognitive impairment, is the leading cause of disability in older adults and currently affects nearly 50 million people globally, with projections reaching 82 million by 2030 and 152 million by 2050. Likewise, the prevalence of dementia, one of the highest globally in Latin America and the Caribbean, is on the rise due to rapid population aging, social inequalities and associated risk factors. Currently, pharmacological interventions to delay cognitive decline have proven to be insufficient. On the other hand, non-pharmacological approaches have gained attention in recent years because they are therapies with minimal risk, which are aimed at preventing deterioration, improving clinical symptoms and decreasing the burden on caregivers. Evidence suggests that physical and cognitive interventions may have a positive effect on the health of older adults. Objective: To evaluate the effect of a program of physical and cognitive interventions on cognition, subjective well-being and physical health in older adults living in Panama City, Panama. Methods: This was a three-arm, single-blind, randomized controlled trial experimental intervention study. The sample consisted of 43 participants aged 60-80 years. Participants who entered the study completed a sociodemographic interview, clinical scales, a battery of cognitive tests and a physical assessment at pre-assessment. After randomization, they were divided into three groups: 1) experimental group 1 (n=15) participated in cognitive and physical interventions, including computerized cognitive training in CogniFit, group sessions of cognitive stimulation and training, and walks 3 to 5 times a week; 2) experimental group 2 (n=15) participated exclusively in walks; and 3) active control group (n=13) received informative talks about health once a month. In addition, experimental groups 1 and 2 participated in group walks once a month. After the intervention, a post-evaluation was carried out applying the same initial measures. Results: Improvements in performance on neuropsychological tests were observed when comparing pre- and post-assessment scores for the three groups. In terms of cognitive outcomes, the combined group showed significant 7 improvements in global cognition (MoCA) and the executive function of abstraction (INECO Refrains subtest). The group that received only physical interventions presented improvements in learning (CERAD Short-term Memory test and Short-term Visual Reproductive), visuospatial skills (Short-term Visual Reproduction Test) and long-term memory (Long-term Visual Reproduction Test). In the control group, increases in learning subtest scores (Short-term Visual Reproduction Test) and the executive function of inhibition (Hayling subtest of the INECO) were observed. In addition, improvements were observed for the combined group in depression (GDS - 15) and quality of life (WHOQoL-OLD total) scores. No significant differences were found between pre- and post-assessment in physical variables for any group. Conclusion: The results obtained suggest that a multidomain intervention program can positively impact cognition and quality of life in older adults. Likewise, physical activity may positively impact cognition. This study could serve as a basis for the implementation of multimodal interventions at the community level aimed at the prevention of cognitive decline.

2024-01-01T00:00:00Z Chavarría Muñoz, Carlos Alfredo http://speiro.usma.ac.pa/handle/123456789/628 2026-01-06T18:56:32Z 2024-01-01T00:00:00Z

ASOCIACIÓN ENTRE DISCRIMINACIÓN, SALUD MENTAL, IDENTIDAD Y NIVELES DE CORTISOL EN UNA MUESTRA LGBTQ+ EN PANAMÁ EN EL AÑO 2023 Chavarría Muñoz, Carlos Alfredo Discrimination against lesbian, gay, bisexual, transgender and queer (LGBTQ+) people can affect overall health, causing psychiatric symptoms such as anxiety, depression, substance abuse and suicidal ideation and behavior. It has been evidenced that vulnerability factors in LGBTQ+ people are related to discrimination and hateful behaviors, generating low self-esteem and psychopathological symptoms. Data on the Latin American region indicate that cases of discriminatory acts against LGBTQ+ people are on the rise. According to the Registry of Violence against Lesbian, Gay, Bisexual, Trans and Intersex persons in the Americas of the Organization of American States, Panama is one of the countries in the region that reports cases of discrimination against LGBTQ+ persons, however, there is no data that establish the incidence of these cases. Chronic exposure to experiences of discrimination can lead to imbalances in mental health and in the biological stress regulation system. The objective of this vii research was to identify the association between perceived discrimination, mental health, and cortisol levels in a sample of LGBTQ+ people in Panama in the year 2023. This study has a cross-sectional design with a quantitative approach and a descriptive correlational non-experimental scope. The sample consisted of 48 LGBTQ+ participants of legal age residing in Panama. Sociodemographic data were collected, and the following scales were used: the Perceived Discrimination Scale, the Depression, Anxiety and Stress Scale and the Dimensions of Sexual Orientation Identity Scale for Lesbians, Gays and Bisexuals. Two saliva samples were collected to assess morning and evening cortisol using an in vitro immunological test. A Pearson correlation was performed to analyze the relationship between perceived discrimination, mental health, identity and cortisol levels. The results showed that younger people present more depressive, anxious and stress symptoms. In addition, a positive correlation was found between discrimination by society and the presence of symptoms of depression and stress. In turn, a positive correlation was found between concern about sexual orientation acceptance and symptoms of anxiety, depression, and stress. A moderated multiple regression model was also performed and showed that perceived group discrimination predicts the occurrence of symptoms of depression, anxiety and stress, being moderated by concern about the acceptance of sexual orientation identity. However, no relationship was found between cortisol levels and psychological variables. These results show that discrimination is related to the quality of mental health of LGBTQ+ people. The present study is the first of its kind to be conducted in Panama and the results contribute to the literature on sexual diversity from a biopsychosocial perspective and promote governmental decision-making based on scientific evidence for the benefit of the health of LGBTQ+ persons.

2024-01-01T00:00:00Z Bacil de las Casas, Ana Karina http://speiro.usma.ac.pa/handle/123456789/627 2026-01-06T16:33:10Z 2024-01-01T00:00:00Z

IMPACTO PSICOLÓGICO EN EL PERSONAL DE ENFERMERÍA Y TÉCNICOS DE LA SALUD DE PANAMÁ POR LA PANDEMIA DE COVID-19 Bacil de las Casas, Ana Karina The COVID-19 pandemic has generated unprecedented challenges for public health systems. Evidence indicates that, faced with a new and highly contagious virus, it is common to feel fear and uncertainty. Added to this, having to work long hours, being continually exposed to the virus, and not having adequate protective equipment supplies, are some of the stressors investigated that increase the risk of health personnel experiencing physical and psychological distress. The objective of this thesis was to describe the psychological impact of the COVID-19 pandemic on non-medical health personnel (nurses and technicians) in Panamá. To carry out this study, approval was obtained from the National Research Bioethics Committee of Panamá (CNBI EC-CNBI-2020-08-87). A mixed research design was defined. A sample of 124 health workers (non-doctors) answered a battery of self-report questionnaires to measure sociodemographic data, work characteristics, coping strategies (COPE-28), stress due to COVID (CPDI), insomnia (Athens Scale) and anxious, depressive and stress symptoms (DASS-21). In a second qualitative stage, 25 people from the sample participated in a semi-structured interview.

2024-01-01T00:00:00Z YÁNEZ Z., YADYRA http://speiro.usma.ac.pa/handle/123456789/626 2025-11-21T20:32:51Z 2025-01-01T00:00:00Z

MEDICIÓN DEL IMPACTO DE UN PROGRAMA DE ARTETERAPIA SOBRE LOS ESTADOS EMOCIONALES Y COGNITIVOS DE PERSONAS MAYORES INSTITUCIONALIZADAS EN UN ALBERGUE PÚBLICO DE LA CIUDAD DE PANAMÁ DURANTE EL PERIODO 2024, 2025. YÁNEZ Z., YADYRA la institucionalización de personas mayores va en aumento debido a la falta de atención domiciliaria, recursos económicos y apoyo familiar limitados, aunado a las dificultades para acceder a servicios de salud. Esto se asocia con una alteración del estado emocional y cognitivo y con un mayor riesgo de enfermedades cardiovasculares, metabólicas y, en algunos casos, negligencia o maltrato. La arteterapia ha demostrado ser una intervención no farmacológica eficaz en entornos geriátricos, reduciendo síntomas depresivos y ansiosos, y mejorando la cognición.

2025-01-01T00:00:00Z