Adherencia terapéutica y relaciones intergeneracionales en mujeres mayores de 60 años y más del municipio de Sibaté –Cundinamarca

Abstract

Introduction. Health statistics show changes in the demographic structure, marked by an increase in people aged 60 and over, the prevalence of chronic illness, dependency and disability, which are manifested mainly in old age. Therefore, the health of old people with chronic disease is a challenge for governments and health systems. The studies on therapeutic adherence in old age, has been carried out from a psychobiomedical approach, and approaches the factors that affect failures to comply with a imposed regime, the family is understood as a "tool" useful to the extent that it responds to a therapeutic end The perspective in which therapeutic adherence is addressed does not account for the historical, family and social processes that accompany the health-disease process of old people throughout life, which made it necessary to explore this phenomenon using the perspective of life course for women over 60 years old and over in the municipality of Sibaté Colombia. The objective of this research was to understand the relationships that exist between different generations, women in a chronic condition and their therapeutic adherence in a rural context such as Sibaté - Colombia. Methodology: Qualitative, descriptive study with a biographical approach. Semi-structured interviews were conducted with eight women older than 60 years and more belonging to the chronic program of the municipality of Sibaté. An interpretative analysis of individual, family and social history was carried out, with identification of life trajectories and their relationship with the health - disease process. Results: The findings made it possible to demonstrate that the life trajectories of women significantly influence the approach that they and their families give to therapeutic adherence in old age, despite the different circumstances to which they are exposed to. throughout his life and that explain the disease health process. In the analysis of the results, the economic and gender inequity expressed in the lack of education, precarious work, intrafamily and couple violence, these two axes intersect to reproduce throughout the life of the female employers. of social exclusion, which reinforce each other, and in old age are expressed as economic dependence. The results showed that the process of exchange and cooperation between the different generations (grandparents, parents, children and grandchildren) is mainly due to transactions of functional and affective type. These transactions affect the way women experience their disease process, transform it into an opportunity that favors self-care, self-management of the disease, empowerment of their treatment, fosters interpersonal relationships with others and allows to maintain ties of solidarity with its different generations. An obstacle for women to achieve adherence in old age is undoubtedly the lack of economic resources, therefore, structural transformations are required in the context to ensure economic security in old age. Conclusion: The perspective of life course allowed to understand the relationship that exists between the social, family and individual history of women aged 60 and over throughout life, to understand that the disease health process is determined by the trajectories of lives. The methodology of the qualitative study with a biographical approach allowed the construction of timelines that provided information to know the historical, social, family and personal processes of the circumstances lived by women throughout their lives. This research has the limitations of the qualitative method, therefore they can not be generalized.