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Health Education Training Program on Chikungunya
Disease
Author: Carmen Yorlet Escalona Belandria
Universidad Pedagógica
Experimental Libertador, UPEL
Barinas, Venezuela
Abstract
The objective of the research was to apply a
training program in health education to the community "Juan Pedro del
Corral", Barinas municipality, Barinas state, in the prevention of
Chikungunya disease. The study responds methodologically to the qualitative paradigm.
The type of study in an action research and field design. Seven (07) key
informants were considered. The technique and instrument used in the collection
of the information was direct observation and as an instrument an in-depth
interview. The study allowed to conclude: The vast majority of the interviewees
have ignorance of Chikungunya disease; as well as the transmitting agent.
However, they handle the knowledge that the transmitting agent is an infected
mosquito. The informants indicated that the symptoms of the disease are framed
in headache, fever, rash in the body and joint pains and the medications used
to relieve it was acetaminophen. They also reported that this disease is
complicated by other diseases. The training program for health represents an
important aspect in the development of the individual because it affects the
integration and participation of the environmental actions in which the
individual develops. A set of inherent activities was planned to improve,
inform and educate the community in the prevention of Chikungunya disease.
Keywords: training; health;
disease.
Date Received: 17-10-2017 |
Date Acceptance: 17-01-2018 |
Programa Formativo de Educación en Salud sobre la
Enfermedad del Chikungunya
Resumen
El objetivo de la investigación fue aplicar un
programa de formación en educación para la salud a la comunidad “Juan Pedro del
Corral”, municipio Barinas, estado Barinas, en la prevención de la enfermedad
del Chikungunya. El estudio responde metodológicamente al paradigma
cualitativo. El tipo de estudio en una investigación acción y el diseño de
campo. Se consideraron siete (07) informantes clave. La técnica e instrumento
que se utilizó en la recolección de la información fue la observación directa y
como instrumento una entrevista en profundidad. El estudio permitió concluir:
La gran mayoría de los entrevistados tienen desconocimiento de la enfermedad
del Chikungunya; así como también el agente transmisor. Sin embargo, manejan el
conocimiento que el agente trasmisor es un zancudo infectado. Los informantes
señalaron que los síntomas de la enfermedad están enmarcados en dolor de
cabeza, fiebre, erupción en el cuerpo y dolores articulares y los medicamentos
utilizados para aliviar la misma fue el acetaminofén. También, informaron que
dicha enfermedad se complica con otras enfermedades. El programa de formación
para la salud representa un aspecto importante en el desarrollo del individuo
porque incide en la integración y participación de las acciones ambientales en
la cual se desenvuelve dicho individuo. Se planificaron un conjunto de
actividades inherentes a mejorar, informar y educar a la comunidad en la
prevención de la enfermedad del Chikungunya.
Palabras
clave:
formación; salud; enfermedad.
Fecha de Recepción: 17-10-2017 |
Fecha de Aceptación: 17-01-2018 |
1. Introduction
Health as a process of training the community to act
to improve their quality of life and health, including greater control over that
process. However, to achieve a state of complete physical, mental and social
well-being, individuals and groups must be able to identify their aspirations,
satisfy their needs and change or know how to manage the environment. This
means controlling the political, economic, social, cultural and environmental
factors, which include: housing, education, food, income, access to health
services, stable ecosystem, sustainable resources, social justice, and others.
Therefore, in any society, the processes of change of
a broader nature are permanently related to processes that involve individuals
in their daily practice. In this sense, Education for Health is important, when
thinking about the training and training of health professionals.
It is assumed that the goals that aim to improve the
quality of life of a country or region, can only be achieved if the political
measures are combined with specific actions within the institutions, especially
in the services of health, and other sectors in which health education is
relevant: schools, businesses, unions, neighborhood associations, religious
communities, and others.
The World Health Organization, cited by Perea (2001):
defines education for health as "the state of well-being, physical, mental
and social" (p.24). This refers to the stage in which the individual is in
good condition emotionally, intellectually, corporately, in interaction with
the context in which he develops. People move from one place to another day
after day, there is no limit set for this process. There is a very broad
environment in which people can be inside health or illness. The state of
health is not constant, but variable. Preventive health includes all the
processes and human experiences that point towards the integral development of
the individual, from the consciousness of his body to the awareness of his
personal and transcendental relationships.
Health education is one of the instruments to promote
and implement its preventive action. It helps citizens or groups to acquire
knowledge about health problems and about useful behaviors to achieve their
goal. Health prevention means reducing the risks that threaten it and modifying
the behaviors that affect it. Improving health reduces poverty and makes growth
possible.
As a result, societies have been evolving in an
accelerated manner, which is why countries have been preoccupied with preparing
to take advantage of the potential of human knowledge in their economic and
social development, promoting education and a culture for creativity,
discipline and job. In this sense, there is a growing conviction that education
is the key element to face the new challenges and achieve a better production
and distribution of goods and services that society generates. From this perspective,
Santander (2010) points out that:
Education has to be understood in the new times, as the condensed
expression of national identity and wisdom, building a social being that
recognizes its location and can extract from it the necessary elements to create
a universal point of view that projects it as a society (p.66).
Interpreting the author, education in postmodern times
is immersed in the feeling or belonging of a community of its values, beliefs
and customs through the knowledge of society in order to deepen in the local,
with a view to a futuristic, universal society, in peace and coexistence of
each of the citizens of the country. In addition, conscious, socialized and
sensitized towards the globalization of actions for the benefit of the quality
of life.
On the other hand, in Venezuela, in the case of the
Primary Education subsystem, currently seeks to concentrate or raise the
quality of education activities inherent in work, the daily life of the
student, significant learning, effective and consistent with the coexistence of
students according to the geographical and social environment of the community
where the school is located, that is to say, the reality very close to them.
Refers Cárdenas (2010):
A priority action to ensure a quality primary education, where students
begin to value natural resources and cultural heritage as potential
alternatives for achieving an economic and sustainable advancement of their
community, is the timely and appropriate curricular articulation with
environmental education and endogenous development, which has as its mission in
Bolivarian Education, the natural integration of society in its cultural,
social and institutional complexity. (p.88).
This is how this vision of environmental education is generated
as a strategy within the context of education, as a human continuum in which
the school and community are simultaneously the object and subject of
development, creating a sense of belonging to the social and educational
reality, seeking the integration of the social actors of the same, in order to
achieve the construction of an educational system that achieves an integral and
quality development, which allows to overcome the needs and expectations of the
school and the community, by opening meeting spaces for the integration,
searching and analyzing opportunities that allow to establish a reliable
diagnosis and, consequently, a way of acting to assume the challenges of the
current dynamic society.
On the other hand, The Pan American Health Organization
and the World Health Organization (WHO, 2009a): "have carried out numerous
scientific works that have contributed data about the knowledge of the biology
and ecology of endemic diseases, by the vectors that generate the mosquito
Aedes albopictus "(page 74). These studies have allowed the creation of
surveillance and control programs for this vector, which has led in some
countries to eradicate and control diseases.
For its part, Duanes (2010): indicates that "the
first chikungunya virus was identified in 1953 and this virus is an alpha
arbovirus, aedes, mosquitoes, responsible for the first and little documented,
said acute disease that was recorded in the tropics" (p.7). The main
symptom is fever, rash, weakness. The epidemic was a surprise since this is an
unexpected emergency, in magnitude, it is a very rare or never previously
discovered clinical case. It is observed that the virus was recognized in the
fifties towards the tropics, it proliferated unexpectedly because it was
unknown of its existence.
In this context, The World Health Organization (WHO,
2009b): states that "the Chikungunya Virus is a new visitor in the
Caribbean Islands, South America and Central America. On July 11, 2014, the Pan
American Health Organization (PAHO) had already declared the presence of
autochthonous cases in these regions" (p.11). That is, people who had not
traveled and who had become ill. The way to have acquired the disease could not
be other, but, that an Aedes of the infected region, it had stung.
In Venezuela, conditions of environmental sanitation
and overcrowding in many sectors of the population have allowed the
proliferation of the mosquito that causes endemic diseases, whose mortality has
increased and this translates into a problem that must be faced and solved.
That is, not only the risk it implies for the health of Venezuelans, but also
the high cost that, in terms of outpatient care, hospitalization and
maintenance of vector prevention and control measures, Gómez (2012a), raises:
On
July 15, the Venezuelan state reports that it has 45 registered cases, of which
2 were being studied because no country had been identified. On July 19, in
just 4 days and Venezuela announced that they have registered 57 cases of fever
due to the virus and that of these 7 are transmitted in the country,
specifically in the State Vargas (p.4).
Se
observa que es alarmante, como se ha ido incrementando las cifras de ciudadanos
y ciudadanas con el padecimiento de este virus. Hoy día el mosquito Aedes albopictus
se ha convertido en Venezuela en un causante de enfermedad epidemiológica que
afecta a los habitantes, la cual es conocida como chikungunya, Gómez (2012b),
manifiesta:
Its mode of infection is through a virus which transmits it causing a
strong affection in the joints. Chikungunya (in the Makonde language:
chikungunya, pronounced / ˌtʃɪkəngʊɲə /), also known as "Chikungunya
epidemic arthritis" or "Chikungunya fever" (abbreviation: CHIK),
is a virus transmitted by arthropods, of the alphavirus genus, which is
transmitted to people through the bite of Aedes carrier mosquitoes; both Aedes
aegypti and Aedes albopictus (p.23).
Interpreting
the aforementioned quotation, the disease manifests itself in a painful way
because it affects the joints of the individuals, in many of the cases
propitiating their immobility; In addition, the pathology presents with
excessive temperature increase and skin breakouts.
All this situation is not alien to the inhabitants of
the Juan Pedro del Corral community, Barinas municipality, Barinas state,
because those who make up the context are human beings that due to the health
characteristics of the area there are foci for the proliferation of the Aedes
albopictus mosquito. Likewise, the awareness of preventive measures, control
and sanitation in the aforementioned community has not been generated. In view
that no fumigation and cleaning processes of both public and private spaces are
appreciated at any time.
The study addresses the following research questions:
What is the situation in the Juan Pedro del Corral community about Chikungunya
disease? What will the health education training program be like for the
community of Juan Pedro del Corral in the community? prevention of Chikungunya
disease? What are the theoretical foundations of the education program for
health and the prevention of Chikungunya disease ?; What are the elements in
the formulation of the health education training program for the Juan Pedro del
Corral community in the prevention of Chikungunya disease? What mechanisms will
be used in the Operationalization of the education training program? for the
health of the Juan Pedro del Corral community in the prevention of Chikungunya
disease? Proposing as a general purpose to apply training program in health education
to the community "Juan Pedro del Corral", Barinas municipality,
Barinas state, in the prevention of Chikungunya disease.
2. Background, Theory and Concepts
2.1.
Record
They are the investigations carried out previous to this
one, therefore, they constitute the results of the intervention of the
variables that are considered for the study, of other investigations that
anteceden it. According to the Universidad Pedagógica Experimental Libertador
(2016): it states that they are "referred to works of Degree, Thesis and
Investigations developed (National and / or International), with similar titles
and related to the research being developed: that is, information documentary
first hand" (p.51). Some of them are presented below.
Gómez (2012c): in his degree work entitled
"Awareness Program for the Reduction of Endemic Diseases of the
Chikungunya Virus in the La Morita Community", the need to develop skills
in students and other community members, in such a way that they project a
sensitizing action before the problem of the chikungunya virus. The methodology
used was descriptive with support in a field investigation. The population was
made up of students, parents and teachers for a total of nine hundred and fifty
(950). The technique used was the survey and as a tool a mixed questionnaire
with open and closed questions.
The author concludes: the importance of educational
awareness work within the school and the community in order to establish
alternative solutions for the current situation and therefore enrich the
quality of life of the population.
On the other hand, Rozo (2013): in his study entitled
"Methodological Proposal for Health Education of the Person, the Family
and the Community". The objective was to elaborate a methodological
proposal with a view to strengthening education for health as part of the
training of the nursing professional in his relationship with the person and
the groups. The methods used were focused on the logical historical,
deductive-inductive and empirical level. The population was constituted by
thirty-two (32) students of seventh, thirty-seven (37) students of eighth and
two (02) professors of two faculties of nursing.
The author concluded that the teaching model adopted
in Colombia establishes training focused more on nursing actions, leaving the
educational and social dimension as secondary, limiting the possibility of
developing prevention and health promotion actions in an integrated manner. at
the individual and collective level.
2.2.
Training Program in Health Education
The world of today demands the training of people with
the ability to function fluidly, harmoniously, make decisions, work with
others, communicate their ideas, manage their actions in view of personal,
educational and work goals, among others, in different scenarios. Therefore,
the topic of integral education has been studied, both in international
organizations such as UNESCO, as well as in those responsible for defining the
guidelines of educational institutions at all levels and, particularly, in
higher education; in virtue of which the integral formation is one of the
purposes that must be reached through the fulfillment of the university
functions: teaching, investigation and extension.
It is proven that an integral formation that
stimulates the development of emotional, social and ethical skills, promotes a
greater well-being and quality of social coexistence, favors better learning
and also helps prevent people from engaging in risky behaviors. On this Ruíz,
(n.d.), points out that:
The training implies a perspective of intentional learning, tending to
the strengthening of a responsible personality, ethical, critical,
participatory, creative, supportive and with the ability to recognize and
interact with their environment to build their cultural identity. Therefore, it
seeks to promote human growth through a process that assumes a multidimensional
vision of the person, and tends to develop aspects such as emotional,
intellectual, social, material and ethical-value intelligence (p.11).
Therefore, the training program involves not only the
acquisition of specific knowledge and the appropriate techniques for
professional practice, but also requires the acquisition of positive attitudes that
affect the daily behavior of the individual in the transformations and
therefore in the improvement of social, environmental, economic and educational
welfare.
2.3.
Education for health
Education for Health, understood as an instrument of
promotion, responds, therefore, to the most evolved approach to it. It implies
the overcoming of the prescriptive and behavioral models a strictly sanitary
look, present even in our environment towards a participative, holistic and
transversal approach in the institutional and pedagogical management of school
organizations, emphasizing the attitudes and behaviors (values) of the people
as responsible for their own health.
In this sense, Nizama (2007): when it raises a
concordance between the different authors on health and education, who point
out that health education deals not only with transmitting information but also
fostering motivation, personal skills (social, emotional and cognitive) and
assessment by oneself and by others, all of which are necessary conditions to
adopt measures aimed at the control and improvement of health.
The World Health Organization (WHO, 2009c): mentions
that health education comprises consciously created learning opportunities that
represent a form of communication aimed at improving health literacy, including
improving the knowledge of the population, in relation to with the development
of personal skills that lead to a state of individual and community well-being.
2.4.
The Chikungunya Disease
The Chikungunya, according to The Pan American Health
Organization (2011):
CHIKV, is an RNA virus belonging to the genus Alphavirus of the
Togaviridae family. The name Chikungunya is derived from a word in Makonde, the
language spoken by the Makonde ethnic group living in southeastern Tanzania and
northern Mozambique. Broadly means "one who hides" and describes the
inclined appearance of people suffering from the characteristic and painful
arthralgia (p.3).
The author states that Chikungunya disease is a virus
that belongs to the Togaviridae family, which affects the body of the
individual through general ailments in the body, the bending of the lower
extremities; specifically affecting the joints of people. On the other hand,
Montero (2014):
Chikungunya is an emerging virus that manifests as a febrile syndrome
with intense arthralgias and rash, caused by an alphavirus transmitted by
mosquitoes, the chikungunya virus. This disease has spread globally in the last
decade, threatening to become pandemic and constituting one of the greatest
emergent virosis of the 21st century. The risk of chikungunya epidemics from
imported cases is especially high in the Americas, where the vectors are
present in sufficient numbers and the population does not have immunity against
the virus (p.2).
The author says that Chikungunya disease is a virus
that appears in the 21st century and that caused great havoc in individuals. It
presents with deep ailments in the joints of people accompanied by high continuous
fevers; It is also transmitted by mosquitoes infected with the virus. It is
important to highlight that the disease has attacked a large part of the
population of the Americas, in which there has not been effective prevention of
it.
As a result, the Chikungunya epidemic has been
observed in a cyclical way, because its geographical distribution has been
worldwide; specifically affecting countries such as Asia and Africa, in which
this epidemic has left many deaths, health deficiency in some individuals and
therefore a weakening in the physical appearance of people. Hence, it has been
considered a latent concern and interest, in one of the diseases that has
become a pandemic, in the prevention and implementation of health programs to
reduce it.
3.
Methodology
3.1.
Nature of the Investigation
It is based on the qualitative paradigm, because
according to Martínez (2006): "it is not, therefore, the study of separate
or separable qualities; it is, then, the study of an integrated whole that
forms or constitutes primarily a unit of analysis and that makes something what
it is ..." (p.66); that is to say, the study that is generated of the
interrelations that are derived from the nature of the realities, in this case
conceptual. Therefore, the subjectivity of who collects the information,
without losing sight of the theoretical and epistemological bases that
characterize it; as well as the methodological aspects to follow that guide the
research that is outlined of the phenomena in direct relation with the contexts
that present it.
3.2.
Type and Design of Research
The type of study was focused on a participatory
action research, because the interaction with the subjects or key informants
that are related to the subject matter of the study is sought. Murcia, cited by
Hurtado y Toro (2007a), states: "the term action research refers to
various efforts to develop investigative approaches that involve the
participation of people who are to be beneficiaries of the research and of
those with whom be done" (p.18). In other words, the action research
affects the participation of individuals who are in a context and are those who
will benefit in this case, the community "Juan Pedro del Corral",
Barinas municipality, Barinas state.
Regarding the design of the research, it was framed in
a field study. In this regard, Márquez (2010), says it is: "that which is
carried out in the place where events take place" (p.20). That is, the
data is collected directly from the reality studied, in which the phenomenon
under study is occurring.
That is why the data will be collected by the
statements made by the key informants that will be described in the
investigation. In addition, the design of the field research also allowed
gathering information in a more precise and concise way at the time of the
application of the primary data collection instrument. In addition, it
represents the systematic analysis of the problems with the purpose of
discovering it, explaining the causes and effects, understanding its nature and
constituent factors or predicting its occurrence, where the data of interest
are collected directly from reality, without manipulating the variables study.
3.2.1.
Phases of the investigation
Participatory action research provides communities and
development agencies with a method to analyze and better understand the reality
of the population (its problems, needs, capacities, resources), allowing them
to plan actions, measures to transform and improve it. It is a process that
combines theory and activity, enabling learning, the critical awareness of the
population about their reality, their empowerment, the reinforcement and
expansion of their social networks, their collective mobilization and their
transformative action. In this order of ideas, the proposal of Hurtado y Toro
(2007b) was used, who expose the following stages: "diagnosis, planning,
execution, evaluation, and systematization, which are specified below"
(p.120).
Stage I:
Diagnosis: Diagnosis is the main element of detecting, directly from
reality, the real events of the situation under study, in this case, the
situation that the inhabitants of the "Juan Pedro del Corral"
community experience in the prevention of the Chikungunya disease.
Stage II: Planning: It consists of the systematization of the actions
that will be followed in the improvement of the situation studied. The needs of
citizens are clearly established in order to anticipate, analyze, anticipate
and try local and future development. As a result, a set of activities will be
planned that will be used to form a training program in health education for
the Juan Pedro del Corral community in the prevention of Chikungunya disease.
Stage III: Execution and Evaluation of the Planned Actions: In
this stage, the execution of the actions planned in an action plan that will
agree to consolidate a training program in health education that accesses the
prevention of Chikungunya disease.
Stage IV: Systematization: Consists in the reconstruction of all
the work, that is, reflection on the achievements obtained in the activities
planned and executed in the action plan. Likewise, it allows monitoring and
control of the actions that guided the development of work in the community.
This systematization led to the set of final reflections made in the inquiry.
3.3.
Key Informants
The key informants are those people who, through their
experiences, ability to empathize and relationships they have in the field, can
sponsor the researcher, becoming an important source of information while
opening access to other people and new scenarios. Hence, seven (07) informants
were taken from the "Juan Pedro del Corral" community, Barinas
municipality, Barinas state.
3.4.
Techniques and instruments
The technique that was used was the
observation, in which field notes the details of the interaction, emphasizing
especially in the language and particular connotations of local feeling but
they must be schematized so that the interviewee does not feel pressured for
everything he says and does. Likewise, the interview technique was applied
using a script of open questions, investigating in the informants what is
related to a training program in health education to the Juan Pedro del Corral
community in the prevention of Chikungunya disease. A face-to-face dialogue was
established, but a peculiar, asymmetric dialogue, where one of the parties
seeks to collect information and the other is presented as a source that
proportions.
4.
Results
The Unit of analysis related to the education training
program, category of comprehensive education and sub-category of knowledge, the
data reflected the ignorance of the informants regarding the handling of
information related to the Chikungunya disease. This is because the disease was
very recent and rapid in Venezuela, especially in the municipality of Barinas,
and the vast majority of individuals were not prepared to receive the disease;
causing great havoc in the Barinese families.
On the other hand, the Chikungunya Disease Prevention
Unit, Environmental Education category and the subcategory of environmental
conditions and preventive activities are perceived as being that the conditions
of the community are deteriorating, given that the community does not is
organized to meet environmental needs, stagnant water, sewage, pollution by
garbage, among others. The Communal Councils and the UBCH lack to act
educational activities in benefit of the social welfare and quality of life.
Similarly, the category of feasibility of intervention
and subcategory Educational Action, Participation, Support, informants revealed
to be willing to participate and collaborate in educational actions that
benefit the community. These activities are related to the Chikungunya disease,
in which citizens are trained and trained to prevent it.
5.
Final thoughts
The health training program seeks educational
training, guidance and key information on the participation of individuals in activities
or actions inherent to the prevention of health, physical, emotional and social
well-being of people. It also represents a practical guide in which the subject
will find preventive measures, treatment, causes, consequences, symptoms,
diagnosis, among others, specifically, Chikungunya disease; influencing changes
in attitude, positive thoughts towards integral formation of the individual,
with a view to strengthening, preserving and preserving the environment that
surrounds him.
The formulation of the program allowed the motivation,
incorporation and integration of the members of the Communal Council, the UBCH
and some members of the community of Juan Pedro del Corral in each of the
actions that were duly planned in the action plan. In addition, there was
interest, on the part of the residents, in attending each of the program's
activities.
It is important to highlight that during the execution
of the activities the participation and the organization of the inhabitants could
be achieved. The attendees said that the workshops met the expectations, are
very useful, since they were unaware of the Chikungunya disease. Likewise, they
expressed that they were taken into account to be trained and oriented in the
prevention of said disease; influencing attitude changes and proactive
knowledge in the face of any adversity.
The activities carried out were evaluated
continuously; The control of attendance at meetings, workshops and talks was
done by means of registration of attendance and minutes, the participants
expressed their opinions and experiences orally. Regarding the effectiveness of
the workshops, these were considered very satisfactory by the participants who
said they were pleased and remembered that this work should continue.
6. References
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Duanes, G. (2010). Perspectiva de calidad de la
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Gómez, L. (2012a,b,c). Programa de
sensibilización para la disminución de las enfermedades endémicas del Virus
Chikungunya en la comunidad La Morita. Maracay, Venezuela: UNEFA.
Hurtado, I. & Toro,
J. (2007a,b). Paradigmas y métodos de investigación en tiempos de cambio. Venezuela: Editorial CEC, S. A.
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Metodología de la Investigación.
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en salud de la persona, la familia y la comunidad. Trabajo de Grado de Maestría, publicada, Cuba: Universidad de la
Habana.
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(2016). Manual de Trabajos de Grado de Especialización y Maestría y
Tesis Doctorales. 5ta.
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Carmen
Yorlet Escalona Belandria
email: marlenism3@gmail.com
Born in the state of Táchira,
Venezuela. Degree in Geography and History (2006-2007). Bachelor in Humanities
at the Liceo Nacional Pedro María Morante. He is currently working in the
technical team of the Primary Unit of the Executive Secretary of Education of
the state of Barinas from 2016-2017. In addition, she has worked as a social
worker in the U.G. José Ignacio del Pumar from 01/08/1995 to 12/31/1995, Dance
Facilitator at C.E.I. Bolivariano Francisco Rivas 01/01/2006 - 07/07/2006,
Professor of Culture C.E.I. Bolivariano Francisco Rivas 2008-2010, Teacher of
Culture Liaison with Initial Education of the Executive Secretary of Education
2011-2014, Regional Technical Team of the Universidad Bolivariana de Venezuela
2014-2015. He has participated in the following days: Resources for learning
with waste material, Directorate of Education from April 10 to 14, 1997,
Therapeutic guidelines for working with children with motor difficulties, Zona
Educativa November 28, 1997. Sex education, Zona Educativa, Barinas. V Regional
Meeting of Initial Education, Zona Educativa, Barinas. Dance Facilitator, Zona
Educativa, Barinas.
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- Original Version in Spanish -
DOI: https://doi.org/10.29394/Scientific.issn.2542-2987.2018.3.8.2.39-58