Relevance of postgraduate upgrading in the care of the elderly


Relevance of postgraduate upgrading in the care of the elderly

Pertinencia de la superación posgraduada en la atención al adulto mayor


Tamara Guevara de León1*
Mario Enrique Sánchez Benítez2
Eleida Valdés Rodríguez3
Mariela Oropesa Molerio1


1University of Medical Sciences of Villa Clara. Academic Vice-rectorate. Graduate Management. Cuba.
2 University of Medical Sciences of Villa Clara. School of Medicine. Graduate Department. Cuba.
3 University of Medical Sciences of Villa Clara. University Polyclinic «Santa Clara». Cuba.


*Author for correspondence. E-mail:




The population aging that Cuba faces in general and its province of Villa Clara as that of more aging inhabitants, requires a greater preparation of the specialists in Comprehensive General Medicine for the attention to this age group that needs a particular care to achieve a good high quality and healthy; for this reason, the authors considered it pertinent to report on an investigation carried out in three stages: the identification of learning needs of the referred doctors, the design of a group of postgraduate upgrading activities to help raise their preparation in comprehensive care for the elderly, and its approval by specialists criteria for its implementation, in order to solve the problem that is analyzed.

MeSH: demographic aging; geriatrics; health programs and plans; education, medical.


El envejecimiento poblacional que enfrentan Cuba en general y su provincia de Villa Clara como la de más habitantes envejecidos, requiere una mayor preparación de los especialistas en Medicina General Integral para la atención a este grupo poblacional que necesita un cuidado particular para lograr un envejecimiento saludable y con calidad de vida; por tal motivo los autores consideraron pertinente informar sobre una investigación realizada en tres etapas: la identificación de necesidades de aprendizaje de los referidos médicos, el diseño de un grupo de actividades de superación posgraduada para contribuir a elevar su preparación en la atención integral al adulto mayor, y su aprobación por criterios de especialistas para su implementación, a fin de solucionar la problemática que se analiza.

DeSC: envejecimiento de la población; Geriatría; planes y programas de salud; educación médica.



Submitted: 12/09/2018



Gerontology is a young discipline that has practically developed in the second half of the 20th century; it was after the Second World War when most of the gerontological associations were deployed, starting by the North American one in 1945 and the Spanish Society of Geriatrics and Gerontology in 1948. This responds to an extraordinarily important phenomenon: the aging of the population, as Birren noted in 1996, referenced by Rojas Pérez et al.(1)

Population aging is the increase in the proportion of older adults with respect to the population to which they belong. The causes have not been determined yet, but the decline in fertility is the most important, followed by the decline in mortality. Likewise, the migrations of the young population and the increase in life expectancy are factors that influence their figures.(2)

In Cuba life expectancy is at the level of developed countries and at the end of the 2011-2013 triennium, it reached 78.45 years, figure that places the largest of the Antilles among the 25 most advantaged nations of the world in this important indicator of human progress in a society. The MSc. Alfonso Fraga, director of the Center for Population and Development Studies (Cepde) of the National Office of Statistics and Information (Onei), said in the Granma newspaper that the aforementioned figure represents a gain of 0.48 compared to the 2005- 2007, when the average was 77, 97 years. The inhabitants of all provinces experienced increases in life expectancy for both genders. Villa Clara is the province with the most elderly population in Cuba with more than 21,6 % of residents over 60 years old; its municipalities Cifuentes, Remedios, and Placetas surpass the provincial average.

Currently the province exceeds 150 centenarians, and according to estimates about 23 % of Villa Clara inhabitants exceeded 60 years during 2015 and forecasts predict a 25% by 2025, according to the Vanguardia newspaper of February 23 2015.

Aging is essentially a triumph of life in which people who live in better conditions can arrive at advanced ages, but in turn it implies a challenge for various spheres of society such as services, material production, social security, among others, so this process has turned into a challenge for contemporary societies, including Cuba. Specifically for the health system, it is a problematic situation since it must ensure and guarantee the quality of life of the aged people, as this process compromises their performance in the most elementary activities of daily life. The third age is a period in which health needs increase due to physiological changes.(3)

Among the policies proposed by the States to deal with aging can be mentioned: improvement of the living conditions of the aging population, maintenance of autonomy to avoid dependence, adoption of healthy lifestyles from an early age, greater coverage in health with primary family care, social assistance programs that encourage their participation in social and family decisions, and make better use of intellectual and cultural heritage deposited in older adults to facilitate quality of life and reduce risk factors related to their health.(4)

Cuban health professionals have the task of strengthening health promotion and disease prevention activities, identifying early risk factors, designing educational strategies that help to modify unhealthy lifestyles and achieve greater and better quality of life in the elderly, without forgetting the interventions at family and community level that allow to support these purposes.(5)

The medical degree study plan(6) projects insufficiently the management of the elderly patient; In spite of including nursing homes for the teaching of Comprehensive General Medicine and some other disciplines of the clinical cycle, only a minimum percentage of students rotates through these institutions. When the complexity of the functions of the general practitioner is analyzed, there is a lack of knowledge, skills, habits and procedures to efficiently care for this population group. Therefore, it corresponds to play an important role to the universities of medical sciences, specifically to the postgraduate area to achieve the professional improvement of human resources in order to respond to their learning needs in terms of management and behavior before elderly patients.

Among the functions of postgraduate education stand out: updating, which allows the systematic renewal of knowledge and professional skills in correspondence with scientific advances; the complementation, consists in making possible the acquisition of new knowledge and professional abilities not received in the previous or acquired studies without the deepening required; and deepening, because it makes it possible to obtain a higher level of scientific-technical knowledge and skills in the specific field of a profession or of a specific area of science and technology.(7)

The quality of the health service starts in first order from the level of competence and performance of its workers in the fulfillment of their labor and social functions. Motivating professionals and technicians to improve their performance and adopt permanent improvement as a way of life in this new millennium, it is not only important but necessary to satisfy the social commitment of the country.(8)

To respond to the needs of society, the university must offer a relevant educational response with the fundamental purpose of educating, training, researching, promoting, generating and disseminating knowledge, as well as developing cooperation and integration mechanisms.(9)

Considering the above and with the aim of helping to raise the preparation of specialists in Comprehensive General Medicine in comprehensive care to the elderly, a research was carried out, which in its first stage identified the learning needs of these specialists in the related subjects to the care of the geriatric patient; the felt needs were investigated through the application of an evaluative instrument with 10 questions. The following were identified: pharmacological prescription in the elderly, psychosocial care for the elderly, updating behavior in the most frequent geriatric pathologies, periodic evaluation and care for patients with dementia. In a second stage a focal group was formed to design postgraduate improvement actions, in response to these learning needs, and as a result of this work the teaching programs of three specialized conferences, 11 courses, a diploma and a master's degree were developed, which in a third stage were positively assessed by a group of specialists and approved by the provincial scientific council for its implementation.



1. Rojas Pérez M, Silveira Hernández P, Martínez Rojas L. Gerontología y Geriatría, un recuento de poco más de un siglo. Acta Med Centro [Internet]. 2014 [citado 05/01/2018];8(1):[aprox. 4 p.]. Disponible en:

2. Collazo Ramos MI, Calero Ricardo JL. Algunas características del envejecimiento poblacional en Cuba. Medicentro Electrónica [Internet]. 2016 [citado 08/01/2018];20(4):[aprox. 3 p.]. Disponible en:

3. Benítez Pérez MO. Envejecimiento poblacional: actualidad y futuro. Medisur [Internet]. 2017 [citado 23/01/2108];15(1):[aprox. 4 p.]. Disponible en:

4. González Rodríguez R, Cardentey García J. El envejecimiento poblacional: un desafío para los profesionales de la salud en Cuba. Rev Haban de Cienc Med [Internet]. 2015 [citado 29/01/2018];14(6):[aprox. 5 p.]. Disponible en:

5. Arias Gallardo AI, Moré Hernández N, Alfonso Alfonso IF. Envejecimiento poblacional: nuevo reto para el plan de estudio de la carrera de Medicina. EDUMECENTRO [Internet]. 2015 [citado 24/01/2018];7(3):[aprox. 6 p.]. Disponible en:

6. Cuba. Ministerio de Salud Pública. Programa de estudio de la asignatura de Medicina General Integral. La Habana: Minsap; 2013.

7. Cuba. Ministerio de Educación Superior. Resolución No.132 /04. Reglamento de la Educación de Posgrado. La Habana: MES; 2004.

8. Salas Perea R. Los procesos formativos, la competencia profesional y el desempeño laboral en el sistema nacional de salud de Cuba. Educ Med Super [Internet]. 2012 [citado 25/01/2018];26(2):[aprox. 3 p.]. Disponible en:

9. Pupo Ávila N, Pérez Perea l, Alfonso García Adianez, Pérez Hoz G, González Varcálcel B. Aspectos favorecedores y retos actuales para la misión de la Universidad de Ciencias Médicas Cubana. Educ Med Super [Internet]. 2013 [citado 25/01/2018];27(1):[aprox. 10 p.]. Disponible en:



Declaration of interests

The authors declare no conflict of interest.



Contribution of the authors

Eleida Valdés Rodríguez and Mariela Oropesa Molerio: they carried out the bibliographic searches and analyzed the content.
Tamara Guevara de León and Mario Enrique Sánchez Benítez: analyzed the content and formed the article.



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