Factores de Riesgo Asociados con Lesiones Precancerosas del Cuello Uterino.
Palabras clave:
cérvix, historial reproductivo, relaciones sexuales, vacunación, VPH.
Resumen
Las lesiones precancerosas del cuello uterino se refieren a cambios anormales que ocurren en las células del cuello uterino y que tienen el potencial de desarrollarse en cáncer si no se tratan a tiempo. Estas lesiones se clasifican en diferentes grados de acuerdo con la severidad y el tipo de células afectadas. Es importante entender esta definición para poder identificar y diagnosticar correctamente estas lesiones, lo que permite tomar medidas preventivas y terapéuticas adecuadas. Los factores de riesgo que se asocian a lesiones precancerosas según los estudios revisados destacan la importancia para prevenir el desarrollo de dichas lesiones. Algunos de los hallazgos clave incluyen procedencia rural, infección por el virus del papiloma humano (VPH), comportamiento sexual, estado del sistema inmunológico, tabaquismo, uso de anticonceptivos hormonales, nutrición, estilo de vida, historia reproductiva, exposición a sustancias químicas, así como factores genéticos y hereditarios. Comprender y abordar estos factores de riesgo nos permite implementar medidas efectivas de prevención y control de las lesiones precancerosas del cuello uterino. El estudio de los factores de riesgo asociados a las lesiones precancerosas del cuello uterino es fundamental para comprender la epidemiología de esta enfermedad y diseñar estrategias de prevención eficientes. Este conocimiento es crucial para informar a la población, promover la adopción de medidas preventivas y facilitar la detección temprana de la enfermedad, salvando así vidas y reduciendo la carga que supone el cáncer cervical en la sociedad.
Descargas
La descarga de datos todavía no está disponible.
Citas
1. Gerstl S, Lee L, Nesbitt RC, Mambula C, Sugianto H, Phiri T, et al. Cervical cancer screening coverage and its related knowledge in southern Malawi. BMC Public Health [Internet]. 1 de diciembre de 2022 [citado 29 de abril de 2024];22(1):1-14. Disponible en: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-022-12547-9
2. Sumarmi S, Hsu YY, Cheng YM, Lee SH. Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: a health belief model. Reprod Health. 1 de diciembre de 2021;18(1).
3. Basagoitia A, Burrowes S, Solis-Soto MT, MacMillan G, Sullivan S. Community and provider perceptions and experiences of cervical cancer screening in Rural Bolivia: a qualitative study. BMC Womens Health. 1 de diciembre de 2023;23(1).
4. Vega Crespo B, Neira VA, Ortíz Segarra J, Andrade A, Guerra G, Ortiz S, et al. Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals. BMC Public Health. 1 de diciembre de 2022;22(1).
5. Addo-Lartey AA, Bonful HA, Sefenu RS, Abagre TA, Asamoah A, Bandoh DA, et al. Effectiveness of a culturally tailored text messaging program for promoting cervical cancer screening in accra, Ghana: a quasi-experimental trial. BMC Womens Health. 1 de diciembre de 2024;24(1).
6. Alshehri HD, Alqudah O, Almadani FB, Aldalbahi AM, Jarrah OA, Albashaireh A. Factors Associated With the Uptake of Cervical Cancer Screening Among Family Medicine Physicians, Compared With Women of the Community in Riyadh, Saudi Arabia. Cureus [Internet]. 31 de enero de 2024 [citado 29 de abril de 2024];16(1):e53283. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38304647
7. Sumarmi S, Hsu YY, Cheng YM, Lee SH. Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: a health belief model. Reprod Health [Internet]. 1 de diciembre de 2021 [citado 29 de abril de 2024];18(1):1-10. Disponible en: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-021-01188-7
8. Ghahramani S, Kasraei H, Shahabi S, Lankarani KB. Facilitating Factors and Barriers of Women’s Cancer Screening in Iran: A Systematic Review. Int J Prev Med [Internet]. 20 de diciembre de 2020 [citado 29 de abril de 2024];11(1). Disponible en: /pmc/articles/PMC8000176/
9. Gebreegziabher ZA, Semagn BE, Kifelew Y, Abebaw WA, Tilahun WM. Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022. BMC Public Health. 1 de diciembre de 2024;24(1).
10. Eshetu B, Bekele H, Debella A, Eyeberu A, Balis B, Habte S, et al. Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Front Glob Womens Health [Internet]. 2023 [citado 29 de abril de 2024];4:1147583. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38025984
11. Zewdie A, Shitu S, Kebede N, Gashaw A, Eshetu HB, Eseyneh T, et al. Determinants of late-stage cervical cancer presentation in Ethiopia: a systematic review and meta-analysis. BMC Cancer. 1 de diciembre de 2023;23(1).
12. Tolossa T, Fetensa G, Zewde EA, Besho M, Jidha TD. Magnitude of postpartum hemorrhage and associated factors among women who gave birth in Ethiopia: a systematic review and meta-analysis. Reprod Health. 1 de diciembre de 2022;19(1).
13. Dawud A, Kera AM, Bekele D, Hiko D, Zewdie A. Factors associated with uptake of human papillomavirus vaccination among adolescent girls in Mettu town, southwest Ethiopia: a school-based cross-sectional study. BMJ Open. 23 de noviembre de 2023;13(11).
14. Petersen Z, Jaca A, Ginindza TG, Maseko G, Takatshana S, Ndlovu P, et al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health. 1 de diciembre de 2022;22(1).
15. Diallo AA, Codjoe NNA, Ken-Amoah S, Agbeno EK. Cervical cancer prevention methods: awareness and use among urban Ghanaian women in Cape Coast, West Africa. Ecancermedicalscience [Internet]. 2023 [citado 29 de abril de 2024];17:1626. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38414947
16. Vasudevan L, Stinnett S, Mizelle C, Melgar K, Makarushka C, Pieters M, et al. Barriers to the uptake of cervical cancer services and attitudes towards adopting new interventions in Peru. Prev Med Rep [Internet]. 1 de diciembre de 2020 [citado 29 de abril de 2024];20. Disponible en: /pmc/articles/PMC7666342/
17. Deguara M, Calleja N, England K. Cervical cancer and screening: knowledge, awareness and attitudes of women in Malta. J Prev Med Hyg [Internet]. 14 de enero de 2020 [citado 29 de abril de 2024];61(4):E584. Disponible en: /pmc/articles/PMC7888396/
18. Hall MT, Simms KT, Murray JM, Keane A, Nguyen DTN, Caruana M, et al. Benefits and harms of cervical screening, triage and treatment strategies in women living with HIV. Nat Med. 1 de diciembre de 2023;29(12):3059-66.
19. Misgun T, Demissie DB. Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia. BMC Cancer. 1 de diciembre de 2023;23(1).
20. Anyolo E, Amakali K, Amukugo HJ. Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia. Health SA [Internet]. 2024 [citado 29 de abril de 2024];29:2433. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38445040
21. Jibat N, Ali R, Adissu W, Buruh G, Abdissa A, Goba GK, et al. Less known but greatly feared: Cervical cancer in Ethiopia community awareness. Heliyon [Internet]. 15 de abril de 2024 [citado 29 de abril de 2024];10(7):e28328. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38601557
22. Singh J, Baliga SS. Knowledge regarding cervical cancer and HPV vaccine among medical students: A cross-sectional study. Clin Epidemiol Glob Health [Internet]. 1 de enero de 2021 [citado 29 de abril de 2024];9:289-92. Disponible en: http://cegh.net/article/S2213398420302207/fulltext
23. Atnafu DD, Khatri R, Assefa Y. Drivers of cervical cancer prevention and management in sub-Saharan Africa: a qualitative synthesis of mixed studies. Health Res Policy Syst. 1 de diciembre de 2024;22(1).
24. Tsegaye K, Hagos A, Kindie H, Minyihun A, Teshale G. Evaluation of cervical cancer screening program in Gondar city administration public health facilities, Northwest Ethiopia, 2021: mixed method approach. BMC Cancer. 1 de diciembre de 2023;23(1).
25. Dadipoor S, Alavi A, Kader Z, Mohseni S, Eshaghi Sani Kakhaki H, Shahabi N. Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran. BMC Cancer. 1 de diciembre de 2023;23(1).
26. Misgun T, Demissie DB. Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia. BMC Cancer. 1 de diciembre de 2023;23(1).
27. Endalew DA, Moti D, Mohammed N, Redi S, Alemu BW. Knowledge and practice of cervical cancer screening and associated factors among reproductive age group women in districts of Gurage zone, Southern Ethiopia. A cross-sectional study. PLoS One. 1 de septiembre de 2020;15(9 September).
28. Alissa NA. Knowledge and intentions regarding the Pap smear test among Saudi Arabian women. PLoS One [Internet]. 1 de junio de 2021 [citado 29 de abril de 2024];16(6):e0253850. Disponible en: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253850
29. Kalliala I, Athanasiou A, Veroniki AA, Salanti G, Efthimiou O, Raftis N, et al. Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature. Annals of Oncology. 1 de febrero de 2020;31(2):213-27.
30. Mwenda V, Mwangi M, Gathecha G, Kibachio J, Too R, Gura Z, et al. Factors associated with late diagnosis of cervical cancer at two national referral hospitals, Kenya 2017: A case control study. Gynecol Oncol Rep. 1 de abril de 2024;52.
31. Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 1 de febrero de 2020;8(2):e191-203.
32. Reich O, Regauer S. Elimination of reserve cells for prevention of HPV-associated cervical cancer. Virus Res. 1 de mayo de 2023;329.
33. Chen X, Dong X, Li H, Wu T, Liu H, Wu J, et al. RNA-binding proteins signature is a favorable biomarker of prognosis, immunotherapy and chemotherapy response for cervical cancer. Cancer Cell Int. 1 de diciembre de 2024;24(1).
34. Miles TT, Riley-Powell AR, Lee GO, Gotlieb EE, Barth GC, Tran EQ, et al. Knowledge, attitudes, and practices of cervical cancer prevention and pap smears in two low-income communities in Lima, Peru. BMC Womens Health [Internet]. 1 de diciembre de 2021 [citado 29 de abril de 2024];21(1):1-11. Disponible en: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01291-8
35. Baharum NN, Ariffin F, Isa MR, Tin ST. Health literacy, knowledge on cervical cancer and pap smear and its influence on pre-marital malay muslim women attitude towards pap smear. Asian Pacific Journal of Cancer Prevention. 1 de julio de 2020;21(7):2021-8.
36. Chen X, Dong X, Li H, Wu T, Liu H, Wu J, et al. RNA-binding proteins signature is a favorable biomarker of prognosis, immunotherapy and chemotherapy response for cervical cancer. Cancer Cell Int. 1 de diciembre de 2024;24(1).
37. Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 1 de febrero de 2020;8(2):e191-203.
38. Kalliala I, Athanasiou A, Veroniki AA, Salanti G, Efthimiou O, Raftis N, et al. Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature. Annals of Oncology. 1 de febrero de 2020;31(2):213-27.
39. Mwenda V, Mwangi M, Gathecha G, Kibachio J, Too R, Gura Z, et al. Factors associated with late diagnosis of cervical cancer at two national referral hospitals, Kenya 2017: A case control study. Gynecol Oncol Rep. 1 de abril de 2024;52.
2. Sumarmi S, Hsu YY, Cheng YM, Lee SH. Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: a health belief model. Reprod Health. 1 de diciembre de 2021;18(1).
3. Basagoitia A, Burrowes S, Solis-Soto MT, MacMillan G, Sullivan S. Community and provider perceptions and experiences of cervical cancer screening in Rural Bolivia: a qualitative study. BMC Womens Health. 1 de diciembre de 2023;23(1).
4. Vega Crespo B, Neira VA, Ortíz Segarra J, Andrade A, Guerra G, Ortiz S, et al. Barriers and facilitators to cervical cancer screening among under-screened women in Cuenca, Ecuador: the perspectives of women and health professionals. BMC Public Health. 1 de diciembre de 2022;22(1).
5. Addo-Lartey AA, Bonful HA, Sefenu RS, Abagre TA, Asamoah A, Bandoh DA, et al. Effectiveness of a culturally tailored text messaging program for promoting cervical cancer screening in accra, Ghana: a quasi-experimental trial. BMC Womens Health. 1 de diciembre de 2024;24(1).
6. Alshehri HD, Alqudah O, Almadani FB, Aldalbahi AM, Jarrah OA, Albashaireh A. Factors Associated With the Uptake of Cervical Cancer Screening Among Family Medicine Physicians, Compared With Women of the Community in Riyadh, Saudi Arabia. Cureus [Internet]. 31 de enero de 2024 [citado 29 de abril de 2024];16(1):e53283. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38304647
7. Sumarmi S, Hsu YY, Cheng YM, Lee SH. Factors associated with the intention to undergo Pap smear testing in the rural areas of Indonesia: a health belief model. Reprod Health [Internet]. 1 de diciembre de 2021 [citado 29 de abril de 2024];18(1):1-10. Disponible en: https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-021-01188-7
8. Ghahramani S, Kasraei H, Shahabi S, Lankarani KB. Facilitating Factors and Barriers of Women’s Cancer Screening in Iran: A Systematic Review. Int J Prev Med [Internet]. 20 de diciembre de 2020 [citado 29 de abril de 2024];11(1). Disponible en: /pmc/articles/PMC8000176/
9. Gebreegziabher ZA, Semagn BE, Kifelew Y, Abebaw WA, Tilahun WM. Cervical cancer screening and its associated factors among women of reproductive age in Kenya: further analysis of Kenyan demographic and health survey 2022. BMC Public Health. 1 de diciembre de 2024;24(1).
10. Eshetu B, Bekele H, Debella A, Eyeberu A, Balis B, Habte S, et al. Insecticide-treated net utilization and associated factors among pregnant women in Ethiopia: a systematic review and meta-analysis. Front Glob Womens Health [Internet]. 2023 [citado 29 de abril de 2024];4:1147583. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38025984
11. Zewdie A, Shitu S, Kebede N, Gashaw A, Eshetu HB, Eseyneh T, et al. Determinants of late-stage cervical cancer presentation in Ethiopia: a systematic review and meta-analysis. BMC Cancer. 1 de diciembre de 2023;23(1).
12. Tolossa T, Fetensa G, Zewde EA, Besho M, Jidha TD. Magnitude of postpartum hemorrhage and associated factors among women who gave birth in Ethiopia: a systematic review and meta-analysis. Reprod Health. 1 de diciembre de 2022;19(1).
13. Dawud A, Kera AM, Bekele D, Hiko D, Zewdie A. Factors associated with uptake of human papillomavirus vaccination among adolescent girls in Mettu town, southwest Ethiopia: a school-based cross-sectional study. BMJ Open. 23 de noviembre de 2023;13(11).
14. Petersen Z, Jaca A, Ginindza TG, Maseko G, Takatshana S, Ndlovu P, et al. Barriers to uptake of cervical cancer screening services in low-and-middle-income countries: a systematic review. BMC Womens Health. 1 de diciembre de 2022;22(1).
15. Diallo AA, Codjoe NNA, Ken-Amoah S, Agbeno EK. Cervical cancer prevention methods: awareness and use among urban Ghanaian women in Cape Coast, West Africa. Ecancermedicalscience [Internet]. 2023 [citado 29 de abril de 2024];17:1626. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38414947
16. Vasudevan L, Stinnett S, Mizelle C, Melgar K, Makarushka C, Pieters M, et al. Barriers to the uptake of cervical cancer services and attitudes towards adopting new interventions in Peru. Prev Med Rep [Internet]. 1 de diciembre de 2020 [citado 29 de abril de 2024];20. Disponible en: /pmc/articles/PMC7666342/
17. Deguara M, Calleja N, England K. Cervical cancer and screening: knowledge, awareness and attitudes of women in Malta. J Prev Med Hyg [Internet]. 14 de enero de 2020 [citado 29 de abril de 2024];61(4):E584. Disponible en: /pmc/articles/PMC7888396/
18. Hall MT, Simms KT, Murray JM, Keane A, Nguyen DTN, Caruana M, et al. Benefits and harms of cervical screening, triage and treatment strategies in women living with HIV. Nat Med. 1 de diciembre de 2023;29(12):3059-66.
19. Misgun T, Demissie DB. Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia. BMC Cancer. 1 de diciembre de 2023;23(1).
20. Anyolo E, Amakali K, Amukugo HJ. Attitudes of women towards screening, prevention and treatment of cervical cancer in Namibia. Health SA [Internet]. 2024 [citado 29 de abril de 2024];29:2433. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38445040
21. Jibat N, Ali R, Adissu W, Buruh G, Abdissa A, Goba GK, et al. Less known but greatly feared: Cervical cancer in Ethiopia community awareness. Heliyon [Internet]. 15 de abril de 2024 [citado 29 de abril de 2024];10(7):e28328. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/38601557
22. Singh J, Baliga SS. Knowledge regarding cervical cancer and HPV vaccine among medical students: A cross-sectional study. Clin Epidemiol Glob Health [Internet]. 1 de enero de 2021 [citado 29 de abril de 2024];9:289-92. Disponible en: http://cegh.net/article/S2213398420302207/fulltext
23. Atnafu DD, Khatri R, Assefa Y. Drivers of cervical cancer prevention and management in sub-Saharan Africa: a qualitative synthesis of mixed studies. Health Res Policy Syst. 1 de diciembre de 2024;22(1).
24. Tsegaye K, Hagos A, Kindie H, Minyihun A, Teshale G. Evaluation of cervical cancer screening program in Gondar city administration public health facilities, Northwest Ethiopia, 2021: mixed method approach. BMC Cancer. 1 de diciembre de 2023;23(1).
25. Dadipoor S, Alavi A, Kader Z, Mohseni S, Eshaghi Sani Kakhaki H, Shahabi N. Predictive power of PEN-3 cultural model in cervical cancer screening among women: a cross- sectional study in South of Iran. BMC Cancer. 1 de diciembre de 2023;23(1).
26. Misgun T, Demissie DB. Knowledge, practice of cervical cancer screening and associated factors among women police members of Addis Ababa police commission Ethiopia. BMC Cancer. 1 de diciembre de 2023;23(1).
27. Endalew DA, Moti D, Mohammed N, Redi S, Alemu BW. Knowledge and practice of cervical cancer screening and associated factors among reproductive age group women in districts of Gurage zone, Southern Ethiopia. A cross-sectional study. PLoS One. 1 de septiembre de 2020;15(9 September).
28. Alissa NA. Knowledge and intentions regarding the Pap smear test among Saudi Arabian women. PLoS One [Internet]. 1 de junio de 2021 [citado 29 de abril de 2024];16(6):e0253850. Disponible en: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253850
29. Kalliala I, Athanasiou A, Veroniki AA, Salanti G, Efthimiou O, Raftis N, et al. Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature. Annals of Oncology. 1 de febrero de 2020;31(2):213-27.
30. Mwenda V, Mwangi M, Gathecha G, Kibachio J, Too R, Gura Z, et al. Factors associated with late diagnosis of cervical cancer at two national referral hospitals, Kenya 2017: A case control study. Gynecol Oncol Rep. 1 de abril de 2024;52.
31. Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 1 de febrero de 2020;8(2):e191-203.
32. Reich O, Regauer S. Elimination of reserve cells for prevention of HPV-associated cervical cancer. Virus Res. 1 de mayo de 2023;329.
33. Chen X, Dong X, Li H, Wu T, Liu H, Wu J, et al. RNA-binding proteins signature is a favorable biomarker of prognosis, immunotherapy and chemotherapy response for cervical cancer. Cancer Cell Int. 1 de diciembre de 2024;24(1).
34. Miles TT, Riley-Powell AR, Lee GO, Gotlieb EE, Barth GC, Tran EQ, et al. Knowledge, attitudes, and practices of cervical cancer prevention and pap smears in two low-income communities in Lima, Peru. BMC Womens Health [Internet]. 1 de diciembre de 2021 [citado 29 de abril de 2024];21(1):1-11. Disponible en: https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-021-01291-8
35. Baharum NN, Ariffin F, Isa MR, Tin ST. Health literacy, knowledge on cervical cancer and pap smear and its influence on pre-marital malay muslim women attitude towards pap smear. Asian Pacific Journal of Cancer Prevention. 1 de julio de 2020;21(7):2021-8.
36. Chen X, Dong X, Li H, Wu T, Liu H, Wu J, et al. RNA-binding proteins signature is a favorable biomarker of prognosis, immunotherapy and chemotherapy response for cervical cancer. Cancer Cell Int. 1 de diciembre de 2024;24(1).
37. Arbyn M, Weiderpass E, Bruni L, de Sanjosé S, Saraiya M, Ferlay J, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 1 de febrero de 2020;8(2):e191-203.
38. Kalliala I, Athanasiou A, Veroniki AA, Salanti G, Efthimiou O, Raftis N, et al. Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature. Annals of Oncology. 1 de febrero de 2020;31(2):213-27.
39. Mwenda V, Mwangi M, Gathecha G, Kibachio J, Too R, Gura Z, et al. Factors associated with late diagnosis of cervical cancer at two national referral hospitals, Kenya 2017: A case control study. Gynecol Oncol Rep. 1 de abril de 2024;52.
Publicado
2024-07-30
Cómo citar
1.
Filián Guillén GJ, Fuentes Chonana D. Factores de Riesgo Asociados con Lesiones Precancerosas del Cuello Uterino. PFR [Internet]. 30 de julio de 2024 [citado 19 de septiembre de 2024];9(2). Disponible en: https://practicafamiliarrural.org/index.php/pfr/article/view/316
Sección
Artículos de revisión
Derechos de autor 2024 Práctica Familiar Rural
Esta obra está bajo licencia internacional Creative Commons Reconocimiento 4.0.
