Pub Date : 2022-01-01DOI: 10.20986/medpal.2022.1379/2022
Katherine Pettus
{"title":"Construyendo un mundo libre de sufrimiento relacionado a la salud","authors":"Katherine Pettus","doi":"10.20986/medpal.2022.1379/2022","DOIUrl":"https://doi.org/10.20986/medpal.2022.1379/2022","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68141696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.20986/medpal.2022.1301/2021
Maria Varela Cerdeira, Daniel Gainza Miranda, Eva María Sanz Peces, Julio de las Heras Mosteiro, Ana Isabel Bravo Guillen, Nuria Pérez de Lucas
Background and objectives : Few studies have reported the end of life for patients with amyotrophic lateral sclerosis (ALS). Our main objective was to describe the end-of- life trajectory in patients monitored by a palliative home care team (PHTC). The secondary objective was to examine factors associated with place of death and survival. Setting and design: Retrospective observational study in a cohort of patients diagnosed with ALS followed by a PHCT. Sociodemographic variables, survival from the start of ventilation and gastrostomy, consumption of health resources, opioid use, care planning, place of death and cause of death were analyzed. Results: Sixty patients were included. Main symptoms were dyspnea and dysphagia. Advance care planning was possible for 83 ░ %. Fifty-two (83 ░ %) died at home or in a palliative care unit. The cause of death was respiratory failure, respiratory infection, death during sleep, and refusal of treatment for 47 ░ %, 16 ░ %, 15 ░ % and 15 ░ %, respectively. Opioids were required in 47 ░ %, and 25 ░ % palliative sedation. Average survival from the start of enteral feeding, noninvasive mechanical ventilation and invasive ventilation was 7, 13 and 12 months, respectively. Average of visits was 14 (SD 12). Having received informal support and not having been admitted to the hospital during the study period were associated with significantly increased of dying at home. Conclusions: The most frequent cause of death was respiratory failure, most cases required opioids, and one out of every four palliative sedation. Most die at home.
{"title":"Seguimiento de pacientes con Esclerosis Lateral amiotrófica por un Equipo de Cuidados Paliativos Domiciliario","authors":"Maria Varela Cerdeira, Daniel Gainza Miranda, Eva María Sanz Peces, Julio de las Heras Mosteiro, Ana Isabel Bravo Guillen, Nuria Pérez de Lucas","doi":"10.20986/medpal.2022.1301/2021","DOIUrl":"https://doi.org/10.20986/medpal.2022.1301/2021","url":null,"abstract":"Background and objectives : Few studies have reported the end of life for patients with amyotrophic lateral sclerosis (ALS). Our main objective was to describe the end-of- life trajectory in patients monitored by a palliative home care team (PHTC). The secondary objective was to examine factors associated with place of death and survival. Setting and design: Retrospective observational study in a cohort of patients diagnosed with ALS followed by a PHCT. Sociodemographic variables, survival from the start of ventilation and gastrostomy, consumption of health resources, opioid use, care planning, place of death and cause of death were analyzed. Results: Sixty patients were included. Main symptoms were dyspnea and dysphagia. Advance care planning was possible for 83 ░ %. Fifty-two (83 ░ %) died at home or in a palliative care unit. The cause of death was respiratory failure, respiratory infection, death during sleep, and refusal of treatment for 47 ░ %, 16 ░ %, 15 ░ % and 15 ░ %, respectively. Opioids were required in 47 ░ %, and 25 ░ % palliative sedation. Average survival from the start of enteral feeding, noninvasive mechanical ventilation and invasive ventilation was 7, 13 and 12 months, respectively. Average of visits was 14 (SD 12). Having received informal support and not having been admitted to the hospital during the study period were associated with significantly increased of dying at home. Conclusions: The most frequent cause of death was respiratory failure, most cases required opioids, and one out of every four palliative sedation. Most die at home.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68138419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.20986/medpal.2022.1356/2022
Manuel Molina Arias, María Luisa Maquedano Martínez
{"title":"Herramientas de lectura crítica. Un ejemplo práctico","authors":"Manuel Molina Arias, María Luisa Maquedano Martínez","doi":"10.20986/medpal.2022.1356/2022","DOIUrl":"https://doi.org/10.20986/medpal.2022.1356/2022","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68140700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.20986/medpal.2022.1343/2022
Agustín Diego Chacón Moreno, Daniel Fernández Robles, Juan Tejero González, Ignacio Borque Roda, María Martínez Cruz, Alejandro David Bendala Estrada
Introduction: In view of the development that is taking place in the field of palliative care and the training recommendations carried out by different international, national and regional strategic plans, the Madrilenian Association of Palliative Care (AMCP) carried out this study with the aim of defining the current situation of training in palliative care in the Community of Madrid in medicine, nursing, psychology and social work degrees. Material and methods: To this end, a questionnaire was drawn up with the data considered relevant according to the evidence, which was sent to the different universities to be completed during the year 2021. If no response was received, the information was completed by the research team by reviewing the official teaching guides. Results: From the data obtained from the 46 university degrees analysed, we found that specific training in palliative care is found in 71.7░% of the universities. In 69.7░% of these, this training is not taught as an independent subject; the average number of ECTS (European Credit Transfer and Accumulation System) attributed to this training is 3. In more than 50░% of the studies there are no compulsory internships and workshops or seminars are only found in 39.5░% of the curricula. The most frequently taught seminar is "How to communicate bad news". The most frequently covered topics are "Emotional approach of patient and family", followed by "Symptom management" and "Ethical aspects". Conclusion: Training in palliative care is present more and more frequently in Madrid universities, usually as part of other subjects. Workshops, seminars, and compulsory internships are scarce. Teachers are mostly tenured and without specific training. We must continue working to achieve the standards set by scientific societies regarding training.
{"title":"Formación de grado en cuidados paliativos en las universidades de la Comunidad Autónoma de Madrid. Estudio descriptivo","authors":"Agustín Diego Chacón Moreno, Daniel Fernández Robles, Juan Tejero González, Ignacio Borque Roda, María Martínez Cruz, Alejandro David Bendala Estrada","doi":"10.20986/medpal.2022.1343/2022","DOIUrl":"https://doi.org/10.20986/medpal.2022.1343/2022","url":null,"abstract":"Introduction: In view of the development that is taking place in the field of palliative care and the training recommendations carried out by different international, national and regional strategic plans, the Madrilenian Association of Palliative Care (AMCP) carried out this study with the aim of defining the current situation of training in palliative care in the Community of Madrid in medicine, nursing, psychology and social work degrees. Material and methods: To this end, a questionnaire was drawn up with the data considered relevant according to the evidence, which was sent to the different universities to be completed during the year 2021. If no response was received, the information was completed by the research team by reviewing the official teaching guides. Results: From the data obtained from the 46 university degrees analysed, we found that specific training in palliative care is found in 71.7░% of the universities. In 69.7░% of these, this training is not taught as an independent subject; the average number of ECTS (European Credit Transfer and Accumulation System) attributed to this training is 3. In more than 50░% of the studies there are no compulsory internships and workshops or seminars are only found in 39.5░% of the curricula. The most frequently taught seminar is \"How to communicate bad news\". The most frequently covered topics are \"Emotional approach of patient and family\", followed by \"Symptom management\" and \"Ethical aspects\". Conclusion: Training in palliative care is present more and more frequently in Madrid universities, usually as part of other subjects. Workshops, seminars, and compulsory internships are scarce. Teachers are mostly tenured and without specific training. We must continue working to achieve the standards set by scientific societies regarding training.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68141065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.20986/medpal.2022.1375/2022
Agustín Diego Chacón Moreno, Victoria López Gómez, Alejandro David Bendala Estrada
{"title":"Evaluación de prevalencia de pacientes con necesidades paliativas en las plantas de hospitalización de agudos de Oncología y Medicina Interna en dos hospitales de tercer nivel de la Comunidad de Madrid","authors":"Agustín Diego Chacón Moreno, Victoria López Gómez, Alejandro David Bendala Estrada","doi":"10.20986/medpal.2022.1375/2022","DOIUrl":"https://doi.org/10.20986/medpal.2022.1375/2022","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68141606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.20986/medpal.2022.1360/2022
Felipe MARTINEZ RIVERA, E.D. Anica Malagón, Rogelio Zapata Arenas, Jaime Camacho Aguilera, Manuel Flores Ibarra, Abraham Sebastián García Zamorano
Introduction: The objective of this study was to determine the prevalence of primary caregiver burden in patients at the end of life who attend the emergency department of this hospital and to determine their sociodemographic characteristics. Patients and methods: An observational, descriptive and prospective study was carried out, including 264 main caregivers of patients who were in the final phase of life, who received medical care for complications of their underlying condition in the emergency department of the General Hospital of Mexico “Dr. Eduardo Liceaga”, in a period of 6 months, from April 1, 2021 to September 31, 2021, with the following inclusion criteria: being the main caregiver, having a family relationship with the patient, voluntary participation, being more than 18 years old. The participants, after signing the informed consent, answered the demographic data questionnaires, the abbreviated Zarit scale, and the Katz scale. Within the multidimensional assessment of the terminally ill patient, the biological assessment is based on the functional status of the patient, to assess dependence on activities of daily living, the Katz index can be used. Results: A total of 264 primary caregivers were included, 187 (70,8░%) were female and 77 (29,2░%) were male; the minimum age was 18 years and the maximum was 80 years, with a median of 44 years; Of the total number of caregivers analyzed, 219 (83░%) presented caregiver collapse syndrome at the time of the interview. Of the subjects studied, 138 (52,3░%) were sole caregivers, of which more than half (57░%) suffered from caregiver collapse syndrome. Conclusions: In conclusion, we have found that the prevalence of caregiver collapse syndrome is higher than that reported in similar studies. According to the sociodemographic characteristics, we observed that the main risk factors are: gender, age of the caregiver, time of performing the role of caregiver, degree of kinship, number of caregivers and degree of dependency on basic activities of daily living.
{"title":"Prevalencia y caracterización de la sobrecarga del cuidador primario de pacientes al final de la vida.","authors":"Felipe MARTINEZ RIVERA, E.D. Anica Malagón, Rogelio Zapata Arenas, Jaime Camacho Aguilera, Manuel Flores Ibarra, Abraham Sebastián García Zamorano","doi":"10.20986/medpal.2022.1360/2022","DOIUrl":"https://doi.org/10.20986/medpal.2022.1360/2022","url":null,"abstract":"Introduction: The objective of this study was to determine the prevalence of primary caregiver burden in patients at the end of life who attend the emergency department of this hospital and to determine their sociodemographic characteristics. Patients and methods: An observational, descriptive and prospective study was carried out, including 264 main caregivers of patients who were in the final phase of life, who received medical care for complications of their underlying condition in the emergency department of the General Hospital of Mexico “Dr. Eduardo Liceaga”, in a period of 6 months, from April 1, 2021 to September 31, 2021, with the following inclusion criteria: being the main caregiver, having a family relationship with the patient, voluntary participation, being more than 18 years old. The participants, after signing the informed consent, answered the demographic data questionnaires, the abbreviated Zarit scale, and the Katz scale. Within the multidimensional assessment of the terminally ill patient, the biological assessment is based on the functional status of the patient, to assess dependence on activities of daily living, the Katz index can be used. Results: A total of 264 primary caregivers were included, 187 (70,8░%) were female and 77 (29,2░%) were male; the minimum age was 18 years and the maximum was 80 years, with a median of 44 years; Of the total number of caregivers analyzed, 219 (83░%) presented caregiver collapse syndrome at the time of the interview. Of the subjects studied, 138 (52,3░%) were sole caregivers, of which more than half (57░%) suffered from caregiver collapse syndrome. Conclusions: In conclusion, we have found that the prevalence of caregiver collapse syndrome is higher than that reported in similar studies. According to the sociodemographic characteristics, we observed that the main risk factors are: gender, age of the caregiver, time of performing the role of caregiver, degree of kinship, number of caregivers and degree of dependency on basic activities of daily living.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68141766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/MEDPAL.2021.1157/2020
Aline Suárez Rayo, Evelia Apolinar Jiménez, Mayra Celia Lemus Mandujano, Nara Elizabeth Lara Pompa, Javier Portilla Segura, J. Martínez
{"title":"Sobrecarga en cuidadores primarios informales de pacientes en cuidados paliativos: Un estudio transversal","authors":"Aline Suárez Rayo, Evelia Apolinar Jiménez, Mayra Celia Lemus Mandujano, Nara Elizabeth Lara Pompa, Javier Portilla Segura, J. Martínez","doi":"10.20986/MEDPAL.2021.1157/2020","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1157/2020","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68130688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/MEDPAL.2021.1196/2020
S. V. Serrano, M. Ojeda, S. Alonso, Juan Ramón Lacalle Remigio
Objective: To know the difficulties and barriers found by health professionals for assistance to people in palliative care, in a health district. Design: Cross-sectional descriptive observational design. Location: Regional hospital and primary care centers of a health district. Participants: 118 health professionals from these centers: Internists, emergency physicians and family doctors; as well as nurses from the same healthcare areas. Main measurements: sociodemographic and professional variables were collected on the training and experience in palliative care through a survey, as well as the items of the Scale of Difficulties in Palliative Care (PCDS). Results: A total of 118 professionals were included, with an average age of 42.2 years, 57.6% being women. Palliative care limited training and the difficulty of accessing information at home were the greatest barriers found by the professionals, with a range observed between 2.27 and 3.26. No statistically significant differences are found when studying the perceived difficulties according to the professional category. In the comparison of care settings, there are differences (p=0.03), with greater difficulties being detected in the emergency department, with the emergency physician having the greatest difficulty compared to the internist (p<0.01). Among the nurses of the three care areas, no differences are identified. Conclusions: Emergency physicians and nurses were the professionals who experienced the greatest difficulties in providing palliative care in their care practice, while the internists were the ones who described the least difficulties.
{"title":"Dificultades y barreras encontradas por los profesionales sanitarios en la atención de pacientes paliativos en un distrito sanitario.","authors":"S. V. Serrano, M. Ojeda, S. Alonso, Juan Ramón Lacalle Remigio","doi":"10.20986/MEDPAL.2021.1196/2020","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1196/2020","url":null,"abstract":"Objective: To know the difficulties and barriers found by health professionals for assistance to people in palliative care, in a health district. Design: Cross-sectional descriptive observational design. Location: Regional hospital and primary care centers of a health district. Participants: 118 health professionals from these centers: Internists, emergency physicians and family doctors; as well as nurses from the same healthcare areas. Main measurements: sociodemographic and professional variables were collected on the training and experience in palliative care through a survey, as well as the items of the Scale of Difficulties in Palliative Care (PCDS). Results: A total of 118 professionals were included, with an average age of 42.2 years, 57.6% being women. Palliative care limited training and the difficulty of accessing information at home were the greatest barriers found by the professionals, with a range observed between 2.27 and 3.26. No statistically significant differences are found when studying the perceived difficulties according to the professional category. In the comparison of care settings, there are differences (p=0.03), with greater difficulties being detected in the emergency department, with the emergency physician having the greatest difficulty compared to the internist (p<0.01). Among the nurses of the three care areas, no differences are identified. Conclusions: Emergency physicians and nurses were the professionals who experienced the greatest difficulties in providing palliative care in their care practice, while the internists were the ones who described the least difficulties.","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68133274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/medpal.2021.1234/2021
Raquel Liliana Vazquez, Didier Andrés Bruno, María Pilar Cean, Mariana Cecilia Herrero, Graciela Vita, Andrés Gabriel Mendez Villarroel, E. M. Baldessari
{"title":"Resultados de un programa de Cuidados Paliativos en pacientes con insuficiencia cardíaca avanzada en etapa final de vida","authors":"Raquel Liliana Vazquez, Didier Andrés Bruno, María Pilar Cean, Mariana Cecilia Herrero, Graciela Vita, Andrés Gabriel Mendez Villarroel, E. M. Baldessari","doi":"10.20986/medpal.2021.1234/2021","DOIUrl":"https://doi.org/10.20986/medpal.2021.1234/2021","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68134144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-01DOI: 10.20986/MEDPAL.2021.1237/2021
L. Gálvez, René Fernando Rodríguez Jurado, Jefferson Vera Murillo
{"title":"CUIDADO PALIATIVO EN INSUFICIENCIA CARDIACA.","authors":"L. Gálvez, René Fernando Rodríguez Jurado, Jefferson Vera Murillo","doi":"10.20986/MEDPAL.2021.1237/2021","DOIUrl":"https://doi.org/10.20986/MEDPAL.2021.1237/2021","url":null,"abstract":"","PeriodicalId":49831,"journal":{"name":"Medicina Paliativa","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68134278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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