Evaluación del conocimiento y práctica de la limitación del esfuerzo terapéutico en personal asistencial de una institución prestadora de servicios de salud para pacientes oncológicos de Medellín, 2018
DOI:
https://doi.org/10.5294/pebi.2020.24.2.5Keywords:
Medical oncology, medical ethics, bioethical issues, personal autonomy.Abstract
Evaluating the Knowledge and Practice of Limitation of Therapeutic Effort in Health Workers at a Health Care Institution for Cancer Patients in Medellín, 2018
Avaliação do conhecimento e da prática da limitação de esforço terapêutico em equipe de atendimento de uma instituição prestadora de serviços de saúde para pacientes oncológicos de Medellín, 2018
Limitation of therapeutic effort (LTE) is any action that involves suspending or not initiating medical treatment or therapeutic measures in patients who will not receive any clinical benefit. In Latin America, some research has proven a lack of familiarization and disagreement with the subject and its practices. The present study tried to objectify the knowledge of LTE of healthcare personnel at an institute in Medellín using a self-administered survey that allowed conducting a cross-sectional descriptive study with non-probabilistic sampling. Within the results, 56.5 % of respondents understood the concept of LTE, and 90 % applied it actively. However, there were discrepancies regarding the core concepts of the definition and practice.
Para citar este artículo / To reference this article / Para citar este artigo
Vallejo LI, Palacio AM, Marulanda V, Restrepo A, Yepes LA, Valencia NL, Cruz MA. Evaluación del conocimiento y práctica de la limitación del esfuerzo terapéutico en personal asistencial de una institución prestadora de servicios de salud para pacientes oncológicos de Medellín, 2018. 2020;24(2):177-87. DOI: https://doi.org/10.5294/pebi.2020.24.2.5
Recibido: 19/07/2019
Aceptado: 08/08/2020
Publicado: 27/11/2020
Downloads
References
Herreros B, Palacios G, Pacho E. Limitación del esfuerzo terapéutico. Rev Clínica Esp. 2012;212(3):134-40. https://doi.org/10.1016/j.rce.2011.04.016
Regateiro DAA. Limitación del esfuerzo terapéutico, una opción en el cuidado de los pacientes en terapia intensiva. Bioética. 2015;15-9. Disponible en: http://www.cbioetica.org/revista/162/1519.pdf
Betancourt DG. Limitación del esfuerzo terapéutico en las unidades de atención al paciente grave. Rev Archivo Médico de Camaguey. 2011;15 (5):776-80. Disponible en: http://scielo.sld.cu/scielo.php?script=sci_arttext&pid=S1025-02552011000500001
Gamboa Antiñolo F. Limitación de esfuerzo terapéutico. ¿Es lo mismo retirar un tratamiento de soporte vital que no iniciarlo? Med Clínica. 2010;135(9):410-6. Disponible en: https://medes.com/publication/60940
Bertolini G, Boffelli S, Malacarne P, Peta M, Marchesi M, Barbisan C, et al. End-of-life decision-making and quality of ICU performance: An observational study in 84 Italian units. Intensive Care Med. 2010;36(9):1495-504. DOI: https://doi.org/10.1007/s00134-010-1910-9
García R, Herreros B, Real de Asúa D, Gámez S, Vega G, García L. Limitación del esfuerzo terapéutico en pacientes hospitalizados en servicios de medicina interna. Rev Clínica Esp. 2018;218(1):1-6. DOI: https://doi.org/10.1016/j.cali.2015.11.004
Solís J, Gómez I. La aplicación de las órdenes de no reanimación y la limitación del esfuerzo terapéutico en pacientes ingresados en Medicina Interna en un hospital comarcal. Rev Calid Asist. 2013;28(1):50-5. DOI: https://doi.org/10.1016/j.cali.2012.09.003
Morales G, Alvarado T, Zuleta R. Limitación del esfuerzo terapéutico en cuidados intensivos pediátricos: conocimiento y actitudes bioéticas del profesional médico. Rev Chil Pediatría. 2016;87(2):116-20. Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0370-41062016000200007
Sprung CL, Cohen SL, Sjokvist P, Baras M, Bulow H-H, Hovilehto S, et al. End-of-Life Practices in European Intensive Care Units. JAMA. 2003;290(6):790-7. DOI: https://doi.org/10.1001/jama.290.6.790
González A, Azcune O, Peñasco Y, Rodríguez JC, Domínguez MJ, Rojas R. Opinión de los profesionales de una unidad de cuidados intensivos sobre la limitación del esfuerzo terapéutico. Rev Calid Asist. 2016;31(5):262-6. DOI: https://doi.org/10.1016/j.cali.2015.12.007
Wunsch H, Harrison DA, Harvey S, Rowan K. End-of-life decisions: A cohort study of the withdrawal of all active treatment in intensive care units in the United Kingdom. Intensive Care Med. 2005;31(6):823-31. DOI: https://doi.org/10.1007/s00134-005-2644-y
Esteban A, Gordo F, Solsona L, Alía I, Caballero J, Bouza C, et al. Withdrawing and withholding life support in the intensive care unit: A Spanish prospective multi-centre observational study. Intensive Care Med. 2001;27(11):1744-9. DOI: https://doi.org/10.1007/s00134-001-1111-7
González Cruz LR. Consideraciones sobre la limitación del esfuerzo terapéutico (LET) en pediatría. [Trabajo de grado]. Bogotá: UNAL; 2014. Disponible en: http://www.bdigital.unal.edu.co/12322/1/luisricardogonzalezcruz.2014.pdf
Restrepo D, Cossio C, Ochoa FL, Jaramillo JC, Bedoya J, Duque D, et al. Conocimientos, actitudes y prácticas frente a la limitación del esfuerzo terapeútico en personal de salud de un hospital universitario. Bioét. 2013;17(2):216-26. Disponible en: http://www.scielo.org.co/scielo.php?script=sci_abstract&pid=S0123-31222013000200006&lng=es&nrm=iso&tlng=es
Hernández A, Hermana MT, Hernández R, Cambra FJ, Rodríguez A, Failde I. Encuesta de ética en las unidades de cuidados intensivos pediátricos españolas. An Pediatría. 2006;64(6):542-9. DOI: https://doi.org/10.1157/13089919
Damghi N, Belayachi J, Aggoug B, Dendane T, Abidi K, Madani N, et al. Withholding and withdrawing life-sustaining therapy in a Moroccan Emergency Department: An observational study. BMC Emerg Med. 2011;11(1). Disponible en: http://bmcemergmed.biomedcentral.com/articles/10.1186/1471-227X-11-12
Cabré L, Solsona JF. Limitación del esfuerzo terapéutico en medicina intensiva. Med Intensiva. 2002;26(6):304-11. Disponible en: https://www.medintensiva.org/es-limitacion-del-esfuerzo-terapeutico-medicina-articulo-13036165
Yoo SH, Yun YH, Kim K-N, Lee JL, Park J, Choi YS, et al. The impact of caregiver’s role preference on decisional conflicts and psychiatric distresses in decision making to help caregiver’s disclosure of terminal disease status. Qual Life Res. 2018;27(6):1571-81. DOI: https://doi.org/10.1007/s11136-018-1814-7
Shin DW, Cho J, Roter DL, Kim SY, Sohn SK, Yoon M-S, et al. Preferences for and experiences of family involvement in cancer treatment decision-making: Patient-caregiver dyads study: Family involvement in treatment decision. Psychooncology. 2013;22(11):2624-31. DOI: https://doi.org/10.1002/pon.3339
Yennurajalingam S, Noguera A, Parsons HA, Torres I, Duarte ER, Palma A, et al. A multicenter survey of Hispanic caregiver preferences for patient decision control in the United States and Latin America. Palliat Med. 2013;27(7):692-8. DOI: https://doi.org/10.1177/0269216313486953
Shin DW, Cho J, Roter DL, Kim SY, Yang HK, Park K, et al. Attitudes toward family involvement in cancer treatment decision making: The perspectives of patients, family caregivers, and their oncologists. Psychooncology. 2017;26(6):770-8. DOI: https://doi.org/10.1002/pon.4226
Sprung CL, Truog RD, Curtis JR, Joynt GM, Baras M, Michalsen A, et al. Seeking worldwide professional consensus on the principles of end-of-life care for the critically ill. The Consensus for Worldwide End-of-Life Practice for Patients in Intensive Care Units (WELPICUS) Study. Am J Respir Crit Care Med. 2014;190(8):855-66. DOI: https://doi.org/10.1164/rccm.201403-0593CC
Velarde JF, Luengo R, González R, Cardenete C, Álvarez B, Palacios D. Limitation of therapeutic effort experienced by intensive care nurses. Nurs Ethics. 2018;25(7):867-79. DOI: https://doi.org/10.1177/0969733016679471
Coombs M, Fulbrook P, Donovan S, Tester R, deVries K. Certainty and uncertainty about end of life care nursing practices in New Zealand Intensive Care Units: A mixed methods study. Aust Crit Care. 2015;28(2):82-6. https://doi.org/10.1016/j.aucc.2015.03.002
Curtis JR, Vincent J-L. Ethics and end-of-life care for adults in the intensive care unit. The Lancet. 2010;376(9749):1347-53. DOI: https://doi.org/10.1016/s0140-6736(10)60143-2
Langley G, Schmollgruber S, Fulbrook P, Albarran JW, Latour JM. South African critical care nurses’ views on end-of-life decision-making and practices: South African critical care nurses’ views on EOL decision-making and practices. Nurs Crit Care. 2014;19(1):9-17. DOI: https://doi.org/10.1111/nicc.12026
Misak CJ, White DB, Truog RD. Medically Inappropriate or futile treatment: Deliberation and justification. J Med Philos. 2016;41(1):90-114. DOI: https://doi.org/10.1093/jmp/jhv035
Baidoobonso S. Patient care planning discussions for patients at the end of life: An evidence-based analysis. Ont Health Technol Assess Ser. 2014;14(19):72. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561366/
Published
How to Cite
Issue
Section
License
Copyright (c) 2020 Persona y Bioética
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Authors who publish with this journal agree to the following terms:
This journal and its papers are published with the Creative Commons License Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0). You are free to share copy and redistribute the material in any medium or format if you: give appropriate credit, provide a link to the license, and indicate if changes were made; don’t use our material for commercial purposes; don’t remix, transform, or build upon the material.
