medigraphic.com
SPANISH

Neurología, Neurocirugía y Psiquiatría

ISSN 0028-3851 (Print)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2023, Number 3

<< Back Next >>

Rev Neurol Neurocir Psiquiat 2023; 51 (3)

The challenge of the application of therapeutic effort limitation in Mexico: attitudes and knowledge of health professionals

Trujillo-De LSZ, Paz-Rodríguez F, Sánchez-Guzmán MA, Canchola-Vázquez AL, Curiel-Ramírez JM, Hernández-Ixtepan JG, Ramírez-Portillo EB
Full text How to cite this article 10.35366/115405

DOI

DOI: 10.35366/115405
URL: https://dx.doi.org/10.35366/115405

Language: Spanish
References: 27
Page: 135-143
PDF size: 194.04 Kb.


Key words:

limitation of therapeutic effort, adequacy of therapeutic effort, decisions at the end of life, knowledge, attitudes.

ABSTRACT

Introduction: the limitation of therapeutic effort (LTE) are maneuvers of infrequent use that usually generate controversy among health professionals in Mexico. Objective: to describe the results of a survey of health personnel in various public and private institutions, inquiring about: knowledge, attitudes and perception about LTE, euthanasia and legal bases. Material and methods: descriptive cross-sectional study, through a survey on the Google Forms Online platform. 230 health professionals participated and were classified into five categories. A descriptive analysis of the variables of interest and comparisons was carried out to find out differences between the respondents. Results: the majority were women (58.7%) with an average age of 36 years. Specialist physicians mainly participated, of these 44.8% reported having relatives in intensive care, 75% made LTE decisions for a relative. Specialist doctors and nurses are the most knowledgeable. 32.2% of the sample confuses LTE with euthanasia. Conclusion: the study shows the lack of knowledge of final decisions such as LTE and its difference with other terms and deficiency of a formally and formative practice hospitalary of LTE.


REFERENCES

  1. GaliciaClinica - Revista Oficial de la Sociedad Gallega de Medicina Interna SOGAMI. (s/f). Galiciaclinica.info. [Recuperado el 13 de julio de 2023] Disponible en: https://galiciaclinica.info/normaspublicacion.asp

  2. Casas Martínez ML. Limitación del esfuerzo terapéutico y cuidados paliativos. Bioethics UPdate. 2017; 3 (2): 137-151. Available in: https://doi.org/10.1016/j.bioet.2017.09.002

  3. Herreros B, Palacios G, Pacho E. Limitación del esfuerzo terapéutico. Revista Clínica Española. 2012; 212 (3): 134-140. Disponible en: https://doi.org/10.1016/j.rce.2011.04.016

  4. Simon JR, Kraus C, Rosenberg M, Wang DH, Clayborne EP, Derse AR. "Futile Care"-an emergency medicine approach: ethical and legal considerations. Ann Emerg Med. 2017; 70 (5): 707-713. Available in: https://doi.org/10.1016/j.annemergmed.2017.06.005

  5. Taylor DR, Lightbody CJ. Futility and appropriateness: challenging words, important concepts. Postgrad Med J. 2018; 94 (1110): 238-243. Available in: https://doi.org/10.1136/postgradmedj-2018-135581

  6. Thurn T, Borasio GD, Chiò A, Galvin M, McDermott CJ, Mora G et al. Physicians' attitudes toward end-of-life decisions in amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener. 2019; 20 (1-2): 74-81. Available in: https://doi.org/10.1080/21678421.2018.1536154

  7. Cartwright CM, White BP, Willmott L, Williams G, Parker MH. Palliative care and other physicians' knowledge, attitudes and practice relating to the law on withholding/withdrawing life-sustaining treatment: survey results. Palliat Med. 2016; 30 (2): 171-179. Available in: https://doi.org/10.1177/0269216315587996

  8. Jahn Kassim PN, Alias F. religious, ethical and legal considerations in end-of-life issues: fundamental requisites for medical decision making. J Relig Health. 2016; 55 (1): 119-134. Available in: https://doi.org/10.1007/s10943-014-9995-z

  9. Belloc RM, Girbes ARJ. Toma de decisiones al final de la vida, el modo neerlandés a traves de ojos españoles. Med Intensiva. 2011; 35 (2): 102-106. Disponible en: https://doi.org/10.1016/j.medin.2010.09.013

  10. Miccinesi G, Fischer S, Paci E, Onwuteaka-Philipsen BD, Cartwright C, van der Heide A et al. Physicians' attitudes towards end-of-life decisions: a comparison between seven countries. Soc Sci Med. 2005; 60 (9): 1961-1974. Available in: https://doi.org/10.1016/j.socscimed.2004.08.061

  11. Wilkinson DJC, Savulescu J. Knowing when to stop: futility in the ICU. Current Opinion in Anaesthesiology. 2011; 24 (2): 160-165. Available in: https://doi.org/10.1097/aco.0b013e328343c5af

  12. Casas MML, Caballero VMC. Dilemas bioéticos y sus posibles soluciones en las unidades de terapia intensiva pediátrica del Distrito Federal (México). Acta Bioethicar. 2013; 19 (2): 275-283. Disponible en: https://doi.org/10.4067/s1726-569x2013000200012

  13. Velázquez AJ, Pulido CA, Ruíz SM, Hurtado LL. Medición del conocimiento de bioética en residentes y médicos de base de cirugía general del Hospital General de México. Cir Gen. 2011; 33 (4): 248-254.

  14. Diario Oficial de la Federación. 2009. DECRETO por el que se reforma y adiciona la Ley General de Salud en Materia de Cuidados Paliativos.

  15. Diario Oficial de la Federación. Norma Oficial Mexicana NOM-011-SSA3-2014. Criterios para la atención de enfermos en situación terminal a través de cuidados paliativos. 2014.

  16. Ochoa MJA. Eutanasia, suicidio asistido y voluntad anticipada: un debate necesario, En: Boletín CONAMED-OPS, 2017, pp. 27-30.

  17. Córdoba NMA, Guzmán CPC, Arevalo OAK, Corredor YA, Eraso PIC. Knowledge, practices, attitudes and opinions of the health personnel of the department of pediatrics of a university hospital in Colombia about the limitation of therapeutic effort in children. Universitas Médica. 2018; 59 (1). Available in: https://doi.org/10.11144/javeriana.umed59-1.letc

  18. González ME. Decisiones al final de la vida en México. Entreciencias diálogos en la Sociedad del Conocimiento. 2015; 3 (8): 267-278. Disponible en: https://doi.org/10.21933/j.edsc.2015.08.110

  19. Ul Haq N, Hassali MA, Shafie AA, Saleem F, Farooqui M, Aljadhey H. A cross sectional assessment of knowledge, attitude and practice towards Hepatitis B among healthy population of Quetta, Pakistan. BMC Public Health. 2012; 12: 692. Available in: https://doi.org/10.1186/1471-2458-12-692

  20. González-Castro 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. Revista de calidad asistencial: Órgano de la Sociedad Española de Calidad Asistencial. 2016; 31 (5): 262-266. Disponible en: https://doi.org/10.1016/j.cali.2015.12.007

  21. Lomero MDM, Jiménez-Herrera MF, Llaurado-Serra M, Bodí MA, Masnou N, Oliver E, Sandiumenge A. Impact of training on intensive care providers' attitudes and knowledge regarding limitation of life-support treatment and organ donation after circulatory death. Nurs Health Sci. 2018; 20 (2): 187-196. Available in: https://doi.org/10.1111/nhs.12400

  22. Restrepo BD, Cossio C, Ochoa JFL, Jaramillo JC, Bedoya J, Duque D, Ospina S. Conocimientos, actitudes y prácticas frente a la limitación de esfuerzos terapéuticos en personal de salud de un hospital universitario. Persona y Bioética, 2013; 17 (2): 216-226. Disponible en: https://www.redalyc.org/articulo.oa?id=83230691006

  23. Morales VG, Alvarado RT, Zuleta CR. Limitación del esfuerzo terapéutico en cuidados intensivos pediátricos: conocimiento y actitudes bioéticas del profesional médico. Rev Chil Pediatr. 2016; 87 (2): 116-120. Disponible en: https://doi.org/10.1016/j.rchipe.2015.10.002

  24. Paredes EMC. Limitación del esfuerzo terapéutico en la práctica clínica: percepciones de profesionales médicos y de enfermería de unidades de pacientes críticos de un hospital público de adultos en la Región Metropolitana. Acta Bioethica. 2012; 18 (2): 163-171. Disponible en: https://doi.org/10.4067/s1726-569x2012000200004

  25. Mansilla-Olivares A, López-Bárcena J, Plancarte-Sánchez R, Valenzuela-Gómez-Gallardo F, Rojo J, Meneses-González F et al. Postura de la Academia Nacional de Medicina de México en relación con las decisiones sobre el final de la vida. Gac Med Mex. 2018; 154 (6): 732-736. Disponible en: https://doi.org/10.24875/GMM.18004743

  26. Knaul FM, Farmer PE, Krakauer EL, De Lima L, Bhadelia A, Jiang Kwete X et al. Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report. Lancet. 2018; 391 (10128): 1391-1454. Available in: https://doi.org/10.1016/s0140-6736(17)32513-8

  27. Pastrana T, De Lima L, Sánchez-Cárdenas M, Van Stejn D, Garralda E, Pons JJ, Centeno C. Atlas de Cuidados Paliativos en Latinoamérica Houston: IAHPC Press [Internet]. 2020.




Table 1
Table 2
Table 3
Table 4

2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Neurol Neurocir Psiquiat. 2023;51