ABSTRACT
BACKGROUND: During the first weeks of March 2020 in Spain, the cases of severe respiratory failure progressively increased, generating an imbalance between the clinical needs for advanced life support (ALS) measures and the effective availability of ALS resources. To address this problem, the creation of triage committees (TC) was proposed, whose main function is to select the best candidates to receive ALS. The main objective of our study is to describe the clinical characteristics of the patients evaluated by the TC of the Alcorcón Foundation University Hospital (AFUH) during the first wave of SARS CoV-2. Other objectives are to determine if there are differences between the patients considered candidates / not candidates for ALS and to analyze the functioning of the TC. METHODS: Retrospective observational study of all patients assessed by the AFUH TC. RESULTS: There were 19 meetings, in which 181 patients were evaluated, 65.4% male and with a mean age of 70.1 years. 31% had some degree of functional dependence, the Barthel median was 100 and Charlson 4. 58.5% were not considered a candidate for ALS at that time. The patients considered candidates to receive ALS were younger (72 vs 66; p < 0.001), had less comorbidity (Charlson 4 vs 3; p < 0.001) and had a better previous functional situation. A median of 5 physicians participated in each meeting and, after being assessed by the TC, 13.6% received ALS: 29.3% of those considered candidates for ALS and 2% of the non-candidates. CONCLUSIONS: The patients evaluated by the TC had a mean age of 70 years, high comorbidity and almost a third had some degree of functional dependence. More than half were not considered candidates for ALS at that time, these patients being older, with more comorbidity and a worse previous functional situation. TC decisions, based on objective clinical criteria, were almost always respected. Public institutions must get involved in triage procedures, which should and in our opinion must include the creation of TC in health centers. The implementation of Anticipated Decision programs (ADP) would help enable patients affected by triage decisions to participate in them.
Subject(s)
COVID-19 , Triage , Advanced Cardiac Life Support , Aged , Female , Humans , Male , Pandemics , Retrospective StudiesABSTRACT
INTRODUCTION: Medical empathy is a characteristic that allows us to understand the subjective experiences and the perspective of the patient. Empathy can improve the clinical outcomes of our clinical actions. However, it is not easy to teach this ability in a medical school program. OBJECTIVE: We aimed to identify the level of empathy and related factors in students enrolled in medicine in 2019. METHODS: We conducted a cross-sectional, descriptive study. We used a questionnaire with sociodemographic questions, and Jefferson's Medical Empathy Scale to measure the variables. RESULTS: We surveyed 189 medical students. The mean score was 118,01 (range: 20 to 140), standard deviation, 11,61; median, 120; and a Cronbach's alpha coefficient of 0,76. We found that the year of the enrollment is inversely related to the level of empathy (p = 0,0095), that the female sex has a higher level of empathy (p = 0,0123) and that practicing a religious denomination is related to a higher level of empathy (p = 0,0001). CONCLUSION: Medical students have an above-average level of empathy when compared to other local studies. We describe higher levels of empathy according to sex, and religious beliefs, and an inverse relation to the year of enrollment.
INTRODUCCIÓN: La empatía médica es una característica que nos permite entender las experiencias internas y la perspectiva del paciente. Aplicándola a nuestro actuar médico, puede mejorar nuestros resultados clínicos. Sin embargo, no es una capacidad fácil de enseñar en el pregrado de la carrera de medicina. OBJETIVO: Identificar el nivel de empatía y factores relacionados con ésta, en estudiantes de la carrera de medicina en el año 2019. MÉTODOS: El presente es un estudio descriptivo transversal. Se utiliza como herramientas un cuestionario con preguntas sociodemográficas y la Escala de Empatía Médica de Jefferson (Jefferson's Medical Empathy Scale). RESULTADOS: Se encuestó a 189 estudiantes de medicina. La media de puntaje fue de 118,01 (rango posible entre 20 y 140), con una desviación estándar de 11,61; mediana de 120 y un coeficiente α de Cronbach de 0,76. Se encontró que el año de estudio tiene una relación inversa con el nivel de empatía (p = 0,0095), que el sexo femenino (p = 0,0123) y practicar alguna religión (p = 0,0001), están relacionados con mayor nivel de empatía. CONCLUSIÓN: Los estudiantes de medicina tienen un nivel de empatía alta, por encima del promedio cuando se compara con otros estudios locales. Describimos mayores niveles de empatía según sexo y confesión religiosa del estudiante y una relación inversa con el año de estudio.
Subject(s)
Education, Medical , Empathy , Students, Medical/psychology , Adult , Cross-Sectional Studies , Female , Humans , Male , Peru , Religion and Psychology , Sex Factors , Surveys and Questionnaires , Young AdultABSTRACT
INTRODUCCIÓN: La empatía médica es una característica que nos permite entender las experiencias internas y la perspectiva del paciente. Aplicándola a nuestro actuar médico, puede mejorar nuestros resultados clínicos. Sin embargo, no es una capacidad fácil de enseñar en el pregrado de la carrera de medicina. OBJETIVO: Identificar el nivel de empatía y factores relacionados con ésta, en estudiantes de la carrera de medicina en el año 2019. MÉTODOS: El presente es un estudio descriptivo transversal. Se utiliza como herramientas un cuestionario con preguntas sociodemográficas y la Escala de Empatía Médica de Jefferson (Jefferson's Medical Empathy Scale). RESULTADOS: Se encuestó a 189 estudiantes de medicina. La media de puntaje fue de 118,01 (rango posible entre 20 y 140), con una desviación estándar de 11,61; mediana de 120 y un coeficiente α de Cronbach de 0,76. Se encontró que el año de estudio tiene una relación inversa con el nivel de empatía (p = 0,0095), que el sexo femenino (p = 0,0123) y practicar alguna religión (p = 0,0001), están relacionados con mayor nivel de empatía. CONCLUSIÓN: Los estudiantes de medicina tienen un nivel de empatía alta, por encima del promedio cuando se compara con otros estudios locales. Describimos mayores niveles de empatía según sexo y confesión religiosa del estudiante y una relación inversa con el año de estudio.
INTRODUCTION: Medical empathy is a characteristic that allows us to understand the subjective experiences and the perspective of the patient. Empathy can improve the clinical outcomes of our clinical actions. However, it is not easy to teach this ability in a medical school program. OBJECTIVE: We aimed to identify the level of empathy and related factors in students enrolled in medicine in 2019. METHODS: We conducted a cross-sectional, descriptive study. We used a questionnaire with sociodemographic questions, and Jefferson's Medical Empathy Scale to measure the variables. RESULTS: We surveyed 189 medical students. The mean score was 118,01 (range: 20 to 140), standard deviation, 11,61; median, 120; and a Cronbach's alpha coefficient of 0,76. We found that the year of the enrollment is inversely related to the level of empathy (p = 0,0095), that the female sex has a higher level of empathy (p = 0,0123) and that practicing a religious denomination is related to a higher level of empathy (p = 0,0001). CONCLUSION: Medical students have an above-average level of empathy when compared to other local studies. We describe higher levels of empathy according to sex, and religious beliefs, and an inverse relation to the year of enrollment.