Limitación del esfuerzo terapéutico. Opinión de los profesionales / Limits of therapeutic effort. professional opinions

Introducción En nuestra práctica asistencial nos encontramos con la necesidad de atender a pacientes con situaciones no reversibles, debido a la avanzada edad o a enfermedades crónicas subyacentes y al cambio del tipo de patologías a las que se enfrenta en la actualidad el personal sanitario. El objetivo de esta investigación fue conocer la valoración ética de los profesionales sanitarios de nuestro centro, respecto a las medidas extraordinarias de soporte de vida. Material y Métodos Estudio descriptivo prospectivo realizado en el Hospital General Universitario de Ciudad Real durante los meses de abril a agosto del año 2010.La muestra de conveniencia estuvo formada por 189 profesionales de diferentes categorías que durante el periodo de estudio prestaban su servicio en nuestro hospital. Se incluyó un cuestionario adaptado para su utilización en el ámbito hospitalario que consta de 18 ítems con respuesta dicotómica. Se solicitó consentimiento informado y se garantizó la confidencialidad de la información. Resultados Se obtiene una muestra total de 189 profesionales, de los cuales un 21,7% fueron varones frente a un 78,3% que fueron mujeres. La media de edad se sitúo en 40,39 años DS± 10, con una moda de 31 años. Los profesionales que participaron fueron médicos, enfermeras y auxiliares de enfermería, con una media de experiencia laboral de 15,8% años DS± 10,4.El 79,9% se encuentra a favor de la eutanasia, el 93,6% en contra de la distanasia, el 92,6% a favor de la antidistanasia y un 99,5% a favor de la ortotonasia. El colectivo médico es el más contrario a la aplicación de la eutanasia p=0,0001.Se han observado diferencias entre la práctica religiosa y la actitud ética ante situaciones al final de la vida. Conclusiones La mayoría de los participantes tomaría en cuenta la decisión del paciente de limitar las medidas extraordinarias en (..) (AU)

Introduction: In our clinical practice we find the need to care for patients with irreversible conditions, due to advanced age or underlying chronic disease, and a change in the types of disease currently facing the health workforce. The objective of this research was to study the ethical assessment of health professionals in our Hospital on extraordinary life supportmeasures. Material and Methods: Prospective descriptive study conducted at the Hospital General Universitario de Ciudad Real during the months of April to August 2010.The convenience sample consisted of 189 professionals from different categories working in our hospital during the study period. It included a questionnaire adapted for use in hospitals, comprising 18 items with dichotomous responses. Informed consent was requested and the confidentiality of information ensured. Results: A sample of 189 professionals, of whom 21.7% were male and 78.3% were female. The mean age was 40.39 years SD + 10, with a mode of 31 years. The professionals involved were doctors, nurses and nursing assistants, with an average experience of 15.8% ± 10.4 SD years. A total of 79.9% were in favour of euthanasia, 93.6% against dysthanasia, 92.6% for antidysthanasia, and 99.5% for orthotonasia. The medical group was the one most against the use of euthanasia P=.0001.Differences were found between religious practice and the ethical situations at the end of life. Conclusions: Most participants took into account the patient’s decision to limit extraordinary measures in terminal disease situations. The study reveals that the effectiveness and usefulness of our clinical practice should include an ethical evaluation by professionals with the patient. It became clear that the majority of the sample of professionals is against over-aggressive treatment, and for a dignified death (AU)

[Limits of therapeutic effort. Professional opinions]. / Limitación del esfuerzo terapéutico. Opinión de los profesionales.

INTRODUCTION: In our clinical practice we find the need to care for patients with irreversible conditions, due to advanced age or underlying chronic disease, and a change in the types of disease currently facing the health workforce.The objective of this research was to study the ethical assessment of health professionals in our Hospital on extraordinary life support measures. MATERIAL AND METHODS: Prospective descriptive study conducted at the Hospital General Universitario de Ciudad Real during the months of April to August 2010. The convenience sample consisted of 189 professionals from different categories working in our hospital during the study period.It included a questionnaire adapted for use in hospitals, comprising 18 items with dichotomous responses.Informed consent was requested and the confidentiality of information ensured. RESULTS: A sample of 189 professionals, of whom 21.7% were male and 78.3% were female. The mean age was 40.39 years SD + 10, with a mode of 31 years.The professionals involved were doctors, nurses and nursing assistants, with an average experience of 15.8% ± 10.4 SD years.A total of 79.9% were in favour of euthanasia, 93.6% against dysthanasia, 92.6% for antidysthanasia, and 99.5% for orthotonasia. The medical group was the one most against the use of euthanasia P=.0001. Differences were found between religious practice and the ethical situations at the end of life. CONCLUSIONS: Most participants took into account the patient's decision to limit extraordinary measures in terminal disease situations.The study reveals that the effectiveness and usefulness of our clinical practice should include an ethical evaluation by professionals with the patient. It became clear that the majority of the sample of professionals is against over-aggressive treatment, and for a dignified death.