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1.
Rev Prat ; 70(2): 212-214, 2020 Feb.
Artigo em Francês | MEDLINE | ID: mdl-32877143

RESUMO

Announcement of a serious illness to a child. Critically ill children should be directly informed about their illness, in a way that is appropriate to their age, family context and alliance with themselves and their parents. The process of the announcement of the diagnosis does not correspond to an isolated moment but must be conceived in successive stages, respecting a different rhythm of progression in the child and in each of his parents, even if sometimes the clinical circumstances require the initiation of treatment fairly quickly. The synthetic principle of informing "without violence or betrayal" guides the conditions for the announcement of the diagnosis of pediatric serious illness, both to parents and to the sick child.


Assuntos
Família , Pais , Criança , Humanos , Revelação da Verdade
3.
Medicine (Baltimore) ; 99(31): e21425, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756147

RESUMO

Best practices for how to respond are unclear when a medical error is discovered in a different system (inter-system medical error discovery or IMED). This qualitative study explored medical error professionals' views on disclosure, feedback, and reporting in these scenarios.We conducted semi-structured telephone interviews from January to September 2018 with 15 medical error professionals from 5 regions of the United States. Interview guides addressed perspectives on best practice, minimum obligations, and mediating factors with respect to IMED. Each transcript was coded independently by two investigators. Analysis followed the inductive approach of interpretive description.Medical error professionals expressed diverse views about minimum obligations and best practices for physicians when responding to IMED events. All cited practical barriers to disclosure, feedback, and reporting in these scenarios. There was general consensus that clear-cut, harmful errors should be disclosed to patients, and most advised investigation and feedback prior to disclosure. Respondents diverged in recommended best practices and thresholds for taking action. All noted the lack of guidance specific to IMED scenarios but differed in how they would extrapolate from more general guidance.While medical error professionals expressed consensus regarding obligations to disclose obvious errors, they differed on particulars. Guidelines or an algorithm could be very useful. Efforts to develop clear guidelines for IMED must take into account these factors, as well as practical and political challenges to communication about errors discovered across systems.


Assuntos
Atitude do Pessoal de Saúde , Guias como Assunto , Erros Médicos/prevenção & controle , Revelação da Verdade , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Estados Unidos
4.
Hu Li Za Zhi ; 67(4): 50-60, 2020 Aug.
Artigo em Chinês | MEDLINE | ID: mdl-32748379

RESUMO

BACKGROUND: Truth-telling is an important step toward reducing the cognitive gap between physicians and patients as well as reducing the psychological pressures applied to physicians by family members. There is a lack of research on the truth-telling experience and needs in the intensive care unit from the perspective of patient family members. PURPOSE: This study is designed to explore the experiences and needs of families in the intensive care unit. METHODS: A descriptive phenomenology method was used in this study. In-depth interviews were conducted with five participants who had family members assessed with acute physiology and chronic health evaluation II scores ≥ 20. Data were analyzed using Giorgi's phenomenological methods and Nvivo 11. RESULTS: Four experience themes were examined, including (1) nothing is clear, requires explanation; (2) helpless to find answers, need a nurse to resolve this issue; (3) professional conduct makes us feel helpless, longing for love from the medical team; (4) decisions are very difficult, hoping to get more help. CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The family members expressed that they were unable to understand the underlying causes of the progression in patient condition because the medical team only presented outcomes to the family and did not discuss related causes. Thus, it is recommended that medical teams learn to recognize the cognitive processes of patient family members and consider their emotions, including their needs and expectations, in order to provide individualized explanations based on a patient's status and progress.


Assuntos
Família/psicologia , Unidades de Terapia Intensiva , Médicos/psicologia , Relações Profissional-Família , Revelação da Verdade , Humanos , Determinação de Necessidades de Cuidados de Saúde , Pesquisa Qualitativa
5.
J Neurol Sci ; 417: 117087, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32798855

RESUMO

INTRODUCTION: The coronavirus disease 2019 (Covid-19) pandemic has led to challenges in provision of care, clinical assessment and communication with families. The unique considerations associated with evaluation of catastrophic brain injury and death by neurologic criteria in patients with Covid-19 infection have not been examined. METHODS: We describe the evaluation of six patients hospitalized at a health network in New York City in April 2020 who had Covid-19, were comatose and had absent brainstem reflexes. RESULTS: Four males and two females with a median age of 58.5 (IQR 47-68) were evaluated for catastrophic brain injury due to stroke and/or global anoxic injury at a median of 14 days (IQR 13-18) after admission for acute respiratory failure due to Covid-19. All patients had hypotension requiring vasopressors and had been treated with sedative/narcotic drips for ventilator dyssynchrony. Among these patients, 5 had received paralytics. Apnea testing was performed for 1 patient due to the decision to withdraw treatment (n = 2), concern for inability to tolerate testing (n = 2) and observation of spontaneous respirations (n = 1). The apnea test was aborted due to hypoxia and hypotension. After ancillary testing, death was declared in three patients based on neurologic criteria and in three patients based on cardiopulmonary criteria (after withdrawal of support (n = 2) or cardiopulmonary arrest (n = 1)). A family member was able to visit 5/6 patients prior to cardiopulmonary arrest/discontinuation of organ support. CONCLUSION: It is feasible to evaluate patients with catastrophic brain injury and declare brain death despite the Covid-19 pandemic, but this requires unique considerations.


Assuntos
Betacoronavirus , Morte Encefálica/diagnóstico , Lesões Encefálicas/etiologia , Infecções por Coronavirus/complicações , Pandemias , Pneumonia Viral/complicações , Idoso , Apneia/etiologia , Hemorragia Cerebral/etiologia , Contraindicações de Procedimentos , Eletroencefalografia , Feminino , Parada Cardíaca/etiologia , Humanos , Hipóxia Encefálica/etiologia , Masculino , Pessoa de Meia-Idade , Neuroimagem , Exame Neurológico , Relações Profissional-Família , Obtenção de Tecidos e Órgãos , Revelação da Verdade
8.
Wien Klin Wochenschr ; 132(13-14): 400-402, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32643017

RESUMO

Mankind has to prepare for a pandemic with respect to medical and practical aspects, but also with respect to ethical issues. There are various ethical guidelines for managing infectious disease outbreaks, but they do not apply to the specific aspects of the COVID-19 pandemic, since they were formulated after the different kinds of outbreaks of avian influenza and Ebola. Today we are confronted with completely new issues endangering our fundamental human rights. As COVID-19 is spreading all over the world, we are in a desperate situation to find treatment solutions; however, despite the urgency, scientific rules have to be applied as bad science is unethical since it might be harmful for patients. Fake news and alternative facts might not be easily recognized and are also threatening scientific values. Pandemics might be leading to a meltdown of the health system if no measures are being taken constraining fundamental human rights. Tracking of persons is violating human rights as well if not accepted on a voluntary basis. A failure to have safeguards for times of crisis leads to a scarcity of medicinal products and goods resulting in a nationalistic approach and ignorance of international solidarity. And last but not least selective measures and triage in intensive care have to be taught to young physicians and nursing staff in medical schools in order to be prepared in times of an infectious disease outbreak and scarcity of resources.


Assuntos
Defesa Civil , Infecções por Coronavirus , Direitos Humanos , Pandemias/ética , Pneumonia Viral , Betacoronavirus , Defesa Civil/ética , Infecções por Coronavirus/epidemiologia , Humanos , Meios de Comunicação de Massa , Pneumonia Viral/epidemiologia , Alocação de Recursos/ética , Revelação da Verdade
10.
MEDICC Rev ; 22(2): 45-46, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: covidwho-485385

RESUMO

As the COVID-19 health crisis engulfs the planet, we are sub-merged in a parallel pandemic: the glut of misinformation and disinformation. The data associated with this phenomenon are creating a disaster within a disaster. In early April 2020, the Span-ish news agency EFE[1] reported that over one million internet ac-counts were dedicated to rumor-mongering, spreading unverifi ed information about the coronavirus. From January through April 13, fact-checkers at Maldita.es[2] had tracked over 400 lies and false alerts circulated about COVID-19 in Spain alone.


Assuntos
Betacoronavirus , Comunicação , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Revelação da Verdade , Cuba , Humanos , Internet
11.
Recenti Prog Med ; 111(6): 357-367, 2020 06.
Artigo em Italiano | MEDLINE | ID: mdl-32573551

RESUMO

The global emergency caused by the SARS-CoV-2 pandemic has suddenly changed how we communicate with families in all the CoViD-19 care settings, due to the obligation to maintain complete social isolation. Healthcare workers are isolated from their families, and must manage the consequences of this isolation just like the patients. They and their families perceive the personal attitudes, closeness and psychological support from the care teams. This perception of genuine participation by the healthcare workers during isolation is especially important when a patient dies, and it may influence the process of grief. This document is intended for all healthcare professionals caring for CoViD-19 patients, particularly those in more severe clinical conditions and it is aimed to help the care team to communicate with families distanced from the patient. The document consists of three parts: 1) presentation of the statements for communicating with patients family members during isolation; 2) discussion of key points as a theoretical framework for the statements; 3) instructions for telephone communication, with a checklist and a worksheet. The document was written by authors from different disciplines (doctors, nurses, psychologists, legal experts) and was then reviewed by a group of experts comprising professionals, people who have experienced ICU hospitalization, and their families. Finally, the document was approved by the National Boards of the Italian Society of Anesthesia and Intensive Care (SIAARTI), Italian Association of Critical Care Nurses (Aniarti), Italian Society of Emergency Medicine (SIMEU), and Italian Society of Palliative Care (SICP).


Assuntos
Betacoronavirus , Comunicação , Infecções por Coronavirus , Pandemias , Isolamento de Pacientes , Pneumonia Viral , Relações Profissional-Paciente , Isolamento Social , Atitude do Pessoal de Saúde , Lista de Checagem , Barreiras de Comunicação , Confidencialidade , Correio Eletrônico , Relações Familiares , Pessoal de Saúde/psicologia , Humanos , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Preferência do Paciente , Relações Profissional-Família , Isolamento Social/psicologia , Apoio Social , Telefone , Revelação da Verdade
13.
PLoS One ; 15(6): e0234142, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32555692

RESUMO

To what extent do children believe in real, unreal, natural and supernatural figures relative to each other, and to what extent are features of culture responsible for belief? Are some figures, like Santa Claus or an alien, perceived as more real than figures like Princess Elsa or a unicorn? We categorized 13 figures into five a priori categories based on 1) whether children receive direct evidence of the figure's existence, 2) whether children receive indirect evidence of the figure's existence, 3) whether the figure was associated with culture-specific rituals or norms, and 4) whether the figure was explicitly presented as fictional. We anticipated that the categories would be endorsed in the following order: 'Real People' (a person known to the child, The Wiggles), 'Cultural Figures' (Santa Claus, The Easter Bunny, The Tooth Fairy), 'Ambiguous Figures' (Dinosaurs, Aliens), 'Mythical Figures' (unicorns, ghosts, dragons), and 'Fictional Figures' (Spongebob Squarepants, Princess Elsa, Peter Pan). In total, we analysed responses from 176 children (aged 2-11 years) and 56 adults for 'how real' they believed 13 individual figures were (95 children were examined online by their parents, and 81 children were examined by trained research assistants). A cluster analysis, based exclusively on children's 'realness' scores, revealed a structure supporting our hypotheses, and multilevel regressions revealed a sensible hierarchy of endorsement with differing developmental trajectories for each category of figures. We advance the argument that cultural rituals are a special form of testimony that influences children's reality/fantasy distinctions, and that rituals and norms for 'Cultural Figures' are a powerful and under-researched factor in generating and sustaining a child's endorsement for a figure's reality status. All our data and materials are publically available at https://osf.io/wurxy/.


Assuntos
Formação de Conceito , Julgamento , Adulto , Criança , Desenvolvimento Infantil , Pré-Escolar , Análise por Conglomerados , Feminino , Humanos , Masculino , Revelação da Verdade
14.
MEDICC Rev ; 22(2): 45-46, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32478708

RESUMO

As the COVID-19 health crisis engulfs the planet, we are sub-merged in a parallel pandemic: the glut of misinformation and disinformation. The data associated with this phenomenon are creating a disaster within a disaster. In early April 2020, the Span-ish news agency EFE[1] reported that over one million internet ac-counts were dedicated to rumor-mongering, spreading unverifi ed information about the coronavirus. From January through April 13, fact-checkers at Maldita.es[2] had tracked over 400 lies and false alerts circulated about COVID-19 in Spain alone.


Assuntos
Betacoronavirus , Comunicação , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Revelação da Verdade , Cuba , Humanos , Internet
15.
Niger J Clin Pract ; 23(6): 857-863, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32525123

RESUMO

Background: HIV-infected children now live longer due to the availability of HIV counseling, testing, and treatment with highly active antiretroviral treatment (HAART). Efforts to help these children to know about the HIV infection and their status are important steps toward long-term disease management. This study was conducted to determine the factors associated with pediatric HIV disclosure among caregivers of children attending Special Treatment Clinic at Dalhatu Araf Specialist Hospital, Lafia. Methods: This was a descriptive cross-sectional study conducted among 160 caregivers of children attending the Special Treatment Clinic (STC) at DASH, Lafia, selected by systematic random sampling technique. Interviewer administered structured questionnaire was used to collect data, while bivariate and multivariate analyses were done with the Epi Info version 7. Results: Pediatric HIV disclosure rate in this study was 33.8%. The mean age at pediatric HIV disclosure was 9.85 ± 1.86 years. The independent predictors for pediatric HIV disclosure following logistic regression were child's age, 10-14 years (AOR = 4.46; 95%CI 1.47-13.61), child knowledge of caregivers' HIV status (AOR = 51.18; 95%CI 13.40-195.66), and caregivers' age ≥40 years (AOR = 3.58; 95%CI 1.25-11.74). Conclusions: The pediatric HIV disclosure was low in this study due to the caregivers' and their wards' factors. Health care workers need to intensify health education on the benefit of pediatric HIV disclosure at the STC clinic.


Assuntos
Cuidadores/psicologia , Infecções por HIV/psicologia , Revelação da Verdade , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Terapia Antirretroviral de Alta Atividade , Criança , Estudos Transversais , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por HIV/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Inquéritos e Questionários
16.
Eur. j. psychol. appl. legal context (Internet) ; 12(1): 23-34, ene.-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-189158

RESUMO

In a countermeasures experiment, we examined to what extent liars who learn about the Model Statement tool and about the proportion of complications (complications/complications + common knowledge details + self-handicapping strategies) can successfully adjust their responses so that they sound like truth tellers. Truth tellers discussed a trip they had made; liars fabricated a story. Participants were of Lebanese, Mexican, and South-Korean origin. Prior to the interview they did or did not receive information about (I) the working of the Model statement and (II) three types of verbal detail: complications, common knowledge details and self-handicapping strategies. We found no evidence that liars sounded like truth tellers after being informed about the Model Statement and/or types of detail we examined. Actually, veracity differences were similar across experimental conditions, with truth tellers reporting more detail and more complications and obtaining a higher proportion of complications score than liars


En un experimento de contramedidas examinamos hasta qué punto los mentirosos que reciben información sobre la Declaración modelo y la proporción de complicaciones que presenta (complicaciones / complicaciones + detalles de conocimiento general + estrategias de autoobstaculización) pueden ajustar sus respuestas con éxito para que parezca que dicen la verdad. Los que dicen la verdad declararon sobre un viaje que habían hecho; los mentirosos inventaron una historia. Los participantes eran de origen libanés, mexicano y surcoreano. Antes de la entrevista habían recibido o no información sobre (I) el funcionamiento de la Declaración modelo y (II) tres tipos de detalles verbales: complicaciones, detalles de conocimiento general y estrategias de autoobstaculización. No encontramos evidencia de que los mentirosos se parecieran a los que dicen la verdad después de ser informados sobre la Declaración modelo y los tipos de detalle que examinamos. En realidad, las diferencias de veracidad fueron semejantes en todas las condiciones experimentales: los que decían la verdad informaron con mayor detalle y de más complicaciones y obtuvieron una mayor puntuación en la proporción de complicaciones que los mentirosos


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Psicologia Experimental/métodos , Detecção de Mentiras/psicologia , Revelação da Verdade , Coleta de Dados/classificação , Entrevistas como Assunto/estatística & dados numéricos , Processos Mentais/classificação , Estudantes/psicologia
17.
Eur. j. psychol. appl. legal context (Internet) ; 12(1): 35-42, ene.-jun. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-189159

RESUMO

Statement Validity Assessment (SVA) proposes that baseline statements on different events can serve as a within-subject measure of a witness' individual verbal capabilities when evaluating scores from Criteria-based Content Analysis (CBCA). This assumes that CBCA scores will generally be consistent across two accounts by the same witness. We present a first pilot study on this assumption. In two sessions, we asked 29 participants to produce one experience-based and one fabricated baseline account as well as one experience-based and one fabricated target account (each on different events), resulting in a total of 116 accounts. We hypothesized at least moderate correlations between target and baseline indicating a consistency across both experience-based and fabricated CBCA scores, and that fabricated CBCA scores would be more consistent because truth-telling has to consider random event characteristics, whereas lies must be constructed completely by the individual witness. Results showed that differences in correlations between experience-based CBCA scores and between fabricated CBCA scores took the predicted direction (cexperience-based = .44 versus cfabricated =.61) but this difference was not statistically significant. As predicted, a subgroup of event-related CBCA criteria were significantly less consistent than CBCA total scores, but only in experience-based accounts. The discussion considers methodological issues regarding the usage of total CBCA scores and whether to measure consistency with correlation coefficients. It is concluded that more studies are needed with larger samples


El Statement Validity Assessment (SVA) propone que las declaraciones sobre diferentes eventos pueden servir como una línea base intrasujeto de la medida de las capacidades verbales individuales de un testigo al evaluar las puntuaciones del Criteria Based Content Analysis (CBCA). Esto implica que las puntuaciones del CBCA serán congruentes en dos relatos del mismo testigo. Presentamos un primer estudio piloto sobre este supuesto. Se pidió a 29 participantes en dos sesiones que elaboraran un relato verdadero (línea base) y otro inventado, además de un relato verdadero y otro inventado (cada uno en situaciones diferentes), arrojando un total de 116 relatos. Se planteó la hipótesis de una correlación al menos moderada entre la declaración fabricada y la verdadera, que indicaría una consistencia entre las puntuaciones en el CBCA de relatos inventados y experimentados y que las puntuaciones en el CBCA inventadas serían más consistentes porque la verdad incluye las características aleatorias de los hechos, mientras que las mentiras las construye totalmente el testigo. Los resultados mostraron que las diferencias en las correlaciones entre las puntuaciones en el CBCA de relatos experimentados y fabricados iban en la dirección predicha (cvivido = .44 frente a cinventado = .61), pero esta diferencia no fue significativa. Como se predijo, un subgrupo de criterios de CBCA relacionados con los hechos fue menos congruente que las puntuaciones totales de CBCA, pero sólo en los relatos de hechos experimentados. Se discuten las implicaciones metodológicas relacionadas con el uso de las puntuaciones totales del CBCA y si se debe medir la consistencia mediante el coeficiente de correlación. Se concluye que se necesitan otros estudios con muestras más grandes


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Psicometria/instrumentação , Psicologia Experimental/métodos , Detecção de Mentiras/psicologia , Revelação da Verdade , Coleta de Dados/classificação , Entrevistas como Assunto/estatística & dados numéricos , Processos Mentais/classificação , Comportamento Verbal/classificação , Testes de Hipótese
18.
Clin Imaging ; 65: 143-146, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32505103

RESUMO

PURPOSE: The aim of the study was to evaluate the effect of a one-hour lecture based communication curriculum on breast imaging trainees' confidence in communicating with patients in a challenging communication setting such as delivering bad news or radiologic error disclosure. METHODS: 12 breast imaging trainees from an academic fellowship program completed questionnaires before and after a communication tutorial. A four breast imaging specific scenario questionnaire assessed confidence by asking the trainees to rank agreement with statements related to their attitude in those specific settings. 12-month follow-up questionnaire was sent to the graduating fellows assessing their -overall confidence in patient communication, the contribution of the curriculum to their self-perceived communication skill and their likelihood in disclosing a radiologic error to a patient. RESULTS: All trainees completed the pre and post lecture questionnaire. After the communication tutorial, all trainees reported increased confidence in communicating with patients in a variety of challenging settings with pre lecture survey mean confidence score of 38/98 and post lecture survey mean score of 85.3/98, P = 0.003. Three of eight trainees who completed the 12-month follow up questionnaire reported confidence in their communication skills and reported that the tutorial significantly contributed to their communication skill development. All three agreed that they would be likely to disclose a medical error should they encounter it in their future career. CONCLUSIONS: A limited resource one-hour lecture communication tutorial provides effective communication training for breast imaging fellows and is a promising part of a breast imaging curriculum.


Assuntos
Mama/diagnóstico por imagem , Relações Médico-Paciente , Radiologia/educação , Competência Clínica , Comunicação , Currículo , Bolsas de Estudo , Feminino , Humanos , Inquéritos e Questionários , Revelação da Verdade
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