Asunto(s)
Cuidados Paliativos/organización & administración , Espiritualidad , Estrés Psicológico/diagnóstico , Encuestas y Cuestionarios/normas , Evaluación de Síntomas/instrumentación , Adulto , Anciano , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los ResultadosRESUMEN
Background: Spiritual issues are an important dimension of health care, but seldom addressed by professionals. Thus, a scale that assesses the presence and intensity of seven spiritual symptoms was developed. Aim: To validate the instrument in palliative care settings. Material and Methods: The spiritual symptoms scale was applied to 103 patients, aged 59 ± 17 years (58% women), admitted to hospice care in two centers located in Santiago. The reproducibility of the scale was evaluated in 33 patients and its internal consistency and liability in 70. Results: The Fleiss Kappa to assess reproducibility was 0.82 and the analysis of variance had a p of 0.94. Cronbach alpha to assess internal consistency was 0.74. Conclusions: The scale renders similar results when applied by different evaluators and has a good liability. Therefore, it can be a reliable instrument to assess spiritual symptoms in palliative care settings. Further studies would be needed to verify its utility in other settings.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Cuidados Paliativos/organización & administración , Estrés Psicológico/diagnóstico , Encuestas y Cuestionarios/normas , Espiritualidad , Evaluación de Síntomas/instrumentación , Estudios Transversales , Reproducibilidad de los ResultadosRESUMEN
Terminally ill patients frequently have difficulties with fluid and food intake. The indication of artificial hydration in these patients has been subject of intense debate in the past years and the clinical practice widely varies, mostly based on anecdotal data and not on clinical evidence about risks and benefits associated to artificial hydration in terminal patients. There are not only technical questions concerning benefits and risks associated to artificial hydration, but also questions related to the ethical principles and values involved. Several topics, such as the effect of artificial hydration alleviating symptoms or reversing neurological alterations as delirium, its life prolonging effect or if it promotes unnecessary suffering, are discussed. In this review we will analyze clinical benefits and risks associated to artificial hydration in terminal patients, making reference to some ethical principles involved.
Asunto(s)
Humanos , Fluidoterapia/normas , Cuidado Terminal/normas , Fluidoterapia/efectos adversos , Guías de Práctica Clínica como Asunto , Factores de Riesgo , Cuidado Terminal , Enfermo TerminalRESUMEN
Terminally ill patients frequently have difficulties with fluid and food intake. The indication of artificial hydration in these patients has been subject of intense debate in the past years and the clinical practice widely varies, mostly based on anecdotal data and not on clinical evidence about risks and benefits associated to artificial hydration in terminal patients. There are not only technical questions concerning benefits and risks associated to artificial hydration, but also questions related to the ethical principles and values involved. Several topics, such as the effect of artificial hydration alleviating symptoms or reversing neurological alterations as delirium, its life prolonging effect or if it promotes unnecessary suffering, are discussed. In this review we will analyze clinical benefits and risks associated to artificial hydration in terminal patients, making reference to some ethical principles involved.
Asunto(s)
Fluidoterapia/normas , Cuidado Terminal/normas , Fluidoterapia/efectos adversos , Humanos , Guías de Práctica Clínica como Asunto , Factores de Riesgo , Cuidado Terminal/ética , Enfermo TerminalRESUMEN
The author reviews the arguments made by Mark Hanson, James Keenan, S.J., and Joel Shuman in this issue. In the first section, she argues that they offer a significant contribution toward an understanding of the inner logic of a new trend in contemporary medicine, genetic engineering. However, she criticizes the authors for relying excessively on procedural guidelines and for failing to bring the practical realities of medicine and technology to bear on theory. She argues that more concrete guidelines, which are ultimately grounded in a Christian conception of the person and on the commandment to love, are necessary. Writing from the Roman Catholic perspective, the author argues that the distinction between genetic enhancement and gene therapy is essential, despite the criticisms which have been offered of this distinction. Understanding this distinction will be critical for identifying as licit only those forms of genetic manipulation which respect the dignity of the human person.