The objective of this study was to identify the attitude of professionals and academics in a university hospital regarding assisted suicide and euthanasia. The study was conducted using a questionnaire and included 354 participants. In cases of patients with terminal illnesses, 68.1% of participants supported the legalization of assisted suicide and 73.2% supported the legalization of euthanasia. The support for legalization of assisted suicide or euthanasia was 46.9% in cases of patients with progressive neurodegenerative diseases and 30.8% in cases of tetraplegia. In cases of terminal illnesses, if those were legalized, 45% of participants would commit assisted suicide, 57% would request euthanasia, 36.5% would aid in assisted suicide and 39.9% would aid in euthanasia. In conclusion, the great support for legalization of euthanasia and assisted suicide among the participants emphasizes the need to broaden the discussion on the subject in the population. Keywords: Suicide assisted. Euthanasia. Right to die. Attitude to death. Bioethics. ResumoSuicídio assistido e eutanásia na perspectiva de profissionais e acadêmicos de um hospital universitário Objetivou-se identificar a atitude de profissionais e acadêmicos de enfermagem, fisioterapia, medicina e psicologia de um hospital universitário perante suicídio assistido e eutanásia. O estudo foi desenvolvido por meio de questionário de autopreenchimento e contou com 354 participantes, entre os quais, 68,1% concordaram com a legalização do suicídio assistido e 73,2% com a legalização da eutanásia para pacientes com doenças terminais. A concordância com a legalização do suicídio assistido ou da eutanásia foi de 46,9% em casos de pacientes com doenças neurodegenerativas progressivas e de 30,8% em casos de tetraplegia. Em casos de doenças terminais, se legalizados, 45% dos participantes cometeriam suicídio assistido, 57% solicitariam eutanásia, 36,5% auxiliariam suicídio assistido e 39,9% auxiliariam eutanásia. Conclui-se que a ampla aceitação da legalização da eutanásia e do suicídio assistido entre os participantes enfatiza a necessidade de se ampliar a discussão sobre o tema entre a população. Palavras-chave: Suicídio assistido. Eutanásia. Direito a morrer. Atitude frente à morte. Bioética. ResumenSuicidio asistido y eutanasia en la perspectiva de profesionales y estudiantes de un hospital universitario Se tuvo como objetivo identificar la actitud de profesionales y estudiantes de enfermería, fisioterapia, medicina y psicología de un hospital universitario ante el suicidio asistido y la eutanasia. El estudio fue desarrollado por medio de un cuestionario de auto-llenado y contó con 354 participantes, entre los cuales el 68,1% concordó con la legalización del suicidio asistido y el 73,2% con la legalización de la eutanasia para pacientes con enfermedades terminales. La concordancia con la legalización del suicidio asistido o de la eutanasia fue del 46,9% en casos de pacientes con enfermedades neurodegenerativas progresivas y del 30,8% en casos de tetraplejia. En...
Despite the best efforts of intensive care units (ICUs) professionals, the extubation failure rates in mechanically ventilated patients remain in the range of 5%–30%. Extubation failure is associated with increased risk of death and longer ICU stay. This study aimed to identify respiratory and non-respiratory parameters predictive of extubation outcome, and to use these predictors to develop and validate an “Extubation Predictive Score (ExPreS)” that could be used to predict likelihood of extubation success in patients receiving invasive mechanical ventilation (IMV). Derivation cohort was composed by patients aged ≥18 years admitted to the ICU and receiving IMV through an endotracheal tube for >24 hours. The weaning process followed the established ICU protocol. Clinical signs and ventilator parameters of patients were recorded during IMV, in the end phase of weaning in pressure support ventilation (PSV) mode, with inspiratory pressure of 7 cm H2O over the PEEP (positive end expiratory pressure). Patients who tolerated this ventilation were submitted to spontaneous breathing trial (SBT) with T-tube for 30 minutes. Those who passed the SBT and a subsequent cuff-leak test were extubated. The primary outcome of this study was extubation success at 48 hours. Parameters that showed statistically significant association with extubation outcome were further investigated using the receiver operating characteristics (ROC) analysis to assess their predictive value. The area under the curve (AUC) values were used to select parameters for inclusion in the ExPreS. Univariable logistic regression analysis and ROC analysis were performed to evaluate the performance of ExPreS. Patients’ inclusion and statistical analyses for the prospective validation cohort followed the same criteria used for the derivation cohort and the decision to extubate was based on the ExPreS result. In the derivation cohort, a total of 110 patients were extubated: extubation succeeded in 101 (91.8%) patients and failed in 9 (8.2%) patients. Rapid shallow-breathing index (RSBI) in SBT, dynamic lung compliance, duration of IMV, muscle strength, estimated GCS, hematocrit, and serum creatinine were significantly associated with extubation outcome. These parameters, along with another parameter—presence of neurologic comorbidity—were used to create the ExPreS. The AUC value for the ExPreS was 0.875, which was higher than the AUCs of the individual parameters. The total ExPreS can range from 0 to 100. ExPreS ≥59 points indicated high probability of success (OR = 23.07), while ExPreS ≤44 points indicated low probability of success (OR = 0.82). In the prospective validation cohort, 83 patients were extubated: extubation succeeded in 81 (97.6%) patients and failed in 2 (2.4%) patients. The AUC value for the ExPreS in this cohort was 0.971. The multiparameter score that we propose, ExPreS, shows good accuracy to predict extubation outcome in patients receiving IMV in the ICU. In the prospective validation, the use of ExPreS decreased the extubation failure rate from 8.2% to 2.4%, even in a cohort of more severe patients.
The objective of this study is to verify if medical students acquired knowledge about delivering bad news to patients during their undergraduate clinical courses. A questionnaire was applied to two groups: Group 1, which had not studied the theme and Group 2, which had already studied it. 29.41% of Group 1 knew about the Spikes Protocol and 100% of Group 2 (p=0.0001) knew about it. 25.88% of Group 1 and 81.01% of Group 2 (p=0.0001) were partially prepared for communication. 17.65% of Group 1 and 83.54% of Group 2 (p=0.0001) felt more secure after the study. 90.59% of Group 1 attributed a maximum grade to the importance of learning and 87.34% of Group 2 (p=0.8166) did the same. It was concluded that all students recognized the importance of learning about delivering bad news and the wide difference of knowledge in favor of Group 2 highlights the effectiveness of its approach during undergraduation. ResumoComunicação de más notícias a pacientes na perspectiva de estudantes de medicina O objetivo deste estudo foi verificar se estudantes de medicina adquiriram conhecimento sobre comunicação de más notícias aos pacientes durante a graduação. Aplicou-se questionário para dois grupos: Grupo 1, que não havia cursado disciplinas sobre o tema, e Grupo 2, que já as havia cursado. Conheciam o protocolo Spikes 29,41% do Grupo 1 e 100% do Grupo 2 (p=0,0001). Consideraram-se parcialmente preparados para a comunicação 25,88% do Grupo 1 e 81,01% do Grupo 2 (p=0,0001). Sentiam-se mais seguros após o estudo 17,65% do Grupo 1 e 83,54% do Grupo 2 (p=0,0001). Atribuíram nota máxima à importância do aprendizado 90,59% do Grupo 1 e 87,34% do Grupo 2 (p=0,8166). Concluiu-se que todos reconheciam a relevância do ensino sobre comunicação de más notícias. Além disso, a ampla diferença de conhecimento do Grupo 2 destaca a eficácia da abordagem ao tema na graduação. Palavras-chave: Comunicação em saúde. Revelação da verdade. Relações médico-paciente. Aprendizagem. Bioética. Resumen Comunicación de malas noticias a los pacientes desde la perspectiva de estudiantes de medicinaEl objetivo de este estudio fue verificar si los estudiantes de medicina adquirieron conocimiento sobre comunicación de malas noticias a los pacientes durante el ciclo clínico de la carrera de grado en la universidad. Se aplicó un cuestionario a dos grupos: Grupo 1, que no había cursado disciplinas sobre el tema, y Grupo 2, que ya las había cursado. Conocían el Protocolo Spikes el 29,41% del Grupo 1 y el 100% del Grupo 2 (p=0,0001). Se consideraron parcialmente preparados para la comunicación el 25,88% del Grupo 1 y el 81,01% del Grupo 2 (p=0,0001). Se sentían más seguros después del estudio el 17,65% del Grupo 1 y el 83,54% del Grupo 2 (p=0,0001). Atribuyeron nota máxima a la importancia del aprendizaje el 90,59% del Grupo 1 y el 87,34% del Grupo 2 (p=0,8166). Se concluyó que todos reconocían la relevancia de la enseñanza de la comunicación de malas noticias. Además, la amplia diferencia de conocimiento del Grupo 2 destaca la eficacia del abordaje del tema durante la carr...
ResumoEste ensaio discute as relações entre os níveis educacionais e a macroeconomia de uma região, passando pela formação de professores. O modelo educacional atual tem demonstrado falhas em educar indivíduos para as novas necessidades econômicas que requerem profissionais criativos e com capacidade de resolução de problemas. Defende-se aqui a ideia de identificação e promoção do desenvolvimento de habilidades naturais, o que, por fim, otimizaria o retorno econômico dos investimentos em educação. Propõe-se que seja ampliado, nos currículos de formação de professores, o ensino de neurociências. Assim, educadores poderão utilizar esse conhecimento para adequar seus métodos de ensino considerando o funcionamento neural. A mudança no sistema educacional, que se inicia com a formação dos educadores, poderia aumentar a eficiência do ensino e preparar melhor novos profissionais para as necessidades do mercado de trabalho, gerando ganhos à economia e à equidade de uma região.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.