An International Consensus Definition of the Wish to Hasten Death and Its Related Factors

Background: The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. Methods: Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy. Findings: All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD. Conclusions: This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention

An International Consensus Definition of the Wish to Hasten Death and Its Related Factors

Abstract Backgroun

An international consensus definition of thewish to hasten death and Its related factors

Abstract Background The desire for hastened death or wish to hasten death (WTHD) that is experienced by some patients with advanced illness is a complex phenomenon for which no widely accepted definition exists. This lack of a common conceptualization hinders understanding and cooperation between clinicians and researchers. The aim of this study was to develop an internationally agreed definition of the WTHD. Methods Following an exhaustive literature review, a modified nominal group process and an international, modified Delphi process were carried out. The nominal group served to produce a preliminary definition that was then subjected to a Delphi process in which 24 experts from 19 institutions from Europe, Canada and the USA participated. Delphi responses and comments were analysed using a pre-established strategy. Findings All 24 experts completed the three rounds of the Delphi process, and all the proposed statements achieved at least 79% agreement. Key concepts in the final definition include the WTHD as a reaction to suffering, the fact that such a wish is not always expressed spontaneously, and the need to distinguish the WTHD from the acceptance of impending death or from a wish to die naturally, although preferably soon. The proposed definition also makes reference to possible factors related to the WTHD. Conclusions This international consensus definition of the WTHD should make it easier for clinicians and researchers to share their knowledge. This would foster an improved understanding of the phenomenon and help in developing strategies for early therapeutic intervention

Inteligencia Emocional y variables relacionadas en Enfermería

[esp]Desde su popularización, la Inteligencia Emocional (IE) ha constituido uno de los conceptos más investigados y difundidos en la literatura científica. Diversos autores afirman que la IE constituye una competencia fundamental para los profesionales de enfermería y defienden que para establecer relaciones terapéuticas es necesario identificar y comprender las emociones propias, así como las emociones de los pacientes y sus familiares. Asimismo, consideran que los profesionales de enfermería han de saber gestionar eficazmente las emociones que suscitan el contacto continuado con la enfermedad y la muerte. A pesar de estas valoraciones, el entrenamiento en habilidades emocionales no ha estado suficientemente considerado en la formación superior. Esta tesis doctoral pretende aportar conocimientos empíricos sobre la relación entre la competencia emocional de los enfermeros y su labor asistencial, así como la relación con otras variables, específicamente aquellas que evalúan el impacto que la muerte causa en estudiantes y profesionales,[eng]Emotional Intelligence has been one of the most researched and disseminated concepts in scientific literature. In the field of nursing, formal research into EI is still a recent phenomenon. However, several authors claim that EI is a core competency for nurses and argue that establishing therapeutic relationships is necessary for them to identify and understand their own emotions and the emotions of patients and their relatives. They believe that nurses need to know how to effectively manage the emotions that result from continued contact with disease and death. Nevertheless, emotional skills training has not been sufficiently considered in the advanced training of these professionals and neither is it integrated in their training programs

Monitor educador

Análisis de las estrategias pedagógicas para enseñar a los niños a afrontar situaciones de agonía y muerte y ofrecer de estos hechos una visión natural..País VascoES

Actitud ante el sida en estudiantes de enfermería: ¿Cuál es el papel de la formación académica? Attitude towards aids in nursing students: What is the role of academic formation?

Los objetivos de este estudio fueron conocer la actitud ante el SIDA que presentan los estudiantes de una escuela de enfermería (N= 242) y comprobar si esta actitud presenta variaciones significativas entre los diferentes cursos. Para la medición de la actitud se utilizó la Escala de Actitud ante el SIDA para Enfermería (EASE). Los resultados del ANOVA no revelaron diferencias estadísticamente significativas entre los tres cursos (F= 0.886; p = 0,414). No obstante, a partir del análisis pormenorizado de las respuestas a los diferentes ítems de la escala se ponen de manifiesto opiniones que reflejan actitudes negativas y prejuiciosas. Los resultados obtenidos plantean la necesidad de una reflexión profunda acerca de las estrategias docentes más adecuadas para modificar positivamente las actitudes y creencias que presentan los estudiantes ante el VIH/SIDA, dentro del objetivo general de formar profesionales capaces de dispensar cuidados de la máxima calidad, independientemente de la enfermedad o características personales de las personas a las que cuida.<br>The aims of this study were to know the attitude towards AIDS of the students of a nursing school (N = 242) and check if this attitude presents significant variations between the different courses. The Nursing Scale of Attitude towards AIDS (EASE, Escala de Actitud ante el SIDA para Enfermería) was used to assess their attitude. The results of the ANOVA did not reveal statistically significant differences among the three courses (F= 0.886; p= 0.414). Nevertheless, a detailed analysis of the answers to several items indicates that there are some negative and biased attitudes. The results obtained reveal the necessity of deep reflections about the most adequate educational strategies in order to improve the attitudes and believes of nursing students towards HIV/AIDS. The main aim is the formation of professionals who are able to give high quality care, independently of the patient’s condition or personal characteristics

Otra manera de enseñar enfermería clínica: el arte como vehículo formador

Resumen: En los estudios de enfermería se reconoce la existencia de problemas que están provocando un bajo rendimiento académico a nivel internacional, así como un aumento de absentismo y abandono de la titulación. Diversos estudios han utilizado el arte como estrategia de enseñanza, demostrando un aumento en el aprendizaje y en la motivación de los estudiantes. El objetivo de este estudio es evaluar una experiencia docente que incluye el arte como vehículo formador en el aprendizaje de la fisiopatología y cuidados enfermeros de la piel. Para ello se realiza un diseño mixto, con una primera fase cualitativa exploratoria preliminar y una segunda fase cuantitativa para evaluar la intervención definitiva. Los principales resultados muestran que el aprendizaje de los contenidos en los que se ha utilizado el arte como metodología docente han sido mejor asimilados, y los estudiantes se han mostrado altamente satisfechos con esta metodología; respecto al pensamiento creativo, la escala EDICOS ha mostrado una alta consistencia en todas las dimensiones, y no se han obtenido diferencias significativas en relación con el género. Los estudiantes expresan que la observación e interpretación del arte les ha permitido una aproximación a la realidad y una reflexión sobre los cuidados enfermeros. Abstract: Several nursing studies recognise the existence of problems that are caused by a low academic performance at international level, as well as an increase in absenteeism and abandonment of the degree. Most of these studies have used art as an instrument of learning, demonstrating an increase in student knowledge and motivation. The objective of this study is to evaluate a teaching experience that includes Arts-Based-Learning of the pathophysiology and nursing care of the skin.A two-phase mixed design was used to evaluate the (definitive) intervention. In the first phase, the qualitative performance was explored, and in the second phase, the quantitative performance was evaluated. Results: showed a better assimilation of learning contents for those students for whom art has been used as a teaching methodology. A high level of satisfaction among students was also observed with this methodology. Regarding creative thinking, the EDICOS scale showed a high consistency in all dimensions. However, no significant gender-related differences were found. Students expressed that the observation and interpretation of art have provided them with an outline of the current situation, and a reflection of nursing care. Palabras clave: Enfermería clínica, Enseñanza universitaria, Pedagogía creativa, Pensamiento creativo, Aprendizaje basado en las artes, Satisfacción, Keywords: Clinical nursing, University teaching, Creative pedagogy, Creative thinking, Arts-based learning, Satisfactio