La capacidad de los pacientes para tomar decisiones: una tarea todavía pendiente.

La evaluación de la capacidad constituye un reto abierto para el modelo de relación clínica basado en la idea de consentimiento informado

Infancia, familias e Internet: un enfoque cualitativo sobre activos para la salud

Objective: To explore the views of the Internet in childhood, identifying both health assets and risks. Method: A qualitative study was performed using 14 focus groups, eight of which comprised boys and girls, four of which comprised parents and two of which were mixed (children and parents) in primary schools in urban and rural settings in Andalusia (Spain). Teachers in these schools were also asked to complete an online questionnaire using LimeSurvey. This study involved 114 individuals: 64 pupils (33 girls and 31 boys), 28 parents (18 mothers and 10 fathers), and 22 teachers (14 women and 8 men). Analysis of manifest content and underlying meanings was carried out. QSR NVivo 9 software was used to facilitate analysis and make it systematic. Results: Our findings show how the differences in the way parents and children understand health and wellbeing affect the way they discuss the Internet and health. The discussion of results looks at the implications of computer literacy for public health and wellbeing, particularly with regard to health assets. Conclusions: Parents and children understand the contribution of the Internet to health and wellbeing differently. Whilst parents emphasize the risks (unsafe environment, relationships and quality of information, social networks, physical problems and addiction), the children emphasize the assets offered by the Internet.Objetivo: Explorar la visión de Internet en la infancia, identificando riesgos y activos para la salud. Método: Estudio cualitativo con 14 grupos focales: ocho con niños y niñas, cuatro con familias y dos mixtos con niños/as y familias en centros de educación primaria de los ámbitos rural y urbano en Andalucía (España). También se aplicó un cuestionario on-line al profesorado de los centros educativos. En total participaron 114 personas (33 chicas y 31 chicos; 18 madres y 10 padres; 14 maestras y 8 maestros). Se llevó a cabo un análisis de contenido manifiesto y contenido latente, utilizando el software QSR NVivo 9 para facilitar dicho análisis y hacerlo más sistemático. Resultados: Los resultados ponen de manifiesto cómo la forma diferencial de entender la salud y el bienestar entre padres/madres e hijos/as influye en la orientación de los discursos sobre Internet y salud. Los resultados son discutidos ampliando el debate existente en torno a las implicaciones en salud pública de la alfabetización digital y su conexión con el enfoque de activos para la salud. Conclusión: Las familias y la infancia entienden la contribución de Internet a la salud y al bienestar de manera muy diferente. Mientras los padres y las madres enfatizan los riesgos (ambiente inseguro, relaciones y calidad de la información, redes sociales, problemas físicos y adicciones), los/las niños/as se centran en enfatizar las potencialidades de Internet, descritas como activos.The study was financial support by the Andalusian Government’s Health Department

Conocimientos y actitudes de los médicos en dos áreas sanitarias sobre las voluntades vitales anticipadas

ObjetivosExplorar los conocimientos y actitudes de los médicos acerca de las voluntades anticipadas en dos áreas de Andalucía. Comparar los resultados de ambas áreas sanitarias. Comparar los resultados de los médicos de atención primaria y atención especializada.DiseñoEstudio descriptivo, transversal, mediante cuestionario autocumplimentado.EmplazamientoÁrea Sanitaria Norte de Málaga y Área Sanitaria Norte de Almería.ParticipantesMédicos de atención primara y especializada.Mediciones y resultados principalesConocimientos y actitudes acerca de las voluntades vitales anticipadas (testamentos vitales); 194 médicos respondieron al cuestionario (tasa de respuesta del 63,19%). Media de edad ± desviación típica, 42,54±80,85 años; el 65,5%, varones, y el 33,5%, mujeres. El 51,55%, médicos de atención primaria, y el 48,45%, de especializada.ConclusionesHay una actitud favorable hacia la utilidad de las voluntades anticipadas tanto para los familiares del paciente como para los profesionales sanitarios; también hacia su utilización y respeto. Desean manifestar su propia voluntad anticipada aunque no en un futuro cercano. El personal de atención primaria muestra una actitud más favorable hacia las voluntades anticipadas en algunos ítems que el personal de especializada.ObjectivesTo explore the knowledge and attitudes of physicians towards advance directives in two healthcare areas.To compare the outcomes of both areas.To compare the outcomes of primary healthcare and specialised healthcare.DesignA cross sectional, descriptive study by means of a self-administered questionnaire.SettingNorth-Málaga and North-Almería healthcare areas, Spain.ParticipantsPhysicians of primary and specialised healthcare.Measurements and main resultsKnowledge and attitudes towards advance directives. 194 (63.19%) questionnaires were filled out by the physicians from both healthcare districts. Mean age (standard deviation) 42.54 (80.85); 65.5% of participants were men and 33.5% were women; 51.55% from primary care and 48.45% from specialised healthcare.ConclusionsPolled physicians revealed a positive attitude towards the usefulness of advance directives for the patient's relatives and for healthcare professionals. They also show a positive attitude towards the use and respect of advance directives. They show a high predisposition to registry their advance directive, but a low predisposition to do so in a short term

Are the health messages in schoolbooks based on scientific evidence? A descriptive study

<p>Abstract</p> <p>Background</p> <p>Most textbooks contains messages relating to health. This profuse information requires analysis with regards to the quality of such information. The objective was to identify the scientific evidence on which the health messages in textbooks are based.</p> <p>Methods</p> <p>The degree of evidence on which such messages are based was identified and the messages were subsequently classified into three categories: Messages with high, medium or low levels of evidence; Messages with an unknown level of evidence; and Messages with no known evidence.</p> <p>Results</p> <p>844 messages were studied. Of this total, 61% were classified as messages with an unknown level of evidence. Less than 15% fell into the category where the level of evidence was known and less than 6% were classified as possessing high levels of evidence. More than 70% of the messages relating to "Balanced Diets and Malnutrition", "Food Hygiene", "Tobacco", "Sexual behaviour and AIDS" and "Rest and ergonomics" are based on an unknown level of evidence. "Oral health" registered the highest percentage of messages based on a high level of evidence (37.5%), followed by "Pregnancy and newly born infants" (35%). Of the total, 24.6% are not based on any known evidence. Two of the messages appeared to contravene known evidence.</p> <p>Conclusion</p> <p>Many of the messages included in school textbooks are not based on scientific evidence. Standards must be established to facilitate the production of texts that include messages that are based on the best available evidence and which can improve children's health more effectively.</p

La capacidad de los pacientes para tomar decisiones: una tarea todavía pendiente.

La evaluación de la capacidad constituye un reto abierto para el modelo de relación clínica basado en la idea de consentimiento informado

Ethics and death with dignity

Comisión Autonómica de Ética e Investigación Sanitaria. Vocales, Pablo Simón Lorda, Francisco J. Alarcos Martínez. Texto paralelo en castellano e inglés.This book is an study about the bill of Death with Dignity Act, written by the Andalusian Commission on Healthcare Ethics and Research. The aim of the Act would be to “establish the criteria and conditions to be adopted by the health system to guarantee adequate healthcare during life’s final process based on the prevention of suffering and respect for each person’s dignity and free choice”.YesEl presente libro es un estudio sobre el Proyecto de Ley sobre la dignidad de las personas ante el proceso de la muerte, elaborado por la Comisión Autonómica de Ética e Investigación Sanitarias. Esta ley trataría de establecer los criterios y condiciones que el sistema sanitario deberá desarrollar para garantizar una atención adecuada durante el proceso final de la vida, basada en evitar el sufrimiento, y el respeto a la dignidad y a la libre decisión de cada uno