0000000000204958
AUTHOR
Pilar Barreto Martín
Teoría y práctica de la dignidad en cuidados paliativos: una revisión
A review study on human dignity is performed in order to theoretically understand this concept in the framework of palliative care, and in which extent these ideas have been developed on a practical level. Specifically, a review of those texts focused on human dignity from philosophy, law, religion, bioethics, health care and palliative care was carried out. This review also tried to find and report some similarities and differences among different approaches. Those differences are the basis of current debate on palliative care. Authors conclude that any approach to human dignity should be closer to the clinical practice in palliative care.
Conspiracy of silence and emotional distress in patients diagnosed with glioblastoma multiforme
Objetivo: En el ámbito de enfermedades muy graves y de mal pronóstico, continúa existiendo un importante porcentaje de familiares que, por motivos beneficentes y de protección, deciden ocultar la verdad a los enfermos que desean conocer lo que les ocurre. El objetivo es identificar la incidencia de conspiración de silencio familiar y su repercusión en los niveles de ansiedad y depresión del paciente diagnosticado de glioblastoma multiforme (GBM). Método: Los niveles de ansiedad y depresión fueron recogidos en cinco momentos del proceso de enfermedad: ingreso, después de la comunicación del diagnóstico, en el alta hospitalaria, un mes después del alta y seis meses después del alta. Las neces…
Mindfulness y duelo: programa MADED, mindfulness para la aceptación del dolor, las emociones y el duelo
Objective: to design a psychological intervention protocol for the accompaniment of pain and emotions in the grieving process based on attention and compassion. Method: mourners over 18 years of age, who have lost their family member at least 6 months ago, who are in phase 2 or 3 of the grieving process and who have no previous mental health problems, will be included. They will be evaluated after signing the informed consent, by means of: the Mindfulness Questionnaire, the Life Satisfaction Questionnaire, the Vitality Questionnaire, the Hospital Anxiety and Depression Scale, the Positive and Negative Affect Scale and the Complicated Grief Inventory. Descriptive statistics, Cohen’s t-test f…
Emotional Distress of Patients at End-of-Life and Their Caregivers: Interrelation and Predictors
Background: Patients at the end of life and their families experience a strong emotional impact. The well-being of these patients and that of their family caregiver are related. Aim: To study the variables related with the emotional well-being of patients with and without cognitive impairment at the end of life and that of their primary family caregivers. Design: Cross- sectional study. Participants: Data was collected from 202 patients at the end of life with different diagnosis (COPD, cancer, and frail elderly) as well as from their respective 202 primary family caregivers. Results: Structural equation models indicated that the emotional state of the patients was best predicted by their f…
Patients with limited communication in end-of-life situations: Initial psychometric properties of a discomfort observation scale
This work presents an observational scale which takes into account different observable indicators of discomfort of patients in end-of-life situations with difficulties in communicating due to cognitive impairment, fatigue or sedation and provides details of its validation. In all, 71 adults participated. Model fit was adequate ( χ2(27) = 43.28, p = .024, comparative fit index = .975, root mean square error of approximation = .092 and confidence interval 90% (.033–.140)). Alpha coefficient was .70 and composite reliability index was .90. Our study provides data regarding the properties of a discomfort assessment scale. Such a scale is needed and could be very useful for the evaluation of su…
Psicología y fin de vida
Pilar.Barreto@uv.es El presente trabajo tiene como objetivo exponer las aportaciones fundamentales de la Psicología al campo de los cuidados al final de la vida. Tras plantear cuestiones básicas que ha de contemplar la intervención interdisciplinar, exponemos los principios y herramientas para la evaluación y las estrategias de intervención. Se explicitan tanto el rol preventivo como asistencial en el profesional de la psicología. Se plantea el counselling como marco clave de la evaluación y la intervención y se comentan estrategias específicas para problemas concretos como ansiedad y depresión. Es evidente que la Psicología tiene un deber profesional en este campo de estudio, aunque su rec…
Trastornos del estado de ánimo al final de la vida: ¿desmoralización o depresión?
This paper analyzes problems that result in an alteration of mood, particularly in the sadness found in people with a serious physical illness at the end of life. The problems and implications of an faulty diagnosis, the confusions associated with a diagnosis of depression, and the importance of differen-tiation between “normal” mood reactions to illness, and pathological reactions, are analyzed. Several studies are reviewed and analyzed that propose the incorporation of a new syndrome to the traditional psychiatric classifications: demoralization. Finally the implications, advantages, and inconveniences of including a demoralization syndrome are discussed.
Toma de decisiones en el paciente diagnosticado de tumor cerebral. A propósito de un caso clínico
Pilar.Barreto@uv.es Justificación: La decisión sobre la alternativa terapéutica más conveniente, que corresponde al paciente asesorado por el equipo sanitario, se hace especialmente difícil en casos del mal pronóstico. Pacientes: Paciente joven con tumor cerebral, reintervenido en diversas ocasiones, al que se detecta una recidiva. Resultados: En contra de la opinión del equipo multidisciplinar, el paciente decide someterse a una reintervención, falleciendo a los cuatro meses presentando una calidad de vida aceptable. Conclusiones: Se plantea la necesidad, a través de un counselling adecuado, de permitir que el paciente escoja el resultado clínico preferido tras la transmisión clara de las …