Decisiones médicas al final de la vida en pacientes oncológicos en Colombia

Castiblanco Delgado, Danny Steven

dc.contributor.advisor	Leal Arenas, Fabian Alexander
dc.contributor.author	Castiblanco Delgado, Danny Steven
dc.contributor.other	de Vries, Esther
dc.contributor.other	Leal, Fabián
dc.contributor.other	van der Heide, Agnes
dc.contributor.other	Murillo, Raúl
dc.contributor.other	Morales, Olga
dc.contributor.other	Gempeler, Fritz
dc.contributor.other	Diaz, Eduardo
dc.contributor.other	Rodríguez, Nelcy
dc.contributor.other	Gonzalez, Beatriz Juliana
dc.coverage.spatial	Bogotá	spa
dc.coverage.spatial	Popayán	spa
dc.coverage.temporal	agosto 2019 a enero 2021	spa
dc.date.accessioned	2021-02-22T16:23:27Z
dc.date.available	2021-02-22T16:23:27Z
dc.date.issued	2020-12-31
dc.identifier.uri	http://hdl.handle.net/10654/37416
dc.description.abstract	El proyecto es un estudio mixto – compuesto por tres diferentes estudios en paralelo: el primero basado en una muestra de personas fallecidas por cáncer recientemente, en el cual mediremos, entre familiares y médicos, cuáles actos médicos ocurrieron en el último mes de la vida del paciente y, en el caso de los familiares, cómo vivieron ellos el último mes de su pariente y qué cambiarían o modificarían de ese proceso. Los médicos nos proveerán información acerca de detalles de tratamientos aplicados o retirados y las razones detrás de las decisiones médicas en este último mes de vida del paciente. A los familiares se les hará una encuesta vía telefónica o de manera presencial, y a los médicos se les aplicará una encuesta internacionalmente usada para este objetivo. En el segundo estudio haremos un inventario de diferentes prácticas médicas y opiniones acerca de éstas, entre profesionales de la salud, mediante grupos focales de oncólogos, paliativistas, enfermeras, nutricionistas o cualquier profesional de la salud. En el tercer estudio preguntaremos a pacientes con cáncer, quienes saben que probablemente morirán por su enfermedad, cuáles son sus deseos para su último mes de vida en términos de lugar (hospital, hospicio, en casa); temas de importancia (ejemplo de estar consciente versus manejo completo de dolor, paliación); temas relacionados con los cuidadores; temas sociales, psicológicos y espirituales, y temas prácticos (legales, herencia). Los resultados de este estudio proveerán información acerca de la frecuencia de diferentes tipos de cuidado médico y decisiones de tratamiento al final de la vida, la aceptación de éstos tanto entre profesionales de la salud, como entre pacientes y familiares, y dará pautas para mejorar la atención y servicios en oncología en la última fase de la vida.	spa
dc.description.sponsorship	Instituto Nacional de Cancerología ESE	spa
dc.description.sponsorship	Colciencias	spa
dc.description.tableofcontents	Proyecto en ejecución	spa
dc.format.mimetype	applicaction/pdf	spa
dc.language.iso	spa	spa
dc.rights.uri	http://creativecommons.org/licenses/by-nc-nd/4.0/	*
dc.title	Decisiones médicas al final de la vida en pacientes oncológicos en Colombia	spa
dc.rights.accessrights	info:eu-repo/semantics/openAccess	spa
dc.type.local	Tesis/Trabajo de grado - Monografía - Especialización	spa
dc.description.abstractenglish	The project is a mixed study - composed of three different studies in parallel: the first based on a sample of people who have recently died of cancer, in which we will measure, among relatives and physicians, what medical acts occurred in the last month of the patient's life and, in the case of relatives, how they experienced their relative's last month and what they would change or modify about that process. Physicians will provide us with information about details of treatments applied or withdrawn and the reasons behind medical decisions in this last month of the patient's life. Family members will be surveyed by telephone or in person, and physicians will be surveyed using an internationally used survey for this purpose. In the second study we will make an inventory of different medical practices and opinions about them, among health professionals, through focus groups of oncologists, palliativists, nurses, nutritionists or any health professional. In the third study we will ask cancer patients, who know they are likely to die from their disease, what their wishes are for their last month of life in terms of location (hospital, hospice, at home); issues of importance (example of being conscious versus full pain management, palliation); issues related to caregivers; social, psychological and spiritual issues; and practical issues (legal, inheritance). The results of this study will provide information about the frequency of different types of medical care and treatment decisions at the end of life, the acceptance of these among both health care professionals and patients and families, and will provide guidelines for improving oncology care and services in the last phase of life.	spa
dc.title.translated	Medical decisions at the end of life in oncology patients in Colombia.	spa
dc.subject.keywords	End of Life	spa
dc.subject.keywords	palliative care	spa
dc.subject.keywords	decision making	spa
dc.subject.keywords	medical decision	spa
dc.publisher.program	Medicina del Dolor y Cuidados Paliativos	spa
dc.creator.degreename	Especialista en Medicina del Dolor y Cuidados Paliativos	spa
dc.subject.decs	Cuidados Paliativos	spa
dc.subject.decs	Oncología Médica	spa
dc.subject.decs	Instituciones Oncológicas	spa
dc.subject.decs	Calidad de Vida	spa
dc.description.degreelevel	Especialización	spa
dc.publisher.faculty	Facultad de Medicina	spa
dc.type.driver	info:eu-repo/semantics/bachelorThesis	spa
dc.rights.creativecommons	Attribution-NonCommercial-NoDerivatives 4.0 International	spa
dc.relation.references	Dalal S, Bruera E. End-of-Life Care Matters: Palliative Cancer Care Results in Better Care and Lower Costs. The Oncologist. 2017 Apr;22(4):361–8.	spa
dc.relation.references	Hunt KJ, Shlomo N, Addington-Hall J. End-of-life care and achieving preferences for place of death in England: results of a population-based survey using the VOICES-SF questionnaire. Palliat Med. 2014 May;28(5):412–21.	spa
dc.relation.references	Neergaard MA, Jensen AB, Sondergaard J, Sokolowski I, Olesen F, Vedsted P. Preference for place-of-death among terminally ill cancer patients in Denmark. Scand J Caring Sci. 2011 Dec;25(4):627–36.	spa
dc.relation.references	Kinoshita H, Maeda I, Morita T, Miyashita M, Yamagishi A, Shirahige Y, et al. Place of death and the differences in patient quality of death and dying and caregiver burden. J Clin Oncol Off J Am Soc Clin Oncol. 2015 Feb 1;33(4):357–63.	spa
dc.relation.references	Gomes B, Higginson IJ. Factors influencing death at home in terminally ill patients with cancer: systematic review. BMJ. 2006 Mar 4;332(7540):515–21.	spa
dc.relation.references	Espinosa-Roca AA, Espinosa-Brito AD, Fernández-Casteleiro E, Sabatés-Llerandi T. Where patients with cancer die in Cuba. BMJ. 2006 Mar 18;332(7542):668.	spa
dc.relation.references	Arnold E, Finucane AM, Oxenham D. Preferred place of death for patients referred to a specialist palliative care service. BMJ Support Palliat Care. 2015 Sep;5(3):294–6.	spa
dc.relation.references	Shepperd S, Gonçalves-Bradley DC, Straus SE, Wee B. Hospital at home: home-based end-of-life care. Cochrane Database Syst Rev. 2016 Feb 18;2:CD009231.	spa
dc.relation.references	de Graaf E, Zweers D, Valkenburg AC, Uyttewaal A, Teunissen SC. Hospice assist at home: does the integration of hospice care in primary healthcare support patients to die in their preferred location - A retrospective cross-sectional evaluation study. Palliat Med. 2016;30(6):580–6.	spa
dc.relation.references	Sanjo M, Miyashita M, Morita T, Hirai K, Kawa M, Akechi T, et al. Preferences regarding end-of-life cancer care and associations with good-death concepts: a population-based survey in Japan. Ann Oncol Off J Eur Soc Med Oncol. 2007 Sep;18(9):1539–47.	spa
dc.relation.references	Baily MA. Futility, autonomy, and cost in end-of-life care. J Law Med Ethics J Am Soc Law Med Ethics. 2011;39(2):172–82.	spa
dc.relation.references	McBride T, Morton A, Nichols A, van Stolk C. Comparing the costs of alternative models of end-of-life care. J Palliat Care. 2011;27(2):126–33.	spa
dc.relation.references	Bentur N, Resnizky S, Balicer R, Eilat-Tsanani T. Utilization and cost of services in the last 6 months of life of patients with cancer - with and without home hospice care. Am J Hosp Palliat Care. 2014 Nov;31(7):723–5.	spa
dc.relation.references	Obermeyer Z, Makar M, Abujaber S, Dominici F, Block S, Cutler DM. Association between the Medicare hospice benefit and health care utilization and costs for patients with poorprognosis cancer. JAMA. 2014 Nov 12;312(18):1888–96.	spa
dc.relation.references	Swart SJ, van der Heide A, van Zuylen L, Perez RSGM, Zuurmond WWA, van der Maas PJ, et al. Continuous palliative sedation: not only a response to physical suffering. J Palliat Med. 2014 Jan;17(1):27–36.	spa
dc.relation.references	Rietjens JAC, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ, van der Wal G. A comparison of attitudes towards end-of-life decisions: survey among the Dutch general public and physicians. Soc Sci Med 1982. 2005 Oct;61(8):1723–32.	spa
dc.relation.references	Rietjens JAC, van der Heide A, Onwuteaka-Philipsen BD, van der Maas PJ, van der Wal G. Preferences of the Dutch general public for a good death and associations with attitudes towards end-of-life decision-making. Palliat Med. 2006 Oct;20(7):685–92.	spa
dc.relation.references	Anquinet L, Rietjens JAC, Seale C, Seymour J, Deliens L, van der Heide A. The practice of continuous deep sedation until death in Flanders (Belgium), the Netherlands, and the U.K.: a comparative study. J Pain Symptom Manage. 2012 Jul;44(1):33–43.	spa
dc.relation.references	Onwuteaka-Philipsen BD, van der Heide A, Koper D, Keij-Deerenberg I, Rietjens JAC, Rurup ML, et al. Euthanasia and other end-of-life decisions in the Netherlands in 1990, 1995, and 2001. Lancet Lond Engl. 2003 Aug 2;362(9381):395–9.	spa
dc.relation.references	Onwuteaka-Philipsen BD, Brinkman-Stoppelenburg A, Penning C, de Jong-Krul GJF, van Delden JJM, van der Heide A. Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey. Lancet Lond Engl. 2012 Sep 8;380(9845):908–15.	spa
dc.relation.references	Van der Heide A, Brinkman-Stoppelenburg A, van Delden J, Onwuteaka-Philipsen B. Sterfgevallenonderzoek 2010: Euthanasie en andere medische beslissingen rondom het levenseinde. Den Haag: ZonMW; 2012.	spa
dc.relation.references	Rietjens JAC, van der Maas PJ, Onwuteaka-Philipsen BD, van Delden JJM, van der Heide A. Two Decades of Research on Euthanasia from the Netherlands. What Have We Learnt and What Questions Remain? J Bioethical Inq. 2009 Sep;6(3):271–83.	spa
dc.relation.references	World Health Organization (WHO). World Health Statistics 2012. Geneva Switzerland: World Health Organization; 2012.	spa
dc.relation.references	Pardo Ramos C, Cendales Duarte R. Incidencia, mortalidad y prevalencia de cáncer en Colombia, 2007-2011. Bogotá: Ministerio de Salud y Protección Social¿: Instituto Nacional de Cancerología; 2015.	spa
dc.relation.references	Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from: http://globocan.iarc.fr, accessed on day/month/year.	spa
dc.relation.references	Stjernswärd J, Foley KM, Ferris FD. The public health strategy for palliative care. J Pain Symptom Manage. 2007 May;33(5):486–93.	spa
dc.relation.references	De Lima L, Perez-Castells M, Berenguel M, Monti C, Aguilar A, Ahumada M, et al. De Lima L, Perez-Castells M, Berenguel M, Monti C, Aguilar A, Ahumada M, Ramirez L, TorresVigil I, Vargas Y, Herrera E, (2013). Indicadores de Cuidado Paliativo ALCP. 1a edicion. Houston: IAHPC Press. [Internet]. 1st ed. Houston: IAHPC Press; 2013. Available from: http://cuidadospaliativos.org/uploads/2013/3/Indicadores%20de%20Cuidado%20Paliativo%20ALC P%20(espanol).pdf	spa
dc.subject.proposal	Final de la vida	spa
dc.subject.proposal	Cuidados paliativos	spa
dc.subject.proposal	Toma de decisiones	spa
dc.subject.proposal	Decisión médica	spa
dc.publisher.grantor	Universidad Militar Nueva Granada	spa
dc.type.coar	http://purl.org/coar/resource_type/c_7a1f	*
dc.type.hasversion	info:eu-repo/semantics/acceptedVersion	spa
dc.identifier.instname	instname:Universidad Militar Nueva Granada	spa
dc.identifier.reponame	reponame:Repositorio Institucional Universidad Militar Nueva Granada	spa
dc.identifier.repourl	repourl:https://repository.unimilitar.edu.co	spa
dc.rights.local	Acceso abierto	spa
dc.coverage.sede	Medicina	spa
dc.rights.coar	http://purl.org/coar/access_right/c_abf2