Maltrato a estudiantes de medicina del Paraguay en 2022: encuesta multicéntrica

Introducción: los estudiantes de medicina son propensos a recibir maltratos de sus colegas, personal administrativo y pacientes. Objetivo: determinar las características del maltrato a estudiantes de medicina del Paraguay en 2022. Metodología: se aplicó un diseño observacional, de corte transversal. Se incluyó a estudiantes de medicina, de ambos sexos, que aceptaban participar de la encuesta telemática. El muestreo fue por conveniencia. Se midieron variables demográficas. La percepción del maltrato fue evaluada según cuatro componentes (psicológico, físico, académico y sexual) utilizando el cuestionario de Munayco-Guillén F et al, previamente validado. El estudio contó con la aprobación del Comité de ética de la Universidad Privada del Este, Paraguay. Resultados: el cuestionario fue contestado por 214 estudiantes, siendo 146 mujeres (edad media 24 ± 3 años) y 68 varones (edad media 25 ± 5 años). La mayoría reside en Asunción (29,4%) y asiste a universidades privadas (92%). La media ± DE del maltrato psicológico fue 1,89 ± 1,02, la del físico fue 1,64 ± 0,89, la del académico fue 2,01 ± 1,11 y la del sexual fue 1,4 ± 0,83. Aplicando puntos de corte en los percentiles 60 y 70, el maltrato fue leve en 126 estudiantes (58,9%), moderado en 24 (11,2%) y grave en 64 (29,9%). El motivo principal para no denunciarlo fue el miedo a ser señalado por los demás o recibir represalias (17,3%). Discusión: se detectó maltrato leve en 58,9%, moderado en 11,2% y grave en 29,9% de los estudiantes de medicina. Se requiere aplicar medidas de prevención y contención de los maltratos.

Introduction: medical students are prone to mistreatment from their colleagues, administrative staff, and patients. Objective: to determine the characteristics of the mistreatment of medical students in Paraguay in 2022. Method: an observational, cross-sectional design was applied. Medical students of both sexes who agreed to participate in the online survey were included. Sampling was for convenience. Demographic variables were measured. The perception of abuse was evaluated according to four components (psychological, physical, academic, and sexual) using the previously validated questionnaire by Munayco-Guillén F et al. The study was approved by the Ethics Committee of the Universidad Privada del Este, Paraguay. Results: the questionnaire was answered by 214 students, 146 being women (mean age 24 ± 3 years) and 68 men (mean age 25 ± 5 years). The majority reside in Asunción (29.4%) and attend private universities (92%). The mean ± SD of psychological abuse was 1.89 ± 1.02, physical abuse was 1.64 ± 0.89, academic abuse was 2.01 ± 1.11, and sexual abuse was 1.4 ± 0. 83. Applying cut-off points at the 60th and 70th percentiles, the abuse was mild in 126 students (58.9%), moderate in 24 (11.2%), and severe in 64 (29.9%). The main reason for not reporting it was fear of being singled out by others or receiving reprisals (17.3%). Discussion: mild abuse was detected in 58.9%, moderate in 11.2%, and severe in 29.9% of medical students. It is necessary to apply measures to prevent and contain abuse.

Panorama das denúncias e processos éticos odontológicos no estado de Santa Catarina / Overview of dental complaints and ethical proceedings in the State of Santa Catarina

O Código de Ética Odontológica pode ser entendido como um conjunto de normas de comportamento que se estabelecem no desenvolvimento do exercício profissional e regem a sua prática. Com isto, almeja-se evidenciar a natureza ética do trabalho e garantir valores importantes para a sociedade no contexto da prática profissional. O objetivo deste estudo foi verificar as denúncias e processos éticos no Conselho Regional de Odontologia de Santa Catarina (CRO-SC), relacionando-os às suas causas. A pesquisa, após a aprovação pelo Comitê de Ética em Pesquisa da UFSC, apurou as denúncias e os processos éticos instaurados junto ao CRO-SC no período de janeiro de 2013 a dezembro de 2017, verificando sua evolução, identificando suas motivações e averiguando as respectivas situações processuais. Os resultados obtidos mostraram um aumento de 7,1% para 60,7% nas denúncias e de 6,2% para 58,4% nos processos éticos. A maior causa de denúncias foi devido à publicidade irregular (65%), originando 68% dos processos éticos com base nesta irregularidade; 39,2% das denúncias resultaram na abertura de processos éticos; 17% foram arquivadas; 21,3% dos processos éticos instaurados foram encerrados, por julgamento ou arquivamento, e 74,7% estão em tramitação. Cerca de 20,3% das denúncias foram classificadas como outras infrações; 4,8% como exercício ilegal da profissão, 2,4% como exercício irregular da profissão e 7,4% como provável erro técnico. Os resultados indicam a importância de uma mudança na visão do cirurgião-dentista em relação aos valores éticos e sociais na Odontologia a fim de conduzir seu trabalho sob uma perspectiva mais humanizada.

The Code of Dental Ethics can be understood as a set of behavioral norms that are established in the development of professional practice and govern its practice. With this, it aims to highlight the ethical nature of work and ensure important values for society in the context of professional practice. The purpose of this study was to verify the complaints and ethical processes in the Regional Dentistry of Santa Catarina (CRO-SC), relating them to their causes. The research, after approval by UFSC's Research Ethics Committee, found the complaints and the ethical processes established with the CRO-SC from January 2013 to December 2017, verifying their growing, identifying their motivations and ascertaining the respective procedural situations. The results obtained showed an increase from 7.1% to 60.7% in complaints and from 6.2% to 58.4% in ethical processes. The main cause of complaints was due to irregular advertising (65%), resulting in 68% ethical processes based on this irregularity; 39.2% of the complaints resulted in the opening of ethical processes; 17% were archived; 21.3% of the ethical proceedings initiated were closed by judgment or filing, and 74.7% are in progress. About 20.3% of the complaints were classified as other infringements; 4.8% as illegal exercise of profession, 2.4% as exercise irregular profession and 7.4% as a probable technical error. The results indicate the importance of a dentist's view of the ethical and social values in dentistry in order to conduct their work from a more humanized perspective.

Faltas frecuentes a la Ley 576 de 2000 presentadas al Tribunal de Ética Profesional de Medicina Veterinaria y Zootecnia en Colombia durante el periodo 2014-2017 / Frequent Infringements of Law 576 of 2000 Presented to the Tribunal of Professional Ethics Veterinary Medicine and Zootechnics in Colombia during the 2014-2017 Period / Ofensas frequentes à Lei 576 de 2000 submetidas ao Tribunal de Ética Profissional de Medicina Veterinária e Zootecnia na Colômbia durante o período 2014-2017

Resumen La medicina veterinaria como profesión en Colombia se remonta a 1884. En 1985 se conformó el Consejo Profesional de Medicina Veterinaria y Zootecnia y Zootecnia de Colombia (Comvezcol), y posteriormente, mediante la Ley 576 de 2000, se creó el código de ética para el ejercicio profesional de la medicina veterinaria, medicina veterinaria y zootecnia y zootecnia, así como el Tribunal Nacional de Ética Profesional (Trinadep), con el fin de tramitar las quejas, adelantar investigaciones e instruir las acciones disciplinarias contra los profesionales de las ciencias animales. En Colombia no se han encontrado reportes que permitan realizar un análisis de las faltas al código de ética, por lo cual en este artículo se busca describir las faltas más frecuentes denunciadas en el periodo 2014-2017. Para ello se realizó un estudio retrospectivo de las sanciones impuestas por el Trinadep por infracción de la Ley 576 de 2000. Según los datos obtenidos durante el periodo de estudio, se sancionaron 96 profesionales, de los cuales el 53,13 % fueron médicos veterinarios, y el 42,71 % fueron médicos veterinarios zootecnistas. Se observó una mayor tasa de infracción en hombres (75 %). Los artículos 5 (22,3 %), 13 (20,56 %), 61 (19,51 %), 27 (12,2 %) y 20 (9,06 %) fueron los que más se infringieron. Estos datos permiten concluir que es necesaria la concientización de estudiantes y profesionales en algunos aspectos del desempeño profesional, como lo son el diligenciamiento adecuado de la historia clínica y los consentimientos informados, el uso debido de ayudas diagnósticas y el uso de terapéuticas acordes con el individuo.

Abstract Veterinary medicine as a profession in Colombia dates back to 1884. In 1985, the Professional Council of Veterinary Medicine and Zootechnics of Colombia (Comvezcol) was formed, and subsequently, through Law 576 of 2000, the code of ethics for the professional practice of veterinary medicine and zootechnics was created, along with the National Tribunal of Professional Ethics (Trinadep), in order to process complaints, conduct investigations, and determine disciplinary actions against animal science professionals. In Colombia, no reports were found that would allow analyzing non-compliance with the code of ethics; consequently, this article seeks to describe the most frequent infringements reported in the period 2014-2017. To this end, a retrospective study of the sanctions imposed by Trinadep was carried out regarding non-compliance with Law 576 of 2000. According to the data obtained during the study period, 96 professionals were sanctioned; 53.13% of them were veterinarians, and 42.71% were zootechnical veterinarians. A higher rate of infraction was observed in men (75%). Articles 5 (22.3%), 13 (20.56%), 61 (19.51%), 27 (12.2%), and 20 (9.06%) were the most frequently infringed. These data allow concluding that it is necessary to raise awareness among students and professionals on some aspects of professional performance, such as the proper completion of clinical history and informed consents, the proper use of diagnostic aids, and the use of therapeutics in accordance with the individual.

Resumo A medicina veterinária como profissão na Colômbia remonta-se a 1884. Em 1985 conformou-se o Conselho Profissional de Medicina Veterinária e Zootecnia da Colômbia (Comvezcol), e posteriormente, mediante Lei 576 de 2000, foi criado o código de ética para a prática profissional da medicina veterinária e zootecnia, bem como o Tribunal Nacional de Ética Profissional (Trinadep), a fim de processar reclamações, conduzir investigações e instruir ações disciplinares contra profissionais das ciências animais. Na Colômbia não tem se encontrado relatórios que permitissem uma análise das violações do código de ética, pelo qual este artigo visa descrever as violações mais frequentes no período 2014-2017. Para isso, foi realizado um estudo retrospectivo das sanções impostas pelo Trinadep por violações da Lei 576 de 2000. De acordo com os dados obtidos durante o período de estudo, 96 profissionais foram sancionados, dos que 53,13% foram médicos veterinários e 42,71% foram médicos veterinários zootécnicos. Observou-se maior taxa de infracção em homens (75%). Os artigos 5 (22,3 %), 13 (20,56 %), 61 (19,51 %), 27 (12,2 %) e 20 (9,06 %) foram os mais violados. Estes dados permitem concluir que é necessária a sensibilização de alunos e profissionais em alguns aspectos do desempenho profissional, como são o preenchimento adequado da anamnese e o consentimento informado, o uso correto de auxílios diagnósticos e o uso de terapêuticas acordes com o indivíduo.

Caracterización de las mujeres maltratadas por su pareja desde la perspectiva de género / Gender Perspective Characterization of Women Battered by their Partners

Fundamento: el estudio de la violencia desde la perspectiva de género aporta una nueva lectura en el comportamiento de las mujeres que rompen o no con relaciones abusivas. Objetivo: caracterizar desde la perspectiva de género a las mujeres que han sido maltratadas por su pareja. Métodos: estudio descriptivo, realizado en el policlínico Área V del municipio Cienfuegos en el año 2010. Fueron estudiadas 21 mujeres que denunciaron el delito y 42 maltratadas que no lo denunciaron, pertenecientes al mismo consultorio. Las variables analizadas fueron: edad, nivel educacional, color de la piel, tipología de la violencia, móvil para denunciar o no, tipificación, estereotipo, identidad y roles de género, tiempo de la relación violenta, percepción del apoyo de los grupos mediatizadores y del equipo básico de salud, reacciones emocionales y trastornos psicofisiológicos. Resultados: al analizar las variables para cada grupo, no se encontraron diferencias significativas en cuanto a las características identificativas, tiempo de la relación violenta y percepción del apoyo del equipo básico de salud. Sí fueron significativas estadísticamente las diferencias halladas con respecto al tipo de violencia, identidad genérica, patrones estereotipados, desempeño de roles, reacciones emocionales negativas, y percepción de los grupos mediatizadores. Conclusiones: el maltrato conyugal repercute de manera negativa en la salud de las mujeres que sufren de violencia íntima, fundamentalmente en las que no denuncian el delito.

Background: The study of violence from a gender perspective provides a new approach on the behavior of women who decide to end or sustain abusive relationships. Objective: To characterize, from a gender perspective, women who have been battered by their partners. Methods: A descriptive study was conducted in the Area V Polyclinic of Cienfuegos in 2010 including 21 women who reported the crime and 42 battered women who did not denounced it, both groups belonging to the same consultation area. The variables analyzed were age, educational level, skin color, type of violence, mobile to make or not the report, characterization, stereotypes, gender identity and roles, lasting time of the violent relationship, perception of the support of mediating groups and basic health team and emotional and psychophysiological reactions. Results: By analyzing these variables for each group, no significant differences were found in terms of the identifying features, lasting time of the violent relationship and perceived support of the basic health team. Differences found in respect to the type of violence were indeed statistically significant, as well as those in gender identity, stereotyped patterns, roles playing, negative emotional reactions, and perceptions of mediating groups. Conclusions: Partners abuse has a negative impact on the health of women experiencing intimate violence, basically in the cases of those who do not report the crime.

Características de los casos juzgados en el Tribunal de Ética Médica de Santander, Colombia, desde la promulgación de la Ley 100 de 1993 / Characteristics about judged medical cases in the Tribunal for Medical Ethics, Santander-Colombia, since the enactment of the Law 100th, 1993

Introducción y objetivos:Desde la promulgación de la Ley 100, de 1993, los usuarios del nuevo Sistema General de Seguridad Social en Salud aumentaron el conocimiento de sus derechos, por ende exigen mejor calidad y cumplimiento en estos servicios por parte de los profesionales de la medicina. El objetivo es identificar las características de los casos demandados ante el Tribunal Ética Médica Santander (TEMS). Metodología: Estudio descriptivo transversal aleatorizado con una muestra de 120 casos. La información fue captada y revisada por un miembro del TEMS, la cual se transcribió sin elementos de identificación de los implicados. Las variables estudiadas incluyen la descripción del demandante, del demandado y la resolución del proceso. Resultados: Se revisaron 136 casos radicados en el TEMS desde 1994 hasta 2009. El 56.6% de los afectados fueron mujeres, y el 47.1% de las demandas fueron remitidas al TEMS por un ente judicial. El 83.1% de los demandados fueron hombres, con una media de 42.12 años, de ellos el 37.5% no tenía especialidad. El tiempo entre la ocurrencia de los hechos y la radicación en el TEMS fue de 244 días en promedio; entre la radicación y el pronunciamiento fue de 761 días en promedio. El 89.5% fue acusado por infringir los artículos de la relación médico-paciente. En el pronunciamiento el 72.7% de los casos fueron absueltos por falta de méritos y 16.2% recibió condena. Conclusiones: Es relevante que se analice la relación médico-paciente y se fortalezcan las acciones de concientización sobre la integridad profesional. Así mismo, es importante revisar las características del procesamiento de los casos. [Rodríguez A, Cadena LP. Características de los casos juzgados en el Tribunal de Ética Médica de Santander, Colombia, desde la promulgación de la Ley 100 de 1993. MedUNAB 2012; 15(3):137-143].

Objective: In 1993 the Colombian government enacted a law concerning Health management by public and private institutions. We intend, in this study, identify the reasons why the doctors underwent lawsuits directed to the Medical Tribunal, beginning in 1994, the year the new Health Law was enforced. Methodology: A descriptive randomized transversal study of 136 medical lawsuits directed to the Medical Tribunal. All the information was revised by one member this study. None of the persons involved in the malpractice lawsuit was identified. The variables analyzed included the characteristics of the Defendant, the Plaintiff, the subpoena subject and process outcome. Results: Medical Tribunal Files, ranging from 1994 through 2009 were thoroughly revised. 56.6% of the alleged victims were women and 47.1% of the malpractice claims came from different sources others than their own. 83.1% of the doctors that underwent a lawsuit were male, with an average age of 42.1 years. 37.5% were generalist doctors. The average time taken for a medical lawsuit to be registered before the Medical Tribunal was 244 days, and the average time taken for the Medical Tribunal to provide the final pronouncement was about 761 days. The most common cause for a malpractice lawsuit was found to be the breaking of doctor-patient relationship. 72.7 of the doctors that underwent a lawsuit were found to be no-guilty and 16.2% were found to be guilty. Conclusions: It is very important for doctors to build a strong relation and empathy with their patients. Doctors need to be cautious with the medical or surgical procedures they perform on for their patients. Asuitable Medical Consent has to be taken for all surgical and special medical treatments. Finally doctors need to select a proper medical procedure in a prompt manner and using an accurate treatment. [Rodríguez A, Cadena LP. Characteristics about judged medical cases in the Tribunal for Medical Ethics, Santander-Colombia, since the enactment of the Law 100th, 1993. MedUNAB 2012; 15(3):137-143].