ABSTRACT
Objetivo. Conocer, desde el punto de vista del paciente oncológico, quién tomó la decisión sobre su tratamiento, así como las principales barreras y facilitadores que permiten la implementación de la toma de decisiones compartidas (TDC). Material y métodos. Estudio transversal y de asociación a partir de un cuestionario autoadministrado a pacientes oncológicos seleccionados mediante muestreo casual en diferentes consultas oncológicas y periodos aleatorios. Ciento ocho pacientes proporcionaron datos analizables. La información recogida fue sobre variables sociodemográficas y clínicas, sobre quién tomó la decisión sobre el tratamiento y el grado de acuerdo o desacuerdo con diferentes barreras y facilitadores. Resultados. El 38,1% de los pacientes afirmó haber tomado la decisión de manera compartida con su médico. Barreras como el tiempo, la dificultad de comprensión, el paternalismo, la falta de comunicación fluida y el disponer de información previa y frecuentemente errónea influyeron en la implicación en la toma de decisiones. Sin embargo, disponer o no de instrumentos suficientes de ayuda a la decisión o el interés del paciente por participar no influyeron. En lo referente a los facilitadores, la motivación del médico, su percepción de mejora y el interés del enfermo tuvieron una influencia positiva. La excepción la constituyó la posibilidad de incentivar económicamente a los médicos. Conclusiones. La nula o escasa participación percibida por los pacientes oncológicos en las decisiones sobre su salud hace necesario introducir mejoras en el modelo de atención sanitaria que permitan superar barreras y promover una actitud más participativa en el paciente (AU)
Objective. To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. Material and methods. A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. Results. More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. Conclusions. The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient (AU)
Subject(s)
Humans , Decision Making, Organizational , Oncology Service, Hospital/organization & administration , Patient Satisfaction , Patient Participation/statistics & numerical data , Physician-Patient Relations , Cross-Sectional StudiesABSTRACT
OBJECTIVE: To determine, from the point of view of the oncological patient, who made the decision about their treatment, as well as the major barriers and facilitators that enabled Shared Decision Making to be implemented. MATERIAL AND METHODS: A cross-sectional, descriptive, sand association study using a self-report questionnaire to selected cancer patients, with casual sampling in different oncology clinics and random time periods. A total of 108 patients provided analysable data. The information was collected on sociodemographic and clinical variables, who made the decision about treatment, and level of agreement or disagreement with various barriers and facilitators. RESULTS: More than one-third (38.1%) of patients claimed to have participated in shared decision making with their doctor. Barriers such as, time, the difficulty of understanding, the paternalism, lack of fluid communication, and having preliminary and often erroneous information influenced the involvement in decision-making. However, to have or not have sufficient tools to aid decision making or the patient's interest to participate had no effect. As regards facilitators, physician motivation, their perception of improvement, and the interest of the patient had a positive influence. The exception was the possibility of financial incentives to doctors. CONCLUSIONS: The little, or no participation perceived by cancer patients in decisions about their health makes it necessary to introduce improvements in the health care model to overcome barriers and promote a more participatory attitude in the patient.
Subject(s)
Decision Making , Neoplasms , Patient Participation , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Neoplasms/therapy , Physician-Patient Relations , Self ReportABSTRACT
Introducción. La búsqueda de información sanitaria en Internet es un fenómeno creciente, siendo su principal inconveniente el desconocimiento de la fiabilidad de las páginas consultadas. El objetivo de nuestro trabajo fue analizar y comparar los principales sellos vigentes de calidad de páginas web sanitarias. Material y métodos. Se realizó un estudio observacional transversal mediante una búsqueda en Medline, IBECS, Google y Yahoo realizado los días 8 y 9 de marzo de 2015 tanto en inglés como español. Se utilizaron diferentes palabras clave en función de si la búsqueda se realizaba en bases de datos médicas o en buscadores genéricos. Los sellos se clasificaron en función de su origen, analizando su carácter, año de implantación, existencia de proceso de acreditación, número de categorías, criterios y estándares, posibilidad de autoevaluación, número de niveles de certificación, ámbito de certificación, vigencia, análisis de la calidad de contenidos, cuota, resultados del proceso de acreditación o solicitud, número de webs con sello concedido y sellos obtenidos por el organismo acreditador. Resultados. Se analizaron siete sellos, cinco de origen nacional (WMA, PAWS, WIS, SEAFORMEC y M21) y dos internacional (HONcode y Health Web Site Accreditation). Existía disparidad en la forma de llevar a cabo el proceso de acreditación, llegando algunos a no detallar aspectos fundamentales de dicho proceso o proporcionar información incompleta, desactualizada e incluso inexacta. Los más rigurosos garantizaban el nivel de confianza que las páginas web poseían en relación con los contenidos de información, pero ninguno revisaba la calidad de los mismos. Conclusiones. Aunque los sellos de calidad rigurosos pueden llegar a ser útiles, las deficiencias detectadas en algunos de ellos pueden hacer dudar de su finalidad (AU)
Background. The search for health related information on the Internet is a growing phenomenon, buts its main drawback is the lack of reliability of information consulted. The aim of this study was to analyse and compare existing quality labels of health websites. Material and methods. A cross-sectional study was performed by searching Medline, IBECS, Google, and Yahoo, in both English and Spanish, between 8 and 9 March, 2015. Different keywords were used depending on whether the search was conducted in medical databases or generic search engines. The quality labels were classified according to their origin, analysing their character, year of implementation, the existence of the accreditation process, number of categories, criteria and standards, possibility of self-assessment, number of levels of certification, certification scope, validity, analytical quality of content, fee, results of the accreditation process, application and number of websites granted the seal, and quality labels obtained by the accrediting organisation. Results. Seven quality labels, five of Spanish origin (WMA, PAWS, WIS, SEAFORMEC and M21) and two international ones (HONcode and Health Web Site Accreditation), were analysed. There was disparity in carrying out the accreditation process, with some not detailing key aspects of the process, or providing incomplete, outdated, or even inaccurate information. The most rigorous guaranteed the level of confidence that the websites had in relation to the content of information, but none checked the quality of them. Conclusions. Although rigorous quality labels may become useful, the deficiencies in some of them cast doubt on their current usefulness (AU)
Subject(s)
Humans , Male , Female , Internet/organization & administration , Webcasts as Topic/organization & administration , Webcasts as Topic/standards , Quality of Health Care/organization & administration , Quality of Health Care/standards , Quality of Health Care , Codes of Ethics/legislation & jurisprudence , Accreditation/methods , Accreditation/organization & administration , Accreditation/standards , Certification/organization & administration , Certification/standards , Internet/standards , InternetABSTRACT
BACKGROUND: The search for health related information on the Internet is a growing phenomenon, buts its main drawback is the lack of reliability of information consulted. The aim of this study was to analyse and compare existing quality labels of health websites. MATERIAL AND METHODS: A cross-sectional study was performed by searching Medline, IBECS, Google, and Yahoo, in both English and Spanish, between 8 and 9 March, 2015. Different keywords were used depending on whether the search was conducted in medical databases or generic search engines. The quality labels were classified according to their origin, analysing their character, year of implementation, the existence of the accreditation process, number of categories, criteria and standards, possibility of self-assessment, number of levels of certification, certification scope, validity, analytical quality of content, fee, results of the accreditation process, application and number of websites granted the seal, and quality labels obtained by the accrediting organisation. RESULTS: Seven quality labels, five of Spanish origin (WMA, PAWS, WIS, SEAFORMEC and M21) and two international ones (HONcode and Health Web Site Accreditation), were analysed. There was disparity in carrying out the accreditation process, with some not detailing key aspects of the process, or providing incomplete, outdated, or even inaccurate information. The most rigorous guaranteed the level of confidence that the websites had in relation to the content of information, but none checked the quality of them. CONCLUSIONS: Although rigorous quality labels may become useful, the deficiencies in some of them cast doubt on their current usefulness.
