ABSTRACT
El presente artículo revisa los principales aspectos relativos al concepto de distrés moral y burnout en el personal sanitario, los factores de riesgo general y específicos propios de la actual emergencia sanitaria, los instrumentos de evaluación disponibles, así como las principales estrategias y recomendaciones de prevención y manejo del cuadro.
This article reviews the main aspects related to the concept of moral distress and burnout among health professionals, general and specific risk factors for the current public health emergency, considering the available assessment instruments, as well as the main strategies and recommendations for its prevention and management.
Subject(s)
Humans , Burnout, Professional , Health Personnel/psychology , Psychological Distress , COVID-19 , Morale , Burnout, Professional/prevention & control , Risk FactorsABSTRACT
El presente artículo revisa las características clínicas y epidemiológicas del suicidio en Chile, así como también los principales factores de riesgo involucrados en esta conducta. Se describen algunos mitos en relación al problema, variables comunicacionales y estrategias de intervención en la consulta del médico no especialista para pacientes con ideación y conducta suicida junto con las principales herramientas para limitar el suicidio.
This article reviews the clinical and epidemiological characteristics of suicide in Chile, as well as the main risk factors involved in this behavior. Some myths are described in relation to the problem, communication variables and intervention strategies in the consultation of the non-specialist doctor for patients with suicidal ideation and behavior along with the main tools to limit suicide.
Subject(s)
Humans , Suicide/prevention & control , Suicide, Attempted/prevention & control , Risk , Social Support , Suicide/statistics & numerical data , Risk Factors , Protective FactorsABSTRACT
BACKGROUND: Very few patients are presented to ethics committees, and individual ethics consultations are a response to this situation. At the intensive care unit (ICU) in Clínica Alemana, Santiago Chile, an ethics consultation system was organized coordinated with the ethics committee. AIM: To report an evaluation of this ethics consultation system. MATERIAL AND METHODS: Analysis of the first 50 cases analyzed in the consultation system. Analysis of the responses of intensive care physicians to a questionnaire about the main ethical problems that they face in their work. RESULTS: The consultation system is mainly required by the ICU staff and reports to the ethics committee. Fifty four percent of patients subjected to consultation were aged over 80 years. The main diagnoses were neurological, oncological or cardiopulmonary problems. The ethical problems identified were treatment limitation (62%), proportionality or futility (42%), need of a peaceful death (36%), lack of anticipated decisions (28%), disagreement between physicians and patient's family (24%), undefined subrogation (14%), and abuse of public resources (14%). Twenty six of 31 ICU physicians answered the questionnaire, using a 1 (min) to 7 (max.) scale. They found that consultation is helpful for decision making (6.3), useful for improving ethical perception (6.0), supportive for staff (6.5), good for patients (6.3), supportive for families (6.7), and timely performed (5.2). CONCLUSIONS: As a complement for the ethics committee's work, consultation is a valid alternative for ethics counselling and a support for physicians and patient's families. Its implementation depends on the particularities of each health institution.
