Patient and Family Descriptions of Ethical Concerns.

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants (N = 196) described 219 unique ethical experiences that spanned many of the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting.

Conflict resolution styles and teen dating violence / Estilos de resolución de conflictos y violencia en parejas de adolescentes

Background/Objective: Training in conflict resolution strategies is a goal in different intervention contexts, and the Conflict Resolution Styles Inventory is a proven, useful tool for assessing these skills. Two studies were conducted, one aimed at analyzing psychometric properties of this instrument, and the other at verifying its ability to discriminate between violent and non-violent adolescent dating partners. Method: In the first study, with 592 adolescents, confirmatory factor analyzes were performed with the two subscales (self and partner). The second study, with 1,938 adolescents, tested whether the factorial structure obtained discriminates between levels of dating violence involvement. Results: Besides verifying the adequacy of items, the results of the first study showed the same three-factor structure in both versions: a positive approach to conflicts and two non-constructive styles, engagement and withdrawal. The second study demonstrated the discriminative capacity of both scales. Conclusions: The final tool, which consisted of 13 items with a good internal consistency, may be useful for assessing the effectiveness of interventions to improve conflict resolution skills, as well as for screening and classification purposes (AU)

Antecedentes/Objetivo: El entrenamiento en resolución de conflictos es objeto de intervención en diferentes contextos, y el Conflict Resolution Styles Inventory ha demostrado su utilidad para evaluar dichas habilidades. Se realizaron dos estudios, uno orientado a analizar las propiedades psicométricas del instrumento, y otro a demostrar su capacidad para discriminar entre parejas de adolescentes violentas y no violentas. Método: En el primer estudio, con 592 adolescentes, se realizó un análisis factorial confirmatorio con las dos sub-escalas (para sí mismo y para la pareja). El segundo estudio, con 1.938 adolescentes, comprobó si la estructura factorial encontrada discrimina entre niveles de implicación en violencia. Resultados: Además de verificar la adecuación psicométrica de los ítems, los resultados del primer estudio mostraron la misma estructura trifactorial en ambas versiones: una aproximación positiva a los conflictos y dos estilos no constructivos, implicación y retirada. El segundo estudio demostró la capacidad discriminante de ambas escalas. Conclusiones: La versión final del instrumento, con 13 ítems y buena consistencia interna, puede ser útil para evaluar la eficacia de las intervenciones para mejorar la resolución de conflictos y con fines de screening y clasificación (AU)

The patient-parent-pediatrician relationship: everyday ethics in the office.

Pediatricians and parents generally try to do what is best for children, but they do not always agree about what that is. Mothers and fathers may disagree with each other. Parents may disagree with pediatricians. Disagreements can arise about the goals, nature, and value of communication with children about health information. Disagreements can arise over the value of particular medical interventions. Some disagreements are grounded in different religious beliefs. Some are about moral values. Some are disagreements about ends, others about the best means to an agreed on end. If there is an intractable disagreement and discussion has failed to resolve that disagreement, pediatricians must decide whether to compromise their own values to preserve a therapeutic relationship, sever that relationship, or try to override a parental choice by referring a case to child protection authorities. Most cases can be resolved and a consensus found. This article discusses some common scenarios in which disagreements arise, including home birth, refusal of vitamin K, vaccine hesitancy, birth control for teens, corporal punishment, and surreptitious drug testing.

Características clínico-epidemiológicas de la intoxicación exógena grave en niños / Clinical and epidemiological characteristics of severe exogenous poisoning in children

Se realiza un estudio con el objetivo de caracterizar desde el punto de vista clínico y epidemiológico a los niños ingresados del Hospital General Docente Octavio de la Concepción y de la Pedraja del municipio Baracoa, con diagnóstico de intoxicación exógena aguda grave, desde el año 2011 al 2012. El universo está constituido por 34 niños. Se concluye que predominaron los niños mayores de 15 años, del sexo femenino, con inestabilidad emocional de la familia, intoxicados principalmente de forma no accidental, con drogas de abuso por vía oral, siendo la de mayor incidencia la carbamazepina que le produjeron fundamentalmente alteraciones del nivel de conciencia y fueron desintoxicados mediante el lavado gástrico, que no necesitaron ventilación mecánica, con estadía hospitalaria de 4 a 6 días, que ingresaron en estado grave y predominando los vivos al alta. Se recomienda realizar estudios de intervención comunitaria con los padres sobre la importancia de la comunicación con sus hijos y como mejorar la funcionabilidad familiar(AU)

A study is performed for characterizing from the standpoint of clinical and epidemiological situation of children admitted at the General Teaching Hospital Octavio de la Concepción y la Pedraja Baracoa, diagnosed with severe acute exogenous intoxication since 2011 to 2012. The universe consists of 34 children. As a conclusion in the research predominated children over 15 years old, female, with family emotional instability, intoxicated mostly not accident, abuse drugs orally, with the highest incidence carbamazepine ,mainly produced alterations level of consciousness and were detoxified by gastric lavage, who required mechanical ventilation with hospital stay of 4-6 days admitted in serious condition and predominantly live at discharge. It is recommended that community intervention studies are made with parents about the importance of Communications with their children and to improve the familiar functionality(AU)

O álcool entre nós:impacto do consumo de álcool no casal / El alcohol entre nosotros: impacto del consumo de alcohol en la pareja / "Alcohol among us": The impact of alcohol consumption in the couple

À medida que aumenta o consumo de álcool, as consequências negativas também aumentam na vida do consumidor, e em particular, no capítulo das suas relações interpessoais. Este estudo teve como objectivo reunir a literatura que tem vindo a debruçar-se sobre a influência do álcool na vida conjugal dos consumidores. Ao longo do artigo apresenta-se também uma sumarização dos resultados divulgados em domínios subjacentes como a satisfação marital, a comunicação e a sexualidade.

A medida que aumenta el consumo de alcohol, los efectos negativos también aumentan en la vida del bebedor, en particular, en el capítulo de sus relaciones interpersonales. Este trabajo tuvo como objetivo revisar las publicaciones que se han enfocado en los efectos del alcohol en la relación conyugal. A lo largo del artículo se presenta un resumen de los resultados divulgados en las áreas de la satisfacción marital, la comunicación y la sexualidad de la pareja.

As alcohol consumption increases, the negative effects also increase in the drinker's life, in particular way, in the chapter of their interpersonal relationships. This article meets the literature that focus on the influence of alcohol on the couple relationship. Throughout the article also presents a summary of the results disclosed in couple areas such as marital satisfaction, communication, conflictuality and sexuality.