Contreras-Fernández Eugenio, Rivas-Ruiz Francisco, Castilla-Soto Jose, Méndez-Martínez Camila
Distrito Sanitario Costa del Sol, Servicio Andaluz de Salud, Mijas, Málaga, España.
Unidad Investigación, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), ISCIII, España.
Aten Primaria. 2015 Oct;47(8):514-22. doi: 10.1016/j.aprim.2014.10.006. Epub 2014 Dec 30.
To identify the underlying interests of the Living Will Declaration (LWD) process and to determine the consensus, using a questionnaire, of the knowledge and attitudes of health professionals.
A study was performed in two phases using a Delphi technique with a Rand method. 1. Dimensions proposed: generation of ideas and their subsequent prioritizing; 2. Proposal and prioritizing of items grouped into blocks of Knowledge and Attitudes, developed between August 2012 and January 2013.
The work was carried out by initial telephone contact with panellists, and then later by the panellists belonged to the Andalusia Public Health System.
The criteria for selecting the eight components of the panel were knowledge and experience in the field of the freedom of the patient in Andalusia.
The Knowledge identified included: 1 A) Legal and general aspects; 2 A) A conceptual definition; 3 A) Standardised LWD documents: 4 A) Practical experience; 5 A) Procedure and registering of the LWDs. The second block included Attitudes: 1 B) Attitudes of the professional in the application of LWDs in clinical practice, and 2 B) Attitudes of the professional in «complex» ethical scenarios The 7 panellists who finally took part proposed 165 items. After applying the prioritizing criteria, scores, and scenario selection, 58 (35.2%) items were identified as suitable scenarios.
The proposed questionnaire included wide parcels of concepts and contents that, once validated, will help to measure the training interventions carried out on health professionals in order to improve knowledge and attitudes on the subject of LWDs.
通过问卷调查确定生前预嘱声明(LWD)流程的潜在利益,并确定卫生专业人员在知识和态度方面的共识。
采用德尔菲技术和兰德方法分两个阶段进行研究。1. 提出维度:产生想法并随后进行优先级排序;2. 对2012年8月至2013年1月期间制定的知识和态度模块中的项目进行提议和优先级排序。
工作通过最初与小组成员进行电话联系开展,随后由安达卢西亚公共卫生系统的小组成员进行。
选择小组八名成员的标准是在安达卢西亚患者自由领域的知识和经验。
确定的知识包括:1A)法律和一般方面;2A)概念定义;3A)标准化的生前预嘱文件;4A)实践经验;5A)生前预嘱的程序和登记。第二个模块包括态度:1B)专业人员在临床实践中应用生前预嘱的态度,以及2B)专业人员在“复杂”伦理场景中的态度。最终参与的7名小组成员提出了165个项目。应用优先级标准、评分和场景选择后,确定58个(35.2%)项目为合适场景。
所提议的问卷包含了广泛的概念和内容,一旦经过验证,将有助于衡量针对卫生专业人员开展的培训干预措施,以提高他们在生前预嘱主题方面的知识和态度。