Análise da decisão de médicos atuantes em cuidados paliativos sobre o uso de antibióticos em pacientes com doenças terminais

Crispim, Douglas Henrique

doi:10.11606/t.5.2020.tde-10032020-095906

Cited by 7 publications

(7 citation statements)

References 30 publications

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“…It is considered that in EoL patients, even in the presence of a confirmed infection, the use of ABT is not always beneficial, as some authors have previously considered that it is only associated with prolonging the patient's suffering [16]. However, these data disagree with the frequencies in the literature regarding the use of ABT upon suspicion of infection, with several national and international series reflecting high rates of therapy introduction upon the presence of infection (suspected or confirmed), including difficulties in discontinuing it after failure in the first days [10,[17][18]. The discrepancies in these results may be associated with the fact that the questionnaire represents fictitious statements that diverge from real situations, with a component of the doctor-patient relationship, and pressures made by patients or families, which may alter clinicians' decisions at certain times.…”

Section: Discussionmentioning

confidence: 99%

Factors That Influence the Prescription of Antibiotic Therapy at the End-of-Life: Construction and Validation of a Scale

Campoa¹,

Reis-Pina²

2022

Cureus

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Introduction: End-of-life care is frequently discussed in clinical practice. Non-beneficial treatments and the need for decision-making regarding therapeutic institutions are increasingly addressed. There are no guidelines regarding prescribing or de-prescribing antibiotic therapy at the end of life, which depends on clinical decisions. In this study, we developed a scale to assess the factors influencing clinicians' decisions when prescribing antimicrobial agents.Methods: This is a quantitative, exploratory, and descriptive study. After the literature review, the scale was constructed with an analysis of internal consistency and temporal stability. It was applied online together with a sociodemographic and clinical questionnaire. Statistical analysis of the scale, its construction, and final validation were performed.Results: A total of 196 physicians participated in this study (76.5% female, 78.6% aged <40 years), 60.2% specialists, and 35.7% without palliative care training. Almost all of the participants (89.9%) reported having end-of-life care concerns with a high frequency. In this study, a scale was developed to assess factors associated with the prescription of antibiotic therapy in end-of-life patients. This scale revealed the presence of 3 factors: infection, patient/illness, and symptoms. Together, the three factors explain 57.4% of the clinician's decisions. The factors associated with symptoms were the most predominant in decisionmaking compared to those associated with infection.Conclusions: Among the multiple factors that may influence the institution of antibiotic therapy at the end of life, symptomatic control is the most important factor.

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Section: Discussionmentioning

confidence: 99%

Factors That Influence the Prescription of Antibiotic Therapy at the End-of-Life: Construction and Validation of a Scale

Campoa¹,

Reis-Pina²

2022

Cureus

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“…A nationwide study with 2,400 physicians showed that 16.5% of physicians earn less than 11,000 reais; 19.7% earn between 11,000 and 16,000 reais; 16.3% earn between 16,000 and 21,000 reais; 12% earn between 21, and 27,000 reais; and 17.2% earn more than 27,000 reais 8 . According to the last ANCP survey, PC physicians earn a median value of 94.37 reais per hour worked 9 . The greater number of physicians graduating after the 2000s may reflect the fact that PM is a recent field of practice in Brazil.…”

Section: Sociodemographic Characteristics Of the Surveyed Physiciansmentioning

confidence: 99%

Profile of the palliative care physician in Brazil

2022

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Palliative care is a multidisciplinary health care model that seeks to provide comfort to patients with life-threatening or severe and terminal illness. Palliative medicine has only recently been recognized in Brazil, and it is essential that physicians working in this area develop their knowledge. Thus, to improve training models in palliative care and in medical education in Brazil, we must understand the characteristics of this professional, identifying sociodemographic profile, professional training, and work activity. This is a cross-sectional, descriptive, and exploratory study, with a quantitative approach. Data were collected from a national survey conducted by means of questionnaires applied to palliative care physicians in Brazil.

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“…Un estudio nacional con 2.400 médicos mostró que el 16,5% de los médicos ganan menos de 11.000 reales; el 19,7% gana entre 11 mil y 16 mil reales; el 16,3% gana entre 16 mil y 21 mil reales; 12% gana entre 21.000 y 27.000 reales y 17,2% gana más de 27.000 reales 8 . Según la última encuesta de la ANCP, un médico que trabaja en CP tiene un valor medio de 94,37 reales por hora trabajada 9 .…”

Section: Continuaciónunclassified

Perfil del médico que actúa en cuidados paliativos en Brasil

2022

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Resumen Los cuidados paliativos son una modalidad de asistencia multidisciplinaria que busca brindar comodidad al paciente con enfermedad potencialmente mortal o con enfermedad grave y terminal. Hace poco tiempo que se ofrece la medicina paliativa en Brasil, por lo que es fundamental la capacitación de los médicos que actúan en esta área. Ante lo anterior, para la mejora de los modelos de formación en el área y en la educación médica en Brasil es importante comprender las características de este profesional al identificar el perfil sociodemográfico, la formación profesional y la actividad laboral. Este estudio es transversal, descriptivo y exploratorio, con enfoque cuantitativo. Los resultados utilizan datos de una encuesta nacional, con la realización de cuestionarios aplicados a médicos que actúan en cuidados paliativos en Brasil.

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Análise da decisão de médicos atuantes em cuidados paliativos sobre o uso de antibióticos em pacientes com doenças terminais

Abstract: Crispim DH. Decision-making analysis of palliative care physicians about antibiotic use in terminally ill patients [thesis]. São Paulo: "

Cited by 7 publications

References 30 publications

Factors That Influence the Prescription of Antibiotic Therapy at the End-of-Life: Construction and Validation of a Scale

Factors That Influence the Prescription of Antibiotic Therapy at the End-of-Life: Construction and Validation of a Scale

Profile of the palliative care physician in Brazil

Perfil del médico que actúa en cuidados paliativos en Brasil

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