Browsing by Author "Rodríguez Núñez, Alfredo"

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    15 años desde la implementación del GES “Alivio del dolor y cuidados paliativos por cáncer”: Análisis de la conformación y formación de los equipos profesionales en centros de cuidados paliativos en Chile
    (2024) Neira Miranda, Rodrigo Alberto; Rodríguez Núñez, Alfredo; Pontificia Universidad Católica de Chile. Facultad de Medicina
    Proyecto de Grado presentado a la Escuela de Medicina de la Pontificia Universidad Católica de Chile optar al grado de Magíster en Salud Pública.Los Cuidados Paliativos (CP) buscan mejorar la calidad de vida de usuarios con enfermedades graves. En Chile, tras 15 años de implementación del Plan de Garantías Explícitas en Salud (GES), es necesario evaluar la conformación y formación de equipos en las distintas Unidades de Cuidados Paliativos (UCP).El objetivo del estudio es evaluar la formación de equipos profesionales en UCP en Chile, determinando las brechas existentes en la conformación y formación de equipos mediante un estudio cuantitativo analítico descriptivo, analizando datos del Censo de Unidades de Cuidados Paliativos. Se aplicaron criterios provenientes de la Asociación Europea de Cuidados Paliativos (EAPC) para definir Unidades Especializadas de Cuidados Paliativos (UECP).Resultados: Solo el 19,6% de las UCP cumplen para ser consideradas UECP. El 82,41% cuentan con equipos multidisciplinarios, el 21,6% cumplen con las horas semanales requeridas, y el 43,72% tienen al menos un profesional con formación en CP. A partir del año 2009, las UCP en Chile han crecido un 305%, con un papel predominante del sector público, sin embargo, solo el 21% de los profesionales posee formación específica en CP. Existe gran disparidad entre la cantidad de UCP entre regiones comprometiendo el acceso equitativo.Se evidencia un desarrollo significativo de los Cuidados Paliativos oncológicos en Chile, estableciendo una base para Cuidados Paliativos Universales. El reto actual es asegurar que las UCP cumplan con estándares de calidad. Se requieren lineamientos claros para la creación de nuevas UCP, considerando características poblacionales y distribución en relación con la complejidad institucional
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    Advanced cancer patients' reported wishes at the end of life : a randomized controlled trial
    (2016) Delgado Guay, Marvin O.; Rodríguez Núñez, Alfredo; De la Cruz, Vera; Frisbee Hume, Susan; Williams, Janet
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    Asistencia técnica y pobladores.
    (1987) Rodríguez Núñez, Alfredo
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    Characteristics and outcomes of patients with advanced cancer evaluated by a palliative care team at an emergency center. A retrospective study
    (2016) Delgado Guay, M.; Rodríguez Núñez, Alfredo; Shin, S.; Chisholm, G.; Williams, J.; Frisbe Hume, S.; Bruera, E.
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    De invasores a invadidos.
    (1972) Rodríguez Núñez, Alfredo
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    Edmonton Symptom Assessment Scale Time Duration of Self-Completion Versus Assisted Completion in Patients with Advanced Cancer: A Randomized Comparison
    (2021) Wong, Angelique; Tayjasanant, Supakarn; Rodríguez Núñez, Alfredo; Park, Minjeong; Liu, Diane; Pérez Zapata, Kresnier; Allo, Julio; Frisbee-Hum, Susan; Williams, Janet; Bruera, Eduardo
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    ¿Es posible generar efecto placebo como parte de las intervenciones paliativas?
    (2016) Rodríguez Núñez, Alfredo; Bruera, Eduardo
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    Impact of a Curriculum Reform in Graduate Students Self-Reported Palliative Care Competencies
    (Elsevier Inc., 2025) Grez Artigues, Mónica Bernardita; Rodríguez Núñez, Alfredo; Maldonado Morgado, Armando José; Castro, Felipe; Orozco Soto, Nicolás Ignacio; Crispino Gastelumendi, Luciana; Villouta Cassinelli, María Francisca; Jaña Pozo, Carolina Andrea; Leiva, Ofelia; Pérez Cruz, Pedro
    Introduction. Expanding quality basic palliative care (PC) training for undergraduate health professionals is a key strategy to secure timely access to PC for the large population in need. However, evidence on the impact of changes in undergraduate medical curriculum in PC remains limited. This study aimed to assess the impact of expanded undergraduate PC training on students’ self-perceived competencies, knowledge, and training adequacy, comparing cohorts before and after a curricular reform. Methods. In this cross-sectional study, recently graduated medical students from two cohorts at the same university—one with limited exposure and the other with extended exposure to a PC curriculum—were invited to complete an electronic survey. The aim was to assess their perception of the PC training received during medical school, their self-assessed core competencies, and their knowledge in the field. Results. 157 (64%) out of 244 graduates answered the survey. Students exposed to the extended PC curriculum, more frequently reported that the theoretical and practical contents received were sufficient (P < 0.001), had higher scores in PC knowledge assessment and, reported having significantly more skills to deliver bad news (P = 0.01), to evaluate physical symptoms (P = 0.04), spiritual symptoms (P = 0.01), to explain what the PC consist of (P = 0.028) and to evaluate emotional symptoms (P = 0.003). Conclusions. Integrating and increasing exposure to PC training throughout the entire medical school curriculum enhances recently graduated medical students’ perception of the adequacy of their training, strengthens their self-perceived competencies, and improves their knowledge in PC. J Pain Symptom Manage 2025;000:1−10.
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    Mapping advance care planning and advance directives in Latin America
    (Springer Nature, 2025) Tardelli, Natália R.; Fukushima, Fernanda B.; Van der Steen, Jenny T.; Rodríguez, Manuel I. C.; Mikelyte, Rasa; Forte, Daniel N.; Palácio, Alex S. W.; Tripodoro, Vilma A.; Burgoa, Mirna G.; Crispim, Douglas H.; Rodríguez Núñez, Alfredo; Cruz, Luis R. G.; Sáez, Mariuska F.; Bonilla Sierra, Patricia; Escobar, Ancu T. F.; Alcántara Godoy, María E. del Rosario; Castellanos, Tulio E. V.; Saldaña, Mónica O.; Reyes, Nisla C.; Ríos, Miriam E. R.; Berenguel Cook, Maria del Rosario ; Pichardo, Gloria C.; Aguilar, Carlos F. A.; Alvarez, Gabriela P.; Gonzalez, Ismariel I. E.; Rodrigues Brito, Leonardo de Andrade; Iglesias de Oliveira Vidal, Edison
    Background/aims The extent to which low- and middle-income countries have implemented Advance Care Planning (ACP) and Advance Directives (AD) remains unclear. We aimed to map the current status of ACP/AD in Latin America. Methods This cross-sectional, mixed-methods survey of ACP/AD in LA comprised interviews with 18 key informants from 18 out of 20 countries, most of whom were appointed by national Palliative Care Associations. Online interviews were conducted with each informant, covering a range of relevant topics from AD regulations to the use of ACP/AD in the context of end-of-life clinical decision making. We performed member checking and data triangulation to confirm our findings. Results Only eight (44%) countries have some form of ACP/AD regulations. Most regulatory frameworks tend to adopt a legalistic pattern heavily influenced by the North American model. Despite that characteristic of AD regulations in LA, the leading strategy used by patients to avoid unwanted treatment at the end of life is through conversations with their families, whereas the least common strategy was consulting with a lawyer. In six (33%) countries, informants believed it was common for patients to grant their families permission to modify their previous choices regarding future treatments. The religiosity/spirituality of populations play an important role in the implementation of ACP in the region. Additionally, respecting patients’ preferences of care at the end of life appears to be tied more to aspects related to the characteristics of doctor-patient relationship, and the degree of integration of palliative care into the healthcare system than the existence or content of AD regulations. There was consensus that none of the countries provide sufficient education about ACP/AD to healthcare professionals. Conclusions Our findings encourage rethinking ACP/AD in LA from a decolonial perspective, considering characteristics such as the preference for a relational model of autonomy in several countries and the importance of taking the religiosity/spirituality of individuals into account during ACP conversations. Our data also suggest that honoring patients’ preferences of care at the end of life entails integrating palliative care into health care systems, educating healthcare professionals and the population, and fostering longitudinal trusting relationships between those professionals, patients, and their families.
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    Multicenter Study of the Psychometric Properties of the New Demoralization Scale (DS-II) in Spanish-Speaking Advanced Cancer Patients
    (2019) Belar, A.; Arantzamendi, M.; Rodríguez Núñez, Alfredo; Santesteban, Y.; Martinez, M.; Lopez-Saca, M.; Consigli, S.; Lopez-Fidalgo, J.; Centeno, C.
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    Objective burden, caregiver psychological distress, and patient religion and quality of life are associated with high-intensity burden of care among caregivers of advanced cancer patients in a Latino population
    (2023) Soto Guerrero, Sebastián; Palacios, Josefa; Langer, Paola; Carrasco, Cecilia; Tupper-Satt, Laura; González-Otaíza, Marcela; Rodríguez Núñez, Alfredo; Pérez Cruz, Pedro
    Objectives: Family caregivers (FCs) of cancer patients experience burden of care. The aims of this study are to describe the caregiving phenomenon among FCs of advanced cancer patients in a Latino community and to identify caregiver and atient characteristics associated with high-intensity subjective caregiver burden. Methods: In this cross-sectional study, advanced cancer patient–caregiver dyads assessed at a Palliative Care Unit in Santiago, Chile, enrolled in a longitudinal observational study were included. FCs completed questions to describe the caregiving phenomenon and surveys to assess burden of care, psychological distress, and perception of patients’ symptoms; patients completed surveys to assess physical distress and quality of life (QOL). We explored associations between high-intensity subjective caregiver burden with caregiver and patient variables. Results: Two hundred seven dyads were analyzed. FCs were on average 50 years old and 75% female. Thirty-two percent of FCs experienced high-intensity subjective burden of care. Eighty two percent of FCs took care of the patient daily and 31% took care of the patient alone. In univariate analysis, high-intensity caregiver burden was associated with caregiver depression (59% vs. 27%; p < 0.001), anxiety (86% vs. 67%; p = 0.003), caring for the patient alone (45% vs. 24%; p = 0.002), perception of patient symptom distress, patient religion, and worse patient QOL (mean [standard deviation] 58 [33] vs. 68 [27]; p = 0.03). In multivariate analysis, FC depression (OR [95% confidence interval] 3.07 [1.43–6.60]; p = 0.004), anxiety (3.02 [1.19–7.71]; p = 0.021), caring for the patient alone (2.69 [1.26–5.77]; p = 0.011), caregiver perception of patient’s fatigue (1.26 [1.01–1.58]; p = 0.04), and patient’s religion (3.90 [1.21–12.61]; p = 0.02) were independently associated with caregiver burden. Significance of results: FCs of advanced cancer patients in a Latino community frequently experience high-intensity burden of care and are exposed to measures of objective burden. High-intensity burden is associated with both caregiver and patient factors. Policies should aim to make interventions on patient–caregiver dyads to decrease caregiving burden among Latinos.
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    Place-of-death preferences among patients with cancer and family caregivers in inpatient and outpatient palliative care
    (2020) Vidal, M.; Rodríguez Núñez, Alfredo; Hui, D.; Allo, J.; Williams, J. L.; Park, M.; Liu, D.; Bruera, E.
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    El problema de vivienda de los "con techo".
    (2004) Rodríguez Núñez, Alfredo
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    Santiago de Chile : metropolización, globalización, desigualdad.
    (2001) Rodríguez Núñez, Alfredo
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    The Effect of Message Content and Clinical Outcome on Patients' Perception of Physician Compassion : A Randomized Controlled Trial
    (2018) Rodríguez Núñez, Alfredo; Tanco, K.; Azhar, A.; Rhondali, W.; Wu, J. M.; Baile, W.; Bruera, E.
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    World Congress Integrative Medicine & Health 2017: Part one
    (2017) Brinkhaus, Benno; Bedregal, Paula; Passi Solar, Alvaro Rodrigo; Rodríguez Núñez, Alfredo; Chang RathKamp, Mayling Raquel; Gutiérrez Oliva, Soledad; Falkenberg, Torkel; Haramati, Aviad; Willich, Stefan N.; Briggs, Josephine P.