Adecuación terapéutica en nueve servicios de urgencia de Chile. Cuándo y cómo se aplica desde la urgencia

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dc.catalogadorvdr
dc.contributor.authorEscudero Graver, Diego Antonio
dc.contributor.authorTorres Jiménez, Consuelo Nicol
dc.contributor.authorCortés Cortés, Javier David Pascual
dc.contributor.authorAcuña Ramírez, David Gonzalo
dc.date.accessioned2025-06-19T20:31:38Z
dc.date.available2025-06-19T20:31:38Z
dc.date.issued2025
dc.description.abstractTherapeutic Adequacy (TA) in Emergency Departments (EDs) aims to avoid futile medical interventions in terminally ill or critically ill patients, prioritizing their quality of life. This descriptive, cross-sectional, observational study analyzed the criteria used by physicians in high- complexity EDs in Chile to indicate TA, while also assessing their preparedness and ethical perceptions. Aim: Examine the criteria that physicians in high-complexity Emergency Departments (EDs) in Chile use to determine Therapeutic Adequacy (TA) in terminally ill or critically ill patients, while also assessing their level of preparedness and ethical perceptions regarding these decisions. Methods: A 14-item closed survey, based on previous studies, was distributed among physicians from 9 high-complexity EDs between February and October 2023. A total of 70 responses were collected. Results: TA was performed more than once a month by 83% of respondents, with patient functionality (97%), chronic diseases (84%), and age (69%) being the most frequently considered criteria. The most common measures included refraining from resuscitation (97%) and mechanical ventilation (94%). While 65% of participants felt prepared to make these decisions, this figure increased to 85% among emergency specialists. However, 67% reported no formal training in bioethics, and 55% expressed discomfort with withdrawing therapeutic measures. Conclusions: TA is a frequent practice in EDs, mainly involving decisions not to initiate treatments. Despite this, there is limited formal training in bioethics, and individual decision-making predominates. This highlights the need to enhance bioethics education, foster collaborative decision- making, and implement hospital protocols that involve patients and their families to ensure an ethical, patient-centered approach.
dc.fechaingreso.objetodigital2025-06-19
dc.format.extent8 páginas
dc.fuente.origenWOS
dc.identifier.doi10.4067/s0034-98872025000200111
dc.identifier.eissn0717-6163
dc.identifier.urihttps://doi.org/10.4067/s0034-98872025000200111
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104718
dc.identifier.wosidWOS:001445063300005
dc.issue.numero2
dc.language.isoes
dc.language.isoes
dc.nota.accesoContenido completo
dc.pagina.final118
dc.pagina.inicio111
dc.revistaRevista Médica de Chile
dc.rightsacceso abierto
dc.rights.licenseCC BY 4.0 Attribution 4.0 International
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/deed.en
dc.subjectCritical Illness
dc.subjectResuscitation Orders
dc.subjectWithholding Treatment
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAdecuación terapéutica en nueve servicios de urgencia de Chile. Cuándo y cómo se aplica desde la urgencia
dc.title.alternativeTherapeutic Adequacy in Nine Emergency Departments in Chile. When and How It Is Applied in Emergency Care
dc.typeartículo
dc.volumen153
sipa.trazabilidadWOS;2025-03-29
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