Publication: Revisión bibliográfica de conocimientos y actitudes de los pacientes sobre las instrucciones previas y el papel de la enfermería
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2020-06-03
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Abstract
Introducción: En los 70 comienzan a reconocerse los derechos de los pacientes y aparecen los Documentos de Instrucciones Previas, que garantizan el respeto de su autonomía en situaciones de incapacidad. En España, a pesar de que su amplia regulación, su uso es bajo y hay factores que limitan su realización. Los profesionales sanitarios son los responsables del fomento de su uso, y entre ellos destacan las enfermeras, pieza clave por su estrecho contacto con el paciente.
Objetivos: Identificar los conocimientos y actitudes de los pacientes, los factores que influyen en el otorgamiento y el papel de las enfermeras en las instrucciones previas en España.
Metodología: Revisión bibliográfica consultando bases de datos mediante descriptores y palabras clave, seleccionando la literatura según los criterios de inclusión y exclusión. La búsqueda de información se acotó entre 2003 y enero de 2020, limitada a estudios realizados en España. Se seleccionaron 30 artículos.
Desarrollo: Se analizan los conocimientos y actitudes de la población ante el documento, y las características de los otorgantes. También los factores que favorecen y limitan su otorgamiento, y el papel de las enfermeras en su fomento.
Conclusiones: Los conocimientos de la población son escasos, mayores en Atención Primaria y los últimos años. La mayoría de los otorgantes son mujeres mayores de 65 años, y los factores que limitan su uso se reducen con la asesoría de un profesional sanitario. Las enfermeras deben liderar su difusión mediante un proceso conjunto de toma de decisiones, y para ello necesitan mayor formación.
Palabras clave: instrucciones previas, Planificación Anticipada de Decisiones, enfermería
Background: In the 1970s, the rights of patients began to be recognized and Advanced Directives Documents appeared, which guaranteed respect for their autonomy in cases of disability. In Spain, despite its extensive regulation, its use is low and there are factors that limit its performance. Health care professionals are responsible for promoting its use, and because of their close contact with patients, nurses are highlighted as a key element for its promotion. Objetive: Identifying patients’ knowledge and attitudes regarding Advanced Directives Documents, the factors that influence their consent, and the role nurses play concerning them. Methodology: Bibliographical revision was carried out, consulting nursing scientific databases, employing Health Sciences Descriptors and key words, and selecting literature according to inclusion and exclusion criteria. The research was limited to the timeframe between 2003 and January 2020, specifically Spain based studies. 30 studies were selected. Results: Knowledge and attitudes of the population towards Advanced Directives was analyzed, considering the traits and the profile of the grantors. The factors that favored or limited its consent was also analyzed, in addition to the role that nurses played in its promotion. Conclusions: There is a lack of knowledge among the population about Advanced Directives, which improves in Primary Care and in recent years. The demographic of the majority of grantors are females above 65 years. The factors which limit its use are greatly reduced upon guidance by a health care professional. Nurses must be proactive in its dissemination via a joint-decision making process, and for this to occur they need further training. Key words: Advance directives, Advance Care Planning, nursing
Background: In the 1970s, the rights of patients began to be recognized and Advanced Directives Documents appeared, which guaranteed respect for their autonomy in cases of disability. In Spain, despite its extensive regulation, its use is low and there are factors that limit its performance. Health care professionals are responsible for promoting its use, and because of their close contact with patients, nurses are highlighted as a key element for its promotion. Objetive: Identifying patients’ knowledge and attitudes regarding Advanced Directives Documents, the factors that influence their consent, and the role nurses play concerning them. Methodology: Bibliographical revision was carried out, consulting nursing scientific databases, employing Health Sciences Descriptors and key words, and selecting literature according to inclusion and exclusion criteria. The research was limited to the timeframe between 2003 and January 2020, specifically Spain based studies. 30 studies were selected. Results: Knowledge and attitudes of the population towards Advanced Directives was analyzed, considering the traits and the profile of the grantors. The factors that favored or limited its consent was also analyzed, in addition to the role that nurses played in its promotion. Conclusions: There is a lack of knowledge among the population about Advanced Directives, which improves in Primary Care and in recent years. The demographic of the majority of grantors are females above 65 years. The factors which limit its use are greatly reduced upon guidance by a health care professional. Nurses must be proactive in its dissemination via a joint-decision making process, and for this to occur they need further training. Key words: Advance directives, Advance Care Planning, nursing