Publication: Modelo de cuidado centrado en la persona con reducción del uso de sujeciones físicas y químicas: conceptualización e implantación
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2017-09-13
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Aranceta Bartrina, Javier
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Universidad Complutense de Madrid
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Abstract
España es un país escasamente centrado en el paciente y con una prevalencia de uso de sujeción elevada, al menos en el paciente geriátrico y psicogeriátrico y fundamentalmente en centros de larga estancia; y sin embargo son muchos los beneficios que al paciente le aporta un modelo de cuidado centrado en él y que no sujeta. Aunque no haya muchos estudios en profundidad sobre prevalencia en el uso de restricciones físicas, existe la percepción de que se trata de una práctica común en numerosos países. Las cifras en este sentido son muy dispares, oscilando entre un 5% y un 70%. Ello es debido a que la prevalencia está muy relacionada con las características de las instituciones y el perfil de los usuarios, lo cual varía mucho de unos centros a otros. Con respecto al panorama nacional, y a pesar de la creciente preocupación que existe por este fenómeno, existen pocos trabajos que aborden el problema y describan la magnitud del mismo. Aún así, los estudios realizados a nivel nacional, en distintos niveles asistenciales, fundamentalmente en centros residénciales para personas mayores, pero también en hospitales de agudos, permiten concluir que la prevalencia global de utilización de dispositivos en los centros españoles ronda entre un 10% y un 20%. Esta tasa de 10-20%, considerando las graves complicaciones asociadas al uso de estos procedimientos, se considera aún excesivamente elevada, sugiriendo los expertos que, con el fin de lograr una atención de calidad, esta debería estar entre el 0% y el 5%...
Spain is a country that places very little value on person-centred care and greater focus on the use of restraints, at least in geriatric and psychogeriatric patients and for the most part in long-term care centres. However, the zero-restraints person-centred care model offers many benefits to such patients. Although very few in-depth studies exist about the use of physical restraints, the perception is that this is a common practice in many countries. The figures in relation to this aspect vary widely, ranging from 5% to 70%. This is because this prevalence is more often than not related to the characteristics of the institutions and the profile of the users, which are usually quite different from each other. With respect to the national situation, and despite growing concern about this phenomenon, very few studies analyse the related problems and describe their magnitude. Nonetheless, studies conducted on a national scale at different care levels, mainly in nursing homes for the elderly and in hospitals providing acute care, allow us to conclude that the overall prevalence regarding use of devices in Spanish centres is between 10% and 20%. In view of the serious complications related to the use of such procedures, this rate, 10- 20%, is considered excessively high, and experts suggest that it should be reduced to between 0% and 5% with a view to achieving a higher quality care...
Spain is a country that places very little value on person-centred care and greater focus on the use of restraints, at least in geriatric and psychogeriatric patients and for the most part in long-term care centres. However, the zero-restraints person-centred care model offers many benefits to such patients. Although very few in-depth studies exist about the use of physical restraints, the perception is that this is a common practice in many countries. The figures in relation to this aspect vary widely, ranging from 5% to 70%. This is because this prevalence is more often than not related to the characteristics of the institutions and the profile of the users, which are usually quite different from each other. With respect to the national situation, and despite growing concern about this phenomenon, very few studies analyse the related problems and describe their magnitude. Nonetheless, studies conducted on a national scale at different care levels, mainly in nursing homes for the elderly and in hospitals providing acute care, allow us to conclude that the overall prevalence regarding use of devices in Spanish centres is between 10% and 20%. In view of the serious complications related to the use of such procedures, this rate, 10- 20%, is considered excessively high, and experts suggest that it should be reduced to between 0% and 5% with a view to achieving a higher quality care...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 21-01-2016