Abstract
Objetivo
Estimar la prevalencia de usuarios que desearían conocer el diagnóstico de enfermedad terminal y analizar los condicionantes relacionados con dicha decisión.
Diseño
Estudio descriptivo, observacional, transversal.
Emplazamiento
Seis cupos pertenecientes a dos zonas básicas de salud del Área Sanitaria III de Asturias.
Participantes
Usuarios de consulta a demanda, mayores de 17 años, seleccionados por muestreo aleatorio sistemático estratificado según el número de consultas del centro. Se excluyó a sujetos diagnosticados de enfermedad terminal y/o con problemas de comunicación.
Mediciones y resultados principales
Mediante encuesta de elaboración propia y entrevista personal, se recogieron variables sociodemográficas y de actitud frente al diagnóstico de enfermedad terminal. El tamaño de la muestra fue de 388 individuos. Se realizó análisis descriptivo y estimaciones poblacionales, aplicándose análisis de regresión logística para identificar variables asociadas.
Resultados
El 70,6% de los encuestados (intervalo de confianza [IC] del 95%, 66–75,1%) desearía conocer el diagnóstico, alegando principalmente el derecho a la información (el 35,1%; IC del 95%, 29–40,6%). Mayoritariamente querrían ser informados por el médico (el 81,9%; IC del 95%, 77,5–86,5%). Las variables que de forma significativa se asociaron con respuesta positiva fueron: varón (odd ratio [OR], 1,91; IC del 95%, 1,1–3,4%), edad (OR, 0,97; IC del 95%, 0,95–0,99%), creencias religiosas (OR: 0,2; IC del 95: 0,1–0,8% para creyentes), temor a dolor e invalidez (OR, 3,8; IC del 95%, 1,2–12%) y planteamiento previo de querer ser informado (OR, 2,2; IC del 95%, 1,2–4%), obteniéndose en el caso de esta última variable el coeficiente de correlación parcial más elevado (R = 0,12).
Conclusiones
La mayoría de los usuarios desea ser informada del diagnóstico de enfermedad terminal. El perfil del paciente que desea conocer la verdad responde a: varón joven, no creyente, sus principales temores ante la enfermedad terminal son el dolor y la invalidez, siendo la variable que más influencia ha tenido sobre la respuesta positiva el planteamiento previo de la pregunta.
Palabras clave: Enfermedad terminal, Muerte, Información al paciente
Abstract
Objective
To calculate the prevalence of users who want to know their diagnosis of terminal illness and to analyse the factors determining their decision.
Design
Descriptive, observational, cross-sectional study.
Setting
Six lists belonging to two Health Districts in Asturias Health Area III. Participants. On-demand users of the clinic, over 17 years old, selected by systematic randomizad sampling stratified according to the number of consultations at the centre.
Main measurements and results
Through a questionnaire composed by the researchers and face-to-face interviews, social and personal variables and attitudes to a diagnosis of terminal illness were collected. The sample consisted of 388 people. A descriptive analysis and population calculations were made, with a logistical regression analysis to identify associated variables.
Results
70.6% of those questioned (95% CI, 66%-75.1%) wanted to know their diagnosis, mainly on the basis of their right to the information (35.1%; 95% CI, 29%-40.6%). Most of these wanted to be informed by the doctor (81.9%; CI, 77.5%-86.5%). The variables significantly linked to a positive reply were: male (OR, 1.91; CI, 1.1%-3.4%), age (OR, 0.97; CI, 0.95%-0.99%), religious beliefs (OR, 0.2; CI, 0.1%-0.8% for believers), fear of pain and disability (OR, 3.8; CI, 1.2%-12%), and having previously thought about wanting to be informed (OR, 2.2; CI, 1.2%-4%). This last variable achieved the highest partial correlation coefficient (R, 0.12).
Conclusions
Most users want to be informed of a diagnosis of terminal illness. The profile of the patient who wants to know the truth is: young male, non-believer, and someone whose main fears of terminal illness are pain and disability. The variable with most influence on the positive reply was having posed the question previously.
Key words: Terminal illness, Death, Patient information
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