Procesos de fin de vida en residencias de ancianos desde la perspectiva de los familiares
Bibliographic record
Abstract
Describir cómo los familiares de los pacientes ingresados en residencias de ancianos califican la muerte y determinar qué factores influyen en esta calificación. Estudio descriptivo y retrospectivo. Se envió un cuestionario a 52 familiares de pacientes fallecidos de 8 hogares de ancianos. Para evaluar los diferentes aspectos de la muerte del paciente se usaron el Inventario Buena Muerte (Good Death Inventory) y la escala de evaluación de síntomas de Edmonton (ESAS), además de preguntas abiertas sobre la toma de decisiones al final de la vida. Se realizaron pruebas no paramétricas para comprobar si había diferencias entre la calificación respecto a variables sociodemográficas y clínicas, síntomas físicos, toma de decisiones y calidad del fin de vida. Treinta y cuatro familiares respondieron al cuestionario. El 67,6% fueron mujeres, con una edad media de 57,03 años (DT = 12,35). En cuanto a los pacientes fallecidos, la mayoría de ellos fueron mujeres (61,8%), con una edad media de 86 años (DT = 7,23). El 48,3% tenía deterioro cognitivo y el síntoma más intenso en los últimos días de vida de fue la depresión (media [m] = 7,75; DT = 2,44). La dimensión que los familiares puntuaron mejor fue «Ser respetado como individuo» (m = 6,01; DT = 1,56) y la peor «Independencia» (m = 1,72; DT = 1,28). Los familiares de pacientes con demencia reportaron en menor porcentaje de una buena muerte (23,1% vs. 61,1%, p = 0,00) que el resto. Las dimensiones «Bienestar físico y psicológico» (p = 0,00), «Mostrar esperanza y placer» (p = 0,03) y «Sentir que su vida vale la pena vivirla» (p = 0,01) obtuvieron mayores puntuaciones en los casos que se informó de una buena muerte. Casi la mitad de los familiares de los pacientes fallecidos en hogares de ancianos informó de una buena calidad de muerte. Aspectos tales como el respeto humano y la intimidad fueron valorados positivamente. La demencia es un factor que debe tenerse en cuenta en futuros estudios. To describe how relatives of patients admitted to nursing homes qualify death and determine which factors influence this qualification. A descriptive and retrospective study. A questionnaire was sent to 52 relatives of deceased patients of 8 nursing homes. The Good Death Inventory (GDI) and Edmonton Symptom Assessment Scale (ESAS) were used to assess different aspects of patient death; in addition open questions on aspects of end of life decisions were included. Non-parametric tests were performed to check for differences between the qualification of sociodemographic and clinical variables, physical symptoms, decision making and quality of end of life. 34 relatives 34 families responded to the questionnaire. 67.6% women with an average age of 57.03 years (SD=12.35). Most of the deceased patients were women (61.8%) with a mean age of 86 years (SD=7,23). The most severe symptom in the last days of life was depression (m=7.75, SD=2.44). Being respected as an individual“was the dimension that scored best (m=6.01; SD=1.56), and”Independence“worst (m=1.72; SD=1.28). Relatives of patients with dementia reported a lower percentage of a good death (23.1% vs. 61.1%, P=.00) than the rest. The dimensions”physical and psychological comfort“(P=.00),”Show Hope and pleasure“(P=.03) and”Feeling that their life is worth living“(P=.01) scored higher in cases which reported a good death. Almost half of the relatives of patients who died in nursing homes reported a good quality of death. Aspects such as human respect and intimacy were highly rated. Dementia is a factor that might be considered in further studies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.027 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".