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COREQ checklist. (DOCX 20 kb)

LAPS_CCC Spanish version. (DOCX 44 kb)

LAPS_CCC Portuguese version. (DOCX 36 kb)

Made available in DSpace on 2018-11-26T15:29:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-03-28 Universidad Francisco de Vitoria (Madrid, Spain) Background: To present learning outcomes in clinical communication for a Core Curriculum for medical undergraduate students in Latin America, Portugal and Spain (LAPS-CCC) and to establish an expert network to support a transnational implementation. Methods: Through an iterative process, an international group of 15 experts developed an initial set of learning outcomes following a review and discussion of relevant international and local literature. A two-round Delphi survey involving 46 experts from 8 countries was performed. Quantative and qualitative analisis permited the definition of the final consensus. Results: The initial proposal included 157 learning outcomes. The Delphi process generated 734 comments and involved the modification, deletion and addition of some outcomes. At the end of the process, a consensus was reached on 136 learning outcomes grouped under 6 competency domains with a high overall acceptance (95.1 %). Conclusions: The learning outcomes of this proposal provide a guide to introduce, support and develop communication curriculae for undergraduate medical studies in the countries involved or in other Spanish-or Portuguese-speaking countries. Univ Francisco de Vitoria, Fac Med, Escuela Med, Edificio E,Ctra Pozuelo Majadahonda,Km 1,800, Madrid 28223, Spain Univ Lisbon, Fac Farm, P-1699 Lisbon, Portugal Pontificia Univ Catolica Chile, Fac Med, Santiago, Chile Univ Maimonides, Fac Med, Buenos Aires, DF, Argentina Univ Estadual Paulista, Fac Med, Botucatu, SP, Brazil Univ Nacl Autonoma Mexico, Fac Med, Mexico City 04510, DF, Mexico Univ Chile, Fac Med, Santiago, Chile Univ Porto, Fac Med, Rua Campo Alegre 823, P-4100 Oporto, Portugal Univ Autonoma Barcelona, Fac Med, E-08193 Barcelona, Spain Univ Antioquia, Fac Med, Medellin, Colombia Univ Fed Santa Catarina, Fac Med, Florianopolis, SC, Brazil Univ Int Catalunya, Barcelona, Spain Spanish Patient Forum, Barcelona, Spain Univ Estadual Paulista, Fac Med, Botucatu, SP, Brazil

Objectives: To measure the health-related quality of life (HRQoL) of multiple sclerosis (MS) patients and their caregivers, and to assess which factors can best describe HRQoL. Methods: A cross-sectional multicenter study of nine hospitals enrolled MS patients and their caregivers who attended outpatient clinics consecutively. The instruments used were the SF-36 for patients and the SF-12 and GHQ-12 for caregivers. Classification and regression tree analysis was used to analyze the explanatory factors of HRQoL. Results: A total of 705 patients (mean age 40.4 years, median Expanded Disability Status Scale 2.5, 77.8% with relapsing-remitting MS) and 551 caregivers (mean age 45.4 years) participated in the study. MS patients had significantly lower HRQoL than in the general population (physical SF-36: 39.9; 95% confidence interval [CI]: 39.1–40.6; mental SF-36: 44.4; 95% CI: 43.5–45.3). Caregivers also presented lower HRQoL than general population, especially in its mental domain (mental SF-12: 46.4; 95% CI: 45.5–47.3). Moreover, according to GHQ-12, 27% of caregivers presented probable psychological distress. Disability and co-morbidity in patients, and co-morbidity and employment status in caregivers, were the most important explanatory factors of their HRQoL. Conclusions: Not only the HRQoL of patients with MS, but also that of their caregivers, is indeed notably affected. Caregivers’ HRQoL is close to population of chronic illness even that the patients sample has a mild clinical severity and that caregiving role is a usual task in the study context

Objective: The aim of the study is to explore if cancer patients actively participate in their care and are involved in treatment decisions. Method: 4 focus groups were organized for a total of 29 participants. One group with patients older than 63 years old, one group with patients younger than 63 years old and one group with caregivers. Moreover, one group was held with the participation of oncologists. Results: Participants have identified the need to receive clear information about treatment options, besides professionals’ advice and experience. Communication skills must be given to professionals; moreover patients need a referent who can accompany them during making decision process. Conclusions: Patients are taking new roles, are more participatory and want to assume more responsibilities about clinical decisions. Patients have a right to understand their illness, prognosis and treatment options. More training programs for physicians are need in order to tailor treatment options to patients’ preferences and needs. Objetivo: El objetivo de este estudio es valorar en qué medida los afectados de cáncer asumen actitudes de participación en relación al propio plan terapéutico, además de conocer la opinión de familiares y la de los profesionales que les atienden. Método: Se organizaron 4 grupos focales, con un total de 29 participantes. Un grupo con afectados mayores de 63 años, un grupo con afectados menores de 63 años y un grupo con familiares de afectados por distintas patologías oncológicas. Además, se organizó un grupo con profesionales sanitarios para conocer su opinión. Resultados: Los participantes de los distintos grupos han identificado la necesidad de disponer de información clara acerca de las posibilidades terapéuticas, además de los consejos y la experiencia que puede aportar el profesional. Debería realizarse formación en habilidades de comunicación, además de contar con un profesional de referencia que pueda ofrecer orientación y apoyo durante el proceso de toma de decisiones. Conclusiones: Existe en la actualidad un nuevo rol de paciente con un perfi l más activo, que desea asumir mayor responsabilidad en las decisiones clínicas. Los pacientes tienen el derecho a recibir la información sobre la propia enfermedad, el pronóstico y las opciones terapéuticas disponibles. Es necesaria mayor formación a los profesionales sanitarios que permita ajustar las opciones terapéuticas a las necesidades y preferencias de los pacientes y familiares.

Medical guidelines and protocols describe the optimal care for a specific group of patients and therefore, when properly applied, improve the quality of patient care. During the last decade, a large number of medical guidelines and protocols have been published. However, the work done on developing and disseminating them far outweighs the efforts on guaranteeing their quality. Indeed, anomalies like ambiguity and incompleteness are frequent in medical guidelines and protocols. An approach grounded on a formal representation, can answer these needs, as we have demonstrated in the Protocure project'. The Protocure II project will aim at integrating formal methods in the life cycle of guidelines.

Medical guidelines and protocols describe the optimal care for a specific group of patients and therefore, when properly applied, improve the quality of patient care. During the last decade, a large number of medical guidelines and protocols have been published. However, the work done on developing and disseminating them far outweighs the efforts on guaranteeing their quality. Indeed, anomalies like ambiguity and incompleteness are frequent in medical guidelines and protocols. An approach grounded on a formal representation, can answer these needs, as we have demonstrated in the Protocure project'. The Protocure II project will aim at integrating formal methods in the life cycle of guidelines.