<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1028-9933</journal-id>
<journal-title><![CDATA[Revista Información Científica]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. inf. cient.]]></abbrev-journal-title>
<issn>1028-9933</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas Guantánamo]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1028-99332023000100051</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Análisis de la futilidad sobre la prolongación del tratamiento en pacientes con enfermedad renal crónica en fase terminal desde la percepción médica]]></article-title>
<article-title xml:lang="en"><![CDATA[Futility analysis of treatment prolongation in patients with end-stage chronic kidney disease from medical perception]]></article-title>
<article-title xml:lang="pt"><![CDATA[Análise da futilidade do prolongamento do tratamento em pacientes com doença renal crônica terminal da percepção médica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Suaste-Pazmiño]]></surname>
<given-names><![CDATA[Denisse Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Sánchez-del Hierro]]></surname>
<given-names><![CDATA[Galo Antonio]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[País-Cadeno]]></surname>
<given-names><![CDATA[Pedro Christian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Regional Autónoma de Los Andes  ]]></institution>
<addr-line><![CDATA[ Ambato]]></addr-line>
<country>Ecuador</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Pontificia Universidad Católica del Ecuador  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Ecuador</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2023</year>
</pub-date>
<volume>102</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1028-99332023000100051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1028-99332023000100051&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1028-99332023000100051&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La enfermedad renal crónica es una patología que disminuye la expectativa y calidad de vida de los pacientes. Los médicos son los principales encargados de preservar la vida del paciente y son responsables en la toma de decisión compartida.  Objetivo:  Analizar la percepción del personal médico sobre la prolongación del tratamiento sustitutivo renal en los pacientes con enfermedad renal crónica en fase terminal en la unidad de diálisis en el Hospital General Docente de Ambato, Ecuador.  Método:  Se realizó una investigación cualitativa, con una entrevista semiestructurada que constó de preguntas guiadas por la teoría-hipótesis del tema. La muestra de estudio estuvo compuesta por los médicos de la unidad de diálisis, responsables del manejo clínico de los pacientes con enfermedad renal crónica en tratamiento de diálisis. El protocolo fue aprobado por el Comité de Ética de investigación en Seres Humanos de la Pontificia Universidad Católica del Ecuador, con código de aprobación CEI-88-2020.  Resultados:  El análisis temático evidenció que los médicos necesitan evaluar ética y clínicamente de manera integral al paciente antes de mantener o dar por terminada la hemodiálisis; el nivel de conocimiento y habilidades ético-clínicas influyen en la toma de decisiones. Además, la aplicación de los principios bioéticos de Beauchamp y Childress para la toma de decisiones es vaga, moramente confusa y por tanto irrelevante para este tipo de decisiones.  Conclusiones:  Los médicos perciben la necesidad de evaluar integralmente al paciente, al tener en cuenta no solo la condición física sino psicológica, social y económica del paciente. Consideran innecesario mantener un tratamiento de hemodiálisis en un paciente con una calidad de vida deteriorada, con autonomía reducida y cuyo tratamiento prolongado podría causarle más dolor que beneficio.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction:  Chronic kidney disease is a pathology that reduces the expectancy and quality of life of patients. Doctors are primarily responsible for preserving the patient's life and are responsible for shared decision making.  Objective:  To analyze the perception of medical personnel regarding the prolongation of renal replacement treatment in patients with chronic kidney disease in the terminal phase in the dialysis unit at the General Teaching Hospital of Ambato, Ecuador.  Method:  A qualitative research was carried out, with a semi-structured interview that consisted of questions guided by the theory-hypothesis of the topic. The study sample was made up of doctors from the Dialysis Unit, responsible for the clinical management of patients with chronic kidney disease undergoing dialysis treatment. The protocol was approved by the Human Research Ethics Committee of the Pontificia Universidad Católica del Ecuador, with approval code CEI-88-2020.  Results:  The thematic analysis showed that doctors need to comprehensively ethically and clinically evaluate the patient before maintaining or terminating hemodialysis; The level of knowledge and ethical-clinical skills influence decision making. Furthermore, the application of Beauchamp and Childress' bioethical principles to decision making is vague, morbidly confusing, and therefore irrelevant to this type of decision.  Conclusions:  Doctors perceive the need to comprehensively evaluate the patient, taking into account not only the physical but also the psychological, social and economic condition of the patient. They consider it unnecessary to maintain hemodialysis treatment in a patient with a deteriorated quality of life, with reduced autonomy and whose prolonged treatment could cause more pain than benefit.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[RESUMO  Introdução:  A doença renal crônica é uma patologia que reduz a expectativa e a qualidade de vida dos pacientes. Os médicos são os principais responsáveis pela preservação da vida do paciente e pela tomada de decisão compartilhada.  Objetivo:  Analisar a percepção do pessoal médico sobre o prolongamento do tratamento renal substitutivo em pacientes com doença renal crônica em fase terminal na unidade de diálise do Hospital Geral Universitário de Ambato, Equador.  Método:  Foi realizada uma pesquisa qualitativa, com entrevista semiestruturada composta por questões norteadas pela teoria-hipótese do tema. A amostra do estudo foi composta por médicos da Unidade de Diálise, responsável pelo manejo clínico de pacientes com doença renal crônica em tratamento dialítico. O protocolo foi aprovado pelo Comitê de Ética em Pesquisa com Seres Humanos da Pontifícia Universidade Católica do Equador, com código de aprovação CEI-88-2020.  Resultados:  A análise temática mostrou que os médicos precisam avaliar o paciente de forma abrangente, ética e clínica, antes de manter ou encerrar a hemodiálise; O nível de conhecimento e as competências ético-clínicas influenciam a tomada de decisão. Além disso, a aplicação dos princípios bioéticos de Beauchamp e Childress à tomada de decisões é vaga, mórbidamente confusa e, portanto, irrelevante para este tipo de decisão.  Conclusões:  Os médicos percebem a necessidade de avaliar o paciente de forma abrangente, levando em consideração não só a condição física, mas também a psicológica, social e econômica do paciente. Consideram desnecessário manter o tratamento de hemodiálise num paciente com qualidade de vida deteriorada, com autonomia reduzida e cujo tratamento prolongado poderia causar mais dor do que benefício.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[futilidad médica]]></kwd>
<kwd lng="es"><![CDATA[autonomía profesional]]></kwd>
<kwd lng="es"><![CDATA[autonomía personal]]></kwd>
<kwd lng="es"><![CDATA[toma de decisiones clínicas]]></kwd>
<kwd lng="es"><![CDATA[ética basada en principios]]></kwd>
<kwd lng="en"><![CDATA[medical futility]]></kwd>
<kwd lng="en"><![CDATA[professional autonomy]]></kwd>
<kwd lng="en"><![CDATA[personal autonomy]]></kwd>
<kwd lng="en"><![CDATA[clinical decision making]]></kwd>
<kwd lng="en"><![CDATA[principled ethics]]></kwd>
<kwd lng="pt"><![CDATA[futilidade médica]]></kwd>
<kwd lng="pt"><![CDATA[autonomia profissional]]></kwd>
<kwd lng="pt"><![CDATA[autonomia pessoal]]></kwd>
<kwd lng="pt"><![CDATA[tomada de decisão clínica]]></kwd>
<kwd lng="pt"><![CDATA[ética baseada em princípios]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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