{"id":30699,"date":"2004-11-06T00:00:00","date_gmt":"2004-11-06T00:00:00","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/el-pronostico-de-los-pacientes-en-situacion-terminal-atendidos-en-domicilio\/"},"modified":"2004-11-06T00:00:00","modified_gmt":"2004-11-06T00:00:00","slug":"el-pronostico-de-los-pacientes-en-situacion-terminal-atendidos-en-domicilio","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/el-pronostico-de-los-pacientes-en-situacion-terminal-atendidos-en-domicilio\/","title":{"rendered":"El pron\u00f3stico de los pacientes en situaci\u00f3n terminal atendidos en domicilio"},"content":{"rendered":"<h2>Tesis doctoral de <strong>  Miguel S\u00e1nchez Cristina De <\/strong><\/h2>\n<p>El \u00e1mbito de este estudio se refiere a la predicci\u00f3n de supervivencia de los pacientes oncol\u00f3gicos en situaci\u00f3n avanzada.  persigue:  1,- determinar si la impresi\u00f3n cl\u00ednica del profesional (icp) es adecuada.  2,- valorar la utilidad del \u00edndice pron\u00f3stico ppi.  3,- determinar qu\u00e9 s\u00edntomas cl\u00ednicos, signos f\u00edsicos y caracter\u00edsticas que definen el estado funcional del paciente  predicen la supervivencia.  4,- construir un nuevo \u00edndice predictor de supervivencia.  se realiza un estudio longitudinal, prospectivo, 150 pacientes oncol\u00f3gicos en situaci\u00f3n terminal atendidos por un equipo de soporte de atenci\u00f3n a domicilio (e.S.A.D). Se recogen variables sociodemogr\u00e1ficas y cl\u00ednicas.  posteriormente se sigui\u00f3 a estos pacientes con visitas semanales hasta el fallecimiento, en las que se recogieron: icp, ppi, s\u00edntomas, signos y estado funcional del pacientes. Se realiz\u00f3 un an\u00e1lisis de concordancia, sensibilidad y especificidad, an\u00e1lisis de supervivencia por el m\u00e9todo de kaplan meier y log rank test, regresi\u00f3n de cox y elaboraci\u00f3n de un \u00edndice de predicci\u00f3n de supervivencia.  la icp se correlaciona de forma moderada con la supervivencia en la primera visita y es buena en la \u00faltima visita anterior al fallecimiento, sin que existan diferencias significativas entre m\u00e9dicos y enfermeras. La exactitud aumenta a medida que se acerca la muerte. Existe una tendencia a hacer estimaciones optimistas. El ppi posee una elevada especificidad, pero baja sensibilidad, por lo que su utilidad en la pr\u00e1ctica cl\u00ednica diaria como m\u00e9todo de predicci\u00f3n es baja. Se identifican como factores predictores de supervivencia. El palliative performance status menor 50, la recuencia cardiaca mayor 100 i.P.M, y la frecuencia respiratoria menor 24 r.P.M. se elabora un \u00edndice predictor de supervivencia y unas de recomendaciones para mejorar la atenci\u00f3n a los pacientes oncol\u00f3gicos en situaci\u00f3n terminal.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>El pron\u00f3stico de los pacientes en situaci\u00f3n terminal atendidos en domicilio<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 El pron\u00f3stico de los pacientes en situaci\u00f3n terminal atendidos en domicilio <\/li>\n<li><strong>Autor:<\/strong>\u00a0  Miguel S\u00e1nchez Cristina De <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Aut\u00f3noma de Madrid<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 11\/06\/2004<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Angel Antonio Otero Puime<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Mar\u00eda Beltr\u00e1n dub\u00f3n <\/li>\n<li>vicente Pastor aldeguer (vocal)<\/li>\n<li>eduardo Diaz rubio (vocal)<\/li>\n<li>Mar\u00eda Naval vicu\u00f1a (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Miguel S\u00e1nchez Cristina De El \u00e1mbito de este estudio se refiere a la predicci\u00f3n de supervivencia de [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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