Elementos estructurales del consentimiento informado

El consentimiento informado es la expresión de la voluntad del paciente, relacionada con una intervención o un tratamiento terapéutico que se hará en su cuerpo, para que se dé aquel; previamente el profesional de la salud debe suministrar veraz, integral y oportunamente la información referente a los riesgos, los procedimientos, las expectativas, el diagnóstico y el pronóstico de su enfermedad y su respectivo tratamiento. Por lo tanto, del consentimiento informado se derivan obligaciones y derechos, tanto para el paciente como para el profesional de la salud, al ser un elemento tan especial y esencial en la relación médico-paciente, y en el mismo acto médico, cobra especial relevancia en la responsabilidad médica. Sin embargo, en la praxis muchas veces se olvida la importancia del consentimiento informado en relación con aquella. El propósito de este artículo consiste en analizar los elementos estructurales del consentimiento informado, los cuales son fundamentales a la hora en que el médico lo solicite. En dicho escenario surgen situaciones que generan dudas jurídicas en cuanto a su formación. De igual forma, para tener una idea concreta y completa del consentimiento informado, dividiremos este artículo en dos partes. En la primera, nos ocuparemos del desarrollo doctrinal del concepto, en el que analizaremos su noción, su evolución en la historia y sus modelos (beneficencia, paternalismo, autonomía, entre otros); posteriormente, estudiaremos la problemática que se puede originar durante el proceso de informar al paciente, debido a que no en todos los casos este está en pleno uso de sus facultades para otorgar su consentimiento. Es allí donde miraremos la capacidad en el ámbito médico y los casos en que se puede pedir un consentimiento informado directo e indirecto. Finalmente, analizaremos el tema del riesgo y el desarrollo que la doctrina ha dado al respecto, para revisar en último lugar el consentimiento en la historia clínica y su solicitud correcta al paciente. En la segunda parte, nos encargaremos de examinar detenidamente el desarrollo jurisprudencial del consentimiento informado surtido en la Corte Constitucional y en el Consejo de Estado de la República de Colombia, desde 1991 a la fecha, del cual sin duda alguna el lector podrá concluir lo esencial e imperioso de este en la práctica médica y en la prevención del daño antijurídico.

Proyecto de autoejercitación personal en limitación ortopédica para miembro inferior

El proyecto de Autoejercitación Personal a través de los beneficios de la salud, busca en el fitness acondicionar o adaptar el desarrollo de las cualidades físicas a aquellos individuos que no pueden realizar una actividad física dentro de los parámetros establecidos por las ciencias del deporte. El programa de ejercicio abarca los componentes del fitness como elementos esenciales en el movimiento humano, en la fisiología, en los cambios de estilos de vida, en la adaptación al ejercicio, obteniendo así una nueva forma de adherencia a un tipo de ejercicio. Componiendo así una integralidad en el ser humano, a través del fitness.

Els Blocs com a eina per fomentar la inclusió social de les persones amb discapacitat intel·lectual: l’experiència del bloc “Mogudes de Tresc”

La inclusió social de les persones amb discapacitat és avui encara un tema pendent, ja que les activitats socials i interpersonals en el col·lectiu són escasses. Diversos estudis demostren que, malgrat es potencia la inserció laboral de les persones amb discapacitat en entorns ordinaris, no es donen millores substancials en altres qüestions relatives a la seva inclusió social

Apoyando proyectos de vida inclusivos: claves para transformar las prácticas socioeducativas de personas adultas con discapacidad intelectual

En el marco del modelo social de la discapacidad cobran importancia la autodeterminación y autogestión de las personas con discapacidad intelectual, replanteando la relación de poder entre profesionales y usuarios. Por ello, la transformación de las prácticas socioeducativas en la construcción y logro de proyectos de vida personalizados constituye un reto para los servicios dirigidos a personas adultas con discapacidad. El objetivo del presente artículo es mostrar, a partir de la revisión de literatura y el análisis de buenas prácticas, algunos elementos clave que facilitan esta transformación. En primer lugar, se presentan las líneas principales de la nueva conceptualización de las personas con discapacidad intelectual como protagonistas de sus proyectos de vida. Seguidamente, y después de contextualizar brevemente el escenario formado por los servicios de adultos en España, se presentan algunas estrategias e instrumentos básicos para la transformación de las prácticas educativas. En las conclusiones se incide en los retos que estas claves plantean en nuestro contexto

¿Contribuye a la inclusión laboral la formación que recibe el alumnado con discapacidad intelectual en la ESO?: análisis y propuestas

Las investigaciones centradas en el análisis de buenas prácticas de inclusión laboral de personas con discapacidad demuestran la importancia de la formación previa, y específicamente la recibida en la etapa de secundaria. El objetivo de este artículo es presentar los resultados de una investigación sobre las características básicas de la formación laboral que reciben los jóvenes con discapacidad intelectual en la ESO. En el primer apartado se realiza una aproximación al papel de la educación secundaria en el desarrollo del rol laboral desde una óptica inclusiva. A continuación, se presenta la investigación realizada con el objeto de obtener datos sobre la adecuación de la formación socio-laboral que se realiza en la ESO (objetivos, método y resultados). Por último se plantean las orientaciones dirigidas a mejorar las oportunidades futuras de inclusión laboral desde el sistema educativo

A atitude dos alunos face à inclusão dos seus pares com deficiência

RESUMO: A escola actual encontra-se perante o desafio de responder com afectividade às necessidades educativas especiais de uma população cada vez mais heterogénea, onde se adopte um modelo de atendimento adequado a cada um. Neste contexto, consideramos os alunos, os professores e os encarregados de educação elementos chave de todo o processo, sobre os quais recaem responsabilidades acrescidas na concretização da filosofia inclusiva. O presente estudo tem como objectivo averiguar a atitude dos alunos face à inclusão dos seus pares com deficiência, determinando o modo como estes percepcionam as atitudes dos professores e dos pais face à inclusão de alunos com NEE de carácter permanente, vantagens e desvantagens da inclusão de alunos com NEE de carácter permanente e a cooperação entre alunos com e sem deficiência, tendo em conta a tipologia da deficiência (motora e mental). No caso do nosso estudo, contámos com a participação de 520 alunos (N= 270 género feminino e N=250 do género masculino), uma amostra distribuída pelo 2ºciclo, 3º ciclo e secundário dos distritos de Setúbal e Lisboa. A recolha de dados concretizou-se pela aplicação do AID – EF, questionário da autoria de Ramos Leitão, 2011.Esta metodologia de recolha e tratamento de informação permitiu-nos concluir que, na opinião dos alunos ditos normais a atitude dos professores face à inclusão de alunos com NEE de carácter permanente (dimensão d1), não varia em função da tipologia da deficiência (deficiência motora e mental). Da mesma forma, não foram encontradas diferenças significativas entre os dois grupos (deficiência motora e mental), na opinião dos alunos ditos normais, no que respeita às vantagens da inclusão dos alunos com NEE de carácter permanente (dimensão d2). Na opinião dos alunos ditos normais os resultados demonstraram que a cooperação entre alunos com e sem deficiência (dimensão d3), varia em função da tipologia da deficiência (deficiência motora e mental), apontando esses resultados para uma maior cooperação entre os alunos ditos normais e os seus pares com deficiência mental. Não foram igualmente encontradas diferenças significativas no que respeita às desvantagens da inclusão dos alunos com NEE de carácter permanente (dimensão 4), quando temos em consideração a tipologia da deficiência (deficiência motora e mental). Da mesma forma, na opinião dos alunos normais ditos normais a atitude dos pais face à inclusão de alunos com NEE de carácter permanente (dimensão d5) não variam em função da tipologia da deficiência (deficiência motora e mental).ABSTRACT: Currently the school is faced with the challenge of responding affectionately to the special educational needs of an increasingly heterogeneous population, where a standard model is adopted for each individual. In this context, we consider the students, teachers and guardians, key elements in the whole process, over which fall increased responsibilities in the implementation of the inclusive philosophy. The present study aims to determine the attitude of students towards the inclusion of peers with disabilities, determining how they perceive the attitudes of teachers and parents towards the inclusion of pupils with permanent special education needs, advantages and disadvantages of including students with permanent special education needs and the cooperation between students with and without disabilities, taking into account the type of disability (mental and motor). In the case of our study, we had the participation of 520 students (N = 270 N = female and 250 male), a sample distributed to the 2nd cycle, 3rd cycle and Secondary schools in the districts of Setúbal and Lisbon. The data collected was enabled by the application of the IDA - EF, questionnaire by Ramos Leitão, 2011. This methodology of collecting and processing information allowed us to conclude that, in the opinion of the so-called normal students the teachers´ attitude towards the inclusion of pupils with permanent special education needs (dimension d1) does not vary according to the type of disability (motor and mental). Likewise, no significant differences were found between the two groups (mental and motor), in the opinion of the so-called normal students, with regard to the benefits of the inclusion of pupils with permanent special education needs (dimension d2). In the opinion of the so-called normal students, the results demonstrated that the cooperation between students with and without disabilities (dimension d3), vary depending on the type of disability (mental and motor), these results pointing to a greater cooperation between the so-called normal students and their peers with mental disabilities. There were also no significant differences with respect to the disadvantages of inclusion of pupils with permanent special education needs (dimension d4), when we take into account the type of disability (mental and motor). Similarly, in the opinion of the so-called normal students, the parents´ attitude towards the inclusion of pupils with permanent special education needs (dimension d5) does not vary according to the type of disability (mental and motor).

Meaning of home : a comparison of the meaning of home as identified by samples of Victorians with, and without, an intellectual disability

This phenomenological study of the meaning of home from the perspectives of people with and without an intellectual disability sought to identify, (a) any common ‘essence’ of meaning held by and, (b) the nature of any differences of perception between, the groups. Purposive samples of 18 people with an intellectual disability and 21 non-disabled people were surveyed using a semi-structured interview to ascertain their experiences of home and 'non-homes'. Inductive analysis of the data revealed a shared understanding of the meaning of home at a fundamental level. This shared meaning of home was found to comprise: the ability to exert control over an area; having a personalised space; feeling content with the living situation; a sense of familiarity with the setting; a set of behaviours and routines usually only enacted when at home; common names and uses for rooms; socialising at home with others; the importance of a positive social atmosphere in the home; and, recognition of places as non-homes because they lacked one or more of these attributes. Further analysis revealed the essence of home is its experience as the place where stress is most reduced or minimised for the individual. The study demonstrates that the concept of stress is superordinate to previously identified concepts considered fundamental to home such as privacy, control and non-homes. Major differences between the two samples were largely differences of degree with people who have an intellectual disability reporting the same fundamental attributes of home as people who do not have an intellectual disability, but in a less elaborated form. Principal among these differences of degree was the notion of control over the home and its derivative elements which encompassed the whole dwelling including its setting for people without an intellectual disability but was very restricted for people with an intellectual disability being largely confined to the person's bedroom. Socialising in or from the home was also very limited for people with an intellectual disability in comparison with that experienced by non-disabled informants with the former group conveying an impression of leading significantly socially isolated lives at home. The major implications of this study are related to the meaning of home per se, to residential service provision to people with an intellectual disability, and to future research.

Use of drugs to manage the behaviour of individuals with intellectual disability

Provides a detailed description and analysis over time of the use of medication to manage the behaviour of individuals with intellectual disability. Drug use was extensive and reasons provided were commonly outside those permitted by legislation. The findings enabled critical appraisal of current monitoring procedures and recommendations regarding policy and practice.

Dual disability : the inherent difficulties in service provision and client management

Dual disability is a particularly important area of study, as the co-occurence of intellectual and psychiatric disability presents signficant challenges to professionals within the health and disability services. Four case studies are presented.

Enhancing juror decision-making through provision of transcripts

This thesis explored how much evidence jurors remember when instructed to reach a verdict. Results indicated that jurors required to rely on memory recalled significantly less evidence than jurors provided with access to the court transcript and were less confident than aided jurors that they had returned the 'right' verdict. The portfolio explored a possible association between chronic childhood challenging behaviours and later offending behaviour in individuals with intellectual disability. Includes four clinical case studies. The importance of early intervention is illustrated.

A model for assessing financial competence

This thesis aimed to design a valid and reliable assessment of financial competence to decide whether or not someone required help in looking after their finances. A multidimensional assessment was developed that was found useful in identifying the financial difficulties experiences by people with a cognitive impairment.

Factors influencing obesity in people with an intellectual disability

These studies indicate that obesity levels, best measured by weight not the Body Mass Index, are high among people with an intellectual disability. Poor knowledge of nutrition and exercise, together with a body image that says "I'm OK", and carers' tolerance for overweight, are indicators of obesity in this population.

Participation, relational justice and social identity in cervical cancer screening

Extending existing health literature by drawing on social and community psychology, this thesis represents the first attempt to explore the conceptualisation of 'participation' in cervical cancer screening. Quantitative and qualitative findings suggested that women's experiences of 'patient participation' and 'voice opportunity' were important and related to various social processes and variables in this health context. Using four case studies, the professional portfolio demonstrates a biopsychosocial approach to assessment and intervention as used by a provisional health psychologist working with clients with intellectual disabilities in order to promote sexual health.

Visual discrimination and reproduction of movement by individuals with an intellectual disability

This study investigates the capacity of individuals with an intellectual disability to make accurate discriminations of computer-generated displays and also to reproduce the characteristics of those displays. The findings suggest that the learning of everyday motor skills in this population may be hampered by difficulties in visually perceiving important characteristics of the demonstration. Procedures, employed for teaching these skills to intellectually disabled, are being reassessed in the light of these findings.