Abstract:
BACKGROUND:In recent years, medical practice has followed two different paradigms: evidence-based medicine (EBM) and values-based medicine (VBM). There is an urgent need to promote medical education that strengthens the relationship between these two paradigms. This work is designed to establish the foundations for a continuing medical education (CME) program aimed at encouraging the dialogue between EBM and VBM by determining the values relevant to everyday medical activities. METHODS:A quasi-experimental, observational, comparative, prospective and qualitative study was conducted by analyzing through a concurrent triangulation strategy the correlation between healthcare personnel-patient relationship, healthcare personnel's life history, and ethical judgments regarding dilemmas that arise in daily clinical practice.In 2009, healthcare personnel working in Mexico were invited to participate in a free, online clinical ethics course. Each participant responded to a set of online survey instruments before and after the CME program. Face-to-face semi-structured interviews were conducted with healthcare personnel, focusing on their views and representations of clinical practice. RESULTS:The healthcare personnel's core values were honesty and respect. There were significant differences in the clinical practice axiology before and after the course (P <0.001); notably, autonomy climbed from the 10th (order mean (OM) = 8.00) to the 3rd position (OM = 5.86). In ethical discernment, the CME program had an impact on autonomy (P ≤0.0001). Utilitarian autonomy was reinforced in the participants (P ≤0.0001). Regarding work values, significant differences due to the CME intervention were found in openness to change (OC) (P <0.000), self-transcendence (ST) (P <0.001), and self-enhancement (SE) (P <0.019). Predominant values in life history, ethical discernment and healthcare personnel-patient relation were beneficence, respect and compassion, respectively. CONCLUSIONS:The healthcare personnel participating in a CME intervention in clinical ethics improved high-order values: Openness to change (OC) and Self Transcendence (ST), which are essential to fulfilling the healing ends of medicine. The CME intervention strengthened the role of educators and advisors with respect to healthcare personnel. The ethical values developed by healthcare professionals arise from their life history and their professional formation.
journal_name
BMC Medjournal_title
BMC medicineauthors
Altamirano-Bustamante MM,Altamirano-Bustamante NF,Lifshitz A,Mora-Magaña I,de Hoyos A,Avila-Osorio MT,Quintana-Vargas S,Aguirre JA,Méndez J,Murata C,Nava-Diosdado R,Martínez-González O,Calleja E,Vargas R,Mejía-Arangure JM,Cdoi
10.1186/1741-7015-11-39subject
Has Abstractpub_date
2013-02-15 00:00:00pages
39issn
1741-7015pii
1741-7015-11-39journal_volume
11pub_type
杂志文章相关文献
BMC Medicine文献大全abstract:BACKGROUND:Breast cancer studies frequently focus on the role of the tumor microenvironment in the promotion of cancer; however, the influence of the normal breast microenvironment on cancer cells remains relatively unknown. To investigate the role of the normal breast microenvironment on breast cancer cell tumorigenic...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-8-27
更新日期:2010-05-21 00:00:00
abstract:BACKGROUND:In many developing countries, the majority of births are attended by traditional birth attendants, who lack formal training in neonatal resuscitation and other essential care required by the newly born infant. In these countries, the major causes of neonatal mortality are birth asphyxia, infection, and low-b...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/1741-7015-9-93
更新日期:2011-08-04 00:00:00
abstract::This comment relates to articles published in archived content of the journal Head and Neck Oncology and is not related to the content of BMC Medicine in any way. ...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-12-24
更新日期:2014-02-05 00:00:00
abstract:BACKGROUND:Polypharmacy is an increasing challenge for primary care. Although sometimes clinically justified, polypharmacy can be inappropriate, leading to undesirable outcomes. Optimising care for polypharmacy necessitates effective targeting and monitoring of interventions. This requires a valid, reliable measure of ...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-018-1078-7
更新日期:2018-06-13 00:00:00
abstract:BACKGROUND:Extended use of combined pharmacotherapies to treat tobacco dependence may increase smoking abstinence; few studies have examined their effectiveness. The objective of this study was to evaluate smoking abstinence with standard nicotine patch (NRT), extended use of combined formulations of nicotine replaceme...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验
doi:10.1186/s12916-016-0626-2
更新日期:2016-06-07 00:00:00
abstract:BACKGROUND:The benefit-risk balance of vaccines is regularly debated by the public, but the utility of media monitoring for regulatory bodies is unclear. A media monitoring study was conducted at the European Medicines Agency (EMA) concerning human papillomavirus (HPV) vaccines during a European Union (EU) referral pro...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0850-4
更新日期:2017-05-02 00:00:00
abstract::The microbes colonizing the infant gastrointestinal tract have been implicated in later-life disease states such as allergies and obesity. Recently, the medical research community has begun to realize that very early colonization events may be most impactful on future health, with the presence of key taxa required for...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/s12916-017-0802-z
更新日期:2017-02-13 00:00:00
abstract:BACKGROUND:Mutations in either of two genes comprising the STSL locus, ATP-binding cassette (ABC)-transporters ABCG5 (encoding sterolin-1) and ABCG8 (encoding sterolin-2), result in sitosterolemia, a rare autosomal recessive disorder of sterol trafficking characterized by increased plasma plant sterol levels. Based upo...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-2-5
更新日期:2004-03-24 00:00:00
abstract::A series of primarily laboratory-based studies found attention bias modification in socially anxious participants to lead to reduced anxiety. It is argued that the failure to replicate the positive results of attention bias modification in the study of Carlbring et al. may be due to reasons other than the application ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-63
更新日期:2012-06-25 00:00:00
abstract:BACKGROUND:We now know that depression is associated with a chronic, low-grade inflammatory response and activation of cell-mediated immunity, as well as activation of the compensatory anti-inflammatory reflex system. It is similarly accompanied by increased oxidative and nitrosative stress (O&NS), which contribute to ...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-11-200
更新日期:2013-09-12 00:00:00
abstract::Although imatinib is firmly established as an effective therapy for newly diagnosed patients with chronic myeloid leukemia (CML), the field continues to advance on several fronts. In this minireview we cover recent results of second generation tyrosine kinase inhibitors in newly diagnosed patients, investigate the sta...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-9-99
更新日期:2011-08-26 00:00:00
abstract:BACKGROUND:Lethal and edema toxins secreted by Bacillus anthracis during anthrax infection were found to incite serious cardiovascular complications. However, the underlying mechanisms in anthrax lethal toxin-induced cardiac anomalies remain unknown. This study was designed to evaluate the impact of antioxidant enzyme ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-134
更新日期:2012-11-07 00:00:00
abstract::Although clinical nutrition is a frequently used intervention in inpatient care, high quality trials proving its effectiveness and safety when used in the acutely-ill polymorbid medical inpatient population are largely lacking. From an evolutionary perspective, illness-related low appetite is protective and part of th...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0812-x
更新日期:2017-02-24 00:00:00
abstract:BACKGROUND:Multiple-arm randomized trials can be more complex in their design, data analysis, and result reporting than two-arm trials. We conducted a systematic review to assess the reporting of analyses in reports of randomized controlled trials (RCTs) with multiple arms. METHODS:The literature in the MEDLINE databa...
journal_title:BMC medicine
pub_type: 杂志文章,随机对照试验,评审
doi:10.1186/1741-7015-11-84
更新日期:2013-03-27 00:00:00
abstract::The approval of sorafenib and active development of many other molecularly targeted agents in hepatocellular carcinoma (HCC) have presented a challenge to understand the mechanism of action of sorafenib and identify predictive biomarkers to select patients more likely to benefit from sorafenib. The preclinical study b...
journal_title:BMC medicine
pub_type: 社论
doi:10.1186/1741-7015-7-42
更新日期:2009-08-24 00:00:00
abstract:BACKGROUND:Interventions to alleviate stigma are demonstrating effectiveness across a range of conditions, though few move beyond the pilot phase, especially in low- and middle-income countries (LMICs). Implementation science offers tools to study complex interventions, understand barriers to implementation, and genera...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-018-1237-x
更新日期:2019-02-15 00:00:00
abstract::Post-traumatic stress disorder (PTSD) can be caused by life threatening illness, such as cancer and coronary events. The study by Forbes et al. made the unexpected finding that military personnel evacuation with medical illness have similar rates of PTSD to those evacuated with combat injuries. It may be that the illn...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-126
更新日期:2012-10-24 00:00:00
abstract:BACKGROUND:It has been presumed that Chlamydia trachomatis is transmitted between men only through anal or oral sex, but no mathematical models have tested this presumption. METHODS:To test this presumption, we created 20 compartmental mathematical models of different sexual practices that included both oral and anal ...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-020-01796-3
更新日期:2020-11-17 00:00:00
abstract:BACKGROUND:This study was conducted to assess whether patient-reported outcomes (PROs) differ by the underlying diagnosis (rheumatoid arthritis (RA)/inflammatory arthritis, osteoarthritis (OA), avascular necrosis of bone (AVN), other) in patients undergoing primary total hip arthroplasty (THA). METHODS:We used prospec...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-11-210
更新日期:2013-09-24 00:00:00
abstract:BACKGROUND:The United States Preventive Services Task Force (USPSTF) recommends screening adults for depression in primary care settings when staff-assisted depression management programs are available. This recommendation, however, is based on evidence from depression management programs conducted with patients alread...
journal_title:BMC medicine
pub_type: 杂志文章,评审
doi:10.1186/1741-7015-12-13
更新日期:2014-01-28 00:00:00
abstract::In a climate of economic uncertainty, cost effectiveness analysis is a potentially important tool for making choices about health care interventions. Methods for such analyses are well established, but the results need to be interpreted carefully and are subject to bias. Making decisions based on results of cost-effec...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-10-10
更新日期:2012-02-01 00:00:00
abstract::In this video Q&A, we talk to Professor Carlos Caldas about the identification of breast cancer subtypes through molecular profiling, and the clinical implications for diagnosis and treatment. ...
journal_title:BMC medicine
pub_type: 面试,杂志文章
doi:10.1186/1741-7015-11-150
更新日期:2013-06-18 00:00:00
abstract::Acute kidney injury (AKI) is independently associated with increased morbidity and mortality. Ischemia is the leading cause of AKI, and short of supportive measures, no currently available therapy can effectively treat or prevent ischemic AKI. This paper discusses recent developments in the understanding of ischemic A...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-9-11
更新日期:2011-02-02 00:00:00
abstract::The Fluid Expansion as Supportive Therapy (FEAST study) was an extremely well conducted study that gave unexpected results. The investigators had reported that febrile children with impaired perfusion treated in low-income countries without access to intensive care are more likely to die if they receive bolus resuscit...
journal_title:BMC medicine
pub_type: 评论,杂志文章
doi:10.1186/1741-7015-11-67
更新日期:2013-03-14 00:00:00
abstract:BACKGROUND:The prognostic significance of tumor-associated macrophages (TAM) in adult classical Hodgkin lymphoma (cHL) remains controversial. Here, we report a meta-analysis of the association of CD68 and CD163 infiltration on the clinical outcome of adult cHL. METHODS:A comprehensive search to identify relevant artic...
journal_title:BMC medicine
pub_type: 杂志文章,meta分析
doi:10.1186/s12916-016-0711-6
更新日期:2016-10-17 00:00:00
abstract:BACKGROUND:Wild type 2 poliovirus was last observed in 1999. The Sabin-strain oral polio vaccine type 2 (OPV2) was critical to eradication, but it is known to revert to a neurovirulent phenotype, causing vaccine-associated paralytic poliomyelitis. OPV2 is also transmissible and can establish circulating lineages, calle...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0937-y
更新日期:2017-10-04 00:00:00
abstract:BACKGROUND:Clinicians are less likely to prescribe guideline-recommended treatments to people with multimorbidity than to people with a single condition. Doubts as to the applicability of clinical trials of drug treatments (the gold standard for evidence-based medicine) when people have co-existing diseases (comorbidit...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1427-1
更新日期:2019-11-12 00:00:00
abstract:BACKGROUND:Breast cancer patients who have not previously attended mammography screening may be more likely to discontinue adjuvant hormone therapy and therefore have a worse disease prognosis. METHODS:We conducted a population-based cohort study using data from Stockholm Mammography Screening Program, Stockholm-Gotla...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-019-1252-6
更新日期:2019-01-31 00:00:00
abstract:BACKGROUND:Despite our substantial understanding of molecular mechanisms and gene mutations involved in cancer, the technical approaches for diagnosis and prognosis of cancer are limited. In routine clinical diagnosis of cancer, the procedure is very basic: nuclear morphology is used as a common assessment of the degre...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/1741-7015-9-28
更新日期:2011-03-26 00:00:00
abstract:BACKGROUND:International medical graduates working in the UK are more likely to be censured in relation to fitness to practise compared to home graduates. Performance on the General Medical Council's (GMC's) Professional and Linguistic Assessments Board (PLAB) tests and English fluency have previously been shown to pre...
journal_title:BMC medicine
pub_type: 杂志文章
doi:10.1186/s12916-017-0829-1
更新日期:2017-03-20 00:00:00