[Effectiveness of a training course in bioethics and of the introduction of a checklist to detect ethical problems in a home care support team].
OBJECTIVE
To study the concordance in the number of ethical problems identified in the care of the terminally ill between the members of a home care support team (HCST) and a group of experts before and after a course in bioethics and the introduction of a checklist.


METHODS
Before-and-after intervention study.


METHODS
Area 7 of Primary Care, Madrid.


METHODS
Terminally ill patients attended by the HCST between November 2001 and June 2002.


METHODS
Bioethics course and introduction of a checklist.


METHODS
Age, sex, basic illness, number of ethical problems identified by the HCST and by the group of experts before and after the intervention. The intraclass correlation coefficient (ICC) for the number of problems identified was calculated in both groups before and after the intervention.


RESULTS
31 cases before and 29 after the intervention were studied. Before the intervention the HCST identified an average of 2.7 +/- 2.3 ethical problems per case; and the group of experts found 11.8 +/- 6.1. The ICC for the number of problems identified was 0.53 (moderate correlation). After the intervention, the HCST identified 5.9 +/- 6.5 ethical problems per case; and the group of experts, 10.7 +/- 7.9. The ICC for the number of problems identified was 0.87 (close correlation).


CONCLUSIONS
The course and the introduction of a checklist helped professionals who were not experts in bioethics to detect ethical problems in treating terminally ill patients.
Barbero Gutiérrez
J
J
Equipo de Soporte de Atención Primaria (ESAD), Area 7, Instituto Madrileño de la Salud, Madrid, Spain.
Garrido Elustondo
S
S
de Miguel Sánchez
C
C
Vicente Sánchez
F
F
Macé Gutiérrez
I
I
Fernández García
C
C
D000368:Aged; D000369:Aged, 80 and over; D001675:Bioethics / Q000193:education*; D016001:Confidence Intervals; D004502:Education, Medical, Continuing; D005260:Female; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000941:ethics; D011320:Primary Health Care; D013030:Spain; D013727:Terminal Care / Q000941:ethics*