title: [Effectiveness of a training course in bioethics and of the introduction of a checklist to detect ethical problems in a home care support team].
abstract: 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.
authors.affiliation: Equipo de Soporte de Atención Primaria (ESAD), Area 7, Instituto Madrileño de la Salud, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Barbero Gutiérrez
authors.forename: S
authors.initials: S
authors.lastname: Garrido Elustondo
authors.forename: C
authors.initials: C
authors.lastname: de Miguel Sánchez
authors.forename: F
authors.initials: F
authors.lastname: Vicente Sánchez
authors.forename: I
authors.initials: I
authors.lastname: Macé Gutiérrez
authors.forename: C
authors.initials: C
authors.lastname: Fernández García
mesh_terms: 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*