Browsing by Author "Pais, D"
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- Cancer During Pregnancy: How to Handle the Bioethical Dilemmas?—A Scoping Review With Paradigmatic Cases-Based AnalysisPublication . Alpuim Costa, D; Nobre, JG; de Almeida, SB; Ferreira, MH; Gonçalves, I; Braga, S; Pais, D
- Informed Treatment Consent and Refusal in Advanced Endonasal Surgery: The Ethical Dilemma of Olfaction Sacrifice in Surgery for Chronic Rhinosinusitis with PolyposisPublication . Subtil, J; Araújo, JP; Saraiva, J; Santos, A; Vera-Cruz, P; Paço, J; Pais, DINTRODUCTION: Olfaction is frequently affected in chronic rhino-sinusitis with polyposis and has been recognised to have important impact on quality of life. Surgical resolution on cases of maximal medical therapy failure is an option to relieve symptoms, with debates as to how extensive surgery should be. A more radical approach will achieve better disease control with less relapse, but can also compromise olfaction. This decision about a more radical surgical approach should be shared with the patient. Thorough informed consent regarding disease control and hyposmia should be taken. MATERIAL AND METHODS: Literature review and consultation with a board of experts. RESULTS AND DISCUSSION: We propose some elements to be included in the informed consent discussion, in order to broadly address the surgical limitations regarding anosmia as a frequent complaint, as well as the different options and their associated consequences. CONCLUSION: Radical surgery decision making should be shared with the patient and the informed consent should be as thorough as possible regarding disease control and hyposmia resolution.
- Patient Safety Culture in Portuguese PrimaryPublication . Ornelas, Marta Dora; Pais, D; Sousa, PIntroduction: According to the European Commission more than 37 million Primary Healthcare (PHC) users suffer Adverse Events (AE). When we talk about these unintentional and undesirable events, most of the time we are dealing with acts committed by competent and dedicated professionals, who often work in disorganized systems, and who are not very oriented towards patient safety and health care professional safety. The adoption of a safety culture is a proven useful tool to make AE less likely to occur and to minimize its consequences when these inevitably take place. Methods: The authors describe some pertinent issues that have made the evaluation of AE and Patient Safety Culture (PSC) in Portuguese PHC particularly challenging and describe the preliminary results of a project for the assessment of PSC using the Medical Office Survey on Patient Safety Culture (MOSOPSC). This instrument has been translated, adapted and validated by the authors for the study population. Results: Studies about AE in PHC are scarce, but admittedly necessary. Despite the socio-economic instability experienced in Portugal, the preliminary results obtained by the authors promise a proactive PSC with dedicated health professionals, working as a team and recognizing the problem of adverse events in PHC of the Madeira Island. Discussion: The concepts and methodologies used in other studies cannot simply be applied to specific populations. On the Madeira Island (one autonomous region of Portugal), the issue of patient safety (PS) is difficult to approach but, nevertheless, with information and discussion it was possible to measure the PSC in PHC. Conclusion: After some adjustments, the MOSOPSC questionnaire, in addition to assessing safety culture, has helped to initiate the dialogue and discussion on the issue of PS among the various professionals. This approach has allowed these professionals to anticipate and prevent the occurrence of AE and, whenever such is not possible, notify, discuss, share and learn from those same events.