El proceso de decisión compartida en el tratamiento del paciente psiquiátricoestudios empíricos y evaluación de la capacidad
- Villagrán Moreno, José María
- Lara Ruiz-Granados, Ignacio
- González Saiz, Francisco
ISSN: 0211-5735
Año de publicación: 2014
Volumen: 34
Número: 123
Páginas: 491-506
Tipo: Artículo
Otras publicaciones en: Revista de la Asociación Española de Neuropsiquiatría
Resumen
Existe investigación empírica sobre experiencias de decisión compartida en salud mental, preferentemente en depresión y esquizofrenia, y algo menos en adicciones. La evidencia disponible a partir de los estudios llevados a cabo en los últimos años muestra que esta práctica mejora la calidad de las decisiones y parece efectiva en el proceso decisorio (aumenta el conocimiento y la participación, favorece una mayor congruencia con los valores y preferencias del paciente), aumentando, generalmente, la satisfacción del usuario. Sin embargo, existe escasa o mínima evidencia acerca de su eficacia sobre indicadores de resultados de salud. Uno de los elementos claves de los procesos de decisión compartida es la determinación de la capacidad del paciente para tomar la decisión clínica en cuestión. Se trata de un juicio clínico que posee un papel relevante en el difícil equilibrio entre autonomía y beneficencia/no maleficencia en la atención sanitaria. Así, una adecuada evaluación de la capacidad de tomar decisiones del paciente debe servir para proteger ambos principios y evitar dos tipos de errores: por un lado, el soslayar injustificadamente la autonomía del paciente para salvaguardar su bienestar; por otro, el injustificable respeto a su autonomía al precio de su bienestar.
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