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Author: search.filters.author.Aguiñaga-Chiñas, Nuria

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    Impact of a bioethics and humanities program on the educational training of nephrology residents
    (Oxford University Press (OUP), 2025-09-24)
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    Gómez Guerrero, Irma
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    Garcia-Villalobos, Gloria
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    Martin Alemañy, Geovana
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    Aguiñaga-Chiñas, Nuria
    Background: Modern medical training must integrate not only clinical skills but also ethical and humanistic competencies. In 2013, a structured program in bioethics and humanism was implemented as part of a nephrology residency curriculum. The objective of this study was to evaluate the impact of a 3-year humanism and bioethics program for nephrology residents that focused on improving clinical communication, reducing complaint and lawsuit numbers, increasing patient satisfaction, and supporting decision-making centered on quality of life. Methods: A longitudinal, ambispective cohort (2010–19), our 3-year curriculum delivered weekly 1-h sessions for 6 months/year to 45 residents and was facilitated by three faculty instructors across six core themes. To relate outcomes to the intervention, analyses were anchored to the 2013 launch and compared pre-program (2010–13) versus post-program (2014–19) rates of formal complaints, legal claims, patient satisfaction and maximum benefit discharges. Results: Formal complaints decreased from 47.8 to 26.0 per year [incidence rate ratio (IRR) 0.54, 95% confidence interval (CI) 0.44–0.67; P < .001; Holm <0.001]. Legal claims were reduced from 4.25 to 0.17 per year (IRR 0.039, 95% CI 0.005–0.295; P = .0016; Holm = 0.0016). Maximum benefit discharges increased from 4.25 to 76.5 per year (IRR 18.0, 95% CI 11.09–29.21; P < .001; Holm <0.001). For satisfaction, the ordinal logistic model showed an odds ratio (OR) of 3.53 (95% CI 1.96–6.38; P < .001; Holm = 0.0001), consistent with the dichotomous sensitivity analysis (≥4 vs ≤3) (OR 4.08, 95% CI 2.16–7.71; P < .000). Conclusions: The humanism and bioethics program was proven to be an effective and transformative educational tool that promoted ethical, empathetic and patient-centered nephrology practices. The positive impact of this program was evident in both clinical indicators and strengthened medical professionalism. ©The authors ©Oxford University Press (OUP) © Clinical Kidney Journal.
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    Perceptions of COVID-19 patients in the use of bioethical principles and the physician-patient relationship: a qualitative approach
    (BioMed Central Ltd, 2024)
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    Gómez-Guerrero, Irma Eloisa
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    Aguiñaga-Chiñas, Nuria
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    López Cervantes, Mariana
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    Jaramillo Flores, Ignacio David
    The COVID-19 pandemic has influenced the approach to the health-disease system, raising the question about the principles of bioethics present in physician–patient relations. The principles while widely accepted may not be sufficient for a comprehensive ethical analysis. Therefore, the aim of this study was to explore the perception of these principles and the physician–patient relationship during a hospital stay through a qualitative approach. Method: Sixteen semi-structured interviews took place to know the patients’ perception during their 2020 hospitalization for COVID-19. The data was analyzed through the constant comparison method, creating categories and comparing them. In the end, seven categories were established and were grouped in three: bioethical principles (dignity, charity, vulnerability, autonomy), doctor-patient relationship (participant commitment, informed consent, health staff-patient relationship) and the experience of the disease (illness, the role of the family). Results: The research found that most patients described a positive experience, with the feeling of having been well cared for with no sense of discrimination or injustice done. The majority also reported that their autonomy was respected in the treatment decisions. The evaluation of these attitudes is an area of opportunity, especially when the patients' vulnerability is at risk. Conclusions: The ethics of virtue offers a better reflection of how human beings manifest themselves by emphasizing the development of virtuous character and behaviors that allow them to realize their values in life. Authorized by the Research Ethics Committee with registration: DI/18/105-B/3/308. © The Author(s) 2024.
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