The needs of bioethics learning in specialists and residents in nephrology specialty in Cuba

Abstract

Introduction: Chronic kidney disease as a treatable process but progressive to end stage, determines the need for physicians know and apply a bioethical focus on their professional performance.
Objective: To identify learning needs in bioethical issues by nephrologists.
Material and Methods: A descriptive cross-sectional study with 81 physicians (41 specialists and 40 residents) in three nephrology services in the country between 2014-2015 was performed. A structured questionnaire for collecting information and different quantitative and qualitative methods for processing information was used. For the statistical processing, R software was used.
Results: Anglo-Saxon bioethics' four principles were recognized as important for professional practice at the hospital (9.4 points) as well as personal involvement in its implementation (9.89 points) with no significant differences between specialists and residents. Lack of training is recognized in various bioethics issues such as palliative care (82.75%), communication skills (80.2%), therapeutic principle of proportionality (72.83%), ethical-clinical conflicts (72, 83%), continuous care plans in these patients (76.54%), advanced care and end of life (81.18%) and prevention of Burnout (81.48%), higher in residents than in specialists; especially therapeutic proportionality (p = 0.007) and clinical - ethical conflict (p = 0.029).
Conclusions: Great importance to bioethical aspects applied to nephrology practice is granted. Customizable learning's needs are identified in specific areas through education plans development during post graduated learning.

Keywords: hemodialysis, chronic renal disease, acute renal failure, bioethics, ethical and clinical problems, dialysis, nephrology continuous care.