array:23 [
  "pii" => "S1130147304704765"
  "issn" => "11301473"
  "doi" => "10.1016/S1130-1473(04)70476-5"
  "estado" => "S300"
  "fechaPublicacion" => "2004-01-01"
  "aid" => "70476"
  "copyright" => "Sociedad Española de Neurocirugía"
  "copyrightAnyo" => "2004"
  "documento" => "article"
  "crossmark" => 0
  "subdocumento" => "fla"
  "cita" => "Neurocirugia. 2004;15:391-8"
  "abierto" => array:3 [
    "ES" => false
    "ES2" => false
    "LATM" => false
  ]
  "gratuito" => false
  "lecturas" => array:2 [
    "total" => 2416
    "formatos" => array:3 [
      "EPUB" => 21
      "HTML" => 1041
      "PDF" => 1354
    ]
  ]
  "itemSiguiente" => array:18 [
    "pii" => "S1130147304704777"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(04)70477-7"
    "estado" => "S300"
    "fechaPublicacion" => "2004-01-01"
    "aid" => "70477"
    "copyright" => "Sociedad Española de Neurocirugía"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "sco"
    "cita" => "Neurocirugia. 2004;15:398-9"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1592
      "formatos" => array:3 [
        "EPUB" => 16
        "HTML" => 819
        "PDF" => 757
      ]
    ]
    "es" => array:7 [
      "idiomaDefecto" => true
      "titulo" => "Comentario al trabajo&#58; <span class="elsevierStyleItalic">La entrevista con los familiares del paciente neuroquir&#250;rgico</span> de S&#46;D&#46; Vega Basulto"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "398"
          "paginaFinal" => "399"
        ]
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "M&#46; Poxa"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Poxa"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704777?idApp=UINPBA00004B"
    "url" => "/11301473/0000001500000004/v1_201305151224/S1130147304704777/v1_201305151224/es/main.assets"
  ]
  "itemAnterior" => array:18 [
    "pii" => "S1130147304704753"
    "issn" => "11301473"
    "doi" => "10.1016/S1130-1473(04)70475-3"
    "estado" => "S300"
    "fechaPublicacion" => "2004-01-01"
    "aid" => "70475"
    "copyright" => "Sociedad Espa&#241;ola de Neurocirug&#237;a"
    "documento" => "article"
    "crossmark" => 0
    "subdocumento" => "fla"
    "cita" => "Neurocirugia. 2004;15:388-90"
    "abierto" => array:3 [
      "ES" => false
      "ES2" => false
      "LATM" => false
    ]
    "gratuito" => false
    "lecturas" => array:2 [
      "total" => 1755
      "formatos" => array:3 [
        "EPUB" => 15
        "HTML" => 907
        "PDF" => 833
      ]
    ]
    "es" => array:10 [
      "idiomaDefecto" => true
      "titulo" => "Diagn&#243;stico por d&#250;plex transcraneal color de una f&#237;stula car&#243;tido-cavernosa traum&#225;tica"
      "tienePdf" => "es"
      "tieneTextoCompleto" => 0
      "tieneResumen" => array:2 [
        0 => "es"
        1 => "en"
      ]
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "388"
          "paginaFinal" => "390"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "en" => array:1 [
          "titulo" => "Postraumatic carotid-cavernous fistula diagnosed by transcranial color-coded duplex sonography"
        ]
      ]
      "contieneResumen" => array:2 [
        "es" => true
        "en" => true
      ]
      "contienePdf" => array:1 [
        "es" => true
      ]
      "autores" => array:2 [
        0 => array:2 [
          "autoresLista" => "M&#46; Casares-Vivas, J&#46; P&#233;rez-B&#225;ecena, J&#46;M&#46; Abadal-Centellas, J&#46; Homar-Ram&#237;rez"
          "autores" => array:4 [
            0 => array:2 [
              "nombre" => "M&#46;"
              "apellidos" => "Casares-Vivas"
            ]
            1 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "P&#233;rez-B&#225;ecena"
            ]
            2 => array:2 [
              "nombre" => "J&#46;M&#46;"
              "apellidos" => "Abadal-Centellas"
            ]
            3 => array:2 [
              "nombre" => "J&#46;"
              "apellidos" => "Homar-Ram&#237;rez"
            ]
          ]
        ]
        1 => array:2 [
          "autoresLista" => "S&#46; Miralv&#233;s-Celma"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "S&#46;"
              "apellidos" => "Miralv&#233;s-Celma"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "es"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704753?idApp=UINPBA00004B"
    "url" => "/11301473/0000001500000004/v1_201305151224/S1130147304704753/v1_201305151224/es/main.assets"
  ]
  "es" => array:15 [
    "idiomaDefecto" => true
    "titulo" => "La entrevista con los familiares del paciente neuroquir&#250;rgico"
    "tieneTextoCompleto" => 0
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "391"
        "paginaFinal" => "398"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "S&#46;D&#46; Vega-Basulto"
        "autores" => array:1 [
          0 => array:4 [
            "nombre" => "S&#46;D&#46;"
            "apellidos" => "Vega-Basulto"
            "email" => array:1 [
              0 => "svega&#64;finlay&#46;cmw&#46;sld&#46;cu"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "<span class="elsevierStyleSup">¿</span>"
                "identificador" => "cor0005"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:1 [
            "entidad" => "Servicio de Neurocirug&#237;a&#46; Hospital &#8220;Manuel Ascunce Domenech&#8221;&#46; Camag&#252;ey&#44; Cuba"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Correspondencia postal&#58; Servicio de Neurocirug&#237;a&#46; Hospital &#8220;Manuel Ascunce Domenech&#8221;&#46; Camag&#252;ey&#46; Cuba&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "en" => array:1 [
        "titulo" => "The interview with the relatives of the neurosurgical patient"
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "fechaRecibido" => "2003-07-10"
    "fechaAceptado" => "2003-10-11"
    "PalabrasClave" => array:2 [
      "es" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Palabras clave"
          "identificador" => "xpalclavsec158527"
          "palabras" => array:6 [
            0 => "Calidad"
            1 => "Educaci&#243;n m&#233;dica"
            2 => "Entrevista familiar"
            3 => "Etica m&#233;dica"
            4 => "Neurocirug&#237;a"
            5 => "Relaci&#243;n m&#233;dico paciente"
          ]
        ]
      ]
      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Key words"
          "identificador" => "xpalclavsec158526"
          "palabras" => array:7 [
            0 => "Medical education"
            1 => "Medical ethics"
            2 => "Neurosurgery"
            3 => "Physician"
            4 => "Patient relationship"
            5 => "Quality"
            6 => "Relative interview"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">La informaci&#243;n de diagn&#243;sticos&#44; conductas terap&#233;uticas e incapacidades es una tarea dif&#237;cil para los neurocirujanos y muy importante para los familiares&#44; si existen riesgos de muerte o invalidez&#46; La entrevista es el mejor instrumento que tiene el neurocirujano para informar integralmente&#59; pero muchos neurocirujanos j&#243;venes no est&#225;n bien preparados para ofrecer informaci&#243;n m&#233;dica y la labor educativa para capacitarlos todav&#237;a es insuficiente&#46;</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Proporcionar algunas experiencias generales&#44; organizadas y pr&#225;cticas sobre c&#243;mo desarrollar la entrevista con los familiares del paciente neuroquirurgico&#46;</p> <span class="elsevierStyleSectionTitle">Desarrollo</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La importancia de la entrevista demanda de&#58; a&#41; conocimiento de todos los datos del paciente&#44; b&#41; disponer de una conclusi&#243;n diagnostica-terap&#233;utica&#44; c&#41; selecci&#243;n adecuada de los participantes en la entrevista y d&#41; precisar el momento y lugar adecuado donde se va a realizar&#46; Los familiares prefieren un especialista que mantenga una actitud de confianza y sinceridad&#44; que exprese sus ideas con claridad y lentamente&#46; Las explicaciones deben ser simples y directas&#46; Pueden concertarse entrevistas repetidas y este m&#233;todo se puede aplicar tambi&#233;n en los casos emergentes&#46;</p> <span class="elsevierStyleSectionTitle">Conclusi&#243;n</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La entrevista debe realizarse lo antes posible y en cuanto est&#233;n disponible los resultados de las investigaciones m&#233;dicas&#46; Debe evitarse el pesimismo y se dar&#225; apoyo&#44; sin perder el contacto con la realidad&#46; El sacrificio de la informaci&#243;n detallada&#44; por dar m&#225;s importancia a la ciencia&#44; origina muchas cr&#237;ticas a los centros neuroquirurgicos y a los neurocirujanos en las dos o tres &#250;ltimas d&#233;cadas&#46; No debemos conformarnos con la firma de un elemental e insuficiente consentimiento informado&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Summary"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Information of diagnoses&#44; therapeutic managements and inabilities are a very difficult task for neurosurgeons and very important for relatives&#46; The interview is the best instrument that the neurosurgeon has to inform integrally&#59; but many young physicians are not well prepared to deal with medical information and the educational work to achieve it still is insufficient&#46;</p> <span class="elsevierStyleSectionTitle">Objective</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">To provide some general&#44; organized and practical experiences on how to develop the interview with the relatives of the neurosurgical patient&#46;</p> <span class="elsevierStyleSectionTitle">Development</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">The importance of the interview demands of&#58; a&#41; knowledge of the patient&#39;s data&#44; b&#41; reaching a specific diagnosis and appropriate therapy&#44; c&#41; accurate selection of the participants in the interview and d&#41; specify when and where we will met the relatives&#46; Most families prefer a physician that maintains an attitude of trust and sincerity and expressesclearly and slowly his thought&#46; The explanations should be direct and simple&#46; Repeated interviews can be concerted and we will perform a similar interview in emergent cases&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The interview should be carried out as soon as possible and as soon as results of the medical investigations were available&#46; The pessimism should be avoided and support will be given&#44; without losing the contact with the reality&#46; Information&#44; which is sacrifi-ced frequently in the art of the Medicine to give more importance to the science&#44; indeed germinates much of the criticism to neurosurgeons and neurosurgical centers in the last two or three decades&#46; We should not conform with the signature of an elementary and insufficient informed consent&#46;</p>"
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara">Vega-Basulto&#44; S&#46;D&#46;&#58; La entrevista con los familiares del paciente neuroquir&#250;rgico&#46; Neurocirug&#237;a 2004&#59; 15&#58; 391&#8211;399&#46;</p>"
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "Bibliograf&#237;a"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:35 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consentimiento informado en neurocirug&#237;a"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "O&#46; Abdullab-El Rubaidi"
                            1 => "O&#46; El Rubaidi Garc&#237;a"
                            2 => "J&#46;M&#46; Galicia Bulnes"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Neurocirug&#237;a"
                        "fecha" => "2002"
                        "volumen" => "4"
                        "paginaInicial" => "349"
                        "paginaFinal" => "357"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Review and commentary&#58; two studies regarding giving bad news"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "E&#46; Ahmann"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatr Nurs"
                        "fecha" => "1998"
                        "volumen" => "24"
                        "paginaInicial" => "554"
                        "paginaFinal" => "556"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10085998"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La expansi&#243;n del conocimiento cient&#237;fico y las especialidades m&#233;dicas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Ar&#233;chiga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "1997"
                        "volumen" => "133"
                        "paginaInicial" => "85"
                        "paginaFinal" => "88"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La bio&#233;tica y la formaci&#243;n cient&#237;fica del m&#233;dico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Ar&#233;chiga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "2001"
                        "volumen" => "137"
                        "paginaInicial" => "375"
                        "paginaFinal" => "386"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11519364"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Consentimiento informado o desinfor mado&#63; El peligro de la medicina defensiva"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;A&#46; Broggi"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Clin &#40;Bar&#41;"
                        "fecha" => "1999"
                        "volumen" => "112"
                        "paginaInicial" => "95"
                        "paginaFinal" => "96"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Communicating bad news"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "C&#46;A&#46; Chisholm"
                            1 => "D&#46;J&#46; Pappas"
                            2 => "M&#46;C&#46; Sharp"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Obstet Gynecol"
                        "fecha" => "1997"
                        "volumen" => "90"
                        "paginaInicial" => "637"
                        "paginaFinal" => "639"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9380331"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Juramento Hipocr&#225;tico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; De Castro"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "titulo" => "Caduceos y Juramentos m&#233;dicos&#46; Cuadernos de historia de la Salud P&#250;blica&#46; La Habana"
                        "fecha" => "2000"
                        "editorial" => "Ed Ciencias M&#233;dicas"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "An assessment of resident&#39;s competence in the del&#237;very of bad news to patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:3 [
                            0 => "S&#46; Eggly"
                            1 => "N&#46; Afonso"
                            2 => "G&#46; Rojas"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "AcadMed"
                        "fecha" => "1997"
                        "volumen" => "72"
                        "paginaInicial" => "397"
                        "paginaFinal" => "399"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Preserving the physicianpatient relationsbip in the era of managed care"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "E&#46;J&#46; Emanuel"
                            1 => "N&#46;N&#46; Dubler"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "JAMA"
                        "fecha" => "1995"
                        "volumen" => "73"
                        "paginaInicial" => "323"
                        "paginaFinal" => "329"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Giving sad and bad news"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "L&#46; Fallowfield"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "1993"
                        "volumen" => "34"
                        "paginaInicial" => "476"
                        "paginaFinal" => "478"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            10 => array:3 [
              "identificador" => "bib11"
              "etiqueta" => "11&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Las demandas a los m&#233;dicos y los hospitales"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "H&#46; Fern&#225;ndez-Varela"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "2002"
                        "volumen" => "138"
                        "paginaInicial" => "336"
                        "paginaFinal" => "339"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            11 => array:3 [
              "identificador" => "bib12"
              "etiqueta" => "12&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Application of the world wide web to neurosurgical practice"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "T&#46; Fujumaki"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neurosurgery"
                        "fecha" => "1997"
                        "volumen" => "41"
                        "paginaInicial" => "995"
                        "paginaFinal" => "996"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9316068"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            12 => array:3 [
              "identificador" => "bib13"
              "etiqueta" => "13&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teaching medical students how to break bad news"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "A&#46; Garg"
                            1 => "R&#46; Buckman"
                            2 => "Y&#46; Kason"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "CMAJ"
                        "fecha" => "1997"
                        "volumen" => "156"
                        "paginaInicial" => "1159"
                        "paginaFinal" => "1164"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9141988"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            13 => array:3 [
              "identificador" => "bib14"
              "etiqueta" => "14&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Communicating bad news&#58; a pediatric department&#39;s evaluation of a simulated intervention"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "L&#46;W&#46; Geeberg"
                            1 => "D&#46; Ochsenschllager"
                            2 => "R&#46; O&#8217;Donnell"
                            3 => "J&#46; Mastruserio"
                            4 => "G&#46;J&#46; Coh&#233;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Pediatrics"
                        "fecha" => "1999"
                        "volumen" => "103"
                        "paginaInicial" => "1210"
                        "paginaFinal" => "1217"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10353931"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            14 => array:3 [
              "identificador" => "bib15"
              "etiqueta" => "15&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La educaci&#243;n de valores en el curr&#237;culo universitario&#46; Un enfoque psicopedag&#243;gico para su estudio"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "V&#46; Gonz&#225;lez Maura"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Cub Ed Med Sup"
                        "fecha" => "2000"
                        "volumen" => "14"
                        "paginaInicial" => "74"
                        "paginaFinal" => "82"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            15 => array:3 [
              "identificador" => "bib16"
              "etiqueta" => "16&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Reflexiones sobre el caso Bristol y la atenci&#243;n m&#233;dica en M&#233;xico Retos y perspectivas"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "J&#46;L&#46; Hern&#225;ndez Arriaga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "2003"
                        "volumen" => "139"
                        "paginaInicial" => "91"
                        "paginaFinal" => "95"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12666418"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            16 => array:3 [
              "identificador" => "bib17"
              "etiqueta" => "17&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "The Communication of neurological bad news to parents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;S&#46; Jan Mohamed"
                            1 => "J&#46;P&#46; Girvin"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Can J Neurol Sci"
                        "fecha" => "2002"
                        "volumen" => "29"
                        "paginaInicial" => "78"
                        "paginaFinal" => "82"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11858541"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            17 => array:3 [
              "identificador" => "bib18"
              "etiqueta" => "18&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Giving bad news&#58; the family perspective"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "G&#46;J&#46; Jurkovich"
                            1 => "B&#46; Pierce"
                            2 => "L&#46; Pananem"
                            3 => "F&#46;P&#46; Rivara"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Trauma"
                        "fecha" => "2000"
                        "volumen" => "48"
                        "paginaInicial" => "865"
                        "paginaFinal" => "870"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10823529"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            18 => array:3 [
              "identificador" => "bib19"
              "etiqueta" => "19&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "El impacto de la tecnolog&#237;a en la pr&#225;ctica de la profesi&#243;n m&#233;dica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46;R&#46; Kretschmer"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "2002"
                        "volumen" => "138"
                        "paginaInicial" => "339"
                        "paginaFinal" => "341"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            19 => array:3 [
              "identificador" => "bib20"
              "etiqueta" => "20&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Informed consent in neurosurgery&#58; patients recall of preoperative discussion"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "W&#46; Krupp"
                            1 => "O&#46; Spanehl"
                            2 => "W&#46; Laubach"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "ActaNeurochir &#40;Wien&#41;"
                        "fecha" => "2000"
                        "volumen" => "142"
                        "paginaInicial" => "233"
                        "paginaFinal" => "239"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            20 => array:3 [
              "identificador" => "bib21"
              "etiqueta" => "21&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La ense&#241;anza de la &#233;tica m&#233;dica en las facultades y escuelas de medicina de M&#233;xico"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "J&#46;B&#46; L&#243;pez Cabello"
                            1 => "R&#46; Alcaraz Ortiz"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Mex Educ Med"
                        "fecha" => "1991"
                        "volumen" => "2"
                        "paginaInicial" => "219"
                        "paginaFinal" => "221"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            21 => array:3 [
              "identificador" => "bib22"
              "etiqueta" => "22&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La informaci&#243;n al paciente grave y en estado terminal"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Lugones"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Cub Ed Med Sup"
                        "fecha" => "2002"
                        "volumen" => "16"
                        "paginaInicial" => "189"
                        "paginaFinal" => "195"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            22 => array:3 [
              "identificador" => "bib23"
              "etiqueta" => "23&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breaking bads news&#58; experience and attitude ofyoung physicians"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "D&#46; Nielsen"
                            1 => "L&#46; Schmidt"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Ugeskr Laeger"
                        "fecha" => "1997"
                        "volumen" => "159"
                        "paginaInicial" => "2862"
                        "paginaFinal" => "2866"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9190714"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            23 => array:3 [
              "identificador" => "bib24"
              "etiqueta" => "24&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breaking bad news to patients&#58; physician&#39;s perception of the process"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;T&#46; Ptacek"
                            1 => "E&#46;A&#46; Fries"
                            2 => "T&#46;L&#46; Eberhardt"
                            3 => "J&#46;J&#46; Ptacek"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Support Care Cancer"
                        "fecha" => "1999"
                        "volumen" => "7"
                        "paginaInicial" => "113"
                        "paginaFinal" => "120"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10335928"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            24 => array:3 [
              "identificador" => "bib25"
              "etiqueta" => "25&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Muerte cerebral y bio&#233;tica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "R&#46; Ramos Z&#250;&#241;iga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Rev Neurol"
                        "fecha" => "2000"
                        "volumen" => "30"
                        "paginaInicial" => "1269"
                        "paginaFinal" => "1272"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10935263"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            25 => array:3 [
              "identificador" => "bib26"
              "etiqueta" => "26&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Evaluating ethics competence in medical education"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46; Savulescu"
                            1 => "R&#46; Crisp"
                            2 => "K&#46;W&#46;M&#46; Fulford"
                            3 => "T&#46; Hope"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Ethics"
                        "fecha" => "1999"
                        "volumen" => "25"
                        "paginaInicial" => "367"
                        "paginaFinal" => "374"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            26 => array:3 [
              "identificador" => "bib27"
              "etiqueta" => "27&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Communica ting medical bad news&#58; parent&#39;s experiences and preferences"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46;C&#46; Sharp"
                            1 => "R&#46;P&#46; Strauss"
                            2 => "S&#46;C&#46; Lorch"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "J Pediatr"
                        "fecha" => "1992"
                        "volumen" => "121"
                        "paginaInicial" => "539"
                        "paginaFinal" => "546"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1403386"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            27 => array:3 [
              "identificador" => "bib28"
              "etiqueta" => "28&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Giving patients bad news"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "C&#46;E&#46; Shields"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Prim Care"
                        "fecha" => "1998"
                        "volumen" => "25"
                        "paginaInicial" => "381"
                        "paginaFinal" => "390"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9628957"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            28 => array:3 [
              "identificador" => "bib29"
              "etiqueta" => "29&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Genetic disorders in Arabs as for OMIM"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "G&#46;O&#46; Tadmouri"
                            1 => "N&#46;B&#46; Tadmouri"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Neuroscience"
                        "fecha" => "1999"
                        "volumen" => "4"
                        "paginaInicial" => "1"
                        "paginaFinal" => "3"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12553884"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            29 => array:3 [
              "identificador" => "bib30"
              "etiqueta" => "30&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Teaching physicians how to break bad news&#58; a 1-day workshop using standardized parents"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "V&#46;U&#46; Vaidya"
                            1 => "L&#46;W&#46; Greenberg"
                            2 => "K&#46;M&#46; Patel"
                            3 => "L&#46;H&#46; Strauss"
                            4 => "M&#46;M&#46; Pollack"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Arch Pediatr Adolesc Med"
                        "fecha" => "1999"
                        "volumen" => "153"
                        "paginaInicial" => "419"
                        "paginaFinal" => "422"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10201727"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            30 => array:3 [
              "identificador" => "bib31"
              "etiqueta" => "31&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Bio &#233;tica pragm&#225;tica en cirug&#237;a neurol&#243;gica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Velazco"
                            1 => "F&#46; Escobedo"
                            2 => "H&#46; Mateo"
                            3 => "S&#46; G&#243;mez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Gac Med Mex"
                        "fecha" => "1997"
                        "volumen" => "133"
                        "paginaInicial" => "211"
                        "paginaFinal" => "229"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9303869"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            31 => array:3 [
              "identificador" => "bib32"
              "etiqueta" => "32&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Orientaciones &#233;ticas para una buena pr&#225;ctica neuroquir&#250;rgica"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46; Velazco Su&#225;rez"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Arch Neurocien"
                        "fecha" => "1999"
                        "volumen" => "429"
                        "paginaInicial" => "110"
                        "paginaFinal" => "116"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            32 => array:3 [
              "identificador" => "bib33"
              "etiqueta" => "33&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Tea ching medical students to give bad news&#58; does formal instruction help&#63;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "J&#46;T&#46; Vetto"
                            1 => "N&#46;C&#46; Eider"
                            2 => "W&#46;L&#46; Tofler"
                            3 => "S&#46;A&#46; Fields"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1080/08858199909528567"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Cancer Educ"
                        "fecha" => "1999"
                        "volumen" => "14"
                        "paginaInicial" => "13"
                        "paginaFinal" => "17"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10328318"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            33 => array:3 [
              "identificador" => "bib34"
              "etiqueta" => "34&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Breaking of bad news Practical advise to physicians for successful communication with patients"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M&#46; Weber"
                            1 => "A&#46; Werner"
                            2 => "C&#46; Nehring"
                            3 => "F&#46;J&#46; Tentrup"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Med Klin"
                        "fecha" => "1999"
                        "volumen" => "94"
                        "paginaInicial" => "453"
                        "paginaFinal" => "457"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            34 => array:3 [
              "identificador" => "bib35"
              "etiqueta" => "35&#46;"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Responsible conduct regarding scientific communication"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => "M&#46;J&#46; Zigmond"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:4 [
                        "tituloSerie" => "J Neurosci"
                        "fecha" => "2000"
                        "volumen" => "20"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10934248"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "es"
  "url" => "/11301473/0000001500000004/v1_201305151224/S1130147304704765/v1_201305151224/es/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/11301473/0000001500000004/v1_201305151224/S1130147304704765/v1_201305151224/es/main.pdf?idApp=UINPBA00004B&text.app=https://revistaneurocirugia.com/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1130147304704765?idApp=UINPBA00004B"
]
Compartir
Información de la revista
Vol. 15. Núm. 4.
Páginas 391-398 (enero 2004)
Compartir
Compartir
Descargar PDF
Más opciones de artículo
Vol. 15. Núm. 4.
Páginas 391-398 (enero 2004)
La entrevista con los familiares del paciente neuroquirúrgico
The interview with the relatives of the neurosurgical patient
Visitas
2398
S.D. Vega-Basulto
Autor para correspondencia
svega@finlay.cmw.sld.cu

Correspondencia postal: Servicio de Neurocirugía. Hospital “Manuel Ascunce Domenech”. Camagüey. Cuba.
Servicio de Neurocirugía. Hospital “Manuel Ascunce Domenech”. Camagüey, Cuba
Este artículo ha recibido
Información del artículo
Resumen
Introducción

La información de diagnósticos, conductas terapéuticas e incapacidades es una tarea difícil para los neurocirujanos y muy importante para los familiares, si existen riesgos de muerte o invalidez. La entrevista es el mejor instrumento que tiene el neurocirujano para informar integralmente; pero muchos neurocirujanos jóvenes no están bien preparados para ofrecer información médica y la labor educativa para capacitarlos todavía es insuficiente.

Objetivo

Proporcionar algunas experiencias generales, organizadas y prácticas sobre cómo desarrollar la entrevista con los familiares del paciente neuroquirurgico.

Desarrollo

La importancia de la entrevista demanda de: a) conocimiento de todos los datos del paciente, b) disponer de una conclusión diagnostica-terapéutica, c) selección adecuada de los participantes en la entrevista y d) precisar el momento y lugar adecuado donde se va a realizar. Los familiares prefieren un especialista que mantenga una actitud de confianza y sinceridad, que exprese sus ideas con claridad y lentamente. Las explicaciones deben ser simples y directas. Pueden concertarse entrevistas repetidas y este método se puede aplicar también en los casos emergentes.

Conclusión

La entrevista debe realizarse lo antes posible y en cuanto estén disponible los resultados de las investigaciones médicas. Debe evitarse el pesimismo y se dará apoyo, sin perder el contacto con la realidad. El sacrificio de la información detallada, por dar más importancia a la ciencia, origina muchas críticas a los centros neuroquirurgicos y a los neurocirujanos en las dos o tres últimas décadas. No debemos conformarnos con la firma de un elemental e insuficiente consentimiento informado.

Palabras clave:
Calidad
Educación médica
Entrevista familiar
Etica médica
Neurocirugía
Relación médico paciente
Summary
Introduction

Information of diagnoses, therapeutic managements and inabilities are a very difficult task for neurosurgeons and very important for relatives. The interview is the best instrument that the neurosurgeon has to inform integrally; but many young physicians are not well prepared to deal with medical information and the educational work to achieve it still is insufficient.

Objective

To provide some general, organized and practical experiences on how to develop the interview with the relatives of the neurosurgical patient.

Development

The importance of the interview demands of: a) knowledge of the patient's data, b) reaching a specific diagnosis and appropriate therapy, c) accurate selection of the participants in the interview and d) specify when and where we will met the relatives. Most families prefer a physician that maintains an attitude of trust and sincerity and expressesclearly and slowly his thought. The explanations should be direct and simple. Repeated interviews can be concerted and we will perform a similar interview in emergent cases.

Conclusions

The interview should be carried out as soon as possible and as soon as results of the medical investigations were available. The pessimism should be avoided and support will be given, without losing the contact with the reality. Information, which is sacrifi-ced frequently in the art of the Medicine to give more importance to the science, indeed germinates much of the criticism to neurosurgeons and neurosurgical centers in the last two or three decades. We should not conform with the signature of an elementary and insufficient informed consent.

Key words:
Medical education
Medical ethics
Neurosurgery
Physician
Patient relationship
Quality
Relative interview

Artículo

Opciones para acceder a los textos completos de la publicación Neurocirugía
Socio
Socio de la Sociedad Española de Neurocirugía

Si es la primera vez que accede a la web puede obtener sus claves de acceso poniéndose en contacto con Elsevier España en suscripciones@elsevier.com o a través de su teléfono de Atención al Cliente 902 88 87 40 si llama desde territorio español o del +34 932 418 800 (de 9 a 18h., GMT + 1) si lo hace desde el extranjero.

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".

Suscriptor
Suscriptor de la revista

Si ya tiene sus datos de acceso, clique aquí.

Si olvidó su clave de acceso puede recuperarla clicando aquí y seleccionando la opción "He olvidado mi contraseña".
Suscribirse
Suscribirse a:

Neurocirugía

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora
Contactar
Teléfono para suscripciones e incidencias
De lunes a viernes de 9h a 18h (GMT+1) excepto los meses de julio y agosto que será de 9 a 15h
Llamadas desde España
932 415 960
Llamadas desde fuera de España
+34 932 415 960
Email
Idiomas
Neurocirugía
Opciones de artículo
Herramientas
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?