Principles Of Care Research Articles

Nontuberculous Mycobacterial Pulmonary Disease: Patients, Principles, and Prospects.

Nontuberculous mycobacterial pulmonary disease (NTM-PD) is increasing in incidence globally and challenging to manage. The 2020 multisociety treatment guideline and the 2022 consensus recommendations provide comprehensive evidence-based guides to manage pulmonary diseases caused by the most common NTM. However, with >190 different NTM species that may require different multidrug regimens for treatment, the breadth and complexity of NTM-PD remain daunting for both patients and clinicians. In this narrative review, we aim to distill this broad, complex field into principles applicable to most NTM species and highlight important nuances, specifically elaborating on the presentation, diagnosis, principles of patient-centered care, principles of pathogen-directed therapy, and prospects of NTM-PD.

Trust, respect, and training: Principles of care for service professionals supporting adults with intellectual disabilities in community residential programs.

Background: Adults with intellectual disabilities in community residential programs receive services from direct support professionals (DSPs) intended to facilitate community engagement. As part of a rate study for Washington State's Developmental Disabilities Administration on community residential services, adults in these programs were asked to provide their perspective on the quality and effectiveness of their care.Method: Twenty-five adults with intellectual disabilities were interviewed focusing on daily activities, staffing, and living situations. Interview transcripts were coded and analyzed for dominant themes.Results: Participants emphasized the desire for trustworthy, caring, and respectful DSPs; DSPs trained in behavioral management techniques made participants feel safe and supported. Nearly all participants called for greater staffing stability.Conclusions: People living in community residential programs are profoundly impacted by the stress and uncertainty of DSPs facing limited resources and high staff turnover. Stable, consistent support makes it easier for participants to engage in community integration.

20 years on from the Dublin Declaration: European Committee for the Prevention of Torture and Inhuman or Degrading Treatment reporting on the provision of prison needle and syringe programmes in the Council of Europe region

BackgroundPrisons in Europe remain high-risk environments and conducive for infectious disease transmission, often related to injection drug use. Many infected people living in prison unaware of their infection status (HIV, hepatitis C). Despite all Council of Europe (CoE) member states providing community needle and syringe programmes (NSP), prison NSP are limited to seven countries. The study aim was to scrutinise the Committee for the Prevention of Torture and Inhuman or Degrading Treatment (CPT) reporting of periodic and ad hoc country mission visits to prisons, with an explicit focus on the extent to which member states are/were fulfilling obligations to protect prisoners from HIV/hepatitis C; and implementing prison NSP under the non-discriminatory equivalence of care principle. Study designSocio-legal review. MethodsA systematic search of the CPT database was conducted in 2024 with no date restriction. All CPT reports were screened in chronological order with the terms; “needle”, “syringe”, “harm reduction” and “NSP”. Relevant narrative content on prison NSP operations, including repeat CPT reminders and any official/publicly expressed reasons for not implementing is presented. ResultsCPT reporting reveals limited prison NSP provision in selected prisons visited on mission, with little change in status over time, despite documented evidence of prior observations around absent/insufficient harm reduction measures and explicit (often longstanding) recommendations to address deficits. Reasons for not implementing prison NSP include; existing availability of opioid substitute treatment, lack of evidence for injecting drug use, for security and maintenance of order, and contradiction with prison protocols sanctioning drug use. ConclusionsPrison health is public health. Regular research and evaluations of prison NSP in Europe are warranted. Future CPT visits should also continue to assess availability and standards of provision; recommend where appropriate including when opioid substitute treatment is already provided, and in line with broad availability of community NSP in Europe.

Age of hepatitis B e antigen loss in Aboriginal, Torres Strait Islander and non-Indigenous residents of tropical Australia; implications for clinical care.

This study determined the hepatitis B e antigen (HBeAg) status of people living with chronic hepatitis B (CHB) in Far North Queensland (FNQ), Australia and their age of HBeAg loss. It was hoped that this would provide data to explain the stark difference in the incidence of hepatocellular carcinoma (HCC) between Aboriginal and Torres Strait Islander individuals living with CHB in FNQ, a finding that has been hypothesised to relate to differences in hepatitis B virus genotype. We identified every FNQ resident with CHB, determined their country of birth, their HBeAg status, the age they lost HBeAg and whether they identified as an Aboriginal, a Torres Strait Islander or a non-Indigenous individual. We then ascertained whether these demographic and virological variables were correlated. Of 1,474 individuals living with CHB in FNQ, 278 (19%) were Aboriginal, 507 (34%) were Torres Strait Islanders and 689 (47%) were non-Indigenous. Aboriginal individuals were less likely to be HBeAg positive (26/278, 9%) than Torres Strait Islander (91/507, 18%) and non-Indigenous (126/689, 18%) individuals, p < 0.0001. Aboriginal individuals lost HBeAg at an earlier age (median (interquartile range): 30 (23-39) years) than Torres Strait Islander (38 (29-49) years) and non-Indigenous (36 (29-47) years) individuals, p < 0.0001. Aboriginal individuals with CHB in FNQ are more likely to be HBeAg negative than Torres Strait Islander and non-Indigenous individuals and lose HBeAg at a younger age. This provides a biological basis for local clinicians' observation that Aboriginal individuals with CHB in FNQ are at a lower risk of HCC and data to support the principle of genotype-based care in the region.

An App Platform-Facilitated Collaborative Palliative Care Intervention for Outpatients With Interstitial Lung Disease: A Pilot Randomized Trial.

Rationale: Outpatients with interstitial lung disease often experience serious symptoms, yet infrequently receive palliative care. Objective: To determine the feasibility and clinical impact of a mobile application (PCplanner) in an outpatient setting. Methods: We conducted a pilot randomized controlled trial among adults with interstitial lung disease in a single-center academic clinic. Clinical outcomes included change in Needs at the End-of-Life Screening Tool (NEST) scale between baseline and 3 months as well as frequency of advance care planning discussions and referrals to palliative care services. Results: Observed feasibility outcomes were similar to targeted benchmarks including randomization rates (82.1% vs 80%) and retention (84.8% vs 80%). Mean NEST scores between the intervention and control group were 38.9 (SD, 18.9) vs 41.5 (SD, 20.5) at baseline, 34.6 (SD, 18.9) vs 33.6 (SD, 19.4) at 1 month after clinic visit, 40.5 (SD, 21.6) vs 35.3 (SD, 25.0) at 3 months after clinic visit. Changes in NEST scores between baseline and 3 months showed no difference in the primary outcome (P = 0.481, 95% CI [-8.45, 17.62]). Conclusion: Among patients with interstitial lung disease, a mobile app designed to focus patients and clinicians on palliative care principles demonstrated evidence of feasibility. Although changes in self-reported needs were similar between intervention and control groups, more patients in the intervention group updated their advance directives and code status compared to the control group. Clinical Trial Registration: Palliative Care Planner (PCplanner) NCT05095363. https://www.clinicaltrials.gov/study/NCT05095363.

Immediate and delayed flap reconstruction have equivalent outcomes and associated costs following soft tissue sarcoma surgery.

Surgical treatment of soft tissue sarcoma (STS) involves wide resection of the tumor, which can necessitate soft tissue reconstruction with local or free tissue flaps. This retrospective study compares cost, surgical and oncologic outcomes between patients undergoing reconstruction with immediate versus delayed flap coverage following STS resection. Thirty-four patients who underwent planned flap reconstruction following resection of primary STS were identified retrospectively. Twenty-four (71%) received immediate reconstruction during the index surgery and 10 (29%) underwent planned delayed reconstruction. Preoperative patient-specific metrics, tumor characteristics, and surgical and patient outcomes were collected. Total hospital charges associated with every encounter during the perioperative period were obtained. Patient demographics, comorbidities, tumor metrics, and surgical characteristics were equivalent between groups. Postoperative wound complications, reoperations, readmissions, and disease-specific survival did not differ between cohorts. Costs associated with each reconstruction strategy were equivalent on bivariate and multivariate testing, when accounting for operating room time, hospital length of stay, and reoperation rate. Our study identifies no significant difference in patient outcome measures or cost between planned immediate and delayed flap reconstruction following STS resection. These results support the implementation of either treatment strategy in keeping with patient-centered, multidisciplinary care principles.

Analisis Perilaku Konsumtif Mahasiswa pada Penggunaan E-commerce dalam Perspektif Maqashid al-Syariah

This research is based on many of university students who use e-commerce. The purpose of this study is to find out students' behavior in buying goods in e-commerce and whether they use the principles of maqashid al-sharia or not. The principles of maqashid al-sharia used are the maintenance of religion (hifz al-din), the maintenance of the soul (hifz al-nafs), the maintenance of reason (hifz al-‘aql), the maintenance of offspring (hifz al-nasl), the maintenance of assets (hifz al-mal), and the maintenance of the environment (hifz al-biah). This research is qualitative research with a phenomenological abbreviation. The sampling technique in this study is purposive sampling. This sample of research totaled 45 1st level students of Sultan Ageng Tirtayasa University. The results of the study show that students have not fully used the principles of maqashid sharia in the use of e-commerce, so students behave consumptuantly. In the principle of religious protection, it is known that not all students buy goods with the intention of worship, in the principle of preserving reason, students cannot decide properly the priority of the goods to be purchased, on the principle of spiritual care, students cannot resist the lust to buy goods that are by the usefulness, on the principle that the descendants of students have not been able to save money for the future, In the principle of assets, students were found to use the pay later feature. And on the principle of protecting the environment, students still need education in the recycling system of goods that have been purchased.

Does maternity care in Australia align with the national maternity Strategy? Findings from a national survey of women’s experiences

BackgroundWomen Centred Care: Strategic directions for Australian maternity services (the Strategy), released in November 2019, provides national guidance on effective maternity care provision. The Strategy is structured around four core values (safety, respect, choice, and access) underpinning twelve woman-centred care principles. AimTo explore whether the experiences of women who accessed Australian maternity services were aligned with the Strategy’s values and principles. MethodsWomen who had completed an entire maternity care episode in Australia between January 2020 and June 2023 were invited to participate in an online survey. Women’s experiences according to the Strategy’s values and principles and their association with model of care, age, place of residence, educational attainment, and household income are reported. FindingsThe survey was completed by 1750 women. A proportion of women perceived the Strategy’s values were not reflected in the care they experienced. At its lowest, only 50.3 % of women received an aspect of care that mostly or always aligned with the values, and 85.9 % at its highest. Women in private models of care were more likely to experience care according to the Strategy. Women in standard and high-risk public hospital care, rural/remote dwelling women, and younger women were less likely to experience care accordingly. Care was universally perceived to be worse in the postnatal period. ConclusionDespite articulating how Australian maternity care should be provided, the intent of the Strategy has not been fully realised. Inequities exist in women’s access to and experiences of care across the entire maternity episode.

Sexual and Reproductive Healthcare Needs of Refugee Women Exposed to Gender-Based Violence: The Case for Trauma-Informed Care in Resettlement Contexts.

This paper assesses literature regarding the sexual and reproductive healthcare (SRH) needs of resettled refugee women who experienced gender-based violence (GBV) and trauma-informed care (TIC) principles utilized among SRH service providers. A systematic search identified relevant studies published between 2000 and 2021; no articles found reflected both SRH and TIC principles among refugee women. The search was therefore separated into two aims: to review the literature about SRH needs for refugee women in resettlement countries who experienced GBV (Aim 1) and to examine the use of TIC principles in SRH care among women who experienced GBV (Aim 2). Thematic analysis of the articles identified key themes. Twenty-six articles were included in the analysis across both aims (Aim 1 = 8, Aim 2 = 18). Aim 1 articles shared three factors shaping the SRH needs of resettled refugee women: the centrality of violence and trauma; structural barriers to SRH care; and actions, practices, and resources for service providers. Aim 2 articles illustrated seven key principles of TIC used in SRH service provision, such as empowerment; trauma-specific services and integrated care; connection; safety; collaboration; identity culture and context; and trustworthiness. Resettled refugee women's experiences of violence necessitate trauma-informed SRH health care. While there is limited peer-reviewed literature regarding TIC-SRH care for refugee women, the findings regarding the SRH needs of refugee women and the findings regarding the implementation of TIC in SRH collectively frame recommendations for how SRH can be infused with TIC. An example from practice, in the form of the Refugee Women's Health Clinic, is included as an exemplar of TIC SRH principles in action for the health of resettled refugee women who have survived gendered violence.

2252 Competencies required by all hospital doctors caring for older adults: a group concept mapping study

Abstract Introduction It is increasingly recognised that for the foreseeable future most hospital inpatient contacts with older adults will be completed by doctors not specifically trained in geriatric medicine. To guarantee the delivery of sufficient healthcare, it is essential that every hospital doctor is equipped with geriatric medicine competencies. Which exact competencies are required and how they should be prioritised for hospital doctors serving the older adult population remains unclear. Allowing for the broad, complex and multidisciplinary nature of geriatric medicine, we carried out a group concept mapping (GCM) study to determine the geriatric medicine competencies required by all hospital doctors. Methods GCM is a mixed methods approach utilising six phases to generate expert group consensus, enabling participants to organise and represent their ideas in order to identify a common understanding about competencies required by all hospital doctors. Healthcare professionals, patient advocacy groups and clinical educators generated and sorted ideas and then rated identified competencies. Hierarchical cluster analysis and multi-dimensional scaling were utilised to analyse participant input. Results Thirty-four stakeholders generated 88 competencies. Twenty completed the subsequent sorting and rating of competencies. Nine competency domains were identified by participants as integral for all hospital doctors to care for older adults: communication skills, medicolegal affairs, prescribing, delirium, falls and bone health, engaging specialist services, universal principles of care, managing hospitalisation and components of specialist gerontology. Domains rated most important related to interpersonal communication skills, medicolegal concerns, recognition, and management of delirium. Conclusion The nine competency domains indicate the diverse skillset required by all doctors to provide comprehensive care to older adults within a hospital setting. This study identifies competencies that may serve as a foundational framework for ensuring quality healthcare for the ageing population. Future initiatives should consider incorporating these competencies to improve inpatient care provided by hospital doctors to older adults.

Transitional Palliative Care for Family Caregivers: Outcomes From a Randomized Controlled Trial

ContextPatients receiving inpatient palliative care often face physical and psychological uncertainties during transitions out of the hospital. Family caregivers often take on responsibilities to ensure patient safety, quality of care, and extend palliative care principles, but often without support or training, potentially compromising their health and well-being. ObjectivesThis study tested an eight-week intervention using video visits between palliative care nurse interventionists and caregivers to assess changes in caregiver outcomes and patient quality of life. MethodsThis randomized controlled trial, conducted from 2018 to 2022, enrolled adult caregivers in rural or medically underserved areas in Minnesota, Wisconsin, and Iowa. Eligible caregivers included those caring for patients who received inpatient palliative care and transitioned out of the hospital. The intervention group received teaching, guidance, and counseling from a palliative care nurse before and for eight weeks after hospital discharge. The control group received monthly phone calls but no intervention. Caregiver outcomes included changes in depression, burden, and quality of life, and patient quality of life, as reported by the caregiver. ResultsOf those consented, 183 completed the intervention, and 184 completed the control arm; 158 participants had complete baseline and eight-week data. In unadjusted analyses, the intervention group and their care recipients showed statistically significant improvements in quality of life compared to the control group. Improvements persisted in adjusted analyses, and depression significantly improved. No differences in caregiver burden were observed. ConclusionAddressing rural caregivers’ needs during transitions in care can enhance caregiver outcomes and improve patient quality of life.

Impact of family-centered Care on Parenting Role and Sense of Competence in Parents of Preterm Neonates: a quasi-experimental study

BackgroundImplementing a family-centered care approach can empower parents to care for their premature infants, positively influencing their sense of competence and parenting role. This study aims to investigate the impact of family-centered care within the context of newborn care on the sense of competence and parenting role of parents with preterm infants who were hospitalized in neonatal intensive care units (NICUs) in Iran. MethodsThis quasi-experimental study employed a design with two groups in neonatal intensive care units (NICUs) located in Kerman, Iran. The research sample consisted of 90 parents. The intervention group received training based on the principles of family-centered care and actively participated in caring for their infants in the intensive care unit. Both groups completed the Parenting Sense of Competence Scale and the Parenting Role Tasks Questionnaire before the intervention, seven days after the intervention, and three months after the intervention. ResultsFollowing the implementation of the family-centered care intervention, the experimental group exhibited a relatively higher increase in the sense of competence score (83.42±6.66) compared to the control group (57.60±9.45). Similarly, the experimental group had a higher mean parenting role score (87.95±6.45) than the control group (54.77±11.80). ConclusionThe study findings suggest that implementing the family-centered care program develops training packages based on the principles of family-centered care for nurses working in neonatal intensive care units. This training will help parents of hospitalized infants enhance their sense of competence and improve their parenting role.

Using Social Learning Spaces to Think Beyond and Innovate Conventional Conferencing Formats

Across the academic landscape, scientific organizations host conferences that enable researchers to come together to foster learning, stimulate innovation, and promote change. Within the diverse field of kinesiology, conferences can help develop and disseminate knowledge on a range of issues such as athlete development and coach education. The purpose of the present article is to discuss the possibilities of thinking beyond conventional conferencing formats by creating dynamic social learning spaces that promote networking, critical thinking, and reflexivity. The theory underpinning social learning spaces is explained, followed by a narrative chronology of the three phases of evolution of the blue room group, an interdisciplinary collaboration of youth sport scholars who aim to foster innovation across subdisciplines of kinesiology. An interpretative summary of the blue room group as a social learning space is presented, in accordance with the principles of caring to make a difference, engaging uncertainty, and paying attention. The perceived benefits of kinesiology, as well as the challenges and limitations of the blue room, are discussed based on the authors’ experiences operating within a continuously evolving and shifting social learning space.

Perlindungan Konsumen Terhadap Produk Pangan Berkemasan Plastik Yang Mengandung Bisphenol-A (BPA)

Introduction: Consumer rights, namely consumer comfort, security and safety are absolute and non-negotiable, including in consuming food products packaged in plastic.Purposes of the Research: This study aims to analyze consumer protection for plastic-packaged food products containing Bisphenol A (BPA).Methods of the Research: The type of legal research used to examine this issue is normative juridical, where this research is based on what is written in the laws and regulations. This research method is based on primary and secondary legal materials and uses a statute approach and a conceptual approach.Results of the Research: The Due Care principle can be used as a benchmark if it is related to the problem of food product packaging containing BPA. This is because the interests of consumers are vulnerable to being misused by business actors who only pursue large profits and because business actors are in a profitable position, business actors have an obligation to pay attention to ensure that consumer interests are not misused. Consumers are always in a vulnerable position if there are business actors who ignore consumer rights. The use of BPA in plastic packaging for food products that does not comply with the provisions is clearly an illegal act. Preventive consumer protection can be carried out by the government through a number of regulations governing provisions regarding food product packaging. Repressive protection can be provided by the government by imposing strict sanctions on business actors who produce food products in plastic packaging containing BPA

Application of foot massage therapy to reduce pain scale of elderly with rheumatoid arthritis

Rheumatoid Arthritis (RA) is a chronic autoimmune disorder characterized by systemic inflammation, joint damage, and persistent pain, particularly in older adults. The debilitating nature of RA significantly impairs individuals' quality of life, leading to diminished independence and increased reliance on pharmacological interventions. While pharmaceutical treatments play a crucial role in managing RA symptoms, complementary and alternative therapies, such as massage, have garnered attention for their potential to alleviate pain and improve overall well-being. This study adopts a descriptive approach to examine the efficacy of foot massage as an intervention for RA-related pain in older adults. Two participants diagnosed with RA were selected for the case study. Family nursing care principles were integrated into the intervention to provide holistic support. Pain scale assessments were conducted before and after each foot massage session to measure changes in pain intensity. Analysis of the data revealed a significant reduction in pain intensity among participants following the foot massage sessions. Pain levels decreased from moderate to mild, indicating the efficacy of foot massage in alleviating RA-associated pain in older adults.The findings of this study support the notion that foot massage can serve as a viable intervention for managing RA-related pain in older adults. The mechanisms underlying the efficacy of foot massage, including its ability to stimulate vasodilation and enhance endorphin production, highlight its potential therapeutic benefits for individuals grappling with RA. Foot massage emerges as a promising adjunctive therapy for alleviating pain and improving the well-being of older adults living with Rheumatoid Arthritis. Integrating foot massage into holistic care approaches can enhance pain management strategies and contribute to the overall quality of life for individuals affected by this debilitating condition. Further research is warranted to explore the long-term effects and optimal frequency of foot massage in RA management.

The Pararectus approach: a preferred surgical approach for fixation of acetabular fractures predominantly involving the anterior column - a narrative review.

Beginning in France in the 1960s, the management of acetabular fractures has increasingly evolved toward surgical treatment strategies. The basic principles established by the pioneers of acetabular surgery, Letournel and Judet - anatomical reconstruction of the joint and stable osteosynthesis - remain unchanged. Modern advancements in surgical techniques aim to reduce access-related trauma and minimize complications. The notable rise in acetabular fractures among the elderly, which predominantly affect the anterior aspects of the acetabulum, has driven the development of less invasive, soft tissue-sparing anterior approaches. This evolution began with the ilio-inguinal approach in the 1960s, progressed to the modified Stoppa approach in the 2000s and, most recently, the Pararectus approach in the 2010s. Each of these approaches upholds the fundamental principles of effective acetabular fracture care, while offering distinct advantages and disadvantages. In this review, we examine the merits and limitations of the Pararectus approach, specifically focusing on its utility in the surgical treatment of anterior column posterior hemitransverse acetabular fractures. Ultimately, the success of the individual patient's outcome is less dependent on the chosen approach and more on the surgeon's experience and expertise. Ideally, surgeons should be proficient in all these approaches to tailor the surgical strategy to the individual patient's requirements, thereby ensuring optimal outcomes.

Striking the Balance: Embracing Technology While Upholding Humanistic Principles in Neurorehabilitation

Background The rapid advancement of technology-focused strategies in neurorehabilitation has brought optimism to individuals with neurological disorders, caregivers, and physicians while reshaping medical practice and training. Objectives We critically examine the implications of technology in neurorehabilitation, drawing on discussions from the 2021 and 2024 World Congress for NeuroRehabilitation. While acknowledging the value of technology, it highlights inherent limitations and ethical concerns, particularly regarding the potential overshadowing of humanistic approaches. The integration of technologies such as robotics, artificial intelligence, neuromodulation, and brain-computer interfaces enriches neurorehabilitation by offering interdisciplinary solutions. However, ethical considerations arise regarding the balance between compensation for deficits, accessibility of technologies, and their alignment with fundamental principles of care. Additionally, the pitfalls of relying solely on neuroimaging data are discussed, stressing the necessity for a more comprehensive understanding of individual variability and clinical skills in rehabilitation. Results From a clinical perspective, the article advocates for realistic solutions that prioritize individual needs, quality of life, and social inclusion over technological allure. It underscores the importance of modesty and honesty in responding to expectations while emphasizing the uniqueness of each individual’s experience. Moreover, it argues for the preservation of human-centric approaches alongside technological advancements, recognizing the invaluable role of clinical observation and human interaction in rehabilitation. Conclusion Ultimately, the article calls for a balanced attitude that integrates both scientific and humanistic perspectives in neurorehabilitation. It highlights the symbiotic relationship between the sciences and humanities, advocating for philosophical questioning to guide the ethical implementation of new technologies and foster interdisciplinary dialogue.

Implementation of evidence-based practice in paediatric nursing care: Facilitators and barriers

BackgroundEvidence-based practice (EBP) is widely recognised in healthcare as a means of improving patient outcomes by incorporating patient preferences, clinical experience, and rigorous research. Although it has demonstrated potential in promoting healthcare, increasing patient safety, and reducing costs, there are still challenges in implementing and applying EBP in practice. The aim of this study was to explore the barriers and facilitators identified by nurses concerning the implementation of EBP in the care provided to children and their families. MethodsTwo focus groups were held with a total of 32 nurses from a paediatric unit of a university hospital. The qualitative data were organised using NVivo, and thematic analysis was undertaken following Bardin’s three-phase process. FindingsThree categories emerged: Facilitators for the Implementation of EBP, Barriers to the Implementation of EBP, and Family and Child-Centred Care in Clinical Practice. The main facilitators are the presence of mentors, institutional recognition, an environment that promotes EBPs, and the interest and motivation of the team. The main barriers highlighted were unassertive intradisciplinary and interdisciplinary communication, time management, tradition, and inexperience in research. Organisations must implement policies that promote environments conducive to EBP. ConclusionIt is crucial to prioritise ongoing professional development, integrate this practice into nursing education, promote innovative organisational cultures, and embrace the principles of Family-Centred Care. Nurses recognise the importance of mentors as key to implementing this practice.

Ethics in Primary Health Care: Responsibilities in Patient Care. Bibliographic review

Medical ethics is essential at the first level of care, where doctors must guarantee the autonomy of patients and equity in terms of health care, according to the World Health Organization (WHO), the International Code of Medical Ethics of the World Medical Association (AMM) and the Ministry of Public Health of Ecuador mention that ethical principles must be implemented and guaranteed in the Primary Health Care physician, the objective of this review is to describe the ethical and moral principles that form part of the doctor in Primary Health Care through reviews of updated bibliographies. It was described that the ethical and moral principles of Primary Health Care are benevolence, justice, wisdom and solidarity and within the main bases on which ethics is focused is the doctor-patient relationship that allows clarifying the correct action on health problems.

Collaborative goal setting in palliative rehabilitation: a case report

BackgroundPalliative rehabilitation amalgamates the principles of palliative care and rehabilitation to enhance patients’ quality of life by optimizing physical function and maximizing autonomy despite advancing illness. Alongside providing non-pharmacological symptom management, it emphasizes personalized goal-setting tailored to individual needs. This case illustrates the transformative impact targeted physiotherapy interventions can have on patients’ physical function, morale and motivation in spite of their expected deterioration.Case presentationAn 85-year-old male with angioimmunoblastic T cell lymphoma was admitted to home hospice care. He was referred for physiotherapy to optimize his function and mobility despite his short prognosis. A conversation guide was used throughout the duration of therapy to identify personal goals, prescribe and review the use of appropriate interventions, and discuss future therapeutic plans. Within a month he achieved his functional goals, experienced reduced physical dependency, and had increased satisfaction in his ability to participate more actively in self-care. This also resulted in significant improvements in his confidence, mood, and overall well-being. Engaging the patient actively in his care and management journey provided him with significant motivation and hope.ConclusionThe case study highlights the vital role of physiotherapists in facilitating transparent communication among patients, healthcare providers, and caregivers throughout palliative rehabilitation. Through open dialogue and utilizing conversation guides, physiotherapists help understand patient preferences, goals, and motivation. This patient-centred approach ensures that therapeutic interventions align with individual needs, enhancing overall patient care and the provision of holistic palliative care.