Browsing by Author "Goset, Karen"

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    Desarrollo de un programa de Pac para personas mayores con deterioro cognitivo institucionalizadas en un Eleam del sector oriente de Santiago
    (Universidad del Desarrollo. Facultad de Medicina, 2025) Cassis Zarzar, Mayra Naime; Goset, Karen
    Este estudio tiene como propósito explorar el interés de un Establecimiento de Larga Estadía para Adultos Mayores (ELEAM) y de las familias involucradas en la implementación de un sistema de Planificación Anticipada de Cuidados (PAC). Este sistema busca ofrecer una atención más alineada con la voluntad de cada residente y su entorno familiar. La meta es crear un documento de PAC subrogada que forme parte de la rutina del establecimiento, normalizando el diálogo y la preparación en torno a este tema. Los resultados de esta iniciativa podrían no solo contribuir a la comprensión de la importancia de la PAC, sino también facilitar su implementación en el ELEAM. Esto permitiría instaurar un modelo de cuidado que respete la individualidad de cada persona y, por ende, promueva el ejercicio de su autonomía.
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    Knowledge, practice and communication barriers for oncology doctors in Chile when addressing the sexuality of their patients
    (2024) Rojas, Daniela; Micolich, Constanza; Goset, Karen; Salas Ibarra, Sofía Patricia
    Introduction: Communication in a doctor-patient relationship constitutes a crucial aspect in medicine, and its multiple dimensions encompass a wide variety of ethical issues. Communication is particularly relevant in oncology, because it requires continually dealing with sensitive topics in one of the most highly vulnerable situations as a human: illness and proximity to death. Sexuality is one of these topics because it constitutes an area that is frequently affected by cancer and cancer treatment, which may include causing significant distress, the reinforcement of a negative self-image, relationship conflicts and a permanent memory of having cancer. The objective of this research is to describe the perception of knowledge and communications practices used by oncology doctors with respect to sexual health in the care of their patients, as well as the barriers found when it comes to confronting the topic. Methods: An exploratory quantitative, descriptive and cross-sectional study was carried out, in which a self-administered questionnaire was given to oncology doctors who practise in Chile. This questionnaire had 41 closed questions with answers on a Likert scale and was previously validated by being reviewed and applied to a pilot group of five professionals (one medical bioethics expert and four doctors in the field of oncology). The data were analysed with the SPSS statistical program v. 20, using descriptive statistics. Results: The main results show that the surveyed doctors consider sexuality to be an important part of patients' quality of life. However, this finding does not align with the practices given for including it as part of clinical care. The professionals refer as the main barriers those that are attributed to the structural functioning of the institution, giving little value to those barriers related to personal aspects or those associated with patient characteristics and/or behaviors. Conclusion: The results of this study show that, despite oncology doctors seeing sexuality as an important aspect of the quality of life of their patients, they do not include the topic in clinical care. Given that one of the main barriers is obstacles relating to the institution, it is necessary to create political institutions that create the conditions for including this area as a relevant part of cancer patient care.
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    Manejo actual de las metástasis vertebrales: un trabajo en equipo
    (2021) Silva, Álvaro; Bravo, Oscar; Salas, Claudio; Yurac, Ratko; Valencia, Javiera; Goset, Karen; Harbst, Hans; Córdova, Andrés
    La enfermedad metastásica vertebral es frecuente en los pacientes con cáncer avanzado, y conlleva a complicaciones inherentes a su progresión, como lo son la fractura patológica vertebral y la compresión neural metastásica. Se realizó una revisión de los aspectos terapéuticos actuales del manejo de la progresión y de las complicaciones de la enfermedad metastásica vertebral, enfatizando su enfrentamiento sistémico y personalizado. Nuestro objetivo principal es proporcionar información sobre el tratamiento actual de esta afección y la utilidad del manejo sistémico y multidisciplinario.
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    PREDICTIVE MODELS FOR PULMONARY FUNCTION CHANGES AFTER RADIOTHERAPY FOR BREAST CANCER AND LYMPHOMA
    (2012) Sánchez, Beatriz; Goset, Karen; Caviedes, Iván; Delgado, Iris; Córdova, Andrés
    Purpose: To propose multivariate predictive models for changes in pulmonary function tests (DPFTs) with respect to preradiotherapy (pre-RT) values in patients undergoing RT for breast cancer and lymphoma. Methods and Materials: A prospective study was designed to measure DPFTs of patients undergoing RT. Sixty-six patients were included. Spirometry, lung capacity (measured by helium dilution), and diffusing capacity of carbon monoxide tests were used to measure lung function. Two lung definitions were considered: paired lung vs. irradiated lung (IL). Correlation analysis of dosimetric parameters (mean lung dose and the percentage of lung volume receiving more than a threshold dose) and DPFTs was carried out to find the best dosimetric predictor. Chemotherapy, age, smoking, and the selected dose-volume parameter were considered as single and interaction terms in a multivariate analysis. Stability of results was checked by bootstrapping. Results: Both lung definitions proved to be similar. Modeling was carried out for IL. Acute and late damage showed the highest correlations with volumes irradiated above 20 Gy (maximum R2 = 0.28) and 40 Gy (maximum R2 = 0.21), respectively. RT alone induced a minor and transitory restrictive defect (p = 0.013). Doxorubicin-cyclophosphamide-paclitaxel (Taxol), when administered pre-RT, induced a late, large restrictive effect, independent of RT (p = 0.031). Bootstrap values confirmed the results. Conclusions: None of the dose-volume parameters was a perfect predictor of outcome. Thus, different predictor models for DPFTs were derived for the IL, which incorporated other nondosimetric parameters mainly through interaction terms. Late DPFTs seem to behave more serially than early ones. Large restrictive defects were demonstrated in patients pretreated with doxorubicin-cyclophosphamide-paclitaxel.

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