<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0213-9111</journal-id>
<journal-title><![CDATA[Gaceta Sanitaria]]></journal-title>
<abbrev-journal-title><![CDATA[Gac Sanit]]></abbrev-journal-title>
<issn>0213-9111</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Española de Salud Pública y Administración Sanitaria (SESPAS)]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0213-91112024000100219</article-id>
<article-id pub-id-type="doi">10.1016/j.gaceta.2024.102435</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[La eutanasia: un estudio de metodología mixta sobre la experiencia de los referentes en Cataluña]]></article-title>
<article-title xml:lang="en"><![CDATA[Euthanasia: a mixed-methods study on referents&#8217; experience in Catalonia]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Masnou]]></surname>
<given-names><![CDATA[Núria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Quintanas]]></surname>
<given-names><![CDATA[Anna]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Planas]]></surname>
<given-names><![CDATA[Carla]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Planes]]></surname>
<given-names><![CDATA[Albert]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario Dr. Josep Trueta Departamento de Donación y Trasplantes ]]></institution>
<addr-line><![CDATA[Girona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Comisión de Garantía y Evaluación de Catalunya (CGAC)  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad de Girona Departamento de Filosofía Observatorio de Ética Aplicada a la Acción Social, Psicoeducativa y Sociosanitaria]]></institution>
<addr-line><![CDATA[Girona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Hospital Universitario Dr. Josep Trueta Comité de Ética Asistencial ]]></institution>
<addr-line><![CDATA[Girona ]]></addr-line>
<country>España</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Centro de Atención Primaria Santa Eugènia de Berga  ]]></institution>
<addr-line><![CDATA[Barcelona ]]></addr-line>
<country>España</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2024</year>
</pub-date>
<volume>38</volume>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_arttext&amp;pid=S0213-91112024000100219&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_abstract&amp;pid=S0213-91112024000100219&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.isciii.es/scielo.php?script=sci_pdf&amp;pid=S0213-91112024000100219&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Objetivo: Identificar fortalezas y dificultades en la prestación de ayuda a morir (PAM) a partir de la experiencia de los referentes de eutanasia del Instituto Catalán de la Salud (ICS).  Método: Estudio de metodología mixta (n=31) utilizando dos cuestionarios de preguntas cerradas (análisis cuantitativo) y dos entrevistas estructuradas con campos libres (análisis cualitativo), autoadministrados por correo electrónico. Los recibieron todos los referentes del ICS (n=50). Los primeros cuestionario (n=31) y entrevista (n=12) fueron dirigidos a todos los referentes. Los segundos cuestionario (n=7) y entrevista (n=6) fueron dirigidos solo a aquellos que también habían intervenido directamente en una PAM. Los resultados se triangularon y se presentan integrados.  Resultados: De la integración de las respuestas cuantitativas y cualitativas emergieron seis bloques temáticos: 1) dedicación y compensación; 2) formación; 3) puntos débiles y dificultades; 4) impacto emocional y psicológico; 5) consideraciones sobre cuestiones de final de vida; 6) motivaciones y consejos de los referentes. Del análisis conjunto se desprendieron propuestas de mejora: compensar la sobrecarga que supone la PAM, mejorar la formación, asegurar que la objeción de conciencia se ajuste a la ley y revisar aspectos de la LORE, como trámites, plazos, interdisciplinariedad, ambigüedades y supuestos excluidos. Se constató la utilidad de la figura del referente, que respetar la autonomía del paciente compensa las emociones negativas de la mayoría de profesionales, y que la PAM favorece la reflexión sobre los fines de la medicina.  Conclusiones: La experiencia de los referentes puede orientar a otros profesionales y sugerir directrices para responsables institucionales y gestores sanitarios.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Objective: To identify strengths and challenges in the provision of assistance in dying (PAM) based on the experiences of the Catalan Health Institute (ICS) euthanasia referents.  Method: Mixed-methods study (n=31), using two closed-ended questionnaires (quantitative analysis) and two structured interviews with open-ended fields (qualitative analysis), self-administered via email. All ICS referents (n=50) received them. The first questionnaire (n=31) and interview (n=12) were addressed to all referents. The second questionnaire (n=7) and interview (n=6) were directed only to those who had also directly participated in a PAM. The results were triangulated and are presented as an integrated analysis.  Results: From the integration of quantitative and qualitative responses, six thematic blocks emerged: 1) dedication and compensation; 2) training; 3) weak points and difficulties; 4) emotional and psychological impact; 5) considerations on end-of-life issues; and 6) motivations and advice from contacts. From the joint analysis, proposals for improvement were concluded: compensate for the workload that PAM implies, improve training, ensure that conscientious objection is in accordance with the law, and review aspects of the LORE, as procedures, deadlines, interdisciplinarity, ambiguities, and excluded cases. It was established: the usefulness of the referent role; respecting patient autonomy offsets negative emotions in professionals; PAM promotes reflection on the purposes of medicine.  Conclusions: Euthanasia referents&#8217; experiences can guide other professionals and suggest guidelines for institutional leaders and health managers.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Eutanasia]]></kwd>
<kwd lng="es"><![CDATA[Suicidio médicamente asistido]]></kwd>
<kwd lng="es"><![CDATA[Muerte asistida]]></kwd>
<kwd lng="es"><![CDATA[Final de vida]]></kwd>
<kwd lng="es"><![CDATA[Prestación sanitaria]]></kwd>
<kwd lng="es"><![CDATA[Personal sanitario]]></kwd>
<kwd lng="en"><![CDATA[Euthanasia]]></kwd>
<kwd lng="en"><![CDATA[Medically assisted suicide]]></kwd>
<kwd lng="en"><![CDATA[Assisted death]]></kwd>
<kwd lng="en"><![CDATA[End of life]]></kwd>
<kwd lng="en"><![CDATA[Healthcare systems]]></kwd>
<kwd lng="en"><![CDATA[Healthcare providers]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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