medigraphic.com
ISSN 1561-3011 (Electronic)

2015, Number 1

Next >>

Rev Cubana Invest Bioméd 2015; 34 (1)

Reflections on the practice and sociocultural perception of clinical autopsy at the Medical School of Benguela, Angola

Hernández PYZ, Agüero CFC

Language: Spanish
References: 54
Page: 1-17
PDF size: 179.31 Kb.


ABSTRACT

Introduction: as a practice in medical research to diagnose causes of death, autopsy has shown to be relevant throughout history. However, it currently exhibits a declining tendency. The reasons for this are manifold, an outstanding role being played by sociocultural processes and factors in Africa and particularly in Benguela, Angola. Contemporary science shows the close relationship between health, medical practice and cultural processes.
Objective: assess the sociocultural perception of clinical autopsy among medical students.
Methods: an exploratory observational descriptive study was conducted based on document analysis of local culture and history. Observation of five funerary processes led to the development of a questionnaire which was applied to 99 students from Benguela Medical School. Three variables were evaluated: sociocultural processes mediating the social perception of autopsy, sociocultural factors among students and opinions about autopsy.
Results: sociocultural conceptions and perceptions of death in the Ovimbundu ethnic group inhibit the scientific search for its causes. Observation of five funerary processes and exploration through a questionnaire applied to 99 medical students revealed limitations and contradictions in relation to these processes irrespective of the academic year being attended.
Conclusions: autopsy is a scientific tool useful to verify the quality of health care services. However, in the context analyzed sociocultural perceptions by the Ovimbundu culture hamper its scientific approach, leading to a variety of contradictions. Training should include a more profound treatment of the topic.


REFERENCES

  1. de Mendoza Amat JH. Autopsia. Garantía de la calidad en medicina; Cap.1. Antecedentes históricos; Cap 2. Definición, beneficios e importancia de la autopsia. La Habana: Editorial Ciencias Médicas. 2009;4,9:14-18.

  2. Espert AN. Aproximación a la Historia de las Autopsias: IV. S. XVII Barroco. S. XVIII Ilustración. S. XIX Romanticismo. Rev Electrónica Autops. 2005 Sep 23;2(1):26–41

  3. Petri CN. Decrease in the frequency of autopsies in Denmark after the introduction of a new autopsy act. International Journal for Quality in Health Care. 1993 Dec;5(4):315-8.

  4. Eriksson L, Sundström C. Decreasing autopsy rate in Sweden reflects changing attitudes among clinicians. International Journal for Quality in Health Care. 1993 Dec;5(4):319-23.

  5. Xiao J, Krueger GRF, Buja LM, Covinsky M. The impact of declining clinical autopsy: need for revised healthcare policy. Amer. Journal of Medical Science. 2009 Jan;337(1):41–6.

  6. Kahl A. Public perceptions of hospital autopsies: results of a representative survey. Pathol. 2011;32(4):345–8.

  7. Oluwasola OA, Fawole OI, Otegbayo AJ, Ogun GO, Adebamowo CA, Bamigboye AE, et al. The Autopsy: Knowledge, Attitude, and Perceptions of Doctors and Relatives of the Deceased. Arch Pathol Lab Med. 2009 Jan 1;133(1):78–82.

  8. Duband S, Méon A-S, Forest F, Prades J-M, Cathébras P, Phelip J-M, et al. An opinion survey about medical autopsy, Saint-Étienne University Hospital: are the French laws of bioethics to be revised?. Rev Médecine Interne Fondée Par Société Natl Francaise Médecine Interne. 2011 Apr;32(4):205–11.

  9. Gallo ÁE, Fernández FF. La autopsia clínica en la web: aspectos generales. Rev Esp Patol. 2003;36(3):267–82.

  10. de Mendoza Amat JH, Montero González T. Es útil realmente realizar autopsias? Rev Cuba Med Mil. 2008;37(1).

  11. de Mendoza Amat JH, Santana RÁ. Situación de la autopsia en Cuba y el mundo. La necesidad de su mejor empleo. Patol Rev Latinoam. 2009;47(3).

  12. Bernal BM. La importancia de la autopsia en la formación del médico en una comunidad colombiana. Rev Electrónica Autops. 2013 May 12;11(1):17–21.

  13. de Mendoza Amat JH. La Autopsia. Experiencia Cubana. Rev Electrónica Autops. 2003 Dec 1;1(1):3–9.

  14. Tóth C. The role of autopsies in 21st century medicine. Orv Hetil. 2010 Mar 28;151(13):542–6.

  15. Schneider W. Death is not the same always and everywhere’ – sociocultural aspects of brain death and the legislation of organ transplantation. Eur Soc. 1999 Enero;1(3):353–89.

  16. Da Rocha A. Relatório económico de Angola 2011. Primeira. Luanda, Angola: Textos Editores. 2012:336p.

  17. De Carvalho P. Exclusão Social em Angola: O caso de dos deficientes físicos de Luanda. 1ra Edición. Luanda, Angola: Editorial Kilombelombe;2008.

  18. Klugman J. Relatório do Desenvolvimento Humano. Sustentabilidade e Equidade: Um Futuro Melhor para Todos. [Internet]. New York. USA: Programa das Nações Unidas para o Desenvolvimento. 2011 [cited 2013 Oct 26]. Available from: http://www.hdr.undp.org

  19. República de Angola. Governo da Província de Benguela. Plano de Desenvolvimento Económico e Social 2009-2013. Versão II. SEPE. Secção de Estudo, Planeamento e Estatística. Administração de Benguela; 2008.

  20. WORLD HEALTH ORGANIZATION. World Health Statistics. Health-related Millennium Development Goals. [Internet]. Geneva, Switzerland: WHO, Press; 2010 [cited 2012 Nov 14]. 177 p. Available from: www.who.org/

  21. WORLD BANK. Angola. Report No. 39829. Country Assistance Evaluation. Country Evaluation and Regional Relations. Independent Evaluation Group. pp. 1 -102 [Internet]. World Bank; 2007 [cited 2011 Sep 10]. Available from: www.worldbank.org/angola

  22. WORLD BANK. Doing Business. Smarter Regulations for Small and Medium-Size Enterprises. [Internet]. Creative Commons Attribution CC BY 3.0. Washington. DC. USA. World Bank Group. 2013 [cited 2013 May 21]. Available from: http://www.doingbusiness.org

  23. International Monetary Fund. IMF Annual Report. Promoting a more secure and stable global economy. [Internet]. Washington. DC. USA. IMF Publishing; 2013 [cited 2013 Jun 19]. Available from: http://www.imf.org

  24. Agüero Contreras FC. Sociedad, Cultura y Currículum Escolar. Germany. Wissenschaftlicher Verlag Berlin WVB. 2006.

  25. Agüero Contreras FC. Perspectiva sociocultural, educación ambiental y socialización en el campo: Innovar el curriculum. Espac Abierto Cuad Venez Sociol. 2011 Mar;20(1):25–49.

  26. Levis-Strauss C. La estructura social. Antropología Lecturas. Segunda. Félix Varela. La Habana, Cuba. 2003:440–74.

  27. Harris M. Antropología Cultural. Salamanca, España: Alianza Editorial; 2001. 311 p.

  28. Ribeiro D. El proceso civilizatorio: etapas de la evolución sociocultural. Ediciones de la Biblioteca Universidad Central de Venezuela;1970.

  29. UNESCO. Década das Nações Unidas para o Desenvolvimento Sustentável, 2005- 2014. Documento Final Plano Internacional de implementação. Edições UNESCO. Brasilia; 2005.

  30. Smith D, Roofe M, Ehiri J, Campbell-Forrester S, Jolly C, Jolly P. Sociocultural contexts of adolescent sexual behavior in rural Hanover, Jamaica. J Adolesc Health. 2003 Jul;33(1):41–8.

  31. Ho M-J. Sociocultural aspects of tuberculosis: a literature review and a case study of immigrant tuberculosis. Soc Sci Med. 2004 Agosto;59(4):753–62.

  32. Consedine NS, Skamai A. Sociocultural considerations in aging men’s health: implications and recommendations for the clinician. J Mens Health. 2009 Sep;6(3):196–207.

  33. Serizawa A, Ito K, Algaddal AH, Eltaybe RAM. Cultural perceptions and health behaviors related to safe motherhood among village women in Eastern Sudan: Ethnographic study. Intern J Nurs Stud. 2014 Apr;51(4):572–81.

  34. Klaver E. Sites of Autopsy in Contemporary Culture. Series in Postmodern Culture. New York, USA. State University of New York Press; 2012.

  35. Brinkman I. War, Witches and Traitors: Cases from the MPLA`s Eastern front in Angola (1966-1975). J Afr Hist. 2003 Jul;44(2):303–25.

  36. Childs GM. Umbundu Kinship and Character, Being a Description of the Social Structure and Individual Development of the Ovimbundu of Angola with Observations Concerning the Bearing on the Enterprise of Christian Missions of Certain Phases of the Life and Culture Described by Gladwyn Murray Childs. London, England.: Oxford University Press;1949.

  37. Florêncio F. Un reino, dos reyes: diferentes legitimidades en Bailundo (Angola). Rev CIDOB Afers Int Cent Estud Int Barc. 2009;167–89.

  38. Mertens DM. Transformative Mixed Methods: Addressing Inequities. Am Behav Sci. 2012;56(6):802–13.

  39. Grinnell RM, Unrau YA, Williams M. Scientific inquiry and social work. Social Work: Research and Evaluation Quantitative and Qualitative Approaches. 7 a Ed. New York, USA: Oxford University Press; 2005.

  40. Creswell JW. Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications, Incorporated; 2013.

  41. Hernandez Sampieri R, Fernández Collado C, Pilar Baptista L. Metodología de la Investigación. Segunda. México: The McGraw-Hill Companies, Inc.; 1998.

  42. Tashakkori A, Teddlie C. SAGE Handbook of Mixed Methods in Social & Behavioral Research. Edition: Second Edition. Los Angeles: SAGE Publications Inc; 2010.

  43. De Ketele JM, Roegiers X. Metodologia da Recolha de Dados. Fundamentos dos métodos de Observações, de questionários, de entrevistas e de Estúdios de documentos. Lisboa, Portugal: Instituto Piaget; 1993.

  44. Deshaies, B. Metodologia da Investigação em Ciencias Humanas. Edição Beauchemin Iteé. Lisboa, Portugal: Instituto Piaget; 1992.

  45. De Andrade MM, Lakatos EM. Metodologia Científica. 6a ed. São Paulo, Brasil: ATLAS S.A.; 2009.

  46. Watkins K. Una crisis encubierta: conflictos armados y educación. El Informe de seguimiento de EPT (Educación para Todos) en el mundo. [Internet]. UNESCO Publishing.; 2011 [cited 2012 Mar 12]. 465 p. Available from: www.efareport.unesco.org

  47. UNESCO. World Conference on Higher Education 2009. Final Report. [Internet]. ED-2010/WS/26 ed. Paris, Francia.: UNESCO Publishing.; 2010 [cited 2011 Nov 14]. 169 p. Available from: http://www.unesco.org/new/en/unesco/resources/onlinematerials/ publications/unesdoc-database/

  48. Yeun E. Attitudes of elderly Korean patients toward death and dying: an application of Q-methodology. Int J Nurs Stud. 2005 Nov;42(8):871–80.

  49. de Mendoza Amat JH, Santana RA, Martínez IB. Base de datos de autopsias en Cuba. Utilización del SARCAP. Rev Electrónica Autops. 2005 Feb 25;3(1):11–7.

  50. de Mendoza Amat JH, Santana RÁ, Martínez IB. Discrepancias diagnósticas en las causas de muerte identificadas por autopsias. Cuba 1994-2003. Cuarta parte. Patología. 2010;48(1):3–7.

  51. Sinard JH. Factors affecting autopsy rates, autopsy request rates, and autopsy findings at a large academic medical center. Exp Mol Pathol. 2001 Jun;70(3):333–43.

  52. Mateos FP, Fernández FA, Fernández MM, Román JG, Bernal JF. La autopsia clínica. Rev Electrónica Autops. 2009 Jun 17;7(1):3–12.

  53. Montero González T, de Mendoza Amat JH. La autopsia en los 50 años del Hospital Militar Central “Dr. Luis Díaz Soto”. Rev Cuba Med Mil. 2013;42(4):426–35.

  54. Schneider W. “Death is not the same always and everywhere” – sociocultural aspects of brain death and the legislation of organ transplantation. Eur Soc. 1999 Jan 1;1(3):353–89.




2020     |     www.medigraphic.com