Survival of cancer patients under treatment with the palliative care team in a Brazilian hospital in São Paulo.

Introduction: The Karnofsky Performance Status Scale is a relevant functional evaluation instrument that can be used to determine which patients should be followed by multidisciplinary palliative care teams. Objective: To analyze the clinical outcomes of patients with performance status lower than 70%, according to the Karnofsky Scale, who received care from a palliative care team compared to those who did not receive care from a palliative care team. Methods: In this retrospective cohort, follow-up of cancer patients by the palliative care team for 10 days was considered the exposure factor, while the dependent variable was patient survival. Data were extracted from medical records and descriptive and survival curve analyses were conducted. Results: Among 581 participants in the sample, 42.5% had metastasis, and the most prevalent medical diagnosis was gastrointestinal cancer (29.1%). Fifty-one (8.7%) were followed by the palliative care team. The mortality rate during the 10 days in the sample was 10.8%, and the rate was higher (15.7%) among patients followed by the palliative care team. Conclusion: Patients with a performance status below 70% who were followed by the palliative care team had poorer clinical conditions and a shorter survival than those who were not followed up by the team.

Survie des patients en oncologie traités par l'équipe de soins palliatifs d'un hôpital de São Paulo, au Brésil.

Introduction: L'échelle de l'indice fonctionnel de Karnofsky (Karnofsky Performance Status Scale) est un instrument d'évaluation pertinent et fonctionnel qui sert à déterminer quelles personnes devraient être suivies par des équipes multidisciplinaires de soins palliatifs. Objectif: Analyser les résultats cliniques de patients, suivis par une équipe de soins palliatifs, dont l'indice fonctionnel de Karnofsky est inférieur à 70 %, et les comparer aux résultats de personnes n'ayant pas bénéficié de ce type de soins. Méthodologie: Dans la présente étude de cohorte rétrospective, le suivi pendant 10 jours des patients par l'équipe de soins palliatifs constituait le facteur d'exposition et la survie, la variable dépendante. Des données ont été extraites des dossiers médicaux afin de réaliser des statistiques descriptives et des analyses des courbes de survie. Résultats: Parmi les 581 participants de l'échantillon, 42,5 % avaient des métastases. Le cancer gastro-intestinal était le diagnostic plus prévalent (29,1 %). Du groupe, 51 participants (8,7 %) étaient suivis par l'équipe de soins palliatifs. Le taux de mortalité pendant les 10 jours de suivi s'élevait à 10,8 %; il était plus élevé encore (15,7 %) chez les patients suivis par l'équipe de soins palliatifs. Conclusion: Les patients ayant un indice fonctionnel inférieur à 70 % qui étaient suivis par l'équipe de soins palliatifs présentaient un piètre état clinique et une période de survie plus réduite comparativement aux autres patients.

Hipodermóclise na história da enfermagem: atribuições para enfermeiras no Brasil (1916-1943) / Hypodermoclysis in the history of nursing: attributions for nurses in Brazil (1916-1943) / ipodermoclisis en la historia de la enfermería: atribuciones de las enfermeras en Brasil (1916-1943)

Objetivo: Analisar a construção histórica entre a hipodermóclise e a enfermagem brasileira sob a ótica da dialética marxista. Métodos: Revisão integrativa com discussão sócio-histórica. A coleta de dados foi baseada em livros publicados no Brasil até o ano de 1949. Extraíram-se informações sobre o tema. As atribuições da enfermagem foram discutidas à luz do materialismo histórico-dialético. Resultados:Os autores disponibilizaram o posicionamento dos enfermeiros sobre conceito, indicação terapêutica, material de consumo, local de administração, precaução, evento adverso e cuidado. Houve maior ênfase a algumas atribuições em detrimento de outras, empoderando os enfermeiros preferencialmente nas questões operacionais. Esse fato influenciou as relações de produção e estabeleceu uma dialética entre o fazer de médicos e enfermeiros. Considerações finais: Dentro da produção econômica da hipodermóclise, houve visões convergentes que fizeram com que as atribuições da enfermagem ganhassem mais empoderamento profissional, situando a posição da enfermagem na infraestrutura do cuidado.

Objective: Analyze the historical construction between hypodermoclysis and Brazilian nursing from the perspective of the Marxist dialectics. Methods: Integrative review with socio-historical discus-sion. Data collection was based on books published in Brazil until 1949. Information on the subject was extracted. The attributions of nursing were discussed in the light of the historical-dialectical materialism. Results: The authors provided the nurses' position on the concept, therapeutic indica-tion, consumption material, place of administration, precaution, adverse event and care. There was greater emphasis on some assignments to the detriment of others, empowering nurses preferentially in operational matters. This fact influenced the production relations and established a dialectic be-tween the actions of doctors and nurses. Final considerations: Within the economic production of hypodermoclysis, there were converging views that made nursing attributions gain more professional empowerment, placing the position of nursing in the care infrastructure.

Objetivo: Analizar la construcción histórica entre la hipodermoclisis y la enfermería brasileña desde la perspectiva de la dialéctica marxista. Métodos: Revisión integradora con discusión sociohistórica. La re-copilación de datos se basó en libros publicados en Brasil hasta 1949. Se extrajo información sobre el tema. Las atribuciones de la enfermería se discutieron a la luz del materialismo histórico-dialéctico. Resultados:Los autores aportaron la posición de los enfermeros sobre el concepto, indicación terapéutica, material de consumo, lugar de administración, precaución, evento adverso y cuidados. Se destacaron algunas asignaciones en detrimento de otras, empoderando preferentemente a los enfermeros en cuestiones operativas. Este hecho influyó en las relaciones de producción y estableció una dialéctica entre las acciones de médicos y enfermeros. Consideraciones finales: Dentro de la producción económica de la hipodermoclisis, hubo visiones convergentes que hicieron que las atribuciones de la enfermería ganaran un mayor empoderamiento profesional, ubicando la posición de la enfermería en la infraestructura asistencial.