RESUMEN
OBJETIVO: descrever como equipes assistenciais identificam a necessidade de cuidados paliativos e solicitam o apoio de equipes de consultoria. METODOLOGIA: estudo descritivo e exploratório, de abordagem qualitativa, realizado em um hospital de ensino no Brasil. A produção dos dados ocorreu entre julho e novembro de 2021, por meio de entrevista semiestruturada com quatro médicos e quatro enfermeiros de unidades de internação clínica. Os dados foram organizados no programa Atlas.ti versão de demonstração e submetidosà Análise de Conteúdo. RESULTADOS:duas unidades de conteúdo compuseram a categoria central "Necessidade de cuidados paliativos: como equipes assistenciais identificam? ", e são apresentadas neste artigo. Na primeira: Experiência clínica e (não) uso de instrumentos padronizados de avaliação. Na segunda: Saberes e práticas sobre (equipe de consultoria) em cuidados paliativos. Através das entrevistas dos profissionais foi possível analisar que os médicos utilizam de sua expertise clínica, e identificam os pacientes através da carga de sintomas que o enfermo apresenta, com baixa frequência fazendo uso de escalas para avaliar as necessidades, e os enfermeiros embora apresentem um conhecimento sobre a avaliação de aspectos clínicos resumem sua identificação através dos registros médicos. CONCLUSÃO: Constata-se a importância em difundir o uso de instrumentos validados, com o objetivo de identificar as pessoas que precisam de cuidados paliativos, e assim ampliando. Deve-se retomar o protagonismo do enfermeiro, descentralizando o cuidado médico e evidenciando o conhecimento dos profissionais de enfermagem, incentivando a necessidade de ocupar espaços centrais no processo de cuidar de pacientes em cuidados paliativos no hospital.
OBJECTIVE: to describe how care teams identify the need for palliative care and request the support of consulting teams. METHODOLOGY: A qualitative, descriptive, and exploratory study conducted in a Brazilian teaching hospital. Data production took place between July and November 2021, through a semi-structured interview with four doctors and four nurses from clinical admission units. The data were organized in the Atlas.ti demo version and submitted to Content Analysis. RESULTS: two content units composed the central category "Need for palliative care: how do care teams identify? "and are presented in this article. The first: Clinical experience and (not) use of standardized assessment instruments. The second: Knowledge and practices on palliative care (consulting team). Through interviews withprofessionals, it was possible to analyze that doctors use their clinical expertise and identify patients through the burden of symptoms that the patient presents, with low frequency using scales to assess needs, and the nurses although they present knowledge about the evaluation of clinical aspects, summarize their identification through the medical records. CONCLUSION: It is important to spread the use of validated instruments, with the objective of identifying people who need palliative care, and thus expanding. The role of the nurse should be resumed, decentralizing medical care and highlighting the knowledge of nursing professionals, encouraging the need to occupy central spaces in the process of caring for patients in palliative care in the hospital.
OBJETIVO: describir cómo los equipos asistenciales identifican la necesidad de cuidados paliativos y solicitan el apoyo de equipos de consultoría. METODOLOGÍA: Estudio cualitativo, descriptivo y exploratorio, realizado en un hospital de enseñanza brasileño. La producción fueentre julio y noviembre de 2021, por medio de una entrevista semiestructurada con cuatro médicos y cuatro enfermeros de unidades de internación clínica. Los datos fueron organizados en el programa Atlas.ti versión de demostración y sometidos al Análisis de Contenido. RESULTADOS: Dos unidades de contenido conformanla categoría central "Necesidad de cuidados paliativos: ¿cómo identifican equipos asistenciales? ". La primera: Experiencia clínica y (no) uso de instrumentos estandarizados de evaluación. La segunda: Saberes y prácticas sobre (equipo de consultoría) en cuidados paliativos. A través de las entrevistas fue posible analizar que los médicos utilizan su experiencia clínica, e identifican a los pacientes a través de la carga de síntomas que el enfermo presenta, con baja frecuencia haciendo uso de escalas para evaluar las necesidades, y los enfermeros, aunque presenten un conocimiento sobre la evaluación de aspectos clínicos resumen su identificación a través de los registros médicos. CONCLUSIÓN: Se constatala importancia dedifundir el uso de instrumentos validados, con el objetivo de identificar a las personas que necesitan cuidados paliativos, y así ampliando. Se debe retomar el protagonismo del enfermero, descentralizando el cuidado médico y evidenciando el conocimiento de enfermería, incentivando la necesidad de ocupar espacios centrales en el proceso de cuidar a pacientes en cuidados paliativos en el hospital.
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Grupo de Atención al Paciente , Personal de Salud/psicología , Enfermería de Cuidados Paliativos al Final de la Vida , Necesidades y Demandas de Servicios de Salud , Cuidados Paliativos , Brasil , Entrevistas como Asunto , Investigación Cualitativa , Hospitales , Enfermeras y Enfermeros/psicologíaRESUMEN
Cancer patients are often not sufficiently oriented to manage side effects at home. Sending text messages with self-care guidelines aimed managing side effects is the main objective of this randomized controlled trial. Patients who started outpatient chemotherapy treatment between March and December 2017 at a hospital in southern Brazil were invited to participate in this study and were allocated to the intervention or control group (ratio 1: 1). Each patient in the intervention group received a daily SMS (short message service) with some guidance on management or prevention of side effects. All text messages were sent to the intervention group patients in an automated and tailored way by our app called cHEmotHErApp. Side effects experienced by patients were verified using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30 (EORTC QLQ-C30). Results showed intervention group patients experienced fewer side effects compared to the control group in cycle 1 (p < 0.05), in general. In addition, intervention group experienced less nausea in relation to the control group, in the cycle 1 and cycle 2 (p < 0.05). This study indicate text messaging may be a tool for supporting side effect management in patients receiving chemotherapy. This study was enrolled in ClinicalTrials.gov with the identification number NCT03087422. This research was performed in accordance with the Declaration of Helsinki.
Asunto(s)
Neoplasias , Envío de Mensajes de Texto , Brasil , Humanos , Neoplasias/tratamiento farmacológico , Calidad de Vida , AutocuidadoRESUMEN
Objetivo: apresentar a experiência de profissionais da saúde ao cuidarem de pessoas com condições crônicas em cuidados paliativos no domicílio durante a pandemia do Coronavírus 2019. Método: ensaio teórico reflexivo de cinco enfermeiras e uma médica ao atenderem pessoas em cuidados paliativos em um Serviço de Atenção Domiciliar no Rio Grande do Sul. Resultados: percebeu-se a necessidade dos profissionais se reinventarem, cujas restrições, distanciamento, uso de equipamentos de proteção são essenciais para o cuidado de modo seguro, e que o olhar da pessoa em cuidados paliativos na integralidade necessita continuar fazendo parte da assistência. Considerações finais: apesar das restrições de distanciamento social com diminuição da aproximação física dos pacientes e cuidadores é possível manter os cuidados paliativos domiciliares e primar pela sua essência, que é cuidar da pessoa em sua integralidade.(AU)
Objective: to present the experience of health professionals when caring for people with chronic conditions in palliative care at home during the 2019 Coronavirus pandemic. Method: reflective theoretical essay of five nurses and a doctor when assisting people in palliative care in a Home Care Service in Rio Grande do Sul. Results: it was noticed the need for professionals to reinvent themselves, whose restrictions, distance, use of equipment protection are essential for safe care, and that the view of the person in palliative care in its entirety needs to remain part of the assistance. Final considerations: despite the restrictions of social distance with a decrease in the physical approach of patients and caregivers, it is possible to maintain palliative care at home and excel in its essence, which is taking care of the person in their entirety.(AU)
Objetivo: presentar la experiencia de los profesionales de la salud al atender a personas con afecciones crónicas en cuidados paliativos en el hogar durante la pandemia de coronavirus de 2019. Método: ensayo teórico reflexivo de cinco enfermeras y un médico al atender a las personas en cuidados paliativos en un servicio de atención domiciliaria en Rio Grande do Sul. Resultados: se notó la necesidad de que los profesionales se reinventaran, cuyas restricciones, distancia, uso de equipos la protección es esencial para una atención segura, y que la visión de la persona en cuidados paliativos en su totalidad debe seguir siendo parte de la asistencia. Consideraciones finales: a pesar de las restricciones de la distancia social con una disminución en el contacto físico de los pacientes y cuidadores, es posible mantener los cuidados paliativos en el hogar y sobresalir en su esencia, que es cuidar a la persona en su totalidad.(AU)
Asunto(s)
Cuidados Paliativos , Grupo de Atención al Paciente , Coronavirus , Atención Domiciliaria de SaludRESUMEN
Cancer treatment is an extremely stressful life experience that is accompanied by a range of psychological, social, physical, and practical difficulties. Cancer patients need to receive information that helps them to better understand the disease, assists them in decision-making, and helps them deal with treatment. Patients are interested in receiving such information. The degree of satisfaction with the information received has been associated with positive health outcomes, specifically regarding quality of life, severity of side effects, and psychological well-being. This study investigates a method of guiding cancer patients, in relation to outpatient chemotherapy treatment, using SMS (short message service) text messaging. A smartphone application called cHEmotHErApp was developed, and its primary function is to send out SMS text messages with guidance for self-care and emotional support for oncology patients undergoing chemotherapy. Thus, the main objective of this study is to evaluate the acceptance and perception of patients of the receipt of these SMS messages, as well as to evaluate the possible benefits reported by the participants. Adult patients diagnosed with cancer, who started the first outpatient chemotherapy treatment scheme between August and November 2016 at the School Hospital (HE) of the Federal University of Pelotas (UFPel), were invited to participate in this pilot study. In total, 14 cancer patients were adherent to this study. Each of these patients received a daily text message on their cell phone with some guidance on encouraging self-care and emotional support. Patients reported that, because of the SMS text messages they received, they felt more confident in their treatment, felt more supported and encouraged, and that the text messages facilitated self-care. In addition, patients reported that the SMS text messages they received helped them to take better care of themselves and to continue further treatment.