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Contributo dos enfermeiros para o planeamento antecipado de cuidados de fim de vida
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Abstract(s)
O Planeamento Antecipado de Cuidados é um processo que visa promover a discussão dos valores, objetivos de vida e preferências individuais, no que diz respeito a cuidados de saúde, pensando no futuro. O objetivo é procurar assegurar que a pessoa receberá cuidados de saúde sintónicos com os seus desejos, perante uma situação de doença ameaçadora da vida. Pode ser realizado por qualquer pessoa com capacidade de decisão e independentemente da sua condição de saúde, sendo recomendável a participação de um profissional relacionado com esta área. Trata-se de um processo contínuo, que se adapta à deterioração da saúde, devendo tornar-se mais específico conforme aconteça o agravamento da doença e proximidade expectável de fim de vida (Martínez et al., 2019; Rietjens et al., 2017; Sudore et al., 2017).
Os Enfermeiros, enquanto membros fulcrais nas Equipas de Cuidados Paliativos, pela formação intrínseca a esta arte, que é a Enfermagem, têm um papel privilegiado e preponderante na adequação dos cuidados às Pessoas em Situação Paliativa e famílias. O reconhecimento da importância do Planeamento Antecipado de Cuidados de Fim de Vida (PAC FV), aliado à constatação da existência de lacunas na abordagem e registo do mesmo, incitou-me a desenvolver competências nesta temática, procurando contribuir para a sensibilização da sua importância e impacto na qualidade dos cuidados prestados, bem como fomentar a sua abordagem.
Este trabalho, baseado na metodologia do trabalho de projeto, assumiu o formato formativo, denominado “Contributo dos Enfermeiros no Planeamento Antecipado de Cuidados de Fim de Vida”, que foi desenhado com objetivo de desenvolver competências de Enfermeira Especialista em Enfermagem Médico-Cirúrgica na área de Enfermagem à Pessoa em Situação Paliativa (EEEMC-PSP), bem como competências de Mestre. Concomitantemente, o objetivo é contribuir para a melhoria da qualidade dos cuidados prestados nesta especialidade tão nobre e sensível, dos Cuidados Paliativos (CP). As atividades desenvolvidas resultaram no aprofundamento individual da temática do PAC FV, bem como na sua disseminação junto de pares e outros profissionais, consequente da frequência com que foi discutida e aplicada na prática diária.
Ao longo deste trabalho, recorri a variadas metodologias para desenvolver as competências preconizadas. Elaborei trabalhos de investigação, como uma Revisão Scoping e um Projeto de Investigação sobre a perceção dos Enfermeiros da aplicação do PAC FV (estudo exploratório, qualitativo, primário e prospetivo). Criei documentos promotores da melhoria dos registos, de abordagem do PAC FV e da qualidade dos cuidados, tendo realizado um modelo de registos baseado no Processo de Cuidados Centrado na Pessoa e uma Checklist. Concomitantemente, mantive a procura de momentos formativos, que trouxeram contributos para o desenvolvimento destas mesmas competências.
Advance Care Planning is a process that aims to promote the discussion of individual values, life goals and preferences with regard to health care, thinking of the future. The aim is to ensure that the person will receive healthcare in line with their wishes in the face of a life-threatening illness. It can be carried out by anyone with decision-making capacity, regardless of their health condition, and the involvement of a professional in this field is recommended. It is an ongoing process that adapts to deteriorating health, and should become more specific as the illness worsens and the end of life approaches (Martínez et al., 2019; Rietjens et al., 2017; Sudore et al., 2017). Nurses, as key members of Palliative Care Teams and due to the training intrinsic to the art of Nursing, have a privileged and preponderant role in the adequacy of care for People in a Palliative Situation and their families. Recognising the importance of Advance Care Planning in the End of Life, as well as the gaps in the way it is approached and recorded, encouraged me to develop skills in this area, seeking to help raise awareness of its importance and impact on the quality of care provided, as well as encouraging its approach. This work, based on the project work methodology, took the form of an educational programme called “Nurses contribution for Advance Care Planning in the End of Life” which was designed with the aim of developing the skills of a Specialist Nurse in Medical-Surgical for People in a Palliative Situation, as well as the skills of a Master. At the same time, the aim is to contribute to improving the quality of care provided by the noble and sensitive area of expertise of Palliative Care (PC). The activities carried out resulted in an individual deepening of the topic of Advance Care Planning in the End of Life (ACP EoL), as well as its dissemination among peers and other professionals, as a result of the frequency with which it was discussed and applied in daily practice. Throughout this work, I used a variety of methodologies to develop the recommended competences. I carried out research work such as a Scoping Review and a Research Project on nurses' perceptions of the application of the ACP EoL (an exploratory, qualitative, primary and prospective study). I created documents promoting the improvement of records, the ACP EoL approach and the quality of care, having created a record model based on the Person-Centred Care Process and a Checklist. At the same time, I continued to seek out training opportunities that contributed to the development of these same competences.
Advance Care Planning is a process that aims to promote the discussion of individual values, life goals and preferences with regard to health care, thinking of the future. The aim is to ensure that the person will receive healthcare in line with their wishes in the face of a life-threatening illness. It can be carried out by anyone with decision-making capacity, regardless of their health condition, and the involvement of a professional in this field is recommended. It is an ongoing process that adapts to deteriorating health, and should become more specific as the illness worsens and the end of life approaches (Martínez et al., 2019; Rietjens et al., 2017; Sudore et al., 2017). Nurses, as key members of Palliative Care Teams and due to the training intrinsic to the art of Nursing, have a privileged and preponderant role in the adequacy of care for People in a Palliative Situation and their families. Recognising the importance of Advance Care Planning in the End of Life, as well as the gaps in the way it is approached and recorded, encouraged me to develop skills in this area, seeking to help raise awareness of its importance and impact on the quality of care provided, as well as encouraging its approach. This work, based on the project work methodology, took the form of an educational programme called “Nurses contribution for Advance Care Planning in the End of Life” which was designed with the aim of developing the skills of a Specialist Nurse in Medical-Surgical for People in a Palliative Situation, as well as the skills of a Master. At the same time, the aim is to contribute to improving the quality of care provided by the noble and sensitive area of expertise of Palliative Care (PC). The activities carried out resulted in an individual deepening of the topic of Advance Care Planning in the End of Life (ACP EoL), as well as its dissemination among peers and other professionals, as a result of the frequency with which it was discussed and applied in daily practice. Throughout this work, I used a variety of methodologies to develop the recommended competences. I carried out research work such as a Scoping Review and a Research Project on nurses' perceptions of the application of the ACP EoL (an exploratory, qualitative, primary and prospective study). I created documents promoting the improvement of records, the ACP EoL approach and the quality of care, having created a record model based on the Person-Centred Care Process and a Checklist. At the same time, I continued to seek out training opportunities that contributed to the development of these same competences.
Description
Keywords
Enfermagem oncológica Cuidados paliativos Cuidados paliativos em fim de vida Planeamento antecipado de cuidados Enfermeiros