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Publication
Ações paliativas ao doente oncológico em fim de vida, e sua família, em contexto de internamento em medicina interna
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Abstract(s)
Os UDHV são, para o doente oncológico e para a sua família, um momento íntimo e
único. A implementação precoce de Ações Paliativas (AP) é fundamental para que este seja
um processo natural e livre de tratamentos fúteis e sofrimento, onde o conforto é o principal
objetivo. Tendo por base a metodologia de projeto, e na etapa de diagnóstico de situação,
realizou-se um levantamento de necessidades formativas no IM do hospital CD, junto da
equipa de enfermagem. Através da ferramenta Google Forms questionaram-se 24
enfermeiros pertencentes à unidade funcional do IM. Verificou-se que, no universo referido,
21 dos enfermeiros revelaram um défice na sua formação acerca do cuidar do doente
oncológico em UDHV e sua família. Este problema denota a sua importância no que remete
ao ir ao encontro das necessidades da equipa, dotando-a de capacidades de promoção do
conforto e de incrementar a qualidade de vida do doente e da sua família até ao fim. Esta
situação problema conduziu à questão de investigação: “Quais as AP realizadas ao doente
oncológico em UDHV e à sua família, em contexto de IM?” com o objetivo de incrementar a
melhoria da qualidade dos cuidados prestados ao doente oncológico em UDHV e sua
família em IM. Primeiramente procedeu-se à realização de uma revisão scoping, através da
pesquisa nas bases de dados MEDLINE e CINAHL, de forma a conhecer a informação já
existente. Após aplicação dos critérios de inclusão e exclusão surgiram 8 artigos que
serviram de base para mapear o conhecimento e dar resposta à questão referida
anteriormente. De seguida realizaram-se de três estágios: em Equipa Intra Hospitalar de
Cuidados Paliativos (EIHCP) que dava apoio ao IM; em Unidade de Cuidados Paliativos
(CP); em IM. Com as atividades desenvolvidas nestes contextos e com a pesquisa anterior,
identificou-se e caracterizou-se as intervenções de enfermagem promotoras do conforto ao
doente oncológico em UDHV e sua família, que foram organizadas de acordo com os quatro
contextos propostos por Kolcaba (físico, ambiental, psicoespiritual e sociocultural). Tendo se, posteriormente, elaborado um Guia Orientador onde estas estão agrupadas e
sistematizadas de forma a apoiar os enfermeiros na promoção da segurança e qualidade
dos cuidados prestados à população referida, através da identificação de necessidades e
prestação de cuidados adequados às mesmas. Por conseguinte, obter-se-á um aumento do
conforto e qualidade de vida do doente oncológico em UDHV e da sua família até ao fim.
Com recurso ao método Delphi, o Guia foi apreciado por quatro peritas em CP e uma
gestora, tendo-se, após duas rondas, chegado a um consenso superior a 80% em todos os
itens avaliados, consolidando-se o Guia Orientador dos Cuidados à pessoa com doença
oncológica em UDHV e sua família.
The last days and hours of life are, for the cancer patient and their family, an intimate and unique moment. The early implementation of Palliative Actions (PA) is essential for this to be a natural process, free from futile treatments and suffering, where comfort is the main objective. In the medical internment of the CD hospital, a survey of training needs was carried out with the nursing team. Through the Google Foarms tool, 24 nurses belonging to the functional unit of the medical internment were questioned. It was found that, in the aforementioned universe, 21 of the nurses revealed a deficit in their training about caring for cancer patients in the UDHV and their families. This problem denotes its importance in terms of meeting the needs of the team, providing it with the ability to promote comfort and increase the quality of life of the patient and his family until the end. This problem situation led to the research question: “Which palliative actions are performed on cancer patients in UDHV and their family, in the context of medical internment?” with the aim of increasing the quality of care provided to cancer patients in UDHV and their families in medical internment. Firstly, a scoping review was carried out, through a search in the MEDLINE and CINAHL databases, in order to know the existing information. After applying the inclusion and exclusion criteria, 8 articles emerged that served as a basis for mapping knowledge and answering the question mentioned above. Then there were three internships: in the Intra Hospital Palliative Care Team that provided support to the medical internment; in a Palliative Care Team; and Medical Internment. These, together with the previous research, resulted in the identification and characterization of nursing interventions that promote comfort to cancer patients in the last days and hours of life and their families, according to the four contexts proposed by Kolcaba (physical, environmental, psycho-spiritual and sociocultural). Through the project methodology, a Guiding Guide was built where they are grouped and systematized in order to increase the nurses' safety in the care provided to the referred population, through the identification of needs and the provision of adequate care to them. Therefore, there will be an increase in the comfort and quality of life of the cancer patient in the last days and hour of life and their family until the end. This document was submitted to the appreciation of four nurses who are experts in palliative care and a manager nurse, and after two Delphi rounds, a consensus of more than 80% was reached on all the items evaluated, thus consolidating the construction of the Guidance Guide for the Care for people with oncological disease in the laste days and hour of life and their families.
The last days and hours of life are, for the cancer patient and their family, an intimate and unique moment. The early implementation of Palliative Actions (PA) is essential for this to be a natural process, free from futile treatments and suffering, where comfort is the main objective. In the medical internment of the CD hospital, a survey of training needs was carried out with the nursing team. Through the Google Foarms tool, 24 nurses belonging to the functional unit of the medical internment were questioned. It was found that, in the aforementioned universe, 21 of the nurses revealed a deficit in their training about caring for cancer patients in the UDHV and their families. This problem denotes its importance in terms of meeting the needs of the team, providing it with the ability to promote comfort and increase the quality of life of the patient and his family until the end. This problem situation led to the research question: “Which palliative actions are performed on cancer patients in UDHV and their family, in the context of medical internment?” with the aim of increasing the quality of care provided to cancer patients in UDHV and their families in medical internment. Firstly, a scoping review was carried out, through a search in the MEDLINE and CINAHL databases, in order to know the existing information. After applying the inclusion and exclusion criteria, 8 articles emerged that served as a basis for mapping knowledge and answering the question mentioned above. Then there were three internships: in the Intra Hospital Palliative Care Team that provided support to the medical internment; in a Palliative Care Team; and Medical Internment. These, together with the previous research, resulted in the identification and characterization of nursing interventions that promote comfort to cancer patients in the last days and hours of life and their families, according to the four contexts proposed by Kolcaba (physical, environmental, psycho-spiritual and sociocultural). Through the project methodology, a Guiding Guide was built where they are grouped and systematized in order to increase the nurses' safety in the care provided to the referred population, through the identification of needs and the provision of adequate care to them. Therefore, there will be an increase in the comfort and quality of life of the cancer patient in the last days and hour of life and their family until the end. This document was submitted to the appreciation of four nurses who are experts in palliative care and a manager nurse, and after two Delphi rounds, a consensus of more than 80% was reached on all the items evaluated, thus consolidating the construction of the Guidance Guide for the Care for people with oncological disease in the laste days and hour of life and their families.
Description
Keywords
Enfermagem oncológica Conforto do paciente Doente terminal Família