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Intervenções não farmacológicas que promovem o conforto da pessoa com dispneia em situação paliativa e fim de vida: Projeto de desenvolvimento de competências clínicas especializadas na área de enfermagem à pessoa em situação paliativa
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Advisor(s)
Abstract(s)
Introdução: Os Cuidados Paliativos (CP), conforme definidos pela Organização Mundial de Saúde (OMS),
desempenham um papel fundamental na melhoria da Qualidade de Vida (QV) de pessoas e suas famílias
diante de doenças potencialmente fatais, abrangendo aspetos físicos, psicológicos, sociais e espirituais. No
contexto dos CP, a dispneia emerge como um sintoma debilitante, de etiologia multifatorial, resultante da
complexa interação entre diferentes mecanismos fisiopatológicos. Este sintoma, prevalente e desconcertante,
impõe limitações funcionais e impacta negativamente na QV da pessoa em situação paliativa. A intervenção
precoce de uma equipa interdisciplinar especializada em CP, com ênfase em intervenções não farmacológicas,
é crucial para o controlo da dispneia e para melhorar a QV da pessoa em situação paliativa e fim vida. Este
relatório explora o desenvolvimento de competências através de dois estudos de caso realizados em
contextos reais de estágio, aprofundando a aplicação das intervenções não farmacológicas para promover o
conforto da pessoa com dispneia em situação paliativa e fim de vida.
Objetivo: Apresentar o percurso de aquisição e desenvolvimento de competências comuns específicas do EE
em Enfermagem Médico-cirúrgica (EMC) na área da pessoa em situação paliativa, realizado durante o Estágio
de Natureza Profissional (ENP), ocorrido em contexto de Unidade de Cuidados Paliativos (UCP) e Equipa Intra-
Hospitalar de Suporte em Cuidados Paliativos (EIHSCP).
Metodologia: O presente relatório baseia-se numa metodologia descritiva, crítico-reflexiva do processo para
obtenção de competências comuns e específicas recomendadas pela Ordem dos Enfermeiros (OE) para o EE
em EMC à Pessoa em Situação Paliativa. Destaca-se a intervenção especializada de enfermagem no controlo
da dispneia, com foco em intervenções não farmacológicas, com vista à melhoria da qualidade dos cuidados
prestados à pessoa em situação paliativa.
Resultados: As atividades realizadas na prática clínica contribuíram para o desenvolvimento de competências
comuns e específicas do EE na área da Pessoa em Situação Paliativa. Destaca-se o desenvolvimento de
habilidades específicas relacionadas ao controlo sintomático, comunicação eficaz, apoio à família e o trabalho
em equipa. A revisão da literatura sobre as intervenções não farmacológicas para promover o conforto da
pessoa com dispneia em situação paliativa e fim de vida foi crucial para fortalecer e adquirir competências na
procura e aplicação de evidências diretamente na prática clínica, conforme as orientações da OE.
Conclusão: Os resultados obtidos da revisão da literatura permitem compreender que as intervenções não
farmacológicas têm um papel fundamental no tratamento da dispneia. Estas medidas são benéficas
terapêuticas iniciais e coadjuvantes na tentativa de melhorar a QV da pessoa em situação paliativa e fim de
vida. A análise crítica das competências adquiridas revelou-se um processo crucial para compreender melhor
os cuidados prestados e estabelecer uma base sólida para a melhoria da qualidade dos cuidados.
Introduction: Palliative Care (PC), as defined by the World Health Organization (WHO), plays a fundamental role in improving the Quality of Life (QoL) of people and their families in the face of potentially fatal illnesses, covering physical, psychological, social and spiritual. In the context of PC, dyspnea emerges as a debilitating symptom, with multifactorial etiology, resulting from the complex interaction between different pathophysiological mechanisms. This symptom, prevalent and disconcerting, imposes functional limitations and negatively impacts the QoL of the person in a palliative situation. Early intervention by an interdisciplinary team specialized in PC, with an emphasis on non-pharmacological interventions, is crucial for controlling dyspnea and improving the QoL of people in palliative and end-of-life situations. This report explores the development of skills through two case studies carried out in real internship contexts, delving deeper into the application of non-pharmacological interventions to promote the comfort of people with dyspnea in palliative and end-of-life situations. Objective: Present the path of acquisition and development of common skills specific to EE in Medical-Surgical Nursing (EMC) in the area of people in palliative situations, carried out during the Professional Nature Internship (ENP), which took place in the context of a Palliative Care Unit (UCP) and Intra-Hospital Palliative Care Support Team (EIHSCP). Methodology: This report is based on a descriptive, critical-reflexive methodology of the process to obtain common and specific skills recommended by the Order of Nurses (OE) for EE in CME for Persons in Palliative Situations. Specialized nursing intervention in the control of dyspnea stands out, with a focus on nonpharmacological interventions, with a view to improving the quality of care provided to people in palliative situations. Results: The activities carried out in clinical practice contributed to the development of common and specific EE skills in the area of Persons in Palliative Situations. The development of specific skills related to symptom control, effective communication, family support and teamwork stands out. The review of the literature on non-pharmacological interventions to promote the comfort of people with dyspnea in palliative and end-oflife situations was crucial to strengthen and acquire skills in the search and application of evidence directly in clinical practice, according to the OE guidelines. Conclusion: The results obtained from the literature review allow us to understand that nonpharmacological interventions have a fundamental role in the treatment of dyspnea. These measures are beneficial initial and supporting therapies in an attempt to improve the QoL of people in palliative and end-of-life situations. Critical analysis of acquired skills proved to be a crucial process to better understand the care provided and establish a solid basis for improving the quality of care.
Introduction: Palliative Care (PC), as defined by the World Health Organization (WHO), plays a fundamental role in improving the Quality of Life (QoL) of people and their families in the face of potentially fatal illnesses, covering physical, psychological, social and spiritual. In the context of PC, dyspnea emerges as a debilitating symptom, with multifactorial etiology, resulting from the complex interaction between different pathophysiological mechanisms. This symptom, prevalent and disconcerting, imposes functional limitations and negatively impacts the QoL of the person in a palliative situation. Early intervention by an interdisciplinary team specialized in PC, with an emphasis on non-pharmacological interventions, is crucial for controlling dyspnea and improving the QoL of people in palliative and end-of-life situations. This report explores the development of skills through two case studies carried out in real internship contexts, delving deeper into the application of non-pharmacological interventions to promote the comfort of people with dyspnea in palliative and end-of-life situations. Objective: Present the path of acquisition and development of common skills specific to EE in Medical-Surgical Nursing (EMC) in the area of people in palliative situations, carried out during the Professional Nature Internship (ENP), which took place in the context of a Palliative Care Unit (UCP) and Intra-Hospital Palliative Care Support Team (EIHSCP). Methodology: This report is based on a descriptive, critical-reflexive methodology of the process to obtain common and specific skills recommended by the Order of Nurses (OE) for EE in CME for Persons in Palliative Situations. Specialized nursing intervention in the control of dyspnea stands out, with a focus on nonpharmacological interventions, with a view to improving the quality of care provided to people in palliative situations. Results: The activities carried out in clinical practice contributed to the development of common and specific EE skills in the area of Persons in Palliative Situations. The development of specific skills related to symptom control, effective communication, family support and teamwork stands out. The review of the literature on non-pharmacological interventions to promote the comfort of people with dyspnea in palliative and end-oflife situations was crucial to strengthen and acquire skills in the search and application of evidence directly in clinical practice, according to the OE guidelines. Conclusion: The results obtained from the literature review allow us to understand that nonpharmacological interventions have a fundamental role in the treatment of dyspnea. These measures are beneficial initial and supporting therapies in an attempt to improve the QoL of people in palliative and end-of-life situations. Critical analysis of acquired skills proved to be a crucial process to better understand the care provided and establish a solid basis for improving the quality of care.
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Keywords
Enfermeiro especialista Cuidados paliativos Competências Intervenções não farmacológicas Dispneia Conforto Qualidade de vida Relatório de estágio