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A perda da via oral na pessoa em situação de fim de vida - Projeto de desenvolvimento de competências clínicas comuns e especializadas na área de enfermagem à pessoa em situação paliativa
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Introdução: Os cuidados paliativos definem-se como "cuidados holísticos ativos, prestados a
pessoas de todas as idades com sofrimento intenso relacionado com a saúde devido a doença
grave, especialmente àquelas que se encontram no final da vida. O objetivo dos Cuidados
Paliativos é melhorar a qualidade de vida dos clientes, das suas famílias e dos seus cuidadores"
(Radbruch et al., 2020). Nos dias de hoje, e perante o aumento da morbilidade e da mortalidade
associadas ao aparecimento de doenças crónicas, oncológicas e neurológicas, resultado do
envelhecimento populacional e do aumento da esperança média de vida aliada aos avanços na
Medicina, torna-se imprescindível que o enfermeiro detenha competências especializadas que
lhe permitam prestar cuidados de elevada complexidade. A formação especializada em
cuidados paliativos deverá ser um aspeto fundamental, exigindo-se a intervenção do enfermeiro
especialista em aspetos fundamentais na abordagem ao cliente e família, com especial enfoque
na gestão clínica e ética da perda da via oral em contexto de fim de vida.
Objetivo: Apresentar o percurso de aquisição e desenvolvimento de competências comuns e
específicas do enfermeiro especialista em enfermagem médico cirúrgica na área da pessoa em
situação paliativa, realizado no âmbito do estágio de natureza profissional, no contexto de uma
unidade de cuidados paliativos e de uma equipa intra-hospitalar de Suporte em cuidados
paliativos .
Metodologia: O presente relatório adota uma metodologia descritiva, crítico-reflexiva,
orientada para a demonstração das competências profissionais adquiridas, conforme o
estipulado na legislação nacional para a obtenção do grau de mestre e de acordo com os
domínios de competência definidos pela ordem dos enfermeiros. A temática orientadora incide
na intervenção especializada do enfermeiro especialista perante a perda da via oral na pessoa
em fim de vida.
Resultados: Apresentam-se as atividades desenvolvidas no Estágio de Natureza Profissional
que contribuíram para o desenvolvimento de competências comuns e específicas em
enfermagem médico cirúrgica à pessoa em situação paliativa, e ainda, a elaboração de uma
revisão narrativa da literatura sobre a temática, que fundamentaram a prática clínica com base
em evidência científica atualizada.
Conclusão: O desenvolvimento de competências comuns e especificas do enfermeiro
especialista, realça o seu papel fundamental em cuidados paliativos na gestão da complexidade
da perda da via oral, mediando decisões éticas e práticas com o cliente, a família e com os
profissionais de saúde, promovendo práticas que objetivem o conforto e garantindo intervenções alinhadas com os valores e expectativas dos envolvidos.
INTRODUCTION: Palliative care is "the active holistic care of individuals across all ages with serious health‑related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers" (Radbruch et al., 2020). Nowadays, the increase in morbidity and mortality associated with the emergence of chronic, oncological and neurological diseases, the result of an ageing population and an increase in average life expectancy, combined with advances in medicine, makes it imperative for nurses to have specialised skills that enable them to provide highly complex care. Specialized training in palliative care should be a fundamental aspect, requiring the intervention of the specialist nurse in key aspects of the approach to patient and family, with a particular emphasis on the clinical and ethical management of the loss of the oral intake in end-of-life context. OBJECTIVE: To present the path of acquisition and development of common and specific competences of the specialist nurse in medical-surgical nursing in the area of the patient in a palliative situation, carried out within the scope of the professional internship, in the context of a palliative care unit and an intra-hospital palliative care support team. METHODOLOGY: This report adopts a descriptive, critical-reflective methodology, aimed at demonstrating the professional competences acquired, as stipulated in the national legislation for obtaining a master’s degree and in accordance with the domains of competence defined by the Order of Nurses. The guiding theme focuses on the specialised intervention of the specialist nurse when faced with the loss of the oral intake of the end-of-life patient. RESULT: The activities developed in the specialized training that contributed to the development of common and specific competences in medical-surgical nursing for people in a palliative situation are presented, as well as the preparation of a narrative review of the literature on the subject, which substantiated clinical practice based on up-to-date scientific evidence. CONCLUSION: The development of common and specific specialist nurse competences emphasises their fundamental part in palliative care managing the complexity of the loss of the oral route, mediating ethical and practical decisions with the client, the family and health professionals, promoting practises that aim for comfort and guaranteeing interventions in line with the values and expectations of those involved.
INTRODUCTION: Palliative care is "the active holistic care of individuals across all ages with serious health‑related suffering due to severe illness and especially of those near the end of life. It aims to improve the quality of life of patients, their families and their caregivers" (Radbruch et al., 2020). Nowadays, the increase in morbidity and mortality associated with the emergence of chronic, oncological and neurological diseases, the result of an ageing population and an increase in average life expectancy, combined with advances in medicine, makes it imperative for nurses to have specialised skills that enable them to provide highly complex care. Specialized training in palliative care should be a fundamental aspect, requiring the intervention of the specialist nurse in key aspects of the approach to patient and family, with a particular emphasis on the clinical and ethical management of the loss of the oral intake in end-of-life context. OBJECTIVE: To present the path of acquisition and development of common and specific competences of the specialist nurse in medical-surgical nursing in the area of the patient in a palliative situation, carried out within the scope of the professional internship, in the context of a palliative care unit and an intra-hospital palliative care support team. METHODOLOGY: This report adopts a descriptive, critical-reflective methodology, aimed at demonstrating the professional competences acquired, as stipulated in the national legislation for obtaining a master’s degree and in accordance with the domains of competence defined by the Order of Nurses. The guiding theme focuses on the specialised intervention of the specialist nurse when faced with the loss of the oral intake of the end-of-life patient. RESULT: The activities developed in the specialized training that contributed to the development of common and specific competences in medical-surgical nursing for people in a palliative situation are presented, as well as the preparation of a narrative review of the literature on the subject, which substantiated clinical practice based on up-to-date scientific evidence. CONCLUSION: The development of common and specific specialist nurse competences emphasises their fundamental part in palliative care managing the complexity of the loss of the oral route, mediating ethical and practical decisions with the client, the family and health professionals, promoting practises that aim for comfort and guaranteeing interventions in line with the values and expectations of those involved.
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Palavras-chave
Cuidados Paliativos Competências Específicas Enfermeiro Especialista Perda da via oral Fim de vida