Terminal care
An approach from the perspective of palliative care
DOI:
https://doi.org/10.5712/rbmfc20(47)4594Keywords:
Palliative care, Terminally ill, Pain management, Quality of lifeAbstract
Introduction: Palliative care is a multidisciplinary support practice applicable at all levels of healthcare, effective in improving the quality of life for patients and families facing life-threatening conditions. The dissemination of knowledge about care for terminal patients can broaden understanding of the needs and challenges faced by this population, as well as support the development of more inclusive health policies. Objective: Therefore, this article aims to describe care for terminal patients, encompassing the dimensions of palliative care and symptom and pain management. Methods: This is a narrative literature review with a qualitative focus. The management of patients in palliative care includes spiritual support, the opportunity to resolve personal matters, having an active voice in the dying process, and minimizing physical and emotional suffering. Results: Pain and symptom control involves understanding that the patient’s experience is individual and influenced by various factors, such as gender, age, culture, and social support. Conclusions: Therefore, a multidisciplinary, integrative, continuous approach with communication skills and an individualized therapeutic plan is essential.
Downloads
Metrics
References
World Health Organization (WHO). Palliative care [Internet]. Genebra: WHO; 2018 [acessado em 24 de agosto de 2024]. Disponível em: https://www.who.int/news-room/fact-sheets/detail/palliative-care
International Association for Hospice & Palliative Care (IAHPC). Consensus-based definition of palliative care [Internet]. Houston: IAHPC; 2021 [acessado em 24 de agosto de 2024]. Disponível em: https://hospicecare.com/what-we-do/projects/ consensus-based-definition-of-palliative-care/definition/
Cifuentes CMC, Gutiérrez JG, Palenzuela SP, Dávalos CN. Incidencia y control de síntomas al final de la vida de pacientes con cáncer. Revista Finlay [Internet]. 2021 [acessado em 24 de agosto de 2024];11(4):381-9. Disponível em: https://revfinlay. sld.cu/index.php/finlay/article/view/1073
Ahluwalia SC, Chen C, Raaen L, Motala A, Walling AM, Chamberlin M, et al. A systematic review in support of the national consensus project clinical practice guidelines for quality palliative care, fourth edition. J Pain Symptom Manage. 2018;56(6):831-70. https://doi.org/10.1016/j.jpainsymman.2018.09.008 DOI: https://doi.org/10.1016/j.jpainsymman.2018.09.008
Guerrero BM. Terminal Illness. Encyclopedia of Child Behavior and Development. 2011. https://doi.org/10.1007/978-0-387- 79061-9_2889
Rother ET. Revisão sistemática X revisão narrativa. Acta Paul Enferm. 2007;20(2):v-vi. https://doi.org/10.1590/S0103- 21002007000200001 DOI: https://doi.org/10.1590/S0103-21002007000200001
Baethge C, Goldbeck-Wood S, Mertens S. SANRA-a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019;4:5. https://doi.org/10.1186/s41073-019-0064-8 DOI: https://doi.org/10.1186/s41073-019-0064-8
Rodenbach RA, Althouse AD, Schenker Y, Smith TJ, Chu E, White DB, et al. Relationships between advanced cancer patients’ worry about dying and illness understanding, treatment preferences, and advance care planning. J Pain Symptom Manage. 2021;61(4):723-31.e1. https://doi.org/10.1016/j.jpainsymman.2020.09.004 DOI: https://doi.org/10.1016/j.jpainsymman.2020.09.004
Gray TF, Plotke R, Heuer L, Topping CE, Nipp RD, Wang AC, et al. Perceptions of prognosis and end-of-life care outcomes in patients with advanced lung and gastrointestinal cancer. Palliat Med. 2023;37(5):740-8. https://doi. org/10.1177/02692163231155511 DOI: https://doi.org/10.1177/02692163231155511
Seiler A, Amann M, Hertler C, Christ SM, Schettle M, Kaeppeli BM, et al. Effects of dignity therapy on psychological distress and wellbeing of palliative care patients and family caregivers - a randomized controlled study. BMC Palliat Care. 2024;23(1):73. https://doi.org/10.1186/s12904-024-01408-4 DOI: https://doi.org/10.1186/s12904-024-01408-4
Mendes BV, Donato SCT, Silva TL da, Penha RM, Jaman-Mewes P, Salvetti M de G. Bem-estar espiritual, sintomas e funcionalidade de pacientes em cuidados paliativos. Rev Bras Enferm. 2023;76(2):e20220007. https://doi.org/10.1590/0034- 7167-2022-0007pt DOI: https://doi.org/10.1590/0034-7167-2022-0007
Souza LC de, Cestari VRF, Nogueira VP, Furtado MA, Oliveira IMM de, Moreira TMM, et al. Análise da evolução histórica do conceito de cuidados paliativos: revisão de escopo. Acta Paul Enferm. 2022;35:eAPE01806. https://doi.org/10.37689/acta- ape/2022AR018066 DOI: https://doi.org/10.37689/acta-ape/2022AR018066
Harris D. Safe and effective prescribing for symptom management in palliative care. Br J Hosp Med. 2019;80(12). https://doi. org/10.12968/hmed.2019.80.12.C184 DOI: https://doi.org/10.12968/hmed.2019.80.12.C184
Dabi A, Rahman O. Termination of Life Support. In: StatPearls [Internet]. StatPearls Publishing; 2024 [acessado em 24 ago. 2024]. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK564312/
Taleb NN. Antifragile: Things that Gain from Disorder [Internet]. 2014 [acessado em 24 ago. 2024]. Disponível em: https:// books.google.com/books/about/Antifragile_Things_that_Gain_from_Disord.html?hl=&id=gxeZ0AEACAAJ
Hospital do Coração (HCor). Protocolo de dor [Internet]. São Paulo: HCor; 2021 [acessado em 24 de agosto de 2024]. Disponível em: https://www.hcor.com.br/area-medica/wp-content/uploads/sites/3/2021/12/17-Protocolo-de-dor.pdf
Gomes-Ferraz CA, Rezende G, Fagundes AA, De Carlo MMRDP. Assessment of total pain in people in oncologic palliative care: integrative literature review. Palliat Care Soc Pract. 2022;16:26323524221125244. https://doi. org/10.1177/26323524221125244 DOI: https://doi.org/10.1177/26323524221125244
Mallah H, Mousa R, Fadl NB, Musmar S, Ball S, Nugent K. Pain severity and adequacy of pain management in terminally ill patients with cancer: an experience from North Palestine. Indian J Palliat Care. 2019;25(4):494-500. https://doi.org/10.4103/ IJPC.IJPC_39_19 DOI: https://doi.org/10.4103/IJPC.IJPC_39_19
Lin HY, Hsieh JG, Hsieh CJ, Wang YW. Differences in the opioid consumption of terminally ill schizophrenic and nonschizophrenic cancer patients: analysis of secondary national population data. J Pain Symptom Manage. 2020;59(6):1232-8. https://doi. org/10.1016/j.jpainsymman.2019.12.360 DOI: https://doi.org/10.1016/j.jpainsymman.2019.12.360
Lowey SE. Management of severe pain in terminally ill patients at home: an evidence-based strategy. Home Healthc Now. 2020;38(1):8-15. https://doi.org/10.1097/NHH.0000000000000826 DOI: https://doi.org/10.1097/NHH.0000000000000826
Yang Y, Cui M, Zhao X, Wang S, Wang Y, Wang X. Association of pain management and positive expectations with psychological distress and spiritual well-being among terminally ill cancer patients admitted to a palliative care unit. BMC Nurs. 2023;22(1):96. https://doi.org/10.1186/s12912-023-01259-z DOI: https://doi.org/10.1186/s12912-023-01259-z
Warth M, Koehler F, Brehmen M, Weber M, Bardenheuer HJ, Ditzen B, et al. “Song of Life”: Results of a multicenter randomized trial on the effects of biographical music therapy in palliative care. Palliat Med. 2021;35(6):1126-36. https://doi. org/10.1177/02692163211010394 DOI: https://doi.org/10.1177/02692163211010394
Chen T, Zhang WW, Chu YX, Wang YQ. Acupuncture for pain management: molecular mechanisms of action. Am J Chin Med. 2020;48(4):793-811. https://doi.org/10.1142/S0192415X20500408 DOI: https://doi.org/10.1142/S0192415X20500408
Billot M, Daycard M, Wood C, Tchalla A. Reiki therapy for pain, anxiety and quality of life. BMJ Support Palliat Care. 2019;9(4):434-8. https://doi.org/10.1136/bmjspcare-2019-001775 DOI: https://doi.org/10.1136/bmjspcare-2019-001775
Rattner M. ‘Total pain’: reverence and reconsideration. Front Sociol. 2023;8:1286208. https://doi.org/10.3389/ fsoc.2023.1286208 DOI: https://doi.org/10.3389/fsoc.2023.1286208
Surges SM, Garralda E, Jaspers B, Brunsch H, Rijpstra M, Hasselaar J, et al. Review of European Guidelines on Palliative Sedation: a foundation for the updating of the european association for palliative care framework. J Palliat Med. 2022;25(11):1721-31. https://doi.org/10.1089/jpm.2021.0646 DOI: https://doi.org/10.1089/jpm.2021.0646
Arantzamendi M, Belar A, Payne S, Rijpstra M, Preston N, Menten J, et al. Clinical aspects of palliative sedation in prospective studies: a systematic review. J Pain Symptom Manage. 2021;61(4):831-44.e10. https://doi.org/10.1016/j. jpainsymman.2020.09.022 DOI: https://doi.org/10.1016/j.jpainsymman.2020.09.022
Wu Y. Pain talk in hospice care: a conversation analysis. BMC Palliat Care. 2020;19(1):116. https://doi.org/10.1186/s12904- 020-00625-x DOI: https://doi.org/10.1186/s12904-020-00625-x
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Gabriela Garcia de Carvalho Laguna, Lorena Sousa de Carvalho, Ruth Ellery Lima Flores, Fernanda Angélica da Silva, Alcione de Almeida Silva, Larissa Cardoso Piloto

This work is licensed under a Creative Commons Attribution 4.0 International License.
By submitting a manuscript to the RBMFC, authors retain ownership of the copyright in the article, and authorize RBMFC to publish that manuscript under the Creative Commons Attribution 4.0 license and identify itself as the vehicle of its original publication.









