Assistência terminal: uma abordagem na perspectiva dos cuidados paliativos

Gabriela Garcia de Carvalho Laguna; Lorena Sousa de Carvalho; Ruth Ellery Lima Flores; Fernanda Angélica da Silva; Alcione de Almeida Silva; Larissa Cardoso Piloto

doi:10.5712/rbmfc20(47)4594

Autores/as

Gabriela Garcia de Carvalho Laguna Universidade Federal da Bahia – Salvador (BA), Brasil. https://orcid.org/0000-0001-7396-647X
Lorena Sousa de Carvalho Universidade Federal da Bahia – Salvador (BA), Brasil.
Ruth Ellery Lima Flores Universidade Federal da Bahia – Salvador (BA), Brasil. https://orcid.org/0000-0001-7866-7874
Fernanda Angélica da Silva Universidade Federal da Bahia – Salvador (BA), Brasil.
Alcione de Almeida Silva Universidade Federal da Bahia – Salvador (BA), Brasil. https://orcid.org/0000-0003-0203-9024
Larissa Cardoso Piloto Universidade Federal da Bahia – Salvador (BA), Brasil. https://orcid.org/0009-0004-3931-4231

DOI:

https://doi.org/10.5712/rbmfc20(47)4594

Palabras clave:

Cuidados paliativos, Enfermo terminal, Manejo del dolor, Calidad de vida

Resumen

Introducción: Los cuidados paliativos son prácticas multidisciplinarias de apoyo aplicables en todos los niveles de atención de salud, eficaces para mejorar la calidad de vida de los pacientes y sus familiares que enfrentan condiciones que amenazan la vida. La difusión del conocimiento sobre la atención a pacientes terminales puede ampliar la comprensión de las necesidades y desafíos que enfrenta esta población, además de respaldar la elaboración de políticas de salud más inclusivas. Objetivo: Por lo tanto, este artículo tiene como objetivo describir la atención a pacientes terminales, abarcando las dimensiones de cuidados paliativos y el manejo de síntomas y dolor. Métodos: Se trata de una revisión narrativa de la literatura con un enfoque cualitativo. El manejo del paciente en cuidados paliativos incluye apoyo espiritual, la oportunidad de resolver asuntos personales, tener voz activa en el proceso de muerte y minimizar el sufrimiento físico y emocional. Resultados: El control del dolor y otros síntomas implica comprender que la experiencia del paciente es individual y está influenciada por diversos factores, como sexo, edad, cultura y apoyo social. Conclusiones: Por ello, se requiere una atención multidisciplinaria, integradora, continua, con habilidades de comunicación y un plan terapéutico individualizado.

Descargas

Los datos de descargas todavía no están disponibles.

Métricas

Cargando métricas ...

Citas

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