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COVID-19: necessidades paliativas numa era centrada em cuidados de agudos
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| 1.08 MB | Adobe PDF |
Authors
Abstract(s)
O presente relatório visa cumprir os requisitos necessários para a obtenção do
grau de mestre em Cuidados Paliativos pela Escola Superior de Saúde Dr. Lopes Dias
do Instituto Politécnico de Castelo Branco. Objetiva apresentar o estágio profissional
realizado, refletir sobre o impacto dessa prática clínica, transparecer os
conhecimentos e as competências adquiridos e expor o trabalho de investigação
desenvolvido.
A primeira parte deste relatório incide na apresentação e descrição do serviço
escolhido para a realização do estágio profissional. A prática clínica decorreu na
unidade de cuidados paliativos de um hospital da cidade de Lisboa, desenvolvendo-se
durante os meses de maio a julho de 2022, cumprindo as 300 horas mínimas
necessárias à conclusão do mestrado.
A segunda parte detalha as atividades desenvolvidas ao longo do estágio,
apresentando a casuística do internamento e sumarizando as características dos
doentes paliativos avaliados durante o trimestre. Realiza-se, ainda, a reflexão crítica
da prática clínica, englobando duas perspetivas. Apresenta-se um caso clínico, a partir
do qual se analisam os conhecimentos e as competências adquiridos nos quatro
pilares dos cuidados paliativos: controlo de sintomas, comunicação adequada, apoio à
família e trabalho em equipa. Termina-se com uma crítica reflexiva final ao estágio,
provando-se a mais-valia do mesmo na formação teórica e no desenvolvimento
prático.
A terceira parte exibe o projeto de investigação desenvolvido na área dos cuidados
paliativos. Trata-se de um trabalho unicêntrico, retrospetivo, longitudinal, descritivo
e correlacional, intitulado “COVID-19: necessidades paliativas numa era centrada em
cuidados de agudos”, objetivando caracterizar as populações de doentes com
necessidades paliativas internadas nas enfermarias dedicadas à COVID-19 num
centro hospitalar central durante os períodos de estado de emergência,
compreendidos de 19 de março a 2 de maio de 2020 e de 6 de novembro de 2020 a 30
de abril de 2021. Visou comparar as abordagens e atitudes terapêuticas realizadas,
enquadrando-as no panorama da adequação de cuidados.
A seleção dos doentes para o estudo teve por base os critérios da Gold Standards
Framework Prognostic Indicator Guidance, obtendo uma amostra de 463 doentes,
distribuídos entre 16 e 447 pelos dois períodos referidos, respetivamente.
O estudo realizado fornece uma visão abrangente das características
sociodemográficas dos doentes com necessidades paliativas internados nas
enfermarias dedicadas à COVID-19, destacando a influência e a relação entre alguns
fatores. Realça a importância da abordagem holística, centrada na pessoa e alicerçada
nas boas práticas e ética profissional, sugerindo a necessidade de investir na
formação dos profissionais de saúde e na criação de protocolos.
Abstract : This report aims to fulfill the necessary requirements to complete the master’s degree in Palliative Care from the Escola Superior de Saúde Dr. Lopes Dias of the Instituto Politécnico de Castelo Branco. It sets out to discuss the now completed internship, to reflect on the impact of its clinical practice, to demonstrate the knowledge and skills acquired herein and to present the developed research work. The first part of this report focuses on the presentation and description of the chosen unit within which to carry out the internship. The clinical practice took place in the palliative care unit of a hospital in the city of Lisbon, taking place from May to July 2022, which fulfilled the minimum 300 hours necessary to complete the master’s degree. The second part details the activities carried out throughout the internship, presenting the unit’s case series, and summarizing the characteristics of the palliative patients evaluated during the three months. Additionally, a critical reflection on clinical practice is also performed, utilizing two different perspectives. A clinical case is presented, from which the knowledge and competencies acquired through the four pillars of palliative care is analyzed: symptom control, adequate communication, family support and teamwork. It ends with a final reflective critique of the internship itself, proving it to be a worthwhile component in theoretical training and practicum development. The third part describes the palliative care research project. It’s an unicentric, retrospective, longitudinal, descriptive, and correlational study, entitled “COVID-19: palliative needs in an era focused on acute care”, aiming to characterize the population of palliative patients admitted to wards dedicated to COVID-19 in a central hospital centre during periods of state of emergency, from March 19th to May 2nd 2020, and from November 6th 2020 to April 30th 2021. It aimed to compare the approaches and therapeutic attitudes performed, framing them within the panorama of adequate care. The selection of patients for the study was based on the Gold Standards Framework Prognostic Indicator Guidance criteria, obtaining a sample of 463 patients, divided into two separate groups - 16 and 447, over the two aforementioned periods. The study provides a comprehensive view of the sociodemographic characteristics of patients with palliative needs admitted to wards dedicated to COVID-19, highlighting the influence and relationship between certain factors. It focuses on the importance of a holistic, person-centered approach, based on good practices and professional ethics, suggesting the need to invest in the training of health professionals and in the creation of protocols.
Abstract : This report aims to fulfill the necessary requirements to complete the master’s degree in Palliative Care from the Escola Superior de Saúde Dr. Lopes Dias of the Instituto Politécnico de Castelo Branco. It sets out to discuss the now completed internship, to reflect on the impact of its clinical practice, to demonstrate the knowledge and skills acquired herein and to present the developed research work. The first part of this report focuses on the presentation and description of the chosen unit within which to carry out the internship. The clinical practice took place in the palliative care unit of a hospital in the city of Lisbon, taking place from May to July 2022, which fulfilled the minimum 300 hours necessary to complete the master’s degree. The second part details the activities carried out throughout the internship, presenting the unit’s case series, and summarizing the characteristics of the palliative patients evaluated during the three months. Additionally, a critical reflection on clinical practice is also performed, utilizing two different perspectives. A clinical case is presented, from which the knowledge and competencies acquired through the four pillars of palliative care is analyzed: symptom control, adequate communication, family support and teamwork. It ends with a final reflective critique of the internship itself, proving it to be a worthwhile component in theoretical training and practicum development. The third part describes the palliative care research project. It’s an unicentric, retrospective, longitudinal, descriptive, and correlational study, entitled “COVID-19: palliative needs in an era focused on acute care”, aiming to characterize the population of palliative patients admitted to wards dedicated to COVID-19 in a central hospital centre during periods of state of emergency, from March 19th to May 2nd 2020, and from November 6th 2020 to April 30th 2021. It aimed to compare the approaches and therapeutic attitudes performed, framing them within the panorama of adequate care. The selection of patients for the study was based on the Gold Standards Framework Prognostic Indicator Guidance criteria, obtaining a sample of 463 patients, divided into two separate groups - 16 and 447, over the two aforementioned periods. The study provides a comprehensive view of the sociodemographic characteristics of patients with palliative needs admitted to wards dedicated to COVID-19, highlighting the influence and relationship between certain factors. It focuses on the importance of a holistic, person-centered approach, based on good practices and professional ethics, suggesting the need to invest in the training of health professionals and in the creation of protocols.
Description
Keywords
Cuidados paliativos Prática clínica Necessidades paliativas Adequação de cuidados COVID-19 Palliative care Clinical practice Palliative needs Adequacy of care