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Publication
Necessidades e dificuldades dos enfermeiros dos Cuidados de Saúde Primários na prestação de ações paliativas no domicílio
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| 7.25 MB | Adobe PDF |
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Abstract(s)
Os cuidados de saúde primários são cuidados centrados na pessoa, nas famílias, na comunidade e ajustados às necessidades de saúde ao longo do ciclo de vida. Com o envelhecimento da população, o aumento do número de pessoas com doenças crónicas não transmissíveis e as expectativas dos doentes e família face aos cuidados de saúde, são desafios frequentes para os enfermeiros dos cuidados de saúde primários responsáveis pelo acompanhamento destes doentes que apresentam necessidades cada vez mais complexas (OMS, 2008). Este relatório foi concebido no âmbito do 2º semestre do 12º Mestrado em Cuidados Paliativos da Escola Superior de Saúde Dr. Lopes Dias do Instituto Politécnico de Castelo Branco e pretende refletir sobre as competências adquiridas ao longo do mesmo. O tema proposto tem como objetivo evidenciar as necessidades e dificuldades dos Enfermeiros dos Cuidados de Saúde Primários na prestação de ações paliativas no domicílio, conhecidas e enfrentadas por muitos profissionais um pouco por todo o mundo. Os cuidados paliativos têm como base competências técnicas, com rigor científico e que visam promover uma melhor qualidade de vida de doentes com doença crónica, incurável, avançada e progressiva e assenta em quatro pilares fundamentais: o controlo de sintomas, a comunicação, o apoio em família e o trabalho em equipa (Neto, 2020; CNCP, 2021). Este relatório sustenta-se nestes quatro pilares e está organizado em três partes: a contextualização e reflexão sobre a prática clínica, a Revisão Sistemática de Literatura e o Projeto de intervenção. Foram identificadas dificuldades na prestação de ações paliativas no domicílio, por parte da equipa de cuidados de saúde primários, relacionadas à falta de conhecimento, de formação, de colaboração e défice de comunicação com outros profissionais da equipa multidisciplinar. O acesso e articulação com os serviços de saúde, bem como a comunicação com doente e família, foram também necessidades identificadas nesta área de cuidados. Para colmatar estas dificuldades e as necessidades sentidas pelos enfermeiros na prestação de ações paliativas é necessário implementar estratégias, tais como incentivo à formação, criação de protocolos, promoção da literacia em saúde e suporte emocional para profissionais de saúde, doentes e família. Medidas que objetivam melhores cuidados de saúde e condições de acesso às equipas especializadas.
Abstract: Primary health care is care centred on the person, their family and the community, and adjusted to health needs throughout the life cycle. With the ageing population, the increase in the number of people with non-communicable chronic diseases and the expectations of patients and their families with regard to healthcare, these are frequent challenges for primary healthcare nurses who are responsible for monitoring these patients who have increasingly complex needs (WHO, 2008). This report was conceived as part of the 2nd semester of the 12th Master's Degree in Palliative Care at the Dr Lopes Dias School of Health of the Polytechnic University of Castelo Branco and aims to reflect on the skills acquired during the course. The proposed theme aims to highlight the needs and difficulties of Primary Health Care Nurses in providing palliative care approach at home, which are known and faced by many professionals all over the world. Palliative care is based on technical skills with scientific rigour and aims to promote a better quality of life for patients with chronic, incurable, advanced and progressive illnesses. It is based on four fundamental pillars: symptom control, communication, family support and teamwork (Neto, 2020; CNCP, 2021). This report is based on these four pillars and is organised into three parts: the contextualisation and reflection on clinical practice, the Systematic Literature Review and the Intervention Project. Difficulties were identified in the provision of palliative care at home by the primary healthcare team, related to a lack of knowledge, training, collaboration and poor communication with other professionals in the multidisciplinary team. Access to and coordination with health services, as well as communication with the patient and family, were also needs identified in this area of care. In order to overcome these difficulties and the needs felt by nurses in providing palliative care approach, it is necessary to implement strategies such as encouraging training, creating protocols, promoting health literacy and emotional support for health professionals, patients and families. These measures aim to improve healthcare and access to palliative care specialist teams.
Abstract: Primary health care is care centred on the person, their family and the community, and adjusted to health needs throughout the life cycle. With the ageing population, the increase in the number of people with non-communicable chronic diseases and the expectations of patients and their families with regard to healthcare, these are frequent challenges for primary healthcare nurses who are responsible for monitoring these patients who have increasingly complex needs (WHO, 2008). This report was conceived as part of the 2nd semester of the 12th Master's Degree in Palliative Care at the Dr Lopes Dias School of Health of the Polytechnic University of Castelo Branco and aims to reflect on the skills acquired during the course. The proposed theme aims to highlight the needs and difficulties of Primary Health Care Nurses in providing palliative care approach at home, which are known and faced by many professionals all over the world. Palliative care is based on technical skills with scientific rigour and aims to promote a better quality of life for patients with chronic, incurable, advanced and progressive illnesses. It is based on four fundamental pillars: symptom control, communication, family support and teamwork (Neto, 2020; CNCP, 2021). This report is based on these four pillars and is organised into three parts: the contextualisation and reflection on clinical practice, the Systematic Literature Review and the Intervention Project. Difficulties were identified in the provision of palliative care at home by the primary healthcare team, related to a lack of knowledge, training, collaboration and poor communication with other professionals in the multidisciplinary team. Access to and coordination with health services, as well as communication with the patient and family, were also needs identified in this area of care. In order to overcome these difficulties and the needs felt by nurses in providing palliative care approach, it is necessary to implement strategies such as encouraging training, creating protocols, promoting health literacy and emotional support for health professionals, patients and families. These measures aim to improve healthcare and access to palliative care specialist teams.
Description
Relatório de prática clínica apresentado à Escola Superior de Saúde Dr. Lopes Dias do Instituto Politécnico de Castelo para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Cuidados Paliativos.
Keywords
Cuidados Paliativos Ações paliativas Enfermeiros de Cuidados de Saúde Primários Domicílio Palliative care Palliative care approach Primary health care nurses Homecare