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Diagnóstico clínico, avaliação e cuidados ao doente nos últimos dias ou horas de vida, em contexto de hospital de agudos
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| 18.33 MB | Adobe PDF |
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Abstract(s)
No âmbito do 2º Curso de Mestrado em Cuidados Paliativos da Escola Superior de Saúde Dr. Lopes Dias, do Instituto Politécnico de Castelo Branco, surge o presente relatório, como parte integrante dos requisitos para obtenção do grau de Mestre em Cuidados Paliativos. Este, tendo por base os objetivos definidos em sede de projeto de prática clínica e relatório e num processo reflexivo e crítico, tem como objetivo descrever as atividades desenvolvidas, em prática clínica e como estas refletem a aquisição de competências. A sua reflexão crítica é suportada por evidência científica no sentido de mobilizar e consolidar conhecimentos teóricos aplicados na prática assistencial.
No seu desenvolvimento procura-se dar resposta aos objetivos: refletir criticamente sobre a tipologia e o modelo de organização da equipa onde decorreu a prática clínica (ESCP); demonstrar competências na implementação de um plano assistencial de qualidade, delineado em equipa interdisciplinar, à pessoa com doença crónica, avançada e progressiva, à sua familia e ao grupo social de pertença maximizando a sua qualidade de vida e diminuindo o sofrimento; demonstrar como se processou a aquisição de competências instrumentais, interpessoais e sistémicas; rever criticamente e de modo integrado as competências adquiridas nas áreas-chave dos cuidados paliativos; descrever o processo de desenvolvimento e implementação do projeto de intervenção numa estrutura residencial para idosos e UCB.
Encontra-se estruturado em dois momentos: a prática clínica desenvolvida segundo os pilares dos cuidados paliativos - trabalho em equipa, controlo de sintomas, comunicação e apoio à família, junto de uma equipa diferenciada em cuidados paliativos e a implementação do projeto de intervenção que privilegia a temática de últimos dias ou horas de vida, no que concerne à sua identificação, avaliação e planeamento dos cuidados. Dado que os últimos dias ou horas de vida correspondem a uma fase especialmente intensiva e delicada pelo impacto que causam no doente, família e profissionais de saúde, é premente que os profissionais adquiram competências pessoais e profissionais que lhes permitam estar preparados para identificar o doente nesta etapa da vida, sentindo-se simultaneamente seguros, perante o processo de gestão dos cuidados em fim de vida. Apenas com um diagnóstico definido é possível reajustar o plano de cuidados e definir como objetivos principais o controlo de sintomas, as medidas de conforto, a suspensão de intervenções inadequadas e o apoio à família.
A sua realização assenta ainda na pretensão e responsabilidade de desafiar e motivar os profissionais de saúde a integrar e aplicar os princípios e filosofia dos Cuidados Paliativos na prática profissional com o intuito de prestar cuidados de excelência.
ABSTRACT: Within the 2nd “Palliative Care Master” of Escola Superior de Saúde Dr. Lopes Dias, from Instituto Politécnico de Castelo Branco, arises this report as an intrinsic part of the requirements for the degree of Master of Palliative Care. This report, based on defined objectives, on project of clinical practice and report and on a reflective and critical process, aims to describe the activities developed in clinical practice and how these reflect the acquisition of skills. Its critical reflection is supported by scientific evidence in order to mobilize and consolidate theoretical knowledge applied in care practice. In its development it is sought to achieve goals: to reflect critically on the type and organization model of the team, who ensued the clinical practice (ESCP); to demonstrate skills in implementing a quality care plan, outlined in an interdisciplinary team, the person with chronic, advanced and progressive disease, their family and social group maximizing their life quality and reducing suffering; to demonstrate how it processed the acquisition of instrumental, interpersonal and systemic competencies; to review, critically and in an integrated manner, the skills acquired in the key areas of palliative care; to describe the development and implementation process of the intervention project in a elderly residential structure and UCB. It is structured in two phases: the clinical practice developed under the pillars of palliative care - teamwork, symptom control, communication and family support, along with a differentiated palliative care team and the intervention project implementation which puts emphasis on the last days or hours of life theme, regarding the identification, evaluation and care planning. Since the last days or hours of life represent an especially intensive and delicate phase because of the impact they have on the patient, family and health professionals, it is urgent that professionals acquire personal and professional skills to enable them to be prepared to identify the patient in this stage of life, feeling simultaneously safe, before the management process of end of life care. Only with a definite diagnosis, it possible to readjust the care plan and set as main goals the symptoms controls, comfort measures, suspension of inappropriate interventions and family support. Its accomplishment is also based on the intention and responsibility to challenge and motivate health professionals to integrate and apply the palliative care principles and philosophy in professional practice in order to provide excellent care.
ABSTRACT: Within the 2nd “Palliative Care Master” of Escola Superior de Saúde Dr. Lopes Dias, from Instituto Politécnico de Castelo Branco, arises this report as an intrinsic part of the requirements for the degree of Master of Palliative Care. This report, based on defined objectives, on project of clinical practice and report and on a reflective and critical process, aims to describe the activities developed in clinical practice and how these reflect the acquisition of skills. Its critical reflection is supported by scientific evidence in order to mobilize and consolidate theoretical knowledge applied in care practice. In its development it is sought to achieve goals: to reflect critically on the type and organization model of the team, who ensued the clinical practice (ESCP); to demonstrate skills in implementing a quality care plan, outlined in an interdisciplinary team, the person with chronic, advanced and progressive disease, their family and social group maximizing their life quality and reducing suffering; to demonstrate how it processed the acquisition of instrumental, interpersonal and systemic competencies; to review, critically and in an integrated manner, the skills acquired in the key areas of palliative care; to describe the development and implementation process of the intervention project in a elderly residential structure and UCB. It is structured in two phases: the clinical practice developed under the pillars of palliative care - teamwork, symptom control, communication and family support, along with a differentiated palliative care team and the intervention project implementation which puts emphasis on the last days or hours of life theme, regarding the identification, evaluation and care planning. Since the last days or hours of life represent an especially intensive and delicate phase because of the impact they have on the patient, family and health professionals, it is urgent that professionals acquire personal and professional skills to enable them to be prepared to identify the patient in this stage of life, feeling simultaneously safe, before the management process of end of life care. Only with a definite diagnosis, it possible to readjust the care plan and set as main goals the symptoms controls, comfort measures, suspension of inappropriate interventions and family support. Its accomplishment is also based on the intention and responsibility to challenge and motivate health professionals to integrate and apply the palliative care principles and philosophy in professional practice in order to provide excellent care.
Description
Relatório de Prática Clínica apresentado à Escola Superior de Saúde Dr. Lopes Dias do Instituto Politécnico de Castelo Branco para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Cuidados Paliativos.
Keywords
Cuidados paliativos Prática clínica Últimos dias ou horas de vida Processo de diagnóstico clínico Palliative care Clinical practice Last hours or days of life Clinical diagnostic process