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Diagnóstico clínico do estado de agonia: experiência numa equipa comunitária de suporte em cuidados paliativos
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Advisor(s)
Abstract(s)
Os Cuidados Paliativos são cuidados ativos e totais, que devem ser prestados por
equipas multidisciplinares com formação e treino adequado. A complexidade destes
doentes exige aos profissionais preparação técnica, formação teórica e experiência
prática, pelo que a formação diferenciada na área é essencial para garantir a
excelência e a qualidade dos cuidados prestados.
Esta dissertação, realizada no âmbito do curso de Mestrado em Cuidados
Paliativos da Escola Superior de Saúde Drº Lopes Dias, consiste no relatório de
prática clínica para obtenção do grau de mestre, realizado sob orientação da
Professora Doutora Paula Sapeta. A temática central do mesmo, que constituiu o meu
projeto de intervenção, são os Cuidados na Agonia - O Diagnóstico Clínico das Últimas
Horas e Dias de Vida do Doente. No mesmo vai ser elaborada uma descrição e relato,
de forma pormenorizada, de todas as atividades preconizadas e realizadas neste
contexto clinico, elaborando paralelamente uma reflexão crítica do meu próprio
desempenho.
A prática clínica foi realizada numa Equipa Comunitária de Suporte em Cuidados
Paliativos, tendo sido uma experiência extremamente enriquecedora que me permitiu
uma assimilação dos conhecimentos adquiridos no primeiro ano e uma partilha de
experiências que se mostrou essencial para o meu desempenho profissional.
Durante a prática clínica foi desenvolvido um projeto de intervenção em conjunto
com uma colega de mestrado, tendo por base os dois temas que cada uma estaria a
desenvolver: Diagnóstico Clínico do Estado de Agonia e Apoio no luto. Visto serem
dois temas que se completavam, organizamos um Curso Básico em Cuidados
Paliativos a ser feito na área onde exercemos funções para todos os profissionais que
quisessem participar. Este curso teve o apoio científico da APCP o que se mostrou
uma mais-valia quer para os formandos quer para nós próprias enquanto
profissionais de saúde.
Os doentes agónicos são um subgrupo de doentes que necessita de cuidados
especializados, com o “objetivo principal de proporcionar o máximo de conforto ao
paciente,promovendo a máxima dignidade de vida,(…) devem ser tomadas as medidas
adequadas, evitando o encarniçamento terapêutico”(NET0, 2010). O deficiente
diagnóstico do estado de agonia vai ser sempre recordado pela família como algo
muito doloroso e tal situação afeta também os profissionais que “podem viver o
acontecimento como um fracasso profissional que questiona os esforços previamente
realizados”ROSARIO, 2002.
ABSTRACT: The Palliative Care are total and assets, which must be provided by multidisciplinary teams with training and graduated people. The complexity of these patients requires the professional technical training, theoretical training and practical experience, so the different formation in the area is essential to ensure the excellence and quality of care. This dissertation, conducted as part of the Graduate Course in Palliative Care, School of Health Dr º Lopes Dias, the report consists of clinical practice for the degree of Master, conducted under the orientation of Professor Paula Sapeta. The central theme of it, which was my project intervention, are the Care in The Last Days and Hours of Life - Clinical Diagnosis of The Last Hours and Days of Life. The same will be an elaborate description and report, in detail, all the activities recommended and performed in this clinical context, working alongside a critical reflection of my own performance. The clinical practice that was performed in a Community Support Team in Palliative Care, having been an extremely enriching experience that allowed me to assimilate the knowledge acquired in the first year and a sharing of experiences that proved essential to my work performance. During clinical practice was developed an intervention project together with a colleague's thesis; based on the two themes that each would develop: Clinical Diagnosis of The Last Hours and Days of Life and Bereavement Support. Since they are two themes that are completed, organized a Basic Course in Palliative Care to be done in the area where we exercise functions for all professionals who wanted to participate. This course was supported scientific APCP which proved an asset both for the trainees want to own us as health professionals. Patients in Last Days and Hours of Life are a subgroup of patients who require specialized care, with the "main objective to provide maximum comfort to the patient, promoting the highest dignity of life, (...) should be taken appropriate action, avoiding the ferocity therapeutic" (NETO, 2010). The poor state diagnosis the Last Days and Hours of Life will always be remembered by his family as very painful and this situation affects also the professionals who "can live the event as a professional failure that questions the efforts previously made" ROSARIO, 2002.
ABSTRACT: The Palliative Care are total and assets, which must be provided by multidisciplinary teams with training and graduated people. The complexity of these patients requires the professional technical training, theoretical training and practical experience, so the different formation in the area is essential to ensure the excellence and quality of care. This dissertation, conducted as part of the Graduate Course in Palliative Care, School of Health Dr º Lopes Dias, the report consists of clinical practice for the degree of Master, conducted under the orientation of Professor Paula Sapeta. The central theme of it, which was my project intervention, are the Care in The Last Days and Hours of Life - Clinical Diagnosis of The Last Hours and Days of Life. The same will be an elaborate description and report, in detail, all the activities recommended and performed in this clinical context, working alongside a critical reflection of my own performance. The clinical practice that was performed in a Community Support Team in Palliative Care, having been an extremely enriching experience that allowed me to assimilate the knowledge acquired in the first year and a sharing of experiences that proved essential to my work performance. During clinical practice was developed an intervention project together with a colleague's thesis; based on the two themes that each would develop: Clinical Diagnosis of The Last Hours and Days of Life and Bereavement Support. Since they are two themes that are completed, organized a Basic Course in Palliative Care to be done in the area where we exercise functions for all professionals who wanted to participate. This course was supported scientific APCP which proved an asset both for the trainees want to own us as health professionals. Patients in Last Days and Hours of Life are a subgroup of patients who require specialized care, with the "main objective to provide maximum comfort to the patient, promoting the highest dignity of life, (...) should be taken appropriate action, avoiding the ferocity therapeutic" (NETO, 2010). The poor state diagnosis the Last Days and Hours of Life will always be remembered by his family as very painful and this situation affects also the professionals who "can live the event as a professional failure that questions the efforts previously made" ROSARIO, 2002.
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 Agonia Ultimas horas ou dias de vida Obstáculos ao diagnóstico clinico Palliative care Agony Last hours or days of life Barriers to clinical diagnosis