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PrevalĂȘncia dos 5 sintomas nos Ășltimos dias e horas de vida, em Portugal e em Espanha
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Abstract(s)
No Ăąmbito do Mestrado em Cuidados Paliativos (CP) da Escola Superior de SaĂșde Dr. Lopes Dias, o presente relatĂłrio surge como predicado Ă aquisição do grau de Mestre, resultado de um percurso de emancipação durante a prĂĄtica clĂnica numa equipa diferenciada, da Comunidade AutĂłnoma da Extremadura.
O perĂodo de prĂĄtica clĂnica foi planificado com base em objetivos, atividades e competĂȘncias em sede de projeto de intervenção, direcionado a uma equipa de suporte em CP, tanto em internamento como na comunidade e, a uma unidade de cuidados continuados integrados, onde exerço a minha profissĂŁo. Os objetivos foram alcançados ao longo de 300 horas, 200 horas destas destinadas Ă Equipa de Suporte de Cuidados (ESCP) e as 100 restantes ao projeto de intervenção em serviço, no alcance da melhoria de cuidados. Os CP sĂŁo uma filosofia de vida que cuida de pessoas com doença incurĂĄvel, grave e com prognĂłstico reservado, promovendo o conforto e o bem-estar. Esta intervenção holĂstica Ă© norteada por quatro pilares: controlo sintomĂĄtico, comunicação adequada, apoio Ă famĂlia e no luto e, trabalho em equipa. O conjunto de atividades implementadas no perĂodo de prĂĄtica clĂnica consolidou a aquisição de competĂȘncias nestes domĂnios. Os Ășltimos dias e horas de vida, exigem um modelo de deliberação de cuidados centrado na pessoa cujo, principal objetivo Ă© exclusivamente o seu conforto. Para isso, os objetivos devem ser realistas para controlar sintomas, evitar açÔes perturbadoras do conforto, reajustar terapĂȘutica, suspender medidas supĂ©rfluas e, apoiar a famĂlia.
O projeto de melhoria dos cuidados, implementado no local onde exerço funçÔes, teve como temĂĄtica âPrevalĂȘncia dos 5 Principais Sintomas nos Ăltimos Dias e Horas de Vida, em Portugal e Espanhaâ para a melhoria da prestação de cuidados, com a atempada identificação destes doentes, atravĂ©s do diagnĂłstico desta fase, com recurso Ă avaliação dos sintomas prevalentes. A pertinĂȘncia do tema Ă© justificada pela inversĂŁo da pirĂąmide etĂĄria e, pelas inĂșmeras admissĂ”es de doentes em fim de vida.
Este relatĂłrio, consiste no registo de todas as intervençÔes implementadas, atravĂ©s de uma postura crĂtica e reflexiva do trabalho desempenhado, na busca metĂłdica do âsaber ser, saber estar e saber fazerâ, para cuidar da melhor forma que um ser humano possa ser cuidado, jamais esquecendo a pessoa que foi e, a pessoa que Ă©. Afinal, todos precisamos uns dos outros e, quando caminhamos lado a lado o, percurso Ă© mais pleno, Ă luz da filosofia que pauta a tĂĄbua de valores CP.
Abstract: Encompassed within the degree of Master of Clinical Practice in Palliative Care of Escola Superior de SaĂșde Dr. Lopes Dias, this report is a predicate for the Master's degree acquisition and results from an emancipation course during clinical practice in a differentiated team from the Autonomous Community of Extremadura, Spain. The clinical practice period was planned by objectives, activities, and competencies, as part of an intervention project targeted towards a support team in Palliative Care, both in inpatient and in the community, and to a continuing health care institution. The goals were achieved over 300 hours, 200 of these for the Palliative Care Support Team and the remaining 100 for the intervention project in service, in order to improve care. Palliative Care is a philosophy of life that cares for people with incurable, severe illness and with a reserved prognosis, promoting comfort and well-being. This holistic intervention is guided by four pillars: symptomatic control, adequate communication, support for family and mourning, and teamwork. The set of activities implemented in the period of clinical practice consolidated the acquisition of competences in these domains. The last days and hours of life require a model of deliberation of care centered on the person's comfort. To achieve this, the objectives must realistically control symptoms, avoid disturbing actions, readjust therapy, suspend superfluous measures, and support the family. The project in care improvement, implemented in said continuing healthcare institution, had as its motif "Prevalence of the 5 Main Symptoms in the Last Days and Hours of Life, in Portugal and Spain", attained by improving of the care giving, with timely identification of these patients, throughout diagnosis, by evaluating the prevalent symptoms. The subject's pertinence is justified by the inversion of the age pyramid and by the numerous admissions of end-of-life patients. This report comprehends the documentation of all interventions implemented, through a critical and thought over position on the work performed, and in the methodical search of "know how to be, know how to do and know how to know", in order to take care of a human being, the best way possible, never forgetting the person who was and the person who is. After all, we all need each other and when we walk side by side, the path is ample, enlightened of the philosophy that guides Palliative Care.
Abstract: Encompassed within the degree of Master of Clinical Practice in Palliative Care of Escola Superior de SaĂșde Dr. Lopes Dias, this report is a predicate for the Master's degree acquisition and results from an emancipation course during clinical practice in a differentiated team from the Autonomous Community of Extremadura, Spain. The clinical practice period was planned by objectives, activities, and competencies, as part of an intervention project targeted towards a support team in Palliative Care, both in inpatient and in the community, and to a continuing health care institution. The goals were achieved over 300 hours, 200 of these for the Palliative Care Support Team and the remaining 100 for the intervention project in service, in order to improve care. Palliative Care is a philosophy of life that cares for people with incurable, severe illness and with a reserved prognosis, promoting comfort and well-being. This holistic intervention is guided by four pillars: symptomatic control, adequate communication, support for family and mourning, and teamwork. The set of activities implemented in the period of clinical practice consolidated the acquisition of competences in these domains. The last days and hours of life require a model of deliberation of care centered on the person's comfort. To achieve this, the objectives must realistically control symptoms, avoid disturbing actions, readjust therapy, suspend superfluous measures, and support the family. The project in care improvement, implemented in said continuing healthcare institution, had as its motif "Prevalence of the 5 Main Symptoms in the Last Days and Hours of Life, in Portugal and Spain", attained by improving of the care giving, with timely identification of these patients, throughout diagnosis, by evaluating the prevalent symptoms. The subject's pertinence is justified by the inversion of the age pyramid and by the numerous admissions of end-of-life patients. This report comprehends the documentation of all interventions implemented, through a critical and thought over position on the work performed, and in the methodical search of "know how to be, know how to do and know how to know", in order to take care of a human being, the best way possible, never forgetting the person who was and the person who is. After all, we all need each other and when we walk side by side, the path is ample, enlightened of the philosophy that guides Palliative Care.
Description
RelatĂłrio de prĂĄtica ClĂnica apresentado Ă Escola Superior de SaĂșde Dr. Lopes Dias, do Instituto PolitĂ©cnico de Castelo Branco para cumprimento dos requisitos necessĂĄrios Ă obtenção do grau de Mestre em Cuidados Paliativos, realizada sob a orientação cientĂfica da Professora Doutora Ana Paula Gonçalves Antunes Sapeta do Instituto PolitĂ©cnico de Castelo Branco.
Keywords
Cuidados paliativos Fim de vida Sintomas Ăltimos dias e horas de vida End of life Palliative care Symptoms Last days and hours of life