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Diretivas antecipadas de vontade: a abordagem dos profissionais de saúde
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Advisor(s)
Abstract(s)
A autora pretendeu com a elaboração deste relatório, obter o grau de Mestre em Cuidados Paliativos, pela Escola Superior de Saúde Dr. Lopes Dias do Instituto Politécnico de Castelo Branco.
Este trabalho encontra-se dividido em duas secções. Na primeira parte a autora elencou os objetivos a que se propôs e pormenorizou o estágio clínico que realizou ao integrar uma equipa de Cuidados Paliativos por um período de 300 horas. Durante esse período observou 157 pessoas, 69 no internamento, 51 na consulta externa e 37 aquando do acompanhamento da Equipa Intra-hospitalar de Cuidados Paliativos. A autora descreveu, também, o acompanhamento de 4 familiares na consulta de Luto. Nesta secção apresentou 3 casos clínicos e submeteu-os a uma análise crítica e reflexiva. De forma sumária, expos a apresentação que realizou no âmbito das reuniões semanais de serviço sobre a Abordagem da Doença Hepática Terminal pelos Cuidados Paliativos.
O projeto de intervenção e de formação estão detalhados na segunda parte do relatório e tiveram como mote a abordagem das Diretivas Antecipadas de Vontade pelos profissionais de saúde. A autora pretendeu, desta forma, melhorar a literacia sobre este tema e o seu registo aquando o acompanhamento de pessoas com condições clínicas paliativas.
Ainda nesta secção, foi desenvolvido o trabalho de investigação que teve como objetivo principal responder às questões: “Qual a evidência atual da eficácia dos Cuidados Paliativos na melhoria da qualidade de vida dos doentes Doença de Parkinson e/ou distúrbios relacionados?” e “Qual a perceção dos efeitos dos Cuidados Paliativos pelas pessoas com Doença de Parkinson e/ou distúrbios relacionados e pelos seus cuidadores?”. Os autores concluíram que os Cuidados Paliativos parecem ser eficazes no acompanhamento destes doentes e dos seus cuidadores, assim como, na melhoria da qualidade de vida dos mesmos.
Contudo, a evidência atual ainda é muito escassa e os resultados dos ensaios clínicos têm sido inconclusivos. O desenvolvimento de mais estudos para melhorar a compreensão e validar o efeito dos Cuidados Paliativos no acompanhamento desta população deve constituir uma preocupação futura. A perceção da escassa referenciação destes indivíduos para seguimento por equipas de Cuidados Paliativos e o conhecimento das necessidades que desenvolvem ao longo do processo de doença, constituíram as principais razões que motivaram a autora a desenvolver este tópico.
Abstract: The author intended, with the preparation of this report, to obtain a Master's degree in Palliative Care, from Escola Superior de Saúde Dr. Lopes Dias of the Instituto Politécnico de Castelo Branco. This work is divided into two sections. In the first part, the author listed the objectives she proposed and detailed the clinical internship she carried out as part of a Palliative Care team for a period of 300 hours. During this period, she observed 157 people, 69 during hospitalization, 51 during external consultation and 37 during monitoring by the Intrahospital Palliative Care Team. The author also described the monitoring of 4 family members in the Bereavement consultation. In this section she presented 3 clinical cases and subjected them to a critical and reflective analysis. Briefly, she explained the presentation made during the weekly service meetings on the Approach to Terminal Liver Disease through Palliative Care. The intervention and training project are detailed in the second part of the report and were based on the approach of Advance Care Directives by health professionals. The author intended, in this way, to improve literacy on this topic and its recording when monitoring people with palliative clinical conditions. Also in this section, research work was developed with the main objective of answering the questions: “What is the current evidence of the effectiveness of Palliative Care in improving the quality of life of patients with Parkinson's disease and/or related disorders?” and “What is the perception of the effects of Palliative Care by people with Parkinson’s Disease and/or related disorders and by their caregivers?”. The authors concluded that Palliative Care appears to be effective in monitoring these patients and their caregivers, as well as improving their quality of life. However, current evidence is still very scarce and results from clinical trials have been inconclusive. The development of more studies to improve understanding and validate the effect of Palliative Care in monitoring this population should be a future concern. The perception of the scarce referral of these individuals for follow-up by Palliative Care teams and the knowledge of the needs they develop throughout the disease process were the main reasons that motivated the author to develop this topic.
Abstract: The author intended, with the preparation of this report, to obtain a Master's degree in Palliative Care, from Escola Superior de Saúde Dr. Lopes Dias of the Instituto Politécnico de Castelo Branco. This work is divided into two sections. In the first part, the author listed the objectives she proposed and detailed the clinical internship she carried out as part of a Palliative Care team for a period of 300 hours. During this period, she observed 157 people, 69 during hospitalization, 51 during external consultation and 37 during monitoring by the Intrahospital Palliative Care Team. The author also described the monitoring of 4 family members in the Bereavement consultation. In this section she presented 3 clinical cases and subjected them to a critical and reflective analysis. Briefly, she explained the presentation made during the weekly service meetings on the Approach to Terminal Liver Disease through Palliative Care. The intervention and training project are detailed in the second part of the report and were based on the approach of Advance Care Directives by health professionals. The author intended, in this way, to improve literacy on this topic and its recording when monitoring people with palliative clinical conditions. Also in this section, research work was developed with the main objective of answering the questions: “What is the current evidence of the effectiveness of Palliative Care in improving the quality of life of patients with Parkinson's disease and/or related disorders?” and “What is the perception of the effects of Palliative Care by people with Parkinson’s Disease and/or related disorders and by their caregivers?”. The authors concluded that Palliative Care appears to be effective in monitoring these patients and their caregivers, as well as improving their quality of life. However, current evidence is still very scarce and results from clinical trials have been inconclusive. The development of more studies to improve understanding and validate the effect of Palliative Care in monitoring this population should be a future concern. The perception of the scarce referral of these individuals for follow-up by Palliative Care teams and the knowledge of the needs they develop throughout the disease process were the main reasons that motivated the author to develop this topic.
Description
Projeto 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 Diretivas antecipadas de vontade Plano antecipado de cuidados Doença de Parkinson Parkinsonismo atípico Advance care directives Advance care plan Atypical Parkinsonian disorders Palliative care Parkinson's disease