Barreiras para o encaminhamento para o cuidado paliativo exclusivo: a percepção do oncologista

Freitas, Renata de; Oliveira, Lívia Costa de; Mendes, Gélcio Luiz Quintella; Lima, Fernando Vítor; Chaves, Gabriela Villaça

doi:10.1590/0103-1104202213306

Cited by 12 publications

(12 citation statements)

References 31 publications

(23 reference statements)

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“…Segundo informações coletadas do serviço de AD do HC IV, o tempo médio de permanência dos pacientes na assistência domiciliar é de 44 dias 26,27 . Tal fato demonstra que ainda existe uma limitação quanto ao encaminhamento dos pacientes para os CP, uma vez que este encaminhamento realizado tardiamente tem relação com a sobrevida curta dos pacientes no serviço de AD e esta ausência ou curto período de cuidado integrado, integral e abrangente do indivíduo pode causar o prolongamento do sofrimento e da dor 28 .…”

Section: Discussionunclassified

Profile of patients in palliative care treated by physiotherapy in home care at an oncology hospital

Moura Pinheiro,

Costa Mendes

2024

Mundo Saúde

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O envelhecimento populacional e o aumento das doenças crônicas não transmissíveis, dentre elas o câncer, têm exigido a incorporação dos Cuidados Paliativos (CP) às redes assistenciais em saúde. Assim, o objetivo deste estudo foi descrever o perfil dos pacientes em cuidados paliativos atendidos pela fisioterapia na assistência domiciliar de um hospital de referência em oncologia. Trata-se de um estudo transversal, quantitativo, retrospectivo e descritivo, da análise de 76 prontuários de pacientes assistidos pela fisioterapia na assistência domiciliar do hospital entre agosto de 2018 a agosto de 2019. A maioria dos pacientes era do sexo feminino (n=51, 67,11%), da raça/cor negra (n=46, 60,52%), na faixa etária de 60 a 80 anos (n=36, 47,37%). O câncer de mama (n= 22, 28,95%), pulmão (n=11, 14,47%) e próstata (n=8, 10,53%) foram os mais frequentes e a maioria apresentava progressão da doença. Por fim, o principal motivo para o acompanhamento pela fisioterapia estava relacionado a funcionalidade e mobilidade. A caracterização dos pacientes que necessitam de atendimento fisioterapêutico na assistência domiciliar de um hospital de referência em oncologia faz-se necessário para melhor planejamento do cuidado pois tais informações podem direcionar possibilidades terapêuticas, permitindo maior efetividade no tratamento.

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Section: Discussionunclassified

Profile of patients in palliative care treated by physiotherapy in home care at an oncology hospital

Moura Pinheiro,

Costa Mendes

2024

Mundo Saúde

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“…Alongside dedicating funds for palliative care specialists, institutions should prioritize formation of designated multidisciplinary palliative care teams including nursing, social work, child-life, and spiritual care experts. 46 According to the ANCP in Brazil, <10% of Brazilian hospitals have a multidisciplinary palliative care team. 47 , 48 Thus, progress in PPC relies on initiatives that train PPC professionals beyond physicians to support team-based PPC services.…”

Section: Discussionmentioning

confidence: 99%

Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil

McNeil,

Godfrey,

Loggetto

et al. 2023

JCO Global Oncology

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PURPOSE Early integration of pediatric palliative care (PPC) for children with cancer is critical to improving the quality of life of both the patient and family. Understanding physician perceptions of palliative care and perceived barriers to early integration is necessary to develop PPC in Brazil. METHODS The Assessing Doctors' Attitudes on Palliative Treatment survey was modified for use in Brazil. The survey was open from January 2022 to June 2022 and distributed to physicians of all specialties from participating institutions who treat children with cancer. Statistical analysis was complemented by qualitative analysis of open-ended responses. RESULTS A total of 272 respondents participated. Most respondents reported access to PPC experts for consultation (77.2%) and 34.5% indicated previous palliative care training. Physician knowledge of PPC was generally aligned with WHO guidance (median alignment, 93.0%; range, 80.5%-98.2%). However, about half (53.3%) felt comfortable addressing physical needs of patients receiving PPC, 35.3% addressing emotional needs, 25.8% addressing spiritual needs, and 33.5% addressing grief and bereavement needs. Most respondents (65.4%) felt palliative care should be involved from diagnosis, but only 10.3% stated that this occurred in their setting. The most important barriers identified were physician discomfort (89.0%), limited physician knowledge (88.6%), and lack of home-based services (83.8%). CONCLUSION Despite a strong understanding of the role of palliative care, physicians in Brazil reported low confidence delivering PPC to children with cancer. Additionally, physicians generally believed that PPC should be integrated earlier in the disease trajectory of children with cancer. This work will direct educational and capacity building initiatives to ensure greater access to high-quality PPC for children with cancer in Brazil to address patient and family suffering.

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“…Referring patients to PC was reported as a negative factor, highlighting difficulties faced by some professionals, related to personal suffering, training, patients' and family members' unrealistic expectations, or even institutional issues 14 . These difficulties may also be associated with the professional's set of beliefs and stigmas attached to PC, which can prevent early referral and become aspects that influence the care provided in a negative manner 15 .…”

Section: "Most Do Not Understand What Palliative Care Is They Have No...mentioning

confidence: 99%

Advanced directives as perceived by healthcare professionals

Barbosa,

Lisboa,

Vilaça

2023

Rev. Bioét.

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Advance directives are instruments that aim to ensure the fulfillment of patients’ will in circumstances where they are unable to express themselves freely. This study investigated how health professionals perceive the use of this tool in palliative care, as well as the main ethical dilemmas and gains or losses related to it. Semi-directed interviews were conducted with nine professionals and the data underwent content analysis. Five categories emerged, pointing to a good reception of the resource, as it ensures patient autonomy, strengthening the perception of care, facilitating decisions and providing psychological comfort. On the other hand, the adversities or challenges involved the need for better technical preparation and greater team integration, professional overload, legal uncertainty about its use, end-of-life as a taboo and society’s lack of knowledge about the subject.

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Barreiras para o encaminhamento para o cuidado paliativo exclusivo: a percepção do oncologista

Cited by 12 publications

References 31 publications

Profile of patients in palliative care treated by physiotherapy in home care at an oncology hospital

Profile of patients in palliative care treated by physiotherapy in home care at an oncology hospital

Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil

Advanced directives as perceived by healthcare professionals

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