Atención a pacientes crónicos avanzados no oncológicos con necesidad de cuidados al final de la vida en un hospital de media y larga estancia

Integrated palliative care in Europe: a qualitative systematic literature review of empirically-tested models in cancer and chronic disease

“…The 14 included studies were built upon quite different designs (Table 2 ) [ 20 – 33 ]. More specifically, there were 6 RCTs, 2 observational studies, 2 cohort studies, 2 pilot evaluation studies, 1 uncontrolled before-and-after studies and 1 quasi-experimental study.…”

“… This pilot study provides tentative evidence that a collaborative home-based PC* service for patients with advanced CHF may increase the likelihood of death in place of choice and reduce inpatient admissions. Advanced Chronic Disease Navarro et al, 2011, (Spain) [ 33 ] Observational, retrospective and descriptive study 26 EoLC* of advanced chronic non-cancer patients identified by multidimensional evaluation and interdisciplinary teamwork in a medium and long term hospital. General data, terminal criteria, diagnostic and prognostic information, development of advance directives, limiting levels of effort care, times from admission, risk of complicated bereavement.…”

“… Model-responsible team + additional experts meeting Chronic Heart Failure Pattenden et al [ 32 ] treating, consulting Homes, hospice, ‘care of the elderly’ wards concurrent, end of life Heart Failure nurse specialists, MCN nurses, MCN health care assistants, cardiology, ‘care for the elderly’ consultants, district nurses, GPs. Model-responsible team + additional experts meeting, protocol Advanced Chronic Disease Navarro et al [ 33 ] treating Hospital concurrent The MDT consists of physicians, head nurse, ward nurses, auxiliary nurses, collaborating with a dietician, psychologist, social worker, rehabilitation physician, physiotherapist, occupational therapist and speech therapist. Model-responsible team + additional experts meeting Table 3 describes five characteristics of the included studies: the focus of the model, the setting, the time frame of the model, the functions represented, and collaboration strategy involved PC palliative care, GP general practitioner, PMU palliative medicine unit, PCT palliative care team, MDT multidisciplinary team, LCP Liverpool Care Pathway, MNC Marie Curie Cancer Care, CHAH Cambridge hospital at home service, ESAD Home Care Support Team, MDM multidisciplinary meetings a meetings of the team that is involved in the implementation of the model b meetings between the team responsible for the implementation of the model and other disciplines involved in the treatment of the patient …”

“…The first type refers to teams comprising medical and nursing staff; 2 studies [ 23 , 25 ]. The second type concerns multidisciplinary teams comprising different professions: general practitioners (GPs), medical specialists, nurses and specialist nurses, psychiatrist and psychologists, health coordinators, administrative assistants, social workers, ambulance services, dieticians and rarely occupational therapists and speech therapists; 4 studies [ 21 , 26 , 33 ]. The third type corresponds to multidisciplinary teams that additionally involve PC experts.…”

Necesidad de cuidados paliativos en la población inmovilizada de un centro de salud de Vigo

“…Al igual que otros estudios publicados, la mayoría tiene insuficiencias orgánicas y enfermedades degenerativas y muchos están al final de sus vidas, pero no están incluidos en los programas de CP. Varios son los motivos: la dificultad para predecir su supervivencia, la tendencia de los médicos a sobrestimar el tiempo de supervivencia de los pacientes con enfermedades avanzadas, la escasez de herramientas predictivas y de escalas de valoración, y la falta de formación específica en medicina paliativa por parte de los profesionales sanitarios 5,12,13,16 .…”