Palliative care in the home: perceptions of nurses in the Family Health Strategy

Abstract

Objective: To understand the perception of nurses from the Family Health Strategy in relation to palliative care in the home. Methods: A descriptive, exploratory study with a qualitative approach conducted with nine nurses from the Family Health Strategy of the municipality of Lavras -MG. Semi-structured interviews were conducted and data were subjected to content analysis. Results: The various dimensions of care in the home context were identified, along with the performance and limitations of nurses in the care of the patient and his family at end of life. The capacity to establish a bond, by the proximity to people who receive their care, is a remarkable point of the action of these nurses with patients and families in end of life situations. Conclusion: The nurses consider the patient and his family as the unit of care, they have the opportunity to share solidarity, experiences and learning, not only from a professional standpoint, but above all, from a human one. Keywords: Family Health Program; Hospice care; Public health nursing; Home nursing reSumo Objetivo: Compreender a percepção de enfermeiras da Estratégia Saúde da Família com relação aos cuidados paliativos no domicílio. Méto-dos: Estudo descritivo, exploratório, com abordagem qualitativa realizado com nove enfermeiras da Estratégia Saúde da Família do município de Lavras -MG. Foram realizadas entrevistas semiestruturadas e os dados foram submetidos à Análise de Conteúdo. Resultados: As várias dimensões do cuidado no contexto domiciliar foram identificadas, bem como a atuação e as limitações das enfermeiras no cuidado do paciente em final de vida e de sua família. A capacidade em estabelecer vínculo, pela proximidade com pessoas que recebem seus cuidados, é um ponto marcante da atuação dessas enfermeiras com pacientes e familiares nas situações de final de vida. Conclusão: As enfermeiras ao considerar o paciente e sua família como unidade de cuidado, têm a oportunidade de compartilhar solidariedade, experiências e aprendizados, não só do ponto de vista profissional, mas, sobretudo, humano. Descritores: Programa Saúde da Família; Cuidados paliativos; Enfermagem em saúde pública; Assistência domiciliar reSumen Objetivo: Comprender la percepción de enfermeras de la Estrategia Salud de la Familia respecto a los cuidados paliativos en el domicilio. Métodos: Estudio descriptivo, exploratorio, con abordaje cualitativo realizado con nueve enfermeras de la Estrategia Salud de la Familia del municipio de Lavras -MG. Se llevaron a cabo entrevistas semi estructuradas y los datos se sometieron al Análisis de Contenido. Resultados: Fueron identificadas las diversas dimensiones del cuidado en el contexto domiciliario, así como también la actuación y las limitaciones de las enfermeras en el cuidado del paciente al final de su vida y de su familia. La capacidad para establecer vínculo, por la proximidad con personas que reciben sus cuidados, es un punto marcante de la actuación de esas enfermeras con pacientes y familiares en las situaciones de final de vida...

Cuidados paliativos, cuidados compartidos

“…En todos y cada uno de ellos juega un papel importante la conexión esencial entre profesionales de enfermería y sus familiares (Sánchez, 2010;Baliza, 2012).…”

New demands for primary health care in Brazil: palliative care

“…Recently, the concept introduced by Saunders regarding specialized care for patients outside therapeutic possibilities led to the creation of specialized units called hospices. 6 Still, the development and world expansion of PC as a multi-professional approach total, active and continuing care given to the patients and their families, 1,3,7,8 is very recent, beginning in 1967, with the foundation of St. Christopher's Hospice, in London. 6 Nowadays, PC are not a specific place to die, but a philosophy of care wherever the patient is, including their home.…”

“…7 In general, the domicile is usually the preferred place for PC in the opinion of patients and family, that is, patients usually prefer to go to their homes in the terminal phase of the disease. 1,8 A study 2 carried out in four European countries identified that people who die at home are more prone to receive PC than people who die in other locations, such as the hospital. A study 11 with the objective of identifying the preferential location for death in patients with advanced-stage cancer in seven European countries (England, Flanders, Germany, Italy, the Netherlands, Portugal and Spain) has identified that 51% of patients in Portugal and 84% of patients in the Netherlands reported that they would like to die at home.…”

“…Due to the proximity with the family, this professional realizes new possibilities of caring and learns new paths of healthcare assistance. 8 Therefore, the empowerment of chronic patients and their caregivers should be assumed as the new role of PHC nurses, so that they can assume their responsibility in the context of home care.…”

Cuidados paliativos na atenção primária à saúde: considerações éticas

“…However, a Brazilian study 8 pointed out that there are still many barriers to the incorporation of PC in PHCS, especially with regard to the inability of professionals to deal with families and the non-availability of technological resources. The same study, however, highlighted the ability of these professionals to link to patients receiving such care, both for its proximity to these people as per their qualification and distinctive profile, emphasizing the inter-relationship between staff, community and family.…”