Structuring a palliative care service in Brazil: experience report

Garcia, João Batista Santos; Rodrigues, Rayssa Fiterman; Lima, Sara Fiterman

doi:10.1016/j.bjane.2013.06.006

Cited by 11 publications

(11 citation statements)

References 6 publications

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“…[ 19 ] Although government's noncommittal approach to the philosophy of PC is said to be the greatest stumbling block to gaining access to and running the PC programs in the developing countries, and that the majority of problems to the implementation of PC services arise from absence of government strategies, consistent national policies, and broad negotiations with countries involved, it seems that structural hurdles to be the main concern of the health system structure of such countries, thereby considering the hindrance to establishing a palliative care system (PCS). [ 9 20 21 ] Based on the researcher's systematic surveys, it seems that the existing knowledge in the field of palliative care is not well expounded, with limited studies delving into the stakeholders’ perceptions about palliative care as well as the obstacles and challenges to its being established. [ 22 23 24 25 ] Therefore, proper planning in relation to palliative care for cancer patients is a perceived need in the Iranian health system.…”

Section: Introductionmentioning

confidence: 99%

Structural challenges of providing palliative care for patients with breast cancer

Khoshnazar

Rassouli

Akbari

et al. 2016

Indian J Palliat Care

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Introduction:To establish a palliative care system (PCS) in Iran, it is necessary to identify the potential barriers.Aim:This study aims to highlight the views of stakeholders to know the challenges of providing palliative care for women with breast cancer.Materials and Methods:Semi-structured in-depth interviews are used with purposeful sampling conducted in Tehran, Iran; from January to June 2015. Twenty participants were included in the study: nine patients with breast cancer and ten health-care providers. The interviews were analyzed using qualitative directed content analysis based on Donabedian model. Data credibility was examined using the criteria of Lincoln and Guba.Results:Based on the pattern of Avedis Donabedian model, two main categories were identified: (1) palliative care services in the health system still remain undefined and (2) lack of adequate care providers. The subcategories emerged from the main categories are: (1) Inexistent home care, (2) specialized palliative care being in high demand, lack of: (a) Rehabilitation program and guidelines, (b) treatment/training protocols, (c) inefficient insurance and out-of-pocket costs, (d) patient referral system, (e) nontransparency of job description, and (f) weakness of teamwork.Discussion:The findings of the study identify views and perceptions of patients as well as the health professionals around the challenges of providing palliative care. To establish a structured PCS, we need to meet the challenges and remove perceived barriers to, including but not limited to, building up knowledge and awareness of health professionals, educating professional, and developing updated, well-defined, and standard treatment protocols, tailored to local conditions.

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Section: Introductionmentioning

confidence: 99%

Structural challenges of providing palliative care for patients with breast cancer

Khoshnazar

Rassouli

Akbari

et al. 2016

Indian J Palliat Care

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“…In 2002, the WHO (12) published its latest definition of palliative care and established nine guiding principles, highlighting multidisciplinary approach as a critical element for full well-being of patients and family members (13) .…”

Section: Discussionmentioning

confidence: 99%

Operation of a hospital palliative care service: a fourth-generation evaluation

et al. 2019

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Objective: Qualitatively evaluate the operation of a palliative care service in oncology. Methodology: Qualitative study conducted in a service in southern Brazil based on a fourth generation evaluation. Between September 2014 and June 2015, 460 hours of operation were observed, and 45 semi-structured interviews and five negotiation meetings were conducted; data were analyzed using the constant comparative method. Results: Potential services are: provision of outpatient palliative care, home and inpatient care provided by a multidisciplinary and support team, meeting the patient’s biological, psychological, social and spiritual needs. Study limitations: ineffective communication between clinical and surgical oncology and palliative care sectors, lack of specialized training for professionals and in interpersonal relationship issues among team members. Final Consideration: For palliative care progress in the service, some arrangements are required to enhance integrality of care.

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“…6 It is noted that PC programs have been increasing considerably in recent years due to the greater number of people at risk of death living with NCDs and the greater family involvement in end-of-life care decisions for their loved ones. 7 For PC to be effective, a broad multidisciplinary approach that involves patients' relatives and uses community resources should be adopted. 8 Therefore, nursing professionals are fundamentally responsible for delivering PC for people with NCDs.…”

Section: Introductionmentioning

confidence: 99%

Nursing diagnoses in patients under palliative care: an integrative Review

Morais

Pereira

Oliveira

et al. 2020

R.pesq.:cuid.fundam.Online

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Objetivo: Identificar as evidências científicas disponíveis acerca dos diagnósticos de enfermagem para pacientes em cuidados paliativos (CP), bem como elencar os mais utilizados nessa prática. Método: Revisão integrativa, na qual foram analisados artigos publicados nos últimos dez anos, nas bases de dados: Literatura Latino-Americana e do Caribe de Informação em Ciências da Saúde (Lilacs); Pubmed; Web of Science; Scopus; CINAHL Resultados: A amostra foi composta por 14 estudos, averiguando-se um maior quantitativo de produções no ano de 2016, sendo a NANDA-I o sistema de classificação mais empregado para a formulação do diagnóstico de enfermagem (DE). Dentre os DE mais prevalentes, destacaram-se: ‘Dor’, ‘Ansiedade relacionada à morte’ e ‘Mobilidade física prejudicada’. Conclusão: Embora seja incipiente a produção de estudos acerca da temática, espera-se que este estudo possa contribuir para a tomada de decisão pelo enfermeiro, baseada em evidências, que possa assegurar ao paciente sob CP uma assistência digna, humanizada, sistematizada e de qualidade.

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Structuring a palliative care service in Brazil: experience report

Cited by 11 publications

References 6 publications

Structural challenges of providing palliative care for patients with breast cancer

Structural challenges of providing palliative care for patients with breast cancer

Operation of a hospital palliative care service: a fourth-generation evaluation

Nursing diagnoses in patients under palliative care: an integrative Review

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