Maria Andréa Fernandes

Percepção dos enfermeiros sobre o significado dos cuidados paliativos em pacientes com câncer terminal

This study sought to assess the perception of nurses with respect to cancer patients under palliative care. It is an exploratory study with a qualitative approach conducted with nurses from a hospital attending cancer patients under palliative care located in the city of Joao Pessoa, State of Paraiba. The study included nine nurses who worked in the hospital. The empirical material was collected using the technique of semi-structured interviews and analyzed using the content analysis technique. The interpretative analysis of the interviews led to the definition of three categories: Improving the quality of life through the alleviation of pain and suffering; Palliative Care: a multi-professional study of terminal patients and their families in the grieving process; Communication: a source of dignity in the terminal care process. The conclusion reached is that the study revealed that the nurses involved acknowledge the importance of the multidisciplinary team. It enables the nurses to reflect on the use of communication as an essential element of care for patient and family under palliative care. It is hoped that the data obtained may foster further research on the topic.

A ANALYSIS AND ASSESSMENT OF THE PEACEFUL END OF LIFE THEORY ACCORDING TO FAWCETT’S CRITERIA

Objective: to assess the Peaceful End of Life Theory according to an assessment framework of nursing theories. Method: reflection developed through the investigation of the Peaceful End of Life Theory and its application in Palliative Care nursing practice, using the analysis and assessment framework proposed by Jacqueline Fawcett. The analysis involved an impartial and detailed investigation of the theory, including the scope, context and content of the theory; and the assessment was based on the criteria of significance, internal consistency, parsimony, testability, empirical adequacy and pragmatic adequacy. Results: what the scope is considered, this is considered a medium-range and predictive theory. Its context is based on Katharine Kocalba’s Comfort Theory. In the content, it presents defined, well-outlined and interrelated concepts. Its significance derives from its explicit definition of the concepts of the metaparadigm; its internal consistency from the definition it provides for each concept and its use of the concepts without contradiction. It is parsimonious because nurses can use it for care to end-of-life patients. Conclusion: the importance of the theory is highlighted, as well as its application in the activities of nurses focused on care to end-of-life individuals and their relatives, as it presents concepts and propositions in line with what Palliative Care proposes. DESCRIPTORS: Nursing. Terminally ill. Palliative care. Nursing theory. Assessment of theory. http://dx.doi.org/10.1590/0104-07072017002920017

Family Structure Assessment Of Patients In Palliative Home Care

This study aims to examine the family structure of patients in palliative home care in the light of the Calgary Family Assessment Model (CFAM). This is a qualitative research, conducted in the residences of patients enrolled in the Palliative Care Unit and Pain Treatment (PCUP) of a university hospital located in Recife/Pernambuco, Brazil, in the period from May to July 2014. The sample consisted of five patients enrolled in the PCUP and five family caregivers. Data collection was performed through an interviewing technique using two instruments: the genogram and eco-map. The empirical material was analyzed in the light of the Calgary Model of Family Assessment. The application of the Model demonstrated external family structure relationship with the non-existent neighborhood; support network in diverse health, with very strong relationship with the PCUP highlighting the link with nursing professional; weak relationship concerning Basic Health Unit and strong connection to the church. The obtained data suggest that each researched family has demands to be thought of as focus of nursing care and have faith as a resource for coping with the disease. It follows that the application of CFAM has highlighted the intra-family ties and the relations established with the support networks, signaling strategies to optimize patient care without a therapeutic possibility of cure and their family.

Cuidados paliativos e luto: um estudo bibliométrico

Analisar a producao cientifica, publicada em periodicos online, sobre os cuidados paliativos e luto. Trata-se de um estudo bibliometrico, realizado com 48 artigos, publicados entre 2005 e 2014, selecionados nas bases de dados LILACS, MEDLINE, IBECS, PubMed, SciELO e DOAJ. Os anos de 2012 e 2013 apresentaram um quantitativo maior de publicacoes. Foram identificados 37 veiculos de divulgacao, dos quais o periodico Medicina Paliativa Journal foi o que mais publicou sobre a tematica, e o American Journal of Psychiatry apresentou o maior fator de impacto. A maioria das publicacoes foi produzida por pesquisadores da area de Medicina e predominaram autores com o titulo de doutor. Espera-se ter contribuido para estimular as producoes cientificas nessa tematica e subsidiar na difusao desse conhecimento especifico e auxiliar na preparacao e formacao dos profissionais para cuidado ao paciente sob cuidados paliativos no enfrentamento do luto.Analyze the scientific production published on online journals about palliative care and grief. This is a bibliometric study, conducted with 48 articles, published between 2005 and 2014, selected in the databases LILACS, IBECS, MEDLINE, PubMed, SciELO and DOAJ. The years 2012 and 2013 presented a greater quantitative of publications. Were identified 37 vehicles of which the Palliative Medicine Journal was the one that most published on the subject, and the American Journal of Psychiatry showed the highest impact factor. Most of the publications were produced by medical researchers and predominated authors with PhD. It is expected to have contributed to stimulate scientific production in this thematic and subsidize the dissemination of this specific knowledge and assist in the preparation and training of professionals for patient care under palliative care in the confrontation of grief.

Constipação em pacientes com doençaoncológica avançada em uso de opioides

A constipacao e um disturbio muito comum em pacientes oncologicos com doenca avancada, podendo causar dor, distensaoabdominal, nauseas e vomitos. O presente estudo teve como objetivo identificar evidencias disponiveis na literatura sobre asacoes de cuidados paliativos para o paciente oncologico, em uso de opioides com constipacao intestinal, considerando-seque sao as acoes decorrentes das necessidades de cuidado que podem contribuir para o controle desse sintoma. A presenteinvestigacao trata-se de uma revisao integrativa da literatura e, para selecionar as publicacoes cientificas, foram acessadas asbases de dados da Biblioteca Virtual de Saude, especificamente LILACS e SciELO. Os criterios de inclusao adotados foram:artigos que retratassem cuidados paliativos ao paciente com constipacao intestinal decorrente do uso de opioides; que estivessemindexados nas bases de dados supracitadas; que fossem publicados na lingua portuguesa, no periodo de 2002 a 2012e cujos resumos e textos estivessem disponiveis online, na integra. Foram excluidos os artigos com acesso restrito. Ao finalda busca, encontraram-se 20 referencias, contudo somente sete se enquadravam nos criterios de inclusao desse estudo. Osartigos inseridos nesta pesquisa ressaltaram que a constipacao e um sintoma bastante comum em pacientes oncologicos comdoenca avancada em uso de opioides. Essa revisao mostrou que a adequada avaliacao, o tratamento nutricional, o uso racionalde medicamentos laxativos e antagonistas de opioides, assim como novos recursos dietoterapicos, como o uso do fungoAgaricus sylvaticus, podem promover o adequado controle desse sintoma, evitando complicacoes e procedimentos invasivos. Constipation is a very common disorder in oncologic patients with advanced disease, and it may cause pain, abdominal distension,nausea and vomit. This study had as its aim to identify available evidences on the literature about actions of palliativecare for oncologic patients, considering these actions to be the result from the necessities of care that may contribute to thecontrol of this symptom. This investigation is a literature integrative review; and to select scientific publications, we accessedthe databases from Virtual Health Library (VHL), specifically LILACS and SciELO. Inclusion criteria were adapted: the articlesportraying palliative care to patients with constipation due to the use of opioids, with were indexed in the databases mentionedabove, which were published in Portuguese in the period from 2002 to 2012 and whose abstracts and texts were availableonline in its entirety. We excluded studies with restricted access. At the end of the research, we found 20 references but onlyseven met the criteria for inclusion. The articles included in this study pointed out that constipation is a very common symptomin cancer patients with advanced disease using opioids. This review showed that a proper evaluation, nutritional management,rational use of medicines and laxatives opioids antagonists, as well as new features such as the use of diet-therapeutic drugsbased on Agaricus sylvaticus can promote adequate control of symptoms, preventing complications and invasive procedures.