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Furtado MA, Nogueira VP, Araújo MCP, Cestari VRF, Pessoa VLMDP. Palliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study. Rev Bras Enferm 2024; 77Suppl 1:e20230218. [PMID: 38958353 PMCID: PMC11213540 DOI: 10.1590/0034-7167-2023-0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 10/19/2023] [Indexed: 07/04/2024] Open
Abstract
OBJECTIVE To comprehend the multiprofessional actions regarding palliative care for patients in the Intensive Care Unit affected by SARS-CoV-2. METHODS A comprehensive qualitative study conducted with 31 professionals from the Intensive Care Units of a university hospital, based on the Theory of Peaceful End of Life. RESULTS The analysis of the discourse led to the identification of two categories: "Multidisciplinary actions to promote comfort at the end of life" and "Palliative care during the pandemic period and the promotion of emotional and spiritual comfort." FINAL CONSIDERATIONS It became evident that local administration needs to invest in measures that reduce barriers to the implementation of palliative care during times of crisis. Understanding the discourse highlighted that non-specialized professionals can provide basic palliative care appropriately, without diminishing the importance and necessity of the presence of palliative care specialists in various hospital areas.
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López-Panza ER, Pacheco-Roys VC, Fernández-Ahumada KJ, Díaz-Mass DC, Expósito-Concepción MY, Villarreal-Cantillo E, Aviles Gonzalez CI. Competencies of the nurses in the limitation of therapeutic effort in the intensive care unit: An integrative review. Int J Nurs Sci 2024; 11:143-154. [PMID: 38352294 PMCID: PMC10859575 DOI: 10.1016/j.ijnss.2023.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 12/04/2023] [Accepted: 12/13/2023] [Indexed: 02/16/2024] Open
Abstract
Objective Nurses inevitably encounter patients who require care aimed at limiting therapeutic effort (LTE), even though many of them are not prepared to provide support to individuals with terminal illnesses and their families. One of the contexts in which the LTE is considered is the intensive care unit (ICU). This review is to describe the competencies for the execution of a nursing professional role in the LTE in the ICU. Method An integrative review of the literature published between the years 2010 and 2023. The search was carried out in five databases: Medline, Wiley Online Library, SciELO, ScienceDirect, and Web of Science. The Critical Appraisal Skills Programme in Spanish was used as the template for study evaluation. The methodology of the Oxford Center for Evidence-Based Medicine (CEBM) was used to assess the level of evidence and the degree of recommendation. Result A total of 25 articles in a wide range of studies were included. The findings suggest that the competencies for LTE in the ICU are direct patient care, family-centered care, and the role of the nurse within the team. However, more high-quality studies are needed to confirm these conclusions. Three categories were identified: (a) competencies as defender agent between the patient, his family, and the interdisciplinary team; (b) competencies for decision-making in limiting the therapeutic effort; and (c) competencies for nursing therapeutic interventions at the end of life. Conclusion The competencies of the nursing professionals who work in the adult ICU in the LTE are essential to the patient's quality of life, dignity of their death, and comprehensive family support for coping with grief.
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Affiliation(s)
- Elvia R. López-Panza
- Nursing Department, Universidad del Norte, Barranquilla, Colombia
- Nursing Program, Faculty of Health Sciences, Universidad Popular del César, Valledupar, Colombia
| | - Vanessa C. Pacheco-Roys
- Nursing Department, Universidad del Norte, Barranquilla, Colombia
- Clínica Valledupar, Valledupar, Colombia
| | - Kelly J. Fernández-Ahumada
- Nursing Department, Universidad del Norte, Barranquilla, Colombia
- Hospital Universidad del Norte, Soledad, Colombia
| | | | | | | | - Cesar I. Aviles Gonzalez
- Nursing Program, Faculty of Health Sciences, Universidad Popular del César, Valledupar, Colombia
- Department of Medical Sciences and Public Health, University of Cagliari, Cittadella Universitaria di Monserrato, Cagliari, Italy
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do Prado E, Camparoto CW, Takemoto AY, Ichisato SMT, Miguel MEGB, Marcon SS. Palliative care strategies in the management of people with serious cases of COVID-19. Rev Bras Enferm 2023; 76Suppl 1:e20220308. [PMID: 36888747 PMCID: PMC9987459 DOI: 10.1590/0034-7167-2022-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 10/13/2022] [Indexed: 03/08/2023] Open
Abstract
OBJECTIVES to analyze the assistance strategies in palliative care developed in the COVID-19 pandemic for critically ill patients and their families. METHODS an integrative review carried out in August 2021 and updated in April 2022 in the Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), US National Library of Medicine (PubMed), Web of Science databases, and presented in the PRISMA flowchart. RESULTS thirteen works were selected for reading and content analysis, from which emerged the two main themes that reflect the reality evidenced in this context: The sudden advent of COVID-19 with impacts on palliative care; and The strategies used in palliative care to mitigate these impacts. FINAL CONSIDERATIONS palliative care is the best strategy for providing health care, used as a comfort to bring relief and comfort to patients and families.
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Velasco Yanez R, Frota Goyanna N, Carvalho Fernandes A, Moura Barbosa Castro R, Holanda da Cunha G, Silva Ferreira I, Miranda Mattos S, Magalhães Moreira T. Palliative Care in Breast Cancer During the COVID-19 Pandemic: A Scoping Review. Am J Hosp Palliat Care 2023; 40:351-364. [PMID: 35581537 PMCID: PMC9127630 DOI: 10.1177/10499091221101879] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic has harmed the provision of palliative care (PC) services for women with breast cancer due to all the restrictions that came along with the virus. OBJECTIVE To map the available evidence on the situation of PC in breast cancer during the COVID-19 pandemic. METHODS A scoping review was carried out based on the methodology proposed by the Joanna Briggs Institute. The search was conducted in nine databases, one electronic repository, and one library, using controlled vocabularies. RESULTS Twenty-nine articles and seven documents were included. The majority (11.4% each) were published in the United Kingdom, Italy, and the United States, 38.9% addressed palliative radiotherapy (RT), and 47.2% consisted of recommendations. From the content analysis, five categories were obtained focused on the recommendations on changes in palliative treatment guidelines and the response of PC teams to the evolving crisis. CONCLUSIONS The evidence pointed to the management of general PC, palliative RT, palliative chemotherapy, management of metastatic breast cancer, and use of technologies in palliative care. No recommendations were found to manage frequent symptoms in PC, indicating the need to develop primary studies that investigate these aspects in detail in this vulnerable group. IMPLICATIONS The results contained in this document can provide professionals working in this field of care with a global view of how other teams have dealt with the pandemic, thereby identifying the best guidelines to apply in their reality, taking into account the clinical and social situation of each patient.
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Affiliation(s)
- Romel Velasco Yanez
- Universidade Federal do Ceará, Fortaleza, Brazil,Romel Velasco Yanez, Department of Nursing, Universidade Federal do Ceará, 1115 Alexandre Baraúna St, Rodolfo Teófilo, Fortaleza 60020-181, Brazil.
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Prado ED, Camparoto CW, Takemoto AY, Ichisato SMT, Miguel MEGB, Marcon SS. Estratégias de cuidados paliativos no manejo de pessoas com casos graves da COVID-19. Rev Bras Enferm 2023. [DOI: 10.1590/0034-7167-2022-0308pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
RESUMO Objetivos: analisar as estratégias assistenciais em cuidados paliativos desenvolvidas na pandemia de COVID-19 aos pacientes graves e familiares. Métodos: revisão integrativa, realizada em agosto de 2021 e atualizada em abril de 2022, nas bases de dados Base de Dados de Enfermagem (BDENF), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medical Literature Analysis and Retrieval System Online (MEDLINE), US National Library of Medicine (PubMed), Web of Science, e apresentadas no fluxograma PRISMA. Resultados: foram selecionados treze trabalhos para leitura e análise de conteúdo, dos quais emergiram as duas principais temáticas que traduzem a realidade evidenciada neste contexto: O advento súbito da COVID-19 com impactos nos cuidados paliativos; e, As estratégias utilizadas em cuidados paliativos para amenizar esses impactos. Considerações Finais: os cuidados paliativos se convergem na melhor estratégia de prestação de atendimento à saúde, usados como um acalento para trazer alívio e conforto aos pacientes e às famílias.
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Wahidie D, Altinok K, Yılmaz-Aslan Y, Brzoska P. [Strategies, guidelines and recommendations for coping with the COVID-19 pandemic in palliative and hospice care facilities. Results of a scoping review]. Z Gerontol Geriatr 2022; 55:151-156. [PMID: 35061068 PMCID: PMC8780045 DOI: 10.1007/s00391-022-02016-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Accepted: 12/17/2021] [Indexed: 11/13/2022]
Abstract
Hintergrund Palliativ- und Hospizeinrichtungen sind durch die COVID-19-Pandemie besonderen Herausforderungen ausgesetzt. Gründe dafür sind insbesondere das hohe Alter und bestehende Vorerkrankungen der Patienten sowie ein körperlich naher Kontakt zwischen Mitarbeitern und Patienten. Ziel der Arbeit Ziel der vorliegenden Studie ist es, bestehende Strategien, Richtlinien und Empfehlungen zum Umgang mit den Herausforderungen der COVID-19-Pandemie in der Palliativ- und Hospizversorgung zu ermitteln, die in Deutschland und anderen Ländern zum Einsatz kommen. Material und Methoden Im Rahmen eines Scoping Reviews wurden die Datenbanken PubMed, CINAHL, Web of Science und PsycInfo durchsucht. Zusätzlich wurde „graue Literatur“ über Google Search und Google Scholar recherchiert. Eingeschlossen wurden alle deutsch- und englischsprachigen Artikel im Zeitraum Januar 2020 bis August 2021, die sich auf die stationäre Palliativ- und Hospizversorgung beziehen. Ergebnisse Insgesamt wurden 51 Veröffentlichungen in die Analyse aufgenommen. Die identifizierten Maßnahmen lassen sich 10 verschiedenen Kategorien zuordnen: Maßnahmen zur Infektionskontrolle, strukturelle Maßnahmen, Besuchsregelungen, Kommunikationsstrukturen, Schulung und Aufklärung, psychosoziale Unterstützungsmaßnahmen, spezifische Überlegungen für Menschen mit Demenz, vorausschauende Pflegeplanung, Abschiednahme sowie Maßnahmen nach dem Tod. Diskussion Bei der Bewältigung der COVID-19-Pandemie dominieren insbesondere Maßnahmen zur Ermöglichung der Kommunikation zwischen Patienten, Mitarbeitern und Angehörigen, psychosoziale Unterstützungsmaßnahmen, strukturelle Maßnahmen und Empfehlungen zur Schulung und Aufklärung aller Beteiligten. Strategien zur Palliativversorgung von Menschen mit Demenz in Pandemiezeiten sowie zu Abschiednahme und Trauerbewältigung von Hinterbliebenen finden weniger Beachtung. Zusatzmaterial online Zusätzliche Informationen sind in der Online-Version dieses Artikels (10.1007/s00391-022-02016-8) enthalten.
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Affiliation(s)
- Diana Wahidie
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland
| | - Kübra Altinok
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland
| | - Yüce Yılmaz-Aslan
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland.,Fakultät für Gesundheitswissenschaften, AG3 Epidemiologie & International Public Health, Universität Bielefeld, Bielefeld, Deutschland.,Fakultät für Gesundheitswissenschaften, AG6 Versorgungsforschung und Pflegewissenschaft, Universität Bielefeld, Bielefeld, Deutschland
| | - Patrick Brzoska
- Fakultät für Gesundheit/Department für Humanmedizin, Lehrstuhl für Versorgungsforschung, Universität Witten/Herdecke, Alfred-Herrhausen-Str. 50, 58448, Witten, Deutschland.
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Cordeiro FR, Dos Santos Marques R, De Oliveira Silva K, Cruz Martins M, Vestena Zillmer JG, Sant'Ana Tristão F. Educação em saúde e final de vida no hospital. AVANCES EN ENFERMERÍA 2021. [DOI: 10.15446/av.enferm.v40n1.86942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objetivo: identificar ações de educação em saúde direcionadas às pessoas em final da vida e seus cuidadores, informais e formais, no hospital, além de avaliar o nível de evidência de tais ações.
Síntese do conteúdo: o estudo foi realizado entre dezembro de 2019 e janeiro de 2020, nas bases de dados Web of Science, Scopus e MEDLINE. Identificaram-se 6.762 artigos, dos quais 42 integram a análise por serem artigos originais ou de revisão escritos em português, espanhol, inglês ou francês; a amostra dos estudos foi composta por pacientes maiores de 19 anos, com doença avançada e/ou em final de vida ou cuidadores ou profissionais de saúde. Os dados foram agrupados por similaridade do tema das ações, conforme Polit e Beck, e o nível de evidência avaliado segundo Melnyk e Fineout-Overholt. O vídeo foi a ação com maior força de recomendação, seguida por cartilhas. As unidades temáticas foram “Ações para o controle da dor”, “Narrativas sobre o final da vida”, “Planejamento de cuidados”, “Dialogando sobre os cuidados paliativos” e “Comunicação e final de vida”.
Conclusões: ações de educação em saúde no final da vida devem considerar as tecnologias da informação e da comunicação, além das condições socioculturais, clínicas e cognitivas dessa etapa do adoecimento.
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Onwuteaka-Philipsen BD, Pasman HRW, Korfage IJ, Witkamp E, Zee M, van Lent LG, Goossensen A, van der Heide A. Dying in times of the coronavirus: An online survey among healthcare professionals about end-of-life care for patients dying with and without COVID-19 (the CO-LIVE study). Palliat Med 2021; 35:830-842. [PMID: 33825567 PMCID: PMC8114455 DOI: 10.1177/02692163211003778] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND During the COVID-19 outbreak restricting measures may have affected the provision of good end-of-life care for patients with and without COVID-19. AIM To describe characteristics of patients who died and the care they received, and to examine how patient characteristics, setting and visiting restrictions are related to provided care and evaluation of the dying process. DESIGN An open observational online survey among healthcare professionals about their experience of end-of-life care that was provided to a patient with or without COVID-19 who died between March and July 2020. SETTING/PARTICIPANTS Healthcare professionals (nurses, physicians and others) in the Netherlands from all settings: home (n = 163), hospital (n = 249), nursing home (n = 192), hospice (n = 89) or elsewhere (n = 68). RESULTS Of patients reported on, 56% had COVID-19. Among these patients, 358 (84.4%) also had a serious chronic illness. Having COVID-19 was negatively, and having a serious chronic illness was positively associated with healthcare staff's favourable appreciation of end-of-life care. Often there had been visiting restrictions in the last 2 days of life (75.8%). This was negatively associated with appreciation of care at the end of life and the dying process. Finally, care at the end of life was less favourably appreciated in hospitals and especially nursing homes, and more favourably in home settings and especially hospices. CONCLUSIONS Our study suggests that end-of-life care during the COVID-19 pandemic may be further optimised, especially in nursing homes and hospitals. Allowing at least some level of visits of relatives seems a key component.
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Affiliation(s)
- Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Ida J Korfage
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Erica Witkamp
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands.,Research Center Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Masha Zee
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Expertise Center for Palliative Care, Amsterdam UMC, VU University, Amsterdam, The Netherlands
| | - Liza Gg van Lent
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Agnes van der Heide
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Carvalheiro AM, Faria C, Semeão I, Martinho SM. Caring for End-of-Life Patients and Their Families, During Life, and Mourning, in the COVID-19 Era-The Experience of a Palliative Care Team in Portugal. Front Psychiatry 2021; 12:624665. [PMID: 33633609 PMCID: PMC7900130 DOI: 10.3389/fpsyt.2021.624665] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 01/04/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
| | - Catarina Faria
- Hospital-Based Palliative Care Team, Leiria Hospital Center, Leiria, Portugal
| | - Isabel Semeão
- Hospital-Based Palliative Care Team, Leiria Hospital Center, Leiria, Portugal
| | - Sérgio M Martinho
- Psychiatry and Mental Health Department, Leiria Hospital Center, Leiria, Portugal
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