Browsing by Author "Freire, Elga"
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- Generating consensus on good practices in the care of Portuguese internal medicine patients facing imminent death: a Delphi studyPublication . Carneiro, Rui; Capelas, Manuel Luís; Simões, Catarina; Freire, Elga; Carneiro, António HenriquesContext: Modern medicine aims to ensure a world in which all people experience a good end of life as an integral part of their life journey. A good end-of-life experience means dying with dignity and receiving the best healthcare based on scientific evidence. Objective: This study aims to reach a consensus about the contents of a comprehensive instrument based on the 10/40 Model of the International Collaborative for the Best Care for the Dying Person for evaluating inpatients facing imminent death in Portuguese internal medicine wards and a proposal for anticipatory medication for symptom control in inpatient and home care settings. Methods: We employed the Delphi method and conducted various rounds of questionnaire administration to 23 Portuguese internists competent in palliative medicine. Data were obtained in July and September of 2022. Results: Consensus was reached among the expert panel on the diagnostic, initial assessment, monitoring, and after-death care items of the tool, with minor adjustments to wording or content. However, it was not possible to reach a consensus on most of the proposals presented for anticipatory medication for symptomatic control. Conclusion: We present the consensus about the contents of a comprehensive instrument for evaluating inpatients facing imminent death in Portuguese internal medicine wards. Best practices in this setting were defined from the point of view of internists with expertise in palliative care. However, the best pharmacological practices still require further reviews of the literature and consensus.
- Validation of an assessment and monitoring instrument for the care of patients in imminent death situation admitted in internal medicine wardsPublication . Carneiro, Rui; Simões, Catarina; Freire, Elga; Capelas, Manuel; Carneiro, AntónioBackground: In Portugal, two thirds of deaths occur in the hospital and it is estimated that these numbers will increase considerably in the coming decades. The proper organization of care at this stage promotes peaceful deaths and catalyzes healthy bereavements. There is no validated instrument that supports health teams in the organization of care in the situation of imminent death syndrome. Aim(s): We propose the validation of an instrument for organizing care for patients in the last hours or days of life in Internal Medicine wards. Methods: We recruited an incidental sample of Internal Medicine doctors with Competence in Palliative Medicine. We will evaluate the response to a semi-structured questionnaire of the Delphi rounds type, evaluating the degree of agreement with the principles proposed by the instrument, which was already validated in accordance with the best international practices and derived from the best scientific evidence by the International Collaborative for the Best for the Dying Person Results: The Delphi rounds are underway Conclusions: The validation of this instrument will be the basis for the subsequent development of a national audit on the subject and the mainstay for the construction of a training model for national Internal Medicine based on the proposed principles of action, that constitutes the main goals of the MiMI Project (Morte iminente em Medicina Interna) of the Portuguese Society of Internal Medicine.