Browsing by Author "Pereira, S. M."
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- A bioethical framework and reasoning on antibiotic use in palliative care: a systematic reviewPublication . Pereira, S. M.; Hernández-Marrero, P.; Brandão, P. J. S.; Araújo, J.; Carvalho, A. S.
- Contact with death, ethical decisions, and communication of bad news in intensive care and palliative units: results from a mixed-methods studyPublication . Teixeira, C.; Pereira, S. M.; Hernández-Marrero, P.Introduction: Professionals working in intensive care and palliative units (ICUs/PCUs) care for patients with life-threatening diseases, make ethical decisions, and provide end-of-life care. However, while palliative care aims to reduce suffering, intensive care has a major focus on saving lives. Objectives: To identify and compare the experiences of ICU and PCU healthcare professionals related to: contact with dying and death, making of ethical decisions and communication and delivery of bad news. Methods: Mixed approach, combining quantitative (questionnaire on experiences in the work context) and qualitative ones (interviews with doctors and nurses). 10 ICU and 9 PCU participated in this study. 392 professionals completed the survey; 28 were interviewed. A descriptive quantitative analysis was performed; the chi-square test was used to analyse the association between variables (significance level of p < .05). Interviews were subject to content analysis. Results: In the week prior to survey completion, more professionals working in ICUs reported a patient's death; this was not statistically significant. The experience most mentioned by the professionals of both types of units during interviews was caring for patients nearing death. In the week before completing the questionnaire, the most common ethical decision was palliative/terminal sedation; this was more, often in ICUs (27 % vs. 12 %; p = .004). In the day of questionnaire completion, the most frequent ethical decision was also palliative sedation. Though this decision was more frequent in ICU, statistical significance was not reached (p = .440). The communication of the diagnosis/prognosis to the patient, either in the week before or in the day of questionnaire completion was more frequent in PCUs (45 % vs. 29 %, p = .005; 22 % vs. 12 %, p = .026, respectively). Communication about the diagnosis/prognosis with the family in the week before survey completion was held with equal frequency by professionals from both contexts (58 % of professionals). Although not reaching statistical significance (p = .303), more professionals from PCU proceeded to communication with family about the diagnosis and prognosis (32 % vs. 26 %) in the survey day. From the analysis of the interviews, it was denoted that it were mainly professionals of PCU who referred to the communication on the diagnosis/ prognosis, both with the patient as with the family. Conclusions: The workplace experiences in ICU and PCU are, despite some differences, guided by similarities. Caring for patients with lifethreatening situations and imminent death and the need to make ethical decisions occur frequently in both contexts. The communication about the diagnosis/prognosis occurs more often in PCU. This highlights the need for integrating communication strategies of palliative care, in intensive care.
- Ethical framework of the integration of palliative care in intensive care: results from a qualitative study with professionalsPublication . Pereira, S. M.; Teixeira, C. M.; Hernández-Marrero, P.; Carvalho, A. S.
- Work-related experiences in intensive and palliative care units and their relation to burnoutPublication . Teixeira, C.; Pereira, S. M.; Hernández-Marrero, P.; Carvalho, A. S.