Loading...
4 results
Search Results
Now showing 1 - 4 of 4
- Integrating palliative care and Intensive care: a spectrum of ethical issuesPublication . Pereira, Sandra Martins; Teixeira, Carla; Carvalho, Ana Sofia; Hernández-Marrero, PabloBackground: The integration of palliative care (PC) in intensive care (IC) can be framed ethically. By integrating the core principles of PC in IC, the ethical principles of autonomy, beneficence, non-maleficence and justice are fostered together with the ethical principles of dignity, integrity and vulnerability. Several organizational initiatives have been described worldwide on integration. Little is known on the ethical principles supporting this integration. Aims: To ethically frame and understand healthcare professionals’ perspectives about integrating PC and IC. Methods: A qualitative study, using in-depth interviews to collect data from healthcare professionals working in Portuguese PC and IC units. Data is being analysed using a thematic analysis approach. A snowball sampling procedure is being applied until reaching theoretical saturation. Up-to-date, 22 professionals (8 physicians and 14 nurses) across settings and cities were interviewed. Results: Participants understand the integration of PC in IC as a way of improving end of life care and end of life decision-making processes. In their speech, an early integration of PC is needed, particularly in other settings (e.g., medical and surgical) in order to prevent invasive interventions and admissions in IC units. This is linked to the application of the ethical principles of beneficence, non-maleficence and justice into practice. Professionals also consider that the integration of PC in IC may foster patient autonomy, by allowing patients to be cared for and die in their place of preference, and integrity, through a holistic approach. Patients in IC are particularly vulnerable; integrating the principles of PC can protect them of any further harm. While professionals working in PC consider that integration should be promoted by implementing a mixed-organizational model, professionals from IC units defend an educational model, which should be promoted during medical specialty training as intensivists, PC being part of this education programme. Conclusions: This is the first study addressing the integration of PC in IC in Portugal, following an ethical frame. Professionals working in PC and IC seem to have different perspectives on how the integration model should be. Findings show the potential for a successful integration; more research is needed to develop an effective, sustainable and ethically sound integration model. Acknowledgments: Fundação Grünenthal and Fundação Merck, Sharp and Dohme.
- Burnout em médicos e enfermeiros: estudo quantitativo e multicêntrico em unidades de cuidados paliativos em PortugalPublication . Pereira, Sandra Martins; Teixeira, Carla Margarida; Ribeiro, Orquídea; Hernández-Marrero, Pablo; Fonseca, António M.; Carvalho, Ana SofiaTheoretical Framework: Systematic contact with death is considered a risk factor for burnout in health, particularly for doctors and nurses who develop their professional activity in palliative care. Objectives: To study the syndrome of burnout in these professionals in Portugal. Methodology: A multicenter quantitative survey study. Results: Out of 142 professionals, 88 returned the completed questionnaire; of these, only 3% were in burnout and 13% at high risk of developing this syndrome. Professing a religion (p=.005) and having post-graduate education/training in palliative care (p=.011) were significantly and inversely associated with burnout. Conflicts with other professionals (p=.012) were significantly associated with developing this syndrome. Conclusion: Although the percentage of professionals with high levels of burnout in palliative care is low, there are risk factors that can be optimized to promote a higher well-being state among professionals.
- Burnout in end-of-life care: Results from a multicenter comparative study between intensive and palliative care unitsPublication . Pereira, Sandra Martins; Teixeira, Carla Margarida; Hernández-Marrero, Pablo; Carvalho, Ana Sofia
- Burnout in end-of-life care: work-related experiences in intensive and palliative care units and relation to burnoutPublication . Teixeira, Carla Margarida; Pereira, Sandra Martins; Hernández-Marrero, Pablo; Carvalho, Ana Sofia