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Introdução: A definição das melhores estratégias de adequação do cuidar para haver
um melhoramento constante dos serviços e qualidade de vida dos utentes em cuidados
paliativos só é possível, através do conhecimento das reais necessidades desta
população. A presente investigação tem como objetivo descrever as patologias e
problemas da cavidade oral dos doentes paliativos internados em unidades de cuidados
continuados e paliativos, o que possibilita aferir se existem necessidades de cuidados
orais e dentários.
Metodologia: Este estudo foi realizado através de revisão da literatura( consulta de
livros técnicos e pesquisa on-line) , observação clínica (protocolo de observação, e uso
de instrumentos como o registo CPOD e Bedside oral exam), formulário( questões sobre
dor na cavidade oral, higiene oral , uso de prótese dentária) e consulta dos registos de
enfermagem de uma amostra(não aleatória acidental) de 14 doentes paliativos de uma
unidade de cuidados paliativos e continuados sem patologia oncológica da cabeça e
pescoço. Obteve-se um grau de concordância interobservador de Kappa=1 e
intraobservador de Kappa=1.
Resultados: Observa-se que as principais patologias e problemas encontrados na
cavidade oral dos doentes paliativos internados em unidades de cuidados continuados
e paliativos são referentes a; deficiente higiene oral, alterações na mucosa oral, na
deglutição, língua, lábios, gengiva e saliva, mobilidade dentária, elevada prevalência de
cárie dentária (índice CPOD=19.6), halitose, próteses mal-adaptadas, edentulação e dor
orofacial. Estas alterações são observadas maioritariamente como disfunções
moderadas, no entanto, observa-se algumas disfunções ligeiras e severas. Todos os
doentes da amostra apresentavam pelo menos uma disfunção. Inexistência de registos
de enfermagem com a informação referente a alterações encontradas na cavidade oral,
intervenções realizadas ou de avaliações após intervenções.
Conclusão: Devido ao reduzido número de doentes avaliados não é possível tirar
conclusões generalistas. No entanto, os resultados obtidos sugerem necessidades e
carências na área da saúde oral
Introduction: The definition of the best strategies of adequacy of care to have a constant improvement of services and quality of life of the users in palliative care, is possible only through the knowledge of the real needs of this population. The objective of the present investigation is to describe the pathologies and problems of the oral cavity of the palliative patients hospitalized in continuous and palliative care units, which makes it possible to determine if oral and dental care needs exist. Methodology: This study was conducted through a literature review (consultation of technical books and online research), clinical observation (protocol of observation, and use of instruments such as registry of decayed, missing and filled teeth, and Bedside oral exam), form (questions about orofacial pain, oral hygiene, dental prosthesis use) and consultation of the nursing records of a sample (accidental non-random sample) of 14 palliative patients from a palliative care unit and continued, without head and neck oncology. An interobserver and intraobserver agreement degree of Kappa =1 was obtained. Results: The main pathologies and problems found in the oral cavity of palliative patients admitted to continuous and palliative care units are: poor oral hygiene, changes at oral mucosal, at deglutition, tongue, lips, gingiva and saliva, dental mobility, high prevalence of dental caries (DMFT index = 19.6), halitosis, maladaptive prostheses, edentulation and orofacial pain. These changes are mostly observed as moderate dysfunctions; however, some slight and severe dysfunctions are observed. All patients in the sample had at least one dysfunction. Inexistence of nursing records with information regarding changes found in the oral cavity, interventions performed or evaluations after interventions. Conclusion: Due to the small number of patients evaluated it is not possible to draw general conclusions. However, the results obtained suggest needs and deficiencies in oral health.
Introduction: The definition of the best strategies of adequacy of care to have a constant improvement of services and quality of life of the users in palliative care, is possible only through the knowledge of the real needs of this population. The objective of the present investigation is to describe the pathologies and problems of the oral cavity of the palliative patients hospitalized in continuous and palliative care units, which makes it possible to determine if oral and dental care needs exist. Methodology: This study was conducted through a literature review (consultation of technical books and online research), clinical observation (protocol of observation, and use of instruments such as registry of decayed, missing and filled teeth, and Bedside oral exam), form (questions about orofacial pain, oral hygiene, dental prosthesis use) and consultation of the nursing records of a sample (accidental non-random sample) of 14 palliative patients from a palliative care unit and continued, without head and neck oncology. An interobserver and intraobserver agreement degree of Kappa =1 was obtained. Results: The main pathologies and problems found in the oral cavity of palliative patients admitted to continuous and palliative care units are: poor oral hygiene, changes at oral mucosal, at deglutition, tongue, lips, gingiva and saliva, dental mobility, high prevalence of dental caries (DMFT index = 19.6), halitosis, maladaptive prostheses, edentulation and orofacial pain. These changes are mostly observed as moderate dysfunctions; however, some slight and severe dysfunctions are observed. All patients in the sample had at least one dysfunction. Inexistence of nursing records with information regarding changes found in the oral cavity, interventions performed or evaluations after interventions. Conclusion: Due to the small number of patients evaluated it is not possible to draw general conclusions. However, the results obtained suggest needs and deficiencies in oral health.
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Palavras-chave
Cuidados à boca Saúde oral Odontologia paliativa Mouth care Oral health Palliative care dentistry