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Authors
Advisor(s)
Abstract(s)
Introdução: A doença hepática crónica (DHC) é uma das principais causas de morbidade
e mortalidade em todo o mundo. Marcada pela incerteza prognóstica e pela trajetória
inconstante, a DHC é caracterizada pelos sucessivos episódios de descompensação,
muitos deles com necessidade de internamento e na sua maioria com elevada carga
sintomática associada. A complexidade da DHC tem condicionado a integração dos
cuidados paliativos (CP), contribuído para o descontrolo sintomático e para a falta de
preparação de um plano de cuidado. O objetivo deste trabalho é criar um protocolo que
avalie os benefícios da intervenção de uma equipa de CP na prestação de cuidados a
doentes com DHC.
Objetivos: Avaliar o impacto da intervenção da Equipa Intra hospitalar de Suporte em
Cuidados Paliativos (EIHSCP) na melhoria do controlo sintomático e na qualidade de vida
(QV) em doentes com DHC terminal.
Métodos: Será desenvolvido um estudo prospetivo e observacional de 2 ramos com
intuito de avaliar o impacto dos CP em doentes com DHC terminal internados num
serviço de gastroenterologia. Num dos ramosserão acompanhados os doentes seguidos
pela EIHSCP desde a sua referenciação em internamento e com posterior seguimento
em consulta (durante os 12 meses seguintes), em comparação ao ramo de controlo que
receberá os cuidados de rotina. O controlo sintomático e a comunicação serão o foco da
intervenção da EIHSCP, sendo utilizada a escala de Palliative Outcome Scale como forma
de avaliação da eficácia dessa intervenção.
Limitações: A reduzida dimensão da amostra, assim como as dificuldades inerentes na
identificação e referenciação de doentes a EIHSCP poderá limitar a realização do estudo.
Finalidade e Implicações Expectáveis: Este estudo pretende consolidar e reafirmar a
importância dos CP na DHC, refletidas nos ganhos em saude e na melhoria da QV destes
doentes
Introduction: Chronic liver disease (CLD) is one of the principal causes of morbidity and mortality globally. Marked by prognostic uncertainty and an inconsistent trajectory, CLD is characterised by successive episodes of decompensation, often requiring secondary care admission and the in majority of cases, associated with significant symptomatic burden. The complexity of CLD and this unique patient population is reliant on access to specialist palliative care (PC) teams, and limitations in access to these PC services has subsequently contributed to loss of symptom control and failure to formulate an appropriate care plan for optimal management. The purpose of this study is to create a protocol that will evaluate the benefits of intervention by the PC team in provision of care for patients with CLD. Aims: This study will evaluate the impact of interventions carried out by the in-hospital supportive and palliative care team (SPCT) in the improvement of symptom control and quality of life (QoL) in patients with end-stage CLD. Methods: This prospective, 2-arm, observational study will be carried out aiming to evaluate the impact of PC team involvement in the care inpatients with end-stage CLD admitted under the care of the Gastroenterology service. In the treatment arm, patients will receive specialist input from the SCPT and will be followed from initial referral and admission, including subsequent follow-up consultations during 12 months, compared with the control arm, where patients will receive current routine standard of care. Interventions carried out by the SCPT will focus on symptom control and communication, and efficacy of interventions will be measured using the Palliative care Outcome Scale (POS). Limitations: Limited numbers of patients may result in a reduced and smaller sample size as well as inherent difficulties in identification and referral of patients to the SCPT may limit the success of this study. Purpose and Expectations: This study aims to consolidate and reiterate the importance of PC in the management of CLD reflected in the benefits achieved in relation to symptom control and improvement in QoL in this patient population.
Introduction: Chronic liver disease (CLD) is one of the principal causes of morbidity and mortality globally. Marked by prognostic uncertainty and an inconsistent trajectory, CLD is characterised by successive episodes of decompensation, often requiring secondary care admission and the in majority of cases, associated with significant symptomatic burden. The complexity of CLD and this unique patient population is reliant on access to specialist palliative care (PC) teams, and limitations in access to these PC services has subsequently contributed to loss of symptom control and failure to formulate an appropriate care plan for optimal management. The purpose of this study is to create a protocol that will evaluate the benefits of intervention by the PC team in provision of care for patients with CLD. Aims: This study will evaluate the impact of interventions carried out by the in-hospital supportive and palliative care team (SPCT) in the improvement of symptom control and quality of life (QoL) in patients with end-stage CLD. Methods: This prospective, 2-arm, observational study will be carried out aiming to evaluate the impact of PC team involvement in the care inpatients with end-stage CLD admitted under the care of the Gastroenterology service. In the treatment arm, patients will receive specialist input from the SCPT and will be followed from initial referral and admission, including subsequent follow-up consultations during 12 months, compared with the control arm, where patients will receive current routine standard of care. Interventions carried out by the SCPT will focus on symptom control and communication, and efficacy of interventions will be measured using the Palliative care Outcome Scale (POS). Limitations: Limited numbers of patients may result in a reduced and smaller sample size as well as inherent difficulties in identification and referral of patients to the SCPT may limit the success of this study. Purpose and Expectations: This study aims to consolidate and reiterate the importance of PC in the management of CLD reflected in the benefits achieved in relation to symptom control and improvement in QoL in this patient population.
Description
Keywords
Cuidados paliativos Doença hepática crónica Controlo sintomático Qualidade de vida Palliative care Chronic liver disease Symptom control Quality of life