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Authors
Advisor(s)
Abstract(s)
Introdução – A dissertação encontra-se integrada numa das componentes do projeto
global elaborado pelo Observatório Português dos Cuidados Paliativos. Os principais
objetivos foram a caracterização dos doentes não oncológicos referenciados e
admitidos nos serviços de cuidados paliativos portugueses e efetividade do controlo
sintomático.
Metodologia – Estudo epidemiológico, observacional, longitudinal e analítico. Dos 61
pedidos de participação efetuados, apenas 6 responderam durante o ano de 2017. A
amostra foi de 53 doentes não oncológicos de um total de 376 doentes. A
caracterização foi sociodemográfica, clínica, do processo de referenciação/admissão e
do controlo sintomático. Estabeleceram-se associações para a efetividade do controlo
sintomático, entre o local de cuidados e o diagnóstico da doença não oncológica, entre
a idade e o score da escala FACIT-Pal e entre a existência de cuidador e o score da
referida escala.
Resultados – A proporção de doentes não oncológicos foi de 14,1%. Os sujeitos foram
maioritariamente mulheres, com idade avançada, casados/viúvos, com escolaridade
básica e possuíam apoio de cuidador. Os principais motivos para a referenciação foram
a necessidade de tratamento e intervenção paliativa e o controlo de sintomas. A
admissão foi realizada nos primeiros dias após referenciação e as medianas de
sobrevivência rondaram os 4 meses. Cerca de 85% da amostra teve avaliação de
sintomas nas 48/72 horas após admissão. Verificou-se significância estatística entre o
local de cuidados e o diagnóstico da doença não oncológica. O aumento da idade foi
associado a menor qualidade de vida a nível físico e funcional avaliado pela escala
FACIT-Pal. Não se verificou efeito da existência de cuidador.
Conclusões – Admitiu-se a presença de um sistema de referenciação tendencialmente
reativo e com reduzida admissão de doentes não oncológicos. Os objetivos associados ao número de doentes referenciados e admitidos a nível nacional e à efetividade do
controlo sintomático não foram atingidos pela insuficiência de dados.
Introduction – The dissertation is included in one of the components of the overall project developed by the Portuguese Observatory of Palliative Care. The main objectives were the characterization of non-cancer patients referred to and admitted to Portuguese palliative care services and the effectiveness of symptomatic control. Methodology – There was an epidemiological, observational, longitudinal and analytical study. Of the 61 applications for participation, only 6 answered during 2017. The sample consisted of 53 non-cancer patients from a total of 376 patients. The characterization was sociodemographic, clinical, of the referral/admission process and of symptomatic control. Associations were established for the effectiveness of symptomatic control, between the place of care and the diagnosis of non-cancer disease, between age and the FACIT-Pal scale score and between the existence of caregiver and the score of the referred scale. Results - The proportion of non-cancer patients was 14,1%. The patients were mostly women, elderly, married/widowed, with basic education and had caregiver support. The main reasons for the referral were the need for treatment and palliative intervention and symptom control. Admission was performed in the first days after referral and median survival was around 4 months. About 85% of the sample had symptom assessment within 48/72 hours after admission. Statistical significance was found between the place of care and the diagnosis of non-cancer disease. The increase in age was associated with lower physical and functional quality of life evaluated by the FACIT-Pal scale. There was no effect of caregiver presence. Conclusions – It was admitted the presence of a tendentially reactive referral system with low admission of non-cancer patients. The objectives associated with the number of patients referred to and admitted nationally and the effectiveness of symptomatic control were not reached by insufficient data.
Introduction – The dissertation is included in one of the components of the overall project developed by the Portuguese Observatory of Palliative Care. The main objectives were the characterization of non-cancer patients referred to and admitted to Portuguese palliative care services and the effectiveness of symptomatic control. Methodology – There was an epidemiological, observational, longitudinal and analytical study. Of the 61 applications for participation, only 6 answered during 2017. The sample consisted of 53 non-cancer patients from a total of 376 patients. The characterization was sociodemographic, clinical, of the referral/admission process and of symptomatic control. Associations were established for the effectiveness of symptomatic control, between the place of care and the diagnosis of non-cancer disease, between age and the FACIT-Pal scale score and between the existence of caregiver and the score of the referred scale. Results - The proportion of non-cancer patients was 14,1%. The patients were mostly women, elderly, married/widowed, with basic education and had caregiver support. The main reasons for the referral were the need for treatment and palliative intervention and symptom control. Admission was performed in the first days after referral and median survival was around 4 months. About 85% of the sample had symptom assessment within 48/72 hours after admission. Statistical significance was found between the place of care and the diagnosis of non-cancer disease. The increase in age was associated with lower physical and functional quality of life evaluated by the FACIT-Pal scale. There was no effect of caregiver presence. Conclusions – It was admitted the presence of a tendentially reactive referral system with low admission of non-cancer patients. The objectives associated with the number of patients referred to and admitted nationally and the effectiveness of symptomatic control were not reached by insufficient data.
Description
Keywords
Cuidados paliativos Doença não oncológica Referenciação Palliative care Non-cancer disease Referral Symptomatic control Controlo sintomático