| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 6.91 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Introdução: A demência é uma condição crónica e progressiva de elevada prevalência e impacto, tendo sido considerada uma prioridade de saúde pública a nível mundial. A introdução precoce de cuidados paliativos e a sua intervenção ao longo da trajetória de doença oferece benefícios, nomeadamente na elaboração de um plano avançado de cuidados. As preferências nos cuidados em final de vida, têm sido associadas ao conceito de “boa morte” e refletem o cuidado centrado na pessoa. Este estudo pretende analisar a evolução dos locais de morte da pessoa com demência, a sua distribuição e acesso a cuidados paliativos. Metodologia: Estudo epidemiológico, transversal, analítico e observacional. Os dados referentes à evolução dos locais de morte foram obtidos através do Instituto Nacional de Estatística. A análise de tendências e regressão linear foi efetuada através do software JoinPoint. A distribuição pelos cuidados de saúde foi evidenciada através da aplicação de um questionário em Microsoft Forms às equipas da RNCCI, RNCP e ERPI, sendo os dados trabalhados em tabelas de cálculo de percentagens. Resultados: Em Portugal faleceram por demência 68 542 pessoas entre 1980 e 2020, 25 492 (37,2%) em domicílio, 31 624 (46,1%) em hospital/ clínica e 11 426 (16,7%) noutro local. As tendências apontam para um decréscimo de mortes em domicílio, com aumento progressivo em hospital/ clínica, e especial relevância noutros locais, como lares. As ERPI admitiram uma percentagem superior de pessoas com diagnóstico de demência entre 2018 e 2022. O crescente número de óbitos neste contexto reflete necessidades paliativas importantes. Conclusões: Os resultados deste estudo revelam incongruências entre o local efetivo de morte e as preferências da população portuguesa. O aumento da permanência e óbito em contexto de ERPI, traduz a importância de elaboração de ações para a melhoria da acessibilidade da pessoa com demência a cuidados paliativos. Os dados obtidos sugerem a necessidade de investigação no âmbito das preferências de final de vida e nível de capacitação das ERPI na abordagem desta população.
Introduction: Dementia is a chronic and progressive condition with high prevalence and impact and has been considered a public health priority worldwide. The early introduction of palliative care and its intervention throughout the disease trajectory offers benefits, particularly in the development of an advanced care plan. Preferences in end-of-life care have been associated with the concept of “good death” and reflect person-centered care. This study aims to analyze the evolution of place of death of people with dementia, their distribution and access to palliative care. Methodology: Epidemiological, cross-sectional, analytical, and observational study. Data on the evolution of place of death was obtained from the National Institute of Statistics. Trend analysis and linear regression were carried out using JoinPoint software. Distribution across healthcare services was evidenced by applying a Microsoft Forms questionnaire to the RNCCI, RNCP and ERPI teams, with the data being processed in percentage calculation tables. Results: In Portugal, 68 542 people died of dementia between 1980 and 2020, 25 492 (37,2%) at home, 31 624 (46,1%) in hospital/clinic and 11 426 (16,7%) in other locations. Trends point to a decrease in deaths at home, with a progressive increase in hospital/clinic, and special relevance in other locations, such as nursing homes. ERPI admitted a higher percentage of people diagnosed with dementia between 2018 and 2022. The increasing number of deaths in this context reflects important palliative care needs. Conclusions: The results of this study reveal inconsistencies between the actual place of death and the preferences of the Portuguese population. The increase in stay and death in ERPI contexts reflects the importance of developing actions to improve access of people with dementia to palliative care. The data obtained suggest the need for research into endof- life preferences and the level of training of ERPI in approaching this population.
Introduction: Dementia is a chronic and progressive condition with high prevalence and impact and has been considered a public health priority worldwide. The early introduction of palliative care and its intervention throughout the disease trajectory offers benefits, particularly in the development of an advanced care plan. Preferences in end-of-life care have been associated with the concept of “good death” and reflect person-centered care. This study aims to analyze the evolution of place of death of people with dementia, their distribution and access to palliative care. Methodology: Epidemiological, cross-sectional, analytical, and observational study. Data on the evolution of place of death was obtained from the National Institute of Statistics. Trend analysis and linear regression were carried out using JoinPoint software. Distribution across healthcare services was evidenced by applying a Microsoft Forms questionnaire to the RNCCI, RNCP and ERPI teams, with the data being processed in percentage calculation tables. Results: In Portugal, 68 542 people died of dementia between 1980 and 2020, 25 492 (37,2%) at home, 31 624 (46,1%) in hospital/clinic and 11 426 (16,7%) in other locations. Trends point to a decrease in deaths at home, with a progressive increase in hospital/clinic, and special relevance in other locations, such as nursing homes. ERPI admitted a higher percentage of people diagnosed with dementia between 2018 and 2022. The increasing number of deaths in this context reflects important palliative care needs. Conclusions: The results of this study reveal inconsistencies between the actual place of death and the preferences of the Portuguese population. The increase in stay and death in ERPI contexts reflects the importance of developing actions to improve access of people with dementia to palliative care. The data obtained suggest the need for research into endof- life preferences and the level of training of ERPI in approaching this population.
Description
Keywords
Demência Cuidados paliativos Local de morte Dementia Palliative care Place of death