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Abstract(s)
Introdução: Nos últimos anos, os avanços na medicina assim como com o
envelhecimento da população, tornaram a morte excessivamente medicalizada e não
parte de um processo natural da vida. Os Cuidados Paliativos vieram consciencializar o
significado de morte e da relevância desta para o doente e para os seus familiares. Esta
dissertação apresenta a evolução dos locais de morte dos doentes não oncológicos
assim como outros indicadores e a preferência da população.
Material e métodos: Estudo retrospetivo e descritivo com base nos óbitos da população
portuguesa acima de 16 anos, de 2012 a 2018, por causa de morte (CID-10, doente não
oncológico - Critérios Comissão Lancet), região de residência e local de morte (hospital,
domicílio e outro). Comparação com preferências dos portugueses (PRISMA) e
indicadores demográficos, sociais e de acessibilidade a cuidados de saúde,
nomeadamente Cuidados Paliativos.
Resultados: A maioria dos doentes não oncológicos morre em meio hospitalar, no total
59.3%, os restantes 28,1% em domicílio e 12,5% em outros locais. A doença mais comum
em domicílio é a D. Alzheimer (42%). O doente não oncológico morre mais em domicílio
e menos em hospital face ao doente oncológico.
Conclusão: Em Portugal, mesmo como o aumento da acessibilidade a Cuidados de saúde
quer cuidados Primários ou Paliativos, continua a existir a uma divergência entre o local
de preferência de morte e o local de morte. De futuro será essencial rever e ajustar as
políticas de saúde às necessidades particulares da população, garantindo assim um
melhor cuidado ao doente e aos familiares/cuidadores.
Introduction: In recent years, the advances in medicine as well as the aging of the population, have made death over-medicalized and not part of the natural process of life. In this context, Palliative Care has been a force of change by raising awareness about the meaning of death and its relevance for the patient and their families. This dissertation presents the evolution of the places of death of non-cancer patients as well as other indicators and the population's preference. Material and Methods: A retrospective and descriptive study based on the deaths of the Portuguese population over 16 years, ranging from 2012 to 2018, by disease (ICD10, non-cancer patient - Lancet Commission Criteria), region of residence and place of death (hospital, home and other). The distribution of deaths by place of death is compared with Portuguese preferences (PRISMA) and by demographic, social and health care accessibility indicators, such as Palliative Care accessibility. Results: Most non-cancer patients die in hospitals, totaling 59.3%. The remaining 28.1% die at home and 12.5% elsewhere. The most common disease to die from at home is Alzheimer Disease (42%). The non-cancer patient dies more at home and less at the hospital when compared to the cancer patient. Conclusion: In Portugal, even with the increase in Health Care accessibility, whether Primary or Palliative Care, there is still a divergence between the place of death preference and the effective place of death. In the future, it will be essential to review and adjust health policies to the needs of the population, ensuring better care for the patient, family members and caregivers.
Introduction: In recent years, the advances in medicine as well as the aging of the population, have made death over-medicalized and not part of the natural process of life. In this context, Palliative Care has been a force of change by raising awareness about the meaning of death and its relevance for the patient and their families. This dissertation presents the evolution of the places of death of non-cancer patients as well as other indicators and the population's preference. Material and Methods: A retrospective and descriptive study based on the deaths of the Portuguese population over 16 years, ranging from 2012 to 2018, by disease (ICD10, non-cancer patient - Lancet Commission Criteria), region of residence and place of death (hospital, home and other). The distribution of deaths by place of death is compared with Portuguese preferences (PRISMA) and by demographic, social and health care accessibility indicators, such as Palliative Care accessibility. Results: Most non-cancer patients die in hospitals, totaling 59.3%. The remaining 28.1% die at home and 12.5% elsewhere. The most common disease to die from at home is Alzheimer Disease (42%). The non-cancer patient dies more at home and less at the hospital when compared to the cancer patient. Conclusion: In Portugal, even with the increase in Health Care accessibility, whether Primary or Palliative Care, there is still a divergence between the place of death preference and the effective place of death. In the future, it will be essential to review and adjust health policies to the needs of the population, ensuring better care for the patient, family members and caregivers.
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Keywords
Local de morte Cuidados paliativos Doentes não oncológicos Portugal Place of death Palliative care Non-cancer patient