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Advisor(s)
Abstract(s)
Introdução: a função primordial dos cuidados paliativos é melhorar a qualidade
de vida. O reconhecimento e tratamento dos sintomas que causam sofrimento é
central para a concretização desse objetivo. A insónia pode causar desconforto
e acarretar um peso acrescido de sofrimento aos doentes e famílias em cuidados
paliativos. O conhecimento sobre a prevalência, fatores associados e tratamento
da insónia nos cuidados paliativos é escasso.
Metodologia: revisão da literatura com o objetivo de sistematizar o
conhecimento sobre a prevalência, os preditores, e as opções de tratamento da
insónia em doentes em cuidados paliativos. As fontes primárias de investigação
foram identificadas e selecionadas através das bases de dados Pubmed e
Scopus. A pesquisa foi complementada pela pesquisa de referências nos artigos
identificados e em revisões selecionadas. A OpenGrey e o Google Scholar foram
usadas para pesquisa de literatura cinzenta. A análise da qualidade dos estudos
foi com base na Newcastle-Ottawa Scale.
Resultados: foram incluídos 65 estudos na revisão. A maior parte dos estudos
teve qualidade aceitável/boa. A prevalência da insónia nos estudos incluídos
variou entre 2.1 a 100%, com prevalência mediana global de 49.5%. Fatores
sociodemográficos como a idade; características clínicas como o estado
funcional, estadio da doença, dor, uso de fármacos específicos, incluído os
opióides; fatores psicológicos como a ansiedade/depressão, e espirituais como
a sensação de bem-estar foram identificados como preditores. As opções de
tratamento identificadas foram biológicas (farmacológicos e não farmacológicos),
psicológicas (visualização, relaxamento) e espirituais (oração).
Conclusões: a revisão sistemática demonstrou que a prevalência da insónia é
alta, com pelo menos um em cada 3 doentes acometidos na maior parte dos
estudos. A insónia nos cuidados paliativos está associada, tanto no seu risco
como no seu tratamento, a fatores físicos, psicológicos, sociais e espirituais,
refletindo a sua verdadeira natureza holística.
Introduction: The primary function of palliative care is to improve quality of life. The recognition and treatment of symptoms that cause suffering is central to the achievement of this goal. Insomnia can cause discomfort and increase suffering of patients and families in palliative care. Knowledge about prevalence, associated factors and treatment of insomnia in palliative care is scarce. Methodology: literature review aimed at systematizing knowledge about the prevalence, predictors, and treatment options of insomnia in palliative care patients. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in identified articles and selected reviews. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: 65 studies were included in the review. Most studies had acceptable / good quality. The prevalence of insomnia in the included studies ranged from 2.1 to 100%, with a median overall prevalence of 49.5%. Sociodemographic factors such as age; clinical characteristics such as functional status, disease stage, pain and use of specific drugs, including opioids; psychological factors such as anxiety / depression, and spiritual factors such as feelings of well-being were identified as predictors. The treatment options identified were biological (pharmacological and non-pharmacological), psychological (visualization, relaxation) and spiritual (prayer). Conclusions: the systematic review showed that the prevalence of insomnia is high, with at least one in three patients affected in most studies. Insomnia’s risk factors and treatment in palliative care, are both associated to physical, psychological, social and spiritual factors, reflecting its true holistic nature.
Introduction: The primary function of palliative care is to improve quality of life. The recognition and treatment of symptoms that cause suffering is central to the achievement of this goal. Insomnia can cause discomfort and increase suffering of patients and families in palliative care. Knowledge about prevalence, associated factors and treatment of insomnia in palliative care is scarce. Methodology: literature review aimed at systematizing knowledge about the prevalence, predictors, and treatment options of insomnia in palliative care patients. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in identified articles and selected reviews. OpenGrey and Google Scholar were used for searching grey literature. Study quality analysis was based on the Newcastle-Ottawa Scale. Results: 65 studies were included in the review. Most studies had acceptable / good quality. The prevalence of insomnia in the included studies ranged from 2.1 to 100%, with a median overall prevalence of 49.5%. Sociodemographic factors such as age; clinical characteristics such as functional status, disease stage, pain and use of specific drugs, including opioids; psychological factors such as anxiety / depression, and spiritual factors such as feelings of well-being were identified as predictors. The treatment options identified were biological (pharmacological and non-pharmacological), psychological (visualization, relaxation) and spiritual (prayer). Conclusions: the systematic review showed that the prevalence of insomnia is high, with at least one in three patients affected in most studies. Insomnia’s risk factors and treatment in palliative care, are both associated to physical, psychological, social and spiritual factors, reflecting its true holistic nature.
Description
Keywords
Cuidados paliativos Insónia Sono Cancro Doença avançada Fim-de-vida Fase terminal Palliative care Insomnia Sleep Cancer Advanced disease End-of-life Terminal life Hospice