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Abstract(s)
O diagnóstico e o prognóstico do cancro determinam e orientam o plano de cuidados em termos nutricionais em cuidados paliativos. Atendendo à prevalência do Cancro em Portugal, que está na origem de 20 a 25% de um total de 60% das mortes resultantes de doenças crónicas evolutivas, deverá atender-se à presença de estados de desnutrição, em doentes com Cancro em Cuidados Paliativos com uma incidência aproximada de 30 a 50% dos casos. Apesar da reduzida informação sobre o estado da arte em Portugal, este artigo de caráter teórico, sustenta a sua exposição numa revisão da literatura diversa sobre nutrição, enfermagem, serviço social e medicina, publicada entre 2005 e 2014 bem como na observação direta. Os objetivos são: (1) Evidenciar os desafios no âmbito da nutrição em cuidados paliativos; (2) Propor uma abordagem sistémica embora personalizada, multidisciplinar e integrada à pessoa doente e à família; (3) Apelar a uma maior humanização da Saúde perante desafios de gestão.Alimentar em oncologia é uma prática que não se firmará sem espaço para alguma controvérsia fundeada em princípios éticos. Que um plano alimentar nutricional adequadamente definido deverá responder a um universo estadios e deverá atender a fatores culturais, económicos e sociais, numa dimensão moral de proteção, de dignificação da vida humana.
The diagnosis and prognosis of cancer determine and guide the care plan in terms of nutritional status in palliative care. Given the prevalence of cancer in Portugal, which is at the origin of 20 to 25% of a total of 60% of the deaths resulting from chronic progressive disease, reference should be made in case of malnutrition in patients with cancer in palliative care. Although the available data is in short supply, we can say that statistically, the incidence is between 30% and 50% of the cases. 40% to 80% of cancer patients evaluated nutritionally for weight loss, have malnutrition, exacerbated in cancer of the digestive tract and head and neck carcinoma. Despite the reduced-date information on this subject in Portugal, this theoretical article is also reflexive and supports it’s exhibition in a revision of the literature of different nature, in areas such as nutrition, nursing, social work and medicine, published between 2005 and 2014 as well as in the analysis and observation in the field of praxis. This article sets out the following objectives: (1) To highlight the challenges faced in nutrition in palliative care by the health teams; (2) To propose a systemic, though personalized and multidisciplinary, approach to the sick person and is family; (3) To suggest reflexive practices which transpose merely biomedical models, for an ethical practice and contribute to the humanization of care and respond to the challenges of health management. Then, we may conclude that if nurture in oncology is an act of caring, it shall not be established without space for any necessary debate based on ethical principles. A properly defined nutrition should respond objectively to a universe of multiplicity of stages and complex cultural storylines, highly valued in the social sciences. The ethical dimensions of care processes require relational processes and moral commitments of protection, of dignity and humanization of provision of hospital care and home care.
The diagnosis and prognosis of cancer determine and guide the care plan in terms of nutritional status in palliative care. Given the prevalence of cancer in Portugal, which is at the origin of 20 to 25% of a total of 60% of the deaths resulting from chronic progressive disease, reference should be made in case of malnutrition in patients with cancer in palliative care. Although the available data is in short supply, we can say that statistically, the incidence is between 30% and 50% of the cases. 40% to 80% of cancer patients evaluated nutritionally for weight loss, have malnutrition, exacerbated in cancer of the digestive tract and head and neck carcinoma. Despite the reduced-date information on this subject in Portugal, this theoretical article is also reflexive and supports it’s exhibition in a revision of the literature of different nature, in areas such as nutrition, nursing, social work and medicine, published between 2005 and 2014 as well as in the analysis and observation in the field of praxis. This article sets out the following objectives: (1) To highlight the challenges faced in nutrition in palliative care by the health teams; (2) To propose a systemic, though personalized and multidisciplinary, approach to the sick person and is family; (3) To suggest reflexive practices which transpose merely biomedical models, for an ethical practice and contribute to the humanization of care and respond to the challenges of health management. Then, we may conclude that if nurture in oncology is an act of caring, it shall not be established without space for any necessary debate based on ethical principles. A properly defined nutrition should respond objectively to a universe of multiplicity of stages and complex cultural storylines, highly valued in the social sciences. The ethical dimensions of care processes require relational processes and moral commitments of protection, of dignity and humanization of provision of hospital care and home care.
Description
Keywords
Qualidade de vida Cancro Anorexia–caquexia Dor total Nutrição Quality of life Cancer Anorexia and cachexia Total pain Nutrition