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Advisor(s)
Abstract(s)
Introdução: Na prática clínica temos observado a aplicação de Terapias Complementares (TC) nos cuidados ao doente paliativo. Contudo, a sua integração não está formalizada nos serviços e muitas vezes não há lugar ao seu registo clínico. Este é um estudo misto, transversal, descritivo e exploratório que visa contribuir para o conhecimento sobre a utilização das Terapias Complementares (TC) nos Cuidados Paliativos (CP) na Europa. Objetivos: Identificar se as TC estão presentes nos planos de cuidados ao doente paliativo, de que forma estão integradas, quais as TC utilizadas e com que finalidade, como acedem os doentes a estas terapias e que juízo fazem os profissionais das equipas de CP sobre a sua pertinência. Material e métodos: Um questionário foi desenhado para o estudo e aplicado a 615 equipas de CP em 16 países europeus. Os dados obtidos foram anonimizados, organizados e tratados numa base de dados. Os dados quantitativos foram tratados e analisados através de métodos estatísticos (IBM SPSS). Os dados qualitativos foram tratados e analisados de acordo com a metodologia de Bardin. Resultados e Discussão: Os resultados demonstram a presença e a integração formal das TC em CP. A massagem e a aromaterapia são as terapias mais utilizadas. As necessidades de TC são, maioritariamente, avaliadas por qualquer elemento da equipa multidisciplinar. A vontade do doente e a alteração do seu estado motivam a avaliação de necessidades para TC. Os procedimentos de avaliação valorizam a autonomia, a disponibilidade, a acessibilidade e a adequação à sintomatologia. A recomendação de TC depende da solicitação do doente, são recomendadas no início dos cuidados ou se a farmacoterapia é insuficiente ou inadequada. As intervenções decorrem maioritariamente em contexto de internamento. Os principais objetivos da utilização de TC são a promoção de bem-estar, de conforto e o controlo sintomático. Os critérios que presidem à indicação de TC são a vontade do doente e a sintomatologia. Grande parte das equipas utilizam instrumentos de avaliação dos efeitos das TC. A maioria dos participantes (75%) considera a utilização das TC de elevada pertinência, i.e., muito pertinente ou essencial. Conclusões: Os resultados do estudo e a perceção de pertinência e de utilidade que as equipas atribuem às TC, colocam este estudo como um ponto de partida para a integração formal das TC nos planos de cuidados ao doente paliativo no nosso país. Concluímos que a integração configura uma abordagem terapêutica válida nas várias dimensões do sofrimento e da complexidade do doente paliativo.
Introduction: In clinical practice, we observe the application of Complementary Therapies (CT) in palliative care. However, their integration is not always formalized in the PC services and there is often no clinical record of them. This is a mixed, crosssectional, descriptive and exploratory study that aims to contribute to knowledge about the use of Complementary Therapies (CTs) in Palliative Care (PC) in Europe. Objectives: To identify whether CTs are included in palliative patient care plans, how they are integrated, which CTs are used and for what purpose, how patients access these therapies and what judgment professionals in PC teams have about their relevance. Material and methods: A questionnaire was designed for the study and applied to 615 PC teams in 16 European countries. The data obtained was anonymized, organized and processed in a database. Quantitative data was processed and analyzed using statistical methods (IBM SPSS). Qualitative data was processed and analyzed according to Bardin's methodology. Results and Discussion: The results show that CTs are present and formally integrated in PC. Massage and aromatherapy are the most used therapies. The needs related to CTs are assessed by any member of the multidisciplinary team. The patient's wishes and changes in their condition motivate the assessment of CT needs. The assessment procedures value autonomy, availability, accessibility and suitability to the symptoms. CT recommendation depends on the patient's request, as well as it is recommended at the start of care or if pharmacological measures are insufficient or inadequate. Most interventions take place in an inpatient setting. The main objectives of using CTs are to promote well-being, comfort and symptom management. Criteria for the indication of CTs are the patient's wishes and symptoms. Most teams use measuring tools to evaluate the effects of CTs. Most participants (75%) consider the use of CTs to be highly relevant, that is, very relevant or essential. Conclusions: The results of the study and the professionals' perception of relevance and usefulness of CTs in PC, make this study a starting point for the formal integration of CTs into PC plans in Portugal. We conclude that this integration constitutes a valid therapeutic approach to the multiple dimensions of palliative patient's suffering and complexity.
Introduction: In clinical practice, we observe the application of Complementary Therapies (CT) in palliative care. However, their integration is not always formalized in the PC services and there is often no clinical record of them. This is a mixed, crosssectional, descriptive and exploratory study that aims to contribute to knowledge about the use of Complementary Therapies (CTs) in Palliative Care (PC) in Europe. Objectives: To identify whether CTs are included in palliative patient care plans, how they are integrated, which CTs are used and for what purpose, how patients access these therapies and what judgment professionals in PC teams have about their relevance. Material and methods: A questionnaire was designed for the study and applied to 615 PC teams in 16 European countries. The data obtained was anonymized, organized and processed in a database. Quantitative data was processed and analyzed using statistical methods (IBM SPSS). Qualitative data was processed and analyzed according to Bardin's methodology. Results and Discussion: The results show that CTs are present and formally integrated in PC. Massage and aromatherapy are the most used therapies. The needs related to CTs are assessed by any member of the multidisciplinary team. The patient's wishes and changes in their condition motivate the assessment of CT needs. The assessment procedures value autonomy, availability, accessibility and suitability to the symptoms. CT recommendation depends on the patient's request, as well as it is recommended at the start of care or if pharmacological measures are insufficient or inadequate. Most interventions take place in an inpatient setting. The main objectives of using CTs are to promote well-being, comfort and symptom management. Criteria for the indication of CTs are the patient's wishes and symptoms. Most teams use measuring tools to evaluate the effects of CTs. Most participants (75%) consider the use of CTs to be highly relevant, that is, very relevant or essential. Conclusions: The results of the study and the professionals' perception of relevance and usefulness of CTs in PC, make this study a starting point for the formal integration of CTs into PC plans in Portugal. We conclude that this integration constitutes a valid therapeutic approach to the multiple dimensions of palliative patient's suffering and complexity.
Description
Keywords
Terapias complementares Cuidados paliativos Integrativo Organização Pertinência Complementary therapies Palliative care Integrative Organization Pertinency