User profiles with palliative care needs linked to a primary healthcare center in the city of Porto Alegre, RS
DOI:
https://doi.org/10.15343/0104-7809.202347e13192022PKeywords:
Palliative care. End-of-Life Palliative Care. Chronic diseases.Abstract
Strengthening in Palliative Care (PC) in Primary Healthcare (PHC) increases the quality of care at the end of life and reduces complications from long hospitalizations. The objective of this work was to analyze data on mortality that occurred in patients with advanced chronic non-communicable diseases associated with the Vila Floresta Primary Healthcare Center of the Conceição Hospital Group (VFPHC-CHG) and to verify how many of these would be eligible to PC. It is a transverse, descriptive and quantitative and retrospective approach research. Data come from electronic health records, management monitoring report, VFPHC-CHG medical records and Porto Alegre Epidemiological Surveillance. The Palliative Care Screening Tool (PCST) scale for PC eligibility criterion. Out of a total of 155 people who died and lived in the VFPHC-CHG covered territory in 2019, 55.2% (n = 86) were female, 54.2% (n = 84) were elderly and more 80 years old, 23.9% (n = 37) had died within five years after diagnosis, in 69.7% (n = 108) of cases the place of death was the hospital, 66.5% (n = 103) had no medical record, were neoplasms the main causes of death in 34.8%(n = 54), and 42.6% (n = 66) were considered eligible for PC according to PCST. It is concluded that the profile of people with diagnosis for over five years of the disease that resulted in death could be observed more carefully by PHC teams regarding PC, increasing the search for those who are eligible and establishing effective communication with hospitals in care transfer.
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References
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24. Paz CRP, Reis JDP, Campos ELPZ, Souza HL, Ferreira GG, Schveitzer MC. New demands for primary health care in Brazil: palliative care. Invest Educ Enferm. 2016; 34(1): 46-57. http://www.doi.org/10.17533/udea.iee.v34n1a06
25. Brasil. Resolução nº 825, 25 de abril de 2016. Redefine a Atenção Domiciliar no âmbito do Sistema Único de Saúde (SUS) e atualiza as equipes habilitadas. https://bvsms.saude.gov.br/bvs/saudelegis/gm/2016/prt0825_25_04_2016.html
26. Ornstein K, et al. Reduction in Symptoms for Homebound Patients Receiving Home-Based Primary and Palliative Care. J Pall. Medicine. 2013; 16(9): 1048-1059. https://doi.org/10.1089/jpm.2012.0546
27. Miyajima K, et al. Association between quality of end-of-life care and possible complicated grief among bereaved family members. J Pall. Medicine. 2014; 17(9): 1025-1031. http://www.doi.org/10.1089/jpm.2013.0552
2. Duncan BB, et al. Doenças crônicas não transmissíveis no Brasil: prioridade para enfrentamento e investigação. Rev Saúde Pública. 2012; 46(suppl 1): 123-134. https://doi.org/10.1590/S0034-89102012000700017
3. Clara MGS, Silva VR, Alves R, Coelho MCR. Escala Palliative Care Screening Tool como instrumento para indicação de cuidados paliativos em idosos. Rev Bras Geriatr Gerontol. 2019; 22(5): 1-10. https://doi.org/10.1590/1981-22562019022.190143
4. Rodrigues MM, Alvarez AM, Rauch KC. Tendência das internações e da mortalidade de idosos por condições sensíveis à atenção primária. Rev Bras Epidemiol. 2019; 22; 1-11. https://doi.org/10.1590/1980-549720190010
5. Brasil. Plano de Ações Estratégicas para o Enfrentamento das Doenças Crônicas e Agravos não Transmissíveis no Brasil 2021-2030. Ministério da Saúde, Secretaria de Vigilância em Saúde, Departamento de Análise em Saúde e Vigilância de Doenças Não Transmissíveis. 2021. http://bvsms.saude.gov.br/bvs/publicacoes/plano_enfrentamento_doencas_cronicas_ agravos_2021_2030.pdf
6. Radbruch L, et al. Redefining Palliative Care-A New Consensus-Based Definition. J Pain Symptom Manage. 2020; 60(4): 754- 764. https://doi.org/10.1016/j.jpainsymman.2020.04.027
7. Castilho RK, Silva VCS, Pinto CS. Manual de cuidados paliativos da Academia Nacional de Cuidados Paliativos (ANCP). 3ª ed. Rio de Janeiro: Atheneu; 2021.
8. Marcucci FCI, et al. Identification and characteristics of patients with palliative care needs in Brazilian primary care. BMC Pall Care. 2016; 15(1): 1-10. http://www.doi.org/10.1186/s12904-016-0125-4
9. Finkelstein EA, et al. Cross Country Comparison of Expert Assessments of the Quality of Death and Dying 2021. J Pain Symptom Manage. 2022; 63(4): 419-429. https://doi.org/10.1016/j.jpainsymman.2021.12.015
10. Justino ET, Treméa E, Kasper M, Santos KS. Os cuidados paliativos na atenção primária à saúde: scoping review. Rev Latino- Am Enfermagem. 2020; 28; 1-11. https://doi.org/10.1590/1518-8345.3858.3324
11. Ribeiro JR, Poles K. Cuidados Paliativos: Prática dos Médicos da Estratégia Saúde da Família. Rev Bras Educ Med. 2019; 43(3): 62-72. https://doi.org/10.1590/1981-52712015v43n3RB20180172
12. Souza HL, Zoboli ELCP, Paz CRP, Schveitzer MC, Hohl KG, Pessalacia JDR. Cuidados paliativos na atenção primária à saúde: considerações éticas. Rev Bioética. 2015; 23(2): 349-59. http://dx.doi.org/10.1590/1983-80422015232074
13. Afshar K, et al. Optimal care at the end of life (OPAL): study protocol of a prospective interventional mixed-methods study with pretest-posttest-design in a primary health care setting considering the view of general practitioners, relatives of deceased patients and health care stakeholders. BMC Health Serv Res. 2019; 19(1): 1-11. https://doi.org/10.1186/s12913-019-4321-9
14. Urquhart R, et al. Stakeholders' views on identifying patients in primary care at risk of dying: a qualitative descriptive study using focus groups and interviews. Br J Gen Pract. 2018; 68(674): e612-e620. http://www.doi.org/10.3399/bjgp18X698345
15. Kamal AH, Currow DC, Ritchie CS, Bull J, Abernethy AP. Community-based palliative care: the natural evolution for palliative care delivery in the U.S. J Pain Symptom Manage. 2013; 46(2): 254-264. http://www.doi.org/10.1016/j. jpainsymman.2012.07.018
16. Brasil. Resolução nº 41, de 31 de outubro de 2018. Dispõe sobre as diretrizes para a organização dos cuidados paliativos, à luz dos cuidados continuados integrados, no âmbito Sistema Único de Saúde (SUS). https://bvsms.saude.gov.br/bvs/ saudelegis/gm/2018/cit0041_23_11_2018.html
17. Silva MLSR. O papel do profissional da Atenção Primária à Saúde em cuidados paliativos. Rev Bras Med Fam Comunidade. 2013; 9(30): 45-53. https://rbmfc.org.br/rbmfc/article/view/718
18. Shadd JD, Burge F, Stajduhar KI, Cohen SR, Kelley ML, Pesut B. Defining and measuring a palliative approach in primary care. Can Fam Physician. 2013; 59(11): 1149-1150. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3828085/pdf/0591149. pdf
19. Gryschek G, Pereira EAL, Hidalgo G. Médicos de Família e Cuidados Paliativos: contribuições ao currículo baseado em competências. Rev Bras Med Fam Comunidade. 2020; 15(42): 1-7. https://doi.org/10.5712/rbmfc15(42)2012
20. Bloom CI, Ricciardi F, Smeeth L, Stone P, Quint JK. Predicting COPD 1- year mortality using prognostic predictors routinely measured in primary care. BMC Medicine. 2019; 17(73): 1-10. https://doi.org/10.1186/s12916-019-1310-0
21. Brownlee S, et al. Evidence for overuse of medical services around the world. Lancet. 2017; 390(10090): 156-168. http:// www.doi.org/10.1016/S0140-6736(16)32585-5
22. Sanderson CR, Cahill PJ, Phillips JL, Johnson A, Lobb EA. Patient-centered family meetings in palliative care: a quality improvement project to explore a new model of family meetings with patients and families at the end of life. Ann Palliat Med. 2017; 6(2): 195-205. https://apm.amegroups.com/article/view/16789/html
23. Almaawiy U, Pond GR, Sussman J, Brazil K, Seow H. Are family physician visits and continuity of care associated with acute care use at end-of-life? A population-based cohort study of homecare cancer patients. Palliat Med. 2014; 28(2): 176-183. http://www.doi.org/10.1177/0269216313493125
24. Paz CRP, Reis JDP, Campos ELPZ, Souza HL, Ferreira GG, Schveitzer MC. New demands for primary health care in Brazil: palliative care. Invest Educ Enferm. 2016; 34(1): 46-57. http://www.doi.org/10.17533/udea.iee.v34n1a06
25. Brasil. Resolução nº 825, 25 de abril de 2016. Redefine a Atenção Domiciliar no âmbito do Sistema Único de Saúde (SUS) e atualiza as equipes habilitadas. https://bvsms.saude.gov.br/bvs/saudelegis/gm/2016/prt0825_25_04_2016.html
26. Ornstein K, et al. Reduction in Symptoms for Homebound Patients Receiving Home-Based Primary and Palliative Care. J Pall. Medicine. 2013; 16(9): 1048-1059. https://doi.org/10.1089/jpm.2012.0546
27. Miyajima K, et al. Association between quality of end-of-life care and possible complicated grief among bereaved family members. J Pall. Medicine. 2014; 17(9): 1025-1031. http://www.doi.org/10.1089/jpm.2013.0552
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2023-03-02
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Bastos, J. M. C., Imthon, M. de O., Pinheiro, P. L., Klug, D., Saavedra, L. P., Jotz, G. P., & Santos, C. E. dos. (2023). User profiles with palliative care needs linked to a primary healthcare center in the city of Porto Alegre, RS. O Mundo Da Saúde, 47. https://doi.org/10.15343/0104-7809.202347e13192022P
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