Primary home care for palliative and terminal patients near lisboa: nursing practice and hospital palliative care team support

In Portugal, a great number of palliative and terminal patients wish to stay and die at home, surrounded by their relatives and significant objects. These patients are commonly cared by professionals, namely nurses, from primary health care system, developing an integrated work with some palliative care units in hospitals. What interventions have those nurses in their everyday practices? How can the relationship and support between these nurses and the hospital palliative care team be optimized? Aims: To identify the interventions conducted by nurses from primary care when caring for palliative and terminal patients at home; to analyze these professionals view about those interventions; to identify the barriers in relation to primary care nursing practice in end-of-life care; to analyze the support given by hospital palliative care teams to those nurses who care for palliative and terminal patients at home. Methods: Qualitative, exploratory and descriptive study. Sample compounded by nurses who work in primary care settings nearby the Portuguese capital (Lisboa) and who provide home care for palliative and terminal patients. Participants are being recruited through intentional sampling. Five in-depth interviews have already been conducted; data collection will be held until theoretical saturation. QSR NVivo 9 is used for content analyzes. Results/Conclusions: Preliminary results (five participants) indicate that the most relevant interventions conducted by these nurses are symptom control and management of complex situations related to family issues and expectations management; these professionals also refer a lack of education in palliative care in order to answer to all the patients and their relatives’ needs. The major barriers are related to organizational aspects. Hospital palliative care teams are seen as a valuable resource however more effective strategies are felt to be needed in order to improve the communication between the hospital and the primary care institution.