Caraterização sintomática e identificação da fase de agonia numa Unidade de Cuidados Paliativos da Rede Nacional de Cuidados Integrados

Abstract

Introduction: The failure to recognize the transition to the agony phase (AP) will compromise the adequacy of care that patients and family receive at this time. The poor quality of care and medicalization at the end of life are reported too often. This study aims to characterize the symptoms of patients during the AP and evaluate its recognition by the medical team in a Palliative Care Unit (PCU) of the National Network of Integrated Continuous Care (NNICC). Material and Methods: Retrospective, descriptive, observational and longitudinal study with a quantitative approach. The studied population consists of the patients admitted to a PCU of the NNICC in the year 2016. The obtained data were evaluated by descriptive and analytical statistics with the use of the Statistical Package for the Social Sciences (SPSS) software, version 24 Results: During the year 2016, 80 patients were admitted to the PCU, of which 52,5% (n=42) were of the female gender. The mean age was 71,3 years. Most of the patients had underlying oncological disease (n=69, 86,25%). The most frequent symptoms and clinical signs were: prostration, pain, wheezing, agitation, dyspnea, disorientation, polypnea. A total of 65 patients died (81,25%). Of the patients who died due to underlying disease progression (n=57), the transition to the AP was identified in 38 cases (66,67%). The family was informed of the situation in most of cases (n=32, 84,21%). Statistical analysis revealed a significant association between the AP and pain (p=0.016). VI Conclusions: The patient at the end of life represents a challenge of great complexity. The recognition of the AP as well as the holistic approach of the patient and family during this final phase are essential to guarantee quality care.

Date of Award	28 Jun 2018
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor)