Desafios e barreiras nos cuidados à pessoa com doença hematológica maligna em fase avançada

Abstract

Patients with malignant haematological diseases present a more unpredictable disease trajectory when compared with advanced solid tumours, making it challenging to identify the moment of transition from curative to palliative phase. The end-of-life phase of these patients often occurs under aggressive curative therapy, with frequent admissions to the emergency department and symptomatic burden identical to advanced-stage solid tumours. The death of these patients occurs mostly in the hospital context, losing the window of opportunity for an appropriate palliative care approach. Aim: The aim of this study is to understand the challenges and barriers identified by health professionals in the care of people with malignant haematological diseases at the end-of-life. Methodology: This is a phenomenological study, based on a qualitative approach. The instruments used were the semi-structured questionnaire and the interview, applied in two phases, to the defined target population, according to the inclusion criteria. Limitations of the study constrains to gain access to hospital settings resulting from the current worldwide pandemic with consequent poor adherence from healthcare professionals; potential reduction of the sample that meets the inclusion criteria due to the mobility of health professionals of the National HealthCare Service in consequence of pandemic; lack of reference literature that explores the current theme, furthermore none within Portuguese care setting. Expected implications of the study: a potential catalyst effect for the development of new studies exploring the context of death of haematological patients; promotion of constructive relationships that enhance multidisciplinary reflection on the context of death of these patients; development of strategies that promote a more adequate response of the National Palliative Care Network to the needs of haematological patients at the end of life.

Date of Award	5 Apr 2022
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Mara de Sousa Freitas (Supervisor)