Dispneia no doente paliativo

: incidência, abordagens e sua efetividade

Abstract

Dyspnea is a subjective symptom, reported in the first person, causing significant distress and suffering to the patient and his family. In order to determine the incidence of dyspnea in patients hospitalized in portuguese palliative care units in 2010, an observational, longitudinal, descriptive study was developed. A sample of 301 patients admitted in 2010 was set from six inpatient units of palliative care. Data was collected by consulting clinical records, gathering information in a registry form. Most patients in the study were cancer patients (90.70%), with co-morbidities (65.78%), male gender (58.5%), with a median age of 76 years. The incidence of dyspnea was 20.27% and the prevalence at admission of 6.65%. There was an incidence of 39.53% among patients with malignant cancer of respiratory and intrathoracic organs and 13.46% among patients with malignant cancer of digestive organs. At the time of admission, the median survival time was 11 days (IQR = 31.50 days). After the occurrence of dyspnea it was three days (IQR = 12.00 days). Evaluation of dyspnea in 48 hours after admission was found on 73.75% of the clinical records, mostly without the use of an evaluation scale (82.39%). The symptomatic control of dyspnea was conducted using pharmacological (78.69%) and nonpharmacological (22.95%) measures, with morphine as the most frequently used drug (25.27%), followed by oxygen (21.98%) and bronchodilators (20.88%). The effectiveness of the approaches for the relief or reduction of dyspnea was possible to be verified in 57.38% of the cases of dyspnea. In these cases, the interventions were effective in fewer than 48 hours after an occurance of dyspnea,where the use of only pharmacological measures was 74.29%, only the nonpharmacological of 8.57% and only both of 17.14%.

Date of Award	2012
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Francisco Pimentel (Supervisor) & Manuel Luís Capelas (Co-Supervisor)