Doentes adultos com necessidades paliativas em serviços de internamento, num hospital distrital

: número de doentes e adequação dos cuidados nos últimos dias de vida

Abstract

Introduction: The main goal of this dissertation is to identify patients (18 or older) with palliative needs admitted to a District Hospital and to know how LPC has been used as a healthcare guideline to patients with limited lifetime prognosis also admitted to District Hospital. This is a descriptive, cross-sectional and observational study.
Methodology: This is a random sample combining adult patients admitted to several units of a Public District Hospital. The data were obtained from a survey to healthcare professionals committed to the patients. No interviews or surveys were made to patients at the Hospital.
Results: 21 professionals participated in the study, 9 (43%) of which are specialists and Assistant Physicians, 7 (33%) Head-Nurses, 3 (14%) Resident physicians and 2 (10%) Heads of Service. All healthcare professionals were not aware of any LCP and stated that palliative care services were inexistent at the Hospital.
Physicians estimate that 58% of all patients admitted with 1 year life expectancy prognosis and an average age of 76.26 years require palliative care while nurses estimate that 44% of the patients are in need of palliative care. According to the physicians’ estimations, patients with 1 year life expectancy prognosis or less have been admitted from 1 to 34 days in the hospital while those referred to by the nurses have been admitted from 1 to 60 days. 15.2 % of the patients are oncologic while 82.8% are non-oncologic.
37.5% of the patients with one year life expectancy or less have digestive system cancer and 25% have lung and hematologic cancer. 40% of non-oncologic patients suffer from cardiovascular disease and 22% from the urinary system. As to the same prognosis, nurses refer that 29.7% have cardiovascular disease and 24.3% urinary system disease.
According to the physicians, 1.9% of the patients were referred to palliative care while nurses stated that 11.3% were referred. 3 (50%) of these patients are oncologic while other 3 (50%) are non- oncologic. Physicians and nurses have not referred these patients to palliative care mainly because: “The patient is still undergoing active treatment”.

Date of Award	1 Feb 2016
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor) & Alexandre Castro Caldas (Supervisor)