Integração de cuidados paliativos e cuidados intensivos

: um estudo de abordagem mista sobre as perspetivas dos profissionais de saúde

Abstract

Introduction: The integration of palliative care and intensive care has been studied in recent years. Studies suggest initiatives that promote this integration, however they are focused on only one dimension of care. Objective: To know healthcare professionals’ perspectives on the integration of palliative care and intensive care, identifying knowledge about integration, organizational models, barriers and promoting factors involved. Methods: Mixed approach study, with a qualitative component (interviews) and a quantitative component (questionnaire). A purposive “snowball” sampling was carried out in Brazil for recruitment. Thematic content analysis of interview transcripts and descriptive analysis of quantitative data (Mann-Whitney and Fisher's Exact tests; Spearman's coefficient (p < 0.05) were performed. Results: Twenty-seven health professionals were included in the study, 14 palliative care professionals and 13 intensive care professionals. The concept of integration seems fundamental among palliative care professionals, and for intensive care professionals (ICU) it is perceived as end-of-life care. A consultation model is especially preferable in these situations; integrated education is recommended by palliative care professionals. Behavior and lack of knowledge (ICU professionals); and lack of institutional and public policies (palliative care professionals) were identified barriers. Training in palliative care was the greatest facilitating factor. Quantitative data showed agreement on the dimensions of care integration, but not evident in the ICUs. There were differences in the items “commitment to the view that the patient is a client” (p = 0.005) and “interdisciplinary teams with well-defined roles and preservation of professional autonomy” (p = 0.0004). Conclusion: Evidence of integration of palliative care and intensive care is limited, especially among ICU professionals. Integration is associated with end-of-life care, despite the recognition of its importance for patients/families.

Date of Award	21 Mar 2022
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Pablo Hernández Marrero (Supervisor) & Sandra Martins Pereira (Co-Supervisor)