Revisão sistemática da literatura

: facilitadores e barreiras na referenciação de oncologia para cuidados paliativos

Abstract

Objective: to review the factors that are involved in the referral process of cancer patients with advanced disease, from oncology to palliative care. Focusing on facilitating factors and barriers. Introduction: an early referral for palliative care is associated with better oncological outcomes and quality of life. However, this occurs late in the disease process. There are factors that influence this referral. Material and Methods: systematic review of the literature with search in search engines such as PUBMED (Medline), EBSCO (Cinahl) and Google Academic, with previously defined inclusion and exclusion criteria. A selection of articles was made in 3 phases, with two reviewers and a third one for conflict assessment. We used online instruments perform analysis, extraction and synthesis of included articles. Results: 54 articles were included. There are several types of barriers that can influence the referral from oncology to palliative care: related to the oncologist (lack of training and communicative skills, stigmatization of palliative care, medical culture, lack of uniformity in the evaluation of these patients); related to the patient and family (resistance in relation to palliative care, lack of knowledge, increased burden of consultations); and related to the institution (lack of human resources, time, space and funding). Within the facilitating factors, we found that an increase in medical training; acquisition of communicative skills; education of the general population; definition of referral criteria; uniform tools to assess these patients as factors that can help to overcome some barriers. Conclusion: the determination of the factors and barriers that influence this referral allow the utilization of facilitating strategies to make referral from oncology to palliative care easier and earlier in the disease course, according to patients needs and the capacity of the hospital services. It will be interesting to see which apply to our Portuguese reality.

Date of Award	7 Jul 2020
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Manuel Luís Capelas (Supervisor)