Fisioterapia Paliativa Aplicada ao Paciente Oncológico Terminal

Author(s):  
Daiane Bruna Leal Burgos

Câncer é o nome dado ao grupo de doenças malignas caracterizadas pelo crescimento celular anormal e que pode se espalhar para várias regiões do corpo. O tratamento dos pacientes oncológicos terminais, sem perspectivas curativas, necessita da multidisciplinaridade da equipe de saúde, incluindo a fisioterapia, que dispõe de técnicas complementares aos cuidados paliativos, tanto na melhora dos sintomas quanto na qualidade de vida desses pacientes. Assim, o presente artigo tem como objetivo descrever os benefícios da atuação do fisioterapeuta nos cuidados paliativos do paciente com câncer terminal. A revisão bibliográfica foi realizada nas bases de dados Lilacs, Medline e SciELO. Sendo os descritores de saúde utilizados: câncer terminal, fisioterapia, oncologia e cuidados paliativos de artigos publicados nas línguas inglesa, espanhola e portuguesa, no período de 2000 a 2014. Dos dez trabalhos incluídos para compor a discussão, oito apresentaram a importância da fisioterapia na equipe multidisciplinar, que trabalha com pacientes oncológicos terminais, sendo estes resultados apresentados por meio dos benefícios de suas técnicas aplicadas a esses pacientes, evidenciada principalmente na dor e na imobilidade. Apenas dois artigos apresentaram objeções quanto ao encaminhamento do tratamento fisioterapêutico paliativo direcionado para pacientes oncológicos terminais, pois em seus estudos, o resultado encontrado foi a falta de investimento público nessa área, o que resulta em desconhecimento da atuação de profissionais fisioterapeutas especialistas em oncologia. Os estudos encontrados mostram que a fisioterapia tem um papel relevante nos cuidados paliativos, entretanto necessita-se de uma maior oferta e implementação deste tratamento nos serviços de saúde.Palavras-chave: Câncer Terminal. Fisioterapia. Oncologia. Cuidados Paliativos.AbstractCancer is the name given to the group of malignant diseases characterized by the abnormal cell growth and can spread to various parts of the body. The treatment of oncological terminal patients without healing perspectives needs a multidisciplinary health team, including physiotherapy that offers complementary techniques to palliative care, both in the symptoms improvement and life quality of these patients. It describes the benefits of the physiotherapist’s role in palliative care of patients with terminal cancer. A literature review was performed using the following databases: Lilacs, Medline and Scielo. The health descriptors used are: terminal cancer, physiotherapy, oncology and palliative care articles published in English, Spanish and Portuguese from 2000 to 2014. Out of the ten papers included to compose the discussion, eight had the importance of the physiotherapy in the multidisciplinary team that works with terminal cancer patients, these results presented through the benefits of its techniques applied to these patients primarily evidenced in pain and immobility. Only two articles had objected to the referral palliative physiotherapy treatment to terminal cancer patients because in their studies, the result found was the lack of public investment in this area which results in a lack of performance from expert physiotherapists in oncology. These studies show that physiotherapy plays an important role in palliative care but a greater supply and implementation of this treatment in health services are needed.Keywords: Terminal Cancer. Physiotherapy. Oncology. Palliative Care.

2019 ◽  
Vol 14 (3) ◽  
pp. 187-192
Author(s):  
Kotaro Hashimoto ◽  
Kazuki Sato ◽  
Mitsuharu Sasaki ◽  
Hiroaki Takabayashi ◽  
Masanori Kawahara ◽  
...  

Cancer ◽  
2004 ◽  
Vol 101 (5) ◽  
pp. 1090-1098 ◽  
Author(s):  
Antonio Vigano ◽  
Nora Donaldson ◽  
Irene J. Higginson ◽  
Eduardo Bruera ◽  
Salaheddin Mahmud ◽  
...  

2006 ◽  
Vol 4 (2) ◽  
pp. 179-188 ◽  
Author(s):  
KEIKO TAMURA ◽  
KAORI ICHIHARA ◽  
EIKO MAETAKI ◽  
KEIKO TAKAYAMA ◽  
KUMI TANISAWA ◽  
...  

Objective: This research explores the potential benefit of a spiritual pain assessment sheet to clinical practice. With spiritual pain defined as “pain caused by extinction of the being and meaning of the self,” the spiritual pain assessment sheet was developed by Hisayuki Murata from his conceptual framework reflecting the three dimensions of a human being as a being founded on temporality, a being in relationship, and a being with autonomy. The assessment sheet was developed from reviews of the literature and examinations from a philosophical perspective on the structure of spiritual pain.Methods: Patients admitted to palliative care units in Japan were interviewed using the assessment sheet. The responses were analyzed qualitatively. The usefulness of the assessment sheet and the burden placed on the patients by its use were also investigated.Results: The spiritual pain elucidated by the assessment sheet was the same as that revealed in the earlier research of Morita. The patients reported that they did not find the use of the assessment sheet a burden, and more than half reported that it was useful. The burden of the assessment sheet on the subjects was thus determined to be low. Positive feedback on the assessment sheet was also received from the nurses who conducted the patient interviews, who said the assessment sheet made it easier to talk with the patients about their spiritual pain.Significance of research: The research results indicate that the spiritual pain assessment sheet provided an appropriate assessment of spiritual pain among terminal cancer patients, showing that such a sheet could be used as an assessment tool in the future.


1989 ◽  
Vol 75 (6) ◽  
pp. 619-625 ◽  
Author(s):  
Vittorio Ventafridda ◽  
Franco De Conno ◽  
Antonio Viganò ◽  
Carla Ripamonti ◽  
Michele Gallucci ◽  
...  

Treatment and care of terminal cancer patients are conducted in different ways, according to the cultural, social, political and economical situations of the countries which have progressively adopted and developed them. In Italy there are no specialized structures such as « hospices » or the « palliative care units » like in the Anglo-Saxon world: the care of terminal cancer patients is carried out either in a general hospital or at their own home. In Milan and elsewhere there are home care teams in which doctors, nurses, social workers and volunteers, all work in connection with hospital structures. In this way, patients can receive specialized care for physical, psycological and social problems at home too. To evaluate costs and effectiveness of this program, a comparison was made between the home care and the conventional treatment carried out in general hospitals. Two groups of thirty terminal cancer patients have been studied: the first group was composed of hospital patients in Desio and the second one included patients cared for by the home care service organized by the Floriani Foundation and the Italian League against Cancer (Milan Section). We evaluated intensity and duration of pain, hours of sleep and hours of standing, sitting and lying, presence of side-effects, performance status and therapies. Data were also collected on the quality of life (Spitzer QLI), social and economical needs of the patients, type and quality of care, degree of awareness of the diagnosis by the patient and the family. This data were collected by the nurse who looked after the patient. Care costs were also quantified. The comparison between the two groups significantly favours the home care group as shown by the performance status after 2 weeks of care, the « health scale » and the Total Index of the Spitzer QLI and in general the greater satisfaction of the care received. Home care produces results equivalent to those achieved in hospitals as far as clinical parameters are concerned. An approximate quantification of the costs shows that an average cost for a day's home care was about Lit. 52,500 as compared with Lit. 360,000 for a day's hospitalization.


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