CUIDADOS ODONTOLÓGICOS PALIATIVOS EM PACIENTES TERMINAIS

Cuidados paliativos são abordagens terapêuticas com o objetivo de aliviar o sofrimento, diante de doenças que ameaçam a vida dos pacientes. Essa conduta terapêutica além de garantir uma melhor qualidade de vida ao paciente e aos familiares que enfrentam alguma patologia apoia- se em uma visão de que a morte deve seguir seu curso natural, proporcionando assim uma maior dignidade ao paciente afetado e promovendo uma sensação de bem-estar. O presente trabalho tem como objetivo apresentar uma revisão de literatura sobre cuidados odontológicos paliativos em pacientes terminais. Foi realizada uma revisão de literatura nas seguintes bases de dados: PubMed, SciELO e Google Scholar. As palavras-chave utilizadas para a procura estudos foram “Cuidados paliativos”, “Equipe Hospitalar de odontologia”, “Cuidados de conforto”. A Odontologia, nos cuidados paliativos, visa diminuir o número de infecções e também evitar a porta de entrada de diversos microrganismos. Esse serviço proporciona um atendimento humanizado ao paciente impossibilitado de ir a um consultório odontológico, e assim fazendo com que o profissional se desloque até o paciente por meio de visitas domiciliares. Os cuidados odontológicos paliativos em pacientes terminais são de grande importância, fornecendo conforto e amparo para o paciente e para família. É importante que hospitais incluam em suas equipes multidisciplinares cirurgiões dentistas capacitados para odontologia hospitalar, assim, tornando a terapia paliativa humanizada para os enfermos. THE PALLIATIVE DENTAL CARE IN TERMINAL PATIENTS ABSTRACT Palliative care is a therapeutic approach with the intention of relieving suffering when facing life-threatening illnesses. This therapeutic approach, besides guaranteeing a better quality of life for the patient and family members who face some pathology, is based on a perspective that death may follow its natural process, thus providing more dignity to the affected patient and promoting a wellbeing feeling. The present paper aims to present a literature review on palliative dental care in terminally ill patients. A literature review was conducted in the following databases: PubMed, SciELO and Google Scholar. The keywords used to research the articles were "Palliative Care", "Hospital Dentistry Team", "Comfort Care". Dentistry, in palliative care, aims to decrease the number of infections and to avoid the entry gate for a range of microorganisms. This is a service that provides humanized care to patients who are unable to go to a dental office, and thus by heaving the professional to visit the patient through home care routine visits. Palliative dental care in terminal patients is of paramount importance since it provides comfort and support to the patient and family. It is worthwhile that hospitals include in their multidisciplinary team dental surgeons trained in hospital dentistry, and thereby enabling the palliative therapy to be humanized for the infirm. Keywords: Palliative Care; Hospital Dentistry Team, Hospice Care.

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The Promise of Palliative Care

Pained ◽

10.1093/oso/9780197510384.003.0058 ◽

2020 ◽

pp. 203-206

Author(s):

Michael D. Stein ◽

Sandro Galea

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

End Of Life ◽

Social Workers ◽

Hospice Care ◽

Care Plan ◽

Life Care ◽

High Quality ◽

Life Threatening

This chapter assesses palliative care. Palliative care focuses on improving the quality of life for people with life-threatening illnesses by involving a team of nurses, doctors, social workers, and clergy in a care plan. Hospice care—administered in dedicated units and in services delivered at home—has been slowly expanding over the past two decades, but the increasing percentage of patients who use hospice for less than 7 days suggests that the full benefits of end-of-life palliative care are not being realized. Meanwhile, the use of unwanted, aggressive end-of-life care, often inconsistent with patient preferences, remains pervasive. For palliative care to be effective, it must be supported by government policies and insurer incentives; it must also be owned by communities, which must continue to ask for help in designing and paying for high-quality palliative care for patients and their caregiving families.

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Palliative and Hospice Care: Educational Needs of Inpatient Registered Nurses

Creative Nursing ◽

10.1891/1078-4535.22.2.114 ◽

2016 ◽

Vol 22 (2) ◽

pp. 114-120 ◽

Cited By ~ 1

Author(s):

Jennifer L. Ashley ◽

Tracy K. Fasolino

Keyword(s):

Quality Of Life ◽

Palliative Care ◽

Acute Care ◽

Formal Education ◽

Care Setting ◽

Hospice Care ◽

Acute Care Setting ◽

Life Threatening ◽

Hospice And Palliative Care

Hospice and palliative care aim to improve the quality of life for patients and families impacted by chronic, serious, and life-threatening illnesses. Patients and families benefit from earlier integration of palliative care and seamless transitions to hospice care. Nurses are an integral part of the care team, and their understanding of these services is critical. However, many nurses do not receive formal education in hospice and palliative care. This leads to lack of skills that nurses need to provide and discuss hospice and palliative care across care settings. Nurses in an acute care setting of a large health system were invited to participate in a survey, Attitudes Towards Care at the End-of-Life. The results of this survey revealed that nurses believe that patients and families need to be communicated with honestly regarding their disease, but nurses lack the knowledge of how to facilitate these discussions. Another key finding is that nurses feel less confident with non-pharmacologic interventions to relieve patients’ suffering. Education is urgently needed in these areas.

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Consensus guideline on parenteral methadone use in pain and palliative care

Palliative & Supportive Care ◽

10.1017/s1478951508000254 ◽

2008 ◽

Vol 6 (2) ◽

pp. 165-176 ◽

Cited By ~ 50

Author(s):

Lauren Shaiova ◽

Ann Berger ◽

Craig D. Blinderman ◽

Eduardo Bruera ◽

Mellar P. Davis ◽

...

Keyword(s):

Chronic Pain ◽

Palliative Care ◽

Pain Management ◽

Hospice Care ◽

Acute Care Hospital ◽

Care Hospital ◽

Chronic Pain Management ◽

Consensus Guideline ◽

Term Care ◽

Line Therapy

ABSTRACTOnce used only as third-line therapy for chronic pain management, methadone is now being used as first- and second-line therapy in palliative care. The risks and stigma associated with methadone use are known, but difficulties with dosing methadone and lack of an established conversion protocol from other opiates have limited the access for patient populations who could potentially benefit from this medication. For palliative care patients, the benefits of methadone can far outweigh its risks. This article provides an overview and specific recommendations on the use of parenteral methadone in pain and palliative care, with a focus on the transition from hospital to home/hospice care. The goal of this consensus guideline is to assist clinicians who are providing chronic pain management in acute care hospital and nonhospital settings (i.e., hospice, long-term care facilities, and community) for patients with life-limiting illnesses, where the goals of care are focused on comfort (i.e., palliative care). The recommendations in this article intend to promote a standard of care involving the use of intravenous methadone with the aim of reaching a broader population of patients for whom this drug would provide important benefits.

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Caregivers burden in people in palliative care: an integrative literature review

Medicina (Ribeirao Preto Online) ◽

10.11606/issn.2176-7262.v49i4p344-354 ◽

2016 ◽

Vol 49 (4) ◽

pp. 344 ◽

Cited By ~ 1

Author(s):

Gabriela Rezende ◽

Cristiane A. Gomes ◽

Fernanda C. Rugno ◽

Renata C. Carvalho ◽

Marysia M. R. P. De Carlo

Keyword(s):

Palliative Care ◽

Literature Review ◽

Supportive Care ◽

Terminal Care ◽

Hospice Care

Modelo do estudo: Revisão Integrativa da Literatura. Objetivo: sintetizar os principais resultados de pesquisas e analisar criticamente as evidências científicas relativas ao tema da sobrecarga de cuidadores de pessoas em Cuidados Paliativos. Método: Busca bibliográfica nas bases de dados MEDLINE, LILACS, CINAHL e na biblioteca virtual SciELO, com os cruzamentos entre os descritores: “Caregivers”, “Palliative Care”, “Terminal Care”, “Hospice Care”, e as palavras-chave “Burden”, “Supportive Care”. Resultados: Foram selecionados 23 artigos publicados em periódicos internacionais, no período de janeiro de 2004 a junho de 2014. Foram categorizados em três unidades de análise: a tarefa de cuidar e as consequências para a vida do cuidador (N=7); a sobrecarga do cuidador diante da proximidade da morte (N=8); programas e serviços de apoio aos cuidadores (N=8). Os artigos indicaram que a sobrecarga do cuidador varia de acordo com sua vivência da tarefa de cuidar e a evolução da doença da pessoa cuidada; o cuidador necessita ser acolhido em suas necessidades e ter acesso a recursos da comunidade e serviços de saúde para diminuir a sobrecarga e melhorar tanto sua qualidade de vida, quanto da pessoa cuidada. Porém, as evidências científicas são consideradas fracas, com níveis 4 (65,2%) e 5 (21,8%) e apenas 13% dos estudos apresentam evidências consideradas fortes. Conclusão: O tema da sobrecarga de cuidadores de pessoas em Cuidados Paliativos é relevante para a pesquisa e para a prática clínica, mas há necessidade de estudos com melhor qualidade metodológica e evidências científicas que alicercem o cuidado a essa população

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Palliative Care and Hospice: A Paradigm for End-of-Life Care in Developing Nations

Journal of Advances in Internal Medicine ◽

10.3126/jaim.v6i2.18541 ◽

2017 ◽

Vol 6 (2) ◽

pp. 38-44 ◽

Cited By ~ 1

Author(s):

Peter A. Clark

Keyword(s):

United States ◽

Palliative Care ◽

End Of Life Care ◽

Hospice Care ◽

The United States ◽

Developing Nations ◽

Comfort Care ◽

Loved One ◽

Legal Perspective ◽

Fear Of Abandonment

Traditionally, medical care has had two mutually exclusive goals: either to cure disease and to prolong life or to provide comfort care. Given this dichotomy, the decision to focus on reducing suffering is made usually only after life-prolonging treatment has been ineffectual and death is imminent, usually by days or hours. As a result, one of the best kept secrets in a hospital today in the United States is palliative care and hospice care. We estimate that of the 2.4 million Americans that die each year, about 80% end their lives in hospitals attached to the latest advances in technology; 300,000 die at home under hospice care. The reasons why more people do not receive palliative or hospice care range from the patient’s fear of abandonment and the unknown, the family’s denial of the inevitability of death of their loved one, and physician’s denial of medicine’s limitations. Unless the options of palliative or hospice care are given to patients the fears that people have of dying--fear of dying alone and fear of dying in pain--will continue to make the dying process one that lacks dignity and respect. In this review article we have reviewed the state of palliative and hospice care in the United States through a historical, ethical and legal perspective. We have discussed its scope in the developing world and the potential challenges.Journal of Advances in Internal Medicine 2017;06(02):38-44.

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A síndrome G6PD e suas implicações no atendimento ao Paciente Odontopediátrico: Uma Revisão da literatura / G6PD deficiency and its implications for Pediatric Dental Care: A Literature Review

ID on line REVISTA DE PSICOLOGIA ◽

10.14295/idonline.v13i47.2093 ◽

2019 ◽

Vol 13 (47) ◽

pp. 900-910

Author(s):

Pablo Caique Neves Leão ◽

Erich Silva Almeida ◽

Felipe Rocha Carvalho ◽

Cleber Oliveira Ribeiro Junior ◽

Milena Tavares de Carvalho ◽

...

Keyword(s):

Literature Review ◽

Dental Care ◽

G6pd Deficiency ◽

Google Scholar

O objetivo do presente estudo, por meio de uma revisão de literatura, levantar dados pertinentes sobre a síndrome G6PD, as limitações nas prescrições medicamentosas e a importância para o cirurgião-dentista, principalmente o Odontopediatra, em ter o conhecimento desta síndrome e suas repercussões sistêmicas. A pesquisa bibliográfica foi realizada em bancos de dados, Pubmed, Google Scholar e Lilacs, nos quais foram utilizados os artigos científicos publicados nos últimos 10 anos para a revisão de literatura. A fim de contribuir para a qualidade de vida dos portadores de deficiência de G6PD, estudos apontam os fármacos ou alimentos que devem ser evitados. Diante de tal situação, salienta-se a função primordial da G6PD na sobrevida dos eritrócitos, e destaca-se que o estudo desta enzimopatia levará ao conhecimento não apenas da via das pentoses, mas também dos mecanismos intracelulares que nosso organismo a todo momento lança mão para garantir o bem-estar do corpo humano.

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Psychiatric issues in palliative care: Recognition of delirium in patients enrolled in hospice care

Palliative & Supportive Care ◽

10.1017/s1478951508000242 ◽

2008 ◽

Vol 6 (2) ◽

pp. 159-164 ◽

Cited By ~ 32

Author(s):

Scott A. Irwin ◽

Sanjai Rao ◽

Kimberly A. Bower ◽

Joanna Palica ◽

Sanjay S. Rao ◽

...

Keyword(s):

Palliative Care ◽

Hospice Care ◽

Retrospective Chart Review ◽

Interdisciplinary Teams ◽

Significant Problem ◽

Term Care ◽

Prevalence Estimates ◽

Life Threatening ◽

Hospice And Palliative Care ◽

The Impact

ABSTRACTObjectives:Delirium is prevalent, difficult to assess, under-recognized, and undertreated in hospice and palliative care settings. Furthermore, it is associated with significant morbidity and mortality. Under-recognition of delirium results in under-treatment and increased suffering. The intent of this study was to retrospectively evaluate the recognition of delirium in a large cohort of hospice patients by interdisciplinary hospice care teams.Methods:A retrospective chart review of 2,716 patients receiving hospice care was conducted in order to determine the baseline rate of recognition of delirium in patients with advanced, life-threatening illnesses by front-line hospice clinicians. Documentation of “delirium” as either a diagnosis or problem was used as an estimate of how often these disorders were considered significant issues by the treating interdisciplinary team.Results:Of the patients receiving home/long-term care, 17.8% (386/2168) had delirium documented as a diagnosis or significant problem. The presence of recognized delirium in this setting was associated with significant differences in marital status, ethnicity, hospice diagnosis, and age. Total length of hospice care was also significantly longer. Of patients receiving inpatient care, 28.3% (614/548) had delirium documented as a diagnosis or significant problem. Recognized delirium in this setting was associated with significant differences in gender, ethnicity, hospice diagnosis, and length of inpatient stay.Significance of results:If documentation is representative of the care that the interdisciplinary teams provide, delirium of any kind appears to be under-recognized in this population. In fact, it is on the low end of prevalence estimates in the literature. Improved delirium assessment is needed in order to minimize the impact of delirium on patients living with advanced, life-threatening illnesses and their caregivers.

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Awareness and Misperceptions of Hospice and Palliative Care: A Population-Based Survey Study

American Journal of Hospice and Palliative Medicine® ◽

10.1177/1049909117715215 ◽

2017 ◽

Vol 35 (3) ◽

pp. 431-439 ◽

Cited By ~ 44

Author(s):

Ariel Shalev ◽

Veerawat Phongtankuel ◽

Elissa Kozlov ◽

Megan Johnson Shen ◽

Ronald D. Adelman ◽

...

Keyword(s):

New York ◽

Palliative Care ◽

Hospice Care ◽

New York State ◽

Population Based ◽

Cross Sectional Study ◽

Community Dwelling ◽

Survey Study ◽

Cross Sectional ◽

Comfort Care

Background: Despite the documented benefits of palliative and hospice care on improving patients’ quality of life, these services remain underutilized. Multiple factors limit the utilization of these services, including patients’ and caregivers’ lack of knowledge and misperceptions. Objectives: To examine palliative and hospice care awareness, misperceptions, and receptivity among community-dwelling adults. Design: Cross-sectional study. Subjects: New York State residents ≥18 years old who participated in the 2016 Empire State Poll. Outcomes Measured: Palliative and hospice care awareness, misperceptions, and receptivity. Results: Of the 800 participants, 664 (83%) and 216 (27%) provided a definition of hospice care and palliative care, respectively. Of those who defined hospice care, 399 (60%) associated it with end-of-life care, 89 (13.4%) mentioned it was comfort care, and 35 (5.3%) reported hospice care provides care to patients and families. Of those who defined palliative care (n = 216), 57 (26.4%) mentioned it provided symptom management to patients, 47 (21.9%) stated it was comfort care, and 19 (8.8%) reported it was applicable in any course of an illness. Of those who defined hospice or palliative care, 248 (37.3%) had a misperception about hospice care and 115 (53.2%) had a misperception about palliative care. Conclusions: Most community-dwelling adults did not mention the major components of palliative and hospice care in their definitions, implying a low level of awareness of these services, and misinformation is common among community-dwelling adults. Palliative and hospice care education initiatives are needed to both increase awareness of and reduce misperceptions about these services.

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Principles of Hospice and Palliative Medicine and Supportive Care

Hospice and Palliative Medicine and Supportive Care Flashcards ◽

10.1093/med/9780190633066.003.0001 ◽

2018 ◽

Author(s):

Sriram Yennurajalingam

Keyword(s):

Palliative Care ◽

Supportive Care ◽

Hospice Care ◽

World Health ◽

Skill Sets ◽

Life Threatening Illness ◽

Assessment And Treatment ◽

Relief Of Suffering ◽

Life Threatening ◽

Health Organization

The World Health Organization defines palliative care as “an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” Hospice care, palliative care, and supportive care are the common terms used to describe the delivery of palliative care. They essentially require the same skill sets and are often delivered by the same group of health professionals. This chapter reviews the definition and core principles of hospice and palliative care.

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PERAWATAN PALIATIF PADA ANAK DENGAN HIV/AIDS SEBAGAI KORBAN TRANSMISI INFEKSI VERTIKAL: LITERATURE REVIEW

Jurnal Kesehatan Bakti Tunas Husada: Jurnal Ilmu-ilmu Keperawatan, Analis Kesehatan dan Farmasi ◽

10.36465/jkbth.v19i2.505 ◽

2019 ◽

Vol 19 (2) ◽

pp. 285

Author(s):

Gusgus Ghraha Ramdhanie

Keyword(s):

Palliative Care ◽

Literature Review ◽

Collaborative Practice ◽

Google Scholar ◽

Pediatric Palliative Care ◽

Mother To Child Transmission ◽

Child Transmission ◽

Mother To Child ◽

Hiv Aids

Kematian anak akibat penyakit terkait HIV/AIDS sebagai korban transmisi vertikal atau disebut Mother To Child Transmission (MTCT) mencapai 110.000 setiap tahun. Dalam hitungan rinci terjadi sekitar 400 anak terinfeksi HIV dan sekitar 290 kematian karena AIDS terjadi setiap harinya. Sebagai korban transmisi infeksi vertikal, banyak anak yang kurang mendapat dukungan dari keluarga. Orang tua dengan HIV/AIDS selain mempunyai masalah kesehatannya sendiri, juga dapat menjadikan anak seorang “yatim piatu” sehingga anak tidak mendapatkan asuhan orang tua. Perlu kajian manajemen pengelolaan asuhan, salah satunya adalah dengan penerapan perawatan paliatif pada anak. Tujuan dari penulisan literature review ini yaitu untuk mengetahui perawatan paliatif pada anak dengan HIV/AIDS sebagai korban infeksi vertikal berdasarkan pada sumber literatur jurnal penelitian ilmiah terkait. Metode yang digunakan dalam penulisan literature review ini adalah penelusuran internet dari database Google Scholar, PubMed, Proquest, Medscape, dan EBSCO dengan menggunakan kata kunci pediatric palliative care, palliative care, dan pediatric HIV/AIDS. Perawatan paliatif pada anak adalah model terintegrasi dimana komponen layanan paliatif dilakukan setelah pasien mulai terdianosis. Sebagian besar pasien anak dengan HIV/AIDS ditemukan dalam stadium klinis berat pada usia yang sangat dini. Manajemen terapi farmakologis, non-farmakologis dan dukungan psikososial serta spiritual diberikan dalam perawatan. Selain itu, manajemen tanda gejala dalam perawatan paliatif harus dilakukan dengan tepat. Perawatan paliatif merupakan pelayanan tenaga profesional dengan mengimplementasikan interprofesional collaborative practice yang dapat diintegrasikan dengan pelayanan berbasis rumah. Perawatan paliatif pada anak dengan HIV/AIDS dapat meningkatkan kualitas hidup anak.

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