scholarly journals Intervenção em cuidados paliativos: conhecimento e percepção dos enfermeiros

2018 ◽  
Vol 12 (5) ◽  
pp. 1325
Author(s):  
Hashilley Alberto da Silva ◽  
Gleice Kelle Beserra Viana ◽  
Ana Karine Girão Lima ◽  
Carla Monique Lopes Mourão ◽  
Ana Luiza Almeida de Lima

RESUMOObjetivo: avaliar a percepção dos enfermeiros sobre cuidado paliativo antes e depois de uma intervenção. Método: estudo quantitativo, quase experimental, desenvolvido nas unidades de um hospital de atenção secundária. O instrumento de coleta de dados foi adaptado de um estudo realizado com anestesiologistas, esses foram analisados no programa Excel e organizados em tabelas, sendo aplicado o teste estatístico de qui-quadrado de Pearson, com tabelas que apresentam os valores obtidos dentro de categorias distintas, mas que eram relacionáveis. Foi calculada, também, a proporção das diferenças entre as respostas do pré-teste e pós-teste, sendo considerados significantes os resultados com p<0,05. Resultados: houve predominância dos profissionais antes da intervenção que escolheram a expressão Morte Digna para designar cuidado paliativo (72,9%). Após a intervenção, os profissionais escolheram a expressão Qualidade de Vida (55,9%). Conclusão: a percepção dos enfermeiros acerca dos cuidados paliativos foi deficiente. Esse fato esteve associado à deficiência na formação técnico-científica ainda na graduação. A intervenção realizada promoveu melhoria da compreensão de conceitos relacionados ao cuidado paliativo colaborando para a assistência diferenciada e promotora da qualidade de vida dos profissionais. Descritores: Cuidados Paliativos; Enfermagem; Qualidade de Vida; Assistência Hospitalar.ABSTRACTObjective: to evaluate nurses' perception of palliative care before and after an intervention. Method: quantitative, almost experimental study, developed in the units of a secondary care hospital. The data collection instrument was adapted from a study carried out with anesthesiologists, these were analyzed in the Excel program and organized into tables, being applied the statistical test of chi-square of Pearson, with tables that present the values obtained within distinct categories, but that they were relatable. The proportion of differences between pre-test and post-test responses was also calculated, and the results with p <0.05 were considered significant. Results: there was a predominance of professionals before the intervention who chose the term Digned Death to designate palliative care (72.9%). After the intervention, professionals chose the term Quality of Life (55.9%). Conclusion: nurses' perception about palliative care was deficient. This fact was associated to the deficiency in the technical-scientific formation still in the graduation. The intervention promoted an improvement of the understanding of concepts related to palliative care collaborating for differentiated assistance and promoting the quality of life of professionals  Descriptors: Palliative Care, Nursing, Quality of Life, Hospital Care.RESUMENObjetivo: evaluar la percepción de los enfermeros sobre el cuidado paliativo antes y después de una intervención. Método: estudio cuantitativo, casi experimental, desarrollado en las unidades de un hospital de atención secundaria. El instrumento de recolección de datos fue adaptado de un estudio realizado con anestesiólogos, se analizaron en el programa Excel y organizados en tablas, siendo aplicado el test estadístico de chi-cuadrado de Pearson con tablas que presentan los valores obtenidos dentro de categorías distintas, pero que eran relacionables. Se calculó, también, la proporción de las diferencias entre las respuestas del pre-test y post-test, siendo considerados significantes los resultados con p <0,05. Resultados: hubo predominancia de los profesionales antes de la intervención que eligieron la expresión Muerte Digna para designar cuidado paliativo (72,9%). Después de la intervención, los profesionales escogieron la expresión Calidad de Vida (55,9%). Conclusión: la percepción de los enfermeros acerca de los cuidados paliativos fue deficiente. Este hecho estuvo asociado a la deficiencia en la formación técnica-científica aún en la graduación. La intervención realizada promovió la mejora de la comprensión de conceptos relacionados al cuidado paliativo, colaborando para la asistencia diferenciada y promotora de la calidad de vida de los profesionales. Descriptores: Cuidados Paliativos, Enfermeira, Calidad de Vida, Atención Hospitalaria.

2017 ◽  
Vol 1 (4) ◽  
pp. 199 ◽  
Author(s):  
Ester Aracil-Lavado ◽  
Carmina Wanden-Berghe ◽  
Javier Sanz-Valero

Objetivo: Revisar la literatura científica relacionada con la calidad de vida según el estado nutricional del paciente paliativo adulto.Método: Análisis crítico de los trabajos recuperados mediante revisión sistemática. Los datos se obtuvieron de la consulta directa y acceso, vía Internet, a las siguientes bases de datos bibliográficas del ámbito de las ciencias de la salud: MEDLINE (vía PubMed), The Cochrane Library, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINHAL), Web of Science y la Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS). Se consideró adecuado el uso de los Descriptores “Quality of life”, “Nutritional Status” y “Palliative care”, utilizando los filtros: «Humans», «Adult» y «Comparative Study» o «Clinical Trial». Fecha de la búsqueda: noviembre de 2016.Resultados: Tras aplicar los criterios de inclusión y exclusión se aceptaron 4 estudios para su revisión y análisis crítico. Al evaluar la calidad de los artículos seleccionados para la revisión mediante el cuestionario CONSORT, las puntuaciones oscilaron entre 11 y 20 sobre una puntuación máxima de 25.Conclusiones: El seguimiento nutricional de los enfermos estaba relacionado directamente con la mejora del estado nutricional, y se correspondía con el incremento de la calidad de vida. Sería deseable utilizar cuestionarios específicos y validados para evaluar la calidad de vida según el estado nutricional que permitirán minimizar cualquier tipo de subjetividad del paciente. Serían necesarios futuros estudios, con una adecuada población, que aclaren la relación directa entre el estado nutricional y la calidad de vida en los enfermos paliativos.


Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 3424-3424
Author(s):  
Maite Antonio ◽  
Montserrat Arnan Sangerman ◽  
Eva Domingo-Domenech ◽  
Eva González-Barca ◽  
Casimiro Javierre ◽  
...  

BACKGROUND As the result of population aging, hematologists increasingly face the challenge of effectively managing older adults with oncological diseases. The heterogeneity of the aging process means that chronological age does not serve as a pivotal variable on which the clinical or treatment decisions are based. To improve outcomes in older population it is critical to select treatment considering patients' frailty profile and patients' needs to ensure they complete the treatment proposedComprehensive geriatric assessment (CGA) is a gold-standard multidimensional tool to characterize older patients according to their biological frailty profile. CGA identifies patient- and condition-related factors that might be potentially reversible through subsequent clinical interventions Older patient may present some degree of physical decline during the treatment due to variables related to the disease itself and/or to the treatment. This can lead to an accelerated decline from aging, affect their functional independence, their quality of life, and their ability to complete the treatment There is evidence that nutritional support and physical exercise during and after oncological treatments provides benefits in muscular and aerobic condition, quality of life, fatigue and adherence to treatment. But data on hematological patient, usually treated with more intensive schemes associated with a higher incidence of cytopenia and fatigue is scarce ENDPOINT - PRIMARY To determine the impact of an individualized geriatric intervention program of physical exercise and nutritional support on adherence to planned oncological treatment in patients ≥ 70 years with hematological malignancies - SECONDARY Analyze the relation between CGA and aging biomarkersEvaluate adherence to the intervention programDetermine the rate of completion and causes for non-completion of treatmentMeasure at the beginning and end of intervention, and 6 months after treatment completion: The program's effect on physical condition parametersChanges in functional capacity: basic and instrumental activities of daily lifeLevels of fatigueQuality of lifeDetermine the incidence and degree of severity of toxicityDetermine treatment response parameters: time to treatment failure and to progression, disease-free, overall and cancer-specific survival METHODS DESIGN Prospective clinical trial, randomized, parallel and open groupsSETTING Comprehensive cancer centerINCLUSION CRITERIA Histopathological diagnosis of hematological malignancies: multiple myeloma, lymphoproliferative syndromes and myelodisplastic syndromesPatients who meet criteria for medical treatment: chemotherapy, radiotherapy, immunotherapy or targeted therapiesPatients in optimal conditions to perform moderate intensity physical exercise (responsible doctor's judgement)Signature of informed consentEXCLUSION CRITERIA Failure to meet any of the inclusion criteria.INTERVENTION All patients will be assessed through a CGA. The intervention group will received the standard treatment according to the clinical protocol of the institution and will participate in a program of personalized physical exercise and nutritional support. The control group will be treated in a standard manner according to the institution's clinical protocolRANDOMIZATION Subjects will be assigned a 1.1 ratio to one of the groups using a simple randomisation methodMAIN VARIABLE: rate of treatment compliance (relationship between the prescribed dose and the dose administered)SECONDARY VARIABLES: CGA scales, aging biomarkers, nutritional parameters and basal body composition before and after the intervention, quality of life before and after the intervention, toxicity and complications during treatment and response to treatment.STATISTICAL ANALYSIS The comparability of the components of the intervention and control group will be analyzed by Chi square test (qualitative variables) and Student's t test and Wilcoxson test (quantitative variables). The analysis of the intervention will be carried out according to the intention of treatment. The main variable will be analyzed by comparison test of chi-square proportions and confidence intervals will be calculated. The variable will be measured at the end of the intervention, according to the degree of compliance with the nutritional and physical exercise program. Disclosures Domingo-Domenech: Takeda: Consultancy, Membership on an entity's Board of Directors or advisory committees, Other: Travel expenses; Seattle Genetics: Research Funding; Bristol-Myers Squibb: Other: Travel expenses; Roche: Other: Travel expenses. González-Barca:Kiowa: Consultancy; Roche: Consultancy, Honoraria; Celgene: Consultancy; Celtrion: Consultancy; AbbVie: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Takeda: Honoraria. Sureda:Roche: Honoraria; BMS: Consultancy, Honoraria; Novartis: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Gilead: Consultancy; Sanofi: Consultancy, Honoraria; Takeda: Consultancy, Honoraria, Speakers Bureau.


2019 ◽  
Vol 6 (2) ◽  
pp. 125-130
Author(s):  
Muyassaroh Muyassaroh ◽  
Tri Lestari

Background: Palliative care can improve the quality of life for patients with end stage nasopharyngeal carcinoma (NPC). Palliative care includes handling nutrition, relieving pain and reducing the severity of symptoms from the disease, side effects of therapy or other complaints. It also improve psychological, social and spiritual aspects. The purpose of this study was to analyze the effect of palliative care on improving the quality of life for end stage NPC patients. Methods: Observational cohort study in 15-70 years old NPC patients included in the screening criteria for palliative care (total score 4). The sample was divided into 2 groups, 20 sampels per group. Quality of life was assessed with modified Gill scale questionnaire. Data was analyzed with t test. Results: The quality of life of NPC patients increased after palliative care (score 31,8 to 35,6). Decreased in groups without palliative care (score 33,0 to 30,9). Statistical analysis found significant differences between before and after palliative care (p = 0.055). Conclusion: Palliative care improves the quality of life for end stage NPC patients. Key word: Quality of life, Palliative care, Nasopharyngeal carcinoma   Latar belakang : Perawatan paliatif dapat meningkatkan kualitas hidup penderita karsinoma nasofaring (KNF) stadium lanjut. Perawatan paliatif meliputi penanganan nutrisi, menghilangkan nyeri dan mengurangi keparahan gejala yang timbul akibat penyakit tersebut ataupun akibat efek samping terapi atau keluhan lain yang tidak lagi responsif terhadap terapi kuratif, serta mengupayakan  perbaikan  dalam  aspek psikologis, sosial dan spiritual. Tujuan penelitian ini adalah menganalisis pengaruh perawatan paliatif terhadap peningkatan kualitas hidup penderita KNF stadium lanjut. Metode : Penelitian kohort observasional pada penderita KNF stadium lanjut usia 15 – 70 tahun yang masuk dalam kriteria penapisan perawatan paliatif (total skor 4). Sampel dibagi menjadi 2 kelompok yaitu kelompok perlakuan dan kelompok kontrol. Besar sampel ditentukan sebanyak 20 tiap kelompok. Kualitas hidup dinilai dengan kuesioner modifikasi skala mc Gill. Analisis data dengan Uji t test. Hasil : Kualitas hidup penderita KNF meningkat setelah dilakukan perawatan paliatif (skor 31,8 menjadi 35,6). Menurun pada kelompok tanpa perawatan paliatif (skor 33,0 menjadi 30,9). Analisis statistik didapatkan perbedaan bermakna antara sebelum dan sesudah dilakukan perawatan paliatif p=0,055.  Simpulan : Perawatan paliatif meningkatkan kualitas hidup penderita KNF stadium lanjut. Key word : Kualitas hidup, Perawatan paliatif, Karsinoma Nasofaring


2020 ◽  
Vol 12 (2) ◽  
pp. 97-106
Author(s):  
Anya Asbar ◽  
Maya Khairani ◽  
Marty Mawarpury

This study aims to determine the effect of the Empathic Caring Consultation (ECC) program on Professional Quality of Life (ProQOL) in psychologists. This study involved seven psychologists. The research sample was taken using purposive sampling method. The research method used was one group pretest-post test design. ProQOL is measured using the Professional Quality of Life Version V scale, while the implementation of ECC training refers to the concept of Prawitasari. Analysis using Wilcoxon signed-rank test with a significant value (p) = 0.340 (BO); 0.932 (STS); 0.496 (CS) (p> 0.05). The results of the study showed that there was no effect of the ECC program on ProQOL on psychologists. This is because there are several variations of the three ProQOL components before and after treatment.


2020 ◽  
Vol 14 ◽  
Author(s):  
Rafael Augusto Paes Lima Rocha ◽  
Elisângela De Moraes Rocha ◽  
Marli Elisabete Machado ◽  
Andressa De Souza ◽  
Felipe Barreto Schuch

Objetivo: correlacionar o impacto da sobrecarga do cuidador na qualidade de vida do paciente oncológico em cuidados paliativos Método: trata-se de um estudo quantitativo, descritivo, observacional, transversal, com 50 pacientes oncológicos em cuidados paliativos e 50 cuidadores. Aplicou-se um questionário sociodemográfico para os cuidadores e familiares, a Escala Zarit Burden Interview, o Questionário EORT QLQ –C15-PAL, a Escala de Resiliência Adaptada de Wagnild & Young e a Escala de Pensamento Catastrófico da Dor, uso do Teste t, Correlação de Spearman, Correlação de Pearson e regressão linear. Utilizou-se o Programa SPSS, versão 20.0 para a análise dos dados. Resultados: informa-se que os domínios da qualidade de vida que mostraram associação independente com a sobrecarga do cuidador foram a fatiga, a falta de apetite, a constipação e o impacto global. Manteve-se associação independente pelo catastrofismo da dor do paciente com a sobrecarga do cuidador, não houve associação entre a resiliência do paciente e a sobrecarga do cuidador e 40% dos cuidadores apresentaram sobrecarga severa. Conclusão: nota-se que o aumento da sobrecarga do cuidador diminui a qualidade de vida do paciente oncológico em cuidados paliativos. Descritores: Sobrecarga de Cuidadores; Qualidade de Vida; Cuidados Paliativos; Oncologia; Dor do Câncer, Resiliência.AbstractObjective: to correlate the impact of caregiver burden on the quality of life of cancer patients in palliative care. Method: this is a quantitative, descriptive, observational, cross-sectional study with 50 cancer patients in palliative care and 50 caregivers. A sociodemographic questionnaire was applied for caregivers and family members, the Zarit Burden Interview Scale, the EORT QLQ –C15-PAL Questionnaire, the Wagnild & Young Adapted Resilience Scale and the Catastrophic Pain Thinking Scale, using the t Test, Spearman's correlation, Pearson's correlation and linear regression. The SPSS program, version 20.0, was used for data analysis. Results: it is reported that the domains of quality of life that showed an independent association with caregiver burden were fatigue, lack of appetite, constipation and the global impact. An independent association was maintained due to the catastrophism of the patient's pain with the burden of the caregiver, there was no association between the patient's resilience and the burden of the caregiver and 40% of the caregivers presented severe burden. Conclusion: it is noted that the increase in caregiver burden reduces the quality of life of cancer patients in palliative care. Descriptors: Caregivers Burden; Quality of Life; Palliative Care; Oncology; Cancer Pain; Resiliencia.ResumenObjetivo: correlacionar el impacto de la carga del cuidador en la calidad de vida de los pacientes oncológicos en cuidados paliativos Método: este es un estudio cuantitativo, descriptivo, observacional, transversal con 50 pacientes oncológicos en cuidados paliativos y 50 cuidadores. Se aplicó un cuestionario sociodemográfico para cuidadores y miembros de la familia, la Escala Zarit Burden Interview, el Cuestionario EORT QLQ-C15-PAL, la Escala de Resiliencia Adaptada Wagnild& Young y la Escala de Pensamiento de Dolor Catastrófico, usando la Prueba t, Correlación de Spearman, la Correlación de Pearson y regresión lineal. El programa SPSS, versión 20.0, se utilizó para el análisis de datos. Resultados: se informa que los dominios de calidad de vida que mostraron una asociación independiente con la carga del cuidador fueron fatiga, falta de apetito, estreñimiento y el impacto global. Se mantuvo una asociación independiente debido al catastrofismo del dolor del paciente con la sobrecarga del cuidador, no hubo asociación entre la resistencia del paciente y la sobrecarga del cuidador y el 40% de los cuidadores presentaron una sobrecarga severa. Conclusión: se observa que el aumento de la sobrecarga del cuidador reduce la calidad de vida de los pacientes oncológicos en cuidados paliativos. Descriptores: Carga del Cuidador; Calidad de Vida; Cuidados Paliativos; Oncología; Dolor de Cáncer, Resiliencia.


2012 ◽  
Vol 68 (2) ◽  
Author(s):  
L. Godlwana ◽  
A. Stewart ◽  
E. Musenga

To determine the impact of lower limb amputation on qualityof life in people in the Johannesburg metropolitan area of South Africa, duringtheir reintegration to their society/community of origin.A longitudinal pre- test- post test design was utilized. Consecutive samplingwas used to recruit and interview participants (n=73) who met the inclusioncriteria. Ethical clearance was obtained. The hospitals and participants gaveinformed consent.The EQ-5D, Barthel Index, and Modified Household Economic andSocial Status Index were used to collect data. Participants were interviewed preoperatively and then followed upthree months post-operatively. Data were analysed using STATA version 10. Categorical data were analysedusing Chi-square/Fischer’s exact test and continuous data were analysed using Wilcoxon signed rank and medianregression.Most (n=21, 52.5 %) participants had no income. One participant was homeless, 17.5% (n=7) lived in shacks.The preoperative and postoperative median VAS of the EQ-5D was 60 and 70 respectively showing no significantimprovement in QOL (median EQ-5D VAS). The preoperative and postoperative median total BI score was 20 and 19respectively, showing a significant reduction in function (median total BI) three months postoperatively (p<0.001).Preoperative mobility was a predictor of postoperative quality of life. Being female was a predictor of higher qualityof life.The average EQ-5D VAS score and overall function (total BI) were generally scored high both preoperativelyand postoperatively but there was no significant improvement in EQ-5D VAS score and there was a significant reductionin function after three months. Higher scores in mobility preoperatively is a predictor of higher quality of lifepostoperatively.


2018 ◽  
Vol 12 (9) ◽  
pp. 2376
Author(s):  
Ana Carolina Macedo De Freitas ◽  
Renata Melo De Miranda Malheiros ◽  
Bruno Da Silva Lourenço ◽  
Fabrício Fernandes Pinto ◽  
Camila Cruz De Souza ◽  
...  

RESUMOObjetivo: avaliar o grau de qualidade de vida dos estudantes concluintes do curso de enfermagem de uma universidade privada acerca dos fatores considerados estressantes. Método: trata-se de estudo quantitativo em que participaram 60 graduandos do curso de enfermagem e que utilizou como instrumento de coleta a Escala de Qualidade de Vida de Flanagan. Resultados: observou-se que a maioria entrevistada é do sexo feminino, com idade entre 23 e 27 anos. Constatou-se que a QV destes alunos conforme as dimensões do questionário foi classificada como média a baixa. Conclusão: os níveis de QV desses alunos são considerados preocupantes, uma vez que a QV implica diretamente no desempenho acadêmico e emocional do indivíduo, ocasionando problemas na sua saúde mental. Esses achados podem contribuir para o desenvolvimento de medidas que diminuam o estresse provocado neste ambiente e, assim, promover a melhora da QV de universitários. Descritores: Estudantes; Enfermagem; Qualidade de Vida; Saúde Mental; Estresse Psicológico; Ansiedade.ABSTRACTObjective: to evaluate the degree of quality of life of nursing graduating students at a private university about the factors considered stressful. Method: quantitative study attended by 60 students of the nursing course, using as a collecting tool the scale of quality of life of Flanagan. Results: most interviewees were female, aged between 23 and 27 years. The QOL of these students according to the dimensions of the questionnaire was classified as medium to low. Conclusion: the levels of QOL of these students are considered worrying, since the QOL implies directly in academic performance and emotional condition of the patient, causing problems in his/her mental health. These findings can contribute to the development of measures to reduce the stress caused in this environment and, thus, promote the improvement of the QOL of university students. Descriptors: Students; Nursing; Quality of Life; Mental Health; Psychological Stress; Anxiety.RESUMENObjetivo: evaluar el grado de calidad de vida de los estudiantes egresados del curso de enfermería en una universidad privada sobre los factores estresantes. Método: estudio cuantitativo al que asistieron 60 estudiantes del curso de enfermería, utilizandóse como una herramienta para recolectar la escala de calidad de vida de Flanagan. Resultados: se observó que la mayoría de los entrevistados es de sexo femenino, de edades comprendidas entre los 23 y los 27 años. Se observó que la CDV de estos estudiantes en función de las dimensiones del cuestionario fue clasificada como de media a baja. Conclusión: los niveles de CDV de estos estudiantes fueron considerados preocupantes, ya que el CDV implica directamente en el rendimiento académico y el estado emocional del paciente, causando problemas en su salud mental. Estos hallazgos pueden contribuir al desarrollo de las medidas para reducir el estrés causado en este entorno y, por lo tanto, promover la mejora de la CDV de los estudiantes universitarios. Descriptores: Estudiantes; Enfermería; Calidad de Vida; Salud Mental; Estrés Psicológico; Ansiedad.


Sign in / Sign up

Export Citation Format

Share Document