Blood Transfusions and Palliative Care: Systematic Literature Review

Anemia is an important condition related with symptoms in the later stages of disease; according to World Health Organization its prevalence is between 68-77% in patients with advanced cancer. There is no specific clinical guideline and we do not have clear evidence of the effect of blood transfusions in palliative care. Objective: Understand indicators and complications of the transfusions on advanced cancer patients. Methodology: In 2019 a systematic review on PubMed and Cochrane took place, using the key words: Palliative care AND Blood transfusion; analyzing: Type of study; sample size; Pathologies; transfusion criterion; Transfusions benefits; side effects; Survival; and amount of transfused concentrates. Results: 81 articles selected, adding 6 after a full text reading. For the most part, patients with solid tumors are described and some with no oncology pathology. The symptoms indicated by the transfusion are: Fatigue, dyspnea, asthenia, headache and/or brisk bleeding. Transfused unit’s average was 2 units. Only two studies present a post-transfusion recovery and less than half display information as to associated mortality. Conclusions: There is no consensus regarding the transfusion indication. The asthenia recovery, well-being, and quality of life based on subjective criteria, are the main effects described. More studies are required.

Los Cuidados Paliativos, una revisión documental

Los cuidados paliativos u hospice son un modelo de cuidados de salud que mejora la calidad de vida del paciente con enfermedades crónicas, debilitantes. Existe escasa literatura publicada que sistematice las características y evolución de los cuidados hospice. Se planteó como objetivo del estudio, examinar el surgimiento y desarrollo de los cuidados paliativos a partir de una revisión documental de la literatura científica publicada. Se realizó un estudio documental con el propósito de describir el desarrollo evolutivo de los Cuidados Paliativos desde su surgimiento y las tendencias que han caracterizado su desarrollo. Se recopiló gran cantidad de información acerca los orígenes de los cuidados hospice en distintos contextos tanto de salud como en el la comunidad y hogar. Se realizó un estudio de varias fuentes de información histórica. Como resultado se obtuvieron datos de gran relevancia sobre cómo se introdujeron y evolucionaron los cuidados paliativos en la atención al paciente críticamente enfermo. Igualmente, se describieron los principios sobre los que se sustentan los cuidados paliativos y las funciones del equipo de salud interdisciplinario. Palabras clave: Cuidados paliativos, enfermedades crónicas, equipo interdisciplinario, cuidados hospice, calidad de vida. Abstract Palliative care or hospice is a model of health care that improves the quality of life of the patient with chronic, debilitating diseases. There is scarce published literature that systematizes the characteristics and evolution of hospice care. The objective of the study was to examine the emergence and development of palliative care based on a documentary review of published scientific literature. A documentary study was carried out with the aim of describing the evolutionary development of palliative care since its emergence and the trends that have characterized its development. A great deal of information was gathered about the origins of hospice care in different health contexts, as well as in the community and at home. A study of several sources of historical information was carried out. As a result, very relevant data were obtained on how palliative care was introduced and developed in the care of the critically ill patient. The principles on which palliative care and the functions of the interdisciplinary health team are supported were also described. Key words: Palliative care, chronic diseases, interdisciplinary team, hospice care, quality of life.

Los Cuidados Paliativos, una revisión documental

Los cuidados paliativos u hospice son un modelo de cuidados de salud que mejora la calidad de vida del paciente con enfermedades crónicas, debilitantes. Existe escasa literatura publicada que sistematice las características y evolución de los cuidados hospice. Se planteó como objetivo del estudio, examinar el surgimiento y desarrollo de los cuidados paliativos a partir de una revisión documental de la literatura científica publicada. Se realizó un estudio documental con el propósito de describir el desarrollo evolutivo de los Cuidados Paliativos desde su surgimiento y las tendencias que han caracterizado su desarrollo. Se recopiló gran cantidad de información acerca los orígenes de los cuidados hospice en distintos contextos tanto de salud como en el la comunidad y hogar. Se realizó un estudio de varias fuentes de información histórica. Como resultado se obtuvieron datos de gran relevancia sobre cómo se introdujeron y evolucionaron los cuidados paliativos en la atención al paciente críticamente enfermo. Igualmente, se describieron los principios sobre los que se sustentan los cuidados paliativos y las funciones del equipo de salud interdisciplinario. Palabras clave: Cuidados paliativos, enfermedades crónicas, equipo interdisciplinario, cuidados hospice, calidad de vida. Abstract Palliative care or hospice is a model of health care that improves the quality of life of the patient with chronic, debilitating diseases. There is scarce published literature that systematizes the characteristics and evolution of hospice care. The objective of the study was to examine the emergence and development of palliative care based on a documentary review of published scientific literature. A documentary study was carried out with the aim of describing the evolutionary development of palliative care since its emergence and the trends that have characterized its development. A great deal of information was gathered about the origins of hospice care in different health contexts, as well as in the community and at home. A study of several sources of historical information was carried out. As a result, very relevant data were obtained on how palliative care was introduced and developed in the care of the critically ill patient. The principles on which palliative care and the functions of the interdisciplinary health team are supported were also described. Key words: Palliative care, chronic diseases, interdisciplinary team, hospice care, quality of life.

CUIDADOS PALIATIVOS E O MODO DE CUIDAR: ATÉ ONDE VAI O ENVOLVIMENTO?

Resumo: Este estudo visou averiguar como está ocorrendo o envolvimento da equipe de enfermagem mediante a situação da pessoa que necessita de cuidados paliativos. Desenvolveu-se uma pesquisa qualitativa, com cinco profissionais de enfermagem, de ambos os sexos, maiores de 19 anos, que trabalham há no mínimo um ano em uma das três Instituições de Longa Permanência para Idosos de Passo Fundo/RS, e prestam cuidados paliativos. Os participantes responderam a entrevistas semi-estruturadas, cujo conteúdo foi analisado qualitativamente, desvelando-se as seguintes categorias: entendimento de cuidados paliativos, trabalhando com a morte, seguindo rotinas e observando o comportamento dos familiares. O cuidador profissional apresenta dificuldades em separar os papéis no contexto social e em saber trabalhar com a morte daqueles que estão sob seus cuidados. O suporte de apoio para os cuidadores profissionais e ocupacionais é raro, pois os mesmos vêm sofrendo um desgaste notável tanto nas intervenções junto aos residentes, quanto frente a determinadas circunstâncias que envolvem os familiares. A qualidade da assistência a esse grupo pode ser melhorada se for dada uma atenção diferenciada à questão dos cuidados paliativos, seja por meio de tecnologia de informação e formação, seja por iniciativas que contemplem programas de educação continuada dirigidos aos cuidadores de idosos. Palavras-chave: Cuidados Paliativos; Instituições de Longa Permanência para Idosos; Assistência terminal. Abstract: This study aimed to investigate how the involvement of the nursing team has been occuring against the situation of the person who needs palliative care. A qualitative research was developed with five nursing professionals, of both sexes, over 19 years old, that have been working at least for one year in one of the three longstay institutions for elderly people, in Passo Fundo, RS, and render palliative care. The participants answered to semi-structured interviews, whose content was qualitatively analyzed, being unveiled the following categories: palliative care understanding, working with the death, proceeding with routines and observating the family behavior. The professional caregiver presents difficulties in separating the roles in the social context and, in knowing how to work with the death of those who are under his care. The support for professional and occupational caregivers is rare once they are suffering a remarkable wear in interventions with residents as much as in certain circumstances involving the relatives. The quality of assistance to this group can be improved if special attention is given to palliative care, whether by means of information and training technologies or initiatives that provide continuing education programs directed to elderly caregivers. Key words: Palliative Care; Long-Stay Institutions for the Old-Aged; Terminal Care.