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Prevalência e caracterização das pessoas idosas com necessidades paliativas residentes em Estruturas Residenciais para Pessoas Idosas (ERPI)
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Abstract(s)
Introdução: O envelhecimento populacional é um fenómeno global que assume especial relevância no nosso país. Portugal é atualmente um dos países mais envelhecidos da União Europeia, prevendo-se que venha a ser o mais envelhecido em 2050. Pela associação de uma maior longevidade a uma maior prevalência de doenças crónicas, é previsível um aumento de necessidades paliativas entre a população idosa (65 ou mais anos), e em particular entre o grupo dos mais idosos (85 ou mais anos). Por outro lado, as ERPI surgem cada vez mais como o último local de residência permanente destes idosos, sendo o contexto onde naturalmente devem ser identificadas e atendidas as suas necessidades paliativas. Objetivo: Determinar a prevalência de necessidades paliativas na população idosa (65 ou mais anos) residente nas ERPI da Santa Casa da Misericórdia de Lisboa (SCML) e identificar as suas características sociodemográficas e clínicas. Métodos: Estudo quantitativo, descritivo, transversal e observacional. Foram utilizados dois instrumentos de recolha de dados: (1) questionário de caracterização sociodemográfica e clínica; e (2) questionário NECPAL. Os questionários foram aplicados por enfermeiros, em 7 ERPI, a 301 idosos. Resultados: Foram identificados 121 idosos (40,2%) com necessidades paliativas (NECPAL+), com uma média de idade de 84,85 anos, dos quais 71,1% mulheres e 57,9% com rede social presente. A maioria dos idosos NECPAL+ não apresenta doença oncológica (83,5%), sendo as principais doenças ou condições crónicas: doença cardíaca crónica (76,9%), demência (56,2%), doença neurológica vascular (54,5%) e fragilidade (51,2%). Somente 38% dos idosos NECPAL+ tinham sido identificados por profissionais de saúde da equipa como tendo necessidade de cuidados paliativos e só um idoso tinha sido referenciado para apoio em cuidados paliativos. Conclusão: Os resultados deste estudo indicam que a maioria dos idosos residentes em ERPI, com doenças crónicas avançadas (sobretudo não oncológicas), não está a receber os cuidados paliativos necessários. A identificação atempada das necessidades paliativas, com recurso a instrumentos validados como o NECPAL, poderá contribuir para melhorar os cuidados prestados e promover uma melhor qualidade de vida destes idosos.
Introduction: Population aging is a global phenomenon that is particularly relevant in our country. Portugal is currently one of the oldest countries in the European Union and is expected to be the oldest in 2050. By associating greater longevity with a higher prevalence of chronic diseases, an increase in palliative needs is expected among the elderly population. (65 years old or more), mainly among the oldest old group (85 years old or more). On the other hand, nursing homes appear more and more as the last place of permanent residence for these elderly people, being the context in which their palliative needs must be identified and met. Aim: Determine the prevalence of elderly people (65 or more years old) in need of palliative care among residents in nursing homes of Santa Casa da Misericórdia de Lisboa (SCML) and identify their sociodemographic and clinical characteristics. Methods: Quantitative, descriptive, cross-sectional and observational study. Two data collection instruments were used: (1) sociodemographic and clinical characterization questionnaire; and (2) NECPAL questionnaire. The questionnaires were applied by nurses, in 7 ERPI, to 301 residents. Results: A total of 121 residents (40.2%) were identified with palliative needs (NECPAL+), mean age 84.85 years, 71.1% women, and 57.9% with a present social network. The majority of NECPAL + elderly people do not have cancer disease (83.5%). Main diseases or chronic conditions: chronic heart disease (76.9%), dementia (56.2%), neurological vascular disease (54.5%) and frailty (51.2%). Only 38% of NECPAL + elderly people had been identified by health professionals in the team as requiring palliative care, and only one elderly person had been referred for support in palliative care. Conclusions: The results of this study reinforce the idea that a large majority of elderly people living in nursing homes, with advanced chronic diseases (especially non-cancer), are not receiving the necessary palliative care. Early identification of palliative needs, using validated instruments such as NECPAL, allows to improve the care provided and contribute to a better quality of life for the elderly.
Introduction: Population aging is a global phenomenon that is particularly relevant in our country. Portugal is currently one of the oldest countries in the European Union and is expected to be the oldest in 2050. By associating greater longevity with a higher prevalence of chronic diseases, an increase in palliative needs is expected among the elderly population. (65 years old or more), mainly among the oldest old group (85 years old or more). On the other hand, nursing homes appear more and more as the last place of permanent residence for these elderly people, being the context in which their palliative needs must be identified and met. Aim: Determine the prevalence of elderly people (65 or more years old) in need of palliative care among residents in nursing homes of Santa Casa da Misericórdia de Lisboa (SCML) and identify their sociodemographic and clinical characteristics. Methods: Quantitative, descriptive, cross-sectional and observational study. Two data collection instruments were used: (1) sociodemographic and clinical characterization questionnaire; and (2) NECPAL questionnaire. The questionnaires were applied by nurses, in 7 ERPI, to 301 residents. Results: A total of 121 residents (40.2%) were identified with palliative needs (NECPAL+), mean age 84.85 years, 71.1% women, and 57.9% with a present social network. The majority of NECPAL + elderly people do not have cancer disease (83.5%). Main diseases or chronic conditions: chronic heart disease (76.9%), dementia (56.2%), neurological vascular disease (54.5%) and frailty (51.2%). Only 38% of NECPAL + elderly people had been identified by health professionals in the team as requiring palliative care, and only one elderly person had been referred for support in palliative care. Conclusions: The results of this study reinforce the idea that a large majority of elderly people living in nursing homes, with advanced chronic diseases (especially non-cancer), are not receiving the necessary palliative care. Early identification of palliative needs, using validated instruments such as NECPAL, allows to improve the care provided and contribute to a better quality of life for the elderly.
Description
Tese de mestrado, Cuidados Paliativos, Universidade de Lisboa, Faculdade de Medicina, 2020
Keywords
Idosos Cuidados paliativos Estrutura residencial Necessidades paliativas NECPAL Teses de mestrado - 2020