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Cuidados paliativos e a qualidade do processo da morte e do morrer
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Introdução: A morte e o processo de morrer são inevitáveis e são enfrentados todos os dias nas mais variadas ocasiões, mas adquirem particular relevância no contexto dos cuidados de saúde. Os cuidados paliativos visam minimizar o sofrimento e melhorar a qualidade de vida dos doentes, mas têm também grande importância no que toca à qualidade de morte e do morrer. No fundo, o que é uma boa morte? Este trabalho pretende fazer uma revisão narrativa sobre a complexidade e os fatores que influenciam a qualidade do processo da morte.
Métodos: Foi realizada uma revisão da literatura recorrendo à base de dados PubMed, com recolha de artigos publicados entre 2000 e janeiro de 2022, utilizando as palavras-chave “quality of death and dying”, “end of life”, “palliative care”. Foi ainda realizada uma pesquisa em contexto nacional, cruzando a palavra-chave “Portugal” na mesma base de dados, bem como na Acta Médica Portuguesa e repositórios digitais das Faculdades de Medicina de Portugal, com posterior triagem e seleção.
Resultados: Foram identificados 20 artigos, que integram a presente revisão, organizados e apresentados de acordo com os seguintes subtemas: definições de qualidade de morte e do morrer e instrumentos de medição, avaliação da qualidade de morte, qualidade de morte em Portugal.
Discussão: A qualidade de morte e do morrer é uma construção multidimensional e subjetiva, podendo ser subdividida em domínios conceptuais. Avaliar este tema é desafiante, devendo considerar-se o contexto dos cuidados de saúde, os intervenientes no processo de morrer e a influência da cultura. Em Portugal, as falhas em investigação nesta área devem constituir um mote para estudos futuros.
Introduction: Death and the dying process are inevitable and are faced every day in the most varied occasions but acquire particular relevance in the context of health care. Palliative care aims to minimize suffering and improve the quality of life of patients, but they are also of significant importance in the dying process. Overall, what is a good death? This paper aims to make a narrative review about the complexity and factors that influence the quality of the process of death. Methods: A review of the national and international literature was conducted using the PubMed database, collecting articles published between 2000 and January 2022, using the keywords "quality of death and dying", "end of life", "palliative care ". Research was also conducted in national setting, using the keyword "Portugal" in the same database, as well as in Acta Médica Portuguesa and digital repositories of the Faculties of Medicine in Portugal, with subsequent screening and selection. Results: Twenty articles were identified, which are part of this review, organized and presented according to the following subthemes: definitions of quality of death and dying and measurement instruments, evaluation of the quality of death, quality of death in Portugal. Discussion: The quality of death and dying is a multidimensional and subjective construction and can be subdivided into conceptual domains. Evaluating this subject is challenging, bearing in mind the context of health care, the participants in the dying process and the influence of culture. In Portugal, research lacunes in this area should be a motto for future studies.
Introduction: Death and the dying process are inevitable and are faced every day in the most varied occasions but acquire particular relevance in the context of health care. Palliative care aims to minimize suffering and improve the quality of life of patients, but they are also of significant importance in the dying process. Overall, what is a good death? This paper aims to make a narrative review about the complexity and factors that influence the quality of the process of death. Methods: A review of the national and international literature was conducted using the PubMed database, collecting articles published between 2000 and January 2022, using the keywords "quality of death and dying", "end of life", "palliative care ". Research was also conducted in national setting, using the keyword "Portugal" in the same database, as well as in Acta Médica Portuguesa and digital repositories of the Faculties of Medicine in Portugal, with subsequent screening and selection. Results: Twenty articles were identified, which are part of this review, organized and presented according to the following subthemes: definitions of quality of death and dying and measurement instruments, evaluation of the quality of death, quality of death in Portugal. Discussion: The quality of death and dying is a multidimensional and subjective construction and can be subdivided into conceptual domains. Evaluating this subject is challenging, bearing in mind the context of health care, the participants in the dying process and the influence of culture. In Portugal, research lacunes in this area should be a motto for future studies.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2022
Palavras-chave
Morte Cuidados paliativos Qualidade de cuidados de saúde Doente terminal