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O CONHECIMENTO ÚTIL DOS PROFISSIONAIS SOBRE CUIDADOS PALIATIVOS NAS ESTRUTURAS RESIDENCIAIS PARA IDOSOS (ERPI) DE UM CONCELHO DA REGIÃO CENTRO
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Abstract(s)
Em ERPI (Estruturas Residenciais para Pessoas Idosas), os Cuidados Paliativos (CP) visam garantir qualidade de vida e dignidade aos utentes com doenças graves e progressivas, abrangendo o alívio de sintomas, suporte emocional e espiritual e o apoio familiar até ao fim da vida e no processo de luto. Neste desiderato, é imperativa a inclusão de CP em ERPI, o que reforça a importância da sua inclusão como valência. Para tal é necessário que os profissionais estejam munidos de um conjunto de conhecimentos úteis que lhes permitam avaliar as necessidades paliativas dos residentes, e estruturar uma resposta adequada em termos de ações paliativas e referenciação atempada.
Este relatório de estágio reflete as competências desenvolvidas para a obtenção do grau de mestre, a partir da prática clínica realizada em dois contextos de Cuidados Paliativos: uma Equipa Intra-Hospitalar de Suporte em Cuidados Paliativos e uma Unidade de Internamento. Nele pretende-se analisar as competências desenvolvidas no âmbito formativo, nos contextos descritos e evidenciar os resultados obtidos através da investigação empírica realizada junto de profissionais de ERPI.
O relatório está estruturado em três componentes: os contextos de prática clínica, a análise reflexiva da experiência obtida através da prática realizada nos contextos e a descrição do estudo quantitativo, descritivo, observacional, sobre os conhecimentos úteis em CP dos profissionais em ERPI.
Na primeira parte caracterizam-se os contextos de aprendizagem. Na segunda parte apresenta-se a análise critico-reflexiva das competências desenvolvidas e preconizadas pela European Association for Palliative Care, que se encontram alinhadas ao modelo interdisciplinar para a prática e educação em Cuidados Paliativos.
A terceira parte do relatório refere-se à apresentação do estudo observacional, descritivo-correlacional e transversal realizado com o objetivo de caracterizar o conhecimento útil dos Profissionais de Saúde e outros Profissionais sobre os Cuidados Paliativos nas ERPI de um concelho da região centro de Portugal.
Da análise dos resultados foi possível identificar lacunas significativas no que diz respeito ao conhecimento útil em Cuidados Paliativos dos profissionais que estavam ativamente a exercer funções em ERPI. Embora a amostra obtida tenha sido inferior ao esperado, limitando a representatividade dos resultados, os estes revelam uma necessidade clara de reforçar a formação contínua e específica nesta área.
Complementarmente, a experiência em contexto de prática clínica permitiu integrar e aprofundar competências, num percurso formativo marcado por desafios, aprendizagens e crescimento profissional. Durante este período foi realizada observação e participação ativa nas atividades da equipa multidisciplinar, incluindo acompanhamento de utentes, famílias, prestação de cuidados diretos e realizadas atividades formativas à equipa.
A articulação entre a prática e a investigação revelou-se fundamental para consolidar uma visão crítica e sensível, destacando a importância da presença dos CP nas ERPI como resposta estruturada e qualificada às necessidades dos utentes institucionalizados.
Estes resultados sugerem a importância de implementar estratégias formativas que visem capacitar as equipas das ERPI a responder de forma mais eficaz às necessidades complexas e multidimensionais dos utentes institucionalizados. A formação deverá ser multidisciplinar, adaptada à realidade concreta das instituições, e articulada com equipas especializadas de CP, garantindo uma abordagem mais integrada, humana e centrada na pessoa.
In ERPI (Residential Structures for the Elderly), Palliative Care (PC) aims to ensure the quality of life and dignity for users with severe and progressive illnesses, covering symptom relief, emotional and spiritual support, and family support throughout the end-of-life process and during the grieving period. To this end, it is imperative to include PC in ERPI, which reinforces the importance of its inclusion as a service. This requires professionals to be equipped with a set of useful knowledge that enables them to assess the palliative needs of residents and structure an appropriate response in terms of palliative actions and timely referral. This internship report reflects the skills developed to obtain a master's degree, based on clinical practice carried out in two palliative care contexts: an Intra-Hospital Palliative Care Support Team and an Inpatient Unit. It aims to analyse the skills developed in the training context and in the described contexts, and to highlight the results obtained through empirical research conducted with ERPI professionals. The report is structured in three components: the contexts of clinical practice, the reflective analysis of the experience gained through practice in these contexts, and the description of the quantitative, descriptive, observational study on the useful knowledge in PC of professionals in ERPI. The first part characterises the learning contexts. The second part presents a critical-reflective analysis of the skills developed and recommended by the European Association for Palliative Care, which are aligned with the interdisciplinary model for practice and education in palliative care. The third part of the report refers to the presentation of the observational, descriptive-correlational and cross-sectional study carried out with the aim of characterising the useful knowledge of Health Professionals and other Professionals about Palliative Care in ERPI in a municipality in the central region of Portugal. The analysis of the results identified significant gaps in the useful knowledge of palliative care among professionals who were actively working in ERPI. Although the sample obtained was smaller than expected, which limited the representativeness of the results, it reveals a clear need to strengthen continuous and specific training in this area. In addition, the experience in a clinical practice context allowed for the integration and deepening of skills in a training course marked by challenges, learning, and professional growth. During this period, observation and active participation in the multidisciplinary team's activities took place, including monitoring of users, families, direct care provision, and training activities for the team. The link between practice and research proved to be fundamental in consolidating a critical and sensitive view, highlighting the importance of the presence of CP in ERPI as a structured and qualified response to the needs of institutionalised users. These results suggest the importance of implementing training strategies aimed at enabling ERPI teams to respond more effectively to the complex and multidimensional needs of institutionalised users. Training should be multidisciplinary, adapted to the specific reality of the institutions, and coordinated with specialised CP teams, ensuring a more integrated, humane and person-centred approach.
In ERPI (Residential Structures for the Elderly), Palliative Care (PC) aims to ensure the quality of life and dignity for users with severe and progressive illnesses, covering symptom relief, emotional and spiritual support, and family support throughout the end-of-life process and during the grieving period. To this end, it is imperative to include PC in ERPI, which reinforces the importance of its inclusion as a service. This requires professionals to be equipped with a set of useful knowledge that enables them to assess the palliative needs of residents and structure an appropriate response in terms of palliative actions and timely referral. This internship report reflects the skills developed to obtain a master's degree, based on clinical practice carried out in two palliative care contexts: an Intra-Hospital Palliative Care Support Team and an Inpatient Unit. It aims to analyse the skills developed in the training context and in the described contexts, and to highlight the results obtained through empirical research conducted with ERPI professionals. The report is structured in three components: the contexts of clinical practice, the reflective analysis of the experience gained through practice in these contexts, and the description of the quantitative, descriptive, observational study on the useful knowledge in PC of professionals in ERPI. The first part characterises the learning contexts. The second part presents a critical-reflective analysis of the skills developed and recommended by the European Association for Palliative Care, which are aligned with the interdisciplinary model for practice and education in palliative care. The third part of the report refers to the presentation of the observational, descriptive-correlational and cross-sectional study carried out with the aim of characterising the useful knowledge of Health Professionals and other Professionals about Palliative Care in ERPI in a municipality in the central region of Portugal. The analysis of the results identified significant gaps in the useful knowledge of palliative care among professionals who were actively working in ERPI. Although the sample obtained was smaller than expected, which limited the representativeness of the results, it reveals a clear need to strengthen continuous and specific training in this area. In addition, the experience in a clinical practice context allowed for the integration and deepening of skills in a training course marked by challenges, learning, and professional growth. During this period, observation and active participation in the multidisciplinary team's activities took place, including monitoring of users, families, direct care provision, and training activities for the team. The link between practice and research proved to be fundamental in consolidating a critical and sensitive view, highlighting the importance of the presence of CP in ERPI as a structured and qualified response to the needs of institutionalised users. These results suggest the importance of implementing training strategies aimed at enabling ERPI teams to respond more effectively to the complex and multidimensional needs of institutionalised users. Training should be multidisciplinary, adapted to the specific reality of the institutions, and coordinated with specialised CP teams, ensuring a more integrated, humane and person-centred approach.
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Keywords
Cuidados paliativos Estruturas residenciais para pessoas idosas Conhecimento em saúde Competência