Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 5 uppsatser.

Thesis (M.S.)--University of Michigan.

Thesis (M.S.)--University of Michigan.

Thesis (M.S.)--University of Wisconsin-Madison, 1988. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 120-125).

Made available in DSpace on 2014-06-11T19:32:55Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-26Bitstream added on 2014-06-13T19:43:47Z : No. of bitstreams: 1 pereira_cr_dr_botfm.pdf: 962736 bytes, checksum: 6a3b10b7b3b5b70dd57a328288829c00 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / Métodos de comunicação tem se mostrado úteispara minimizar o estresse do profissional de saúde e facilitar o processo de informar más notícias em saúde para os pacientes. Este trabalho tem por objetivo descrever um protocolo de comunicação (protocolo PACIENTE) e avaliar sua aceitação. Foram realizados treinamentos sobre comunicação de más notícias, onde o método PACIENTE foi apresentado. Após obtenção consentimento livre e esclarecido, distribui-se um questionário com 12 perguntas de múltipla escolha sobre a experiência pregressa em comunicação e sobre as impressões acerca de protocolo apresentado. Houve 200 participantes, sendo 100 médicos e 100 enfermeiros. Os temas considerados mais dificeis no processo de comunicação foram: falar sobre a morte (39,5%)... / Methods of communicationg bad news has been proven effective to minimize heath professionals' stress and easier the bad news disclosure to the patients. The objective of this research is to describe a communication protocol (PACIENTE) and evaluate its acceptance. The protocol PACIENTE was presented during trainings about bad news disclosure. After informed consent, a questionnaire of multiple choice responses was given to the participants concerning previous experiences in communication and about their impressions on the presented protocol. There were 200 participants, 100 doctors and 100 nurses. The most difficult points on the communicating bad news were: discuss death (39,5%), and... (Complete abstract click electronic access below)

Background: According to World Health Organization is palliative care a human right. The focus of palliative care is relieving suffering and having quality of life as the main goal. The nurse's role is to enable symptom control, to be a support for the patient and close relatives, as well as contributing to a good and worthy death. Although death is a part of life, strong feelings arise about death and the dying. Aim: The aim of this study was to describe nurse experiences of palliative care. Method: The method used was a literature study based on international qualitative research. Eleven articles were analyzed and resulted in four main themes and nine sub-themes. Results: The findings were four main themes; the profession, relationships, work environment and feelings as well as nine sub themes; experiences and knowledges, the patient, relatives, stress, support from colleagues, lack of support from colleagues, grief and impotency, satisfaction and mental strain. Conclusion: The nurse’s experience of palliative care is individual and varies depending on, experience, interaction with colleagues and self-perception regarding individual values and existential questions.

This qualitative phenomenological study attempts to gain the physician's essences, meanings and understanding surrounding death and dying. Starting with themes revealed in literature, in-depth interviews were used to ask selected physicians providing care: How does death affect them? Are physicians receiving adequate training in end-of-life care? Does the medical culture still see death as failure? How do they find meaning in end-of-life care? Using three different groups of physicians: early in career, mid-career, and retired, this research attempted to examine the phenomena of death and dying over apparent time and developmental experiences of physicians. Results: Physicians have not been adequately trained to handle end-of-life care. Communications skills, specific end-of-life care training and support for physicians dealing with death and dying are needed.

TITLE: Palliative Care: Viewpoints from Nurses Palliative Care has been described as care that includes the physical, intellectual, emotional, social, and spiritual needs of an individual when they are diagnosed with a serious or life-limiting illness. The ultimate goal of palliative care is to promote the best quality of life possible. Palliative care should be implemented across the lifespan and across different health care settings. The purpose of this study was to describe the perceptions, impact, and meaning of palliative care from the viewpoint of nurses who provide basic palliative care to patients and their families. This study used a qualitative design to investigate the meaning, experiences, and feelings of nurses who provide palliative care in small or critical access hospitals and other agencies in this rural area. Three focus groups and eleven interviews were conducted with nurses working in a variety of agencies from October 2015 to February 2016. The four themes that emerged from the data included inconsistencies, knowledge deficits, communication issues, and emotional responses and rewards to providing palliative care. The themes focused on the need for clarification of the meaning of palliative care, more education on the topic and better communication. The nurses shared that it was rewarding to provide palliative care but identified barriers that they felt should be addressed. Nurses participating in the study did not perceive that they had palliative care at their agencies. Recommendations included that more health education about palliative care be provided to healthcare professionals, the community, and individuals with life-limiting illnesses and their families. Key words: palliative care, quality of life, life-limiting illness, nursing

Introdução: Os Cuidados Paliativos envolvem aspectos nutricionais e éticos, onde a Bioética pode auxiliar na reflexão sobre estas condutas. Objetivos: Descrever os cuidados nutricionais envolvidos no atendimento de pacientes internados no NCP/HCPA e seus aspectos bioéticos associados, bem como avaliar o perfil clínico e demográfico destes pacientes. Métodos: Foi realizado um estudo transversal retrospectivo de internações do NCP/HCPA entre 2007 e 2010. Foram coletados dados demográficos, clínicos e nutricionais de 135 internações, analisados de forma quantitativa e qualitativa. Os pesquisadores assinaram um Termo de Compromisso para Uso de Dados. Resultados: A amostra é variada quanto aos aspectos demográficos. A Nutrição Enteral foi prescrita em 80% das vezes para pacientes terminais ou em fim de vida e bem debilitados. Em 14,1% das internações houve evolução do nutricionista. Os aspectos bioéticos encontrados em 33 internações foram a Beneficência, em todas elas (100%); Autonomia (51,5%); Veracidade (18,9%) e questões sobre Informação (36,4%). Conclusão: Estes dados evidenciam as dificuldades enfrentadas na implantação do Núcleo de Cuidados Paliativos, período em que ocorreram as internações avaliadas, em termos da compreensão do que são as medidas paliativas e a necessidade de ampliar a comunicação adequada, e o seu devido registro em prontuário, entre os diferentes profissionais envolvidos no atendimento destes pacientes. / Background: the Palliative Care includes nutritional and ethics issues, and Bioethics can help in the reflection about this conduct. Objective: to describe the nutritional care in inpatients assistance on NCP/HCPA and their bioethical issues associated, as well as evaluate the patients clinical and demographic profile. Methods: A retrospective cross-sectional study was made in the admissions on NCP/HCPA between 2007 and 2010. The demographic, clinical and nutritional data was collected of 135 admissions, analyzed by quantitative and qualitative ways. The researchers signed a commitment form to use the data. Results: The sample is varied in relation to demographic data. The Enteral Nutrition was performed in 80% of the time for terminally ill inpatients or “end-of-life”, in a very weak condition. In 14,1% of the admissions there was evolution record of de nutritionist. The bioethical issues (in 33 admissions) include the Beneficence (100%); Autonomy (51,1%); Veracity (18,9%) and information issues (36,4%). Conclusion: This results evidence the difficulties faced in the implementation of the Palliative Care Unit, period in which the hospitalizations occurred, about the comprehension of what are the palliative course of treatment and the need to extend adequate communication, and its proper medical records, between the different professionals involved in the assistance of these inpatients.

Introdução: Os Cuidados Paliativos envolvem aspectos nutricionais e éticos, onde a Bioética pode auxiliar na reflexão sobre estas condutas. Objetivos: Descrever os cuidados nutricionais envolvidos no atendimento de pacientes internados no NCP/HCPA e seus aspectos bioéticos associados, bem como avaliar o perfil clínico e demográfico destes pacientes. Métodos: Foi realizado um estudo transversal retrospectivo de internações do NCP/HCPA entre 2007 e 2010. Foram coletados dados demográficos, clínicos e nutricionais de 135 internações, analisados de forma quantitativa e qualitativa. Os pesquisadores assinaram um Termo de Compromisso para Uso de Dados. Resultados: A amostra é variada quanto aos aspectos demográficos. A Nutrição Enteral foi prescrita em 80% das vezes para pacientes terminais ou em fim de vida e bem debilitados. Em 14,1% das internações houve evolução do nutricionista. Os aspectos bioéticos encontrados em 33 internações foram a Beneficência, em todas elas (100%); Autonomia (51,5%); Veracidade (18,9%) e questões sobre Informação (36,4%). Conclusão: Estes dados evidenciam as dificuldades enfrentadas na implantação do Núcleo de Cuidados Paliativos, período em que ocorreram as internações avaliadas, em termos da compreensão do que são as medidas paliativas e a necessidade de ampliar a comunicação adequada, e o seu devido registro em prontuário, entre os diferentes profissionais envolvidos no atendimento destes pacientes. / Background: the Palliative Care includes nutritional and ethics issues, and Bioethics can help in the reflection about this conduct. Objective: to describe the nutritional care in inpatients assistance on NCP/HCPA and their bioethical issues associated, as well as evaluate the patients clinical and demographic profile. Methods: A retrospective cross-sectional study was made in the admissions on NCP/HCPA between 2007 and 2010. The demographic, clinical and nutritional data was collected of 135 admissions, analyzed by quantitative and qualitative ways. The researchers signed a commitment form to use the data. Results: The sample is varied in relation to demographic data. The Enteral Nutrition was performed in 80% of the time for terminally ill inpatients or “end-of-life”, in a very weak condition. In 14,1% of the admissions there was evolution record of de nutritionist. The bioethical issues (in 33 admissions) include the Beneficence (100%); Autonomy (51,1%); Veracity (18,9%) and information issues (36,4%). Conclusion: This results evidence the difficulties faced in the implementation of the Palliative Care Unit, period in which the hospitalizations occurred, about the comprehension of what are the palliative course of treatment and the need to extend adequate communication, and its proper medical records, between the different professionals involved in the assistance of these inpatients.