Submitted by Jean Medeiros (jeanletras@uepb.edu.br) on 2018-05-16T14:07:45Z No. of bitstreams: 1 PDF - Myriam de Oliveira Melo.pdf: 29579114 bytes, checksum: a196ba702b5e7b45cb03e998bbffe9c7 (MD5) / Approved for entry into archive by Secta BC (secta.csu.bc@uepb.edu.br) on 2018-05-22T20:51:08Z (GMT) No. of bitstreams: 1 PDF - Myriam de Oliveira Melo.pdf: 29579114 bytes, checksum: a196ba702b5e7b45cb03e998bbffe9c7 (MD5) / Made available in DSpace on 2018-05-22T20:51:08Z (GMT). No. of bitstreams: 1 PDF - Myriam de Oliveira Melo.pdf: 29579114 bytes, checksum: a196ba702b5e7b45cb03e998bbffe9c7 (MD5) Previous issue date: 2017-03-17 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Through more humanized assistance, palliative care seeks to reduce suffering, relieve pain, and maintain human dignity for people with diseases beyond the therapeutic reach of their families. Population aging and the increase in the number of patients with chronic diseases amplify the need to strengthen palliative actions in comprehensive healthcare. Basic Healthcare is important for such care because it is responsible for monitoring the users throughout their lives, especially those who have serious illnesses. The general objective of the research was to analyze the practices related to the palliative care of health professionals who are part of multi-professional basic healthcare teams in the city of Campina Grande, state of Paraíba, Brazil. The method used was quantitative-qualitative. The instruments used were a socio-demographic questionnaire, an interview by guidelines, and a field diary. The data were read through enunciation analysis and descriptive statistics. The sample consisted of twenty- nine professionals. The results showed an essentially female profile (89.7%). None of the professionals had training in palliative care. 93.1% of participants confirmed having palliative care users under their responsibility. Analysis of the speeches showed that the palliative theory is not effectively incorporated among basic healthcare professionals. Their actions were dominated by guidelines, listening, and some technical procedures, such as dressing bandages. The main difficulties were the lack of resources in basic care, the lack of professionals and the lack of training of the team. Most of the participants stated that they had a calm position in relation to the death of the users. It is not a common practice for professionals to assist the family in mourning. This study was relevant because it is a topic that has not been extensively studied in Brazil, and because it is an instigator for the State to create public policies that include palliative care in basic healthcare. Everyone deserves to live with dignity, even in their last days of life. / Por meio de uma assistência humanizada, os cuidados paliativos (CP) buscam a diminuição do sofrimento, o alívio da dor e a manutenção da dignidade humana de pessoas com doenças fora do alcance terapêutico e de seus familiares. O envelhecimento populacional e o aumento do número de portadores com doenças crônicas ampliam a necessidade de reforçar as ações paliativistas na atenção integral à saúde. A Atenção Básica é importante para esses cuidados por ser responsável pelo acompanhamento do usuário durante toda sua vida, principalmente com os que têm enfermidade grave. O objetivo geral da pesquisa foi analisar as práticas referentes aos cuidados paliativos de profissionais de saúde que fazem parte de equipes multiprofissionais na atenção básica na cidade de Campina Grande – PB. O método foi quantiqualitativo. Os instrumentos foram um questionário sociodemográfico, uma entrevista por pautas e o diário de campo. A leitura dos dados foi realizada através da análise de enunciação e da estatística descritiva. A amostra foi composta por vinte e nove profissionais. Os resultados apresentaram um perfil essencialmente feminino (89,7%). Nenhum profissional tem formação em cuidados paliativos. 93,1% dos participantes confirmaram ter usuários em cuidados paliativos sob suas responsabilidades. A análise dos discursos mostrou que a teoria paliativista não está efetivamente incorporada entre os profissionais da atenção básica. As ações eram predominadas por orientações, escutas e alguns procedimentos técnicos, como o curativo. As principais dificuldades foram a falta de recursos na atenção básica, déficit de profissionais e falha na capacitação da equipe. A maioria dos participantes declarou ter posicionamento tranquilo sobre a morte de usuários. Não é uma prática habitual dos profissionais assistir à família no momento de luto. Esse estudo foi relevante por se tratar de um tema pouco trabalhado no Brasil. E por ser instigador para o Estado na criação de políticas públicas que incluam os CP na atenção básica. Todos merecem viver com dignidade, mesmo nos seus últimos dias de vida.

Andelen äldre personer ökar i Sverige och världen vilket innebär att efterfrågan av vård ökar, men all vård behöver inte ske på sjukhus. Insatser som kan förhindra undvikbar slutenvård bör vara viktiga att arbeta fram dels ur ett hållbarhetsperspektiv, men även viktigt för att minska den påfrestning, förvirring och försämrad hälsostatus en sjukhusvistelse kan innebära för den äldre sköra patienten. Mobila närsjuksvårdsteam som utgår från sjukhusen är en relativt ny vårdform i Sverige och introducerades i Västra Götalandsregionen för ungefär 10 år sedan. Mobila närsjukvårdsteam gör insatser för sköra patienter med komplexa behov i hemmet och i teamen arbetar bland annat sjuksköterskor. Inom sjuksköterskans kompetensområde ingår att självständigt kunna ansvara för omvårdnad av patienter, inneha förmågan att se hela patientens livsvärld samt arbeta för en säker vård.  Syftet med den här studien är att belysa sjuksköterskans arbete med sköra patienter i mobila närsjukvårdsteam. Denna studie har genomförts som kvalitativ metod med induktiv ansats och bygger på intervjuer som datainsamlingsmetod. Vi har intervjuat sjuksköterskor verksamma på tre olika mobila närsjukvårdsteam. Resultatet av vår studie har visat att sjuksköterskan i mobila närsjukvårdsteam har en viktig roll då de utför avancerad vård i hemmet genom samverkan i team och med andra vårdaktörer. Sjuksköterskan har ett helhetsperspektiv med patienten i fokus och på så sätt kan andelen onödiga sjukhusinläggningar minska. Vår studie visar att snabb uppföljning i hemmet av sköra patienter som skrivs ut från sjukhus skapar trygghet samt minskar återinläggningar. Dessutom är rätt vård av sköra äldre patienter en organisatorisk fråga och vården behöver bedrivas av rätt kompetens. Sjuksköterskans arbete i mobila närsjukvårdsteam innebär att arbeta med hållbar utveckling genom att konsumtion av slutenvård minskar. / The proportion of older people is increasing in Sweden and the world, which means that the demand for care is increasing, but all care need not executed in hospitals. Efforts that can prevent avoidable outpatient care should be important to work on from a sustainability perspective, but also important to reduce the stress, confusion and deteriorating health status a hospital stay can cause for the older fragile patient. Mobile local health care teams executed from the local hospital are a relatively new form of care in Sweden. Mobile local health care teams were introduced in the Västra Götaland region about 10 years ago. Mobile local health care teams makes efforts for fragile patients with complex needs in their home.  The registered nurse’s expertise includes being able to independently be responsible for the care of patients, having the ability to see the entire patient's needs and working for patient's safety. The aim of this study is to illustrate the nurse's work with fragile older patients in mobile local health care teams. This study has been conducted as a qualitative method with an inductive approach and is based on interviews as a data collection method. We have interviewed nurses working on three different mobile local health care teams. The result has shown that the registered nurse in mobile local health care teams plays an important role as they carry out advanced care in the home through collaboration in teams and with other healthcare players. The registered nurse has a holistic perspective with the patient in focus, unnecessary hospitalizations and re-admission can be reduced. This study shows that fast follow-up in the home of fragile patients who are discharged from hospitals creates security and reduces re-admissions. In addition, proper care of fragile elderly patients is an organizational issue and care needs to be conducted by the right expertise. Registered nurse's work in mobile local health care teams means working with sustainable development by reducing the consumption of inpatient care.