Neuropaliativismo: uma revisão sobre os cuidados paliativos em pacientes neurológicos
##plugins.themes.bootstrap3.article.sidebar##
##plugins.themes.bootstrap3.article.main##
Resumo
Objetivo: Explorar a prática dos cuidados paliativos em pacientes neurológicos, com foco na eficácia desses cuidados em melhorar a qualidade de vida e reduzir o sofrimento em contextos de doenças neurodegenerativas. Métodos: A pesquisa bibliográfica foi conduzida nas bases de dados PubMed e Portal Regional da Biblioteca Virtual em Saúde do Ministério da Saúde, utilizando os descritores “Palliative Care”, “Patient”, “Nervous System Diseases” e “Terminal Care”. Foram selecionados 26 artigos que abordavam diferentes aspectos dos cuidados paliativos em pacientes neurológicos. Resultados: A análise dos artigos revelou uma variedade de resultados, destacando a eficácia dos cuidados paliativos na melhoria do conforto e na gestão de sintomas, especialmente em pacientes com tumores cerebrais e demência. No entanto, foram identificados desafios, incluindo a variação na qualidade e acessibilidade dos serviços de cuidados paliativos, além de obstáculos culturais e educacionais que impactam sua implementação eficaz. Considerações finais: Esta revisão sublinha a importância crítica dos cuidados paliativos em pacientes neurológicos, ressaltando a necessidade de estratégias direcionadas para melhorar a educação dos profissionais de saúde, promover discussões precoces sobre planejamento de cuidados e fortalecer o suporte aos cuidadores familiares. Investimentos em pesquisa são fundamentais para adaptar e validar abordagens que maximizem o benefício dos cuidados paliativos.
##plugins.themes.bootstrap3.article.details##
Copyright © | Todos os direitos reservados.
A revista detém os direitos autorais exclusivos de publicação deste artigo nos termos da lei 9610/98.
Reprodução parcial
É livre o uso de partes do texto, figuras e questionário do artigo, sendo obrigatória a citação dos autores e revista.
Reprodução total
É expressamente proibida, devendo ser autorizada pela revista.
Referências
2. AOKI T, et al. Current Status of Palliative and Terminal Care for Patients with Primary Malignant Brain Tumors in Japan. Neurologia medico-chirurgica. 2020; 60(12): 34-45.
3. BÉREAU M, et al. Terminal Care in Parkinson’s Disease: Real-Life Use of Continuous Subcutaneous Apomorphine Infusion to Improve Patient Comfort. Journal of Parkinson’s disease/Journal of Parkinson’s disease (Online). 2024; 14(1): 209–219.
4. BLUCK MB. Providers’ Perspectives on Palliative Care in a Neuromedicine-Intensive Care Unit: End-of-Life Expertise and Barriers to Referral. J Palliat Med. 2019; 22(4): 364–369.
5. EARP M, et al. Hospital-based acute care in the last 30 days of life among patients with chronic disease that received early, late or no specialist palliative care: a retrospective cohort study of eight chronic disease groups. BMJ Open. 2021; 11(3): 044196.
6. FLEMMING K, et al. The experiences of, and need for, palliative care for people with motor neurone disease and their informal caregivers: A qualitative systematic review. Palliative Medicine. 2020; 34(6): 708–730.
7. GABBARD J, et al. Prognostic Awareness, Disease and Palliative Understanding Among Caregivers of Patients With Dementia. American Journal of Hospice and Palliative Medicine®. 2019; 37(9): 683–691.
8. GOTANDA H, et al. Trends in advance care planning and end‐of‐life care among persons living with dementia requiring surrogate decision‐making. Journal of the American Geriatrics Society. 2022; 70(5): 1394–1404.
9. HOCHWALD IH, et al. Ethical challenges in end-stage dementia: Perspectives of professionals and family care-givers. Nursing Ethics. 2021; 28(7): 1228–1243.
10. ISENBERG-GRZEDA E, et al. Legal assistance in dying for people with brain tumors. Annals of Palliative Medicine. 2021; 10(1): 893–898.
11. KOEKKOEK JAF, et al. Palliative care and end-of-life care in adults with malignant brain tumors. Neuro-Oncology. 2022; 25(3): 216-222.
12. LACKRAJ D, et al. Implementation of Specialist Palliative Care and Outcomes for Hospitalized Patients with Dementia. Journal of the American Geriatrics Society. 2021; 69(5): 1199–1207.
13. LINDSKOG M. Acute healthcare utilization in end-of-life among Swedish brain tumor patients – a population based register study. BMC Palliative Care. 2022; 21(1): 133-146.
14. LUTH EA, et al. Associations between dementia diagnosis and end-of-life care utilization. Journal of the American Geriatrics Society. 2022; 70(10): 2871–2883.
15. MC VEIGH C, et al. Palliative care for patients with motor neurone disease and their bereaved carers: a qualitative study. BMC Palliative Care. 2019; 18(1): 39-43.
16. MIYASHITA M, et al. Symptom burden, service use and care dissatisfaction among older adults with cancer, cardiovascular disease, respiratory disease, dementia and neurological disease during the last 3 months before death: A pooled analysis of mortality follow-back surveys. Palliat Med. 2024; 38(5): 582–592.
17. NÅHLS NS, et al. Effect of palliative care decisions making on hospital service use at end-of-life in patients with malignant brain tumors: a retrospective study. BMC Palliative Care. 2023; 22(1): 23-39.
18. OHNSORGE K, et al. Wishes to die at the end of life and subjective experience of four different typical dying trajectories. A qualitative interview study. PLoS One. 2019; 14(1): 0210784–4.
19. OLVERA CE. Community-based neuropalliative care. Handb Clin Neurol. 2023, 191(3): 49–66.
20. OZANNE A, et al. Symptom relief during last week of life in neurological diseases. Brain and Behavior. 2019; 9(8): 01348.
21. PUENTE-FERNÁNDEZ D, et al. Palliative Care Symptoms, Outcomes, and Interventions for Chronic Advanced Patients in Spanish Nursing Homes with and without Dementia. International Journal of Environmental Research and Public Health. 2020; 17(5): 1465–1475.
22. RAPP M, et al. Would they do it again? Final treatment decisions in malignant brain tumour patients-a caregiver’s perspective. Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer. 2022; 30(5): 3985–3993.
23. TAY RY, et al. Comfort and Satisfaction With Care of Home-Dwelling Dementia Patients at the End of Life. Journal of Pain and Symptom Management. 2020; 59(5): 1019-1032.
24. TAYLOR BL, et al. Inpatients with neurologic disease referred for palliative care consultation. Neurology. 2019; 92(17): 1975–81.
25. WALTER HAW, et al. The Role of Palliative Care in Chronic Progressive Neurological Diseases—A Survey Amongst Neurologists in the Netherlands. Frontiers in Neurology. 2019; 14(9): 7-15.
26. WANG Y, et al. Advance directives and end-of-life care: knowledge and preferences of patients with brain Tumours from Anhui, China. BMC Cancer. 2021; 21(1): 8-13.