Palavras-chave
Insuficiência cardíaca
Qualidade de vida
Como Citar
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Resumo
Objetivo: Analisar o momento adequado para a integração dos cuidados paliativos em pacientes com insuficiência cardíaca avançada e discutir estratégias para uma abordagem humanizada e centrada na pessoa. Revisão bibliográfica: A trajetória imprevisível da insuficiência cardíaca dificulta a delimitação da terminalidade e favorece encaminhamentos tardios. A literatura indica que a avaliação de necessidades paliativas deve considerar carga sintomática persistente, hospitalizações recorrentes, declínio funcional, fragilidade, sofrimento psicossocial, sobrecarga do cuidador e complexidade das decisões terapêuticas. Ensaios clínicos e sínteses de evidência mostram resultados heterogêneos, com benefícios mais consistentes sobre sintomas, qualidade de vida, comunicação, suporte familiar e utilização de serviços do que sobre mortalidade. Modelos ambulatoriais, domiciliares e por telessaúde podem ampliar o acesso, desde que integrados ao tratamento cardiológico e adaptados às necessidades individuais. Considerações finais: Os cuidados paliativos devem ser incorporados progressivamente ao cuidado da insuficiência cardíaca avançada, sem depender exclusivamente da proximidade da morte. A abordagem deve combinar manejo ativo de sintomas, comunicação clara, decisão compartilhada, apoio aos cuidadores e atenção às desigualdades de acesso.
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