Doentes Crónicos e Cuidados Paliativos: Da Identificação Precoce ao Cuidado Centrado na Família, num Serviço de Medicina Interna
DOI:
https://doi.org/10.24950/R/45/21/3/2021Palavras-chave:
Cuidados Paliativos, Doença Crónica, Medicina Interna, PrognósticoResumo
Os chamados doentes crónicos com critérios de cuidados paliativos, que apresentam necessidades de cuidados multidisciplinares e de gestão de controlo sintomático, são cada vez mais frequentes no internamento de um Serviço de Medicina Interna. O estabelecimento do prognóstico nestes doentes torna-se fundamental para a definição de plano terapêutico adequado à necessidade individual (evitando terapêuticas e/ou investigações desnecessárias), para a comunicação eficaz e adequada com a família e para a redução de custos associados à prestação de cuidados. Apesar de existirem na literatura diversos índices prognósticos, torna-se difícil a sua aplicabilidade, por diversas razões. Os autores deste artigo propõem, então, como dados pertinentes na admissão de um doente no internamento de Medicina Interna, de forma que se facilite o estabelecimento do prognóstico e se permita um plano de abordagem multidisciplinar, os seguintes itens: estados funcional e cognitivo; patologias definidoras de prognóstico e síndrome da fragilidade; questão surpresa no serviço de urgência; comunicação com a família.
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