How patients die in Internal Medicine wards: a retrospective study
Keywords:
palliative care, chronic disease, painAbstract
Terminal patients are daily present in our medical wards, and there
is no universal standard protocol for palliative care. The aim of
this work is to be an observational study, in order to see how we
treat and how we care for our terminal patients, including cancer
patients, as well as other chronic diseases as dementia, heart
failure, HIV/AIDS and chronic obstructive pulmonary disease. A
retrospective analysis of 286 clinical files of deceased patients,
in a 16 month period, in a Lisbon hospital was made. The epidemiologic characterization was, as expected, an old and dependent
population, with a major presence of cardiovascular diseases
followed by respiratory diseases. Regarding the population, 73%
of deaths were expected, but just 44% were considered to be
in palliative care. Pain was evaluated predominantly in cancer
patients, being treated in 77% of cases. The decision of palliative care was discussed with the family in 26% of patients, but
it was not discussed with the patient him/herself. Education in
this area is necessary in order to make a systematic intervention
with terminal patients. A definition of patients’ expectations and
systematic pain research in all terminal patients is needed to
improve quality of end-of-life care.
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