Portrait of the Palliative Needs of an Internal Medicine Service of a Tertiary Hospital in Portugal
DOI:
https://doi.org/10.24950/rspmi.1594Keywords:
Health Services Needs and Demand, Internal Medicine , Off-Label Use; Palliative Care;Terminal Care.Abstract
Introduction: The clinical profile of patients admitted to Internal Medicine services is characterized by increasing frailty
and complexity. The main objective of this study was to determine the prevalence of palliative care needs in an Internal
Medicine Service using the NECPAL instrument.
Material and Methods: An institutional, clinical, descriptive,
observational and cross-sectional study was conducted. Of the 148 patients admitted to the Internal Medicine Service of a tertiary hospital on 20th April of 2022, 122 patients presented
eligibility criteria for application of the NECPAL inquiry by health professionals (doctors and nurses). Statistical analysis
was performed in SPSS® version 26 software.
Results: The prevalence of palliative needs in this Internal
Medicine Service was 88.5% (n = 108). Of these, 72.2 % (n =
78) were in stage 3 prognosis of NECPAL, whose median survival is 3.6 months. Most healthcare professionals (56.9%, n = 29) had no basic training in palliative care. Nurses and physicians were concordant in most of their assessments regarding the surprise question, differing in 27.9% (n = 34) of patients, and in all of these the prognosis-defining disease was non-oncologic.
Discussion/Conclusion: The palliative needs in this Internal
Medicine Service are high, possibly portraying the national
reality. Giving visibility to the needs of our population is
imperative for better management of individual care, human
resources and creation of government plans.
Downloads
References
Gonçalves, JA. A boa morte: ética no fim da vida. Porto: Faculdade de Medicina da Universidade do Porto; 2007.
Santana P. A Geografia da Saúde da população. Evolução nos últimos 20 anos em Portugal Continental. Coimbra: Centro de Estudos em Geografia e Ordenamento do Território; 2015. doi: 10.17127/cegot/2015.GS.
Instituto Nacional de Estatística [INE.pt]. Projeções de População Residente 2018-2080l; 2020. [consultado em Maio 2022]. Disponível em: https://www.ine.pt/xportal/xmain?xpid=INE&xpgid=ine_destaques&DESTAQUESdest_
boui=406534255&DESTAQUESmodo=2&xlang=pt.
Carneiro R, Freire E, Alves J, Rocha N. Gestos e atitudes em medicina: Centrada no doente num serviço de medicina interna. Acta Med Port. 2010; 23:1035-42.
Neto IG, Barbosa A, Pina PR, Tavares F. Manual de Cuidados Paliativos. 3ª ed. Lisboa: Núcleo de Cuidados Paliativos do Centro de Bioética da Faculdade Medicina de Lisboa; 2016.
Eti S. Palliative care: an evolving field in medicine. Prim Care. 2011; 38:p.159-71, vii. doi: 10.1016/j.pop.2011.03.001.
Stewart M, Brown JB, Donner A, McWhinney IR, Oates J, Weston WW, Jordan J. The impact of patient-centered care on outcomes. J Fam Pract.2000; 49:796-804.
Gómez-Batiste X, Martínez-Muñoz M, Blay C, Amblàs J, Vila L, Costa X, et al. Identifying patients with chronic conditions in need of palliative care in the general population: Development of the NECPAL tool and preliminary prevalence rates in Catalonia. BMJ Support Palliat Care. 2013; 3:300–8. doi: 10.1136/bmjspcare-2012-000211
Santana MT, Gómez-Batiste X, Silva LM, Gutiérrez MG. Cross-cultural adaptation and semantic validation of an instrument to identify palliative requirements in Portuguese. Einstein. 2020;18:eAO5539. doi: 10.31744/ einstein_journal/2020AO5539.
Gómez-Batiste X, Martínez-Muñoz M, Blay C, Amblàs J, Vila L, Costa X, et al. Practical recommendations for identifying and establishing prognostic approach of people with advanced chronic conditions and palliative care needs in health and social services –NECPAL 4.0 Prognostic. Barcelona: Càtedra de Cures Palliatives, ICO, Institut Català D’Oncologia;2021.
Martins O. Identificação de Doentes Internados num Serviço de Medicina Interna com Necessidade de Cuidados Paliativos. Med Interna. 2020; 27:131-8. doi: 10.24950/O/265/19/2/2020
Monteiro P, Silva M J, Fraga M, Mota C, Suarez A, Ponte C, et al. Necessidade de Cuidados Paliativos num Serviço de Medicina Interna. Med Interna. 2013;20:7-20.
Gómez-Batiste X, Martínez-Muñoz M, Blay C, Espinosa J, Contel JC, Ledesma A. Identifying needs and improving palliative care of chronically ill patients: a community-oriented, population-based, public-health approach. Curr Opin Support Palliat Care. 2012;6:371-8. doi: 10.1097/SPC.0b013e328356aaed.
Kim S, Lee K, Kim S. Knowledge, attitude, confidence, and educational needs of palliative care in nurses caring for non-cancer patients: a cross-sectional, descriptive study. BMC Palliat Care. 2020; 19: 105. doi: 10.1186/s12904-020-00581-6.
Gómez-Batiste X, Turrillas P, Tebé C, Calsina-Berna A, Amblàs-Novellas J. NECPAL tool prognostication in advanced chronic illness: a rapid review and expert consensus. BMJ Support Palliat Care. 2022;12(e1):e10-e20. doi: 10.1136/bmjspcare-2019-002126.
Turrillas P, Peñafiel J, Tebé C, Amblàs-Novellas J, Gómez-Batiste X. NECPAL prognostic tool: a palliative medicine retrospective cohort study. BMJ Support Palliat Care. 2021:bmjspcare-2020-002567. doi: 10.1136/bmjspcare-2020-002567.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2023 Internal Medicine
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright (c) 2023 Medicina Interna
Open Access
