Nursing interventions in palliative care in primary health care: Scoping review
DOI:
https://doi.org/10.33448/rsd-v10i8.17365Keywords:
Palliative care; Primary health care; Nursing care; Nursing.Abstract
Objective: to map nursing interventions in palliative care in primary health care. Method: This is a scope review. The PRISMA Extension for Scoping Review instrument was used for the writing of the study. Searches were performed in six databases, using the descriptors palliative care, primary health care and nursing care. Results: 23 studies were selected and, from them, 63 nursing interventions were identified, focused on: operationalization of palliative care in primary health care; promotion of qualified and integrated assistance; family/caregiver within the home; pain control; establishing efficient and effective communication; and psychosocial and spiritual changes. Conclusion: The mapping of scientific production showed that, although there have been advances in recent years, nursing interventions in palliative care in primary health care have still been implemented in an incipient way. This fact reflects the need for improved professional training in order to expand access to palliative care and improve the service provided.
References
Academia Nacional de Cuidados Paliativos. (2020). Atlas de Cuidados Paliativos no Brasil 2019. São Paulo.
Afshar, K., Wiese, B., Schneider, N., & Müller-Mundt, G. (2020). Systematic identification of critically ill and dying patients in primary care using the German version of the Supportive and Palliative Care Indicators Tool (SPICT-DE). German medical science: GMS e-journal, 18, Doc02. https://doi.org/10.3205/000278
Almeida, P., Marin, J. & Casotti, E. (2017). Estratégias Para Consolidação da Coordenação do Cuidado pela Atenção Básica. Trab. educ. Saúde, 15(2):373-398. https://doi.org/10.1590/1981-7746-sol00064
Ann-Yi, S., Bruera, E., Wu, J., Liu, D. D., Agosta, M., Williams, J. L., et al. (2018). Characteristics and Outcomes of Psychology Referrals in a Palliative Care Department. Journal of pain and symptom management, 56(3), 344–351. https://doi.org/10.1016/j.jpainsymman.2018.05.022
Arksey, H. & O'Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1):19-32. DOI: https://doi.org/10.1080/1364557032000119616
Baer, L. & Weinstein, E. (2013). Improving oncology nurses' communication skills for difficult conversations. Clinical journal of oncology nursing, 17(3):E45–E51. https://doi.org/10.1188/13.CJON.E45-E51
Barros, M. A. A., Pereira, F. J. R., Abrantes, M. W., Silva, G. B., Porto, V. A. & Carvalho, M. A. P. (2020). Produção Científica Acerca da Dor em Cuidados Paliativos: Contribuição da Enfermagem no Cenário Brasileiro. Revista Online de Pesquisa Cuidado é Fundamental, 12(1):744-750. http://dx.doi.org/10.9789/2175-5361.rpcfo.v12.9452
Borba, A. S., Ramos, T. M., Rodrigues, G. M. M. & Lemos, L. R. (2019). Sistematização da assistência de enfermagem a pacientes com distúrbios depressivos. Brazilian Journal of Health Review, 2(6):5217-5227. https://doi.org/10.34119/bjhrv2n6-026
Brant, J., Fink, R. & Thompson, C. (2019). Global Survey of the Roles, Satisfaction, and Barriers of Home Health Care Nurses on the Provision of Palliative Care. Journal of palliative medicine, 22(8):945-960. https://doi.org/10.1089/jpm.2018.0566
Brasil. Ministério da Saúde; Política Nacional de Atenção Básica, Departamento de Atenção Básica. (2017). Portaria no. 2.436 de 21 de setembro de 2017. Brasília, 2017.
Bulechek, G., Butcher, H. & Dochterman, J. (2016). NIC Classificação das Intervenções de Enfermagem. 6 ed. São Paulo.
Campos, S., Zhang, L., Sinclair, E., Tsao, M., Barnes, E. A., Danjoux, C., et al. (2009). The palliative performance scale: examining its inter-rater reliability in an outpatient palliative radiation oncology clinic. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 17(6), 685–690. https://doi.org/10.1007/s00520-008-0524-z
Cleary, A. (2016). Integrating palliative care into primary care for patients with chronic, life-limiting conditions. The Nurse practitioner, 41(3):42–49. https://doi.org/10.1097/01.NPR.0000480588.01667.58
Colquhoun, H., Levac, D., O’Brien, K. K., Straus, S., Tricco, A. C., Perrier, L., et al. (2014). Scoping reviews: Time for clarity indefinition, methods and reporting. Journal of Clinical Epidemiology, 67(12).1291-1294. https://doi.org/10.1016/j.jclinepi.2014.03.013
Coyne, P., Mulvenon, C. & Paice, J. (2018). American Society for Pain Management Nursing and Hospice and Palliative Nurses Association Position Statement: Pain Management at the End of Life. Pain management nursing: official journal of the American Society of Pain Management Nurses, 19(1):3-7. https://doi.org/10.1016/j.pmn.2017.10.019
Cronin, J. & Finn, S. (2017). Implementing and evaluating the COMFORT Communication in palliative care curriculum for oncology nurses. J Hosp Palliat Nurs, 19(2017):140-146. 10.1097 / NJH.0000000000000320
Dadalto, L. Testamento Vital. Editora Atlas, São Paulo. 2015.
Dahlin, C., Coyne, P. & Cassel, J. (2016). The Advanced Practice Registered Nurses Palliative Care Externship: A Model for Primary Palliative Care Education. Journal of palliative medicine, 19(7):753–759. https://doi.org/10.1089/jpm.2015.0491
Danielsen, B. V., Sand, A. M., Rosland, J. H., & Førland, O. (2018). Experiences and challenges of home care nurses and general practitioners in home-based palliative care - a qualitative study. BMC palliative care, 17(1), 95. https://doi.org/10.1186/s12904-018-0350-0
Elk, R., Felder, T. M., Cayir, E., & Samuel, C. A. (2018). Social Inequalities in Palliative Care for Cancer Patients in the United States: A Structured Review. Seminars in oncology nursing, 34(3), 303–315. https://doi.org/10.1016/j.soncn.2018.06.011
Fan, Z., Chen, L., Meng, L., Jiang, H., Zhao, Q., Zhang, L., & Fang, C. K. (2019). Preference of cancer patients and family members regarding delivery of bad news and differences in clinical practice among medical staff. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 27(2), 583–589. https://doi.org/10.1007/s00520-018-4348-1
Fitch, M., Fliedner, M. & O'Connor, M. (2015). Nursing perspectives on palliative care 2015. Annals of palliative medicine, 4(3):150–155. https://doi.org/10.3978/j.issn.2224-5820.2015.07.04
Fox, S., Azman, A. & Timmons, S. (2020). Palliative care needs in Parkinson's disease: focus on anticipatory grief in family carers. Annals of palliative medicine, 9(1):S34–S43. https://doi.org/10.21037/apm.2020.02.04
Frazzatto, C. & Sawaia, B. (2016). A critical view of the 'social reinsertion' concept and its implications for the practice of psychologists in the area of mental health in the Brazilian Unified Health System (Sistema Único de Saúde). Journal of health psychology, 21(3):409–418. https://doi.org/10.1177/1359105316628751
Galvão, M., Borges, M. & Pinho, D. (2017). Comunicação interpessoal com pacientes oncológicos em cuidados paliativos. Rev baiana enferm, 31(3). http://dx.doi.org/10.18471/rbe.v31i3.22290
Graaf, E. (2016). Hospice assist at home: does the integration of hospice care in primary healthcare support patients to die in their preferred location - A retrospective cross-sectional evaluation study. Palliative Medicine, 30(6):580-586. https://doi.org/10.1177/0269216315626353
Griffiths, J., Ewing, G., Wilson, C., Connolly, M., & Grande, G. (2015). Breaking bad news about transitions to dying: a qualitative exploration of the role of the District Nurse. Palliative medicine, 29(2), 138–146. https://doi.org/10.1177/0269216314551813
Griffiths, J., Wilson, C., Ewing, G., Connolly, M., & Grande, G. (2015). Improving communication with palliative care cancer patients at home - A pilot study of SAGE & THYME communication skills model. European journal of oncology nursing: the official journal of European Oncology Nursing Society, 19(5), 465–472. https://doi.org/10.1016/j.ejon.2015.02.005
Gunnarsdottir, S., Sigurdardottir, V., Kloke, M., Radbruch, L., Sabatowski, R., Kaasa, S., et al. (2017). A multicenter study of attitudinal barriers to cancer pain management. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 25(11), 3595–3602. https://doi.org/10.1007/s00520-017-3791-8
Harzheim, E., Pinto, L. F., Hauser, L. & Soranz, D. (2016). Assessment of child and adult users of the degree of orientation of Primary Healthcare in the city of Rio de Janeiro, Brazil. Ciência & Saúde Coletiva, 21(5):1399-1408. https://dx.doi.org/10.1590/1413-81232015215.26672015
Hawkins, K., Parker, P. M., Hommer, C. E., Bhattarai, G. R., Huang, J., Wells, T. S., Ozminkowski, R. J., & Yeh, C. S. (2015). Evaluation of a high-risk case management pilot program for Medicare beneficiaries with Medigap coverage. Population health management, 18(2), 93–103. https://doi.org/10.1089/pop.2014.0035
Hernando, C., Limonero, J. & Gil, F. (2020). Psychological intervention in patients with advanced cancer at home through Individual Meaning-Centered Psychotherapy-Palliative Care: a pilot study. Supportive care in cancer: official journal of the Multinational Association of Supportive Care in Cancer, 28(10):4803–4811. https://doi.org/10.1007/s00520-020-05322-2
Holmdahl, S., Sävenstedt, S. & Imoni, R. (2014). Parenteral nutrition in home-based palliative care: Swedish district nurses experiences. Scandinavian journal of caring sciences, 28(1):89–96. https://doi.org/10.1111/scs.12038
Hudson, B. F., Best, S., Stone, P., & Noble, T. B. (2019). Impact of informational and relational continuity for people with palliative care needs: a mixed methods rapid review. BMJ open, 9(5), e027323. https://doi.org/10.1136/bmjopen-2018-027323
Hweidi, I. M., Tawalbeh, L. I., Al-Hassan, M. A., Alayadeh, R. M., & Al-Smadi, A. M. (2017). Research Use of Nurses Working in the Critical Care Units: Barriers and Facilitators. Dimensions of critical care nursing: DCCN, 36(4), 226–233. https://doi.org/10.1097/DCC.0000000000000255
Ikeda, L., Marcheti, M., Sales, A., Giacon, B. & Marques, F. (2017). Dificuldades de uma equipe de enfermagem para prestar cuidados paliativos. CIAIQ., 2(1):732-741.
Karnick, P. M. (2016). Evidence-Based Practice and Nursing Theory. Nursing science quarterly, 29(4):283–284. https://doi.org/10.1177/0894318416661107
Knaul, F. M., Farmer, P. E., Krakauer, E. L., De Lima, L., Bhadelia, A., Jiang Kwete, X., et al. Lancet Commission on Palliative Care and Pain Relief Study Group (2018). Alleviating the access abyss in palliative care and pain relief-an imperative of universal health coverage: the Lancet Commission report. Lancet (London, England), 391(10128), 1391–1454. https://doi.org/10.1016/S0140-6736(17)32513-8
Lai, X., Wong, F. & Ching S. (2018). The experience of caring for patients at the end-of-life stage in non-palliative care settings: a qualitative study. BMC palliative care, 17(1):116. https://doi.org/10.1186/s12904-018-0372-7
Levac, D., Colquhoun, H. & O'Brien, K. (2010). Scoping studies: advancing the methodology. Implementation science: IS, 5:69. https://doi.org/10.1186/1748-5908-5-69
Levine, S., O'Mahony, S., Baron, A., Ansari, A., Deamant, C., Frader, J., et al. (2017). Training the Workforce: Description of a Longitudinal Interdisciplinary Education and Mentoring Program in Palliative Care. Journal of pain and symptom management, 53(4), 728–737. https://doi.org/10.1016/j.jpainsymman.2016.11.009
Lokker, M. E., Swart, S. J., Rietjens, J., Van Zuylen, L., Perez, R., & van der Heide, A. (2018). Palliative sedation and moral distress: A qualitative study of nurses. Applied nursing research: ANR, 40, 157–161. https://doi.org/10.1016/j.apnr.2018.02.002
Malta, R., Rodrigues, B. & Priolli, D. (2018). Paradigma da formação Médica: Atitudes e Conhecimentos de Acadêmicos sobre a Morte e Cuidados Paliativos. Rev. Brasileira de Educação Médica, 42(2):34-44. https://doi.org/10.1590/1981-52712015v42n2rb20170011.
Marcucci, F. C., Cabrera, M. A., Perilla, A. B., Brun, M. M., de Barros, E. M., Martins, V. M., et al. (2016). Identification and characteristics of patients with palliative care needs in Brazilian primary care. BMC palliative care, 15, 51. https://doi.org/10.1186/s12904-016-0125-4
Mayahara, M., Foreman, M. D., Wilbur, J., Paice, J. A., & Fogg, L. F. (2015). Effect of hospice nonprofessional caregiver barriers to pain management on adherence to analgesic administration recommendations and patient outcomes. Pain management nursing: official journal of the American Society of Pain Management Nurses, 16(3), 249–256. https://doi.org/10.1016/j.pmn.2014.07.001
Meier, E. A., Gallegos, J. V., Thomas, L. P., Depp, C. A., Irwin, S. A., & Jeste, D. V. (2016). Defining a Good Death (Successful Dying): Literature Review and a Call for Research and Public Dialogue. The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry, 24(4), 261–271. https://doi.org/10.1016/j.jagp.2016.01.135
Mertens, F., De Gendt, A., Deveugele, M., Van Hecke, A., & Pype, P. (2019). Interprofessional collaboration within fluid teams: Community nurses' experiences with palliative home care. Journal of clinical nursing, 28(19-20), 3680–3690. https://doi.org/10.1111/jocn.14969
Midtbust, M. H., Alnes, R. E., Gjengedal, E., & Lykkeslet, E. (2018). Perceived barriers and facilitators in providing palliative care for people with severe dementia: the healthcare professionals' experiences. BMC health services research, 18(1), 709. https://doi.org/10.1186/s12913-018-3515-x
Mishelmovich, N., Arber, A. & Odelius, A. (2016). Breaking significant news: The experience of clinical nurse specialists in cancer and palliative care. European journal of oncology nursing: the official journal of European Oncology Nursing Society, 21:153–159. https://doi.org/10.1016/j.ejon.2015.09.006
Nevado, D., Babarro, A. & Lozano, M. (2012). Continuidad de cuidados, innovación y redefinición de papeles profesionales en la atención a pacientes crónicos y terminales. Informe SESPAS, Gaceta Sanitaria, 24(1):63-68. https://doi.org/10.1016/j.gaceta.2011.09.032
Omondi, S., Weru, J., Shaikh, A. J., & Yonga, G. (2017). Factors that influence advance directives completion amongst terminally ill patients at a tertiary hospital in Kenya. BMC palliative care, 16(1), 9. https://doi.org/10.1186/s12904-017-0186-z
Paim, J. (2018). Sistema Único de Saúde (SUS) aos 30 anos. Ciência & Saúde Coletiva, 23(6):1723-1728. https://dx.doi.org/10.1590/1413-81232018236.09172018
Pereira, D. G., Fernandes, J., Ferreira, L. S., Rabelo, R. O., Pessalacia, J. D. R. & Souza, R. S. (2017). Significados dos cuidados paliativos na ótica de enfermeiros e gestores da atenção primária à saúde. Revista de Enfermagem UFPE, 11(3):1357-1364. https://doi.org/10.5205/1981-8963-v11i3a13977p1357-1364-2017
Peters, M. D. J., Godfrey, C., McInerney, P., Munn, Z., Tricco, A. C. & Khalil, H. (2020). Capítulo 11: Revisões do escopo (versão 2020). In: Aromataris, E. & Munn Z (Editores). JBI Manual for Evidence Synthesis , JBI. https://doi.org/10.46658/JBIMES-20-12
Pfeil, T., Laryionava, K. & Reiter-Theil, S. (2015). What keeps oncologists from addressing palliative care early on with incurable cancer patients? An active stance seems key. The oncologist, 20(1):56–61. https://doi.org/10.1634/theoncologist.2014-0031
Picollo, D. & Fachini, M. (2018). A atenção do enfermeiro ao paciente em cuidado paliativo. Rev Ciênc Med, 27(2):85-92. http://dx.doi.org/10.24220/2318-0897v27n2a3855
Pirret, A., Neville, S. & La Grow, S. (2015). Nurse practitioners versus doctors diagnostic reasoning in a complex case presentation to an acute tertiary hospital: a comparative study. International journal of nursing studies, 52(3):716–726. https://doi.org/10.1016/j.ijnurstu.2014.08.009
Portela, G. (2017). Atenção Primária à Saúde: um ensaio sobre conceitos aplicados aos estudos nacionais. Physis: Revista de saúde coletiva, 27(2):255-176. https://doi.org/10.1590/s0103-73312017000200005
Ribeiro, J. & Poles, K. (2019). Cuidados Paliativos: Prática dos Médicos da Estratégia Saúde da Família. Rev. Bras. Educ. Med., 43(3):62-72. https://doi.org/10.1590/1981-52712015v43n3rb20180172
Roth, A. & Canedo, A. (2019). Introduction to Hospice and Palliative Care. Primary care, 46(3):287-302. https://doi:10.1016/j.pop.2019.04.001
Silva, M. (2013). O papel do profissional da Atenção Primária à Saúde em cuidados paliativos. Revista Brasileira de Medicina de Família e Comunidade, 9(30):45-53. DOI: https://doi.org/10.5712/rbmfc9(30)718
Sousa, J. & Alves, E. (2015). Competências do enfermeiro para o cuidado paliativo na atenção domiciliar. Acta Paulista de Enfermagem, 28(3):264-269. https://doi.org/10.1590/1982-0194201500044
Srivastava, P. & Hopwood, N. (2009). A practical iterative framework for qualitative data analysis. Int J Qual Methods, 8(1):76-84. https://doi.org/10.1177/160940690900800107
Stenner, K., Carey, N. & Courtenay, M. (2012). Prescribing for pain--how do nurses contribute? A national questionnaire survey. Journal of clinical nursing, 21(23-24):3335-3345. https://doi.org/10.1111/j.1365-2702.2012.04136.x
Tornøe, K., Danbolt, L. J., Kvigne, K., & Sørlie, V. (2015). A mobile hospice nurse teaching team's experience: training care workers in spiritual and existential care for the dying - a qualitative study. BMC palliative care, 14, 43. https://doi.org/10.1186/s12904-015-0042-y
Tricco, A. C., Lillie, E., Zarin, W., O'Brien, K. K., Colquhoun, H., Levac, et al. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and Explanation. Annals of internal medicine, 169(7), 467–473. https://doi.org/10.7326/M18-0850
Ullrich, A., Ascherfeld, L, Marx, G., Bokemeyer, C., Bergelt, C. & Oechsle, K. (2017). Quality of life, psychological burden, needs, and satisfaction during specialized inpatient palliative care in family caregivers of advanced cancer patients. BMC palliative care, 16(1):31. https://doi.org/10.1186/s12904-017-0206-z
Van den Brekel, L., Van der Baan, F. H., Zweers, D., Koldenhof, J. J., Vos, J., de Graeff, A., et al. (2020). Predicting Anxiety in Hospitalized Cancer Patients. Journal of pain and symptom management, 60(3), 522–530.e1. https://doi.org/10.1016/j.jpainsymman.2020.04.005
Van der Plas, A. G., Onwuteaka-Philipsen, B. D., Vissers, K. C., Deliens, L., Jansen, W. J., & Francke, A. L. (2016). Appraisal of cooperation with a palliative care case manager by general practitioners and community nurses: a cross-sectional questionnaire study. Journal of advanced nursing, 72(1), 147–157. https://doi.org/10.1111/jan.12818
Virdun, C., Luckett, T., Lorenz, K., Davidson, P. M., & Phillips, J. (2017). Dying in the hospital setting: A meta-synthesis identifying the elements of end-of-life care that patients and their families describe as being important. Palliative medicine, 31(7), 587–601. https://doi.org/10.1177/0269216316673547
Warth, M., Kessler, J., Koehler, F., Aguilar-Raab, C., Bardenheuer, H. J., & Ditzen, B. (2019). Brief psychosocial interventions improve quality of life of patients receiving palliative care: A systematic review and meta-analysis. Palliative medicine, 33(3), 332–345. https://doi.org/10.1177/0269216318818011
Watts, T. (2014). Secondary breast cancer: the role of primary care nurses. Practice Nurse. 2014; 44(5):36-41.
Wenger, N. S., Roth, C. P., Martin, D., Nickels, L., Beckman, R., Kamberg, C., et al. (2011). Quality of Care Provided in a Special Needs Plan Using a Nurse Care Manager Model. Journal of the American Geriatrics Society, 59(10):1810-1822. DOI: https://doi.org/10.1111/j.1532-5415.2011.03599.x
Wittenberg, E. & Goldsmith J. (2016). The COMFORT Communication Project.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Juliana Carvalho de Oliveira; Melissa Santos Nassif; Munyra Rocha Silva Assunção; Paula Damaris Chagas Barrioso; Andréia Cristina Barbosa Costa; Isabelle Cristinne Pinto Costa
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
