Nursing actions in home palliative care for the elderly supported by multidimensional assessments: integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i10.18989

Keywords:

Palliative care; Home nursing; Health of the elderly; Nursing assessment; Nursing process.

Abstract

Objective: To analyze the nursing actions that are systematized by the use of multidimensional assessment instruments during palliative care assistance to the elderly at home. Method: Integrative review of articles published between 2011 and 2020, identified in the MEDLINE, LILACS, BVS, BDENF and IBECS, CINAHL databases, in Portuguese, English or Spanish; with abstracts and/or text available for full reading and free access, seeking to answer the research question “In the PC for elderly people, the nurse's assessment using assessment instruments adopted in other care contexts guide nursing actions in palliative home care?”. Results: From the searches in the databases, 242 articles were identified, of which 19 were included in the present study, enabling the identification of multidimensional assessment instruments and focuses of nursing action. Conclusion: The scope and complexity of nurses' activities in the context of home palliative care was evidenced, involving the management of care needs and the promotion of targeted actions, with a multidimensional and holistic character.

References

Abernethy, A. P., Currow, D. C., Shelby-James, T., Rowett, D., May, F., Samsa, G. P., … Phillips, P. A. (2013). Delivery Strategies to Optimize Resource Utilization and Performance Status for Patients With Advanced Life-Limiting Illness: Results From the “Palliative Care Trial” [ISRCTN 81117481]. Journal of Pain and Symptom Management, 45(3), 488–505. https://doi.org/10.1016/j.jpainsymman.2012.02.024

Adamy, E. K., Zocche, D. A. de A., & Almeida, M. de A. (2020). Revista Gaúcha de Enfermagem Contribuição do processo de enfermagem para construção identitária dos profissionais de enfermagem. Rev Gaúcha Enferm, 41, 20190143. https://doi.org/10.1590/1983-1447.2020.20190143

Allen, K. R., Hazelett, S. E., Radwany, S., Ertle, D., Fosnight, S. M., & Moore, P. S. (2012). The Promoting Effective Advance Care for Elders (PEACE) Randomized Pilot Study: Theoretical Framework and Study Design. Population Health Management, 15(2), 71–77. https://doi.org/10.1089/pop.2011.0004

Barbosa, A. N., Nascimento, I. A. do, Carvalho, M. J. S. de, Aoyama, E. de A., & Lima, R. N. de. (2019). A importância da assistência humanizada prestada pelo enfermeiro nos cuidados paliativos ao paciente oncológico terminal. Revista Brasileira Interdisciplinar de Saúde, 1(4), 92–96.

Brasil. Portaria No 2.528 de 19 de outubro de 2006 (2006).

Brasil. Portaria No 2.029 de 24 de agosto de 2011 (2011).

Brasil. (2014). Diretrizes metodológicas: elaboração de revisão sistemática e metanáçise de estudos observacionais comparativos sobre fatores de risco e prognóstico (1st ed.). Retrieved from www.saude.gov.br

Burns, M., & McIlfatrick, S. (2015). Palliative care in dementia: literature review of nurses’ knowledge and attitudes towards pain assessment. International Journal of Palliative Nursing, 21(8), 400–407. https://doi.org/10.12968/ijpn.2015.21.8.400

Caveião, C., Hey, A. P., Bernardes, K., Lara, R., Alfaro, A. S., & Prestes, F. da S. (2019). Ações do enfermeiro em cuidados paliativos na oncologia : uma revisão integrativa Actions of the nurse in palliative care in oncology : an integrating review. Revista Saúde e Desenvolvimento, 13(16), 14.

Donato, H., & Donato, M. (2019). Stages for undertaking a systematic review. Acta Medica Portuguesa, 32(3), 227–235. https://doi.org/10.20344/amp.11923

Duursma, F., Schers, H. J., Vissers, K. C., & Hasselaar, J. (2011). Study protocol: optimization of complex palliative care at home via telemedicine. A cluster randomized controlled trial. BMC Palliative Care, 10(1), 13. https://doi.org/10.1186/1472-684X-10-13

Enfermagem, conselho federal de. (2009). RESOLUÇÃO COFEN 358/2009.

Esteban-Burgos, A. A., El Mansouri-Yachou, J., Muñoz-Ramirez, R., Hueso-Montoro, C., Garcia-Caro, M. P., & Montoya-Juarez, R. (2019). Prognostic Models Associated with 6-Month Survival of Patients Admitted to Nursing Homes. Gerontology, 65(1), 40–44. https://doi.org/10.1159/000490243

Faller, J. W., Zilly, A., Moura, C. B. de, & Brusnicki, P. H. (2016). Escala multidimensional na avaliação da dor e sintomas de idosos em cuidados paliativos. Cogitare Enferm, 21(2), 1–10.

Fristedt, S., Nystedt, P., & Skogar, Ö. (2019). Mobile Geriatric Teams – A Cost-Effective Way Of Improving Patient Safety And Reducing Traditional Healthcare Utilization Among The Frail Elderly? A Randomized Controlled Trial. Clinical Interventions in Aging, Volume 14, 1911–1924. https://doi.org/10.2147/CIA.S208388

Gardona, R. G. B., & Barbosa, D. A. (2018). The importance of clinical practice supported by health assessment tools. Revista Brasileira de Enfermagem, 71(4), 1815–1816. https://doi.org/10.1590/0034-7167-2018710401

Gutiérrez-Sánchez, D., Gómez-García, R., Cuesta-Vargas, A. I., & Pérez-Cruzado, D. (2020). The suffering measurement instruments in palliative care: A systematic review of psychometric properties. International Journal of Nursing Studies, 110. https://doi.org/10.1016/j.ijnurstu.2020.103704

Harman, L. E., Guthrie, D. M., Cohen, J., Declercq, A., Fisher, K., Goodridge, D., … Seow, H. (2019). Potential quality indicators for seriously ill home care clients: a cross-sectional analysis using Resident Assessment Instrument for Home Care (RAI-HC) data for Ontario. BMC Palliative Care, 18(1), 3. https://doi.org/10.1186/s12904-018-0389-y

Henoch, I., Strang, P., Löfdahl, C.-G., & Ekberg-Jansson, A. (2019). Equal palliative care for patients with COPD? A nationwide register study. Upsala Journal of Medical Sciences, 124(2), 140–147. https://doi.org/10.1080/03009734.2019.1586803

Hermans, K., De Almeida Mello, J., Spruytte, N., Cohen, J., Van Audenhove, C., & Declercq, A. (2014). A Comparative Analysis of Comprehensive Geriatric Assessments for Nursing Home Residents Receiving Palliative Care: A Systematic Review. Journal of the American Medical Directors Association, 15(7), 467–476. https://doi.org/10.1016/j.jamda.2014.01.002

Hermans, K., De Almeida Mello, J., Spruytte, N., Cohen, J., Van Audenhove, C., & Declercq, A. (2018). Does using the interRAI Palliative Care instrument reduce the needs and symptoms of nursing home residents receiving palliative care? Palliative and Supportive Care, 16(1), 32–40. https://doi.org/10.1017/S1478951517000153

Johnston, B., Patterson, A., Bird, L., Wilson, E., Almack, K., Mathews, G., & Seymour, J. (2018). Impact of the Macmillan specialist Care at Home service: a mixed methods evaluation across six sites. BMC Palliative Care, 17(1), 36. https://doi.org/10.1186/s12904-018-0281-9

Lamppu, P. J., Laurila, J., Finne-Soveri, H., Laakkonen, M.-L., Kautiainen, H., & Pitkälä, K. H. (2019). Training nursing home staff to improve residents’ end-of-life care: design and baseline findings from a randomized controlled trial. European Geriatric Medicine, 10(4), 649–657. https://doi.org/10.1007/s41999-019-00200-5

Larissa, K., Coutinho, B., & Teixeira, F. B. (2021). Atenção domiciliar: Desafios para a promoção da saúde de idosos Home care : Challenges for the promotion of elderly health Atención en el hogar : Desafíos para la promoción de la salud de los ancianos. 2021, 1–6.

Leandro, T. A., Alves, A. M., Pinheiro, A. K. B., Araujo, T. L. de, Quirino, G. da S., & Oliveira, D. R. de. (2019). Nurses’ competencies in health promotion for homebound older people. Revista Brasileira de Enfermagem, 72(suppl 2), 311–318. https://doi.org/10.1590/0034-7167-2018-0446

Little, S., Rodgers, G., & Fitzpatrick, J. M. (2019). Managing deterioration in older adults in care homes: a quality improvement project to introduce an early warning tool. British Journal of Community Nursing, 24(2), 58–66. https://doi.org/10.12968/bjcn.2019.24.2.58

Malta, D. C., Bernal, R. T. I., Lima, M. G., Araújo, S. S. C. de, Silva, M. M. A. da, Freitas, M. I. de F., & Barros, M. B. de A. (2017). Noncommunicable diseases and the use of health services: analysis of the National Health Survey in Brazil. Revista de Saúde Pública, 51(suppl 1). https://doi.org/10.1590/s1518-8787.2017051000090

Marques, F. P., & Bulgarelli, A. F. (2020). The significance of home care in caring for the elderly in their twilight years: The human perspective of the SUS professional. Ciencia e Saude Coletiva, 25(6), 2063–2072. https://doi.org/10.1590/1413-81232020256.21782018

Meireles, D. S. de, Bittencourt, G. K. G. D., Montenegro, C. P. D., Fortunato, C. N., Melo, G. M. O. G. de, Soares, H. de S., … Santos, M. S. dos. (2020). Assistência de enfermagem ao idoso em cuidados paliativos: um relato de experiência. Brazilian Journal of Development, 6(6), 40854–40867. https://doi.org/10.34117/BJDV6N6-576

Mestre, T. F. S., & Silva, C. A. da. (2020). Realidades do mundo do trabalho de uma equipa comunitária de suporte em cuidados paliativos e as suas implicações nos cuidados aos doentes em trajetórias de fim de vida. Sociologia: Revista Da Faculdade de Letras Da Universidade Do Porto, 40, 35–56. https://doi.org/10.21747/08723419/soc40a2

Mitchell, G. K., Senior, H. E., Bibo, M. P., Makoni, B., Young, S. N., Rosenberg, J. P., & Yates, P. (2016). Evaluation of a pilot of nurse practitioner led, GP supported rural palliative care provision. BMC Palliative Care, 15(1), 93. https://doi.org/10.1186/s12904-016-0163-y

Nunes De Moraes, E. (2012). ATENÇÃO À SAÚDE DO IDOSO: Aspectos Conceituais (1a). Brasília.

Okoli, C., Duarte, T. por:David W. A., & Mattar, R. técnica e introdução:João. (2019). Guia Para Realizar uma Revisão Sistemática de Literatura. EaD Em Foco, 9(1). https://doi.org/10.18264/EADF.V9I1.748

Passarelles, D. M. do A., Rios, A. A., & Santana, R. F. (2019). Diagnósticos de enfermería en cuidados paliativos oncológicos: revisión integrativa. Enfermeria Global, 18(3), 579–589. https://doi.org/10.6018/EGLOBAL.18.3.345201

Perreira, B. dos R., Jesus, I. M. O. de, & Martins, M. M. F. (2020). Perfil sociodemográfico da mortalidade da população idosa no nordeste brasileiro. 18, 9–21. https://doi.org/https//doi.org/10.13037/ras.vol18n64.6273

Roberts, D., McLeod, B., Stajduhar, K. I., Webber, T., & Milne, K. (2014). Applying Research Into Practice. Home Healthcare Nurse, 32(2), 88–95. https://doi.org/10.1097/NHH.0000000000000018

Rotter, B., & Grant, M. (2018). Symptom Assessment and Hospital Utilization in a Home-Based Palliative Care Program. Journal of Hospice & Palliative Nursing, 20(4), 332–337. https://doi.org/10.1097/NJH.0000000000000448

Sanvezzo, V. M. de S., Montandon, D. S., & Esteves, L. S. F. (2018). Instrumentos de avaliação de funcionalidade de idosos em cuidados paliativos: uma revisão integrativa. Revista Brasileira Geriatria Gerontológica, 21(5), 627–638. Retrieved from https://www.scielo.br/pdf/rbgg/v21n5/pt_1809-9823-rbgg-21-05-00604.pdf

Stajduhar, K. I., Funk, L., Roberts, D., McLeod, B., Cloutier-Fisher, D., Wilkinson, C., & Purkis, M. E. (2011). Home care nurses’ decisions about the need for and amount of service at the end of life. Journal of Advanced Nursing, 67(2), 276–286. https://doi.org/10.1111/j.1365-2648.2010.05491.x

Torres, K. R. B. de O., Campos, M. R., Luiza, V. L., & Caldas, C. P. (2020). Evolução das políticas públicas para a saúde do idoso no contexto do Sistema Único de Saúde. Physis: Revista de Saúde Coletiva, 30(1), 1–22. https://doi.org/10.1590/s0103-73312020300113

Veras, R. (2020). A contemporary and innovative care model for older adults. Revista Brasileira de Geriatria e Gerontologia, 23(1). https://doi.org/10.1590/1981-22562020023.200061

Wenger, N. S., Roth, C. P., Martin, D., Nickels, L., Beckman, R., Kamberg, C., … Ganz, D. A. (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. https://doi.org/10.1111/j.1532-5415.2011.03599.x

Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of advanced nursing, 52(5), 546-553.

World Health Organization. (2018). Integrating palliative care and sympton relief into primary health care (1st ed.). Geneva.

World Health Organization. (2020). Global Atlas Of Palliative Care. Retrieved from www.thewhpca.orgwww.thewhpca.org

Zulueta Egea, M., Prieto-Ursúa, M., & Bermejo Toro, L. (2020). Good palliative nursing care: Design and validation of the palliative nursing care quality scale (PNCQS). Journal of Advanced Nursing, 76(10), 2757–2767. https://doi.org/10.1111/jan.14464

Published

17/08/2021

How to Cite

SOUZA, T. de M. .; SOARES, L. A. e C. .; BARBOSA, S. de S.; TOLEDO, S. T. .; REZENDE, M. S. .; CASTRO, E. A. B. de. Nursing actions in home palliative care for the elderly supported by multidimensional assessments: integrative review. Research, Society and Development, [S. l.], v. 10, n. 10, p. e520101018989, 2021. DOI: 10.33448/rsd-v10i10.18989. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/18989. Acesso em: 25 nov. 2024.

Issue

Section

Health Sciences