Transición del hospital al hogar de pacientes en cuidados paliativos a la luz de la teoría de Afaf Ibrahim Meleis
DOI:
https://doi.org/10.5216/ree.v27.77687Palabras clave:
Cuidados Paliativos, Alta del Paciente, Cuidado de Transición, Teoría de Enfermería, EnfermeríaResumen
Objetivo: reflexionar sobre el proceso de transición del hospital al hogar de pacientes en cuidados paliativos, a partir de la Teoría de las Transiciones de Afaf Ibrahim Meleis. Métodos: estudio teórico-reflexivo, basado en publicaciones (búsqueda no sistemática) sobre la temática en los idiomas portugués, español e inglés, publicadas entre 2018 y 2023, en las siguientes fuentes de información: Embase, LILACS, MEDLINE (vía PubMed de la National Library of Medicine) y Web of Science, utilizando los descriptores controlados: Cuidado de transición, Alta del paciente y Cuidados paliativos. Resultados: las reflexiones se presentan en tres ejes temáticos: condicionantes facilitadores en el proceso de transición hospital-hogar de pacientes en cuidados paliativos; condicionantes inhibidores en el proceso de transición hospital-hogar de pacientes en cuidados paliativos; e intervenciones terapéuticas de enfermería. Conclusión: es imprescindible que los profesionales de la salud observen, evalúen y planifiquen la transición, considerando todos los condicionantes facilitadores e inhibidores del proceso, con el fin de garantizar la continuidad de una atención segura para pacientes en cuidados paliativos y sus familiares.
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Radbruch L, Lima L, Knaul F, Wenk R, Ali Z, Bhatnaghar S, et al. Redefining palliative care - a new consensus-based definition. J Pain Symptom Manage. 2020 May 6;60(4):754–64. https://doi.org/10.1016/j.jpainsymman.2020.04.027
Ministério da Saúde (BR), Secretaria-Executiva, Superintendência Estadual do Ministério da Saúde no Rio de Janeiro. Desospitalização: reflexões para o cuidado em saúde e atuação multiprofissional [Internet]. Brasília: Ministério da Saúde; 2020 [cited 2023 May 15]. 170 p. Available from: https://bvsms.saude.gov.br/bvs/publicacoes/desospitalizacao_reflexoes_cuidado_atuacao_multiprofissional.pdf
Weetman K, Dale J, Mitchell SJ, Ferguson C, Finucane AM, Buckle P, et al. Communication of palliative care needs in discharge letters from hospice providers to primary care: a multisite sequential explanatory mixed methods study. BMC Palliative Care. 2022 Sept 6;21:155. https://doi.org/10.1186/s12904-022-01038-8
Coleman EA, Boult C. improving the quality of transitional care for persons with complex care Needs. J Am Geriatr Soc. 2003 Mar 26;51(4):556-7. https://doi.org/10.1046/j.1532-5415.2003.51186.x
Souza FN, Silva VG, Silva AS. Factors associated with emergency room visits or hospitalization in care oncology home care: an integrative review. R Pesq Cuid Fundam. 2023;15:e12000. https://doi.org/10.9789/2175-5361.rpcfo.v15.12000
Cordeiro FR, Kruse MHL. It possible to die at home? Analysis of the Brazilian and French scenarios. Texto contexto - enferm. 2019 Apr 8;28:e20170602. https://doi.org/10.1590/1980-265X-TCE-2017-0602
Freire MOL, Gomes WL, Braga JEF, Macêdo JQ. Compreensão de pacientes sobre a continuidade do pós-operatório, a partir do autocuidado domiciliar. Ciencia y Enfermeria. 2021;27:4. https://doi.org/10.29393/ce27-4cpml40004
Santos TL, Laprano MGG, Conceição AP. Orientações de alta hospitalar para o desempenho do autocuidado após a cirurgia cardíaca: revisão integrativa. Rev baiana enferm. 2020 July 27;34:e35284. https://doi.org/10.18471/rbe.v34.35284
Silva FRR, Pereira RA, Souza AC, Gimenes FRE, Simino GPR, Dessote CAM, et al. Construction and validation of a booklet for home palliative care after hospital discharge. Acta Paul Enferm. 2022;35:eAPE028112. https://doi.org/10.37689/acta-ape/2022AO02812
Meleis AI. Transitions Theory: Middle range and situation- specific theories in research and nursing practice. New York: Springer Publishing Company; 2010.
Mertens F, Sercu M, Derycke A, Naert L, Deliens L, Deveugele M, et al. Patients’ experiences of transfers between care settings in palliative care: an interview study. Ann Palliat Med. 2022 Sept 27;11(9):2830-43. https://doi.org/10.21037/apm-22-146
Marston C, Morgan DD, Philip J, Agar MR. Experience and acceptability of a carer-focussed intervention in acute oncology settings: A qualitative study of people with advanced cancer and their carers. Aust Occup Ther J. 2023 June 4;70(5):570–80. https://doi.org/10.1111/1440-1630.12887
Isenberg SR, Killackey T, Saunders S, Scott M, Ernecoff NC, Bush SH, et al. “Going Home [Is] Just a Feel-Good Idea With No Structure”: A Qualitative Exploration of Patient and Family Caregiver Needs When Transitioning From Hospital to Home in Palliative Care. J Pain Symptom Manage. 2021 Feb 22;62(3):e9-19. https://doi.org/10.1016/j.jpainsymman.2021.02.026
Lundereng ED, Dihle A, Steindal SA. Nurses’ experiences and perspectives on collaborative discharge planning when patients receiving palliative care for cancer are discharged home from hospitals. J Clin Nurs. 2020 June 13;29:3382-91. https://doi.org/10.1111/jocn.15371
Arias-Rojas M, Carreño-Moreno S, Posada-López C. Incerteza dos cuidadores familiares na doença de pacientes sob cuidados paliativos e fatores associados. Rev Lat Am Enfermagem. 2019 Oct 14;27:e3200. https://doi.org/10.1590/1518-8345.3185.3200
Van Der Plas AGM, Oosterveld-Vlug MG, Pasman HR, Schweitzer B, Onwuteaka-Philipsen BD. Continuity of GP care after the last hospitalization for patients who died from cancer, chronic obstructive pulmonary disease or heart failure: a retrospective cohort study using administrative data. Fam Pract. 2018 June 30;36(3):304-9. https://doi.org/10.1093/fampra/cmy065
Olario PS, Moreira MC, Moreira IB, Martins JCA, Souza AT. Desospitalização em cuidado paliativos: perfil dos usuários de uma unidade no Rio de Janeiro/ Brasil. Cogitare Enferm. 2018 July 5;23(2):e53787. https://doi.org/10.5380/ce.v23i2.53787
Acosta AM, Câmara CE, Weber LAF, Fontenele RM. Atividades do enfermeiro na transição do cuidado: realidades e desafios. Rev enferm UFPE on line. 2018 Dec 2;12(12):3190-7. https://doi.org/10.5205/1981-8963-v12i12a231432p3190-3197-2018
Saunders S, Weiss ME, Meaney C, Killackey T, Varenbut J, Lovrics E, et al. Examining the course of transitions from hospital to home-based palliative care: A mixed methods study. Palliat Med. 2021 Sept 2;35(8):1590-601. https://doi.org/10.1177/02692163211023682
Scott M, Shaver N, Lapenskie J, Isenberg SR, Saunders S, Hsu AT, et al. Does inpatient palliative care consultation impact outcomes following hospital discharge? A narrative systematic review. Palliat Med. 2020 Oct 4;34(1):5-15. https://doi.org/10.1177/0269216319870649
Killackey T, Lovrics E, Saunders S, Isenberg SR. Palliative care transitions from acute care to community-based care: A qualitative systematic review of the experiences and perspectives of health care providers. Palliat Med. 2020 Aug 8;34(10):1316-31. https://doi.org/10.1177/0269216320947601
Villalon GE. Continuidad del cuidado. Evidencia Actualizacion En La práctica Ambulatoria. 2021;21(1):e002112. https://doi.org/10.51987/evidencia.v24i1.6922
Almeida Filho RF, Trezza MCSF, Comassetto I, Silva LKB, Lopes MP, Santana KGS, et al. Espiritualidade na incerteza da doença: a perspectiva de pacientes oncológicos. Rev Bras Enferm. 2023 Oct 9;76(4):e20220712. https://doi.org/10.1590/0034-7167-2022-0712pt
Santos AFJ, Ferreira EAL, Guirro UBP. Atlas dos Cuidados Paliativos no Brasil 2019 [Internet]. São Paulo: Academia Nacional de Cuidados Paliativos (ANCP); 2020 [cited 2025 June 03]. 52 p. Available from: https://paliativo.org.br/wp-content/uploads/2020/05/ATLAS_2019_final_compressed.pdf
Portaria nº 825 do Ministério da Saúde, de 25 de abril de 2016 (BR). Redefine a Atenção Domiciliar no âmbito do Sistema Único de Saúde (SUS) e atualiza as equipes habilitadas [Internet]. Brasília: Ministério da Saúde; 2016 [cited 2023 June 06]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/gm/2016/prt0825_25_04_2016.html
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Derechos de autor 2025 Revista Eletrônica de Enfermagem
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
