DSpace Collection:
https://hdl.handle.net/10171/60424
2024-03-29T11:57:32ZThe state of transience, and its influence on the wish to die of advanced disease patients: insights from a qualitative phenomenological study
https://hdl.handle.net/10171/69219
Title: The state of transience, and its influence on the wish to die of advanced disease patients: insights from a qualitative phenomenological study
Abstract: Background: The experience of Wish to Die is common in patients living with Advanced Disease. It has been studied worldwide and qualitative studies have contributed to the understanding of the complexity of the phenomenon of the WTD but a deeper understanding on the individual's views is still needed. The objective of this study was to identify common characteristics of the experience of wish to die in advanced disease.
Methods: A phenomenological study was carried out with multicenter participation of patients with advanced disease who had expressed their wish to die to health professionals. Semi-structured interviews were employed to obtain an in-depth perspective of each patient's lived experience. A phenomenological analysis of the data collected was performed to describe and explore the characteristic aspects of the phenomenon under study.
Results: Fourteen patients with advanced disease were interviewed. Most of them had cancer. In the analysis of the patients' accounts of their experiences, three common characteristics were identified: a) experiencing a state of transience; b) the attempt to reconnect with oneself; and c) additional disease-related aspects that influence the wish to die. Patients expressed the need for a safe space to address the wish to die and the importance of receiving care that considers both 'being' and 'doing'.
Conclusions: Patients with advanced disease and wish to die experience a state of transience where the patient lives and ephemeral state of existence. Interventions focused on reinforcing the intrinsic value of the individual emerge as essential components of a compassionate accompaniment of those facing the wish to die.2024-01-01T00:00:00ZCaregivers burden in palliative care patients: a problem to tackle
https://hdl.handle.net/10171/68572
Title: Caregivers burden in palliative care patients: a problem to tackle
Abstract: Family members who are close to the patient may play the role of caregiver, well-being enhancer, diversity
of tasks fulfiller, minimizer and managing suffering, palliative care facilitator and responsible for the
continuity of care, apprentice and participant of health teams. The family caregiver often gives priority to
the problems of his dependent family member, becoming almost ‘invisible’ to the health system. It should
also be consider the relevance of this issue into future bereavement process. Considering all these aspects,
the family caregiver is often considered by the healthcare teams as ‘overall tasks’ performers’.2016-01-01T00:00:00ZHow to Advance Palliative Care Research in South America? Findings From a Delphi Study
https://hdl.handle.net/10171/68466
Title: How to Advance Palliative Care Research in South America? Findings From a Delphi Study
Abstract: Context. Progress in palliative care (PC) necessarily involves scientific development. However, research conducted in South
America (SA) needs to be improved.
Objectives. To develop a set of recommendations to advance PC research in SA.
Methods. Eighteen international PC experts participated in a Delphi study. In round one, items were developed (open-
ended questions); in round two, each expert scored the importance of each item (from 0 to 10); in round three, they selected
the 20 most relevant items. Throughout the rounds, the five main priority themes for research in SA were defined. In Round
three, consensus was defined as an agreement of ≥75%.
Results. 60 potential suggestions for overcoming research barriers in PC were developed in round one. Also in Round one,
88.2% (15 of 17) of the experts agreed to define a priority research agenda. In Round two, the 36 most relevant suggestions
were defined and a new one added. Potential research priorities were investigated (open-ended). In Round three, from the 37
items, 10 were considered the most important. Regarding research priorities, symptom control, PC in primary care, public poli-
cies, education and prognosis were defined as the most relevant.
Conclusion. Potential strategies to improve scientific research on PC in SA were defined, including stimulating the formation
of collaborative research networks, offering courses and workshops on research, structuring centers with infrastructure resour-
ces and trained researchers, and lobbying governmental organizations to convince about the importance of palliative care. In addition, priority research topics were identified in the region.2023-01-01T00:00:00ZAnálisis de costo-efectividad de los cuidados paliativos a pacientes oncológicos de fin de vida
https://hdl.handle.net/10171/68465
Title: Análisis de costo-efectividad de los cuidados paliativos a pacientes oncológicos de fin de vida
Abstract: En pacientes con enfermedad terminal, los servicios de cuidados paliativos do-
miciliarios pueden alinear sus preferencias de cuidado en domicilio con resul-
tados sanitarios deseables. El objetivo fue estudiar la costo-efectividad de los
cuidados paliativos domiciliarios en pacientes oncológicos en el último año de
vida en el subsector público de salud de una provincia argentina. Se desarrolló
un modelo de Markov de costo-efectividad desde una perspectiva social y del
financiador de salud, de modo que el mismo pudiera reflejar la realidad de
los cuidados paliativos domiciliarios en el ámbito local, en comparación con
los cuidados habituales. Se calcularon los costos directos para el sistema de
salud, con base en información local, así como también los costos indirectos
de los cuidados informales no remunerados. La provisión de cuidados palia-
tivos incrementó en un 10,32% la probabilidad que los pacientes fallezcan
en el hogar, en relación con los cuidados habituales, con un ahorro anual de
USD 750 y USD 1.012 por paciente desde la perspectiva social y del financia-
dor, respectivamente, en el subsector público de salud de Río Negro. Tanto des-
de la perspectiva social como del financiador, la estrategia de implementación
de un servicio organizado de cuidados tiene una mayor efectividad, medida en
porcentaje de pacientes que fallecen en su domicilio, a un menor costo. El prin-
cipal inductor de costos corresponde, desde la perspectiva social, a los cuidados
informales provistos por las familias, mientras que desde la perspectiva del
financiador corresponde a los salarios del personal de salud.; Home palliative care services of terminal patients
may associate home care preferences with desir-
able health outcomes. This study aimed to evalu-
ate the cost-effectiveness of home palliative care of
cancer patients in the last year of life in the pub-
lic health subsector in a province of Argentina. A
cost-effectiveness Markov model was developed
from a social and the health funder’s perspective
in order to reflect the reality of home palliative
care at the local level compared with usual care.
Direct costs to the health system and indirect costs
of unpaid informal care were estimated based on
local information. Palliative care increased the
likelihood of patients dying at home by 10.32%
compared with usual care, with annual savings of
USD 750 and USD 1,012 per patient, respectively,
from both the social and the funder’s perspec-
tive in the public health subsector in Río Negro.
From both the social and financial perspective, the
strategy to implement organized care services was
more effective and lower-cost, measured by the
percentage of patients who died at home. From a
social perspective, the main cost inducer was the
formal care provided by families, but from the
funder’s perspective, it refers to the salaries of the
health team.; Os serviços de cuidados paliativos domiciliares de
pacientes terminais podem associar as preferên-
cias de cuidado domiciliar com resultados desejá-
veis de saúde. O objetivo deste texto foi avaliar a
relação custo-efetividade dos cuidados paliativos
domiciliares em pacientes oncológicos no último
ano de vida, no subsetor de saúde pública de uma
província na Argentina. Um modelo Markov de
custo-efetividade foi desenvolvido a partir de uma
perspectiva social e do financiador de saúde para
que pudesse refletir a realidade dos cuidados pa-
liativos domiciliares em âmbito local comparado
aos cuidados habituais. Os custos diretos para o
sistema de saúde e os custos indiretos de cuidados
informais não remunerados foram calculados com
base em informações locais. A prestação de cuida-
dos paliativos aumentou 10,32% a probabilidade
de os doentes morrerem em casa em relação com
os cuidados habituais, com uma economia anual
de USD 750 e USD 1.012 por paciente, respeti-
vamente, na perspectiva social e do financiador,
no subsetor da saúde pública de Rio Negro. Tan-
to do ponto de vista social como no financeiro, a
estratégia de implantação de serviços de cuidados
organizados foi mais eficaz e com menor custo,
medida pelo percentual de pacientes que faleceram
em casa. O principal indutor de custos correspon-
de, do ponto de vista social, aos cuidados infor-
mais prestados pelas famílias, enquanto do ponto
de vista do financiador se refere aos salários da
equipe de saúde.2023-01-01T00:00:00Z