Palliative care in emergency care: invoking Kairos and rethinking health care systems

Detalhes bibliográficos
Autor(a) principal: Diego Lima Ribeiro
Data de Publicação: 2022
Outros Autores: Marco Antonio de Carvalho Filho
Tipo de documento: Artigo
Idioma: eng
por
Título da fonte: Cadernos de Saúde Pública
Texto Completo: https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004
Resumo: Acute crises of decompensation of a chronic disease are, in most cases, handled in an Emergency Room setting. In these services, emergency care professionals face several challenges, such as incomplete information on the patient’s disease, scarce resources, and the pressure of having to make decisions in a short time. In this context, what can be done to provide patient-centered care that is at the same time technically appropriate and aligned with their values? Understanding the patient's situation in relation to their disease; talking to the patient about their clinical condition, comprehending their values and feelings; and understanding time as Kairos - that is, the time of the consultation as an opportunity to understand the patient’s needs and build a shared therapeutic plan - are possible solutions to this challenge. Proper handling of patients with severe diseases requires that all links of health care systems are functional and coordinated from primary health care to hospital and home care, starting with the education of health care professionals and the strengthening of work settings that foster the expression of Kairos. This is a long and fundamental path for health care systems such as the Brazilian Unified National Health System (SUS) and that health managers and professionals should not afford to ignore.
id FIOCRUZ-5_357c047433a190a4f2abf211b50dad8e
oai_identifier_str oai:ojs.teste-cadernos.ensp.fiocruz.br:article/8004
network_acronym_str FIOCRUZ-5
network_name_str Cadernos de Saúde Pública
repository_id_str
spelling Palliative care in emergency care: invoking Kairos and rethinking health care systemsCuidados paliativos na emergência: invocando Kairós e repensando os sistemas de saúdePalliative CareEmergency Medical ServicesDelivery of Health CareCuidados PaliativosServiços Médicos de EmergênciaAtenção à SaúdeAcute crises of decompensation of a chronic disease are, in most cases, handled in an Emergency Room setting. In these services, emergency care professionals face several challenges, such as incomplete information on the patient’s disease, scarce resources, and the pressure of having to make decisions in a short time. In this context, what can be done to provide patient-centered care that is at the same time technically appropriate and aligned with their values? Understanding the patient's situation in relation to their disease; talking to the patient about their clinical condition, comprehending their values and feelings; and understanding time as Kairos - that is, the time of the consultation as an opportunity to understand the patient’s needs and build a shared therapeutic plan - are possible solutions to this challenge. Proper handling of patients with severe diseases requires that all links of health care systems are functional and coordinated from primary health care to hospital and home care, starting with the education of health care professionals and the strengthening of work settings that foster the expression of Kairos. This is a long and fundamental path for health care systems such as the Brazilian Unified National Health System (SUS) and that health managers and professionals should not afford to ignore.Las crisis agudas de descompensación de una enfermedad crónica se manejan con mayor frecuencia en un entorno de Urgencias. En estos servicios, los profesionales de urgencias se enfrentan a varios desafíos como la falta de información completa sobre la enfermedad del paciente, la escasez de recursos y la presión de tener que tomar decisiones en poco tiempo. En ese contexto, ¿qué se puede hacer para proporcionar un cuidado centrado en el paciente, que sea al mismo tiempo técnicamente adecuado y alineado a sus valores? Comprender la situación del paciente con respecto a su enfermedad; hablar con el paciente sobre su condición clínica, comprender sus valores y sentimientos; comprender el tiempo como Kairós, es decir, el tiempo de consulta como una oportunidad para comprender las necesidades del paciente y construir un plan terapéutico compartido, son posibles soluciones a este desafío. El manejo adecuado de los pacientes con enfermedades graves requiere que todos los eslabones de los sistemas de salud funcionen y se integren desde la atención primaria a la salud hasta la asistencia hospitalaria y la atención domiciliaria; teniendo como punto de partida la educación de los profesionales de salud y el fortalecimiento de ambientes de trabajo que favorezcan la expresión de los Kairós. Se trata de un camino largo y fundamental para los sistemas de salud como el Sistema Único de Salud brasileño (SUS) y qué los gestores y profesionales de salud no deberían darse el lujo de ignorar.As crises agudas de descompensação de uma doença crônica são, na maioria das vezes, manejadas em ambiente de pronto-socorro. Nesses serviços, os profissionais emergencistas enfrentam vários desafios, como falta de informação completa sobre a doença do paciente, escassez de recursos e a pressão de ter que tomar decisões em pouco tempo. Nesse contexto, o que pode ser feito para prestar um cuidado centrado no paciente, que seja, ao mesmo tempo, tecnicamente adequado e alinhado a seus valores? Compreender a situação do paciente em relação a sua doença; conversar com o paciente sobre sua condição clínica, compreendendo seus valores e sentimentos; entender o tempo como Kairós, ou seja, o tempo da consulta como uma oportunidade de entender as necessidades do paciente, e construir um plano terapêutico compartilhado são possíveis soluções para esse desafio. O manejo adequado de pacientes portadores de doenças graves demanda que todos os elos dos sistemas de saúde estejam em funcionamento e integrados desde a atenção primária à saúde até a assistência hospitalar e a atenção domiciliar, tendo como ponto de partida a educação dos profissionais de saúde e o fortalecimento de ambientes de trabalho que favoreçam a expressão de Kairós. Trata-se de um caminho longo e fundamental para sistemas de saúde como o Sistema Único de Saúde (SUS) e que gestores e profissionais de saúde não deveriam se dar ao luxo de ignorar.Reports in Public HealthCadernos de Saúde Pública2022-09-23info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmltext/htmlapplication/pdfapplication/pdfhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004Reports in Public Health; Vol. 38 No. 9 (2022): SeptemberCadernos de Saúde Pública; v. 38 n. 9 (2022): Setembro1678-44640102-311Xreponame:Cadernos de Saúde Públicainstname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZengporhttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17928https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17929https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17930https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17931Diego Lima RibeiroMarco Antonio de Carvalho Filhoinfo:eu-repo/semantics/openAccess2024-03-06T15:30:19Zoai:ojs.teste-cadernos.ensp.fiocruz.br:article/8004Revistahttps://cadernos.ensp.fiocruz.br/ojs/index.php/csphttps://cadernos.ensp.fiocruz.br/ojs/index.php/csp/oaicadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br1678-44640102-311Xopendoar:2024-03-06T13:09:11.501777Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)true
dc.title.none.fl_str_mv Palliative care in emergency care: invoking Kairos and rethinking health care systems
Cuidados paliativos na emergência: invocando Kairós e repensando os sistemas de saúde
title Palliative care in emergency care: invoking Kairos and rethinking health care systems
spellingShingle Palliative care in emergency care: invoking Kairos and rethinking health care systems
Diego Lima Ribeiro
Palliative Care
Emergency Medical Services
Delivery of Health Care
Cuidados Paliativos
Serviços Médicos de Emergência
Atenção à Saúde
title_short Palliative care in emergency care: invoking Kairos and rethinking health care systems
title_full Palliative care in emergency care: invoking Kairos and rethinking health care systems
title_fullStr Palliative care in emergency care: invoking Kairos and rethinking health care systems
title_full_unstemmed Palliative care in emergency care: invoking Kairos and rethinking health care systems
title_sort Palliative care in emergency care: invoking Kairos and rethinking health care systems
author Diego Lima Ribeiro
author_facet Diego Lima Ribeiro
Marco Antonio de Carvalho Filho
author_role author
author2 Marco Antonio de Carvalho Filho
author2_role author
dc.contributor.author.fl_str_mv Diego Lima Ribeiro
Marco Antonio de Carvalho Filho
dc.subject.por.fl_str_mv Palliative Care
Emergency Medical Services
Delivery of Health Care
Cuidados Paliativos
Serviços Médicos de Emergência
Atenção à Saúde
topic Palliative Care
Emergency Medical Services
Delivery of Health Care
Cuidados Paliativos
Serviços Médicos de Emergência
Atenção à Saúde
description Acute crises of decompensation of a chronic disease are, in most cases, handled in an Emergency Room setting. In these services, emergency care professionals face several challenges, such as incomplete information on the patient’s disease, scarce resources, and the pressure of having to make decisions in a short time. In this context, what can be done to provide patient-centered care that is at the same time technically appropriate and aligned with their values? Understanding the patient's situation in relation to their disease; talking to the patient about their clinical condition, comprehending their values and feelings; and understanding time as Kairos - that is, the time of the consultation as an opportunity to understand the patient’s needs and build a shared therapeutic plan - are possible solutions to this challenge. Proper handling of patients with severe diseases requires that all links of health care systems are functional and coordinated from primary health care to hospital and home care, starting with the education of health care professionals and the strengthening of work settings that foster the expression of Kairos. This is a long and fundamental path for health care systems such as the Brazilian Unified National Health System (SUS) and that health managers and professionals should not afford to ignore.
publishDate 2022
dc.date.none.fl_str_mv 2022-09-23
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004
url https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004
dc.language.iso.fl_str_mv eng
por
language eng
por
dc.relation.none.fl_str_mv https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17928
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17929
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17930
https://cadernos.ensp.fiocruz.br/ojs/index.php/csp/article/view/8004/17931
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
text/html
application/pdf
application/pdf
dc.publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
publisher.none.fl_str_mv Reports in Public Health
Cadernos de Saúde Pública
dc.source.none.fl_str_mv Reports in Public Health; Vol. 38 No. 9 (2022): September
Cadernos de Saúde Pública; v. 38 n. 9 (2022): Setembro
1678-4464
0102-311X
reponame:Cadernos de Saúde Pública
instname:Fundação Oswaldo Cruz (FIOCRUZ)
instacron:FIOCRUZ
instname_str Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str FIOCRUZ
institution FIOCRUZ
reponame_str Cadernos de Saúde Pública
collection Cadernos de Saúde Pública
repository.name.fl_str_mv Cadernos de Saúde Pública - Fundação Oswaldo Cruz (FIOCRUZ)
repository.mail.fl_str_mv cadernos@ensp.fiocruz.br||cadernos@ensp.fiocruz.br
_version_ 1798943397098029056

Registros relacionados