Palliative care in emergency care: invoking Kairos and rethinking health care systems
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | |
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. |
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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 |
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1798943397098029056 |