Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients

Detalhes bibliográficos
Autor(a) principal: Reis-Pina, Paulo
Data de Publicação: 2019
Outros Autores: dos Santos, Rita Gameiro
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911
Resumo: Palliative care in oncology is an interdisciplinary approach, centered on patients and their families, carried out along the course of neoplastic diseases, based on symptom control, assertive communication and shared decision-making. Although clinical guidelines recommend a holistic intervention, early integration of palliative care into traditional oncological treatment, research shows a great delay in referral of patients, restricting palliative care to end-of-life care. Why does there seem to be a rationing of the early referral, sometimes in violation of human dignity? To a large extent it has to do with lack of knowledge, training and education of health professionals about palliative care and the techniques to deal with the process of death and dying. Several studies have demonstrated the benefit of integrating palliative actions into the routine of active cancer treatments, not only in terms of effective control of physical and psychological symptoms, but also in terms of overall quality of life, patient and family satisfaction, health care costs and survival in some cases. It is necessary to take measures that encourage oncologists to obtain further training in palliative care, as a formal, compulsory internship, integrated in their specific training program. This way, a new generation of physicians will surely change the lives of cancer patients, and their families, integrating — without disproportionate rationing — oncology and palliative medicine.
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spelling Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer PatientsReferenciação Precoce para Cuidados Paliativos: O Racionamento dos Cuidados Eficientes de Saúde em Doentes OncológicosDelivery of Health CareIntegratedPalliative CarePatient Care TeamReferral and ConsultationTerminal CareCuidados PaliativosCuidados TerminaisEncaminhamento e ConsultaEquipa de Assistência ao DoentePrestação Integrada de Cuidados de SaúdePalliative care in oncology is an interdisciplinary approach, centered on patients and their families, carried out along the course of neoplastic diseases, based on symptom control, assertive communication and shared decision-making. Although clinical guidelines recommend a holistic intervention, early integration of palliative care into traditional oncological treatment, research shows a great delay in referral of patients, restricting palliative care to end-of-life care. Why does there seem to be a rationing of the early referral, sometimes in violation of human dignity? To a large extent it has to do with lack of knowledge, training and education of health professionals about palliative care and the techniques to deal with the process of death and dying. Several studies have demonstrated the benefit of integrating palliative actions into the routine of active cancer treatments, not only in terms of effective control of physical and psychological symptoms, but also in terms of overall quality of life, patient and family satisfaction, health care costs and survival in some cases. It is necessary to take measures that encourage oncologists to obtain further training in palliative care, as a formal, compulsory internship, integrated in their specific training program. This way, a new generation of physicians will surely change the lives of cancer patients, and their families, integrating — without disproportionate rationing — oncology and palliative medicine.Os cuidados paliativos oncológicos constituem uma abordagem interdisciplinar, centralizada no doente e nas suas famílias, realizada ao longo da trajetória das doenças neoplásicas, alicerçada no controlo de sintomas, na comunicação assertiva e na tomada de decisão compartilhada. Apesar de as normas de orientação clínica aconselharem uma intervenção holística, integrando precocemente os cuidados paliativos no tratamento oncológico tradicional, a investigação demonstra um grande atraso na referenciação dos doentes, restringindo os cuidados paliativos no fim de vida. Por que razão parece existir um racionamento da referenciação precoce, atentatório da dignidade humana? Em grande parte, é por falta de conhecimento, treino e educação dos profissionais de saúde sobre os cuidados paliativos e as técnicas para lidar com o processo de morrer e a morte. Vários estudos demonstram o benefício da integração de ações paliativas na rotina dos tratamentos oncológicos ativos, não só a nível do controlo eficaz de sintomas físicos e psicológicos, mas a nível da qualidade de vida global, da satisfação do doente e da família, dos custos dos cuidados de saúde e também da sobrevida, em alguns casos. É necessário tomar medidas que encorajem o oncologista a obter mais formação em cuidados paliativos, como um estágio formal, obrigatório, integrado no seu internato de formação específica. Deste modo, uma nova geração de médicos mudará seguramente a vida dos doentes com cancro, e suas famílias, integrando — sem racionamento desproporcionado — oncologia e medicina paliativa.Ordem dos Médicos2019-08-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/vnd.openxmlformats-officedocument.wordprocessingml.documentapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911oai:ojs.www.actamedicaportuguesa.com:article/11911Acta Médica Portuguesa; Vol. 32 No. 7-8 (2019): July-August; 475-476Acta Médica Portuguesa; Vol. 32 N.º 7-8 (2019): Julho-Agosto; 475-4761646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/5726https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/11179https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/11284https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/11307Direitos de Autor (c) 2019 Acta Médica Portuguesainfo:eu-repo/semantics/openAccessReis-Pina, Paulodos Santos, Rita Gameiro2022-12-20T11:06:26Zoai:ojs.www.actamedicaportuguesa.com:article/11911Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:20:06.231549Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
Referenciação Precoce para Cuidados Paliativos: O Racionamento dos Cuidados Eficientes de Saúde em Doentes Oncológicos
title Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
spellingShingle Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
Reis-Pina, Paulo
Delivery of Health Care
Integrated
Palliative Care
Patient Care Team
Referral and Consultation
Terminal Care
Cuidados Paliativos
Cuidados Terminais
Encaminhamento e Consulta
Equipa de Assistência ao Doente
Prestação Integrada de Cuidados de Saúde
title_short Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
title_full Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
title_fullStr Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
title_full_unstemmed Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
title_sort Early Referral to Palliative Care: The Rationing of Timely Health Care for Cancer Patients
author Reis-Pina, Paulo
author_facet Reis-Pina, Paulo
dos Santos, Rita Gameiro
author_role author
author2 dos Santos, Rita Gameiro
author2_role author
dc.contributor.author.fl_str_mv Reis-Pina, Paulo
dos Santos, Rita Gameiro
dc.subject.por.fl_str_mv Delivery of Health Care
Integrated
Palliative Care
Patient Care Team
Referral and Consultation
Terminal Care
Cuidados Paliativos
Cuidados Terminais
Encaminhamento e Consulta
Equipa de Assistência ao Doente
Prestação Integrada de Cuidados de Saúde
topic Delivery of Health Care
Integrated
Palliative Care
Patient Care Team
Referral and Consultation
Terminal Care
Cuidados Paliativos
Cuidados Terminais
Encaminhamento e Consulta
Equipa de Assistência ao Doente
Prestação Integrada de Cuidados de Saúde
description Palliative care in oncology is an interdisciplinary approach, centered on patients and their families, carried out along the course of neoplastic diseases, based on symptom control, assertive communication and shared decision-making. Although clinical guidelines recommend a holistic intervention, early integration of palliative care into traditional oncological treatment, research shows a great delay in referral of patients, restricting palliative care to end-of-life care. Why does there seem to be a rationing of the early referral, sometimes in violation of human dignity? To a large extent it has to do with lack of knowledge, training and education of health professionals about palliative care and the techniques to deal with the process of death and dying. Several studies have demonstrated the benefit of integrating palliative actions into the routine of active cancer treatments, not only in terms of effective control of physical and psychological symptoms, but also in terms of overall quality of life, patient and family satisfaction, health care costs and survival in some cases. It is necessary to take measures that encourage oncologists to obtain further training in palliative care, as a formal, compulsory internship, integrated in their specific training program. This way, a new generation of physicians will surely change the lives of cancer patients, and their families, integrating — without disproportionate rationing — oncology and palliative medicine.
publishDate 2019
dc.date.none.fl_str_mv 2019-08-01
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/5726
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/11179
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/11284
https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/11911/11307
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2019 Acta Médica Portuguesa
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 32 No. 7-8 (2019): July-August; 475-476
Acta Médica Portuguesa; Vol. 32 N.º 7-8 (2019): Julho-Agosto; 475-476
1646-0758
0870-399X
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