Identification and characteristics of patients with palliative care needs in Brazilian primary care

BMC Palliative Care

Research Article

Marcos A. S. Cabrera¹  John P. Rosenberg²  Fernando C. I. Marcucci³  Marilia Maroneze Brun⁴  Anamaria Baquero Perilla⁴  Eder Marcos L. de Barros⁴  Vanessa M. Martins⁴  Patsy Yates⁵ 

[1] Department of Internal Medicine, Universidade Estadual de Londrina, Londrina, Brazil;Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia;Postgraduate Program in Public Health, Universidade Estadual de Londrina, Londrina, Brazil;Av. Robert Koch, 60. Vila Operaria, 86038-350, Londrina, Parana State, Brazil;School of Medicine, Universidade Estadual de Londrina, Londrina, Brazil;School of Nursing and Institute of Health and Biomedical Innovation, Queensland University of Technology, Kelvin Grove, Queensland, Australia;

关键词: Palliative care;    Primary health care;    Family health;    Government Programs;   

DOI  :  10.1186/s12904-016-0125-4

 received in 2016-02-10, accepted in 2016-05-24,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe Brazilian healthcare system offers universal coverage but lacks information about how patients with PC needs are serviced by its primary care program, Estratégia Saúde da Família (ESF).MethodsCross-sectional study in community settings. Patients in ESF program were screened using a Palliative Care Screening Tool (PCST). Included patients were assessed with Karnofsky Performance Scale (KPS), Edmonton Symptom Assessment System (ESAS) and Palliative Care Outcome Scale (POS).ResultsPatients with PC needs are accessing the ESF program regardless of there being no specific PC support provided. From 238 patients identified, 73 (43 women, 30 men) were identified as having a need for PC, and the mean age was 77.18 (95 % Confidence Interval = ±2,78) years, with non-malignant neurologic conditions, such as dementia and cerebrovascular diseases, being the most common (53 % of all patients). Chronic conditions (2 or more years) were found in 70 % of these patients, with 71 % scoring 50 or less points in the KPS. Overall symptom intensity was low, with the exception of some cases with moderate and high score, and POS average score was 14.16 points (minimum = 4; maximum = 28). Most patients received medication and professional support through the primary care units, but limitations of services were identified, including lack of home visits and limited multi-professional approaches.ConclusionPatients with PC needs were identified in ESF program. Basic health care support is provided but there is a lack of attention to some specific needs. PC policies and professional training should be implemented to improve this area.

【 授权许可】

CC BY   
© The Author(s). 2016