Cuidados paliativos ao paciente com covid-19 na fase final de vida: estudo com profissionais de enfermagem

Abstract

Introduction: Palliative care aims to provide comprehensive assistance through a multidisciplinary team to patients with life-threatening diseases, ensuring a better quality of life for both patients and their families from diagnosis to end-of-life and through the bereavement process. This includes patients with COVID-19. In this context, the participation of nursing professionals as members of the palliative care team is noteworthy. This thesis comprises three studies in the form of articles. The first study is a scoping review aimed at mapping scientific evidence regarding nursing care for end-of-life COVID-19 patients under palliative care in a hospital setting. The first original article aimed to analyze nursing interventions for COVID-19 patients in palliative care in light of the Peaceful End of Life Theory. The second article aimed to analyze strategies adopted by nursing technicians when providing care to end-of-life COVID-19 patients in palliative care, also based on the Peaceful End of Life Theory. Methodology: This is an exploratory qualitative study. The study sample consisted of 15 nurses and 15 nursing technicians working in two public hospitals in João Pessoa, Paraíba, Brazil, which were designated as reference centers for COVID-19 patient care. Data collection was conducted virtually between May and September 2022 using an online form with guiding questions related to the proposed study. The empirical material from the participants' reports was categorized using content analysis techniques and qualitatively analyzed in light of the Peaceful End of Life Theory. It is worth noting that the research was conducted following the ethical guidelines outlined in Resolution No. 466/2012 of the National Health Council. The research project was approved by the Research Ethics Committee under CAAE: No. 53083221.3.0000.5188. Results: Two articles were developed from the qualitative analysis: "Palliative care in the end-of-life phase: nursing interventions for COVID-19 patients" and "Palliative care for end-of-life COVID-19 patients: a study with nursing technicians." The first manuscript allowed for the construction of two categories: Nursing care for COVID-19 patients in palliative care, with an emphasis on pain relief and respiratory symptoms; and Valuing dignity and spirituality for COVID-19 patients in palliative care to promote peace at the end of life. The second study revealed the following categories: Communication as a strategy to promote closeness between palliative care COVID-19 patients and their families, aiming for a peaceful end of life; and Nursing care for COVID-19 patients in palliative care at the end of life, with an emphasis on their physical needs to promote comfort. Final Considerations: The scoping review highlighted the importance of nursing professionals' roles in providing care to end-of-life COVID-19 patients under palliative care in a hospital setting. The original articles reveal the significance of the Peaceful End of Life Theory in guiding the actions of the nursing professionals participating in the study regarding the provision of care to COVID-19 patients in palliative care.