Palliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study

Furtado, Marilia Alves; Nogueira, Vitória Pessoa; Araújo, Maria Clara Passos; Cestari, Virna Ribeiro Feitosa; Pessoa, Vera Lúcia Mendes de Paula

doi:10.1590/0034-7167-2023-0218

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 77 (Suppl 1) • 2024 • https://doi.org/10.1590/0034-7167-2023-0218 copy

Palliative Care for SARS-CoV-2 Patients in the Intensive Care Unit: A Comprehensive Study

Cuidados Paliativos al paciente con SARS-CoV-2 en una unidad de cuidados intensivos: un estudio integral

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To comprehend the multiprofessional actions regarding palliative care for patients in the Intensive Care Unit affected by SARS-CoV-2.

Methods:

A comprehensive qualitative study conducted with 31 professionals from the Intensive Care Units of a university hospital, based on the Theory of Peaceful End of Life.

Results:

The analysis of the discourse led to the identification of two categories: “Multidisciplinary actions to promote comfort at the end of life” and “Palliative care during the pandemic period and the promotion of emotional and spiritual comfort.”

Final Considerations:

It became evident that local administration needs to invest in measures that reduce barriers to the implementation of palliative care during times of crisis. Understanding the discourse highlighted that non-specialized professionals can provide basic palliative care appropriately, without diminishing the importance and necessity of the presence of palliative care specialists in various hospital areas.

Descriptors:
Covid-19; Intensive Care Unit; Palliative Care; Sars-Cov-2; Terminal Care

Lexographic Analysis			Classes (% of total)	Categories according to TPFE (Theory of Peaceful End of Life)
Word	X²2 World Health Organization (WHO). Integrating palliative care and symptom relief into the response to humanitarian emergencies and crises: a WHO guide [Internet]. Geneva: WHO; 2018 [cited 2021 May 1]. 107 p. Available from: https://apps.who.int/iris/handle/10665/274565 https://apps.who.int/iris/handle/10665/2...	%	Classes (% of total)
To obtain To talk Doctor Time ICU To work To leave	32.98 29.95 28.52 25.67 25.11 24.75 15.21	61.90 100.00 46.15 47.06 62.5 100.00 58.33	1 - Challenges of palliation in the pandemic scenario (17.16%)	Palliative care in the pandemic period and the promotion of emotional and spiritual comfort (42.2%)
To play Music Catholic Family Day To ask To like Anointing oil Conscious To stay	62.33 57.04 40.34 34.23 32.09 26.22 24.20 23.96 21.84 16.23	73.33 100.00 100.00 44.44 83.33 71.43 80.00 100.00 62.50 34.62	4 - Emotional and spiritual comfort in the face of pandemic difficulties (11.27%)
Visit Infirmary Family Death Cry Person Contact Moment Release Cell phone Exist	45.56 38.86 36.12 25.65 25.65 20.38 20.38 19.29 19.14 19.14 16.73	100.00 69.23 69.23 100.00 100.00 71.43 71.43 50.00 100.00 100.00 62.50	6 - Approach between individuals in illness and dying during the pandemic period: the reintegration of spirituality and individuality of individuals (13.73%)
Palliative Care Action Reiki Question Massage	83.29 81.32 20.40 16.66 15.22	71.88 73.33 100.00 45.83 100.00	2 - Attention to spiritual comfort (16.67%)	Multidisciplinary actions for end-of-life comfort (57.8%)
Maximum Try Palliative Nursing Maintain People Measure	39.00 30.18 29.31 28.89 24.46 17.40 16.73	80.00 66.67 46.43 43.75 63.64 47.06 62.50	3 - The multiprofessional effort to relieve physical suffering (13.73%)
Continue Change of position Mute Care Hygiene Change Alone Nursing	98.98 47.45 44.26 38.70 36.70 21.88 17.83 17.27	93.33 64.71 100.00 42.11 100.00 80.00 46.67 34.38	5 - No change in the nursing care routine and attention to physical aspects of care (12.25%)
Physiotherapy Mode Aspiration Secretion Ventilator Uncomfortable Remove Condition	96.21 22.77 22.77 22.77 16.99 16.99 16.70 16.70	94.44 100.00 100.00 100.00 100.00 100.00 80.00 80.00	7 - Attention to physical aspects of care and limitation in the use of invasive painful measures (15.2%)

Participant Characteristics	n (%)
Gender
Female	24 (77.4)
Male	7 (22.5)
Age (years)
Mean±SD (Standard Deviation)	39.38±6.1
Minimum	29
Maximum	54
Highest Education
Technical level	3 (9.6)
Undergraduate	10 (32.2)
Postgraduate	8 (25.8)
Master's	8 (25.8)
Doctorate	5 (16.1)
Specialization in Palliative Care
Yes	2 (6.4)
No	29 (93.5)
Palliative Care Discipline or Course in Professional Training
Yes	11 (35.4)
No	20 (64.5)

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[1] Corresponding author: Marilia Alves Furtado , E-mail: br.mariliaalves@gmail.com