Avaliação da paliação e do grau funcional em Atenção Domiciliária

Abstract

Introduction: Most NCDs generate disabilities, leading patients to a progressive functional deficit. In this way, many of these become eligible for palliation, therefore, the development of planned actions focused on the implementation of palliative care is necessary. Objective: The objective of this study was evaluate the degree of functional impairment and indication of palliation in home care of users in palliative care registered in the ‘’Melhor em casa Program’’. Methodology: This is a cross sectional study with a quantitative approach executed in the city of São Luís (MA) with a sample of 110 users in palliative care. The data collection happened remotely, through telephone calls by family members, as a result of the Corona Virus Disease 2019 (COVID-19) pandemic between February and May of 2021. Results: Of these, 60 (54,55%) were composed of females and 44 single persons (40,00%). The predominant age group was up to 59 years old (35,45%) and over 80 (33,64%). In relation to race/color, brown stood out with 46 people (41,82%). As for the level of education, most patients were illiterate, totalizing 57 people (51,82%). About the patients' occupation, it was observed that 54 people (49,09%) were employed or working as self-employed and 46 (41, 82%) had some benefit. As for family income, 77 people (70,00%) earned between 1 and 2 minimum salaries. Regarding housing conditions, the study revealed that 95 people (86,36%) lived in their own properties, so as to 95 people (86,36%) have 4 or more rooms. The Palliative Care Screening Tool (PCST) and the Palliative Performance Scale (PPS) were applied, resulting in 48 (43,6%) patients with reduced motor function. Regarding the degree of dependence, it was observed that 81 people (73,6%) fitted the eligibility criteria for palliation. As for walking, 80 (72,7%) of the patients were very compromised, as these patients were bedridden and only 1,8% were able to walk completely. As for self-care, 67 (60,9%) patients had a functional degree of complete dependence and only three (2,7%) were fully capable of taking care of themselves. By evaluating the PPS scale, it was verified that they presented a low performance. Only two (1,8%) of these people had a PPS with a good prognosis, which denotes low disease activity, however, 34 (30,9%) had functionality with a marked decline in their general condition. Conclusion: The study made it possible to know the physical, biopsychosocial and financial fragility of these patients and their families. The relationship between dependence and self-care are intrinsically linked and, therefore, deserve importance when seeking to evaluate the ability of these patients to achieve common activities, a fact that requires from the nurse who assists them in the home environment, knowledge and mastery on the subject in order to offer individualized care based on the unique needs of each patient.