Úlceras por pressão em pessoas com câncer recebendo cuidados paliativos domiciliares
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Data
2013-04-27
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Universidade Federal de Goiás
Resumo
Patients with advanced cancer are impaired in their various dimensions and therefore
have a higher risk for developing pressure ulcers (PU). Little is known about the
magnitude of this problem in patients receiving palliative care which hampers
progress in comprehensive care for the patient and family. In order to broaden the
understanding of the topic, this study was developed with the purpose to analyze the
pressure ulcers and the risk for development of pressure ulcers in cancer patients
receiving palliative home care. This is a longitudinal, descriptive and quantitative
approach, closed cohort, conducted at the Grupo de Apoio Paliativo ao Paciente
Oncológico of the Associação de Combate ao Câncer de Goiás, from December
2011 to July 2012. Data collection was performed on 7 evaluations. The first
evaluation was undertaken at the patient’s home through interview and clinical
assessment of patients. The remaining evaluations were done via telephone 7, 14,
21 and 28 days after the first evaluation. Forty-five and 90 days after the date of
inclusion in the study, patients were assessed for survival. Data on
sociodemographic, clinical, PU (when present), risk of PU by the Braden Scale and if
patient was alive or not was collected. Descriptive analysis was performed as well as
the Fisher exact test and associations were considered significant when p<0.05. The
study included 64 patients with cancer in palliative care (68.8% male, 45.3% white,
54.7% under 70 years old, 62.5% with KPS <50%, 57.8% with urinary incontinence).
Forty-six patients completed the evaluations to D28, and at 45 and 90 days, a total of
25 and 33 participants had died, respectively. Twelve (18.8%) patients had PU. Of
these, 75.0% were men, they had one to three PUs, totaling 19 lesions, of which
89.4% started at home and 47.4% were stage 3 lesions. The only statistically
significant difference between the groups was that the presence of PU was more
frequent among those who already had a history of previous wound. There was an
increased risk of PU throughout the study period and found that the risk for PU was
higher in those who died within 45 days after the first evaluation. There was no
significant association between PU and survival using the Kaplan-Meier method
(p=0.072). PU consisted of a significant event occurring in the population studied and
the risk increased with the approach of death. This indicates that systematic care for
prevention of PU to reduce risk and achieve early diagnosis of PU should be
performed by palliative care health team, minimizing the suffering of terminal
patients.
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QUEIROZ, Ana Carolina de Castro Mendonça. Úlceras por pressão em pessoas com câncer recebendo cuidados paliativos domiciliares. 2013. 148 f. Dissertação (Mestrado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2013.