Care received in Primary Health Care: perspective of patients in palliative oncological care and their families
DOI:
https://doi.org/10.26694/reufpi.v14i1.5336Keywords:
Palliative Care, Hospice Care, Primary Health Care, Unified Health System, FamilyAbstract
Objective: to understand how health care is provided in Primary Health Care from the perspective of oncological patients in palliative care and their families. Methods: descriptive-exploratory study, with a qualitative approach, carried out with patients diagnosed with cancer in palliative care and their families. Data collection took place between September and November 2023, using open-ended interviews, guided by a semi-structured instrument. The audio recorded was transcribed in full and later analyzed using Content Analysis. Results: two thematic categories were identified: “Health care provided by Primary Health Care” and “Satisfaction with care despite obstacles perceived”. Health care involved referrals to specialists, support in the initial diagnosis and treatment of the physical consequences of the disease. Despite the obstacles experienced, such as delays and lack of professional training, the participants perceived the care as satisfactory. Conclusion: : palliative care is not present in the daily routine of Primary Health Care, which to some extent may reflect the need for professional training.
References
Ministério da Saúde (BR). Portaria nº 2.488, de 21 de outubro de 2011. Aprova a Política Nacional de Atenção Básica, estabelecendo a revisão de diretrizes e normas para a organização da Atenção Básica, para a Estratégia Saúde da Família (ESF) e o Programa de Agentes Comunitários de Saúde (PACS). Brasília: Ministério da Saúde; 2011.
Abrasco (Associação Brasileira de Saúde Coletiva). Desafios da APS no SUS no enfrentamento da Covid-19. Seminário Virtual Rede APS Abrasco [Internet]. Rio de Janeiro; 2020. Acesso em: 14 jul. 2023. Disponível em: http://www.abeno.org.br/ arquivos/downloads/ABRASCO.pdf
Flores TG, Silva KF, Giaretton DWL, Weiller H, Pucci VR. Formação profissional: cuidado ao paciente oncológico sem possibilidade terapêutica na Atenção Básica. Rev APS. [Internet]. 2019;22(3). doi: https://doi.org/10.34019/1809-8363.2019.v22.15931
Paraizo-Horvath CMS, Fernandes DS, Russo TMS, Souza AC, Silveira RCCP, Galvão CM, et al. Identification of people for palliative care in primary health care: integrative review. Ciênc saúde coletiva [Internet]. 2022;27(9):3547–57. doi: https://doi.org/10.1590/1413-81232022279.01152022
Cordeiro FR, Medeiros JB, Fernandes VP, Giudice JZ, Arnemann CT. Clinical and sociodemographic profile of adults hospitalized in palliative care. Rev Enferm UFPI [Internet]. 2022;10(1): e766. doi: https://doi.org/10.26694/reufpi.v10i1.766
Castilho RK, Silva VCS, Pinto CS. Manual de cuidados paliativos da Academia Nacional de Cuidados Paliativos (ANCP). 3rd. Rio de Janeiro: Atheneu; 2021.
Rodrigues LF, Silva JFM, Cabrera M. Palliative care: pathway in primary health care in Brazil. Cad. Saúde Pública [Internet]. 2022;38(9):e00130222. doi: https://doi.org/10.1590/0102-311XPT130222
Clara MGS, Silva VR, Alves R, Coelho MCR. The Palliative Care Screening Tool as an instrument for recommending palliative care for older adults. Rev Bras Geriatr Gerontol [Internet]. 2019;22:e190143. doi: https://doi.org/10.1590/1981-22562019022.190143
Ribeiro JR, Poles K. Cuidados Paliativos: Prática dos Médicos da Estratégia Saúde da Família. Rev bras educ med [Internet]. 2019;43(3):62–72. doi: https://doi.org/10.1590/1981-52712015v43n3RB20180172
Malta DC, Andrade SSCA, Oliveira TP, Moura L, Prado RR, Souza MFM. Probability of premature death for chronic non-communicable diseases, Brazil and Regions, projections to 2025. Rev bras epidemiol [Internet]. 2019;22:e190030. doi: https://doi.org/10.1590/1980-549720190030
Abreu DMX, Araújo LHL, Reis CMR, Lima ÂMLD, Santos AF, Jorge AO, et al. Service users’ perception about healthcare provided by teams participating in the National Program for Primary Care Access and Quality Improvement in Brazil. Epidemiol Serv Saúde [Internet]. 2018;27(3):e2017111. doi: https://doi.org/10.5123/S1679-49742018000300002
Hennink M, Kaiser BN. Sample sizes for saturation in qualitative research: A systematic review of empirical tests. Soc Sci Med [Internet]. 2022; 292(114523): https://doi.org/10.1016/j.socscimed.2021.114523.
Bardin L. Análise de conteúdo. 5th. São Paulo (SP): Edições 70; 2020.
Gomide MFS, Pinto IC, Bulgarelli AF, Santos ALP, Serrano Gallardo MP. User satisfaction with primary health care: an analysis of access and care. Interface (Botucatu) [Internet]. 2018;22(65):387–98. doi: https://doi.org/10.1590/1807-57622016.0633
Freire JR, Silva CBG, Costa MV, Forster AC. Educação Interprofissional nas políticas de reorientação da formação profissional em saúde no Brasil. Saúde debate [Internet]. 2019;43(spe1):86–96. doi: https://doi.org/10.1590/0103-11042019S107
Madsen R, Larsen P, Carlsen AMF, Marcussen J. Nursing care and nurses’ understandings of grief and bereavement among patients and families during cancer illness and death – A scoping review. Eur J Oncol Nurs [Internet]. 2023; 62: 102260. https://doi.org/10.1016/j.ejon.2022.102260.
ElMokhallalati Y, Bradley SH, Chapman E, Ziegler L, Murtagh FE, Johnson MJ, Bennett MI. Identification of patients with potential palliative care needs: A systematic review of screening tools in primary care. Palliat Med [Internet]. 2020;34(8):989-1005. doi: https://doi.org/10.1177/0269216320929552.
Crimmins RM, Elliott L, Absher DT. Palliative care in a death-denying culture: exploring barriers to timely palliative efforts for heart failure patients in the Primary Care Setting. Am J Hosp Palliat Care [Internet]. 2021;38(1):77-83. doi: https://doi.org/10.1177/1049909120920545
Garcia-Vivar C, Elizondo N, Ambrosio L. Primary Care Nursing Is Essential to Fully Implement Survivorship Care Plans for Long-term Cancer Survivors and Their Families. Cancer Nurs [Internet]. 2019;42(3):177-8. doi: https://doi.org/10.1097/NCC.0000000000000704.
Hermosilla-Ávila AE, Sanhueza-Alvarado O, Chaparro-Díaz L. Palliative care and quality of life in patients with cancer during the terminal phase. A family/patient perspective. Enferm Clin [Internet]. 2021;31(5):283-93. doi: http://doi.org/10.1016/j.enfcle.2021.04.002
Santos AF, Rocha HA, Lima AMLD, Abreu DMX, Silva EA, Araújo LHL, et al. Contribution of community health workers to primary health care performance in Brazil. Rev Saude Publica [Internet]. 2020;54:143. https://doi.org/10.11606/s1518-8787.2020054002327
Benites AC, Rodin G, Leite AC, Nascimento LC, Santos MA. 'The experience of spirituality in family caregivers of adult and elderly cancer patients receiving palliative care: A meta-synthesis'. Eur J Cancer Care [Internet]. 2021; 30:e13424. https://doi.org/10.1111/ecc.13424
Konradsen H, Brødsgaard A, Østergaard B, Svavarsdóttir E, Dieperink KB, Imhof L, Luttik ML, Mahrer-Imhof R, García-Vivar C. Health practices in Europe towards families of older patients with cancer: a scoping review. Scand J Caring Sci [Internet]. 2021;35(2):375-89. doi: https://doi.org/10.1111/scs.12855
Hökkä M, Melender HL, Lehto JT, Kaakinen P. Palliative nursing competencies required for different levels of palliative care provision: a qualitative analysis of health care professionals' perspectives. J Palliat Med [Internet]. 2021; 1516-24. doi: http://doi.org/10.1089/jpm.2020.0632
Sarmento WM, Araújo PCB, Silva BN, Silva CRDV, Dantas RCO, Véras GCB. Formação acadêmica e qualificação profissional dos enfermeiros para a prática em cuidados paliativos. Enferm Foco [Internet]. 2021;12(1):33-9. doi: https://doi.org/10.21675/2357-707X.2021.v12.n1.3805
Boaventura J R, Pessalacia JDR, Martins TCR, Silva AE, Marinho MR, Neto PKS. Participation and social control in the politic context of palliative care: a theoretical reflection. Rev Enf Cent Oeste Min [Internet]. 2019; 9:e3433. Doi: https://doi.org/10.19175/recom.v9i0.3433
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Rev Enferm UFPI

This work is licensed under a Creative Commons Attribution 4.0 International License.
Autores mantém os direitos autorais e concedem à REUFPI o direito de primeira publicação, com o trabalho licenciado sob a Licença Creative Commons Attibution BY 4.0 que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.