Adult intensive care nursing in the face of Advance Directives: qualitative research
DOI:
https://doi.org/10.26694/reufpi.v14i1.5370Keywords:
Nursing, Advance Directives, Hospital Assistance, Intensive Care Units, Nursing TeamAbstract
Objective: To understand the knowledge and practices of the Adult Intensive Care nursing team about the Advance Directives. Methods: Qualitative research carried out with 14 nursing professionals from an Adult Intensive Care Unit in the Northeast region of the state of Rio Grande do Sul. Data were collected through semi-structured interviews, between May and June 2022 and submitted to Content Analysis. Results: Three thematic categories emerged: Knowledge of the nursing team about the Advance Directives (directives related to care; nursing technicians are unaware of the concept of directives); Practice of the nursing team related to the wishes and desires of the patient (there is a sensitivity of nursing to the care of the Advance Directives of the patient, by communication and discussion in a multidisciplinary round) and Decisions of medical professionals or family members: (dis)respect for the autonomy of the patient (physicians and family members do not respect the prior decision of the patient and the invisibility of the nursing team by physicians, regarding compliance with the directives, was evidenced). Conclusion: There was little knowledge about Advance Directives by nursing technicians in Adult Intensive Care. The patient's wishes are met by affective care. [...]
References
Trarieux-Signol S, Bordessoule D, Ceccaldi J, Malak S, Polomeni A, Fargeas JB. Advance directives from haematology departments: the patient’s freedom of choice and communication with families: a qualitative analysis of 35 written documents. the patient’s freedom of choice and communication with families: a qualitative analysis of 35 written documents [Internet]. Available from:https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-017-0265-1.
Saioron I, Ramos FRS, Scheneider DG, Silveira RS, Silveira LR. Diretivas antecipadas de vontade: percepções de enfermeiros sobre os benefícios e novas demandas. Revista Escola Anna Nery [Internet]. 2017 [acesso em 11 jan 2023]; 21(4). Available from:https://www.scielo.br/j/ean/a/c4t4GsLg38y59mdvcRrLYDs/?format=html
Ramos FR, Saioron I, Amadigi FR, Diaz PS. Diretivas antecipadas de vontade: desafios legais e educacionais na visão de enfermeiros. Rev. Eletr. Enferm [Internet]. 2017 [acesso em 14 mar 2023]; 19-44. DOI: https://doi.org/10.5216/ree.v19.43587
Leite CDS, Fernandes CA. Desfechos do Planejamento Antecipado de Cuidado e Diretivas Antecipadas em Unidade de Terapia Intensiva: Revisão Integrativa. Rev. SBPH [Internet]. 2021 [acesso em 17 mar 2023]; 24(1):28-38. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1516-08582021000100004
Nogario ACD, Barlema EL, Barlem JGT, Silveira RS, Cogo SB, Carvalho DP. Implementação de diretivas antecipadas de vontade: facilidades e dificuldades vivenciadas por equipes de cuidados paliativos. Rev Gaúcha Enferm [Internet]. 2020 [acesso em 20 mar 2023]; 41. DOI: https://doi.org/10.1590/1983-1447.2020.20190399
Cano CW A, et al. Finitude da vida: compreensão conceitual da eutanásia, distanásia e ortotanásia. Revista Bioética [Internet]. 2020 [citado 2023 dez 4]; DOI https://doi.org/10.1590/1983-80422020282399
Souza VR, Marziale MH, Silva GT, Nascimento PL. Tradução e validação para a língua portuguesa e avaliação do guia COREQ. Acta Paul Enferm [Internet]. 2021 [acesso em 23 mar 2023]; 34. DOI: http://dx.doi.org/10.37689/acta-ape/2021ao02631
Bardin L. Análise de conteúdo. 2016; 70.
Ojedoyin OE, Jegede AS. A quantitative study of nurses perception to advance directive in selected private and public secondary healthcare facilities in Ibadan, Nigeria. BMC Med Ethics [Internet]. 2022 [acesso em mar 26 2023]; 23(1):87. DOI: https://doi.org/10.1186/s12910-022-00825-5
Hassegawa LCU, Rubira MC, Vieira SM, Rubira APA, Katsuragawa TH, Gallo JH, et. al. Approaches and reflexions on advance healthcare directives in Brazil. Rev Bras Enferm [Internet]. 2019 [acesso em 29 mar 2023]; 72(1):256-64. DOI:http://dx.doi.org/10.1590/0034-7167-2018-0347
Eggenberger T, Howard H, Prescott D, Luck G. Exploring quality of life in end-of-life discussions. Am J Hosp Palliat Care [Internet]. 2020 [acesso em 01 de abr 2023]; 37(6):465-73. DOI: 10.1177/1049909119890606
Macchi MJ, Pérez MV, Alonso JP. Planificación de los cuidados en el final de la vida: perspectivas de profesionales de oncología y cuidados paliativos. Sex Salud Soc [Internet]. 2020 [acesso em 04 abr 2023]; 35: 218-36. DOI: http://doi.org/10.1590/1984-6487.sess.2020.35.11.a
Medeiros MO, Meire MV, Frafa FMR, Sobrinho CLN, Rosa DO, Silva RS. Conflitos bioéticos nos cuidados de fim de vida. Revista Bioética [Internet]. 2020 [acesso 07 abr 2023]; 28(1): 128-34. DOI: https://doi.org/10.1590/1983-80422020281375
Sousa GM, Lustosa MA, Carvalho VS. Dilemas de profissionais de unidade de terapia intensiva diante da terminalidade. Revista bioética [Internet]. 2019 [acesso 10 abr 2023];27(3):516-27. DOI: https://doi.org/10.1590/1983-80422019273336.
Cappell K, Sundaram V, Park A, Shiraz P, Gupta R, Jenkis P, et al. Advance directive utilization is associated with less aggressive end-of-life care in patients undergoing allogenic hematopoietic cell transplantation. Biol Blood Marrow Transplant [Internet]. 2018 [acesso em 13 abr 2023]; 24(5):1035-40. Disponível: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364975/pdf/nihms-938817.pdf
Kuczmarski TM, Odejide OO. Goal of a "Good Death" in End-of-Life Care for Patients with Hematologic Malignancies-Are We Close? Curr Hematol Malig Rep [Internet]. 2021 [acesso em 16 abr 2023]; 16(2):117-125. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8409152/pdf/nihms-1727658.pdf
Shu W, Miao Q, Feng J, Liang G, Zhang J, Zhang J. Exploring the needs and barriers for death education in China: Getting answers from heart transplant recipients' inner experience of death. Front Public Health. [Internet] 2023 [acesso em 19 abr 2023]; 13:11. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968799/pdf/fpubh-11-1082979.pdf
Cardin VS, Nery LMG. Até quando prolongar a sua vida? Revista Brasileira de Sociologia do Direito [Internet]. 2021 [acesso em 22 abr 2023]; 8(1): 18-3. DOI: https://doi.org/10.21910/rbsd.v8i1.386
Cogo SB, Nietsche EA, Badck MR, Sehnem GD, Salbego C, Ramos TK, Antunes AP, Ilha AG, Malheiros LCS. Diretivas antecipadas de vontade na assistência hospitalar: perspectiva de enfermeiros. Rev. Bioética [Internet]. 2021 [acesso em 25 abr 2023]; 29(1):139-47. DOI: https://doi.org/10.1590/1983-80422021291454
Oriakhi M, Sealy C, Adenote A, Alabi O, Ahluwalia M. Improving residents’ skills and confidence on advance directive discussion: a quality improvement project. J Community Hosp Intern Med Perspect [Internet].2019 [acesso em 29 abr 2023]; ;9(5):419-21. DOI: https://doi.org/10.1080/20009666.2019.1643218
Moore N, Detering KM, Low T, Nolte L, Fraser S, Sellars M. Doctors’ perspectives on adhering to advance care directives when making medical decisions for patients: an Australian interview study. BMJ Open [Internet]. 2019 [acesso em 02 jan de 2023];9(10):1-11. Available from:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6830700/pdf/bmjopen-2019-032638.pdf
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