Profissionais de saúde no contexto da assistência a pacientes em Unidade de Terapia Intensiva COVID-19 : enfoque em cuidados paliativos.

Abstract

Introduction: The arrival of the coronavirus caused discussions around the world, mainly in the field of health. This scenario enabled the rescue of humanized care and the adoption of health promotion strategies that met the immediate need. The management of COVID-19 highlighted measures of comfort, relief of suffering and increased quality of life, in line with the principles of palliative care (PC). The application of this care does not underestimate the physical space, and can occur both in the home environment and in any health service, at different levels of care, including the Intensive Care Unit (ICU). The present study is justified, because although the number of scientific publications involving the theme of PC is high, the number of studies aimed at investigating the relationship of this approach to the COVID-19 pandemic is scarce. In addition, it is understood the importance of producing reflections closely linked to the quality of life and death of human beings. General objective: To analyze the characteristics of ICU health professionals in relation to PC in the care of patients with COVID-19. Article 1: Objective: To understand how the PC were worked by doctors and nurses in the COVID-19 ICU. Method: Quantitative and cross-sectional study with a non-probabilistic sample of hospitals in southern Brazil (snowball sampling technique). A descriptive and analytical statistical analysis (significance level of p<0.05) of the variables on PC and sociodemographic characteristics of professionals was performed. Results: 104 nurses and doctors participated in the study, 74% of the professionals were female, 81.7% from Rio Grande do Sul, 8.7% from Santa Catarina and 9.6% from Paraná. Of these, 83 (79.8%) participants reported knowledge about PC and 100% were in favor of such care. However, 63 (60.6%) professionals did not follow the institutional protocol, 90 (86.5%) did not undergo specific PC training for COVID-19, and 101 (97.1%) professionals did not consider the death a failure. Furthermore, 103 (99%) of them agreed on the inclusion of a PC approach in graduation. Final considerations: An adaptation of PC to emerging diseases is necessary to prepare health professionals for new pandemic situations. Article 2: Objective: The aim was to investigate the perceptions of nurses and physicians in the COVID-19 ICU about the challenges experienced in PC care, as well as propositional measures to improve this approach in daily work practice. Method: This is an exploratory and descriptive study with a qualitative approach, carried out with COVID-19 ICU nurses and doctors from hospitals in the South Region of Brazil. The collection took place from January to March 2022 and was based on the snowball sampling technique. Data were analyzed by Content Analysis. Results: The results obtained showed that professionals had difficulty applying PC during the pandemic, mainly due to lack of knowledge on the subject. However, they recognize that this approach contributed to the humanization of patient and family care in the COVID-19 ICU. Final considerations: The need for greater incentives for studies on PC was evident, even after the critical phase of COVID-19, in addition to carrying out continuing education programs so that it is possible to simplify the practice of professionals, regardless of crisis situations. Final considerations of the dissertation: Entering the master's degree in itself was a challenge, since the return after four years away from the university forced me to leave the "comfort zone" to embrace a totally new routine that included a lot of reading and scientific production. Those two years were essential for my personal development and the difficulties along the way only made me stronger, as I could understand that obstacles, when faced with courage, are no longer obstacles and become part of the experiences I had. In the end, everything is learning!