Percepção dos profissionais de saúde sobre terminalidade e indicação de cuidados paliativos em um hospital privado de Porto Alegre

Abstract

Introduction: The need to improve care for patients with complex and life-threatening or life-threatening diseases is unquestionable. However, there is evidence that health professionals cannot correctly identify patients who need specialized palliative care. Many hospitalized patients are in their last months of life, but we find great resistance to talk about terminality and to establish prognosis by health professionals. This is the first study in Brazil to use the surprise question (Would you be surprised if this patient died within the next six months?) As a diagnostic tool over a six months period. Method: This is a prevalent case study and used the surprise question answered by doctors and nurses to assess their perception of their patients' terminality, the indication of palliative care and the occurrence of death among these individuals within 6 months. Results: It was observed that professionals have similar distribution in relation to the answers to the surprise question, but weak agreement and association without statistical significance were obtained. Professionals had accuracy around 60% and high negative predictive value, but doctors showed greater sensitivity than nurses. After six months of answering the surprise question, 19.5% of the patients died. A significant relationship was found with the clinical data and the worst prognostic criteria. Conclusion: The surprise question proved to be an easily supported decision making tool with results that allow professionals to reflect on the treatment they are proposing to their patients and offer the most appropriate care for their needs.