Diretivas antecipadas de vontade sob a perspectiva de enfermeiros: uma revisão integrativa

Abstract

Introduction: With advances in medicine, new therapeutic and medicinal approaches have emerged that have made it possible to prolong human life. It is recognized that some of these treatments, despite keeping the patient alive, result in prolonging their own suffering and the suffering of their family members, with no prospect of reversing the clinical condition. Advance Directives (AD) enable a person to express their preferences and instructions regarding future medical care, becoming effective when the individual can no longer make decisions for themselves due to a terminal condition or irreversible injury. These guidelines are intended to guide health professionals, family members and others involved in the patient's care, providing an approach that is more aligned with the desires and values of the individual in question. Objective: To know and understand the perspective/view of nurses regarding the advance directives of patients at the end of their lives. Methods: This is an Integrative Literature Review (IR), a method that makes it possible to gather, analyze and synthesize the broad approach of multiple studies on the topic. Carried out in an orderly manner, it brings contributions and applicability of results in practice and reflections on carrying out future research. Results: National and international studies indicate that nurses are professionals who care about meeting the needs of their patients. However, many still face difficulties when approaching or initiating conversations about Advance Directives (AD). This hesitation can be attributed to the lack of knowledge and appropriate training, resistance from other members of the healthcare team, opposition from patients' families, the involvement of ethical issues, religious beliefs and the absence of legislation that protects them regarding their conduct. Final considerations: Nurses' perceptions of directives may vary depending on several factors, including organizational culture, training received, personal experiences, and understanding of local laws. We understand that the topic is still very controversial, subject to and requiring several continuous efforts to overcome the identified gaps. The search for advances must be based on collaboration between health professionals, legislators and educational institutions, aiming to improve the quality of care to guarantee the respect and desires of patients at the end of life.