Avaliação da funcionalidade de pacientes internados em cuidados paliativos

Abstract

Introduction: Palliative Care is an approach to promot well-being in the face of life-threatening illnesses, promoting physical and emotional comfort. The lack of functionality promotes complications that reduce patients' well-being, such as the inability to walk without assistance, directly impacting the ability to promote self-care, independence in activities of daily living and socialization. Objective: To analyze the impact on functionality caused by immobility, presence of invasive resources and sedatives in patients undergoing palliative care. Methods: Retrospective, quantitative and qualitative research, with 1381 patients over 18 years of age, included in the palliative care plan admitted to the Hospital de Clínicas of the Federal University of Uberlândia (HC-UFU). In this analysis of electronic medical records, the following were collected: vital signs, sedation, ventilation, urinary and feeding tubes and functionality using the Intensive Care Unit Mobility Scale (IMS). Results: A total of 1,381 medical records were analyzed, of which 738 were men and 623 were women. The mean age was 65.5 ± 15.5 years in women and 66.5 ± 15.1 in men. It was observed that 984 patients had an IMS value between 0 and 2; 45 patients had an IMS of 3 to 6; and 181 patients had an IMS of 7 to 10. The time until evaluation by the palliative care team was, on average, 17.0 ± 28.4 days, showing that, in many cases, inclusion in the program occurs late. Regarding the clinical outcome, 506 patients were discharged from hospital and 855 died. Conclusion: The mean age was similar in both sexes. Functionality assessed by the IMS identified a higher incidence in patients confined to bed, possibly due to the severity of the patients' condition or level of sedation. However, it is important to highlight that some information was missing from the medical records. The aim of this research is to suggest a standardized assessment to evaluate functionality.