Atuação dos profissionais de saúde no cuidado paliativo na atenção primária à saúde

Abstract

Palliative care is an approach that improves the quality of life of patients and families facing problems associated with life-threatening illnesses; and primary care, as ordering and coordinating, is responsible for longitudinallymonitoring such user. Objective: To understand the perception of primary health care professionals regarding their performance in palliative care in a municipality in western Paraná. Methodology: This is an integrative literature and field reviewresearch. The review was carried out in May 2022, in the Virtual Health Library, with the descriptors 'Palliative Care' and 'Primary Health Care' and 'Health Personnel', including studies in Portuguese that addressed the research topic. 132 publications were obtained, seven of which met the inclusion criteria, being organized in a synoptic table. The analysis was performed using descriptive statistics and Minayo's thematic analysis. Field research, descriptive, qualitative, with an approach to Alfred Schütz's social phenomenology, took place from November 2021 to March 2022, in16 of the 44 primary health care units of the public network in the municipality, considering the statistical sample calculation of proportion by Software R®. The study included 38 professionals, 12 physicians, 16 nurses and 10 social workers. Information was collected through a semi-structured interview, with the help of the Recorder® recording application. Objective data were systematized by XLSTAT®, while subjective data were systematized by IRaMuteQ®. Results: In the integrative literature review, five publications were obtained. Two thematic units were identified: Difficulties of the professionals, with emphasis on the restricted availability of the team; and difficulties of patients and family members, with emphasis on access to professional support for home management. In the field research, of the 38 participants, 16 are nurses (42.1%), 12 doctors (31.6%) and 10 social workers (26.3%) with an average training time of 13 years (13.3± 8.8) and an average of 8 years in the current position (8.5±6.8). The units of meaning captured were: Understanding the concept of palliative care; Organization of the work process on palliative care in the health unit; Referral and counter-referral of patients; Perception of how palliative care was offered during the pandemic; Possibilities and expectationsfor assistance in palliative care and Training on palliative care. Professionals partially understand what palliative care is, putting interdisciplinary action on the back burner, the work process has significant limitations in their perceptions, intensified due to the Sars-CoV-2 pandemic, the Reasons-why turn to the apprehension of difficulties ofthe work process and the Reasons-for for training and expanding the teams. Study contributions: The study reveals the role of health professionals and the reality of such care, supporting the understanding of their motivations. Such understanding makes it possible, as contributions to the area, to discuss the needs of these professionals in relation to the necessary adaptations of the conditions that culminate in a more adequate palliative care in a future action, as well as highlighting the need to implement and improve public policies aimed at theme.