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      Abordaje del paciente en emergencia en la perspectiva de los cuidados paliativos Translated title: Approach to the emergency patient from the perspective of palliative care

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          Abstract

          Resumen Objetivo: conocer el abordaje del equipo de salud de emergencia en la atención de pacientes con enfermedad avanzada en la perspectiva de los cuidados paliativos. Método: Estudio exploratorio-descriptivo de enfoque cualitativo, en el que participaron 29 profesionales del servicio de emergencias en una capital del Noreste de Brasil. Se utilizó el Análisis de Contenido Temático de Bardin. Resultados: surgieron dos categorías temáticas de las unidades de registro, a saber: (1) Los cuidados paliativos como sinónimo de confort y alivio del dolor, y (2) Comunicación y control de los síntomas como núcleo del enfoque paliativo en caso de emergencia. Los profesionales vislumbran importantes retos en el cuidado de las personas en cuidados paliativos basados en una perspectiva interdisciplinaria y empática, a favor de la atención con miras al confort y al alivio del dolor. Conclusión: Fue posible entender que el abordaje de equipo para el paciente con enfermedad avanzada debe basarse en promover el confort y el control de síntomas, utilizando la comunicación empática e involucrando al paciente y su familia.

          Translated abstract

          Abstract Objective: to know the approach of the emergency health team in the care of patients with advanced disease from the perspective of palliative care. Method: An exploratory-descriptive study with a qualitative approach, in which 29 emergency service professionals in a capital of Northeast Brazil participated. Bardin's Thematic Content Analysis was used. Results: two thematic categories of the registry units emerged: (1) Palliative care as a synonym for comfort and pain relief, and (2) Communication and control of symptoms as the core of the palliative approach in case of emergency. Professionals see important challenges in caring for people in palliative care based on an interdisciplinary and empathetic perspective, in favour of care with a view to comfort and pain relief. Conclusion: It was possible to understand that the team's approach to patient with advanced disease should be based on promotion of comfort and symptom control, using empathic communication and involving the patient and the family.

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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              Sympathy, empathy, and compassion: A grounded theory study of palliative care patients’ understandings, experiences, and preferences

              Background: Compassion is considered an essential element in quality patient care. One of the conceptual challenges in healthcare literature is that compassion is often confused with sympathy and empathy. Studies comparing and contrasting patients’ perspectives of sympathy, empathy, and compassion are largely absent. Aim: The aim of this study was to investigate advanced cancer patients’ understandings, experiences, and preferences of “sympathy,” “empathy,” and “compassion” in order to develop conceptual clarity for future research and to inform clinical practice. Design: Data were collected via semi-structured interviews and then independently analyzed by the research team using the three stages and principles of Straussian grounded theory. Setting/participants: Data were collected from 53 advanced cancer inpatients in a large urban hospital. Results: Constructs of sympathy, empathy, and compassion contain distinct themes and sub-themes. Sympathy was described as an unwanted, pity-based response to a distressing situation, characterized by a lack of understanding and self-preservation of the observer. Empathy was experienced as an affective response that acknowledges and attempts to understand individual’s suffering through emotional resonance. Compassion enhanced the key facets of empathy while adding distinct features of being motivated by love, the altruistic role of the responder, action, and small, supererogatory acts of kindness. Patients reported that unlike sympathy, empathy and compassion were beneficial, with compassion being the most preferred and impactful. Conclusion: Although sympathy, empathy, and compassion are used interchangeably and frequently conflated in healthcare literature, patients distinguish and experience them uniquely. Understanding patients’ perspectives is important and can guide practice, policy reform, and future research.
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                Author and article information

                Journal
                index
                Index de Enfermería
                Index Enferm
                Fundación Index (Granada, Granada, Spain )
                1132-1296
                1699-5988
                December 2021
                : 30
                : 4
                : 297-301
                Affiliations
                [3] Senhor do Bonfim Bahia orgnameUniversidade do Estado da Bahia Brazil
                [1] Salvador Bahia orgnameUniversidade Federal da Bahia orgdiv1Programa de Posgrado en Enfermería y Salud Brazil
                [2] Salvador Bahia orgnameEscola Bahiana de Medicina e Saúde Pública Brazil
                Article
                S1132-12962021000300005 S1132-1296(21)03000400005
                1e4fee75-46a6-4a07-84aa-39ea8220735c

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

                History
                : 03 March 2021
                : 17 January 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 5
                Product

                SciELO Spain

                Categories
                Originales

                Communication,Servicio de Urgencia en Hospital,Cuidados paliativos,Grupo de Atención al Paciente,Comodidad del paciente,Comunicación,Emergency Service,Hospital,Palliative care,Patient Care Team,Patient comfort

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