Management of pressure ulcers in palliative care patients: nurses' view
DOI:
https://doi.org/10.15253/2175-6783.20212262774Keywords:
Nursing Care; Nursing; Palliative Care; Pressure Ulcer; Wound Healing.Abstract
Objective: to understand the management of pressure ulcers in palliative care patients from the perspective of nurses. Methods: qualitative study, in which 17 care nurses participated through semi-structured interviews. Data were submitted to thematic categorical analysis. Results: two categories were listed: Nursing management of pressure ulcers in palliative care patients and Outcome of pressure ulcers in palliative care patients. Their management occurs by means of individualized assistance and may vary according to the different moments in which the individual is and should be malleable. The possibility of three outcomes was also observed: complete healing, clinical improvement and clinical stabilization. Conclusion: despite all the frailty of these patients in palliative care, it was perceived that the clinical improvement of the lesions occurs, although it is a slow path, by means of handling the lesions in an individualized manner and focused on the search for comfort.
References
Sternal D, Wilczynski K, Szewieckek J. Pressure ulcers in palliative ward patients: hyponatremia and low blood pressure as indicators of risk. Clin Interv Aging. 2017; 12:3-44. doi: https://doi.org/10.2147/CIA.S122464
Morais EM, Conrad D, Mattos EM, Cruz SAC, Machado GC, Abreu MO. Palliative care: coping nurses in a private hospital in the city of Rio de Janeiro - RJ. J Res Fundam Care Online. 2018; 10(2):318-32. doi: http://dx.doi.org/10.9789/2175-5361.2018.v10i2.318-325
Dincer M, Doger C, Tas SS, Karakaya D. An analysis of patients in palliative care with pressure injuries. Niger J Clin Pract. 2018; 21(4):484-91. doi: http://dx.doi.org/10.4103/njcp.njcp_51_17
Lai TT, Yip O, Sham MMK. Clinical parameters of wound healing in patients with advanced illness. Ann Palliat Med. 2019; 8(Suppl 1):5-14. doi: http://dx.doi.org/10.21037/apm.2019.01.05
Ferris A, Price A, Harding K. Pressure ulcers in patients receiving palliative care: a systematic review. Palliat Med. 2019; 33(7):770-82. doi: https://dx.doi.org/10.1177/0269216319846023
Leite PO, Sant’Ana JKA, Vilela RPB. Lesão por pressão e cuidados paliativos: uma resenha crítica. CuidArte Enferm [Internet]. 2019 [cited Jan 20, 2021]; 13(2):213-6. Available from: http://www.webfipa.net/facfipa/ner/sumarios/cuidarte/2019v2/213.pdf
Cordeiro FR, Tristão FS, Zillmer JGV, Padilha MAS, Fonseca ACF, Fernandes VP. Avaliação e cuidados com a pele no final da vida. Rev Evidentia [Internet]. 2019 [cited Jan 20, 2021];16:e.12334. Avai- lable from: http://ciberindex.com/index.php/ev/article/view/e12334
Sussman G. Dealing with a wound in palliative care. In: MacLeod RD, Block LV, (eds). Text book of palliative care. Springer Cham; 2018. p.1-14. doi: https://doi.org/10.1007/978-3-319-31738-0_115-1
Vasconcelos JMB, Caliri MHL. Nursing actions before and after a protocol for preventing pressure injury in intensive care. Esc Anna Nery. 2017; 21(1):e20170001. doi: https://doi.org/10.5935/1414-8145.20170001
Cardoso MFPT, Martins MMFPS, Ribeiro OMPL, Fonseca EF. Nurses’ attitudes towards death in the hospital context: differentiation by care units. Esc Anna Nery. 2021; 25(1):e20200100. doi: http://dx.doi.org/10.1590/2177-9465-ean-2020-0100
Bardin L. Análise de conteúdo. São Paulo: Edições 70; 2016.
Tippett A. Guest editorial: an introduction to palliative chronic wound care. Ostomy Wound Manag [Internet]. 2012 [cited Jan 20, 2021]; 58(5):8. Available from: https://www.o-wm.com/content/introduction-palliative-chronic-wound-care
Silva ACO, Filho ESR, Sousa RS, Silva JFS, Silva AL, Araújo CMS. As principais coberturas utilizadas pelo enfermeiro. Rev UNINGÁ [Internet]. 2017 [cited Jan 20, 2021]; 53(2):117-23. Available from: http://revista.uninga.br/index.php/uninga/article/view/1426/1041
Teixeira AKS, Menezes LCG, Oliveira RM. Serviço de estomaterapia na perspectiva dos gerentes de enfermagem. Estima. 2016; 14(1):3-12. doi: 10.5327/Z1806-3144201600010002
National Pressure Injury Advisory Panel (NPIAP). Prevention and treatment of pressure ulcers/injuries: clinical practice guideline [Internet]. 2019 [cited Jan 20, 2021]. Available from: https://www.biosanas.com.br/uploads/outros/artigos_os/127/956e02196892d7140b9bb3cdf116d13b.pdf
Moraes JT, Borges EL, Lisboa CR, Cordeiro DCO, Rosa EG, Rocha NA. Conceito e classificação de lesão por pressão: atualização do National Pressure Ulcer Advisory Panel. Enferm Cent O Min. 2016; 6(2):2292-306. doi: https://doi.org/10.19175/recom.v6i2.1423
Oliveira SM, Costa KNFM, Santos KFO, Oliveira JS, Pereira MA, Fernandes MGM. Comfort needs as perceived by hospitalized elders: an analysis under the light of Kolcaba’s theory. Rev Bras Enferm. 2020; 73(Suppl 3):e20190501. doi: http://dx.doi.org/10.1590/0034-7167-2019-0501
Artico M, D’Angelo D, Piredda M, Petitti T, Lamarca L, Marinis MG, et al. Pressure injury progression and factors associated with different endpoints in a home palliative care setting: a retrospective chart review study. J Pain Symp Manage. 2018; 56(1):23-32. doi: http://dx.doi.org/10.1016/j.jpainsymman.2018.03.011
Ruggeri E, Martoni AA, Malavasi I, Agostini F, Piccinelli E, Mazzetti M, et al. The treatment of pressure ulcers in advanced cancer patient: the importance of a dedicated team. Acta Vulnologica [Internet]. 2016 [cited Jan 20, 2021];14(2):65-77. Available from: https://www.ant.it/wp-content/uploads/2016/09/Articolo-giugno-142-2016.pdf
