ABSTRACT
Objective: The objectives of this study were to identify the nursing diagnoses in patients under palliative care according to the literature and highlight those most used. Methods: This integrative review with a descriptive nature was carried out by analyzing articles published over the last ten years. Literature search was conducted in the following online databases: Caribbean Literature on Health Sciences (LILACS), PubMed, Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL). Results: The sample consisted of 14 articles. Most of them were published in 2016. Also, the NANDA-I was the most used classification system for the formulation of the nursing diagnoses. Among the most prevalent diagnoses, 'Pain', 'Death Anxiety', and 'Impaired Physical Mobility' were highlighted. Conclusion: Although research on the topic is incipient, it is hoped that this study can make it easier for nurses to make decisions based on evidence to ensure that patients under palliative care receive dignified, humanized, systematized, and quality care
Objetivo: Identificar as evidências científicas disponíveis acerca dos diagnósticos de enfermagem para pacientes em cuidados paliativos e elencar aqueles mais utilizados nessa prática. Método: Trata-se de um estudo descritivo de revisão integrativa, na qual foram analisados artigos publicados nos últimos dez anos, nas bases de dados: Lilacs; Pubmed; Web of Science; Scopus; CINAHL. Resultados: a amostra foi composta por 14 estudos, averiguando-se um maior quantitativo de produções no ano de 2016, sendo a NANDA-I o sistema de classificação mais empregado para a formulação do diagnóstico de enfermagem. Dentre os diagnósticos mais prevalentes, destacaram-se: 'Dor', 'Ansiedade relacionada à morte' e 'Mobilidade física prejudicada'. Conclusão: embora seja incipiente a produção de estudos acerca da temática, espera-se que esta pesquisa possa contribuir para a tomada de decisão pelo enfermeiro, baseada em evidências, que possa assegurar ao paciente sob cuidados paliativos uma assistência digna, humanizada, sistematizada e de qualidade
Objetivo: Identificar la evidencia científica disponible sobre diagnósticos de enfermería para pacientes en cuidados paliativos y enumerar los más utilizados en esta práctica. Método: este es un estudio descriptivo de una revisión integradora, en el cual los artículos publicados en los últimos diez años fueron analizados en las bases de datos: Lilacs; Pubmed Web de la Ciencia; Scopus Cinahl. Resultados: la muestra consistió en 14 estudios, verificando una mayor cantidad de producciones en el año 2016, siendo NANDA-I el sistema de clasificación más utilizado para la formulación del diagnóstico de enfermería. Entre los diagnósticos más frecuentes, se destacaron los siguientes: "Dolor", "Ansiedad relacionada con la muerte" y "Movilidad física deteriorada". Conclusión: aunque la producción de estudios sobre el tema es incipiente, se espera que este estudio pueda contribuir a la toma de decisiones por parte de las enfermeras, con base en la evidencia, que puede garantizar al paciente bajo cuidados paliativos con dignidad, humanización, sistematización y calidad
Subject(s)
Humans , Male , Female , Palliative Care , Nursing Diagnosis/classification , Standardized Nursing Terminology , Evidence-Based Nursing , Clinical Decision-MakingABSTRACT
Abstract Background Metastatic tumours sometimes present with neuropsychiatric symptoms, however psychiatric symptoms as rarely the first clinical manifestation. Cutaneous melanoma is the third most common cause of brain metastasis, with known risk factors increasing the chance of such central nervous system metastization. Objectives We present a clinical report of delirium as the first clinical manifestation of melanoma brain metastases, illustrating the relevance of an adequate and early differential diagnosis. Methods In addition to describing the clinical case, searches were undertaken in PubMed and other databases using keywords such as “brain metastasis”, “melanoma”, “agitation”, “psychiatric” and “delirium”. Results We here report the case of a 52-year-old female patient evaluated by Liaison Psychiatry after sudden onset of delirium while admitted at the Gastroenterology Department to study a hypothesis of pancreatitis. A head CT scan identified brain metastases, and after further examination, including brain biopsy, melanoma brain metastization was confirmed. Discussion Some of the diagnostic challenges of psychiatric symptoms associated with secondary brain tumours are discussed, underlining the importance of an adequate differential diagnosis when working in Psychiatry Liaison.