Acompañamiento a los pacientes al final de la vida durante la pandemia por COVID-19 / Accompaniment of patients at the end of life during the COVID-19 pandemic

RESUMEN

OBJETIVOS: Describir el acompañamiento y la despedida de los pacientes en situación de últimos días a nivel hospitalario y residencial y conocer las actitudes profesionales hacia el cuidado de los pacientes al final de su vida durante la pandemia por COVID-19. MÉTODO: Estudio descriptivo transversal dirigido a profesionales de enfermería. La recogida de datos se realizó a través de un cuestionario ad hoc a través de Google Forms, durante abril y mayo de 2020. Se recogieron variables sociodemográficas, laborales, de formación, variables de satisfacción, motivación y estrés laboral y la escala de actitudes hacia el cuidado de pacientes al final de la vida. Se realizó un análisis descriptivo univariante de los sujetos de la muestra y de cada una de las variables estudiadas mediante proporciones, frecuencias, medidas de tendencia central y de dispersión mediante SPSS 22.0. RESULTADOS: Según los profesionales, un porcentaje importante de pacientes con diagnóstico de COVID-19 (38,8 %, n = 110) no han estado acompañados en las últimas 48 horas de vida; este se ha limitado a horas (56,4 %, n = 154). La despedida se ha producido mayoritariamente antes del fallecimiento (44,1 %, n = 143). Gran parte de los profesionales han notado cambios en el acompañamiento y despedida (77,3 %, n = 211), al igual que en su forma de cuidar. Un 52,4 % (n = 143) refieren haber encontrado algún paciente fallecido al entrar en la habitación. CONCLUSIONES: A pesar de la existencia de protocolos de acompañamiento y el esfuerzo de los sanitarios, la soledad ha estado presente en los pacientes durante la pandemia. Los profesionales han modificado el cuidado proporcionado a los pacientes al final de la vida, generando conflictos y actitudes emocionales negativas hacia el cuidado de estos pacientes durante la pandemia. La situación de aislamiento supone un coste emocional para profesionales y familias en duelo, que será importante valorar y estudiar a medio plazo

ABSTRACT

OBJECTIVES: This study describes how patients were accompanied and bidden farewell in their last few days of life at hospitals and nursing homes. It also describes the attitudes of health professionals towards the care of patients in the last days of life during the COVID-19 pandemic. METHOD: A cross-sectional descriptive study was conducted in nurses. Data collection was done by an ad-hoc questionnaire in April and May 2020 through Google Forms. Collected variables included social demographics, work environment, training, satisfaction variables, motivation, work-related stress, and an attitude towards patients at the end of life scale. A descriptive univariate analysis of the subjects in the sample was carried out using the SPSS 22.0 software including proportions, frequencies, measurements of central tendency, and distribution. RESULTS: According to professionals, an important number of patients diagnosed with Covid-19 (38.8%, n = 110) were not accompanied in their last 48 hours of life. This was limited to a few hours (56.4%, n = 154), and saying goodbye was done in a majority of cases before death (44.1%, n = 143). A great number of professionals have noticed changes in accompanying and saying goodbye (77.3%, n = 211), including their way of caring. A total of 52.4%, n = 143, said that they had found patients dead on entering the room; 53.1%, n = 178 were aware of accompanying protocols. CONCLUSIONS: It is obviously clear that many patients were alone during their last hours in spite of accompaniment protocols and the efforts of the staff looking after them. Professionals have modified the care given to patients at the end of life during the pandemic, generating conflicts and negative emotional attitudes. Isolation has a great emotional cost for the staff and for families during bereavement, which is important to study and evaluate in the mid-term