Cuidados de enfermagem ao doente com doença hepatobiliopancreática avançada: resultados de um estudo retrospetivo

Abstract

Introduction: Hepatobiliopancreatic cancers are among the most aggressive malignancies and have a significant impact on both quality of life and survival. In Portugal, there is limited information on the trajectory of these patients and the care they receive, despite their complex symptoms and multiple needs. Objectives: To describe the nursing care (nursing diagnoses and interventions) provided to patients with advanced hepatobiliopancreatic cancer in a hospital setting. Material and methods: Descriptive, retrospective study focused on patients who died between January/2017-March/2023 in a surgical department of a central hospital in Portugal. The study includes patients aged 18 years, diagnosed with advanced hepatobiliopancreatic cancer. Data were collected using a form developed by the researchers. The study was approved by an ethics committee. Results: Out of 177 deceased patients, 103 met the eligibility criteria (63.1% male; X(age)=72.1 years, SD=12.1 years, range:38-94 years). Most (82.5%) were admitted through emergency services and died after an average hospital stay of 18 days. Of these, 57.3% were referred to palliative care (60% on the day of death but 16.9% were not observed). Nursing diagnoses were recorded in the physical (n=44diagnosis), sociocultural (n=4diagnosis), and psycho-spiritual (n=1diagnosis) domains. The most reported signs/symptoms were pain (67%), oedema (36.9%), fever (32%), disorientation (21.4%), and agitation (14.6%). Most nursing diagnoses/interventions focused on self-care. Conclusions: Nursing care mainly focused on physical domain and interdependent interventions, missing the complexity of patients' conditions and needs. Enhanced training in palliative care, more precise record-keeping, and a shift in organizational paradigms are crucial.