Percepción profesional en el final de la vida en los servicios de  urgencias. Un estudio cualitativo

Daniel Vázquez-García; Marisa De-La-Rica-Escuín; Concepción Germán-Bés; Ana Caballero-Navarro

Daniel Vázquez-García Departamento de Fisiatría y Enfermería, Universidad de Zaragoza (Zaragoza, España). Grupo de Investigación Enfermera en Procesos de Final de Vida (GIISA026), Instituto de Investigación Sanitaria de Aragón (Zaragoza, España). Grupo AURORA MAS de Investigación en Cuidados IC, AMAS (Zaragoza, España) https://orcid.org/0000-0002-6283-7477
Marisa De-La-Rica-Escuín Departamento de Fisiatría y Enfermería, Universidad de Zaragoza (Zaragoza, España). Grupo de Investigación Enfermera en Procesos de Final de Vida (GIISA026), Instituto de Investigación Sanitaria de Aragón (Zaragoza, España). Grupo AURORA MAS de Investigación en Cuidados IC, AMAS (Zaragoza, España) https://orcid.org/0000-0002-4270-1660
Concepción Germán-Bés Departamento de Fisiatría y Enfermería, Universidad de Zaragoza (Zaragoza, España). Grupo AURORA MAS de Investigación en Cuidados IC, AMAS (Zaragoza, España) https://orcid.org/0000-0002-8304-1056
Ana Caballero-Navarro Departamento de Fisiatría y Enfermería, Universidad de Zaragoza (Zaragoza, España) https://orcid.org/0000-0003-4600-6072

Palabras clave: Actitud frente a la muerte, Actitud del personal de salud, Cuidados paliativos al final de la vida, Enfermo terminal, Investigación cualitativa, Servicio de urgencias en hospital

Key-words: Attitude to death, Attitude of health personnel, Emergency service, Hospital, Hospice care, Qualitative research, Terminally ill

Resumen

Objetivo: Describir el proceso de la atención al final de la vida (AFV) a través de la percepción de los profesionales sanitarios en los servicios de urgencias hospitalarios (SUH). Método: Se realizó un estudio cualitativo-descriptivo mediante entrevistas en profundidad a médicos, enfermeras y auxiliares pertenecientes a servicios de urgencias de Aragón; se realizaron siguiendo un guion semiestructurado. El análisis de los datos se realizó de manera inductiva siguiendo las 3 fases del proceso de análisis cualitativo de Rodríguez G. Resultados: Se realizaron 27 entrevistas, emergiendo 3 categorías temáticas de los hallazgos recogidos: Características intrínsecas de los profesionales que influyen en la AFV; Factores internos de los servicios de urgencias que condicionan la atención adecuada a los enfermos terminales; Elementos externos al departamento que afectan a la atención terminal (AT). Conclusiones: Los profesionales perciben más dificultades durante la atención en fallecimientos por situaciones agudo-críticas que crónico-paliativas, percibiéndose en las primeras una mayor carga emocional y situaciones más complejas durante la atención, como la donación de órganos. Las dificultades durante la AFV también se perciben de forma distinta según el tipo de centro hospitalario, señalando una mayor falta de recursos en los servicios de urgencias en hospitales de nivel I/II y una elevada carga asistencial en los de nivel III. En función de las categorías profesionales, los médicos refieren dificultades para la comunicación de malas noticias, mientras que las enfermeras y las auxiliares de enfermería señalan una falta de tiempo para abarcar los cuidados terminales

Abstract

Objetive: To describe the process of end-of-life care through the experience and perception of health professionals within emergency services. Methods: A descriptive, qualitative study was carried out through in-depth interviews with doctors, nurses, and nursing assistants belonging to emergency services of public health centers in the region of Aragón (Spain). The interviews were conducted following a semi-structured script. Data analysis was carried out inductively in three phases following the qualitative analysis process described by Rodríguez G. Results: A total of 27 interviews were conducted, from which three thematic categories emerged pertaining to obtained outcomes: Intrinsic factors of professionals that influence end-of-life care in emergency services; Factors internal to emergency services that condition appropriate care for the terminally ill; Elements external to the department that affect end-of-life care. Conclusions: Health professionals report more difficulties during care of patients who die from acute-critical situations, since, in these situations, a greater emotional burden emerges and more complex situations such as organ donation arise. Difficulties during end-of-life care are also perceived differently depending on the type of hospital, pointing to a greater lack of resources in emergency services in level I/II hospitals and a high care burden in level I/II hospitals. Regarding professional categories, doctors referred to difficulties during the delivery of bad news, whilst nurses and nursing assistants pointed to a lack of time for caregiving

Bibliografía

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Percepción profesional en el final de la vida en los servicios de urgencias. Un estudio cualitativo

End-of-life perceptions of professionals working in the emergency services. A Qualitative Study

Resumen

Abstract

Bibliografía