Palabras clave
Síntomas neurológicos
cuidado paliativo
enfermería
enfermo terminal
delirio
cuidado paliativo
enfermería
enfermo terminal
delirio
Cómo citar
Ibáñez Alfonso, L. E., López Alba, J. A., Ramírez Ospina, M. A., Escobar Ruíz, M. C., & Sánchez Cárdenas, M. A. (2018). Abordaje de los sintomas neurológicos desde la perspectiva de los cuidados paliativos. Salud UIS, 50(3), 233–245. https://doi.org/10.18273/revsal.v50n3-2018008
Resumen
Objetivo: Abordar los síntomas neurológicos desde la perspectiva de los cuidados paliativos a través de la revisión de literatura científica disponible teniendo en cuenta los componentes teóricos del Modelo Revisado del Manejo de Síntomas de Marylin J. Dodd. Metodología: Siguiendo los pasos propuestos por la declaración Prisma, se realizó revisión sistemática de las publicaciones realizadas entre el año 2002 y 2017 de artículos relacionados que abordaban los síntomas neurológicos desde la perspectiva del cuidado paliativo aplicando los componentes del Modelo Revisado del Manejo de Síntomas de Marylin J. Dodd, los cuales incluyen la experiencia del síntoma, los componentes de las estrategias para el manejo de síntomas y el resultado en términos del estado y el impacto del síntoma. Resultados: De los 60 articulos identificados inicalmente, 50 cumplieron con los criterios de selección y se clasificaron según las categorias de la Teoría Manejo de síntomas. Conclusiones: El aporte multidisciplinario optimiza el control de síntomas y la calidad de vida, pero son las enfermeras las responsables de detectar las respuestas humanas y distinguir entre el dolor y la agitación, equilibrar los riesgos de sub y sobremedicación y la posibilidad de acelerar la muerte. Se necesitan enfoques innovadores para alinear los comportamientos profesionales de la salud con el mejor cuidado donde se incluya una atención integral que mejore significativamente la atención al paciente.
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5. Anderson GF, Chu E. Expanding priorities--confronting chronic disease in countries with low income. N Engl J Med. 2007; 356(3): 209-211. doi: 10.1056/NEJMp068182.
6. Corona T, Román GC. Multiple Sclerosis in Latin America. Neuroepidemiol. 2006; 26(1): 1-3. doi: 10.1159/000089230.
7. Pradilla G, León-Sarmiento FE. Esclerosis múltiple en Colombia: cerrando la brecha. Acta Neurol Colomb. 2007; 23(1): 3.
8. Fachado AA, Martínez NS, Roselló MM, Ria JJV, Oliver EB, García RG, et al. Spanish adaptation and validation of the supportive & palliative care indicators tool – SPICT-ESTM. Rev Saúde Pública. 2018; 52: 3. doi: 10.11606/s1518-8787.2018052000398.
9. Twycross R. Medicina paliativa: filosofía y consideraciones éticas. Acta Bioeth. 2000; 6(1): 27-46. doi: 10.4067/S1726-569X2000000100003.
10. Gooding MP, Amaya E, Parra M, Ríos AM. Prevalencia de las demencias en el municipio de Neiva 2003-2005. Acta Neurol Colomb. 2006; 22(3): 243-248.
11. Silva FA, Zarruk JG, Quintero C, Arenas W, Rueda-Clausen CF, Silva SY, et al. Enfermedad cerebrovascular en Colombia. Rev Col Cardiol. 2006; 13(2): 85-89.
12. Toro J, Sarmiento OL, Díaz del Castillo A, Satizábal CL, Ramírez JD, Montenegro AC, et al. Prevalence of multiple sclerosis in Bogotá, Colombia. Neuroepidemiology. 2007; 28(1): 33-38.
13. Oliver DJ, Borasio GD, Caraceni A, de Visser M, Grisold W, Lorenzl S, et al. A consensus review on the development of palliative care for patients with chronic and progressive neurological disease. Eur J Neurol. 2016; 23(1): 30-38. doi: 10.1111/ene.12889.
14. Carver AC, Foley KM. Symptom assessment and management. Neurol Clin. 2001; 19(4): 921-947.
15. León MX, Flórez SP, Torres M, Rengifo ML, Prada D. La importancia de evaluar síntomas y alteraciones funcionales en enfermedades neurológicas crónicas: experiencia en cuidado paliativo y rehabilitación en una institución colombiana. Aquichan. 2010; 10(3): 228-243.
16. Ferrell BR, Coyle N, Paice JA. Oxford Textbook of Palliative Nursing. 4ed. Oxford: Oxford University Press. 2015.
17. Dodd M, Janson S, Facione N, Faucett J, Froelicher ES, Humphreys J, et al. Advancing the science of symptom management. J Adv Nurs. 2001; 33(5): 668-676.
18. Santos CM, Pimenta CA, Nobre MRC. The PICO strategy for the research question construction and evidence search. Rev Lat Am Enfermagem. 2007; 15(3): 508-511.
19. Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009; 6(7): e1000097. doi: 10.1371/journal.pmed.1000097.
20. Cwiekala K, Parkyn B, Modliszewska K, Analysis of University of California in San Francisco (UCSF) Symptom Management theory and theory Implication for Persons with Neurological Disorders/Diseases. J Neurol Neurosurg Nursing. 2017; 6(2): 55-65. doi: 10.15225/PNN.2017.6.2.2.
21. Kerr CW, Donnelly JP, Wright ST, Luczkiewicz DL, McKenzie KJ, Hang PC, et al. Progression of delirium in advanced illness: a multivariate model of caregiver and clinician perspectives. J Palliat Med. 2013;16(7): 768-773. doi: 10.1089/jpm.2012.0561.
22. Mystakidou K, Parpa E, Katsouda E, Galanos A, Vlahos L. Pain and desire for hastened death in terminally ill cancer patients. Cancer Nurs. 2005; 28(4): 318-324.
23. Spoozak L, Seow H, Liu Y, Wright J, Barbera L. Performance status and symptom scores of women with gynecologic cancer at the end of life. Int J Gynecol Cancer. 2013; 23(5): 971-978. doi: 10.1097/IGC.0b013e318291e5ef.
24. Warth M, Kessler J, Bardenheuer HJ. Insomnia and autonomic function predict well-being in patients receiving palliative care. J Palliat Med. 2017; 20(12): 1395-1399. doi: 10.1089/jpm.2017.0032.
25. Covarrubias A, Hernández EE, Ruiz S, López C-Estrada M. Assessment of pain and other symptoms in Mexican patients with advanced illness. J Pain Palliat Care Pharmacother. 2014; 28(4): 394-398. doi: 10.3109/15360288.2014.959235.
26. Irwin SA, Pirrello RD, Hirst JM, Buckholz GT, Ferris FD. Clarifying delirium management: practical, evidenced-based, expert recommendations for clinical practice. J Palliat Med. 2013;16(4): 423-435. doi: 10.1089/jpm.2012.0319.
27. Morita T, Chinone Y, Ikenaga M, Miyoshi M, Nakaho T, Nishitateno K, et al. efficacy and safety of palliative sedation therapy: a multicenter, prospective, observational study conducted on specialized palliative care units in Japan. J Pain Symptom Manage. 2005; 30(4): 320-328.
28. Rubio ML, Adalid C, de Castro C. Dilemas éticos en el cuidado de un paciente terminal: una visión desde la asistencia primaria. Aten Primaria. 2001; 27: 621-622.
29. Sharon K. Delirium in older persons. N. Engl J Med. 2006; 354: 1157-1165. doi: 10.1056/NEJMra052321.
30. Gagnon P, Allard P, Gagnon B, Mérette C, Tardif F. Delirium prevention in terminal cancer: assessment of a multicomponent intervention. Psychooncology. 2012; 21(2): 187-194. doi: 10.1002/pon.1881.
31. Akechi T. Desire for early death in cancer patients and clinical oncology. Jpn J Clin Oncol. 1999; 29(12): 646-646. doi: https://doi.org/10.1093/jjco/29.12.646.
32. Alt-Epping B, Stäritz AE, Simon ST, Altfelder N, Hotz T, Lindena G, et al. What is special about patients with lung cancer and pulmonary metastases in palliative care? Results from a nationwide survey. J Palliat Med. 2012; 15(9): 971-977. doi: 10.1089/jpm.2011.0434.
33. Öhlén J, Russell L, Håkanson C, Alvariza A, Fürst CJ, Årestedt K, et al. Variations in care quality outcomes of dying people: latent class analysis of an adult national register population. J Pain Symptom Manage. 2017; 53(1): 13-24. doi: 10.1016/j.jpainsymman.2016.08.006.
34. Benítez M, Cabrejas A, Fernández R, Pérez M. Complicaciones psiquiátricas, neurológicas y cutáneas en el paciente con enfermedad en fase terminal. Aten Primaria 2002; 30 (3): 179-182.
35. Rifà F, Pons S. El final de la vida. Síntomas y complicaciones más frecuentes. Servicio de Oncología Médica. Hospital Universitario Son Dureta. Palma de Mallorca (Illes Balears). Manual SEOM de Cuidados Continuos.
36. Hosie A, Agar M, Lobb E, Davidson PM, Phillips J. Palliative care nurses’ recognition and assessment of patients with delirium symptoms: a qualitative study using critical incident technique. Int J Nurs Stud. 2014; 51(10):1353-1365. doi: 10.1016/j.ijnurstu.2014.02.005.
37. Verstraete L, Joosten E, Milisen K. Opinions of physicians and nurses regarding the prevention, diagnosis and management of delirium. Tijdschr Gerontol Geriatr. 2008; 39: 26-34.
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