Necessidades da equipe de enfermagem atuante nos cuidados paliativos domiciliares: revisão integrativa
DOI:
https://doi.org/10.37914/riis.v9.504Palavras-chave:
cuidados paliativos, assistência domiciliar, enfermagemResumo
Enquadramento: a Equipe de Enfermagem é a principal responsável pelo monitoramento clínico e articulação do plano de cuidados dos pacientes em Cuidados Paliativos na Atenção Domiciliar, enfrentam desafios na formação profissional, desafios emocionais e relacionais, evidenciando a exigência de qualificação profissional específica. Objetivo: analisar as necessidades da Equipe de Enfermagem no manejo de pacientes em Cuidados Paliativos na Atenção Domiciliar. Metodologia: revisão Integrativa da Literatura nas bases de dados LILACS, BDENF, MEDLINE, Web of Science e Scopus, partindo da pergunta de pesquisa “Quais as necessidades encontradas pela equipe de enfermagem no manejo do paciente em Cuidados Paliativos na Atenção Domiciliar?” elaborada seguindo a estratégia PICo, identificados inicialmente 4694 artigos e incluídos 29 artigos para análise. Resultados: foram elencadas três categorias analíticas: Necessidades relacionadas a Qualificação profissional em Cuidados Paliativos, Organização do trabalho em Equipe Interdisciplinar e Autocuidado e Suporte emocional. Conclusão: a revisão cumpriu seu objetivo identificando que as categorias analíticas evidenciadas são eixos que sustentam a qualidade do serviço, com isso, sugere a implementação de educação continuada e suporte psicológico para a preparação integral da equipe.
Referências
Alhaddar, M., Falna, H., Sultan, H., Abu-Odah, H., Khleif, M., & Najjar, S. (2025). Towards enhancing palliative care competencies through comprehensive training for nurses and physicians in resource-limited settings: a cross-sectional study. BMC Nursing, 24, 688. https://doi.org/10.1186/s12912-025-03412-2 DOI: https://doi.org/10.1186/s12912-025-03412-2
Aromataris, E., Lockwood, C., Porritt, K., Pilla, B., & Jordan, Z. (Eds.). (2024). JBI manual for evidence synthesis. JBI. https://doi.org/10.46658/JBIMES-24-01 DOI: https://doi.org/10.46658/JBIMES-24-01
Bagchus, C., Zee, M. S., van der Steen, J. T., Klapwijk, M. S., Dekker, N. L., Onwuteaka-Philipsen, B. D., & Pasman, H. R. W. (2024). Challenges in recognizing and discussing changes in a resident's condition in the palliative phase: focus group discussions with nursing staff working in nursing homes about their experiences. BMC Palliative Care, 23(144). https://doi.org/10.1186/s12904-024-01479-3 DOI: https://doi.org/10.1186/s12904-024-01479-3
Barrué, P., & Sánchez-Gómez, M. (2021). La experiencia emocional de enfermeras de la unidad de hospitalización a domicilio en cuidados paliativos: un estudio cualitativo exploratorio. Enfermería Clínica, 31(4), 211-221. https://doi.org/10.1016/j.enfcli.2020.11.006 DOI: https://doi.org/10.1016/j.enfcli.2020.11.006
Beyermann, A., Asp, M., Godskesen, T., & Söderman, M. (2023). Nurses' challenges when supporting the family of patients with ALS in specialized palliative home care: a qualitative study. International Journal of Qualitative Studies on Health and Well-being, 18(1), article 2238984. https://doi.org/10.1080/17482631.2023.2238984 DOI: https://doi.org/10.1080/17482631.2023.2238984
Bolt, S. R., Meijers, J. M. M., van der Steen, J. T., Schols, J. M. G. A., & Zwakhalen, S. M. G. (2020). Nursing staff needs in providing palliative care for persons with dementia at home or in nursing homes: a survey. Journal of Nursing Scholarship, 52(2), 164-173. https://doi.org/10.1111/jnu.12542 DOI: https://doi.org/10.1111/jnu.12542
Bovero, A., Spada, M. F., Cito, A. L., Pidinchedda, A. V., Tosi, C., & Carletto, S. (2025). Autocuidado em profissionais de saúde paliativa: um estudo qualitativo. Nursing Reports, 15(5), artigo 139. https://doi.org/10.3390/nursrep15050139 DOI: https://doi.org/10.3390/nursrep15050139
Brännström, M., Philipsson, J., & Andersson, S. (2024). Healthcare professionals’ experiences of video consultations in palliative care in rural areas: an intervention study in community care. BMC Health Services Research, 24, 740. https://doi.org/10.1186/s12913-024-11196-5 DOI: https://doi.org/10.1186/s12913-024-11196-5
Brant, J. M., Fink, R. M., Thompson, C., Li, Y. H., Rassouli, M., Majima, T., Osuka, T., Gafer, N., Ayden, A., Khader, K., Lascar, E., Tang, L., Nestoros, S., Abdullah, M., Michael, N., Cerruti, J., Ngaho, E., Kadig, Y., Hablas, M., ... Silbermann, M. (2019). Global survey of the roles, satisfaction, and barriers of home health care nurses on the provision of palliative care. Journal of Palliative Medicine, 22(8), 945–955. https://doi.org/10.1089/jpm.2018.0566 DOI: https://doi.org/10.1089/jpm.2018.0566
Bucher, S. M. A., Dimech, A. M. S., Müller, B., & Beeler, P. E. (2024). Interprofessional collaboration during a specialised mobile palliative care service pilot in the rural area of Lucerne. PLOS ONE, 19(9), e0308256. https://doi.org/10.1371/journal.pone.0308256 DOI: https://doi.org/10.1371/journal.pone.0308256
Castilho, R. K., Silva, V. C., & Pinto, C. S. (2021). Manual de cuidados paliativos da Academia Nacional de Cuidados Paliativos (ANCP) (3ª ed.). Editora Ateneu. DOI: https://doi.org/10.26694/jcshuufpi.v3iSupl.3.898
Chen, X., Chen, M., Zheng, H., Wang, C., Chen, H., Wu, Q., Liao, H., Zhu, J., Lin, J., Ou, X., Zou, Z., Wang, Z., Zheng, Z., Zhuang, X., & Chen, R. (2022). Effects of psychological interventions on empathy fatigue in nurses: a meta-analysis. Frontiers in Public Health, 10, 952932. https://doi.org/10.3389/fpubh.2022.952932 DOI: https://doi.org/10.3389/fpubh.2022.952932
Congresso Nacional (Brasil). (1986). Lei nº 7.498, de 25 de junho de 1986. Diário Oficial da União, Seção 1(119), 9273-9275. https://hdl.handle.net/20.500.12178/217515
Crape, B., Nurlybekova, A., Turganbekova, A., Ospanova, G., & Khudaibergenova, M. (2025). Behind the care: emotional struggles, burnout, and denial in Kazakhstan’s professional palliative care workforce. BMC Palliative Care, 24, 161. https://doi.org/10.1186/s12904-025-01798-z DOI: https://doi.org/10.1186/s12904-025-01798-z
Dadich, A., Hodgins, M., Womsley, K., & Collier, A. (2023). ‘When a patient chooses to die at home, that's what they want… comfort, home’: brilliance in community‐based palliative care nursing. Health Expectations, 26(4), 1716–1725. https://doi.org/10.1111/hex.13780 DOI: https://doi.org/10.1111/hex.13780
Daneau, S., Bourbonnais, A., Allard, É., Asri, M., Ummel, D., & Bolduc, E. (2023). 'Intensive palliative care': a qualitative study of issues related to nurses' care of people with amyotrophic lateral sclerosis at end-of-life. Palliative Care & Social Practice, 17, 1–13. https://doi.org/10.1177/26323524231170881 DOI: https://doi.org/10.1177/26323524231170881
Dantas, H. L. L., Costa, C. R. B., Costa, L. M. C., Lúcio, I. M. L., & Comassetto, I. (2021). Como elaborar uma revisão integrativa: sistematização do método científico. Revista Recien, 12(37), 334–345. https://doi.org/10.24276/rrecien2022.12.37.334-345 DOI: https://doi.org/10.24276/rrecien2022.12.37.334-345
Dehghannezhad, J., Hassankhani, H., Taleghani, F., Rahmani, A., SattarPour, S., & Sanaat, Z. (2021). Home care nurses’ attitude towards and knowledge of home palliative care in Iran: a cross‐sectional study. Iranian Journal of Nursing and Midwifery Research, 26(4), 272–278. https://doi.org/10.4103/ijnmr.IJNMR_249_19 DOI: https://doi.org/10.4103/ijnmr.IJNMR_249_19
Dijxhoorn, A.-F. Q., Heijnen, Y., van der Linden, Y. M., Leget, C., Raijmakers, N. J. H., & Brom, L. (2023). Nursing assistants' perceptions and experiences with the emotional impact of providing palliative care: a qualitative interview study in nursing homes. Journal of Advanced Nursing, 79(10), 3876–3887. https://doi.org/10.1111/jan.15733 DOI: https://doi.org/10.1111/jan.15733
Ervik, B., Brøndbo, P. H., & Johansen, M.-L. (2020). Adapting and going the extra mile: a qualitative study of palliative care in rural Northern Norway from the perspective of healthcare providers. Cancer Nursing, 43(6), E323–E330. https://doi.org/10.1097/NCC.0000000000000815 DOI: https://doi.org/10.1097/NCC.0000000000000815
Ervik, B., Dønnem, T., & Johansen, M. (2023). Dying at "home" - a qualitative study of end-of-life care in rural Northern Norway from the perspective of health care professionals. BMC Health Services Research, 23(1359). https://doi.org/10.1186/s12913-023-10329-6 DOI: https://doi.org/10.1186/s12913-023-10329-6
Fundação Hospitalar do Estado de Minas Gerais. (2024). Linha de cuidado e diretrizes assistenciais: Cuidados paliativos (Caderno 2). https://www.fhemig.mg.gov.br/files/1394/Protocolos-Clinicos/33307/Linha-de-Cuidado-e-Diretrizes-Assistenciais---Cuidados-Paliativos-%C2%A0(caderno%C2%A0n%C2%BA2).pdf.
García-Salvador, I., Chisbert-Alapont, E., Antonaya Campos, A., Hurtado Navarro, C., Fernández Peris, S., Gómez Royuela, L. A., Rodríguez Castellano, P., & Casaña Mohedo, J. (2025). Evaluation of the effectiveness of basic palliative care training for primary care nurses in a health area in Spain: a quasi-experimental study. Healthcare, 13(19), 2419. https://doi.org/10.3390/healthcare13192419 DOI: https://doi.org/10.3390/healthcare13192419
Gershater, M. A., Brenner, J., Nordberg, M., & Hommel, A. (2024). Nurse assistants' perception of caring for older persons who are dying in their own home: an interview study. BMC Palliative Care, 23(70). https://doi.org/10.1186/s12904-024-01399-2 DOI: https://doi.org/10.1186/s12904-024-01399-2
Geuenich, P., Schlömer, L., Owusu-Boakye, S., & Stanze, H. (2025). Supervision, moral distress and moral injury within palliative care: a qualitative study. International Journal of Environmental Research and Public Health, 22, 1156. https://doi.org/10.3390/ijerph22071156 DOI: https://doi.org/10.3390/ijerph22071156
Guo, J., Dai, Y., Chen, Y., Liang, Z., Hu, Y., Xu, X., & Xiao, Y. (2024). Competências essenciais entre enfermeiros que atuam em cuidados paliativos: uma revisão de escopo. Journal of Clinical Nursing, 33(11-12), 3905-3922. https://doi.org/10.1111/jocn.17294 DOI: https://doi.org/10.1111/jocn.17294
Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), artigo e1230. https://doi.org/10.1002/cl2.1230 DOI: https://doi.org/10.1002/cl2.1230
Hudson, J., Reblin, M., Clayton, M. F., & Ellington, L. (2019). Addressing cancer patient and caregiver role transitions during home hospice nursing care. Palliative & Supportive Care, 17(5), 523–530. https://doi.org/10.1017/S1478951518000214 DOI: https://doi.org/10.1017/S1478951518000214
Johannesen, E. J. D., Timma, H., & Róin, Á. (2024). District nurses experiences in providing terminal care in rural and more urban districts. A qualitative study from the Faroe Islands. Scandinavian Journal of Primary Health Care, 42(3), 367-377. https://doi.org/10.1080/02813432.2024.2329207 DOI: https://doi.org/10.1080/02813432.2024.2329207
Johansen, H., Grøndahl, V. A., & Helgesen, A. K. (2022). Palliative care in home health care services and hospitals the role of the resource nurse, a qualitative study. BMC Palliative Care, 21(64). https://doi.org/10.1186/s12904-022-00956-x DOI: https://doi.org/10.1186/s12904-022-00956-x
Khemai, C., Janssen, D. J. A., Schols, J. M. G. A., Naus, L., Kemper, S., Jole, I., Bolt, S. R., & Meijers, J. M. M. (2020). Nurses' needs when collaborating with other healthcare professionals in palliative dementia care. Nurse Education in Practice, 48(102866). https://doi.org/10.1016/j.nepr.2020.102866 DOI: https://doi.org/10.1016/j.nepr.2020.102866
Lagerin, A., Melin-Johansson, C., Holmberg, B., Godskesen, T., Hjorth, E., Junehag, L., Lundh Hagelin, C., Ozanne, A., Sundelöf, J., & Udo, C. (2025). Interdisciplinary strategies for establishing a trusting relation as a pre-requisite for existential conversations in palliative care: a grounded theory study. BMC Palliative Care, 24(1), 47. https://doi.org/10.1186/s12904-025-01681-x DOI: https://doi.org/10.1186/s12904-025-01681-x
Lin, C.-P., & Chu, W.-M. (2025). Home-based palliative care: benefits, challenges, opportunities and future directions in a super-aged society. Journal of Hospice and Palliative Care, 28(3), 81–88. https://doi.org/10.14475/jhpc.2025.28.3.81 DOI: https://doi.org/10.14475/jhpc.2025.28.3.81
Machado, M. M. S., Ribeiro, F. S., Siqueira, N. R., Campos, J. L., & Santos, D. P. M. A. (2022). Protocolo de assistência de enfermagem ao paciente em cuidado terminal: construção através de revisão integrativa. Nursing (Edição Brasileira), 25(292), 8662–8673. https://doi.org/10.36489/nursing.2022v25i292p8662-8673 DOI: https://doi.org/10.36489/nursing.2022v25i292p8662-8673
Melo, C. M., Sangol, K. M., Kochhann, J. K., Hesler, L. Z., & Fontana, R. T. (2021). Concepções, desafios e competências dos enfermeiros em cuidados paliativos na atenção primária à saúde. Revista Nursing, 24(277), 5833-5839. https://doi.org/10.36489/nursing.2021v24i277p5833-5846 DOI: https://doi.org/10.36489/nursing.2021v24i277p5833-5846
Ministério da Saúde (Brasil). (2024). Portaria GM/MS nº 3.681, de 7 de maio de 2024. Diário Oficial da União, Seção 1(98), 215. https://www.in.gov.br/web/dou/-/portaria-gm/ms-n-3.681-de-7-de-maio-de-2024-561223717
Ministério do Trabalho e Emprego (Brasil). (s.d.). Qualificação profissional. https://www.gov.br/trabalho-e-emprego/pt-br/servicos/trabalhador/qualificacao-profissional
Moher, D., Liberati, A., Tetzlaff, J., & Altman, D. G. (2009). Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement. PLoS Medicine, 6(7), artigo e1000097. https://doi.org/10.1371/journal.pmed.1000097 DOI: https://doi.org/10.1371/journal.pmed.1000097
Mrayyan, M. T., Abunab, H. Y., Abu Khait, A., Rababa, M. J., Al-Rawashdeh, S., Algunmeeyn, A., & Abu Saraya, A. (2023). Competency in nursing practice: a concept analysis. BMJ Open, 13(6), e067352. https://doi.org/10.1136/bmjopen-2022-067352 DOI: https://doi.org/10.1136/bmjopen-2022-067352
Muldrew, D. H. L., Kaasalainen, S., McLaughlin, D., & Brazil, K. (2018). Ethical issues in nursing home palliative care: a cross-national survey. BMJ Support Palliative Care, 10(3) https://doi.org/10.1136/bmjspcare-2018-001643 DOI: https://doi.org/10.1136/bmjspcare-2018-001643
Näppä, U., Nässén, E., & Winqvist, I. (2023). Palliative care in rural areas - collaboration between district nurses and doctors: an interview study. BMC Palliative Care, 22(73). https://doi.org/10.1186/s12904-023-01190-9 DOI: https://doi.org/10.1186/s12904-023-01190-9
Nardino, F., Olesiak, L. R., & Quintana, A. M. (2021). Significações dos cuidados paliativos para profissionais de um serviço de atenção domiciliar. Psicologia: Ciência e Profissão, 41, artigo e222519. https://doi.org/10.1590/1982-3703003222519 DOI: https://doi.org/10.1590/1982-3703003222519
Nascimento, N. B., Ferreira, B. E. S., Assis, V. L., Castro, C. M. F., Ferreira, G. R., Pereira, V. L. D., Silva, E. L., & Araújo, C. M. (2024). Atuação do enfermeiro a pacientes em cuidados paliativos: uma revisão integrativa de literatura. Nursing (Edição Brasileira), 28(312), 9359–9365. https://doi.org/10.36489/nursing.2024v28i312p9359-9365 DOI: https://doi.org/10.36489/nursing.2024v28i312p9359-9365
Neto, E. G. R., Caldas, C. M. G., Santos, S. P., Vilela, A. B. A., & Gomes, R. M. (2024). Abordagem interprofissional à pacientes em cuidados paliativos: uma revisão integrativa da literatura. Revista Saúde.Com, 20(4), 3583-3593. https://doi.org/10.22481/rsc.v20i4.15154 DOI: https://doi.org/10.22481/rsc.v20i4.15154
Pan American Health Organization. (2025). Interprofessional health teams for integrated care. https://iris.paho.org/items/87f8c74c-9c68-4f33-b230-98682a292043
Pesut, B., Thorne, S., Wright, D. K., & Banwell, M. (2024). The centrality of nursing in realizing high quality palliative care: exploring Canada’s framework on palliative care priorities. BMC Nursing, 23, artigo 814. https://doi.org/10.1186/s12912-024-02488-6 DOI: https://doi.org/10.1186/s12912-024-02488-6
Porter, A. S., Zalud, K., Applegarth, J., Woods, C., Gattas, M., Rutt, E., Williams, K., Baker, J. N., & Kaye, E. C. (2021). Community hospice nurses’ perspectives on needs, preferences, and challenges related to caring for children with serious illness. JAMA Network Open, 4(10), e2127457. https://doi.org/10.1001/jamanetworkopen.2021.27457 DOI: https://doi.org/10.1001/jamanetworkopen.2021.27457
Schröder, J., Riiser, K., & Holmen, H. (2024). The needs of healthcare personnel who provide home-based pediatric palliative care: A mixed-method systematic review. BMC Health Services Research, 24, 45. https://doi.org/10.1186/s12913-023-10495-7 DOI: https://doi.org/10.1186/s12913-023-10495-7
Silva, E. M., Moraes, A., Casarolli, A. C. G., & Ribeiro, C. C. F. S. (2023). Gestão de cuidados paliativos em domicílio: perspectivas de enfermeiros de um município do oeste do Paraná. Arquivos de Ciências da Saúde da UNIPAR, 27(5), 3283-3302. https://doi.org/10.25110/arqsaude.v2715.2023-074 DOI: https://doi.org/10.25110/arqsaude.v27i5.2023-074
Sørstrøm, A. K., Ludvigsen, M. S., & Kymre, I. G. (2023). Home care nurses facilitating planned home deaths. A focused ethnography. BMC Palliative Care, 22, artigo 175. https://doi.org/10.1186/s12904-023-01303-4 DOI: https://doi.org/10.1186/s12904-023-01303-4
Sørstrøm, A. K., Kymre, I. G., & Ludvigsen, M. S. (2024a). Nursing care to patients who have the home as the preferred place of death: a scoping review. BMC Health Services Research, 24, Article 123. https://doi.org/10.1186/s12913-024-11757-8 DOI: https://doi.org/10.1186/s12913-024-11757-8
Sørstrøm, A. K., Ludvigsen, M. S., & Kymre, I. G. (2024b). Facilitating planned home death: a qualitative study on home care nurses' experiences of enablers and barriers. Journal of Advanced Nursing, 81(1), 340–352. https://doi.org/10.1111/jan.16171 DOI: https://doi.org/10.1111/jan.16171
Souza, M. T., Silva, M. D., & Carvalho, R. (2010). Revisão integrativa: O que é e como fazer. Einstein, 8(1 Pt 1), 102–106. https://doi.org/10.1590/s1679-45082010rw1134 DOI: https://doi.org/10.1590/s1679-45082010rw1134
Souza, J. M., & Alves, E. D. (2015). Cuidados paliativos de enfermagem na atenção domiciliar. Revista de Enfermagem UFPE on line, 9(2), 669–676. https://periodicos.ufpe.br/revistas/revistaenfermagem/article/view/10386
Spelten, E., Timmis, J., Heald, S., & Duijts, S. F. A. (2019). Rural palliative care to support dying at home can be realised: experiences of family members and nurses with a new model of care. Australian Journal of Rural Health, 27(4), 336–343. https://doi.org/10.1111/ajr.12518 DOI: https://doi.org/10.1111/ajr.12518
Tan, L., Sheri, S., Goh, Y. Y., Fong, R., Govindasamy, R., Ong, Y. T., Hamid, N. A. B. A., Low, T. L. X., & Krishna, L. K. R. (2025). Experiences of healthcare professionals providing palliative care in home settings - a scoping review. BMC Palliative Care, 24, artigo 83. https://doi.org/10.1186/s12904-025-01728-z DOI: https://doi.org/10.1186/s12904-025-01728-z
van den Bosch, G., van Schaik, M., Pasman, H. R., Janssens, R., Widdershoven, G., & Metselaar, S. (2023). Moral challenges of nurses and volunteers in Dutch palliative care: a qualitative study. Journal of Palliative Care, 38(3), 364–371. https://doi.org/10.1177/08258597221098129 DOI: https://doi.org/10.1177/08258597221098129
Vasconcellos, S. A., Viegas, A. C., Muniz, R. M., Cardoso, D. H., Azevedo, N. A., & Amaral, D. E. D. (2020). Experiências vividas por enfermeiros sobre os cuidados paliativos no ambiente domiciliar. Journal Health NPEPS, 5(2), 274-290. https://doi.org/10.30681/252610104728 DOI: https://doi.org/10.30681/252610104728
Wit, R. F., de Veer, A. J. E., Batenburg, R. S., & Francke, A. L. (2023). International comparison of professional competency frameworks for nurses: a document analysis. BMC Nursing, 22, 343. https://doi.org/10.1186/s12912-023-01514-3 DOI: https://doi.org/10.1186/s12912-023-01514-3
World Health Organization. (2020, August, 5). Palliative care. https://www.who.int/news-room/fact-sheets/detail/palliative-care
Wu, C.-Y., Wu, Y.-H., Chang, Y.-H., Tsay, M.-S., Chen, H.-C., & Hsieh, H.-Y. (2021). Community nurses' preparations for and challenges in providing palliative home care: a qualitative study. International Journal of Environmental Research and Public Health, 18(11838). https://doi.org/10.3390/ijerph182211838 DOI: https://doi.org/10.3390/ijerph182211838
Ye, Z., Jing, L., Zhang, H., Qin, Y., Chen, H., Yang, J., Zhu, R., Wang, J., Zhang, H., Xu, Y., & Chu, T. (2023). Attitudes and influencing factors of nursing assistants towards hospice and palliative care nursing in Chinese nursing homes: a cross‐sectional study. BMC Palliative Care, 22, 49. https://doi.org/10.1186/s12904-023-01175-8 DOI: https://doi.org/10.1186/s12904-023-01175-8
Zhang, J., Cao, Y., Su, M., Cheng, J., & Yao, N. (2022). Challenges faced by Chinese community nurses when providing home-based hospice and palliative care: a descriptive qualitative study. BMC Palliative Care, 21(14). https://doi.org/10.1186/s12904-022-00905-8 DOI: https://doi.org/10.1186/s12904-022-00905-8
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