Conventional infusion therapy and hypodermoclysis in
palliative patients: comparison between general and oncology hospitals.
Vascular Access Devices; Hypodermoclysis; Palliative Care; Quality of
Health Care; Oncology Nursing.
Infusional therapy is a critical process and constitutes the primary resource used in the
treatment of diseases through the administration of medications and fluids directly
through catheters in non-physiological access routes. Thus, conventional infusional
therapy is characterized by being widely used in the healthcare environment.
Approximately 90% of hospitalized patients receive medicinal solutions vascular route,
and furthermore, 50% to 75% of patients are on peripheral intravenous therapy. Among
the options for medicinal routes, subcutaneous infusion (hypodermoclysis) is a
technique that stands out for its ease of insertion, handling, promotion of comfort and
autonomy, as well as the reduction of the risk of local or systemic complications. From
this perspective, hypodermoclysis is a technology used in the healthcare field,
particularly in palliative care infusional therapy. The goal of palliative care is to provide
active holistic care and improve the quality of life, thus promoting symptom
management, comfort, and a low risk of complications. In this regard, the incorporation
of healthcare technologies can contribute to the sustainability of public policies,
especially those that are already in use and can demonstrate therapeutic impact. In this
perspective, the study purpose to compare the clinical and therapeutic characteristics
related to the hospitalization process of palliative care patients undergoing conventional
therapy and hypodermoclysis in a general hospital and an oncological hospital. This is a
quantitative prospective cohort study that will be conducted with oncological patients in
palliative care who use conventional infusional therapy and hypodermoclysis. The study
will take place in two oncology reference services with exclusive coverage for the
Unified Health System (SUS) in the state of Rio Grande do Norte. The study population
will consist of oncological patients in palliative care who are hospitalized. To calculate
the sample size for this research, a power of 80% and a significance level of 0.05 were
considered, resulting in a total sample of 84 patients to be evaluated. Patients admitted
to hospitals following palliative care guidelines or those who are beyond therapeutic
possibilities will be included in this study, while patients not using infusional therapy
will be excluded. The study outcomes will include death, home care, and transfer to
other units. Data collection will involve the use of an instrument for sociodemographic
and clinical data, as well as an algorithm for eligibility for adult patients receiving
hypodermoclysis, the Edmonton Symptom Assessment Scale, and the Karnofsky
Performance Status Scale. Data will be organized in Microsoft Excel and analyzed
using the Statistical Package for the Social Sciences version 22.0, with a significance
level of 0.05. The study has obtained favorable approval from the Research Ethics
Committee under the number 6.289.214 and CAAE 71440423.6.0000.5537, and will
adhere to the ethical principles for research involving human subjects as described in
Resolution 466/2012 of the National Health Council.