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.
The objective of the study is to compare the clinical and therapeutic characteristics related to the hospitalization course in palliative patients undergoing conventional therapy and hypodermoclysis in a general and oncology hospital. It is a study with a quantitative approach, prospective cohort, to structure it, Strengthening the Reporting of Observational Studies in Epidemiologi was used. It took place in two oncology reference services with exclusive services to the Unified Health System in the state of Rio Grande do Norte. The study population consisted of cancer patients undergoing palliative care who were hospitalized. Therefore, to calculate the sample for this research, it showed a power of 80% and a level of evidence of 0.05, so the overall sample was 84 patients to be evaluated. This research included patients admitted to hospitals that present palliative care procedures or that are beyond therapeutic possibilities, and excluded patients whose at least the main caregiver had no knowledge about palliative care procedures. For the outcomes of this study, death, hospital discharge and transfer to other units will be considered. For data collection, an instrument for sociodemographic and clinical data was used, in addition to the algorithm for eligibility of hypodermoclysis in adult patients, the Edmonton Symptom Assessment Scale and the Palliative Performance Scale. The data was organized in Microsoft Excel and analyzed using the statistical software Statistical Package for the Social Sciences version 22.0, statistical tests were carried out to analyze the data, with a significance level of 0.05 adopted. The study obtained a favorable opinion from the Research Ethics Committee under number 6.289.214 and CAAE 71440423.6.0000.5537, thus following the ethical precepts in research with human beings described in Resolution 466/2012 of the National Health Council. Study was divided into hospital 1 (29 patients) and hospital 2 (55 patients), this is justified by the discrepancy in the number of hospital beds in hospital 2 in relation to hospital 1. The results indicate that in both hospitals the median age They are in the sixty-year-old age group, female (37.0% - 63.0%), and predominantly reside in the interior of the state (36.2% - 63.8%). The types of cancer that prevailed were of gastrointestinal origin (45.9%), followed by lung (11.8%) and breast (8.2%), in addition, the number of days of hospitalization had a median of six days in hospital 1 and four in hospital 2. The study showed that palliative patients used the peripheral venous catheter more frequently (53.3%) with a median of one day in usage time, the central venous catheter had a median in usage time of thirteen days and hypodermoclysis of one day. Therefore, the routes are effective, however, adverse events related to the catheter and assistance were observed, such as: infiltration, erythema, hematomas, venous fragility, which will present different levels of complications in relation to the catheter and puncture site of choice. Furthermore, infusion therapy works to control signs and symptoms, contributing to comfort and quality of life. This study verified the access route that guarantees quality, safety and comfort for patients in hospital, as well as contributing to a safe and cost- effective transition of care for health services and users.