End-of-Life Care During the Pandemic. Perspectives from Healthcare Professionals in Home-based Palliative Care in Colombia
DOI:
https://doi.org/10.17533/udea.iatreia.228Keywords:
Terminal care, Palliative care, COVID 19, Health personnel, PandemicsAbstract
Introduction: The COVID-19 pandemic has had a significant social and health impact. Given the high risk of contagion and the potential collapse of the healthcare system, strategies such as social isolation, the use of personal protective equipment, and an increased reliance on telemedicine were adopted. These measures altered the dynamics of end-of-life patient care.
Methodology: This observational cross-sectional study explored the experiences of home care staff providing end-of-life care and the impact of the pandemic on the care process, as well as on their quality of life and emotional well-being. A survey incorporating the adapted Care Of the Dying Evaluation (iCODE) questionnaire was conducted, alongside an assessment of quality of life using question 30 of the EORTC QLQ, and emotional wellbeing using the PANAS scale.
Results: The experiences of 131 deceased patients were characterized. Professionals reported adequate therapeutic efforts in managing pain, dyspnea, and delirium. Additionally, they noted that the pandemic impeded treatment in 24% of the patients. The average quality of life score for professionals was 6 points, with a predominantly positive affect reported.
Conclusions: Healthcare professionals in home-based care programs observed that the pandemic affected the treatment of nearly a quarter of end-of-life patients. Nonetheless, they highlighted that satisfactory symptomatic care and control were maintained. Additionally, they reported an adequate quality of life.
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(1) Rossi R, Socci V, Pacitti F, Lorenzo GD, Marco AD, Rossi A, et al. Mental Health Outcomes Among Frontline and Second-Line Health Care Workers During the Coronavirus Disease 2019 (COVID-19) Pandemic in Italy. JAMA Netw Open [Internet]. 2020;3(5):e2010185. https://doi.org/10.1001/jamanetworkopen.2020.10185
(2) Mathieu E, Mathieu H, Rodés-Guirao L, Appel C, Giattino C, Hasell J, et al. Coronavirus (COVID-19) Cases - Statistics and Research - Our World in Data [Internet]. [consultado 2022 jan 8]. Disponible en: https://ourworldindata.org/covid-cases
(3) World Health Organization. Situation by Region, Country, Territory & Area [Internet]. 2021 [consultado 2022 Jan 8]. Disponible en: https://covid19.who.int/table?tableDay=yesterday&tableChartType=heat
(4) Our World in Data. Coronavirus (COVID-19) Deaths - Statistics and Research [Internet]. [consultado 2021 Jul 30]. Disponible en: https://ourworldindata.org/covid-deaths
(5) Coronavirus (COVID-19) [Internet]. [cited 2021 Jul 30]. Disponible en: https://www.minsalud.gov.co/salud/publica/PET/Paginas/Covid.aspx
(6) Ministerio de Salud y Protección Social. Dirección de Epidemiología y Demografía [Internet]. Disponible en. https://www.minsalud.gov.co/salud/publica/epidemiologia/Paginas/default.aspx
(7) Congreso De La República De Colombia. Decreto 417 17 Mar 2020. Minist Protección Soc [Internet]. 2020;16. Disponible en: https://dapre.presidencia.gov.co/normativa/normativa/DECRETO 417 DEL 17 DE MARZO DE 2020.pdf
(8) Congreso De La República De Colombia. Decreto 547 de la República de Colombia [Internet]. Disponible en: https://www.minsalud.gov.co/Normatividad_Nuevo/Decreto %200547 %20DE %201996.pdf
(9) Hanna JR, Rapa E, Dalton LJ, Hughes R, Quarmby LM, McGlinchey T, et al. Health and social care professionals' experiences of providing end of life care during the COVID-19 pandemic: A qualitative study. Palliat Med [Internet]. 2021;35(7):1249-1257. https://doi.org/10.1177/02692163211017808
(10) Onwuteaka-Philipsen BD, Pasman HRW, Korfage IJ, Witkamp E, Zee M, van Lent LGG, et al. Dying in times of the coronavirus: An online survey among healthcare professionals about end-of-life care for patients dying with and without COVID-19 (the CO-LIVE study). Palliat Med [Internet]. 2021;35(5):830–42. https://doi.org/10.1177/02692163211003778
(11) Romero CS, Delgado C, Catalá J, Ferrer C, Errando C, Iftimi A, et al. COVID-19 psychological impact in 3109 healthcare workers in Spain: The PSIMCOV group. Psychol Med [Internet]. 2020;52(1):188-194. https://doi.org/10.1017/S0033291720001671
(12) Danet-Danet A. Impacto psicológico de la COVID-19 en profesionales sanitarios de primera línea en el ámbito occidental. Una revisión sistemática. Med Clin (Barc) [Internet]. 2021;156(9):449–58. https://doi.org/10.1016/j.medcli.2020.11.009
(13) Contraloría General de la República. Encuesta de la Contraloría a personal de la salud confirma falta de implementos de seguridad y desventajosas condiciones laborales. Sala de prensa. Comunicado de prensa 087, julio 2020. Disponible en: https://www.contraloria.gov.co/es/w/encuesta-de-la-contralor %C3 %ADa-a-personal-de-la-salud-confirma-falta-de-implementos-de-seguridad-y-desventajosas-condiciones-laborales
(14) Linares-Parra GD, Guedez-Salas YS. Síndrome de burnout enfermedad invisible entre los profesionales de la salud. Aten Primaria [Internet]. 2021;53(5):102017. https://doi.org/10.1016/j.aprim.2021.102017
(15) Maguiña-Vargas C, Gastelo-Acosta R, Tequen-Bernilla A. El nuevo Coronavirus y la pandemia del Covid-19. Rev Medica Hered [Internet]. 2020;31(2):125–31. http://dx.doi.org/10.20453/rmh.v31i2.3776
(16) Epicrisis. La salud mental y síndrome de burnout en los médicos [Internet]. 2019 [consultado 2021 Jul 30]. Disponible en: https://epicrisis.org/2019/01/01/la-salud-mental-y-sindrome-de-burnout-en-los-medicos/
(17) Sánchez-Pedraza R, Valdelamar-Jiménez A. Validación para utilización en Colombia de la escala EORTC QLQ C-30 para evaluación de la calidad de vida de los pacientes con cáncer. Rev Colomb Cancerol [Internet]. 2020;24(2):61–71. https://doi.org/10.35509/01239015.128
(18) Sandín B, Chorot P, Lostao L, Joiner TE, Santed MA, Valiente RM. Escala PANAS de afecto positivo y negativo: validación factorial y convergencia transcultural. Psicothema [Internet]. 1999;11(1):37-51 Disponible en: https://reunido.uniovi.es/index.php/PST/article/view/7556
(19) Das S, Singh T, Varma R, Arya YK. Death and Mourning Process in Frontline Health Care Professionals and Their Families During COVID-19. Front Psychiatry [Internet]. 2021;12:624428. https://doi.org/10.3389/fpsyt.2021.624428
(20) Spacey A, Porter S, Michele Board, Scammell J. Impact of the COVID-19 pandemic on end of life care delivery in care homes: A mixed method systematic review. Palliat Med. 2021;35(8):1468–79. http://dx.doi.org/10.1177/02692163211029806
(21) Sutherland M, Stilos KK. Evaluating the Pharmacological Management of Terminal Delirium in Imminently Dying Patients With and Without the Comfort Measure Order Set. J Hosp Palliat Nurs [Internet]. 2019;21(5):430-437. http://dx.doi.org/10.1097/NJH.0000000000000585
(22) Ben-Jacob TK, Peterson LN. Drastic changes in the practice of end-of-life care during the COVID-19 pandemic. J Crit Care [Internet]. 2022;67:195-197. http://dx.doi.org/10.1016/j.jcrc.2021.09.019
(23) Silva-Gomes RN, Silva-Gomes VT. Pandemia de la COVID-19: síndrome de Burnout en profesionales sanitarios que trabajan en hospitales de campaña en Brasil. Enferm Clin [Internet]. 2021;31(2):128-129. http://dx.doi.org/10.1016/j.enfcli.2020.10.011
(24) Navinés R, Olivé V, Fonseca F, Martín-Santos R. Estrés laboral y burnout en los médicos residentes, antes y durante la pandemia por COVID-19: una puesta al día. Med Clin (Barc) [Internet]. 2021;157(3):130-140. http://dx.doi.org/10.1016/j.medcli.2021.04.003
(25) Miguel-Puga JA, Cooper-Bribiesca D, Avelar-Garnica FJ, Sanchez-Hurtado LA, Colin-Martínez T, Espinosa-Poblano E, et al. Burnout, depersonalization, and anxiety contribute to post-traumatic stress in frontline health workers at COVID-19 patient care, a follow-up study. Brain Behav [Internet]. 2021;11(3):e02007. http://dx.doi.org/10.1002/brb3.2007
(26) Lozano-Vargas A. El síndrome de burnout en los profesionales de salud en la pandemia por la COVID-19. Rev Neuropsiquiatr [Internet] 2021;84(1):1. http://dx.doi.org/10.20453/rnp.v84i1.3930
(27) Varani S, Ostan R, Franchini L, Ercolani G, Pannuti R, Biasco G, et al. Caring Advanced Cancer Patients at Home During COVID-19 Outbreak: Burnout and Psychological Morbidity Among Palliative Care Professionals in Italy. J Pain Symptom Manage [Internet]. 2021;61(2):e4-e12. http://dx.doi.org/10.1016/j.jpainsymman.2020.11.026
(28) Tovar-Sandoval Y, Tíjaro-Perico EA, Rodríguez-Franky RN, Riaño-Useche LL. Percepción del Burnout en el personal de enfermería durante el Covid -19 en Ibagué, Colombia [Tesis]. Bogotá; Universidad EAN. 2021. Disponible en: http://hdl.handle.net/10882/10821
(29) Rosenberg AR, Weaver MS, Fry A, Wiener L. Exploring the Impact of the Coronavirus Pandemic on Pediatric Palliative Care Clinician Personal and Professional Well-Being: A Qualitative Analysis of U.S. Survey Data. J Pain Symptom Manage [Internet]. 2021;61(4):805-811. http://dx.doi.org/10.1016/j.jpainsymman.2020.09.037
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