Palliative Care in Portugal-From Intention to Reality, What Is Yet to Be Accomplished

Autores da FMUP

• Maria Francisca Melo Pojal Da Silva Rego

  Autor

• Rui Manuel Lopes Nunes

  Autor

Participantes de fora da FMUP

• Marques, P

Unidades de investigação

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• Medicina da Comunidade, Informação e Decisão em Saúde

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Highlights What are the main findings? The flexibility of the palliative care implementation model is as or more important than its principles. Public education is a fundamental requirement for the dissemination of palliative care. What is the implication of main findings? The participation of health actors is essential for higher-level decisions to be effective. It is crucial to invest in basic knowledge on PC in undergraduate training of health professionals and in the establishment of a medical palliative care specialty.Highlights What are the main findings? The flexibility of the palliative care implementation model is as or more important than its principles. Public education is a fundamental requirement for the dissemination of palliative care. What is the implication of main findings? The participation of health actors is essential for higher-level decisions to be effective. It is crucial to invest in basic knowledge on PC in undergraduate training of health professionals and in the establishment of a medical palliative care specialty.Abstract Objectives: This article focuses on exploring the evolution of palliative care in Portugal. Ten years after the approval of its Basic Law, the aim was to investigate the quality of the path followed and the guidelines that could promote its development. Thus, this study sought to identify (a) the goals of the current members of parliament concerning palliative care, (b) the major priorities that should guide the development of palliative care in the coming decade, (c) the facilitating or hindering factors to accelerating the process, and (d) to propose consensually agreed measures for the integral development of palliative care within the health system. Methods: The qualitative data analysis was performed through the reading of the literature and interviews conducted via Zoom with several intentionally chosen participants. The data extracted from the previous studies were analyzed in a focus group. The NVivo (R) 10 was used for the data processing and categorization. Results: Three key themes emerged concerning the current status of palliative care: the policymakers, the health professionals, and the society. This first line of structuring is explained by a second set of categories, namely, (a) the knowledge about palliative care; and (b) palliative care organization from the policymakers' perspective. In the health professionals' domain: (a) knowledge about palliative care, (b) clinical training, and (c) medical specialty. Finally, in society: (a) knowledge about palliative care. Significance of the results: Advancing general education, increasing the qualitative training for different health professionals, reformulating the laws supporting them, promoting the flexibility of the implementation methodologies, and establishing a medical specialty are crucial to achieving the proposed goal. This study was not registered.

Keywords

• palliative care; health policy; health knowledge; education; organizational efficiency