Metodologias de ensino de cuidados paliativos em estudantes da área da saúde uma revisão exploratória
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Oct 4, 2022
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Resumo
Introdução: a necessidade de ensinar cuidados paliativos aos profissionais de saúde é cada vez mais prevalente no mundo e na América Latina. Os educadores devem reconhecer os avanços no ensino dos cuidados paliativos por meio de novas formas de aprendizagem. Objetivo: caracterizar as metodologias, conteúdos e efeitos do ensino de cuidados paliativos em estudantes da área da saúde na literatura publicada entre os anos de 2016 a 2020. Métodos: foi realizada uma revisão da literatura do tipo scoping review. Foram revisados artigos publicados em periódicos indexados nas bases de dados Medline, Cuiden, Lilacs, CINAHL no período 2016-2020 nos idiomas inglês, espanhol e português. 25 investigações foram selecionadas após fazer o processo de crítica de evidências. Resultados: os estudos incluídos foram em sua maioria realizados com metodologias quantitativas, nos Estados Unidos e com populações de estudantes de enfermagem. As informações extraídas dos artigos foram organizadas em quatro temas: 1) cursos educativos em cuidados paliativos, 2) estratégias de simulação, 3) conhecimento dos alunos sobre cuidados paliativos, e 4) atitudes e emoções dos alunos em relação aos cuidados paliativos. Conclusões: as estratégias encontradas para ensinar cuidados paliativos incluem cursos totalmente virtuais ou multimodalidade e simulação clínica ou em importancia. Em geral, as evidências mostram o interesse que existe por parte dos alunos em receber esse tipo de curso e a importancia que eles têm em seu desenvolvimento profissional.
Keywords
cuidados paliativos, revisión, estudiantes del área de la salud, educación en enfermeríapalliative care, review, students, nursing educationcuidados paliativos, revisão, estudantes, educação em enfermagem
References
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3. Acevedo LL, Acevedo LJL, Ferro LS, Muñoz JEG, Quintero LA, Moreno SPC. Lecciones aprendidas de la implementación de un programa de cuidado paliativo. Rev Salud, Hist Y Sanid. 2021;16(1):3-9. https://doi.org/10.5281/zenodo.4663387
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6. C Centeno C, Sitte T, de Lima L, Alsirafy S, Bruera E, Callaway M, et al. Documento de Posición Oficial sobre la Promoción Global de Cuidados Paliativos: Recomendaciones del Grupo Internacional Asesor PAL-LIFE de la Academia Pontificia de la Vida, Ciudad del Vaticano. J Palliat Med. 2018;21(10):1398-407. https://doi.org/10.1089/jpm.2018.0387
7. Andrea D, Camacho A, Beatriz D, Medina C, Gallardo Jiménez GP, Stephanie D, et al. Características de la formación para el desarrollo de competencias en pregrado de enfermería en la deficinición y principios de los cuidados paliativos: revisión de la literatura [tesis doctoral]. Bogotá: Universidad del Bosque; 2019.
8. Voutilainen A, Saaranen T, Sormunen M. Conventional vs. e-learning in nursing education: A systematic review and meta-analysis. Nurse Education Today. 2017;50:97-103. https://doi.org/10.1016/j.nedt.2016.12.020
9. Risling T. Educating the nurses of 2025: Technology trends of the next decade. Nurse Education in Practice. Churchill Livingstone; 2017;22:89-92. https://doi.org/10.1016/j.nepr.2016.12.007
10. Camarena VD. Cuidados paliativos: experiencia educativa virtual. Enfoque. Revista Científica de Enfermería. 2011;9(4):17-22.
11. de Castilho WL, Chavaglia SRR, Ohl RIB, Gamba MA, Freitas MA de O. Educational module in a virtual learning environment on Diabetes Mellitus. Enferm Glob. 2020;19(3):345-88. https://doi.org/10.6018/eglobal.320631
12. Organización Panamericana de la Salud. Cuidados paliativos en América Latina - ECHO - OPS/OMS. [Internet]. Washington; 2020 [citado 2 mayo 2021]. Disponible en: https://www.paho.org/es/cuidados-paliativos-america-latina-echo
13. Joanna Briggs Institute. The Joanna Briggs Institute Reviewers’ Manual 2015. Methodology for JBI Scoping Reviews. [Internet]. South Australia; 2015 [citado 31 octubre 2021]. Disponible en: https://nursing.lsuhsc.edu/JBI/docs/ReviewersManuals/Scoping-.pdf
14. Cha J, Lihm H, Kim Y, Kang J. Changes in perceptions and attitudes of medical students toward end-of-life care after hospice and palliative medicine education. Korean J Hosp Palliat Care. 2019;22(4):166-73. https://doi.org/10.14475/kjhpc.2019.22.4.166
15. Price JE, Mendizabal-Espinosa RM, Podsiadly E, Marshall-Lucette S, Marshall JE. Perinatal/neonatal palliative care: Effecting improved knowledge and multi-professional practice of midwifery and children’s nursing students through an inter-professional education initiative. Nurse Educ. 2019;40:102611. https://doi.org/10.1016/j.nepr.2019.08.005
16. Robinson E, Epps F. Impact of a palliative care elective course on nursing students’ knowledge and attitudes toward end-of-life care. Nurse Educ. 2017;42(3):155-158. https://doi.org/10.1097/NNE.0000000000000342
17. Glover TL, Garvan C, Nealis RM, Citty SW, Derrico DJ. Improving End-of-Life Care Knowledge Among Senior Baccalaureate Nursing Students. Am J Hosp Palliat Med. 2017;34(10):938-45. https://doi.org/10.1177/1049909117693214
18. Smothers A, Young S, Dai Z. Prelicensure Nursing Students’ Attitudes and Perceptions of End-of-Life Care. Nurse Educ. 2019;44(4):222-5. https://doi.org/10.1097/NNE.0000000000000606
19. American Association of Colleges of Nursing. End-of-Life-Care (ELNEC) [Internet]. Washington; 2020 [citado 31 octubre 2021]. Disponible en: https://www.aacnnursing.org/ELNEC
20. Akdeniz Kudubes A, Bektas M. The effect of web-based pediatric palliative care education on the palliative care knowledge level and practices of nursing students. Perspect Psychiatr Care. 2020;56(3):533-40. https://doi.org/10.1111/ppc.12463
21. Schulz-Quach C, Wenzel-Meyburg U, Fetz K. Can elearning be used to teach palliative care? – medical students’ acceptance, knowledge, and self-estimation of competence in palliative care after elearning. BMC Med Educ. 2018;18(1):1-7. https://doi.org/10.1186/s12909-018-1186-2
22. Parikh PP, White MT, Buckingham L, Tchorz KM. Evaluation of palliative care training and skills retention by medical students. J Surg Res. 2017;211:172–7. https://doi.org/10.1016/j.jss.2016.11.006
23. Kirkpatrick AJ, Cantrell MA, Smeltzer SC. Relationships among nursing student palliative care knowledge, experience, self-awareness, and performance: An end-of-life simulation study. Nurse Educ Today. 2019;73:23–30. https://doi.org/10.1016/j.nedt.2018.11.003
24. Mahan P, Taggart H, Knofczynski G, Warnock S. Transforming nursing students’ attitudes toward end-of-life care. J Hosp Palliat Nurs. 2019;21(6):496–501. https://doi.org/10.1097/NJH.0000000000000555
25. Lewis C, Reid J, McLernon Z, Ingham R, Traynor M. The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision. BMC Palliat Care. 2016;15(1):1-7. https://doi.org/10.1186/s12904-016-0143-2
26. Ferguson R, Cosby P. Nursing Students’ Attitudes and Experiences Toward End-of-Life Care: A Mixed Methods Study Using Simulation. Clin Simul Nurs. 2017;13(8):343–6. https://doi.org/10.1016/j.ecns.2017.03.006
27. Lindemulder L, Gouwens S, Stefo K. Using QSEN competencies to assess nursing student end-of-life care in simulation. Nursing. 2018;48(4):60-5. https://doi.org/10.1097/01.NURSE.0000531006.94600.28
28. Dame L, Hoebeke R. Effects of a simulation exercise on nursing students’ end-of-life care attitudes. J Nurs Educ. 2016;55(12):701-5. https://doi.org/ 10.3928/01484834-20161114-07
29. Jiang Q, Lu Y, Ying Y, Zhao H. Attitudes and knowledge of undergraduate nursing students about palliative care: An analysis of influencing factors. Nurse Educ Today. 2019;80:15-21. https://doi.org/10.1016/j.nedt.2019.05.040
30. Aboshaiqah AE. Predictors of palliative care knowledge among nursing students in Saudi Arabia: A cross-sectional study. J Nurs Res. 2020;28(1):1-9. https://doi.org/10.1097/jnr.0000000000000301
31. Pieters J, Dolmans DHJM, Verstegen DML, Warmenhoven FC, Courtens AM, Van Den Beuken-Van Everdingen MHJ. Palliative care education in the undergraduate medical curricula: Students’ views on the importance of, their confidence in, and knowledge of palliative care. BMC Palliat Care. 2019;18(1):1-8. https://doi.org/10.1186/s12904-019-0458-x
32. Ismaile S, Alshehri HH. Knowledge of palliative care among nursing students. Stud Health Technol Inform. 2017;238:261-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28679939/
33. Khraisat OM, Hamdan M, Ghazzawwi M. Palliative care issues and challenges in Saudi Arabia: Knowledge assessment among nursing students. J Palliat Care. 2017;32(3–4):121-6. https://doi.org/10.1177/0825859717743229
34. Dimoula M, Kotronoulas G, Katsaragakis S, Christou M, Sgourou S, Patiraki E. Undergraduate nursing students’ knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey. Nurse Educ Today. 2019;74:7-14. https://doi.org/10.1016/j.nedt.2018.11.025
35. Al-Azri M, AL-Saidi S, Al-Musilhi J, Al-Mandhari Z, Panchatcharam SM. Knowledge and Experiences of Final Year Medical and Nursing Students with Regard to Palliative Care at Government University in Oman: A Questionnaire Based Study. J Cancer Educ. 2020;36(4):747-754. https://doi.org/10.1007/s13187-020-01699-0
36. Weber M, Schmiedel S, Nauck F, Alt-Epping B. Knowledge and attitude of final - Year medical students in Germany towards palliative care - An interinstitutional questionnaire-based study. BMC Palliat Care. 2011;10:19. https://doi.org/10.1186/1472-684X-10-19
37. Kim DY, Kim KJ, Shin SJ, Heo DS, Lee SN, Nam EM. Factors That Influence Attitudes Toward End-of-Life Care Among Medical Students: Nationwide Survey for Fourth-Year Korean Medical Students. Am J Hosp Palliat Med. 2019;36(6):460-5. https://doi.org/10.1177/1049909118822287
38. Jeong SH, Lee SJ, Cho SM, Cho H. Systematic Review on the Influencing Factors of Nurses’ and Nursing Students’ Attitudes Toward Hospice and Palliative Care. J Hosp Palliat Nurs. 2020;22(2):130-6. https://doi.org/10.1097/NJH.0000000000000627
39. Ribada Fraga D, Esperón Rodríguez I, del Campo Pérez V. Actitud y sentimientos de estudiantes de Enfermería frente a los cuidados al final de la vida. Metas de Enfermería. 2018;21(10):732-8. https://doi.org/10.35667/MetasEnf.2019.21.1003081332
40. Turton BM, Williams S, Burton CR, Williams L. Arts-based palliative care training, education and staff development: A scoping review. Palliat Med. 2018;32(2):559-70. https://doi.org/10.1177/0269216317712189
41. Pereira LM, Andrade SMO de, Theobald MR. Cuidados paliativos: los desafíos para la enseñanza en salud. Rev Bioética. 2022;30(1):149-61. https://doi.org/10.1590/1983-80422022301515ES
2. Hunter DJ, Reddy KS. Noncommunicable Diseases Country Profiles. New England Journal of Medicine. 2018; 369(14):1336-1343. https://doi.org/10.1056/nejmra1109345
3. Acevedo LL, Acevedo LJL, Ferro LS, Muñoz JEG, Quintero LA, Moreno SPC. Lecciones aprendidas de la implementación de un programa de cuidado paliativo. Rev Salud, Hist Y Sanid. 2021;16(1):3-9. https://doi.org/10.5281/zenodo.4663387
4. Pastrana T, De Lima L, Sánchez-Cárdenas M, Van Steijn D, Garralda E, Pons JJ CC. Atlas de cuidados paliativos en Latinoamérica 2020 [Internet]. Houston; 2021 [citado 29 abril 2021]. Disponible en: https://cuidadospaliativos.org/uploads/2021/8/Atlas%20de%20Cuidados%20Paliativos%20en%20Latinoamerica%202020.pdf
5. Sekse RJT, Hunskår I, Ellingsen S. The nurse’s role in palliative care: A qualitative meta-synthesis. Journal of Clinical Nursing. 2018; 27(1-2):e21-38. https://doi.org/10.1111/jocn.13912
6. C Centeno C, Sitte T, de Lima L, Alsirafy S, Bruera E, Callaway M, et al. Documento de Posición Oficial sobre la Promoción Global de Cuidados Paliativos: Recomendaciones del Grupo Internacional Asesor PAL-LIFE de la Academia Pontificia de la Vida, Ciudad del Vaticano. J Palliat Med. 2018;21(10):1398-407. https://doi.org/10.1089/jpm.2018.0387
7. Andrea D, Camacho A, Beatriz D, Medina C, Gallardo Jiménez GP, Stephanie D, et al. Características de la formación para el desarrollo de competencias en pregrado de enfermería en la deficinición y principios de los cuidados paliativos: revisión de la literatura [tesis doctoral]. Bogotá: Universidad del Bosque; 2019.
8. Voutilainen A, Saaranen T, Sormunen M. Conventional vs. e-learning in nursing education: A systematic review and meta-analysis. Nurse Education Today. 2017;50:97-103. https://doi.org/10.1016/j.nedt.2016.12.020
9. Risling T. Educating the nurses of 2025: Technology trends of the next decade. Nurse Education in Practice. Churchill Livingstone; 2017;22:89-92. https://doi.org/10.1016/j.nepr.2016.12.007
10. Camarena VD. Cuidados paliativos: experiencia educativa virtual. Enfoque. Revista Científica de Enfermería. 2011;9(4):17-22.
11. de Castilho WL, Chavaglia SRR, Ohl RIB, Gamba MA, Freitas MA de O. Educational module in a virtual learning environment on Diabetes Mellitus. Enferm Glob. 2020;19(3):345-88. https://doi.org/10.6018/eglobal.320631
12. Organización Panamericana de la Salud. Cuidados paliativos en América Latina - ECHO - OPS/OMS. [Internet]. Washington; 2020 [citado 2 mayo 2021]. Disponible en: https://www.paho.org/es/cuidados-paliativos-america-latina-echo
13. Joanna Briggs Institute. The Joanna Briggs Institute Reviewers’ Manual 2015. Methodology for JBI Scoping Reviews. [Internet]. South Australia; 2015 [citado 31 octubre 2021]. Disponible en: https://nursing.lsuhsc.edu/JBI/docs/ReviewersManuals/Scoping-.pdf
14. Cha J, Lihm H, Kim Y, Kang J. Changes in perceptions and attitudes of medical students toward end-of-life care after hospice and palliative medicine education. Korean J Hosp Palliat Care. 2019;22(4):166-73. https://doi.org/10.14475/kjhpc.2019.22.4.166
15. Price JE, Mendizabal-Espinosa RM, Podsiadly E, Marshall-Lucette S, Marshall JE. Perinatal/neonatal palliative care: Effecting improved knowledge and multi-professional practice of midwifery and children’s nursing students through an inter-professional education initiative. Nurse Educ. 2019;40:102611. https://doi.org/10.1016/j.nepr.2019.08.005
16. Robinson E, Epps F. Impact of a palliative care elective course on nursing students’ knowledge and attitudes toward end-of-life care. Nurse Educ. 2017;42(3):155-158. https://doi.org/10.1097/NNE.0000000000000342
17. Glover TL, Garvan C, Nealis RM, Citty SW, Derrico DJ. Improving End-of-Life Care Knowledge Among Senior Baccalaureate Nursing Students. Am J Hosp Palliat Med. 2017;34(10):938-45. https://doi.org/10.1177/1049909117693214
18. Smothers A, Young S, Dai Z. Prelicensure Nursing Students’ Attitudes and Perceptions of End-of-Life Care. Nurse Educ. 2019;44(4):222-5. https://doi.org/10.1097/NNE.0000000000000606
19. American Association of Colleges of Nursing. End-of-Life-Care (ELNEC) [Internet]. Washington; 2020 [citado 31 octubre 2021]. Disponible en: https://www.aacnnursing.org/ELNEC
20. Akdeniz Kudubes A, Bektas M. The effect of web-based pediatric palliative care education on the palliative care knowledge level and practices of nursing students. Perspect Psychiatr Care. 2020;56(3):533-40. https://doi.org/10.1111/ppc.12463
21. Schulz-Quach C, Wenzel-Meyburg U, Fetz K. Can elearning be used to teach palliative care? – medical students’ acceptance, knowledge, and self-estimation of competence in palliative care after elearning. BMC Med Educ. 2018;18(1):1-7. https://doi.org/10.1186/s12909-018-1186-2
22. Parikh PP, White MT, Buckingham L, Tchorz KM. Evaluation of palliative care training and skills retention by medical students. J Surg Res. 2017;211:172–7. https://doi.org/10.1016/j.jss.2016.11.006
23. Kirkpatrick AJ, Cantrell MA, Smeltzer SC. Relationships among nursing student palliative care knowledge, experience, self-awareness, and performance: An end-of-life simulation study. Nurse Educ Today. 2019;73:23–30. https://doi.org/10.1016/j.nedt.2018.11.003
24. Mahan P, Taggart H, Knofczynski G, Warnock S. Transforming nursing students’ attitudes toward end-of-life care. J Hosp Palliat Nurs. 2019;21(6):496–501. https://doi.org/10.1097/NJH.0000000000000555
25. Lewis C, Reid J, McLernon Z, Ingham R, Traynor M. The impact of a simulated intervention on attitudes of undergraduate nursing and medical students towards end of life care provision. BMC Palliat Care. 2016;15(1):1-7. https://doi.org/10.1186/s12904-016-0143-2
26. Ferguson R, Cosby P. Nursing Students’ Attitudes and Experiences Toward End-of-Life Care: A Mixed Methods Study Using Simulation. Clin Simul Nurs. 2017;13(8):343–6. https://doi.org/10.1016/j.ecns.2017.03.006
27. Lindemulder L, Gouwens S, Stefo K. Using QSEN competencies to assess nursing student end-of-life care in simulation. Nursing. 2018;48(4):60-5. https://doi.org/10.1097/01.NURSE.0000531006.94600.28
28. Dame L, Hoebeke R. Effects of a simulation exercise on nursing students’ end-of-life care attitudes. J Nurs Educ. 2016;55(12):701-5. https://doi.org/ 10.3928/01484834-20161114-07
29. Jiang Q, Lu Y, Ying Y, Zhao H. Attitudes and knowledge of undergraduate nursing students about palliative care: An analysis of influencing factors. Nurse Educ Today. 2019;80:15-21. https://doi.org/10.1016/j.nedt.2019.05.040
30. Aboshaiqah AE. Predictors of palliative care knowledge among nursing students in Saudi Arabia: A cross-sectional study. J Nurs Res. 2020;28(1):1-9. https://doi.org/10.1097/jnr.0000000000000301
31. Pieters J, Dolmans DHJM, Verstegen DML, Warmenhoven FC, Courtens AM, Van Den Beuken-Van Everdingen MHJ. Palliative care education in the undergraduate medical curricula: Students’ views on the importance of, their confidence in, and knowledge of palliative care. BMC Palliat Care. 2019;18(1):1-8. https://doi.org/10.1186/s12904-019-0458-x
32. Ismaile S, Alshehri HH. Knowledge of palliative care among nursing students. Stud Health Technol Inform. 2017;238:261-4. Disponible en: https://pubmed.ncbi.nlm.nih.gov/28679939/
33. Khraisat OM, Hamdan M, Ghazzawwi M. Palliative care issues and challenges in Saudi Arabia: Knowledge assessment among nursing students. J Palliat Care. 2017;32(3–4):121-6. https://doi.org/10.1177/0825859717743229
34. Dimoula M, Kotronoulas G, Katsaragakis S, Christou M, Sgourou S, Patiraki E. Undergraduate nursing students’ knowledge about palliative care and attitudes towards end-of-life care: A three-cohort, cross-sectional survey. Nurse Educ Today. 2019;74:7-14. https://doi.org/10.1016/j.nedt.2018.11.025
35. Al-Azri M, AL-Saidi S, Al-Musilhi J, Al-Mandhari Z, Panchatcharam SM. Knowledge and Experiences of Final Year Medical and Nursing Students with Regard to Palliative Care at Government University in Oman: A Questionnaire Based Study. J Cancer Educ. 2020;36(4):747-754. https://doi.org/10.1007/s13187-020-01699-0
36. Weber M, Schmiedel S, Nauck F, Alt-Epping B. Knowledge and attitude of final - Year medical students in Germany towards palliative care - An interinstitutional questionnaire-based study. BMC Palliat Care. 2011;10:19. https://doi.org/10.1186/1472-684X-10-19
37. Kim DY, Kim KJ, Shin SJ, Heo DS, Lee SN, Nam EM. Factors That Influence Attitudes Toward End-of-Life Care Among Medical Students: Nationwide Survey for Fourth-Year Korean Medical Students. Am J Hosp Palliat Med. 2019;36(6):460-5. https://doi.org/10.1177/1049909118822287
38. Jeong SH, Lee SJ, Cho SM, Cho H. Systematic Review on the Influencing Factors of Nurses’ and Nursing Students’ Attitudes Toward Hospice and Palliative Care. J Hosp Palliat Nurs. 2020;22(2):130-6. https://doi.org/10.1097/NJH.0000000000000627
39. Ribada Fraga D, Esperón Rodríguez I, del Campo Pérez V. Actitud y sentimientos de estudiantes de Enfermería frente a los cuidados al final de la vida. Metas de Enfermería. 2018;21(10):732-8. https://doi.org/10.35667/MetasEnf.2019.21.1003081332
40. Turton BM, Williams S, Burton CR, Williams L. Arts-based palliative care training, education and staff development: A scoping review. Palliat Med. 2018;32(2):559-70. https://doi.org/10.1177/0269216317712189
41. Pereira LM, Andrade SMO de, Theobald MR. Cuidados paliativos: los desafíos para la enseñanza en salud. Rev Bioética. 2022;30(1):149-61. https://doi.org/10.1590/1983-80422022301515ES
Como Citar
Arias-Rojas, M., Posada López, C., Carreño-Moreno, S., & Arredondo Holgín, E. (2022). Metodologias de ensino de cuidados paliativos em estudantes da área da saúde: uma revisão exploratória. Investigación En Enfermería: Imagen Y Desarrollo, 24. https://doi.org/10.11144/Javeriana.ie24.mecp
Seção
Artículos de Revisión Integrativa o Sistemática
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