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Abstract(s)
A presente dissertação, desenvolvida no âmbito da Unidade Curricular Estágio, do Mestrado em Ciências Farmacêuticas inclui um primeiro capítulo ou estudo de caso centrado nas diferenças entre a dor crónica oncológica e a dor crónica não oncológica, do ponto de vista da abordagem terapêutica e enquadramento social/emocional, na sequência da utilização do medicamento, com o objectivo de explorar a existência de um nicho por explorar em matéria de aconselhamento farmacêutico que poderá contribuir para benefício, aos futuros utentes em cuidados paliativos. O segundo capítulo da dissertação consiste no relatório final ao estágio realizado em farmácia comunitária.
O primeiro capítulo designa-se “Estudo comparativo na abordagem da dor entre um doente em tratamento de dor crónica não oncológica e um doente em tratamento de dor crónica oncológica”. A dor crónica, uma das condições globais mais comuns, associada a um tratamento ineficaz, diminui significativamente a saúde e qualidade de vida do doente (QOL). O envelhecimento da população e o aumento das patologias crónicas associadas à idade fazem prever um aumento da prevalência da dor crónica e do recurso a cuidados paliativos, a nível global. A dor definida por uma experiência desagradável de causas e características multifactoriais é um dos sintomas mais incómodos e prevalentes do cancro, a nível global, uma ameaça que duplicou nos últimos 30 anos do Século XX, esperando-se que duplique novamente até 2020 e triplique por volta de 2030. O controlo adequado da dor crónica depende de uma correcta classificação da intensidade da mesma, através de ferramentas de classificação validadas e correctamente aplicadas, pela percepção e promoção da comunicação entre o doente e os profissionais de saúde. Depende, ainda, da experiência do profissional de saúde responsável e da sua colaboração com os demais profissionais, da correcta aplicação das normas e recomendações, sendo os fármacos opióides, a escolha de eleição, tendo em conta o carácter individualizado do doente, para a abordagem terapêutica da dor crónica e, da correcta informação prestada ao doente aquando de todo o seu acompanhamento farmacoterapêutico. O tratamento farmacológico da dor crónica não oncológica e da dor crónica oncológica é uma experiência distinta e multidimensional que exige cada vez mais uma estreita colaboração entre o profissional de saúde, o doente e os seus familiares/cuidadores e uma abordagem holística, para tratar a pessoa e não apenas a doença, numa gestão integrativa da dor. Nesta gestão integrativa da dor são várias as competências farmacêuticas, por explorar, no contexto de farmácia hospitalar e comunitária, que concretizando-se, trarão benefícios inequívocos aos futuros utentes em cuidados paliativos, em Portugal. Pretende-se evidenciar a realidade do impacto e do papel do farmacêutico, numa unidade hospitalar portuguesa e, na comunidade a ela circunscrita, envolvendo um doente em tratamento de dor crónica oncológica e um doente em tratamento de dor crónica não oncológica. Pretende-se, também, lançar as bases para uma reforma nos cuidados da dor crónica oncológica e não oncológica, em Portugal e, para a redefinição do farmacêutico como parte integrante de equipas multidisciplinares de saúde, para o tratamento da dor.
O segundo capítulo corresponde ao relatório de estágio em Farmácia Comunitária, onde procuro descrever a responsabilidade, a abrangência e os limites do papel do farmacêutico na promoção da qualidade dos cuidados de saúde do utente, numa análise e reflexão sobre todas as actividades em que participei e dos conhecimentos adquiridos, ao longo do meu estágio, de 800 horas, na Farmácia Holon Covilhã.
The present dissertation falls under the scope of the internship curricular unit of the Master Degree Course in Pharmaceutical Science. It includes a first chapter or case study focused on the differences between chronic cancer pain and chronic non-cancer pain, viewed by therapeutic approach and social/emotional framework, as a result of the use of the drugs, exploring the existence of a possibility to explore in the area of pharmaceutical intervention which may contribute to benefit the future patients in palliative care. The second chapter offers an account of the internship at a community pharmacy. The first chapter is titled "comparative study on pain between a patient approach in treatment of chronic non-cancer pain and one patient approach in treatment of chronic cancer pain.” Chronic pain, one of the most common global conditions, associated with an ineffective treatment, decreases significantly the health and quality of life (QOL) of patients. The aging of population and the increase of chronic diseases associated with age will contribute to an increase in the prevalence of chronic pain and palliative care needs, at a global level. The pain, an unpleasant experience of multi-factorial causes and characteristics is one of the most common symptoms due to cancer, worldwide, a threat that has doubled in the past 30 years of the 20th century are expected to double again until 2020 and triple around 2030. The adequate control of chronic pain needs a correct classification of its intensity, through validated classification tools, correctly applied, by perception and promotion of communication between the patient and healthcare professionals. The adequate control of chronic pain depends of the health professional experience and his collaboration with other professionals, the correct application of the standards and recommendations, taking into account the individualized nature of the patient and pathology, and the information provided to the patient during the complete pharmacotherapy follow-up. Pharmacological treatment of chronic non-cancer pain and chronic cancer pain is a distinct and multidimensional experience that requires increasingly close collaboration between the health professional, the patient and their families/caregivers and a holistic approach, to treat the person and not just the disease, into an integrative pain management. This integrative pain management includes several pharmaceutical skills, if better explored, in the context of hospital and community pharmacy context, will bring benefits to future patients in palliative care, in Portugal. The present work aims at demonstrating the reality of the impact and the role of the pharmacist in a hospital unit, and in the surrounding community, involving a patient in treatment of chronic cancer pain and one patient in treatment of chronic non-cancer pain. This dissertation also puts forward some thoughts about a reform in the Portuguese care of cancer and non-cancer chronic pain, and for resetting the pharmacist as part of multidisciplinary health teams, for the treatment of pain. The second chapter of this dissertation concerns the community pharmacy curricular internship, where is described the responsibility, the dimension and limits of the pharmacist's role in promoting the quality of health care, including the analysis and reflection about all the activities and the knowledge gained throughout my internship, during 800 hours, at the pharmacy Holon Covilhã.
The present dissertation falls under the scope of the internship curricular unit of the Master Degree Course in Pharmaceutical Science. It includes a first chapter or case study focused on the differences between chronic cancer pain and chronic non-cancer pain, viewed by therapeutic approach and social/emotional framework, as a result of the use of the drugs, exploring the existence of a possibility to explore in the area of pharmaceutical intervention which may contribute to benefit the future patients in palliative care. The second chapter offers an account of the internship at a community pharmacy. The first chapter is titled "comparative study on pain between a patient approach in treatment of chronic non-cancer pain and one patient approach in treatment of chronic cancer pain.” Chronic pain, one of the most common global conditions, associated with an ineffective treatment, decreases significantly the health and quality of life (QOL) of patients. The aging of population and the increase of chronic diseases associated with age will contribute to an increase in the prevalence of chronic pain and palliative care needs, at a global level. The pain, an unpleasant experience of multi-factorial causes and characteristics is one of the most common symptoms due to cancer, worldwide, a threat that has doubled in the past 30 years of the 20th century are expected to double again until 2020 and triple around 2030. The adequate control of chronic pain needs a correct classification of its intensity, through validated classification tools, correctly applied, by perception and promotion of communication between the patient and healthcare professionals. The adequate control of chronic pain depends of the health professional experience and his collaboration with other professionals, the correct application of the standards and recommendations, taking into account the individualized nature of the patient and pathology, and the information provided to the patient during the complete pharmacotherapy follow-up. Pharmacological treatment of chronic non-cancer pain and chronic cancer pain is a distinct and multidimensional experience that requires increasingly close collaboration between the health professional, the patient and their families/caregivers and a holistic approach, to treat the person and not just the disease, into an integrative pain management. This integrative pain management includes several pharmaceutical skills, if better explored, in the context of hospital and community pharmacy context, will bring benefits to future patients in palliative care, in Portugal. The present work aims at demonstrating the reality of the impact and the role of the pharmacist in a hospital unit, and in the surrounding community, involving a patient in treatment of chronic cancer pain and one patient in treatment of chronic non-cancer pain. This dissertation also puts forward some thoughts about a reform in the Portuguese care of cancer and non-cancer chronic pain, and for resetting the pharmacist as part of multidisciplinary health teams, for the treatment of pain. The second chapter of this dissertation concerns the community pharmacy curricular internship, where is described the responsibility, the dimension and limits of the pharmacist's role in promoting the quality of health care, including the analysis and reflection about all the activities and the knowledge gained throughout my internship, during 800 hours, at the pharmacy Holon Covilhã.
Description
Keywords
Cuidados Paliativos Dor Dor Crónica Não Oncológica Dor Crónica Oncológica Envelhecimento Farmacêutico Farmácia Comunitária Farmácia Hospitalar Intervenção Farmacêutica Saúde Terapia da Dor