Abstract
Background: While evidence demonstrates that end-of-life care practices vary across countries, there is still a lack of evidence regarding the healthcare that is received by adult individuals in the last months of life in Portugal. Methods: This is a systematic review that aims to examine the evidence published until 2019 regarding the healthcare received by adult individuals in the last months of life in Portugal. Results: Nine studies were included in this review. All of these were quantitative and retrospective studies, used patient records as the source of information, and were conducted in hospital settings. The time frame analysis before death ranged from 48 h to 3 months. The majority of the studies focused on the physical aspects of care, such as physical needs assessment and symptom management, prescribed medication, and invasive interventions. No evidence was found regarding spiritual, psychological, social or cultural needs. Conclusion: Although using patient records as a source of information may introduce a bias, this study indicates that there is a greater emphasis on the physical aspects of care and less on the psychological, spiritual or social aspects of care received by adult individuals in their last months of life in Portugal.
Highlights
Increased life expectancy and better health conditions are allowing people to live longer [1] and to manage many chronic conditions over time
Two studies had no defined time frame analysis. This is consistent with international follow-back surveys [8,18]. This result may, in part, explain the results we obtained in the outcome measures, as the most studied measures we found in the included studies are related to the physical aspects of care like the place of death, prescribed medication, needs assessment and symptom management, and invasive interventions
This study provided baseline evidence of the healthcare received by adult individuals with chronic disease in the last months of life in Portugal
Summary
Increased life expectancy and better health conditions are allowing people to live longer [1] and to manage many chronic conditions over time. It is estimated that by 2060, 47% of all people will die with serious health-related suffering [6] In this context, debates about a dignifying death have been ongoing since the 1960s with the start of the hospice movement [7], and end-of-life care is increasingly receiving the attention of the public and policymakers [8]. Methods: This is a systematic review that aims to examine the evidence published until 2019 regarding the healthcare received by adult individuals in the last months of life in Portugal. Conclusion: using patient records as a source of information may introduce a bias, this study indicates that there is a greater emphasis on the physical aspects of care and less on the psychological, spiritual or social aspects of care received by adult individuals in their last months of life in Portugal
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