Palliative care in primary health care: Challenges for training in the Brazilian public system (Unified Health System - SUS)

Abstract

The improvement in biomedical and healthcare resources has led to an increased life expectancy in the Brazilian population. This aging, coupled with new lifestyle habits, has contributed to the occurrence of non-communicable chronic diseases - particularly cancers, often incurable - making palliative care (PC) emerge as the sole therapeutic recourse. PC involves an approach aimed at promoting the quality of life for patients and their families in the face of therapeutic non-resolvability and the inevitability of life continuation. Early case identification, comprehensive assessment, pain management, and addressing other psychosocial distress are fundamental elements of this practice. Furthermore, healthcare services need to organize themselves in response to this growing demand, with Primary Health Care being a fertile environment for providing this care. Besides allowing geographical, cultural, and emotional proximity of the patient to their loved ones, ensuring their final days with integrity and autonomy. Such care is still offered at other levels, based on the logic of Health Care Networks, comprehensiveness, humanization, referral and counter-referral. The challenge for the curricula of health education courses is to keep up with these changes, seeking to train professionals with a scientific and humanitarian basis consistent with this new clinical reality, whether in specific disciplines – teaching focuses on deepening the technical and human aspects; or through transversal teaching – discussing PC throughout the training, in any discipline. Thus, it is expected that professionals will provide care, offering comfort and tranquility to the patient and their families, collaborating in the humanization of the "ways of dying" in Brazil.