Definição de competências em cuidados paliativos para a formação médica

Abstract

Brazil shows, like other countries in development, a demographic change with the reduction of birth and mortality rates, an increase of life expectancy, and population’s aging. Against this scenario, the number of life-threatening chronic diseases also increases. To care of patients affected by those ills, palliative care is being studied and developed. The curricular medical school matrix should agree with professional practices to be ruled by society's needs. The medical formation in Brazil presents some deficiency in the palliative care approach. The objective of this study is to define competencies in palliative care that are needed for the generalist medical formation. The research was descriptive and exploratory, using the Delfos technique. The sample consisted of 11 doctors who’s expertise allow’s an occupation area in palliative care. At the first round of questions, the competencies that the professionals think as necessary to a generalist doctor has been listed; in the second, they choose the competences after the first round collected ones, with the increase of some competencies cited in the White Book; at the third round, the matrix constructed by consensus was validated. The panelist’s most voted recommendations were: knowledge on palliative care, palliative care on basic care, symptoms control, interprofessional work, communication skills, and bioethics. A 30 competences matrix was developed, sorting out that one’s related to knowledge and others related to skills. From these results, a product was developed. Knowing that a competencies matrix optimizes the medical graduation’s duration and leads the content taught in the course to the social and health context reality, the product has as objective the adequacy the competences matrix resulted from this study to the teaching-learning cycles on FAMED/UFAL. When a deficiency was identified on the approach of palliative care in the curricular matrix of UFAL’s Medicine graduation course, it was proposed a new competences matrix, with the transversal increase of knowledge and skills in palliative care, considering the learning cycles. In this study the Delphi technique was used, an important qualitative research tool that provided the elaboration of a competences matrix in palliative care that may contribute to the qualification of medical formation. The challenge will be to implant this adequation in front of a medical curriculum that already possesses vast content, needing discussions between Structure Teaching Nucleus, the collegiate, and professors with expertise in these subjects.