Facultad de Enfermería
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Browsing Facultad de Enfermería by Author "Barría Sandoval, Claudia Paz"
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Item Necesidad de atención paliativa en personas con enfermedades crónicas avanzadas en Región del Biobío pre y post pandemia por COVID-19.(Universidad de Concepción, 2023) Barría Sandoval, Claudia Paz; Espinoza Venegas, MaritzaThe predominant model of palliative care (PC) focuses on chronic oncological diseases (COD). However, PC should also be extended to all people with chronic non-oncological diseases (CNOD) in order to improve their quality of life. Knowing the magnitude of the need for PC is essential to generate guidance in planning current public policies and future pandemics. This need for PC can be determined by direct methods using research instruments or by indirect methods with estimation from death records. Objectives: Assess the demand for PC among living individuals dealing with advanced chronic diseases (ACE) the Municipal Health Administration Directorate (DAS) of Santa Juana, located in the Biobío Region, during the pandemic period. Determine the probability of mortality due to ACE in both the pre-pandemic and pandemic periods within the Biobío Region. Methodology: This study was grounded in the positivist paradigm, guiding a quantitative investigation that employed a descriptive, cross-sectional, correlational, and predictive design. The research process unfolded in two distinct phases. In the first phase, a direct method was utilized. The NECPAL Chile Instrument was administered by nursing professionals. They provided responses based on the health records of individuals with chronic diseases whom they regularly attended to and who were registered patients in DAS Santa Juana, Biobío Region. The sampling approach employed was non-probabilistic, quotabased, and data analysis involved descriptive statistics. These statistics were used for variable selection and the identification of prevailing clinical factors related to severity, progression, and frailty that impact the need for PC and 12 month mortality. Subsequently, in the second phase, an indirect method was employed. The sample included 100% of records deaths resulting from chronic diseases in the Biobío Region during the period from 2010 to 2022. Descriptive statistics were applied to indirectly gauge the demand for PC. Simultaneously, various statistical classification and prediction models were employed to comprehend the bio-sociodemographic variables contributing to mortality due to ACE. Results: In the direct estimation of the need for PC in DAS Santa Juana, the results revealed a 58.9% potential requirement for PC; mostly in the older adult and female age group (56.4%), with a dominant prevalence of chronic kidney disease and chronic obstructive pulmonary disease, both in men and women. In the indirect estimate of the need for PC in the Biobío Region, 76.25% of deaths due to CNOD and COD, represented a total of 77,618 people during the study period and who would have required PC. Of this group, 26.17% were deaths due to COD that were probably incorporated into the National Cancer Pain Relief and Palliative Care Program. However, 50.09% were deaths due to CNOD, which represents 50,983 people in the Biobío Region who were excluded PC; of which 81.49% corresponded to people over 65 years of age. Conclusions: The direct and indirect estimation of the need for PC makes visible the care requirements of people with ACE, and provides relevant input that can facilitate the health system in making decisions on the inclusion and coverage of government programs; which, consequently, improves the quality of life in this population group and humanizes care in advanced stages of the disease.