IMPLEMENTATION OF PEDIATRIC PALLIATIVE CARE: RETROSPECTIVE ANALYSIS OF CHRONIC LONG-STAY PATIENTS AT HC-UFTM

Abstract

Introduction: Pediatric Palliative Care (PPC) represents a multidisciplinary approach that aims to alleviate the suffering and improve the quality of life of children with serious illnesses and their families. Although standardized in Brazil, the implementation of CPP still faces challenges, mainly due to the lack of specialized professionals and cultural resistance. This study aims to evaluate the effectiveness and scope of SSC in a referral hospital in Brazil, identifying barriers and potentialities to optimize this care. Goal:

OBJECTIVE: To analyze long-term pediatric hospitalizations at the Hospital de Clínicas of the Federal University of Triângulo Mineiro (HC-UFTM) and to verify the flow of chronic patients who could benefit from SSC, seeking to understand the profile of hospitalizations and factors that influence late inclusion in this care. Methodology: A retrospective study was carried out based on the review of medical records of children hospitalized for more than 30 days between 2018 and 2022 in the Pediatrics sectors of HC-UFTM, including children's emergency room, nursery, pediatric ICU, and wards. Criteria such as length of hospital stay, pathologies, frequency of hospitalizations, and difficulties in discharge were analyzed. The data were organized into tables and frequency graphs for easy visualization. The study was approved by the Research Ethics Committee (CAAE: 57388722.7.0000.5154) and formalized in Plataforma Brasil. Findings:

A total of 180 medical records were analyzed, of which 106 hospitalizations lasted 100 days or more. Among the patients, 23.9% died and, of the 180, only ten were formally included in SSC. The main causes of hospitalization were prematurity (30.6%) and respiratory distress (22.8%). The analysis revealed that 87.5% of the patients included in PPC died on the same day or one day after the start of palliative care, suggesting the late introduction of this care. The lack of documentation and the abrupt disconnection of families from the team's follow-up reflect the need for improvements in the implementation of CPP. Conclusion:

The low incidence of SSC and the late introduction of care reflect structural and cultural challenges in the implementation of these services. There is an urgent need for investments in job training, infrastructure and ongoing support for families during the grieving process. Partnerships with institutions experienced in CPP can strengthen the quality of care, ensuring a more dignified and compassionate approach to children with serious illnesses and their families.