Analysis of the historical evolution of the concept of palliative care: a scoping review

Souza, Lorena Campos de; Cestari, Virna Ribeiro Feitosa; Nogueira, Vitória Pessoa; Furtado, Marilia Alves; Oliveira, Ingrid Mikaela Moreira de; Moreira, Thereza Maria Magalhães; Salvetti, Marina de Góes; Pessoa, Vera Lúcia Mendes de Paula

doi:10.37689/acta-ape/2022AR0180666

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Acta Paulista de Enfermagem

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Review Article • Acta Paul Enferm 35 • 2022 • https://doi.org/10.37689/acta-ape/2022AR0180666 copy

Analysis of the historical evolution of the concept of palliative care: a scoping review

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective

To analyze the historical evolution of the concept of palliative care and identify its essential elements.

Methods

This is a scope review based on the Joanna Briggs Institute Reviewer’s manual, which included the definitions of palliative care from scientific articles selected from health databases and portals. Twenty-one studies were selected for analysis. The IRaMuTeQ^® software was used to group the data.

Results

From 1993 to 2020, the most cited definition of palliative care was that of the World Health Organization. The palliative approach was implemented in the physical, biopsychosocial and spiritual spheres for patients with acute or chronic illnesses to promote comfort, dignity and quality of life. The essential elements identified in the definitions were life, care, quality, family, multidisciplinary team, comfort, and relief.

Conclusion

It was found that the definition of palliative care has matured, by adding elements to guarantee a dignified quality of life, regardless of type of disease, and integrating family and interprofessional team in this process.

Paliative care; Comprehensive health care; Humanization of assistance; Terminal care

Authors Year/Country	Design	Frameworks	Definitions
Porzsolt F/1993/ Germany⁽⁸⁾	Descriptive	Bruera et al. (1986)	Approach to alleviate symptoms, prevent impending problems, improve quality of life and extend survival, if possible.
Santos OM/2011/ Brazil⁽⁹⁾	Descriptive	WHO (2002)	Approach that aims to improve the quality of life of patients who face problems arising from an incurable disease with limited prognosis and/or serious disease (life-threatening) and their families, through the presence of a multidisciplinary team and relief of suffering, using early identification, proper assessment and rigorous treatment of symptoms not only physical, such as pain, but also psychosocial and spiritual.
Tosello B et al./2015/ France⁽¹⁰⁾	Exploratory	République française (2002)	Active and continuous care provided by a multidisciplinary team in an institution or at home, with the objective of alleviating pain, reducing mental suffering, preserving patients’ dignity and supporting their family and friends.
Silva MM et al./2014/ Brazil⁽¹¹⁾	Descriptive	WHO (2007)	PC is promoted by a multidisciplinary team, aiming to improve the quality of life of persons and their families in the face of a life-threatening disease, through the prevention and relief of suffering, early identification, impeccable assessment and treatment of pain and other physical, social, psychological and spiritual symptoms
Wright R et al./2020/ United Kingdom⁽¹²⁾	Action research	WHO (2011)	Multidisciplinary biopsychosocial-spiritual care of a person with serious illness and his/her family.
Damani A et al./2020/ India⁽¹³⁾	Descriptive	Roma et al. (2011)	Holistic care of physical, psychological, social and spiritual health, with a focus on alleviating widespread suffering through effective symptom control, promoting quality of life, and making complex decisions, all of which play an important role in care.
Padmanabhan DL et al./2020/ EUA⁽¹⁴⁾	Exploratory	WHO (2012)	An approach that improves the quality of life of patients and their families who face the problems associated with potentially fatal diseases through the prevention and relief of suffering through the identification, assessment and early treatment of pain and other physical, psychosocial and spiritual challenges.
Qu X et al./2018/ China⁽¹⁵⁾	Descriptive	Kang, Zhu and Liu (2012)	Approaches that improve the quality of life of patients and help their families overcome the problems associated with life-threatening illnesses, to help the terminal patient experience peace, comfort and dignity.
Pavlic DR et al./2019/ European countries⁽¹⁶⁾	Exploratory	WHO (2013)	Holistic approach that improves the quality of life of patients and their families facing problems associated with life-threatening illnesses. It offers prevention and relief from suffering through early identification, diligent assessment and treatment of pain and other physical, psychosocial or spiritual problems.
Zuniga- Villanueva G et al./2019/ Mexico⁽¹⁷⁾	Exploratory	WHO (2014)	Comprehensive approach that focuses on improving the quality of life of children, in its final stages and is usually provided for life-threatening illnesses with poor prognosis.
Zalaf LR et al./2017/ Brazil⁽¹⁸⁾	Cross-sectional	WPCA (2014)	A holistic approach that improves the quality of life of children with life-limiting illnesses through a family-centered approach to care and alleviation of physical, psychosocial and spiritual suffering
Xiang YR et al/2018/ China⁽¹⁹⁾	Descriptive	Hu and Feng (2016)	Comprehensive treatment of physical, psychological, social and spiritual care for terminal patients, aiming at improving the quality of life of patients and their families.
Çeliker MY et al./2017 /Cambodia⁽²⁰⁾	Descritivo	WHO (2016)	An approach that improves the quality of life of patients and their families facing life-threatening disease-associated problems through the prevention and alleviation of suffering through early identification and impeccable assessment and treatment of pain and other physical, psychosocial and spiritual problems.
Ofosu-Poku R et al./2020/ Ghana ⁽²¹⁾ Ribeiro JR et al./2019/ Brazil⁽²²⁾	Exploratory Descriptive	WHO (2017)	An approach that promotes quality of life for users (adults and children) and their families who face problems associated with life-threatening diseases, preventing and alleviating suffering through early identification, correct assessment and treatment of pain and other physical, psychosocial or spiritual problems.
Fassbender K/2017/ Canada⁽²³⁾	Descriptive	Fassbender (2017)	Care that helps patients and families to address physical, psychological, social, spiritual, and practical issues and their associated expectations, needs, hopes, and fears, as well as preparing and managing the end of life and death process, coping with loss and grief during illness.
Zapponi S et al./2018/ Italy⁽²⁴⁾	Exploratory	Zapponi et al. (2018)	Different set of treatments that are basically provided to people near death and to people with incurable diseases, preference for cancer patients than to patients with serious infectious diseases
Brainbridge E et al./2010/ Canada⁽²⁵⁾	Descriptive	CHPCA (NI)	Support to assist those at the end of their lives to spend their remaining time in comfort and dignity.
Borimnejad L et al./2014/ Iran⁽²⁶⁾ Kozlov E et al./2017/ USA⁽²⁷⁾	Descriptive	Vanderbilt Health (NI)	Specialist care that focuses on patients facing life-threatening illnesses or injuries, with the aim of providing experience and treatment plans for symptom control, as well as practical and emotional support, considering the whole patient and their situation. It is not just for end-of-life patients
Radbruch L et al./2020/ Multicentric⁽²⁸⁾	Descriptive	Radbruch et al. (2020)	Active holistic care of individuals of all ages with health-related suffering, with the intention of improving the quality of life of patients, their families and their caregivers.

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[1] Corresponding author: Lorena Campos de Souza E-mail: lorena.2306@hotmail.com