INTEGRATION OF PALLIATIVE CARE INTO CLINICAL PRACTICE OF CHRONIC DISEASES: AN INTEGRATIVE REVIEW OF CURRENT APPROACHES

Abstract

Introduction: Palliative care aims to provide quality of life to patients with chronic and incurable diseases, focusing on symptom relief and emotional support. Early integration of palliative care into clinical practice has been shown to be effective in improving well-being and reducing unnecessary hospitalizations, in addition to contributing to a more holistic and patient-centered approach. However, its implementation still faces barriers, such as lack of training and awareness among health professionals. Objective: This integrative review aims to analyze current approaches to the integration of palliative care into clinical practice for chronic diseases, discussing their contributions and challenges for the quality of care. Methodology: The search was carried out in the PubMed, Scopus, Web of Science and SciELO databases, covering studies published between 2013 and 2023. Articles that addressed the application of palliative care in patients with chronic diseases, such as heart failure, chronic obstructive pulmonary disease (COPD), dementia and cancer, were included. Twenty-four studies that met the inclusion criteria were analyzed, with an emphasis on the outcomes of palliative interventions and implementation strategies. Results and Discussion: The reviewed studies indicate that early integration of palliative care in patients with chronic diseases significantly improves quality of life, alleviates symptoms such as pain and dyspnea, and provides psychological support for both patients and their families. The most effective approaches involved multidisciplinary teams and ongoing education of health professionals. However, widespread adoption of palliative care is still limited by cultural barriers, lack of resources, and the misperception that this care is restricted to the end of life. The need for training professionals and the inclusion of palliative protocols in all phases of chronic disease were highlighted as essential factors for more effective implementation. Conclusion: The integration of palliative care into clinical practice for chronic diseases is essential to improve the quality of care, promote comfort, and reduce unnecessary interventions. Although the benefits are widely recognized, standardizing palliative care and overcoming barriers to implementation are challenges that need to be addressed to maximize its impact.