Knowledge and Clinical Practice of the Intensive Care Physiotherapist about palliative care

Abstract

Objective: to understand the approach of intensivist physiotherapists in adult patients under palliative care, identifying the main difficulties encountered in decision-making for patients in palliative care. Methods: a cross-sectional, descriptive, quantitative field study conducted from November 2023 to October 2024 with intensivist physiotherapists from public and private hospitals in Fortaleza. Data were collected through an online questionnaire using the Google Forms platform. The data were tabulated in a Microsoft Excel® 2016 spreadsheet and transferred to SAS 9.4 M7, SAS Inc., for statistical analysis. Results: a total of 85 physiotherapists participated, 87.1% of whom were female. Only 14.1% of the participants had training or specialization in palliative care. All participants identified the correct concept of palliative care. The majority (84.7%) reported the existence of a palliative care team at their institution, and 44.7% of participants stated that physiotherapists are part of these teams. When asked about the physiotherapist's role in palliative care, 42.4% mentioned palliative extubation, followed by therapeutic decision-making (38.8%). For most participants (96.5%), the main goal of physiotherapy is to identify the patient's needs and goals, as well as the problems affecting their functionality. Conclusion: the main difficulty faced by physiotherapists is the withdrawal of life-sustaining procedures and the lack of consensus in decision-making within the team, highlighting the importance of additional training in palliative care to improve outcomes for patients and families.