Educação permanente para a atenção primária: cartilha de cuidados paliativos para capacitação médica no município de Juiz de Fora

Abstract

Introduction: Palliative care (PC) promotes quality of life and dignity for people living with life-threatening illnesses and their families through the prevention and relief of physical, psychological, social, and spiritual suffering. Population aging and the increasing prevalence of chronic progressive diseases have expanded the demand for this approach, making Primary Health Care (PHC) a strategic setting for its implementation. In Brazil, this role was strengthened by the National Palliative Care Policy established in 2023. However, gaps in professional training and Permanent Health Education continue to hinder the integration of palliative care into the Family Health Strategy (FHS). Objective: To assess the knowledge of physicians working in the Family Health Strategy in Juiz de Fora, Minas Gerais, Brazil, regarding palliative care and to develop a technical-technological educational product focused on Permanent Health Education to improve palliative care delivery in PHC. Methods: A crosssectional, descriptive study was conducted as part of an intervention project. A structured questionnaire was administered to PHC physicians in Juiz de Fora to assess their knowledge, practices, and educational needs regarding palliative care. The findings supported the development of the technical-technological product and the preparation of the three scientific articles included in this Master's Thesis. Results: A total of 52 physicians participated in the study, representing 53% of the municipality's Primary Health Care Units and 22.9% of PHC physicians. The findings revealed important gaps in identifying patients eligible for palliative care, using assessment tools, clinical management, communication of bad news, and understanding local healthcare pathways. These results highlight the need to strengthen Permanent Health Education strategies tailored to the realities of Primary Health Care, contributing to the improvement of palliative care delivery. Technical-Technological Product (TTP): The online educational booklet Palliative Care for Primary Health Care in Juiz de Fora was developed as the technical-technological product of this study. Based on the educational needs identified during the research and grounded in the principles of Family and Community Medicine, palliative care, and Permanent Health Education, the booklet was made available online and as a downloadable PDF, accompanied by an introductory video lecture, reflective questions, and a clinical case. The material covers patient identification, symptom management, communication of bad news, advance care planning, grief, medication prescribing, and local healthcare referral pathways, providing practical support for improving palliative care in PHC. This Master's Thesis was developed within the Stricto Sensu Professional Master's Degree Program in Family Health (PROFSAÚDE).