Perspectivas de profissionais de saúde sobre o desenvolvimento de um protocolo de cuidados paliativos perinatais na saúde suplementar

Abstract

Perinatal Palliative Care (PPC) is an essential approach to ensure quality of life and dignity for newborns with life-limiting conditions and their families. In Brazil, despite legal advances, such as the State Policy on Palliative Care, there are still significant gaps in the practical implementation of this care, especially in the supplementary health sector. The absence of clear protocols, specific training, and institutional support directly affect the quality of care and the well-being of professionals and families. Using a quantitative-qualitative approach with multi-methods, this investigation aimed to evaluate the perspectives of health professionals in the maternal and child area regarding the importance and possible benefits of the implementation of a PPC Protocol in a hospital institution. The study was based on the principles of PPC and adopted Interprofessionality and Collaborative Practices as a theoretical framework. The methodological design included two articulated stages, the first being represented by a scoping review and the second by the application of a questionnaire, sensitization and focus groups. Initially, a scoping review was carried out to map the scientific production on SSC and its offer by the multiprofessional team, at different levels of health care, and a manuscript was prepared, following the methodology proposed by the Joanna Briggs Institute Collaboration – JBIC and the report was guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) and the results indicated a predominance of studies focused on physicians and nurses working at the tertiary level, with low interprofessional integration. In the subsequent stage, professionals from different areas of maternal and child care from a private hospital in the interior of São Paulo participated, such as nursing, medicine, psychology, physiotherapy, speech therapy and social work. The analysis of the second stage was conducted through the Discourse of the Collective Subject technique, allowing the systematization of perceptions and experiences and the identification of structuring elements for interprofessional palliative practices in the perinatal period, the results indicated that the vast majority of participants believe that the adoption of a protocol can promote greater safety, reduce anguish and qualify the care offered to families; whereas sensitization and focus groups have been found to be effective strategies to support daily practice and foster reflections on humanised care; The absence of clear guidelines, the fragmentation of practices and the need for continuous training were highlighted as challenges. It is concluded that the implementation of an interprofessional protocol for PPC can strengthen collaborative practice among health professionals, promoting greater technical and emotional safety in maternal and child care. By being limited to supplementary health, the study has an innovative character and potential impact on the qualification of institutional practices, in line with the guidelines of the World Health Organization and recent public policies aimed at the humanization of parental grief.