<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2184-0628</journal-id>
<journal-title><![CDATA[Gazeta Médica]]></journal-title>
<abbrev-journal-title><![CDATA[Gaz Med]]></abbrev-journal-title>
<issn>2184-0628</issn>
<publisher>
<publisher-name><![CDATA[Círculo Médico]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2184-06282022000400348</article-id>
<article-id pub-id-type="doi">10.29315/gm.v1i1.617</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Últimas Horas/Dias de Vida num Hospital Versus Domicílio]]></article-title>
<article-title xml:lang="en"><![CDATA[The Last Hours/Days of Life at Hospital Versus at Home]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gaudêncio]]></surname>
<given-names><![CDATA[Margarida]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Distrital da Figueira da Foz Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Figueira da Foz ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>12</month>
<year>2022</year>
</pub-date>
<volume>9</volume>
<numero>4</numero>
<fpage>348</fpage>
<lpage>352</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2184-06282022000400348&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2184-06282022000400348&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2184-06282022000400348&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo O envelhecimento populacional constitui uma das principais transformações sociais do século XXI, com implicações transversais a todos os setores da sociedade. Este envelhecimento está acompanhado de um aumento da prevalência de doenças oncológicas e crónicas, progressivas, com elevado grau de dependência funcional, declínio cognitivo, diminuição da qualidade de vida e aumento da taxa de mortalidade. A transformação social que estamos a assistir implica a necessidade urgente de planear a alocação de serviços de apoio ao fim de vida, nomeadamente o desenvolvimento dos cuidados paliativos. Mundialmente, é muito frequente o final de vida ocorrer em meio hospital, sendo que, Portugal não é exceção. Diversos estudos têm demonstrado uma enorme variabilidade na qualidade dos cuidados em fim de vida nos hospitais de agudos. Alguns estudos evidenciam o problema do tratamento em fim de vida nos hospitais de agudos, bem como, a grande dificuldade dos médicos em decidir quando suspender os cuidados curativos e iniciar o suporte paliativo. De acordo com alguns dados a nível nacional, a maioria dos portugueses prefere morrer no domicílio, no entanto, a realidade é outra. A falta de acesso aos cuidados médicos é um dos principais motivos para a recusa do processo de morte em domicílio. A maioria dos familiares, embora possa defender a morte no domicílio, entende que esta deve ocorrer no hospital pela necessidade de cuidados permanentes e pela falta de apoio domiciliário que garanta uma assistência de qualidade. Como tal, urge a necessidade urgente de se repensar as políticas nacionais em saúde, procurando melhorar a acessibilidade aos cuidados paliativos, nomeadamente com a criação de equipas comunitárias/domiciliárias, de modo a melhorar o suporte destes doentes no domicílio e assim, libertar os hospitais de agudos.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Population aging is one of the main social transformations of the 21st century, with implications for all sectors of society. The aging is accompanied by an increase in the prevalence of oncological and chronic, progressive diseases, with a high degree of functional dependence, cognitive decline, decreased quality of life and an increase in the mortality rate. The social transformation that we are witnessing implies the urgent need to plan the allocation of end-of-life support services, namely the development of palliative care. Worldwide, the end of life is very common in a hospital and Portugal is no exception. Several studies have demonstrated enormous variability in the quality of end-of-life care in acute hospitals. Some studies highlight the problem of this kind of care in acute hospitals, as well as the great difficulty that doctors have in deciding when to suspend curative care and initiate palliative support. According to some data, most Portuguese prefer to die at home, however, the reality is different. The lack of access to medical care is one of the main reasons for refusing the death process at home. Most family members, although they can defend death at home, understand that it should occur in the hospital due to the need for permanent care and the lack of home support that guaranteed quality care. So, there is an urgent need to rethink national health policies, seeking to improve accessibility to palliative care, namely with the creation of community/home teams, in order to improve the support of these patients at home and thus free the acute hospitals.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Cuidados Paliativos]]></kwd>
<kwd lng="pt"><![CDATA[Cuidados Terminais]]></kwd>
<kwd lng="pt"><![CDATA[Futilidade Terapêutica]]></kwd>
<kwd lng="pt"><![CDATA[Hospitalização]]></kwd>
<kwd lng="pt"><![CDATA[Respeito]]></kwd>
<kwd lng="pt"><![CDATA[Serviços de Cuidados Domiciliares]]></kwd>
<kwd lng="en"><![CDATA[Home Care Services]]></kwd>
<kwd lng="en"><![CDATA[Hospitalization]]></kwd>
<kwd lng="en"><![CDATA[Medical Futility]]></kwd>
<kwd lng="en"><![CDATA[Palliative Care]]></kwd>
<kwd lng="en"><![CDATA[Respect]]></kwd>
<kwd lng="en"><![CDATA[Terminal Care]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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