Recent research has found that a team-based palliative care model involving registered nurses (RNS) and nursing technicians (NTS) providing home care is an effective and affordable way to support patients with advanced cancer.
Palliative care is important for managing symptoms and improving the quality of life of patients near the end of life. A Brazilian program called “Better at Home” allows interdisciplinary teams to provide palliative care in patients' homes, with nurses playing a key role, especially in areas with limited healthcare resources.
Published in the American Journal of Hospice and Palliative Medicine, this study examined the clinical and functional profiles of patients receiving home-based palliative care for advanced stage cancer. We also evaluated the scope and coordination of nursing interventions carried out by the Brazilian Sad-Caratinga Program (SAD-CP).
Researchers at the faculdade deciência smédicas smédicas smédicas de minasgerais in Belo Horizonte, Brazil, University of Texas Anderson Cancer Center, San Francisco, analyzed 10-year medical records from 471 cancer patients treated through SAD-CP. The patient averaged 70 years of age. Approximately 95% experienced pain, and 77% reported difficulty breathing as the main symptom. The typical length of stay in the program was 48 days.
In the SAD-CP program, RNS handled complex procedures, supervised the NTS, handled trained caregivers, and NTS managed routine clinical tasks and routine care. Throughout the study period from 2013 to 2023, structured caregiver education based on comfort, airway management, restlessness and delirium, emotional and mental support and self-care (CARE) models was required prior to patient admission. The main goal of the care model is to promote peaceful death, understand the difference between normal progression and suffering in the dying stage of a family, and encourage all involved parties to practice self-care.
One RN was consistently assigned to patients in the program to ensure continuity in nursing supervision. The number of NTS was varied. The team worked 40 hours a week on turn shifts to provide full coverage to patients.
Almost all patients died at home and cooperated with palliative care objectives. These results highlight the important role of RNs in the coordination and delivery of home palliative cancer care within interdisciplinary teams.
Researchers found that interdisciplinary, intensive, home-based palliative care programs enhance patient symptom management and reduce hospital deaths. Research shows that the SAD-CP model, which integrates RN and NT caregivers through structured training, demonstrates feasibility through structured training, and has a positive impact on resource-limiting environments.
“The SAD-CP model, structured around (RN) leadership and supported by a trained NT workforce, provides a scalable, resource-efficient framework that can be adapted to other resource-low-resource regions,” the researchers write. “Even in the face of structural constraints, interdisciplinary care demonstrates that continuity, safety and dignity can be ensured at the end of life when strategically organized.”
