Barriers and facilitators for the nurse's role in palliative cardiac care in adults: an integrative review

Abstract

Introduction: Palliative Care constitutes a care approach aimed at improving the quality of life of patients with life-threatening diseases, through the relief of physical, psychosocial, and spiritual suffering. Cardiovascular Diseases remain the leading cause of mortality worldwide and require the incorporation of this approach into specialized cardiovascular care, especially in view of the increased survival and clinical complexity of these patients. The Nurse assumes a strategic role in the implementation of this practice, due to continuous and comprehensive care. Objective: To identify, in the scientific literature, the barriers and facilitators for the Nurse’s performance in cardiological Palliative Care in adults. Method: This was an Integrative Review of the literature, conducted in the databases BDENF, LILACS, MEDLINE, SciELO, Web of Science, Scopus, Cochrane Library, and Google Scholar, guided by the research question: “What are the barriers and facilitators for the Nurse’s performance in cardiological Palliative Care in adults?” The search was conducted using the descriptors “Nurses,” “Cardiology,” and “Palliative Care,” in Portuguese, English, and Spanish. Results: A total of 685 articles were identified and, after screening and eligibility stages, 3 studies were included in the IR. The results were discussed in depth in three thematic classes: models of care intervention, advance care planning, and barriers to Nursing practice in cardiological palliative care. Final considerations: Structured strategies, such as collaborative models and educational interventions, favor the integration of palliative care into cardiology, especially in Primary Care and outpatient follow-up. The nurse assumes a strategic role in this process, acting in education, monitoring, and mediation of therapeutic decisions. However, barriers related to the cure-centered care model, insufficient specific training, and difficulties in coping with finitude still limit this practice, reinforcing the need for investment in continuing education and strengthening of teamwork.