Communication and management of antibiotic therapy in palliative care: a narrative review
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Introduction: Palliative Care (PC) improves the quality of life of people with life-limiting illnesses and their families. It is considered active and coordinated care that ensures the principle of autonomy is respected. Thus, discussing the use of antibiotics in PC is of particular importance in decision-making. Objective: To understand how the communication process influences decision-making regarding the use of antibiotics in end-of-life care. Methodology: A narrative review was conducted using the databases MEDLINE Complete, CINAHL Complete, Cochrane Central Register of Controlled Trials, Cochrane Databases of Systematic Reviews, Cochrane Methodology Register, and PubMed. Results: 14 studies focused on communication about the use of antibiotics in PC were included, addressing the study objective. The data were organized into seven categories, based on Leininger’s Theory of Culture Care Diversity and Universality: communication and interaction, decision-making, culturally sensitive care, quality of care, education and training, involvement of health professionals, ethics, and responsibility. Discussion of Results: The use of antibiotics at the end of life should strictly consider the benefits, guidelines for appropriate use, and the impact on the quality of life of the person, who should be involved in the decision-making process, prioritizing the principle of autonomy and contributing to the quality of care. Communication training is essential to ensure humanized care that aligns with the values of the person. Conclusions: Effective communication that respects people’s preferences is essential for appropriate decisions in PC. The lack of clear discussions leads to decisions misaligned with people’s wishes, compromising the continuity and quality of care, emphasizing the importance of continuous training.
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