Palliative care in the pre-hospital service in Brazil: experiences of health professionals.

Background: An integrated care network between emergency, specialized and primary care services can prevent repeated hospitalizations and the institutionalized death of terminally ill patients in palliative care (PC). To identify the perception of health professionals regarding the concept of PC and their care experiences with this type of patient in a pre-hospital care (PHC) service in Brazil.

Methods: Study with a qualitative approach, of interpretative nature, based on the perspective of Ricoeur's Dialectical Hermeneutics.

Results: Three central themes emerged out of the professionals' speeches: (1) unpreparedness of the team, (2) decision making, and (3) dysthanasia.

Conclusions: It is necessary to invest in professional training associated with PC in the home context and its principles, such as: affirming life and considering death as a normal process not rushing or postponing death; integrating the psychological and spiritual aspects of patient and family care, including grief counseling and improved quality of life, adopting a specific policy for PC that involves all levels of care, including PHC, and adopt a unified information system, as well as more effective procedures that favor the respect for the patients' will, without generating dissatisfaction to the team and the family.