Ferramenta de indicadores de cuidados paliativos e de suporte

SPICT-PT™ 2019
We have made one change from the SPICTTM 2017. Low muscle mass is now seen as an important indicator of poor and deteriorating health not just weight loss so this has been added.

For more information on SPICT-PT™ contact: 

Dr Mariana Mira:maranetemira@gmail.com

Dr Paulo Reis-Pina:paulopina@medicina.ulisboa.pt

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Ferramenta de indicadores de cuidados paliativos e de suporte

A SPICT-PTTM é um instrumento que permite identificar pessoas em situação de doença grave e irreversível. Permite avaliar a necessidade de cuidados paliativos e fazer o seu planeamento.

Segundo dados recentes do Observatório Português de Cuidados Paliativos, Portugal tem aproximadamente 10.5 milhões de residentes, sendo que morrem cerca de 106 mil pessoas por ano, o que resulta numa taxa de mortalidade de 10 óbitos por cada 1000 residentes.

Tem-se verificado um envelhecimento da população, condicionando um aumento do número de doenças crónicas e da esperança média de vida. Assim, é um grande desafio o tratamento de doenças crónicas, durante cada vez mais tempo, até fases muito avançadas da sua progressão.

Torna-se, portanto, essencial identificar os doentes que precisam de cuidados paliativos, que são cuidados activos de conforto (físico, psíquico, social e espiritual), não com o objetivo curativo, mas sim de promoção de qualidade de vida em todas as suas vertentes.

Os doentes com necessidade de cuidados paliativos estão nos hospitais, nas unidades de cuidados continuados, mas estão sobretudo na comunidade, que inclui o domicílio e os lares de acolhimento.

Atualmente há ainda um número muito elevado de doentes que poderiam beneficiar de cuidados paliativos, mas não os têm, por serem sido correta e precocemente identificados como doentes a carecer de uma abordagem paliativa.

O que torna a escala SPICT-PT essencial é facto de ser uma ferramenta importante e de fácil utilização na identificação de doentes paliativos, podendo ser usada por médicos de todas as especialidades.


According to recent data from the Portuguese Palliative Care Observatory, Portugal has a population of approximately 10.5 million, and around 106,000 people die each year, resulting in a mortality rate of 10 deaths per 1000 residents.

The population is ageing along with an increase in the number of chronic diseases and rising average life expectancy. Thus, there is a great challenge: to treat chronic diseases, for much longer until the advanced phases of illness.

It is, therefore, essential to identify patients who need palliative care, which is an active approach to care which encourages comfort, both physical, psychosocial and spiritual, not for cure but promoting quality of life in all its aspects.

Patients who are in need of palliative care are admitted to several departments in hospitals, are users of some continuing care programs, but the majority are living in the community, both in homes and long term care services (including assisted living, nursing homes, continuing care retirement communities, etc.).
A very large number of patients would benefit from palliative care. They do not have access to palliative care because they are not identified in a timely and effective way.

What makes the SPICT-PT essential for health care professionals is the fact that it is a user-friendly tool, can be used by doctors and other colleagues from all specialties, and it helps us to identify and manage patients needing palliative care.


Process of translation and validation of the SPICT-PT

The process of translation and validation of the SPICT scale 

for Portuguese of Portugal language (PT) was done by the “Faculdade de Medicina da Universidade de Lisboa, Portugal”.

It followed the following phases:

  1. The process started in 2017 when SPICT was translated into Portuguese by a certified translator. 
  2. In the second phase, both the translation and the original version were analysed by specialists in palliative care, in order to verify and confirm that the SPICT-PT translation was done accordingly to the recommendations.
  3. Next, the SPICT-PT was applied by 8 medical doctors (specialists in palliative care, oncology and family doctors). All of them applied the scale to more than 90 patients and they also answered to two mandatory questions (1- Do with think that SPICT-PT is useful to identify patients needing palliative care in your daily clinical practice; 2- Do you consider SPICT-PT a user-friendly scale?). All of them answered ‘Yes’ to both questions.
  4. The last phase is ongoing. We are statistically analysing the collected data in order to publish in a peer-review journal article with our SPICT-PT version (including its reliability and validity assessments).
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