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Avaliação do processo de luto : na perspectiva do cuidador enlutado
Resumo(s)
Introdução: A perda de um ente querido traduz um nível elevado de sofrimento e pesar e implica a vivência de um processo de luto inerente. A maioria das pessoas experiencia um luto dito adequado, evidenciando manifestações associadas ao longo deste processo, mas também uma diminuição da qualidade de vida. A prestação de cuidados paliativos estende-se ao período do luto com o intuito de promover uma adaptação à vida sem o ente querido.
Objectivo: Analisar o processo de luto dos cuidadores enlutados de familiares acompanhados pela Equipa de Cuidados Continuados Integrados de Odivelas.
Metodologia: estudo de abordagem qualitativa, com a realização de entrevistas semi-estruturadas a quinze cuidadores enlutados que tenham sido alvo de intervenção no luto por profissionais da Equipa de Cuidados Continuados Integrados de Odivelas. As entrevistas foram analisadas através do método de análise de conteúdo.
Resultados: Os cuidadores enlutados descrevem o processo de doença, fim de vida e morte dos seus familiares e expõem as suas vivências enquanto cuidadores principais. São expressas manifestações integrantes do processo de luto, salientando-se como principais sentimentos a dor e o sofrimento. Abordam factores que facilitam e dificultam o luto, sendo o apoio formal e informal e a consciência de que tudo fizeram pelo seu ente querido os principais factores que facilitam este processo. São identificados ganhos do apoio luto, nomeadamente o encerramento da relação com a equipa e o alívio do sofrimento.
Conclusão: Cuidar de um doente no período da doença, fim de vida e morte pressupõe uma diversidade de sentimentos manifestados pelos cuidadores, nomeadamente o sofrimento e uma constante preocupação, mas também uma adaptação progressiva a este papel. Muitas vezes, a exigência dos cuidados e as alterações familiares e sociais podem implicar uma sobrecarga do cuidador e, consequente, exaustão. A agonia e a morte são momentos de grande angústia nos quais o profissional de saúde deverá ter uma intervenção mais intensificada e dirigida. O luto é um processo que contempla diversas fases e manifestações que se alteram e evoluem e é influenciado por factores internos e externos ao enlutado. A intervenção das equipas de cuidados paliativos deve estender-se ao período do luto, pois este apoio implica ganhos para o cuidador enlutado, possibilitando uma maior tranquilidade e uma evolução adaptativa deste processo. Sobressai um possível algoritmo para o apoio no luto, adaptado de guidelines internacionais e da prática de cuidados, possibilitando uma uniformização de cuidados neste contexto.
Introduction: The loss of a loved one brings a high level of suffering and sorrow and involves experiencing a grieving process. Most people experience an adequate bereavement, with associated manifestations throughout the process, but also a decreased quality of life. Palliative care extends to mourning in order to facilitate adapting to life without the loved one. Purpose: To analyze the grieving process in bereaved caregivers of family members that were followed by a home care team. Methodology: Qualitative study, conducting semi -structured interviews with fifteen bereaved caregivers who had support from home care professionals. The interviews were analyzed with of content analysis method. Results: Bereaved caregivers described the disease, end of life and death process of their family member and talked about their experience as primary caregivers. They expressed manifestations, mainly pain and suffering. They talked about aspects that facilitate and hinder the grieving process, saying that formal and informal support, and the awareness that they did everything they could for the loved one, were the main factors that helped in this process. Benefits of bereavement support were identified and include the closure of the relationship with the care team and the relieve of suffering. Conclusion: Taking care of a patient during their illness, end of life and death assumes a diversity of feelings by the caregivers, including suffering and a constant concern, but also a progressive adaptation to this role. Often, the care requirements and family and social changes may cause burden and exhaustion of the caregiver. Death and dying are moments of great distress involving an intensified and targeted intervention by the healthcare professionals. Bereavement is a process that comprises several phases and manifestations that change and evolve, and is influenced by internal and external factors. Palliative care should extend to the period of mourning, because it has benefits for the bereaved caregivers, providing greater tranquility and adaptive evolution of this process. It stands a possible algorithm to bereavement support, adapted from international guidelines and practice, enabling standardization of care in this area.
Introduction: The loss of a loved one brings a high level of suffering and sorrow and involves experiencing a grieving process. Most people experience an adequate bereavement, with associated manifestations throughout the process, but also a decreased quality of life. Palliative care extends to mourning in order to facilitate adapting to life without the loved one. Purpose: To analyze the grieving process in bereaved caregivers of family members that were followed by a home care team. Methodology: Qualitative study, conducting semi -structured interviews with fifteen bereaved caregivers who had support from home care professionals. The interviews were analyzed with of content analysis method. Results: Bereaved caregivers described the disease, end of life and death process of their family member and talked about their experience as primary caregivers. They expressed manifestations, mainly pain and suffering. They talked about aspects that facilitate and hinder the grieving process, saying that formal and informal support, and the awareness that they did everything they could for the loved one, were the main factors that helped in this process. Benefits of bereavement support were identified and include the closure of the relationship with the care team and the relieve of suffering. Conclusion: Taking care of a patient during their illness, end of life and death assumes a diversity of feelings by the caregivers, including suffering and a constant concern, but also a progressive adaptation to this role. Often, the care requirements and family and social changes may cause burden and exhaustion of the caregiver. Death and dying are moments of great distress involving an intensified and targeted intervention by the healthcare professionals. Bereavement is a process that comprises several phases and manifestations that change and evolve, and is influenced by internal and external factors. Palliative care should extend to the period of mourning, because it has benefits for the bereaved caregivers, providing greater tranquility and adaptive evolution of this process. It stands a possible algorithm to bereavement support, adapted from international guidelines and practice, enabling standardization of care in this area.
Descrição
Tese de mestrado, Cuidados Paliativos, Faculdade de Medicina, Universidade de Lisboa, 2014
Palavras-chave
Luto Apoio no luto Cuidados paliativos Cuidador Domicílio Teses de mestrado - 2014