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A adesão em pacientes com dor oncológica crónica : uma abordagem exploratória
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A presente investigação insere-se nas Áreas da Psicologia da Saúde e
da Doença. Contou com a colaboração de 21 pacientes com dor oncológica
crónica, todos utentes da Consulta da Dor de um serviço de medicina paliativa.
A dor é uma das principais razões que leva os pacientes a aderir ao
tratamento.
Porém, esta adesão é moldada por vários factores, sendo necessário
compreender quais os mais determinantes no processo de adesão nesta
população. Os objectivos prosseguidos neste estudo são: a) Conhecer quais
são os temas centrais/básicos inerentes à experiência da doença e quais os
determinantes da adesão ao tratamento, em termos de representatividade e
preponderância; b) Identificar o tema básico de cada uma das 7 áreas
problemáticas avançadas; bem como, c) Identificar os temas mais significativos
para os diferentes sub-grupos encontrados a partir da descrição da amostra.
Trata-se de um estudo de carácter exploratório e caracterizador,
utilizando uma metodologia de cariz qualitativo. A metodologia eleita passou
pela elaboração de um guião de entrevista semi-estruturada. A análise de
conteúdo efectuada permitiu identificar 30 temas centrais.
Pode-se concluir que a percepção de utilidade das recomendações e
prescrições médicas é essencial na adesão, assim como a relação
estabelecida com o médico e os mitos/crenças acerca da instituição de saúde
onde é assistido e terapêutica administrada. A influência do apoio social
também se mostrou determinante, especialmente na adesão a outras formas
de tratamento não farmacológico. Por fim, verifica-se também, que a percepção
de morte próxima influencia a desistência face à luta contra a doença e
interfere com o próprio processo de adesão.
The present study takes place in the field of Health and Disease Psychology. The contribution of 21 patients suffering from Oncological Chronic Pain (OCP) was essential for this research. Pain is one of the main reasons why patients adhere to health professionals' prescriptions/recommendations. Adherence is, however, shaped by several elements, making it necessary to explore and understand which are the more influential determinants of adherence processes within this population (OCP patients). General aims of this project are: a) to identify which are the basic/central themes related to the experience of such an illness, and which are the more representative and/or preponderant ones related to adherence; b) to identify the most central theme for each one of the problematic areas selected; as well as c) to identify the more significant themes for several subsets of participants that compose the initial sample. This study is an exploratory one, following a qualitative methodology, and based on a semi-structured interview script. Content analysis applied over the participants discourses allowed for the identification of 30 Central Themes. Results point out that Utility of Prescriptions/Recommendations made by, as well as the Kind of Relationship established with, health professionals are essential to the adherence process. Myths/beliefs about Health Care Resources also showed to be of primary importance. Social support also has a great influence on adherence, particularly on the process of adherence to different, non-pharmacological, approaches. And last, but not least, Near Death Perception seems to contribute to a progressive weakening of Disease Fighting and adherence to treatments processes.
The present study takes place in the field of Health and Disease Psychology. The contribution of 21 patients suffering from Oncological Chronic Pain (OCP) was essential for this research. Pain is one of the main reasons why patients adhere to health professionals' prescriptions/recommendations. Adherence is, however, shaped by several elements, making it necessary to explore and understand which are the more influential determinants of adherence processes within this population (OCP patients). General aims of this project are: a) to identify which are the basic/central themes related to the experience of such an illness, and which are the more representative and/or preponderant ones related to adherence; b) to identify the most central theme for each one of the problematic areas selected; as well as c) to identify the more significant themes for several subsets of participants that compose the initial sample. This study is an exploratory one, following a qualitative methodology, and based on a semi-structured interview script. Content analysis applied over the participants discourses allowed for the identification of 30 Central Themes. Results point out that Utility of Prescriptions/Recommendations made by, as well as the Kind of Relationship established with, health professionals are essential to the adherence process. Myths/beliefs about Health Care Resources also showed to be of primary importance. Social support also has a great influence on adherence, particularly on the process of adherence to different, non-pharmacological, approaches. And last, but not least, Near Death Perception seems to contribute to a progressive weakening of Disease Fighting and adherence to treatments processes.
Descrição
Tese de mestrado em Psicologia (Área de Especialização em Psicoterapia e Psicologia da Saúde), apresentada à Universidade de Lisboa, através da Faculdade de Psicologia e de Ciências da Educação, 2007
Palavras-chave
Psicoterapia Psicologia da saúde Dor oncológica crónica Processo de adesão