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Vivências de profissionais que cuidam de doentes em fase terminal
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Introdução: Nas sociedades pós-modernas a morte passou a ser institucionalizada, e sujeita a uma crescente intervenção técnica com o intuito de ser adiada. Neste contexto, são exigidas aos profissionais de saúde competências diferenciadas ao cuidar de doentes em fase terminal. No entanto, este cuidar pode tornar-se uma tarefa difícil para a equipa de saúde. Objetivos: Caracterizar o significado que os profissionais atribuem à morte atendendo à experiência profissional; identificar as dificuldades sentidas pelos profissionais na prestação dos cuidados ao doente em fase terminal; identificar as estratégias utilizadas pelos profissionais na gestão das dificuldades referidas no cuidar de um doente em fase terminal; e identificar as estratégias utilizadas pelos profissionais para minimizar o sofrimento e promover o bem-estar do doente em fase terminal. Método: Foram realizadas 16 entrevistas semiestruturadas a todas as classes de profissionais de um Serviço de Cirurgia e Especialidades Cirúrgicas de uma Unidade de Saúde da Área Metropolitana de Lisboa. As entrevistas foram gravadas em áudio e transcritas na íntegra, e analisadas a partir da análise de conteúdo segundo os critérios de Bardin (2016). Resultados: Foram identificadas três grandes temáticas. Em relação à 1ª temática, significado atribuído à morte, os profissionais referem mais aspetos de caráter positivo do que negativo. As subcategorias mais mencionadas dizem respeito a uma passagem, ao terminus e a um processo natural. As dificuldades sentidas pelos profissionais (2ª temática) foram subdivididas em quatro categorias: enquanto prestador de cuidados, condições físicas, trabalho em equipa e gestão de recursos humanos. As duas subcategorias mais mencionadas dizem respeito à falta de formação em Cuidados Paliativos e às condições físicas não ideais/falta de privacidade. Em relação às estratégias mencionadas (3ª temática), estas subdividem-se em duas categorias: para o doente e enquanto prestador de cuidados. As subcategorias mais mencionadas foram proporcionar conforto ao doente, gerir a terapêutica no alívio da dor e promover a privacidade do doente. Conclusão: Os resultados deste estudo sugerem ser necessária uma mudança na forma como lidar com a morte e no cuidar do doente em fase terminal. Assim a formação dos profissionais em cuidados paliativos assume um papel primordial na transmissão de conhecimentos e competências, associadas a valores e atitudes fundamentais para um cuidar holístico.
Introduction: In postmodern societies death began to be institutionalized, subject to increasing technical intervention in order to be postponed. In this context, health professionals are required to have differentiated competences when caring for a terminally ill patient. However, this care of them can become a difficult task for the health team. Objectives: To characterize the meaning that professionals attribute to death considering their professional experience; identify the difficulties experienced by professionals in providing care to terminally ill patient; identify the strategies used by health professionals in the management of the difficulties presented by them in caring of terminally ill patients; and identify the strategies used by health professionals to minimize the suffering and promote the well-being of the terminally ill patients. Method: 16 semi-structured interviews were conducted to all classes of professionals from a Surgery and Surgical Specialties Service of a Health Unit in the Metropolitan Area of Lisbon. The interviews were audio recorded and transcribed in full and analyzed using the Bardin´s method. Results: Three major themes were identified. Regarding the 1st theme, meaning attributed to death, the professionals mentioned more positive than negative aspects in relation to death. The most mentioned subcategories concern to a passage, the terminus, and a natural process. The difficulties experienced by the professionals (2nd theme) were subdivided into four areas: as a care provider, physical conditions, teamwork, and human resource management. The two most frequently mentioned subcategories relate to the lack of training in Palliative Care and the nonideal physical conditions/lack of privacy. Regarding the strategies mentioned (3rd theme), these were subdivided into two areas, namely: for the patient, and as a care provider. The most mentioned subcategories were providing patient comfort, managing pain relief therapy, and promoting patient privacy. Conclusion: The results of this study suggest that a change is needed in how to deal with death and caring for the terminally ill patient. Therefore, the training of professionals in palliative care assumes a key role in the transmission of knowledge and skills, associated with fundamental values and attitudes for holistic care.
Introduction: In postmodern societies death began to be institutionalized, subject to increasing technical intervention in order to be postponed. In this context, health professionals are required to have differentiated competences when caring for a terminally ill patient. However, this care of them can become a difficult task for the health team. Objectives: To characterize the meaning that professionals attribute to death considering their professional experience; identify the difficulties experienced by professionals in providing care to terminally ill patient; identify the strategies used by health professionals in the management of the difficulties presented by them in caring of terminally ill patients; and identify the strategies used by health professionals to minimize the suffering and promote the well-being of the terminally ill patients. Method: 16 semi-structured interviews were conducted to all classes of professionals from a Surgery and Surgical Specialties Service of a Health Unit in the Metropolitan Area of Lisbon. The interviews were audio recorded and transcribed in full and analyzed using the Bardin´s method. Results: Three major themes were identified. Regarding the 1st theme, meaning attributed to death, the professionals mentioned more positive than negative aspects in relation to death. The most mentioned subcategories concern to a passage, the terminus, and a natural process. The difficulties experienced by the professionals (2nd theme) were subdivided into four areas: as a care provider, physical conditions, teamwork, and human resource management. The two most frequently mentioned subcategories relate to the lack of training in Palliative Care and the nonideal physical conditions/lack of privacy. Regarding the strategies mentioned (3rd theme), these were subdivided into two areas, namely: for the patient, and as a care provider. The most mentioned subcategories were providing patient comfort, managing pain relief therapy, and promoting patient privacy. Conclusion: The results of this study suggest that a change is needed in how to deal with death and caring for the terminally ill patient. Therefore, the training of professionals in palliative care assumes a key role in the transmission of knowledge and skills, associated with fundamental values and attitudes for holistic care.
Descrição
Tese de mestrado, Cuidados Paliativos, Universidade de Lisboa, Faculdade de Medicina, 2022
Palavras-chave
Profissionais Dificuldades e estratégias em cuidar Cuidados paliativos Doente terminal Morte Teses de mestrado - 2022