IntroductionCONTEXTUALIZATION: Palliative sedation is a resource used to control symptoms of terminal patients in general. It is considered that it should be discussed by the professionals involved in the process, based on the competence of each one, as well as with family members and patients when possible.ObjectivesAIM: To understand symbolic meanings attributed by nursing professionals who provide assistance to the terminal patient regarding to the act of the palliative sedation.MethodsStrategies: Clinical-qualitative design, semi-directed interview of open questions in depth. Nine oncologist nurses participated in the study; sample closed by the criterion of theoretical information saturation. Interviews were audio recorded, transcribed fully, categorized by qualitative content analysis. The results were discussed by colleagues of the Laboratory of Clinical Qualitative Research at the University of Campinas.ResultsFINDINGS: The treatment of the data led to 6 emerging categories: (1) death maintains its ambivalent values in our culture; (2) serving the death symbolically on a tray; (3) the act of sedation and its “unfortunate coincidences”; (4) palliative sedation: agent of a pious death; (5) late sedation: cause for distress to the professional; (6) the professional’s self-comfort considering certain psychological strength from the patient and family.ConclusionsFinal considerations: palliative sedation takes a general and individual meanings for the professional and even in case of experienced professionals regard to palliative sedation, the death phenomenon conduct them to expresses multiple and peculiar emotional issues, not ever perceveid.DisclosureNo significant relationships.
Knowing the symbolizations constructed in people's consciousness, based on lived experiences, is crucial to understanding how they structure their lives. Palliative Sedation (PS) integrates treatment in terminal palliative care, with the purpose of offering support and relief of refractory symptoms that may occur at the end of life. This study aimed at interpreting psychic fantasies that permeate thoughts, as reported by a sample of nurses when administering palliative sedation to patients in the final stage of life. This is a clinical-qualitative study conducted in a large hospital in the city of São Paulo (state of São Paulo, Brazil), a national reference in oncology. The study included 11 nurses working in the care of cancer patients. For data collection, we used the technique of SDIOQD – Semi-Directed Interview with Open-ended Questions in-Depth. The treatment by CQCA - Clinical-Qualitative Content Analysis is grounded on psychodynamic concepts. The interpretation of the meaning cores found in the interviews, complemented by observation of the para-verbal and nonverbal manifestations of the interviewees, led to the construction of three categories: (1) to symbolically serve death on a tray; (2) the act of sedation and its unfortunate coincidences; (3) palliative sedation as an agent of mercy death. This study suggests that nurses face dilemmatic situations, going through periods of self-questioning and moments of the ambivalence of feelings of beneficence and maleficence. When sedating a patient, the nurses envision to be offering dignity in death. Euthanasia fantasies in the process of administering sedation are latent in consciousness.
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