Perception of Nursing Professionals About Patient Care of the Terminally Ill in the Hospital Environment

Abstract

ABSTRACT:This study aimed to understand how nursing professionals perceive the care provided to patients with terminal illness in the hospital environment. This was an exploratory study with a qualitative approach, conducted with 23 professionals in the ambulatory service of a university hospital in southern Brazil. Semi-structured interviews were used for data collection, in 2011. Using discursive textual analysis, dialogue was shown to be a fundamental instrument in caring for patients in terminal illness, enabling the facilitation of the difficulties experienced by these patients and their families. The importance of family presence for these patients was identified, making it indispensable for caring for their loved one. Continuous education of the staff is necessary, using problematization of the difficulties experienced in the workplace, humanizing and qualifying the nursing care, ensuring dignity and comfort to patients and their families. PERCEPÇÃO DOS TRABALHADORES DE ENFERMAGEM ACERCA DO CUIDADO AO PACIENTE EM TERMINALIDADE NO AMBIENTE HOSPITALARRESUMO: Este estudo teve por objetivo compreender como os trabalhadores de enfermagem percebem o cuidado prestado ao paciente na terminalidade, em ambiente hospitalar. Trata-se de um estudo exploratório, com abordagem qualitativa, desenvolvido com 23 profissionais da clínica médica de um hospital universitário, no extremo sul do Brasil. Os dados foram coletados por meio de entrevistas semiestruturadas, em 2011. Mediante análise textual discursiva, constatou-se que o diálogo constitui-se em instrumento fundamental para o cuidado aos pacientes na terminalidade, possibilitando amenizar dificuldades vivenciadas por esses pacientes e seus familiares. Verificou-se, também, a importância da presença do familiar junto a esses pacientes, fazendo-se indispensável sua instrumentalização para cuidar do seu ente querido. Nesse sentido, ressalta-se a necessidade de permanente capacitação dos trabalhadores, a partir da problematização das dificuldades vivenciadas no ambiente de trabalho, humanizando e qualificando o cuidado de enfermagem, além de assegurar dignidade e conforto aos pacientes e seus familiares.DESCRITORES: Paciente terminal. Enfermagem. Ética. Família. PERCEPCION DE LOS TRABAJADORES DE ENFERMERÍA SOBRE EL CUIDADO AL PACIENTE EN FASE TERMINAL EN EL AMBIENTE HOSPITALARIORESUMEN: Este estudio tuvo por objetivo comprender como los trabajadores de enfermería perciben el cuidado prestado al paciente en fase terminal, en el ambiente hospitalario. Se trata de un estudio exploratorio, con abordaje cualitativo desarrollado con 23 profesionales de la clínica médica de un hospital universitario, en el extremo sur de Brasil. Los datos fueron recolectados por medio de entrevistas semiestructuradas en 2011. Mediante análisis textual discursiva, se constató que el diálogo se constituyó en instrumento fundamental para el cuidado a los pacientes en fase terminal, posibilitando amenizar dificultades vividas por eses pacientes y sus familiares. Se verificó, también, la importanci...

Experience of people with advanced cancer faced with the impossibility of cure: a phenomenological analysis

“…This is because human existence becomes the target of questions in various contexts, especially when the Being-there experiences a certain experience difficult to overcome or elaborate, causing fear, fear and anguish. 8 In this understanding, the facticity of death can be perceived in the statements of the deponents, in the parallel between being with cancer and the incurability of the disease. And this reality transports them into nothingness, that is, simply waiting for death to come, death is brought/ anticipated by cancer.…”

“…16;20 But if, on the one hand, anguish causes the Being to fall before itself, it also causes it to transcend itself by taking its existence into its hands, that is, living authentically their Being-thrown-into-the-world. 8 Facticity and decay are components that constitute inauthentic existence. Existential facticity, that is, being thrown into the world is an involuntary condition of man, since being in the world has no choice between happiness or suffering, as the experiences occur independently of his desire.…”

“…In this sense, the Being-there opens to itself its own being, and this opening eliminates obstructions, cover-ups, obscurations and shows itself. 8 In this showing its clarity, people reveal themselves as Being-with, assuming the severe and limiting disease, recognizing the condition of incurability that the disease imposes on them.…”

“…Thus, an authentic process of openness based on a comprehensive dialog with patients and family members is important and necessary in order to enable respect for their wishes and to avoid unnecessary suffering. 8 Given the unknowns that perpetuate the experience of the impossibility of curing cancer and terminality, here is an important gap: need to deepen the understanding of the needs and meanings that emerge from this experience and that interfere in the life of these beings and the uniqueness of their existence.…”

The Medical Futility Experience of Nursing Professionals in Greece

“…Note, however, that this is a completely paternalistic and morally unacceptable approach. End-of-life decision is a shared decision-making process where all the stakeholders (i.e., patient, relatives and health care team, ethicists, spiritual care counsellors) must be involved [13,18,21]. The end-of-life decision is a di cult decision in uenced by many individual patient factors [7,21].…”