Espiritualidade nos cuidados paliativos: questão de saúde pública?

Abstract

Resumo Reconhecido pela Organização Mundial da Saúde como essencial às boas práticas em assistência paliativa, “cuidado espiritual” é termo recente na saúde brasileira e carece de reflexão específica. A fim de diminuir tal lacuna, este estudo apresenta o estado da arte sobre a temática, traz breves orientações sobre como identificar necessidades espirituais e descreve quatro ferramentas úteis para esse cuidado. Após contextualização, reflete-se, de forma introdutória e com base nos campos da bioética e da teologia pública, se esse tipo de cuidado seria questão de saúde pública. O texto conclui com recomendações para subsidiar políticas públicas voltadas à implementação do cuidado espiritual na assistência paliativa no Brasil.

Religiosity and Indigenous Cosmology in a Brazilian Hospital Setting: The Challenges Faced by Health Professionals

“…In this context, the reports of the perceptions and experiences of health professionals have drawn attention to the role attributed to and expected of social welfare assistants and, in particular, psychologists, in the mediation of the process of communicating with the families and the negotiation of a potential integration of the requirements of medicine and the cosmological policies of each tribe. The literature reveals that resistance, desistance, and sometimes the total refusal of the Indian to resort to traditional Western treatment are down to its fundaments in the Eurocentric, Western paradigm, ignoring traditional, spiritual methods that prevail in the communities and in the cultural, historical, social, and political contexts of the indigenous people (Cote and Schissel 2008;Duran 1990;Hill 2003;Poonwassie and Charter 2005;Smye 2004;Smylie et al 2011;Stewart 2008;Vukic et al 2009). This reality has demanded of the health professionals an effort to appropriate holistic and culturally sensitive approaches that mix indigenous curing practices with Western cure models (Cote and Schissel 2008;Hill 2003;Poonwassie and Charter 2005;Rojas and Stubley 2014), although this is also rife with ethical and bioethical implications.…”

Competencies for quality spiritual care in palliative care in Latin America: from the Spirituality Commission of the Latin American Association for Palliative Care

“…Health care professionals should adopt and implement structured and validated instruments of spiritual assessment to facilitate the documentation of spiritual needs and evaluate the outcomes of spiritual interventions (7,9,21,23,43). We recognize also that tools used in other countries will need to be validated in the Latin American context.…”

“…Ideally, this care is provided by an interdisciplinary palliative care team (hereafter referred to as a team) (7)(8)(9)(10)(13)(14)(15)(16)(17)(18)(19). Whereas general spiritual care is the responsibility of all team members, ideally, each team will have a professional spiritual care provider who is responsible for specialized spiritual care (7,9,10,(13)(14)(15)17,20,21). Spiritual care generalists must have basic training in spiritual care to be able to identify any spiritual crisis/need, to complete a spiritual history and do basic spiritual care interventions (such as compassionate presence, listening and/or refer to a Spiritual care specialist).…”