Estratégias de comunicação utilizadas por profissionais de saúde na atenção à pacientes sob cuidados paliativos

Abstract

RESUmoO presente estudo objetivou verificar a relevância e a utilização de estratégias de comunicação em cuidados paliativos. Estudo quantitativo multicêntrico, realizado entre agosto/2008 e julho/2009, junto a 303 profissionais de saúde que trabalhavam com pacientes sob cuidados paliativos, por meio da aplicação de questionário. Os dados sofreram tratamento estatístico descritivo. A maioria (57,7%) não foi capaz de citar ao menos uma estratégia de comunicação verbal e apenas 15,2% mencionaram 5 sinais ou estratégias não verbais. As estratégias verbais mais citadas foram as de cunho interrogativo sobre a doença/ tratamento e, dentre as não verbais, destacaram-se o toque afetivo, olhar, sorriso, proximidade física e escuta ativa. Embora os profissionais tenham atribuído alto grau de relevância para a comunicação em cuidados paliativos, evidenciaram escasso conhecimento de estratégias de comunicação. Faz-se necessária a capacitação dos profissionais no que tange à comunicação em cuidados paliativos. dESCRitoRES Comunicação Cuidados paliativos Equipe de assistência ao paciente Relações interpessoaisCommunication strategies used by health care professionals in providing palliative care to patients * Original article AbStRACtThe objective of this study is to verify the relevance and utilization of communication strategies in palliative care. This is a multicenter qualitative study using a questionnaire, performed from August of2008 to July of2009 with 303 health care professionals who worked with patients receiving palliative care. Data were subjected to descriptive statistical analysis. Most participants (57.7%) were unable to state at least one verbal communication strategy, and only 15.2% were able to describe five signs or non-verbal communication strategies. The verbal strategies most commonly mentioned were those related to answering questions about the disease/treatment. Among the non-verbal strategies used, the most common were affective touch, looking, smiling, physical proximity, and careful listening. Though professionals have assigned a high degree of importance to communication in palliative care, they showed poor knowledge regarding communication strategies. Final considerations include the necessity of training professionals to communicate effectively in palliative care. RESUmEnVerificar la relevancia y la utilización de estrategias de comunicación en cuidados paliativos. Estudio cuantitativo multicéntrico, realizado entre agosto/2008 y julio/2009, con 303 profesionales de salud que trabajaban con pacientes bajo cuidados paliativos, mediante aplicación de cuestionario. Los datos recibieron análisis estadístico descriptivo. La mayoría (57,7% no fue capaz de citar al menos una estrategia de comunicación verbal, y apenas 15,2% mencionó 5 señales o estrategias no verbales. Las estrategias verbales más nombradas fueron las de cuño interrogativo acerca de la enfermedad/tratamiento, y entre las no verbales se destacaron caricias afectivas, miradas, sonrisas, proximidad física y escucha activa. Aunque los pro...

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“…Also, what is to be informed requires clarity and the use of communication strategies when interacting and trying to express oneself, to clarify a fact or validate the understanding of something. It is a form of privileged interaction by the nurse when exploring information or providing guidance (26)(27) . In this type of communication, the use of familiar terms, frequent use of examples, repositioning and argumentative power are key points to be considered (4,26) .…”

“…In this type of communication, the use of familiar terms, frequent use of examples, repositioning and argumentative power are key points to be considered (4,26) . However, it is worth to emphasize that non-verbal communication was poorly remembered by the participants, a concerning issue, since it is the non-verbal dimension that qualifies verbal interaction (4,(26)(27) . Thus, the inquiry regarding the valorization of the verbal dimension arises, due to the unfamiliarity with the nonverbal influence in the interaction.…”

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“…The effectiveness of a type of communication improves the link between patient and team, and between patient and family. In addition, it allows the patient to express his decisions and maintain social contact, allowing his requests to be attended until the end of life 2,6 .…”

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“…Non-verbal strategies, also mentioned by the participants, were pointed out in study [31] as important in the context of the terminally ill, once they denote interest on the other person, they are essential premises for the approach and the establishment of ties of trust with patients. In this approach, there is a reverence to therapeutic listening, which requires from professionals the association of all non-verbal fields of studies already presented, proclaimed by some participants of the study: In the fragments of the above statements, the professionals mention listening as an essential intervention in the caring of the patient in terminal illness.…”

“…These phenomena result in physical weakness and walking difficulties, limiting the patient to the bed, skin lesions and increasing the risk of pressure ulcer. [30][31] …”