Dialética da autonomia dos equilíbrios nos conflitos entre pacientes e cirurgiões oncológicos

Abstract

OBJECTIVE:To comprehend different logics of autonomy that are present in conflicts between surgical prescriptions and the expectations of patients with diagnoses of cancer.METhODOLOgICAL PROCEDuRES: This is a qualitative study in which 11 semistructured interviews were conducted with oncological surgeons specializing in head and neck tumors, in the city of Rio de Janeiro, Southeastern Brazil, between 2000 and 2005. The participants were selected by means of chain sampling and the fieldwork was halted in accordance with the criterion of saturation. The discourse analysis technique was used to identify the premises that structured the concept of autonomy and would constitute the discursive dialectics within the context of patients who fight against undergoing surgery that is considered to be of mutilating nature. ANALySIS Of RESuLTS:At first, the surgeons expressed standardized statements centered on deontological concepts of autonomy. As they narrated their experiences, self-questioning that brought out contradictions regarding the routine concept of "informed resectability" was observed. At this point, the standardized discourse became permeated by self-questioning about the need to return to the existential balance that had been harmed by the cancer. CONCLuSIONS:The narratives expressed demands for "balanced autonomy" in the form of a semi-project that is not aprioristically idealizable but is dependent on mutual interactions. The results indicated the need for reflection on the concept of autonomy as a linear, categorical and individual premise that, although superficially elaborated, governs everyday actions.

Psycho-social risks at work: stress and coping strategies in oncology nurses

“…It should be added that head and neck surgery entails inescapable sequelae, sometimes more mutilating than the disease in its initial stage, causing mental, emotional and physical suffering (15) . Although the potential for stress among these professionals has been confirmed empirically, investigations on occupational stress in oncology nurses working in the area of Head and Neck Surgery were not found in the literature review which preceded the present study.…”

Comunicação entre profissional de saúde e paciente

“…VASCONCELOS-SILVA; NOLASCO, 2009), as dificuldades na comunicação e as atitudes dos médicos (GILBAR; AUDREY et al, 2008;. Dois estudos discutem acerca dos desafios da comunicação entre médicos do cuidado convencional e profissionais que trabalham com medicina alternativa ou complementar (MAC) (SAXE et al, 2008;SCHIFF;GOLAN, 2008).…”