O desenvolvimento do conceito de morte digna na UTI Pediátrica

Abstract

The purpose of this research was to develop the concept of dignified death for children in the Pediatric Intensive Care Unit. The Hybrid Model of Concept Development was applied in its three phases: Theoretical, Fieldwork and Final Analytical. In the Theoretical Phase 49 papers in the Medical and Nursing fields were analyzed, which studied and focused on the dignified death for children. The Fieldwork was conducted through semi-structured interviews with nine doctors and seven registered nurses who worked in pediatric ICUs. The data from the Fieldwork Phase was analyzed having the results of Theoretical Phase as the theoretical axis and the Content Analysis as the methodology. In the Final Analytical Phase, the results from the Theoretical and Fieldwork Phases and were compared, analyzed and integrated. The data show that the DIGNIFIED DEATH for children in the pediatric ICU means having a clinical treatment of excellence at the end-of-life, honoring the benefits of the natural evolution of the disease, respecting the socio-cultural aspects, physical comfort and welfare. A dignified death occurs in a context of veracity and partnership between the team and the family, in which it is possible to express hopes and fears. The result of the dignified death is the relief of suffering from both the child and the family. Data from the Theoretical Phase suggests that the antecedents, attributes and consequences of dignified death as being protocol situations, however, in the Fieldwork it was possible to identify the component of the experience behind the conduct of the professionals when dealing with children at end-of-life. Thus, it was possible to understand how the manifestation of the concept occurs in clinical practice, allowing the expansion of the data identified in the Theoretical Phase. Clarifying the concept of dignified death in the pediatric ICU can strengthen theories about end-of-life care to children and families and makes it possible to professionals who work in clinical practice to reflect on the motivations that guide their attitudes and decisions when dealing with a child in life-sustaining condition.

Desenvolvimento de conceitos: novas direções para a pesquisa em tanatologia e enfermagem

“…The data of the Field Phase were analyzed by using the results of the Theoretical Phase with theoretical axle and Content Analysis (20) as methodological reference. In the Analytical Phase the results of the Theoretical Phase and Field Phase were compared, analyzed and integrated (11) . We should stress that the project was submitted to the Committee of Ethics in Research of the three hosting institutions and was approved by all of them (Institution 1 -Protocol 091/ 06; Institution 2 -Protocol 06/396; Institution 3 -Protocol 534/12/2006).…”

“…The Interdisciplinary Nucleus of Research on Losses and Grieving (NIPPEL) of the Nursing School of the University of São Paulo (EEUSP) has contributed to the body of knowledge in the area of Thanatology within the most varied contexts of healthcare: decision-making process at the end of life (7)(8) , organ transplants (9) , experience of healthcare providers at the end of life (10)(11) . Helping dignifying and humanizing the last phase of life and death in Brazil has become a challenge for the Nucleus.…”

Aspectos conceituais teóricos e subjetivos da sobrevivência ao câncer: contribuições para a enfermagem oncológica

“…Lembrando que conhecimento é constituído pelo movimento do senso comum à consciência crítica dos conceitos, de forma que esses podem apresentar confusões em seu uso ou definição, sendo empregados inadequadamente. A falta de clareza de determinados conceitos resulta em uma ciência menos consistente que o desejável (POLES, 2008). Portanto, para que uma palavra e/ou um termo saíam do senso comum e entrem no campo epistemológico do conhecimento científico, é preciso que sejam moldados pela análise conceitual (NUOPPONEN, 2011).…”

“…A ausência de informação cria no senso comum a construção de símbolos irreais, os quais podem permanecer na vida do adoecido por tempo indeterminado. Nos estudos de Chen et al (2006), Rowland, Hewitt e Ganz (2006), Towsley, Beck e Watkins, (2007), Rowland (2008b), Absolom et al (2009) ECONOMOU, 2008;ROWLAND, 2008a;ABSOLOM et al, 2009;GANZ, 2009…”