Attitudes of cancer patients in palliative care towards death in the context of home care/ Atitudes de pacientes oncológicos em cuidados paliativos frente à morte no contexto da internação domiciliar

Abstract

Objective: To know the attitude of cancer patients in palliative care towards death in the context of home care. Methods: This is a descriptive, qualitative study with six cancer patients undergoing palliative care in home care in southern Brazil. Data collection occurred from January to March 2018, through semi-structured interviews, which was recorded, transcribed, and then categorized by the Ethnography 6.0 software. For data analysis, Laurence Bardin s content analysis was used. Results: Five categories emerged: regret as a life experience; death as rupture and rest; life after illness; the experience of spirituality and religiosity; wishes at the end of life. Conclusion: Patients showed five attitudes towards death: regret, questioning of what death would be and where it would take them; the reflection on the present and the resignification of the current moment; manifestation and strengthening of faith, religion, and hope in a deity; and wishes. Descriptors: Palliative care. Attitude to death. Nursing. Home care services. Hospice Care. RESUMO Objetivo: conhecer a atitude de pacientes oncológicos em cuidados paliativos frente a morte no contexto da internação domiciliar. Métodos: estudo descritivo, qualitativo, com seis pacientes oncológicos em cuidados paliativos em internação domiciliar no Sul do Brasil. A coleta de dados ocorreu, de janeiro a março de 2018, por meio de entrevistas semiestruturadas, gravadas e transcritas, e categorizadas pelo software Ethnograph 6.0. Para análise dos dados, se utilizou a análise de conteúdo de Laurence Bardin. Resultados: emergiram cinco categorias: o arrependimento como experiência de vida; a morte como ruptura e descanso; a vida após o adoecimento; a vivência da espiritualidade e da religiosidade; os desejos no final da vida. Conclusão: os pacientes apresentaram cinco atitudes frente a morte: o arrependimento, questionamento sobre o que seria a morte e aonde ela os levaria; a reflexão sobre o agora e à ressignificação do momento atual; manifestação e fortificação da fé, da religião e da esperança em uma divindade; e desejos. Descritores: Cuidados paliativos. Atitude frente a morte. Enfermagem. Serviços de assistência domiciliar. Cuidados Paliativos na Terminalidade da Vida. RESUMEN Objetivo: conocer la actitud de pacientes oncológicos en cuidados paliativos ante la muerte en el contexto de la internación domiciliaria. Métodos: estudio descriptivo, cualitativo, con seis pacientes oncológicos en cuidados paliativos en internación domiciliaria en el sur de Brasil. La recolección de datos se realizó, de enero a marzo de 2018, a través de entrevistas semiestructuradas, grabadas y transcritas, y categorizadas por el software Ethnograph 6.0. Para el análisis de datos, se utilizó el análisis de contenido de Laurence Bardin. Resultados: surgieron cinco categorías: el arrepentimiento como experiencia de vida; la muerte como ruptura y reposo; vida después de la enfermedad; la experiencia de espiritualidad y religiosidad; deseos al final de la vida. Conclusión: los pacientes mostraron cinco actitudes ante la muerte: arrepentimiento, cuestionamiento sobre qué sería la muerte y hacia dónde los conduciría; reflexión sobre el ahora y resignificación del momento actual; manifestación y fortalecimiento de la fe, la religión y la esperanza en una deidad; y deseos. Descriptores: Cuidados paliativos. Actitud frente a la muerte. Enfermería. Servicios de atención de salud a domicilio. Cuidados Paliativos al Final de la Vida. ISSN: 2238-7234 Sartor SF, et al. Attitudes of cancer patients in palliative care.. 2 English Rev Enferm UFPI. 2021 10:e803. DOI: 10.26694/reufpi.v10i1.803 INTRODUCTION Palliative care is an approach that improves the quality of life of patients and their families who face problems associated with potentially fatal diseases, such as cancer, dementias, kidney and heart failure. It also prevents and relieves suffering through early identification, the correct assessment, and treatment of pain and other physical, psychosocial, or spiritual problems. Home care is one of the contexts in which palliative care is inserted, which is regulated by Ordinance 825, of April 25, 2016, redefining Home Care within the scope of the Unified Health System (SUS), and updating qualified teams. Home care is an integral part of home assistance, which is a complementary modality to hospitalization since the home team can provide humanized care and close to the family. This type of care can offer comfort and safety for the patient and family by being at home and having the presence of family members, avoiding wear and tear, hospitalizations, costly budget, and hospital contamination. In the context of cancer patients, being aware of the process of illness and the worsening of the disease can trigger various attitudes towards death being a desolate moment, causing anxiety and fear in the face of what is to come. In this way, the multiprofessional health team needs to develop care to offer physical, emotional, and spiritual comfort, including family members and caregivers, and dialoguing about the multidimensional aspects involved in the illness and end of life process. Thus, we justified the interest of the study in the perspective of knowing the attitudes of the cancer patient who is in palliative care in the face of death and, in this way, to offer a better quality of care during the illness process in the field of nursing. Therefore, we defined a research question: what are the attitudes of cancer patients in palliative care towards death in the context of home care? Consequently, the article aimed to understand the attitudes of cancer patients in palliative care towards death in the context of home care.