Enfrentando a morte com esperança: evidências qualitativas para a prática de enfermagem no cuidado paliativo

Abstract

Identify the production of knowledge in the health literature about hope in palliative care, and analyze the implications of this feeling in the process of health and illness of patients in palliative care. This is a qualitative meta-synthesis, used to create an interpretive synthesis of qualitative primary evidence, in order to assist in making possible clinical decisions. To the realization of this research, the recommendations described in Enhancing Transparency in Reporting the Synthesis of Qualitative Research were used with the scientific descriptors of DeCS and MeSH, using the following databases: PubMed; Lilacs; Web of Science. Palliative care (PC) is one of the pillars of comprehensiveness in the treatment of patients in advanced stages of the disease. The patient should be included in anticancer treatment from the time the diagnosis is made, instead of at the end of life. For many people, the finiteness of life process can be interpreted as a cold and painful moment, as the approach of death grants a mix of feelings and emotions, such as fear of pain, fear of invasive procedures, loneliness and hopelessness. Thereby, hope is a feeling of great importance for facing the difficulties in this period. The loss of hope in better days and the adoption of hope in order to control death anxiety or as a form of protection in defense of life has been reflected as central themes in some studies on palliative care. When dealing with the process of death and dying, sick patients and their families face phenomena closely linked to their particularities, their culture, and very subjective feelings that are correlated with their life journey. However, hope linked to spirituality, at the level of awareness and behavior, can offer patients suffering from life-threatening diseases, tools and subsidies that make them face this arduous moment, giving new meanings to the disease, leading to personal maturity. Sometimes, it became evident that hope can bring difficulties and barriers in the dialogue with patients about their finiteness of life and their prognosis. The research carried out has great potential to help health service professionals to foster hope in their patients in order to encourage them in the health and disease process.