Contributions of the chaplaincy service to the care of terminal patients

PHYSICIANS’ KNOWLEDGE ABOUT PATIENTS’ RELIGIOUS BELIEFS IN PEDIATRIC CARE

Objective:

To describe the knowledge of pediatricians and pediatric residents about the meaning of death according to the most prevalent religions in Brazil.

Methods:

A cross-sectional survey was conducted among pediatricians and pediatric residents at a tertiary-level children’s hospital in the city of São Paulo, SP, Brazil, questioning about their knowledge and experience related to spiritual care and the most common religious beliefs among pediatric palliative care patients in Brazil.

Results:

116 physicians answered the questionnaire, 98 (84.5%) considered themselves religious, defined as followers of any spiritual creed around the world, and 18 (15.5%) non-religious. Of the total, 97 (83.6%) considered themselves capable of dealing with the spiritual care of Catholic patients, 49 (42.2%) of Protestant patients and 92 (79.3%) of patients that follow Spiritism in the process of death. Religious doctors used less chaplaincy services than non-religious doctors (relative risk - RR 2.54; p=0.0432; confidence interval of 95% - 95%CI 1.21-5.34). Among the physicians, 111 (96%) believe that spirituality is beneficial in accepting the death process, responses were associated with the religiosity of the physicians (RR 1.18; p=0.0261; 95%CI 0.95-1.45). Also, 106 (91.4%) are unaware of the religion of their patients and the same number of participants consider pediatricians, in general, unprepared to deal with the spiritual aspect of death. These data are not associated with the participants’ religiosity.

Conclusions:

Although most pediatricians and residents consider themselves able to deal with the most prevalent religions in Brazil and affirm that spirituality is beneficial during the death process, little importance is given to the spiritual identity of their patients, which could limit an appropriate approach to their death process.

Operation of a hospital palliative care service: a fourth-generation evaluation

OBJECTIVE

Qualitatively evaluate the operation of a palliative care service in oncology.

METHODOLOGY

Qualitative study conducted in a service in southern Brazil based on a fourth generation evaluation. Between September 2014 and June 2015, 460 hours of operation were observed, and 45 semi-structured interviews and five negotiation meetings were conducted; data were analyzed using the constant comparative method.

RESULTS

Potential services are: provision of outpatient palliative care, home and inpatient care provided by a multidisciplinary and support team, meeting the patient's biological, psychological, social and spiritual needs. Study limitations: ineffective communication between clinical and surgical oncology and palliative care sectors, lack of specialized training for professionals and in interpersonal relationship issues among team members.

FINAL CONSIDERATION

For palliative care progress in the service, some arrangements are required to enhance integrality of care.