Cuidado espiritual: componente essencial da prática da enfermeira pediátrica na oncologia

Spiritual Well-Being and Related Factors in Children With Cancer

Introduction: There are specific gaps that call for empirical research in the experiences of spiritual well-being among children 12 years old and younger with cancer. Understanding these relationships can help to develop holistic and family centered care in pediatric oncology wards. This study assessed the spiritual well-being of children with cancer in association with their general well-being, happiness, quality of life, pain intensity, and personal characteristics. Method: The data were collected in Lithuania between June 2020 and November 2021. Children with cancer (N = 81) who were hospitalized at pediatric oncology-hematology centers participated in the study. Inclusion criteria were age (from 5 to 12 years old), diagnosis of oncologic disease for the first time, and absence of other chronic diseases. The instruments used were: Feeling Good, Living Life; Oxford Happiness Questionnaire, Short Form; Well-Being Index; PedsQL™3.0 Cancer Module, and a Wong-Baker FACES® Pain Rating Scale. Results: Communal and personal domains of spiritual well-being had the highest scores among pediatric oncology patients while both dimensions of the transcendental domain scored lowest. Age, level of education, and family composition revealed differences in children's spiritual health, happiness, and well-being, and church attendance was significant for overall spiritual well-being and its transcendental domain on lived experience dimension. Happiness had the strongest effect on all four domains of spiritual well-being. Discussion: Children emphasized the importance of spiritual aspects to feel better to a greater extent than they experienced in their lives. Despite their young age, children were familiar with family traditions, that is, religious practice and church attendance, and followed them in a particular sociocultural context.

Spiritual Distress in Cancer Patients: A Synthesis of Qualitative Studies

Cancer affects individuals in all human dimensions. Cancer patients are more susceptible to spiritual distress. Several studies have addressed spiritual distress using quantitative designs; however, a qualitative approach to the experience of spiritual distress could provide a deeper understanding of the phenomenon. This study aims to synthesis the experience of spiritual distress as lived by cancer patients in qualitative primary studies. This is a literature review based on electronic databases search. A total of 4075 citations was identified and 23 studies were included. The most frequent qualitative research method was phenomenology (n = 15), and interviews were the main data collection method (n = 20). Two major themes have been identified related to the experience of spiritual distress: suffering and coping. Spiritual distress is an intimate, deep and suffering experience in life, which requires coping strategies and involves spiritual values and beliefs. Healthcare providers should be aware of this experience and recognize spiritual distress in cancer patients, as it is critical in providing holistic nursing care.

Atenção às necessidades espirituais na prática clínica de enfermeiros

Al considerar la integralidad del cuidado, es necesario que los enfermeros sistematicen el cuidado espiritual y propongan intervenciones en esta dimensión a sus pacientes. Objetivo: analizar la comprensión del enfermero acerca del cuidado espiritual y su experiencia en la promoción de este cuidado a los pacientes en la práctica clínica. Método: investigación descriptiva, con análisis cualitativo de los datos, desarrollada con 17 enfermeros. Se recolectaron los datos por medio de entrevistas semiestructuradas, analizadas mediante análisis de contenido cualitativo. Resultados: los enfermeros identificaron la necesidad de intervención en la dimensión espiritual de sus pacientes y consideraron importante atender a esta necesidad; sin embargo, ellos presentaron dificultades en brindar este cuidado. Falta de conocimiento y organización del proceso de trabajo fueron dificultades citadas para la no realización del cuidado espiritual y la priorización de los cuidados físicos. Se señala, aun, que el cuidado espiritual, cuando fue ofrecido, no fue sistematizado. Conclusión: esta investigación presenta potencial para despertar discusiones en cuanto a la formación del enfermero para el ofrecimiento del cuidado espiritual, además demuestra sus dificultades y facilidades para la ejecución de tal cuidado en la cotidianidad del trabajo de enfermería.

[Maternal perceptions about the birth of a premature child and care after discharge]

This is a qualitative study, which aimed to identify maternal perceptions on premature birth and care of the newborn during hospitalization and after discharge. The data were collected through semi-structured interviews with 16 mothers of premature infants in NICU or in follow up ambulatory for infants discharged from NICU. The interviews were taped, transcribed and analyzed based on Content Analysis. Results revealed feelings of sadness, anguish, guilt and powerlessness. It was also reveled confidence in the health care team, uncertainty with the care of child at home, the importance of social network support and the role of spirituality for families. Professionals who work with infants should devote more attention to their families, understanding and accepting critical experiments in a humane way.

Cuidados paliativos na assistência hospitalar: a vivência de uma equipe multiprofissional

Trata-se de um estudo qualitativo, exploratório e descritivo, que objetivou conhecer a vivência de uma equipe multiprofissional no cuidado paliativo no contexto hospitalar. Participaram do estudo seis membros de uma equipe multiprofissional de saúde, que atende pacientes em cuidados paliativos, de um Hospital Escola no Sul do Brasil. Identificou-se que os profissionais, ao iniciarem sua trajetória de cuidado na terminalidade, referiram frustração e impotência. Contudo, a experiência fez com que encontrassem novos significados para o cuidado prestado, passando a entender a morte como evento natural da vida e a importância de garantir qualidade de vida e conforto ao paciente. Os participantes relataram a necessidade do fortalecimento da comunicação, do trabalho em equipe e de um espaço para discutirem a terminalidade. Assim, a atenção hospitalar deve atender as necessidades do paciente em cuidados paliativos e família, articulando e promovendo ações que garantam o alívio dos sofrimentos e uma sobrevida digna.