scholarly journals Communication of bad news in the context of neonatal palliative care: experience of intensivist nurses

2022 ◽  
Vol 43 ◽  
Author(s):  
Beatriz Helena Naddaf Camilo ◽  
Taynnara Caroline Serafim ◽  
Natália Rejane Salim ◽  
Álida Maria de Oliveira Andreato ◽  
Júlia Rudzinski Roveri ◽  
...  

ABSTRACT Objectives: To know the experiences of nurses in neonatal intensive care units in the face of the process of communicating bad news to the family of newborns in palliative care. Methods: Study with a descriptive qualitative approach, in which 17 professionals participated. Data were collected through a semi-structured interview script, from December/2018 to February/2019, and submitted to content analysis. Results: Four theoretical categories emerged, with 11 subcategories inserted: meanings attributed to bad news; nursing as a support for the family; difficulties in dealing with the process of communicating bad news; nursing and involvement with the family’s suffering. Final considerations: The challenges to deal with the situation are related to lack of preparation, impotence, and subjectivities. The results broaden knowledge on the subject and enable the improvement of nursing care in this context.

2011 ◽  
Vol 5 (2) ◽  
pp. 399 ◽  
Author(s):  
Isabel Maria Tarico Bico Correia ◽  
Gilson de Vasconcelos Torres

ABSTRACTObjective: to understand the process of mourning of the families face the patient oncological on end of life. Method: this is an exploratory study, kind case study, from qualitative approach, with discourse analysis of the subject, from the point of departure: As family reacts to the proximity of death and how it renders the mourning? Harvesting data was conducted through interviews recorded ten family members accompanying cancer patients in terminal stage in domicile. Before starting the study, the relatives have been informed about the theme, the objectives, purpose and the possible usefulness of same. Results: after analysis of the interviews have emerged the following categories: Preparation, beginning of the end and the patient's Perception. In each category the subcategories inferred in the analysis. Conclusion: given the proximity of death, the family want to stay with the patient. On the other hand, the patient expresses wish to die at home. The grieving process initially manifests itself with the expression of feelings, which are predominantly: revolt and sadness. The funeral rituals are of extreme importance for the development of the grieving process. Descriptors: terminally ill; family caregivers; bereavement and death.RESUMOObjetivo: compreender o processo de luto dos familiares face ao doente oncológico em fim de vida. Método: estudo de caso, exploratório, de abordagem qualitativa, com análise do discurso dos sujeitos, a partir da questão de partida: Como reage a família perante a proximidade da morte e como se processa o luto? A colheita de dados foi realizada por meio de entrevistas gravadas a dez familiares que acompanhavam doentes oncológicos em fase terminal no domicilio. Antes de iniciar o estudo, os familiares foram informados sobre o tema, os objetivos, a finalidade e a possível utilidade do mesmo. Resultados: após a análise das entrevistas surgiram as seguintes categorias: Preparação, Início do Fim e Percepção do doente. Em cada categoria as subcategorias inferidas na análise. Conclusão: face à proximidade da morte, o familiar deseja permanecer junto do doente. Por outro lado, o doente manifesta o desejo de morrer em casa. O processo de luto numa fase inicial, manifesta-se com a expressão de sentimentos, que são predominantemente: a revolta e a tristeza. Os rituais fúnebres são de extrema importância para o desenvolvimento do processo de luto. Descritores: doente terminal; familiar cuidadores; luto e morte.RESUMENObjetivo: entender el proceso de duelo de los familiares frente al paciente Oncológico en final de vida. Método: case study, enfoque cualitativo, exploratorio, con análisis de discurso del sujeto, desde  la pergunta inicial: como reacciona la família a la proximidad de la muerte y cómo se procesa el luto? Los datos de explotación se recorreron através de enquestas grabadas de diez miembros de la familia que acompaña a los pacientes de cáncer en fase terminal en el domicilio. Antes de empezar el estudio, los familiares han sido informados sobre el tema, los objetivos, propósitos y de su posible utilidad. Resultados: después del análisis de las entrevistas han surgido las siguientes categorías: Preparación, comienzo del final y la percepción del paciente. En cada categoría las subcategorías inferidas en el análisis. Conclusión: dada la proximidad de la muerte, la familia desea permanecer con el paciente. Por otro lado, el paciente expresa su deseo de morir en su casa. El inicio del proceso de duelo se manifiesta con la expresión de sentimientos, que son predominantemente: revuelta y tristeza. Los rituales funerarios son de extrema importancia para el desarrollo del proceso de duelo. Descriptores: enfermos; familiares proveedores de atención médica; duelo y muerte.


Author(s):  
Hugo Fernandes ◽  
Maykon Brito Brandão ◽  
Roberto Alvarenga de Castilho-Júnior ◽  
Paula Hino ◽  
Conceição Vieira da Silva Ohara

Objective: to analyze the perception of nursing students about the care given to the persistent family aggressor. Method: a descriptive study, with a qualitative approach. Madeleine Leininger’s Theory of Diversity and Universality of Care was used as a theoretical reference. The data collection took place with 37 in the last year of at a public university in Southeast Brazil. We used the technique of Projective Design with a Topic and semi-structured interview. The data were analyzed with the content analysis. Results: the examination of the narratives underpinned the construction of four categories: The care of the aggressor with the family, Recognition of family values and culture, The search for knowledge to care for the aggressor and family, Multidisciplinary and intersectoral care to confront violence. Conclusion: there is an acknowledgment that the care for the aggressor should not only be individual but should involve all those affected. For this, multidisciplinary work is important, and the search for knowledge on the subject is essential for culturally significant care.


2019 ◽  
Vol 23 (2) ◽  
Author(s):  
Ieda Aparecida Diniz ◽  
Bárbara Radieddine Guimarães ◽  
Juliana Barony da Silva ◽  
Tatiana Silva Tavares ◽  
Elysângela Dittz Duarte

ABSTRACT Objective: to identify aspects that contribute to the discontinuation of outpatient follow-up of newborns from Neonatal Intensive Care Units (NICU) from the perspective of mothers. Method: exploratory, qualitative study, whose theoretical framework was Symbolic Interactionism. Fifteen mothers of children with NICU who discontinued outpatient follow-up in Belo Horizonte-MG were included in a semi-structured interview. Data were analyzed based on the proposal of Hsieh and Shannon. Results: distance from the health service, absence of family support, difficulty in leaving work, maternal health status, organization of the health service itself and deficiency of public transportation were predisposing factors for outpatient abandonment. Mothers understand that their children do not need differentiated care of children at usual risk. Conclusion: service organization, socioeconomic status of the family and social support perceived by mothers were related with the lack of compliance with outpatient follow-up.


1970 ◽  
Vol 5 (4) ◽  
pp. 13-19
Author(s):  
Cristiane Rosa Guedes ◽  
Bianca Del Ducca Alvarenga ◽  
Isabella Rotella ◽  
Débora Vitória Alexandrina Lisboa Vilella

RESUMOObjetivo: Identificar o significado para o enfermeiro em prestar cuidados para pacientes com Depressão.  Materiais e métodos: Estudo exploratório e descritivo com abordagem qualitativa, a amostra foi de 12 enfermeiras, o cenário de estudo foram Unidades Básicas de Saúde e Estratégias de Saúde da Família, urbanas da cidade de Itajubá-MG. A coleta de dados foi por meio do roteiro de entrevista semiestruturada composta por questionário contendo uma pergunta inerente ao assunto. Resultados: Encontramos oito categorias como estigma da depressão, suicídio, dificuldade em lidar, tempo escasso, envolvimento familiar, aceitação da doença, acolhimento e dar medicamento, de acordo com os discursos dos sujeitos coletados na entrevista. Conclusão: Os enfermeiros não estão em contato direto com portadores de depressão no seu trabalho, não entendem que é sua tarefa identificar e encaminha-los para tratamento especializado. Sugerimos que outros estudos sejam desenvolvidos sobre essa temática.Palavras-chave: Depressão. Relação Enfermeiro-Paciente. Assistência de Enfermagem. ABSTRACTObjective: To identify the meaning for nurses when providing care for patients with depression. Materials and Methods: exploratory and descriptive study with qualitative approach, the sample consisted of 12 nurses, the study scenario was the urban Unidades Básicas de Saúde e Estrategia de Saúde da Família, in the city of Itajubá. Data collection was done through semi-structured interview guides consisting of a questionnaire containing a question related to the subject. Results and Discussion: we found eight categories as stigma of depression, suicide, coping difficulties, scarce time, family involvement, acceptance of the disease, host and give medicine, according to the speeches of the subjects collected in the interview. Conclusion: nurses are not in direct contact with individuals with depression in their work, do not understand that it is their job to identify and refer them to specialized treatment. We suggest that other studies be developed on this theme.Keywords: Depression, Nurse-patient Relationship, Nursing care.


2016 ◽  
Vol 34 (3) ◽  
pp. 205-211 ◽  
Author(s):  
Mansooreh Azzizadeh Forouzi ◽  
Marjan Banazadeh ◽  
Jila Soltan Ahmadi ◽  
Farideh Razban

Objective: Neonatal nurses face numerous barriers in providing end-of-life (EOL) care for neonates and their families. Addressing neonatal nurses’ attitudes could provide insight into barriers that impede neonatal palliative care (NPC). This study thus conducted to examine neonatal nurses’ attitude toward barriers in providing NPC in Southeast Iran. Method: In this cross-sectional study, a translated modified version of Neonatal Palliative Care Attitude Scale was used to examine attitudes of 70 nurses toward barriers of palliative care in 3 neonatal intensive care units in Southeast Iran. Results: Findings indicated that overall 42.63% of nurses were strongly agreed or agreed with the proposed barriers in NPC. Among all categories, the highest and the lowest scores belonged to the categories of “insufficient resources” (3.42 ± 0.65) and “inappropriate personal and social attitudes” (2.33 ± 0.48), respectively. Neonatal nurses who had less education and study regarding NPC reported the presence of more barriers to NPC in the categories of “inappropriate organizational culture” and/or “inadequate nursing proficiency.” Also, younger nurses had more positive attitudes toward the category of inappropriate organizational culture as being a barrier to provision of NPC (4.62). Conclusion: The findings suggest that developing a context-based instrument is required to represent the barrier more precisely. Neonatal palliative care can be improved by establishing a special environment to focus on infants’ EOL care. This establishment requires standard palliative care guidelines and adequate NPC-trained nurses.


2016 ◽  
Vol 50 (spe) ◽  
pp. 47-53 ◽  
Author(s):  
Margarida Maria Florêncio Dantas ◽  
Maria Cristina Lopes de Almeida Amazonas

This paper presents a reflection about being terminally ill and the various ways that the subject has at its disposal to deal with this event. The objective is to understand the experience of palliation for patients undergoing no therapeutic possibilities of cure. The methodology of this study has the instruments to semi-structured interview, the participant observation and the field diary, and the Descriptive Analysis of Foucault’s inspiration how the narratives of the subjects were perceived. The Results of paper there was the possibility of looking at the experience of illness through the eyes of a subject position assumed by the very sick. As conclusion we have than when choosing palliative care, the terminally ill opts for a way to feel more comfortable and resists the impositions of the medical model of prolonging life.


2015 ◽  
Vol 36 (2) ◽  
pp. 56-62 ◽  
Author(s):  
Adriana Ferreira da Silva ◽  
Helena Becker Issi ◽  
Maria da Graça Corso da Motta ◽  
Daisy Zanchi de Abreu Botene

OBJECTIVE: To reveal the perceptions, expertise and practices of multi-professional teams providing palliative care to children in a paediatric oncology unit. The research questions were based on everyday care, facilitations and difficulties, essential aspects of professional approaches, and the inter-disciplinary focus of care for children in palliative care and their families. METHOD: Qualitative, exploratory and descriptive research. Data were collected from June to October 2013 from nine professional multidisciplinary team members by means of a semi-structured interview submitted to thematic analysis. RESULTS: The following four themes emerged from analysis: palliative care: conceptions of the multi-professional team; the construction of singular care; the facilitations and difficulties experienced by the team and significant lessons learned. CONCLUSIONS: The subjects revealed that the team also suffers with the death of a child and, like the family, moves toward the construction of coping mechanisms for the elaboration of mourning. Paradoxically, the team shares knowledge to determine the foundations of a singular therapeutic project and inserts the family in this process so that it can be the protagonist of the child's care.


2016 ◽  
Vol 38 (2) ◽  
pp. 153 ◽  
Author(s):  
Sâmia Jamylle Santos de Azevedo ◽  
Flávia Andrea Pereira Soares dos Santos ◽  
Caroline Evelin Nascimento Kluczynik Vieira ◽  
Larissa Soares Mariz ◽  
Aylla Nauanna da Silva ◽  
...  

The male participation in the process of breastfeeding needs to be encouraged as it can contribute significantly to the prevention of early weaning. In this sense, this research aimed to identify a parent's knowledge about breastfeeding. This is an exploratory and descriptive study with a qualitative approach, performed in the Family Health Strategy in Bom Jesus, Rio Grande do Norte State, Brazil. Data were collected through semi-structured interview with the guiding question: what is your understanding of breastfeeding? The population was 15 men with aged over 18 years old and preserved mental faculties, who lived with his wife and the child under one year of age and performed development and growth consultations in the Family Health Strategy. The interviews were conducted in place previously defined parent. The information was organized as content analysis Bardin, giving rise to two categories and analyzed according to the symbolic interacionism. It was observed that parents of participating antenatal clinics have more knowledge about it and recognize the benefits of breastfeeding in this way can encourage their wives in order to exclusive breastfeeding.


2019 ◽  
Vol 13 ◽  
Author(s):  
Clara Fróes de Oliveira Sanfelice ◽  
Juliana Vanessa da Silva Costa ◽  
Elenice Valentim Carmona

Objetivo: identificar a percepção da equipe de Enfermagem sobre a humanização da assistência prestada em uma Unidade de Terapia Intensiva Neonatal. Método: trata-se de um estudo qualitativo, descritivo, exploratório. Entrevistaram-se 22 profissionais, dos quais um enfermeiro e 21 técnicos de enfermagem. Coletaram-se os dados por meio de entrevistas semiestruturadas, gravadas em áudio, transcritas e analisadas seguindo a técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: revelaram-se quatro categorias: a) Humanização enquanto segurança para os pais, profissionais e neonatos; b) Cuidado que abrange o recém-nascido e a família; c) Humanização como cultura da equipe e política institucional e d) Contradições do cuidado humanizado. Conclusão: evidencia-se a necessidade de se promover atividades educativas para que a abordagem humanizada seja melhor compreendida e implementada no cuidado neonatal. Descritores: Humanização da Assistência; Recém-Nascido; Unidades de Terapia Intensiva Neonatal; Enfermagem Neonatal; Equipe de Enfermagem; Pesquisa Qualitativa.AbstractObjective: to identify the perception of the Nursing team about the humanization of care provided in a Neonatal Intensive Care Unit. Method: this is a qualitative, descriptive, exploratory study. 22 professionals were interviewed, including one nurse and 21 nursing technicians. Data was collected through semi-structured interviews, audio recorded, transcribed and analyzed following the technique of Content Analysis in the Thematic Analysis modality. Results: four categories were revealed: a) Humanization as safety for parents, professionals and newborns; b) Care that covers the newborn and the family; c) Humanization as a team culture and institutional policy; and d) Contradictions of humanized care. Conclusion: there is a need to promote educational activities so that the humanized approach is better understood and implemented in neonatal care. Descriptors: Humanization of Assistance; Newborn; Neonatal Intensive Care Units; Neonatal Nursing; Nursing, Team; Qualitative Research.ResumenObjetivo: identificar la percepción del equipo de Enfermería sobre la humanización de la atención brindada en una Unidad de Cuidados Intensivos Neonatales. Método: este es un estudio cualitativo, descriptivo, exploratorio. Se entrevistaron 22 profesionales, entre ellos un enfermero y 21 técnicos de enfermería. Los datos fueron recolectados a través de entrevistas semiestructuradas, audio grabado, transcrito y analizado siguiendo la técnica de Análisis de Contenido en la modalidad de Análisis Temático. Resultados: se revelaron cuatro categorías: a) Humanización como seguridad para los padres, profesionales y recién nacidos; b) Cuidado que cubre al recién nacido y la familia; c) La humanización como cultura de equipo y política institucional, y d) Contradicciones de la atención humanizada. Conclusión: es necesario promover actividades educativas para que el enfoque humanizado se entienda mejor y se implemente en la atención neonatal. Descriptores: Humanización de la Atención; Recién Nacido; Unidades de Cuidado Intensivo Neonatal; Enfermería Neonatal; Grupo de Enfermería; Investigación Cualitativa.


2021 ◽  
Vol 9 (204) ◽  
pp. 1-18
Author(s):  
Gabriela Dantas da Silva

The main topic of this article is to analyze the philosophical contributions on the subject and to criticize the State's actions as an entity that supports this family model. In a second moment, emphasis is given to the philosophical contributions of Immanuel Kant and Aristotle on morals and ethics, extending them to the family and social sphere. The concept of the Eudemonist Family with great Aristotelian influence, as well as some of the main contemporary family entities in brief contextualization, is also presented, to finally address the main problem of this article: the legal challenges of the Eudemonist family in the face of the majority understanding of biological bond as a characterizing element of the family entity. In conclusion, the philosophical nature is of great importance for the understanding of these new conceptions of the family, since the Brazilian legal system did not, in fact, contemplate the experience of society, not giving up texts that were expressly discriminatory and that excluded fundamental rights of individuals.


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