Experiências de familiares cuidadores de pacientes oncológicos em cuidados paliativos à luz da teoria de Meleis

Abstract

Cancer is considered the second leading cause of death in the Region of the Americas, being diagnosed in the year 2020, four million new cases and about 1.4 million deaths due to the disease. At a global level, one in six deaths are related to cancer, highlighting the need for investments in health promotion and in the search for changing the patterns of exposure to risk factors. The diagnosis of the disease mobilizes in patients and their families positive and negative feelings that need to be understood by health professionals. Therefore, families are included in the care process, as a way of adapting them to situations related to illness and terminality, so that they can also provide adequate support to their patients. At this moment, family members experience a transition to a new role, as a family caregiver. In view of such considerations, and the relevance of this theme in the field of Nursing, Afaf Ibrahim Meleis' Theory of Transitions was selected as the theoretical basis for the present study. The general objective is to analyze the experiences of family caregivers of cancer patients in palliative care, in the light of Afaf Meleis' theory of transitions. And as specific objectives: to understand the transition experiences of the family member of patients in oncological palliative care when exercising the role of caregiver; to describe the facilitating and inhibiting factors of transition in the process of caring for cancer patients; to know how family caregivers experience grief and its phases during the process of caring for a patient in oncological palliative care. This is a descriptive study with a qualitative approach. Held at the Palliative Care Clinic (CCPO) 1 and 2 of the Ophir Loyola Hospital (HOL), in the period of June 2022. Participated in the study 15 family caregivers of cancer patients undergoing treatment at these held, aged over 18 years, with ties of kinship, affection and/or friendship with the patient, in physical, emotional, and psychological conditions to answer the questions in the interview script, and who voluntarily agreed to participate in the study after reading and signing the Free and Informed Consent Term. Data analysis was carried out using Braun and Clarke's Thematic Analysis (TA), a qualitative analysis technique composed of six phases. Thus, three major themes emerged, which were analyzed and discussed based on the model of Meleis' Transitions Theory: the transition of roles, the facilitating and inhibiting factors of the transition to the care process and the stages of mourning and religiosity in the death process and die. Such categories show a situational transition given the acquisition of a new role, identifying the properties of awareness, engagement and change, with the acquisition of skills and attitudes towards the illness of a loved one, permeated by nursing therapies and the multidisciplinary team in the context of the palliative care, the results reflect that not all family caregivers experienced a healthy transition. From the results, it was possible to understand the experiences of family caregivers of cancer patients in palliative care, and the importance of nursing interventions in the process of death and dying, thus promoting a healthy transition in the context of care.