Espiritualidade como dimensão humana nos cuidados paliativos oncológicos para mulheres

Abstract

Introduction: Comprehensive care includes the spiritual dimension, considered a fundamental component of Palliative Care quality. Neglecting Spiritual Care means leaving the sick subject's psychosocial environment. Mapping the available studies on spirituality in women's oncology Palliative Care and how Palliative Care teams carry out this approach in the health work process can help identify what is already being done in different parts of the world. It also helps with the existing frontiers of knowledge, expanding discussions on care guideline implementation in local services. Therefore, this work includes two products: a paper and a proposal for educational activity to train health professionals who are part of Palliative Care teams. Objectives: To map the frontiers of existing knowledge on how oncology Palliative Care teams address the spiritual dimension in the care of women in the hospital context, seeking to support future discussions on implementing assistance guidelines in Palliative Care in local services; to identify studies that show the spirituality of Palliative Care in women with cancer, carried out by multidisciplinary and/or interdisciplinary teams in a hospital context; to identify the spiritual assessment instruments used in hospital context palliative care; and to develop a proposal for permanent education focused on the professional approach to the health dimension, which helps the Palliative Care teams of the State Health Department of the Federal District. Method: For the paper, we used the Joanna Briggs Institute methodology for Scoping Review, reported according to the PRISMA-ScR Extension for Scoping Review guidelines. Searches were carried out in six databases, based on the descriptors: women, neoplasms, spirituality, palliative care, patient care team, and tertiary health care; without language and year of publication restrictions. For the educational activities, the proposal promotes a 40-hour course, distributed in 8 meetings, using the Active Teaching Methodologies: Problem-Based Learning, Word Café, and the construction of an existential diary. Results: In the paper, of the 801 studies found and analyzed, only 4 met the criteria for inclusion in the Scoping Review. The publications we found on the subject are recent, with studies published between 2014 and 2020. The total number of participants in the primary studies was 1,532, with 733 females and 433 males. Only one study has 366 caregivers/family members as participants, 62% female and 38% male. The minimum age ranged between 18 and 21 years. The paper was accepted and is in the process of being published in the journal Research, Society, and Development. As for the educational action proposal, the project built from the results of the paper has implementation possibilities. Conclusions: The results of the paper indicate that the focus of Spiritual Care interventions in hospital Palliative Care was direct care to patients and their caregivers/family members, using the following tools: assessment of care needs; proposal/care plan; symptom management/treatment adjustments; health education focused on Spiritual Well-Being; preparation for death and dignified death. Faced with the complexity of the approach, palliative health professionals need to deepen the discussion about their spirituality in the work environment.