The Meaning of Life and Religious Coping in the Fight Against Cancer: A Study with Oncology Patients in Brazil in Light of Viktor Frankl's Theory

This study aimed to describe the perception of the meaning of life and coping strategies of 19 patients with cancer at a public hospital in Brazil. This is descriptive and qualitative research that used Amedeo Giorgi's phenomenological model, and the interpretation was performed in light of Viktor Frankl's theory. Two themes have emerged: (1) the perception of the meaning of life in the experience with cancer and (2) religious coping to fight the disease. This study showed that revealing the meaning of life in the cancer experience contributes to better treatment compliance, a more favorable view of the future and better quality of life. On the other hand, religious coping is the strategy most used by patients who believe in God, showing a greater state of psychological and spiritual well-being.

The Medical Healing of Souls: a strategy for welcoming post-pandemic mental health

OBJECTIVE

to reflect on the applicability of the Medical Healing of Souls (MHS) by health professionals as a welcoming strategy in post-pandemic mental health.

METHODS

a theoretical and reflective study, based on Viktor Frankl's philosophy, based on the book "The Doctor and the Soul, From Psychotherapy to Logotherapy" and scientific literature.

RESULTS

the study was structured in two discursive approaches: MHS in the field of health; The applicability of MHS in post-pandemic mental health care.

FINAL CONSIDERATIONS

MHS can be used in mental health care, in health emergencies, promoting a more humane performance of health professionals, facilitating the integration of inevitable suffering into a meaningful life.

Percepção de Residentes de Enfermagem e Medicina acerca do Telemonitoramento em Saúde

Trata-se de um estudo que pretende compreender a percepção dos residentes sobre o telemonitoramento como ferramenta capaz identificar necessidade de ações em saúde ao paciente em pré-operatório de Artroplastia total de Joelho (ATJ). Considerando que a integralidade da assistência é o recurso que auxilia o permeio das ações entre os níveis assistenciais (primário, secundário e terciário) para um mesmo indivíduo, identificamos ser de fundamental importância que os agentes de saúde envolvidos na assistência sejam capazes de reconhecer a necessidade de articular interfaces de atendimento com os diferentes níveis de atenção, para garantir a eficiência e eficácia dos tratamentos. Nesta perspectiva, pretende-se analisar a percepção dos residentes de enfermagem e medicina acerca da possibilidade de acompanhar as condições de saúde e as comorbidades de pacientes na fila de espera da cirurgia de ATJ, segundo Merleau-Ponty. O filósofo descreve a percepção enquanto acontecimento que origina a vida subjetiva apoiada no mundo percebido (realidade originária). Neste modo, as reflexões sobre a vida subjetiva transformam-se no local em que se situam e ocorrem as análises específicas a respeito da percepção e da noção do próprio corpo. Entender a percepção dos residentes de ortopedia sobre a prevenção e promoção à saúde impactará na formação de profissionais mais qualificados a prestar um cuidado mais amplo e qualificado que atenda às necessidades dos pacientes. Tendo como objetivo geral Identificar a percepção dos residentes de enfermagem e medicina ortopédica acerca de estratégias de telemonitoramento em saúde a pacientes na fila de espera de Artroplastia Total de Joelho. Palavras-Chave: Residência não Médica não Odontológica; Residência Médica; Telemonitoramento

Distress and Spiritual Well-Being in Brazilian Patients Initiating Chemotherapy during the COVID-19 Pandemic-A Cross-Sectional Study

Social distancing and the priority given to COVID-19 patients in health services, which caused postponement of appointments and cancer treatment, may have triggered unprecedented levels of distress in cancer patients. The aim of this study was to analyze the prevalence of distress and the levels of spiritual well-being of people initiating chemotherapy during the COVID-19 pandemic, identifying the factors associated with distress, and determining if there is a relationship between distress and spiritual well-being. A cross-sectional study was conducted with 91 Brazilians. Data were collected by applying the Spiritual Well-Being Scale (SWBS) and the Distress Thermometer and Problem List for Patients. The prevalence of distress was 59.5%, and the average score of spiritual well-being was 106.54 (±9.06). Emotional issues were the most reported by patients with distress. The Poisson regression showed that male sex (PR = 0.588; 95% CI 0.392–0.881), age (PR = 0.985; 95% CI 0.973–0.996), and spiritual well-being score were predictors of distress (PR = 0.971; 95% CI 0.946–0.996). These findings indicate that distress relief involves implementation of public health programs capable of integrating spiritual interventions into cancer care.

Meaning of life as perceived by nurses at work in oncology palliative care: a phenomenological study

OBJECTIVE

To understand the meaning of life as perceived by nurses at work in oncology palliative care.

METHOD

This is a qualitative study, with a phenomenological approach, based on the theoretical-philosophical framework by Viktor Emil Frankl. It was developed with nurses in a unit specialized in oncology palliative care located in the city of Rio de Janeiro and used phenomenological interviews. Data were processed using the phenomenological method by Amedeo Giorgi.

RESULTS

Thirty-four nurses participated in the study. The study conveys an existential message to nurses through selftranscendence. Through their work, they represent their own identity, which is directly impacted by the way they perceive freedom and responsibility in the face of actions taken. They build their reality and make work viable as a source of life. The care provided is no longer just a task to be qualified as a solidary, relational, existential, dynamic, and temporal issue.

CONCLUSION

The experience in a scenario of life finitude allows these professionals to experience an authentic encounter with their self, the awakening of values giving meaning to their existence, and self-transcendence, deeply contributing to society through a more human, comprehensive, and quality assistance.

Distress in the context of cancer and chemotherapy: A mixed-method study

BACKGROUND

There are controversial results about the effects of cancer and chemotherapy on the perception of distress.

AIMS

The purpose to the study is to explore the meaning of the distress experienced by patients with cancer and verify whether the cancer diagnosis, stage and receiving chemotherapy influence this experience.

DESIGN

This is a mixed-methods study with cancer patients.

METHODS

Data were collected in 2018 using a phenomenological interview (n = 18) and one suffering inventory (n = 100). Qualitative analysis was performed using the empirical-comprehensive model and quantitative using statistical tests. The results were triangulated.

RESULTS

Distress originated from difficulties faced in health services, diagnosis confirmation, beginning treatment and interruption of life projects. Patients mobilized resources in the spiritual dimension that allowed them to redefine their distress positively. Chemotherapy brought hope back and promoted healing expectations. Higher average scores for distress were found in patients with advanced stage and receiving palliative chemotherapy. Not having begun chemotherapy and having head and neck cancer were associated with higher average scores for distress.

CONCLUSION

Distress was greater among patients who had not yet begun chemotherapy; nearness of death and difficulty talking about feelings caused distress; distress was redefined by mobilization of spiritual resources.

RESSIGNIFICANDO O CUIDADO ATRAVÉS DA PERCEPÇÃO DA EQUIPE DE SAÚDE QUE ATUA EM AEROPORTO E AERONAVE

Objetivo: compreender o cuidado através da percepção da equipe de saúde que atua em aeroporto e aeronave.Método: pesquisa descritiva, com abordagem qualitativa. O estudo foi realizado no período de janeiro a março de 2019 com 16 participantes. A coleta de dados foi realizada com profissionais que atuam no Posto de Atendimento Pré-Hospitalar de um aeroporto na cidade do Rio de Janeiro. A análise foi fundamentada à luz da fenomenologia de Merleau-Ponty.Resultados: da análise emergiram duas subcategorias: A experiência e o mundo vivido como alicerce do cuidado no aeroporto e aeronave, e O corpo do profissional como mediador do cuidado humanizado no aeroporto e aeronave.Considerações finais: O estudo poderá contribuir para o cuidado prestado aos usuários que utilizam esse meio de transporte, bem como utilizam as dependências do aeroporto, contribuir para o ensino e pesquisa, e dar visibilidade à equipe de saúde que atua no aeroporto e aeronave.

Suffering experiences of people with cancer undergoing chemotherapy: A meta-ethnographic study

This meta-ethnography had the objectives of identifying, evaluating, and summarizing the findings of qualitative studies regarding the suffering experiences of people undergoing chemotherapy, as well as developing an explanatory conceptual structure regarding what affects these experiences. A systematic literature review was carried out, covering the past 10 years, in the following databases: CINAHL, Embase, Medline, LILACS and Scopus. By using meta-ethnographic synthesis methods, the following themes were found: the pain of loss; evaluating, measuring, and neutralizing the threat; and social contours of suffering. The experience of living with cancer and undergoing chemotherapy was synthesized into a theoretical-explanatory model with a structure that resembles barbed-wire loops. The model expresses people's suffering experiences as marked by the feeling of loss, restraint of emotions, and resilience. While transcendent movements broke the cycle of suffering, resilience emerged as a learning experience that made patients more resistant to the pain of loss. The results indicated a complex and diverse set of factors that influence suffering, which confirmed that experiences are individual, comprehensive, and continuously reinterpreted.

Psicoterapia Centrada en el Sentido: Una revisión acerca de estrategias psicoterapéuticas para el tratamiento del paciente con cáncer

Objetivo: presentar las estrategias psicoterapéuticas utilizadas en el tratamiento de pacientes con cáncer, cuya finalidad sea trabajar el sentido de la vida. Método: Se realizó una revisión sistemática inscrita en el registro PROSPERO con el número CRD42019132385, siguiendo el método PRISMA, en las bases Lilacs, Medline, Scopus y Web of Science. Resultados: Se incluyeron 11 artículos publicados entre 2014 y 2020. La Psicoterapia Centrada en el Sentido (PCS) es la estrategia psicoterapéutica más utilizada y efectiva para ayudar al paciente acerca de su sentido de la vida. Discusión: Se desarrollaron tres categorías: 1. Encontrando el sentido de la vida por medio de la PCS; 2. Bienestar espiritual y psicológico de la PCS y 3. Terapias individuales, grupales y de pareja como estrategias eficaces de la PCS. Conclusiones: Este estudio señala que la PCS, además de ser beneficioso para los pacientes, puede servir como una alternativa de trabajo para el psicólogo principalmente en regiones de habla portuguesa donde no se encontraron estudios.

Nursing process for a patient with needle phobia: a case study

OBJECTIVES

to report a clinical case of needle phobia which culminated in cardiac arrest and describe the outcome of a care plan based on fear and anxiety diagnoses, using the Roy adaptation model as the framework.

METHODS

case study conducted in a chemotherapy outpatient unit in Rio de Janeiro. Care was guided by the nursing process and the use of instruments to assess the venous network, anxiety and fear.

RESULTS

the Roy adaptation model enabled proposing nursing interventions that allowed the study subject to adapt to the external and internal stimuli triggered by vasovagal syndrome. The instruments indicated the choice of an adequate semi-implanted venous access device and led to improved levels of anxiety and fear.

FINAL CONSIDERATIONS

after carrying out the nursing activities, anxiety was reduced, and the patient achieved greater control over fear.

A percepção dos jovens e adultos sobre evasão escolar: uma visão merlopontiliano

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O sentido da vida dos enfermeiros no trabalho em cuidados paliativos: revisão integrativa de literatura

Objetivou-se identificar evidências científicas acerca do sentido da vida dos enfermeiros no trabalho em cuidados paliativos no contexto hospitalar numa perspectiva existencialista. Revisão integrativa conduzida nas bases indexadas LILACS, MEDLINE, BDENF, CINAHL e SCOPUS no período de 2008 a junho de 2019, seguindo as recomendações da ferramenta PRISMA. Foram selecionados 12 artigos internacionais dos quais emergiram três categorias temáticas: “experiências existenciais de enfermeiros que trabalham aos cuidados paliativos”, “os sentidos e significados atribuídos pelos enfermeiros em cuidados paliativos”, e “estratégias de enfrentamento e intervenções apontadas como superação de questões existenciais”. Para que o trabalho dos enfermeiros tenha sentido e represente um valor importante em sua vidas, torna-se importante conhecer as fontes motivadoras que orientam suas decisões, bem como a criação de janelas estratégicas no cuidado que promovam satisfação e desempenho no processo de trabalho e favoreça a cultura do cuidado a pacientes em cuidados paliativos. Descritores: Existencialismo; Espiritualidade; Enfermeiros; Cuidado Paliativo.

O sentido da vida dos enfermeiros no trabalho em cuidados paliativos: revisão integrativa de literatura

Objetivou-se identificar evidências científicas acerca do sentido da vida dos enfermeiros no trabalho em cuidados paliativos no contexto hospitalar numa perspectiva existencialista. Revisão integrativa conduzida nas bases indexadas LILACS, MEDLINE, BDENF, CINAHL e SCOPUS no período de 2008 a junho de 2019, seguindo as recomendações da ferramenta PRISMA. Foram selecionados 12 artigos internacionais dos quais emergiram três categorias temáticas: “experiências existenciais de enfermeiros que trabalham aos cuidados paliativos”, “os sentidos e significados atribuídos pelos enfermeiros em cuidados paliativos”, e “estratégias de enfrentamento e intervenções apontadas como superação de questões existenciais”. Para que o trabalho dos enfermeiros tenha sentido e represente um valor importante em sua vidas, torna-se importante conhecer as fontes motivadoras que orientam suas decisões, bem como a criação de janelas estratégicas no cuidado que promovam satisfação e desempenho no processo de trabalho e favoreça a cultura do cuidado a pacientes em cuidados paliativos.

O trabalho no trânsito e a saúde dos motoristas de ônibus: estudo fenomenológico

Objetivo: compreender as percepções dos motoristas de ônibus quanto às vivências no trabalho e aos impactos em seu corpo.Métodos: estudo descritivo pautado no pensamento do fenomenólogo Maurice Merleau-Ponty, realizado em uma garagem de ônibus, de julho 2017 a janeiro de 2018. Foram entrevistados 24 motoristas de ônibus, com mais de dois anos de profissão. As perguntas abertas do roteiro de entrevista fenomenológica possibilitaram a livre expressão dos significados do trabalho sobre a saúde.Resultados: as relações interpessoais no trânsito impactam diretamente o estado físico e psicológico, e a relação com o tempo influencia o comportamento dos condutores.Conclusão: melhorias no trabalho e nas relações interpessoais são necessárias a fim de garantir a preservação da saúde do motorista de ônibus, que é parte essencial no processo de deslocamento da população, e atenção à saúde mental dos motoristas é pouco valorizada, mas indispensável para o trabalho com pessoas.

Health in the school: perceptions of being adolescent

OBJECTIVES

to understand adolescents' perceptions on school health.

METHODS

qualitative and descriptive research grounded on Maurice Merleau-Ponty's phenomenology, which was developed with 90 adolescent students from a federal school of the state of Rio de Janeiro. Data were produced by gathering answers to the following question: what is your perception on school health? Those who chose to write their answer to the guiding question deposited the manuscripts in polls.

RESULTS

school health is linked to hygienist practices and to the hegemonic assistentialist model. Nevertheless, we assigned senses and meanings to the practice of physical activity and health education by integrating and expanding behavioral strategies and healthy habits.

FINAL CONSIDERATIONS

a healthy school environment implies the protagonism of adolescents in school health promotion actions.

O olhar do estudante médico em relação ao parto humanizado em maternidade mageense: aprendizado e Merleau-Ponty

O objetivo do estudo foi captar a percepção dos estudantes de medicina em relação ao parto em unidade hospitalar do Sistema Único de Saúde com foco na humanização de sua práxis na cidade de Magé/Rio de Janeiro, onde é incipiente a implementação da Política Nacional  de  Humanização.  O referencial  filosófico  teve  embasamento  em  Maurice Merleau-Ponty.  Foi  estudo  qualitativo  em  que,  por  meio  de  entrevista  apoiada  na fenomenologia com dezoito estudantes de medicina, em sala apropriada durante o horário do estágio não curricular dos mesmos, foram transcritos seus relatos e assim, se fez possível a reflexão da vivência dos  mesmos  em  relação  ao  aprendizado  do  parto normal ou cesáreo. Após a  aprovação  por Comitê  de  Ética  em  Pesquisa  específico  (parecer  número  2.872.462),  realizou-se a entrevista fenomenológica. Os estudantes colocaram a qualidade de aprendizado do parto normal no referido estabelecimento de saúde como satisfatória, entretanto, apontaram a dificuldade de se colocarem em prática a  humanização,  diante  da  alta  demanda  de atendimentos na instituição de saúde em estudo.  A análise da percepção do outrem reencontra a dificuldade que o mundo cultural suscita, conforme Merleau-Ponty, e assim se observa, por vezes, um lapso na formação de parte dos entrevistados, no tocante à construção da empatia, como elemento do humanizar. Depreende-se que a melhora do ensino médico prático em Obstetrícia deve envolver a compreensão do contexto sociocultural das gestantes e aspectos de gestão de recursos e política, capazes de impactar o cuidado integral da gestante e formação do médico.

Spirituality and meaning of life in nursing education: report of experience in teaching

ABSTRACT Objectives: To report the experience in teaching internship in the elective discipline “Spirituality in the Health Field” of the curriculum of the graduation course in Nursing of Universidade Federal Fluminense. Methods: This is a case report with descriptive-reflexive approach of the class “the meaning of life as spiritual care strategy in the nursing practice”. For the elaboration of the discipline, a lesson plan and active methodologies were used. Results: The strategy used for preparation of the class allowed transmitting and constructing knowledge objectively. The reflections disclosed along with students showed the importance of the meaning of life as spiritual care in nursing practices for the health professional and for the act of being cared for. Final considerations: The class was considered a successful experience, as the theme proposed was essential for the theoretical-reflective construction about spirituality and meaning of life as a form of care that transcends technical procedures.

SUFFERING AMONG PATIENTS WITH CANCER UNDERGOING NEUROTOXIC CHEMOTHERAPY: A PHENOMENOLOGICAL APPROACH

ABSTRACT Objective: reveal experiences of cancer patients undergoing neurotoxic chemotherapy. Method: phenomenology-based, qualitative study, carried out with nine adult patients in antineoplastic neurotoxic treatment, interviewed in June and July 2018. The testimonies were analyzed using an empirical comprehensive model. Results: the following categories were delineated: nerves on edge: perception of limitations caused by neuropathic pain induced by chemotherapy; chemotherapy drains me of energy; the suffering of starting again; the suffering of enduring it; alone in a desert, I heard the cry of my silence; chemotherapy: an infusion of hope; and there is no suffering on earth that heaven cannot heal. Conclusion: the study presented various meanings of suffering that emerge from experiences with neurotoxic treatment and found that many dimensions of suffering interpenetrate, making it impossible to disassociate them.

Portfólio digital desenvolvido a partir da percepção do preceptor cirurgião dentista: um estudo fenomenológico

RESUMO O presente trabalho tem como objetivo geral compreender o processo de trabalho do preceptor cirurgião dentista através da avaliação da sua percepção explícitas em Maurice Merleau Ponty analisando o fenômeno a partir de suas vivências e expertises melhorando integração serviço-universidade contribuindo na qualidade do ensino na saúde e na assistência da população. Realizar o desenvolvimento de um portfólio digital a fim de contribuir para o aperfeiçoamento de todos os envolvidos na atividade de preceptoria melhorando a relação da Universidade e preceptor, possibilitando ao acadêmico obter um melhor conhecimento da realidade no atendimento da população. A metodologia proposta seria a pesquisa descritiva, com abordagem metodológica qualitativa, utilizando técnicas padronizadas de coleta de dados, como questionários e observação sistemática a população do estudo será cirurgiões – dentistas preceptores que atuem no serviço de emergência .

Nurses’ experiences in the care of high-risk newborns: a phenomenological study

ABSTRACT Objective: To describe nurses’ experience in the care of high-risk newborns. Method: This is a descriptive study with a qualitative approach, based on Merleau-Ponty’s phenomenology and performed at the Fernando Magalhães Maternity Hospital in the state of Rio de Janeiro, through interviews with 30 nurses who work in neonatal care, according to the phenomenological thinking of Maurice Merleau- Ponty. Results: Three categories emerged: “experienced body of the nurse practitioner on the high-risk newborn”; “experienced world of the nurse practitioner on the high-risk newborn”; and “time spent by the nurse practitioner with the high-risk newborn”. Final considerations: The study allowed us to describe, through the participants’ speeches, that the care of the high-risk newborn is broad, that is, objective, subjective and carried out with advanced technologies, their experiences and scientific improvement are composed of shared practice and theory with the family, professionals and beginners in the neonatal universe, favoring a differentiated and humanized care.

Perception of women with breast cancer undergoing chemotherapy: a comprehensive analysis

ABSTRACT Objective: To comprehensively analyze the perception of women with breast cancer on the experience of undergoing chemotherapy. Method: This was a qualitative, descriptive, phenomenological study, supported by the Merleau-Ponty philosophy. It was conducted in a chemotherapy outpatient clinic with 20 participants who completed a phenomenological interview. Results: The phenomenological data analysis demonstrated that the perception of women about the experience of chemotherapy is about change, not only of the physical body, but of their identity, and that it considers existential aspects. Three categories emerged from the experience of alopecia, fatigue, and spirituality, respectively: the body itself, the current and habitual body, and transcendence. Final considerations: Bodily changes, and the existential implications perceived by the women in this study, analyzed from the Merleau-Ponty perspective, makes it possible to consider body concept, and provides support for humanized care based on singularity and the socio-cultural context.

Health in the school: perceptions of being adolescent

OBJECTIVE

To understand adolescents' perceptions on school health.

METHOD

Qualitative and descriptive research grounded on Maurice Merleau-Ponty's phenomenology, which was developed with 90 adolescent students from a federal school of the state of Rio de Janeiro. Data were produced by gathering answers to the following question: what is your perception on school health? Those who chose to write their answer to the guiding question deposited the manuscripts in polls.

RESULTS

School health is linked to hygienist practices and to the hegemonic assistentialist model. Nevertheless, we assigned senses and meanings to the practice of physical activity and health education by integrating and expanding behavioral strategies and healthy habits.

FINAL CONSIDERATIONS

a healthy school environment implies the protagonism of adolescents in school health promotion actions.

Alterações estéticas no contexto da doença renal crônica e complicações associadas à autoimagem

Objetivo: Identificar na literatura as alterações estéticas decorrentes da doença renal crônica (DRC) e seutratamento e as complicações associadas a mudanças na autoimagem. Método: Revisão integrativa realizada emjaneiro de 2016, na Lilacs, Medline, Biblioteca Digital de Teses e Dissertações e Google Acadêmico, utilizandoa estratégia PVO - P (problema/população): Insuficiência Renal Crônica; Diálise Renal; Fístula Arteriovenosa;V (variáveis do problema): Estética; O (outcomes/resultados): Autoimagem; Imagem Corporal. Incluíram-se aspublicações disponíveis em português, inglês e espanhol, publicados no período de 2010 a 2015 e que tratavamda temática. As publicações foram lidas, analisadas, sumarizadas e discutidas. Resultados: A amostra final de 28publicações apontou que o aspecto estético decorrente das fístulas e da presença de cateteres são as principaiscausas da autoimagem negativae implicam em complicações psicossociais, como sofrimento e sentimento deinferioridade. Outras alterações estéticas identificadas foram a baixa estatura, ganho e perda de peso e palidez.Conclusão: São necessários conhecimentos que desvelem a percepção do sujeito sobre seu corpo e que guardevaloração subjetiva de vivência diante da doença e sua estética.Palavras-chave: Insuficiência renal crônica; Estética; Autoimagem. ABSTRACTObjective: To identify in literature aesthetics changes resulting from chronic kidney disease (CKD) and itstreatment and complications associated with changes in self-image. Method: Review study conducted in January2016 in Lilacs, Medline, Digital Library of Theses and Dissertations and Google Scholar, using PVO strategy:PVO - P (problem/population): Renal Insufficiency, Chronic; Renal Dialysis; Arteriovenous Fistula; V (problemvariables): Esthetics; O (outcomes): Self Concept; Body Image. Were included the publications about the theme,available in Portuguese, English and Spanish, published between 2010-2015. The publications were read,analyzed, summarized and discussed. Results: The final sample of 28 publications pointed out that the aestheticappearance resulting from fistulas and the presence of catheters are the main causes of the negative self-imageand involve psychosocial complications such as pain and feeling of inferiority. Conclusion: Knowledge that revealthe perception of the subject on his body and saving subjective experience of valuation on the disease and itsaesthetics are required. Other aesthetics changes identified were short stature, gain and weight loss and pallor.Keywords: Renal Insufficiency Chronic; Esthetics; Self Concept

Acolhimento aos familiares de vítimas de óbitos por causas externas

Os agravos que contemplam as causas externas, anualmente, matam mais de 5 milhões de pessoas em todo omundo, o que representa cerca de 9% da mortalidade mundial. Este estudo objetivou descrever a experiênciavivenciada pela equipe no acolhimento aos familiares de vítimas de óbitos por causas externas em um hospital dereferência em Alagoas. Trata-se de um relato de experiência vivenciado no decorrer das práticas profi ssionais emum hospital de referência em trauma em Alagoas. Desde da implantação do Hospital em 2003 aos dias atuais, váriastransformações foram acontecendo na prática hospitalar, como demanda de vítimas de acidentes ou violências, bemcomo ocorrências de óbitos foram aumentando. Simultaneamente a todas essas mudanças, vários questionamentosiam sendo feitos pelos próprios profi ssionais e familiares referentes à condução do corpo após o óbito. A partir daanálise desta realidade, evidenciou-se a necessidade de defi nição de um fl uxograma, com participação efetiva daequipe interdisciplinar, para facilitar a condução do corpo após o óbito. Portanto, o trabalho da equipe interdisciplinarno acolhimento aos familiares de vítimas de óbitos por causas externas caracterizou-se como uma estratégia deaperfeiçoamento pessoal, profi ssional e teórico/prático-científi co, possibilitando redução do tempo para liberaçãodo corpo da Unidade Hospitalar para o Instituto Médico Legal e, posteriormente, velório e sepultamento.Palavras-chave: Comunicação Interdisciplinar; Acolhimento; Morte; Relações Profi ssional-Família; Causas Externas. ABSTRACTThe external causes’ aggravation annually kill more than 5 million people worldwide, representing about 9% ofglobal mortality. This study aimed to describe the experience lived by the reception staff to family victims’ externalcauses in a referral trauma specialized hospital in Alagoas. Since the deployment - in 2003 - until today, severalchanges were happening in hospital practice, as demand for victims of accidents or violence and occurrences’ deathswere being increased. Simultaneously, with all these changes, many questions were being made by professionalsthemselves and their families regarding the conduct of the body after death. From the analysis of this reality, itshowed the indispensability on defi ning a fl ow chart, with the effective participation of an interdisciplinary team, tofacilitate body conduction after death. Therefore, the work of the interdisciplinary team in welcoming these death’sparents characterized as personal development strategy, professional and theoretical / practical-scientifi c, enablingreduced time to release the body from the Hospital Unit to Forensic Institute and then wake and burial.Keywords: Interdisciplinary Communication; User Embracement; Death; Professional-Family relations; External Causes.

A fenomenologia Merleau-Pontyana e o profissional da saúde: uma reflexão teórico-filosófica

DOI: http://dx.doi.org/10.31011/1519-339X.2018a18n85.15 Objetivou-se apresentar uma reflexão acerca dos afazeres do profissional da saúde, privilegiando uma atitudedialética entre a objetividade e a subjetividade no acolhimento humanizado das demandas de clientes. Tratase de um estudo de reflexão fundamentado na base teórico-filosófica da Fenomenologia de Maurice MerleauPonty, discutindo pontos principais desta linha de pensamento. O texto foi organizado em duas partes: “Algunsesclarecimentos fenomenológicos” e “O profissional da saúde, a epoché e a humanização”. A primeira parte esclarececonceitos fenomenológicos; já a segunda demarca a conexão entre a Fenomenologia e a prática profissional. Buscaracolher o outro e sua demanda, reduzindo-se fenomenologicamente, é praticar a sensibilidade, há muito tempoesquecida num modelo de saúde engessado no paradigma biomédico. Humanizar-se é um exercício constante queatravessa sujeitos, redes e subjetividades.Palavras-chave: Empatia; Humanização da Assistência; Ciências da Saúde. ABSTRACTAimed to present a reflection on the health professional's work, favoring a dialectic attitude between objectivityand subjectivity in the humanized reception of client demands. It is a study of reflection based on the theoreticalphilosophical basis of the Maurice Merleau-Ponty’s Phenomenology, discussing main points of this line of thought.The text was organized in two parts: "Some phenomenological clarifications" and "The health professional, theepoché and the humanization". The first part clarifies phenomenological concepts; the second one demarcatesthe connection between Phenomenology and professional practice. Receiving the other and its demand, reducingphenomenologically, is to practice the sensitivity, so long forgotten in a health model hardened in the biomedicalparadigm. Humanizing yourself is a constant exercise that crosses subjects, networks and subjectivities.Keywords: Empathy; Humanization of Assistance; Health Sciences.

Acolhimento aos pacientes e familiares atendidos no ambulatório de oncologia: um relato de experiência

O objetivo deste estudo é relatar as experiências vivenciadas por uma enfermeira e sua equipe, referente aoatendimento prestado aos pacientes e seus familiares em um ambulatório de oncologia clínica de um hospitalespecializado na cidade do Rio de Janeiro. Trata-se de relato de experiência vivenciado no decorrer das práticasprofissionais. O primeiro contato do paciente e seus familiares no ambulatório acontece na recepção, no momento daentrega do cartão de consulta ou dos encaminhamentos, para os pacientes de primeira vez. Quando o paciente chegaà recepção com qualquer queixa, imediatamente a equipe de enfermagem recebe a informação da necessidade domesmo e realiza o atendimento, onde são aferidos os sinais vitais e o enfermeiro realiza a avaliação a partir examefísico associado ao diálogo, a fim de identificar as necessidades de saúde e a prioridade para o atendimento médicoa partir das queixas descritas pelo paciente e/ou familiar. Concluí-se que experiências vivenciadas no ambulatóriode oncologia clínica contribuíram de formas satisfatórias para compreensão de gerenciar os serviços e as ações daequipe de enfermagem, no que se refere acolhimento aos pacientes e familiares, bem como para tomada de decisão.Palavras-chave: Humanização da Assistência; Neoplasias; Cuidados de Enfermagem.

Health as a right and the care of the self: conception of nursing professionals

ABSTRACT Objective: To analyze health as a right from the perspective of care of the self, in the conception of nursing professionals. Method: Qualitative study, carried out in a Federal Hospital of the city of Rio de Janeiro, with the participation of 10 nurses and 20 nursing technicians through interviews recorded, transcribed and analyzed in light of the Discursive Textual Analysis. Results: Two categories emerged: Health as the right of professionals and their "non-right" to health; and Care of the self for the health professional: work and torture. Conclusion: There are many challenges to overcome, such as the search for satisfactory public funding, the need to improve the quality of Primary Health Care services, the implementation of a care model compatible with the country's demographic and epidemiological situation; all professionals need an effective endorsement for care of the self, such as their knowledge of the right to health.

Impact of venous ulcers on patients' quality of life: an integrative review

OBJECTIVE

To analyze knowledge gathered about the impact of venous ulcers on patients' quality of life.

METHOD

Systematic bibliographic review study with an integrative approach. Databases of MEDLINE, LILACS, IBECS, CINAHL Complete, Web of Science, Scopus, and CUIDEN Plus were used for selection with the PICOT guiding criteria, through the DeCS and MeSH: adult, aged, varicose ulcer, and quality of life, in Portuguese, Spanish, and English. The inclusion criteria were: full original articles available in the databases selected with adherence to the theme in Portuguese, Spanish, and English, published from 2007 to 2016.

RESULTS

The sample included 14 national and international articles with different methodological approaches and investigative contexts, published from 2012 to 2016.

CONCLUSION

Chronic venous ulcers act on patients' bio-psycho-social-spiritual and socioeconomic spheres, having a negative impact on their quality of life.

Sequenciamento de infusão de antineoplásicos: contribuições para a prática de enfermagem oncológica baseada em evidência

Este estudo objetivou identificar as evidências científicas disponíveis acerca das interações medicamentosas entre antineoplásicos decorrentes da ordem de infusão para, então, descrever a melhor sequência de aplicação e discutir sua aplicabilidade na Sistematização da Assistência de Enfermagem (SAE). Revisão integrativa da literatura operacionalizada em 2018 nas bases MEDLINE, LILACS, CINAHL e BVS, a partir dos termos Neoplasms, Drug Therapy, Drug Interactions, Chemotherapy e Sequence Administration. Foram analisados 57 estudos que, em conjunto, estudaram 40 combinações de antineoplásicos, apontando as interações farmacocinéticas e farmacodinâmicas decorrentes da ordem de infusão, as quais subsidiaram a construção de um quadro determinando o melhor sequenciamento para cada uma dessas combinações. Um fluxograma também foi produzido para, junto com o quadro, apoiar a SAE na perspectiva da prática de enfermagem oncológica baseada em evidência. Selecionar as sequências de infusão de antineoplásicos combinados representa nova estratégia conceitual para enfermeiros que administram protocolos de poliquimioterapia.

The body marked by the arteriovenous fistula: a phenomenological point of view

OBJECTIVE

To understand the experience of people with chronic kidney disease using arteriovenous fistula.

METHOD

Qualitative and exploratory study based on Social Phenomenology, conducted on 30 adults undergoing hemodialysis by using the fistula, interviewed in 2017. The interviews were analyzed according to the empirical-comprehensive model proposed by Amedeo Giorgi.

RESULTS

We found the categories "The changed body aesthetics"; "The perception of the other about my body"; and "The fistula as an inseparable condition for life maintenance."

FINAL CONSIDERATIONS

The experience of people using fistula showed that this venous access leaves marks that change the body aesthetics, making the body imperfect. Such changes cause low self-esteem and attract the look of the other, causing embarrassment in those who have the body changed. Thus, they react by camouflaging the fistula, without which there is no life. This perception arises from the fear that works as a catalyst for self-care.

Application of Merleau-Pontyan perspective on the physical and psychological implications of venous ulcers

OBJECTIVE

to verify the application of the Merleau-Pontyan perspective on the physical and psychological implications of chronic venous ulcers in the existence of people who experience the disease.

METHOD

a qualitative study, of the descriptive phenomenological type, developed with 36 patients. The field of investigation was the Outpatient Clinic of Wound Repair of the Hospital Universitário Antônio Pedro. The collection occurred from June to December 2016, through a phenomenological interview.

RESULTS

the experiences inherent in people who have venous ulcers pass through the world and "return" to the body itself, reflecting on the biopsychosocial aspects and the sensitivity left on the being.

CONCLUSION

the biological characteristics of the subject affected by the venous ulcer have repercussions on their physical aspect, promoting influences along with the emotional and social changes originating from the clinical picture on the social aspects and consequently reverberating on the quality of life of this individual.

Counseling and Spiritual Assistance to Chemotherapy Patients: A Reflection in the Light of Jean Watson's Theory

Abstract Aim: To reflect on the use of spiritual interventions and methods of psychological, theological and psychotherapeutic counseling applicable to nursing. Method: Theoretical reflection article, used to identify approximations and distances of counseling methods and spiritual interventions with Jean Watson's Theory of Human Care. Results: The critical analysis of methods of psychological, theological and psychotherapeutic counseling indicates approximations with the Theory of Human Care, promoting the improvement of spiritual interventions directed to patients in chemotherapy. Conclusion: From Jean Watson's Theory emerged a creative, original and unique advice in nursing. Implications for practice: Understanding counseling methods and spiritual interventions are important tools for the practice of oncological nursing, as well as enhancing the resources available to integrate spirituality and health.

Gerontological contributions to the care of elderly people in long-term care facilities

OBJECTIVE

To analyze Brazilian scientific productions from the last 11 years which show the contributions of nursing to elderly people in long-term care facilities.

METHOD

This is an integrative literature review. The search took place in the Virtual Health Library (VHL) in the BDENF and LILACS databases and the SCIELO virtual library, between June and October 2016, using the keyword long-term care facility and the descriptors nursing and geriatrics.

RESULTS

Eleven studies were selected, published 2005 and 2016, with various methodological approaches that enabled discussion of the proposed objective.

CONCLUSION

The contributions of nursing to institutionalized elderly people were linked to health promotion measures, as well as simple interventions, such as listening, interacting, offering recreation and helping in psychoaffective relationships. These activities contributed to raising the self-esteem of the individuals.

Nursing students' perception about humanized care: an integrative review

ABSTRACT Objective: To analyze the productions of knowledge about the students' perception of humanized care. Method: Study of bibliographical revision of the integrative type. The databases Pubmed, Lilacs, Cuiden and the SciELO virtual library were chosen for selection in October 2017, using the health descriptors "Students, Nursing", "Perception" and "Humanization of assistance", in the languages Portuguese, English and Spanish. Results: Only eight studies were included that met the objectives of the study, where the majority portrays the Brazilian reality. Conclusion: Given the current discussion of society on the subject and the scarcity of publications, it is clear the need to adapt the academic field to complaints of society, as well as reflection of why the problem does not have a significant approach in international setting.

Spiritual needs experienced by the patient's family caregiver under Oncology palliative care

ABSTRACT Objective: To understand the spiritual needs of the patients' family caregiver under Oncology palliative care. Method: A descriptive, qualitative study with 20 family caregivers of patients hospitalized in an Oncology palliative unit. The data were collected through a phenomenological interview, and analyzed by the method of Amadeo Giorgi supported in the Merleau-Ponty's Phenomenology of Perception. Results: The categories were unveiled: "Spirituality as a foundation for life"; "Spiritual needs sublimated by the family caregiver"; and "Care expected by the nurse". Conclusion: Family caregivers appropriate spirituality as a coping strategy and meeting the purpose and meaning of the moment experienced. It is profitable for the nurse to contemplate the spiritual needs of the caregiver in order to provide a guided assistance in the humanization of care and comprehensive care. Therefore, there is a need for new studies that address this dimension to the family caregiver in the field of Oncology, since this care is incipient by the nurse.

The face-to-face encounter in indigenous health care: a perspective in Lévinas

ABSTRACT Objective: To reflect on the sensitive behaviors of indigenous healthcare professionals based on the philosophy of Emmanuel Lévinas, to ratify completeness, equity, and humanity. Method: reflective study. Reflection: Studies have identified inadequacies in meeting the indigenous singularities. In the hospital and outpatient settings, they are diluted in the search for care. The difficulty of the professionals to admit them generates conflicts and non-adherence of indigenous individuals to treatments that disregard their care practices. In Lévinas, consciousness requires, "a priori," sensitivity to access the Infinity on the Face of the Other, which in the face-to-face encounters is presented to the Self as radical Alterity, proposing an Ethical relationship through transcendence. The freedom of the Self as to the Other is finite, as the Self cannot possess the Other, and infinite for its responsibility for the Other. Final considerations: The Self builds essence and existence in responsibility. In the Ethics of Alterity, in Lévinas, reflections are proposed that influence sensitive behaviors.

The discursive production of professionals about humanizing health: singularity, rights and ethics

Objective:

to describe the discursive production of professionals about the humanization of health.

Method:

qualitative study of descriptive approach, inspired by the social representation theory, with 24 professionals in the healthcare field, working in a university hospital with the established humanization policy. The selection of participants was conducted according to criteria of adequacy and diversity for an intentional sample. Data collection was conducted by semi-structured interviews.

Results:

through content analysis, three categories emerged, around which the analyses were conducted: "humanizing health as an act of accepting the other as unique", "humanizing health as a matter of right" and "humanizing health as an ethical issue". The discursive production of professionals is based on a perspective which is based on the humanist prospect with socio-historical bias.

Conclusion:

healthcare professionals must know the National Humanization Policy in order to provide quality care, promoting the meeting, welcoming and recognition of oneself, others and their profession in the political and socio-historical scenario of their country as a citizen, not only of rights, but also of obligations.

Nursing technologies applied to families’ members: Integrative review

Background: When practing care, the nurse is able to apply all technologied possibilities in favor of the demands of the necessities of both patients and their relativies Objective: To reveal the kinds of light technologies that have been developed by nurses to the families of patients who take care of them. Method: Integrative literature review conducted by the search in the databases LILACS, MEDLINE, BDENF and Scopus, with the key words "technology", "nursing", "care" and "family", published between 2005 and 2016 with a final selection of 16 items.  Results: The categories developed by similar subject for analysis were: light technologies focused on family care; group technology as a strategy of care for families and educational technologies in nursing care context. Conclusion: The nurse takes control of soft Technologies based on the development of care for Family members. But there are gaps to consolidate this assistance having the necessity of implementing public policies to ensure, in fact, these necessities. Keywords: Technology. Caution. Nursing. Family

Impact of home visits on the functional capacity of patients with venous ulcers

ABSTRACT Objective: to compare the impact of home visits, before and after instructions, on the functional capacity of adult and elderly patients with venous ulcers, by means of the KATZ-EIAVD Scale. Method: experimental, clinical, randomized, non-blind and controlled study, developed with 32 patients (case and control groups). The research settings were the Wound Care Clinic of the University Hospital Antonio Pedro, and the homes of patients assisted in this clinic. Data collection took place from February to June 2014, by means of a health unit evaluation tool, the KATZ-EIAVD Scale, and a script of instructions to be given to the research subjects that had received a home visit. Results: the studied population present excellent independence for activities of daily living, with no significant variation among them. Conclusion: the studied groups have functional capacity with similar progress.

Intercâmbio acadêmico cultural internacional: uma experiência de crescimento pessoal e científico

Este estudo objetivou descrever a experiência discente ao integrar um programa de mobilidade acadêmica internacional, durante a graduação em enfermagem. Trata-se de relato da vivência acadêmica em Portugal, na Universidade do Algarve, viabilizada pela Universidade Federal de Santa Maria, Rio Grande do Sul, Brasil. A experiência de intercâmbio realizada no período de seis meses, possibilitou a aquisição de novos conhecimentos científicos e culturais, inclusive inovações de tecnologias em saúde, desenvolvimento de pesquisa e vínculos acadêmicos. Como contribuições, espera-se estimular e intensificar a mobilidade internacional especialmente no âmbito da graduação, considerando a sua importância para o aperfeiçoamento da formação acadêmica e a excelência do ensino superior brasileiro por meio do intercâmbio científico e cultural no exterior.

[Ethical dilemmas in ICU: contributions of Max Scheler's Theory of Values]

The study aimed to reflect, based on the theoretical framework of Max Scheler, about the ethical dilemmas experienced by nurses in the ICU, and about the values that guide their actions and decisions,. This is qualitative research, and ten ICU nurses have been interviewed at a university hospital. It was identified the experience of ethical dilemmas related to the terminality related to the limits of intervention and use of material resources, as well as the issue of blood transfusion in case of religious restrictions. The values identified were: respect, dignity of the patient, scientific knowledge, humility, passion for the profession and love of God. The theory of values is an important tool for nursing because it allows the approach of an ethics of humanizing praxis, especially in situations of ethical dilemmas.

[Advances and challenges of nursing in the scientific production on Psoriasis]

The Psoriasis, chronic disease with uncertain cause, affects 1 to 3% of world population, produces great psychological impact and changes in quality of life, a challenging reality. The objective is to analyze the scientific production of nursing on Psoriasis in 1997/2008, examining the approaches and contributions to care. Bibliographic study based on virtual database Medline using the terms "Psoriasis" and "Nursing". Of the 21 articles selected, 19% focus on the pathophysiology and differential diagnosis, 48% treatment, 28% psychological aspects and 42% in nursing care. The rescue of the scientific knowledge increases the challenge of maximizing the scientific production about this subject, bringing significant contributions to advances to a more holistic intervention and higher quality with this clientele.

Cultura, saúde e enfermagem: o saber, o direito e o fazer crítico-humano

Trata-se de um trabalho que apresenta uma reflexão teórico-filosófica acerca da cultura, saúde e enfermagem. Selecionamos autores que entendem a filosofia como um saber que coloca os problemas do pensar e do agir como questão ou processo. Focalizamos três instâncias, a saber: a cultura, a saúde e a enfermagem como saber, direito e fazer crítico. A cultura é compreendida como resposta do homem ao desafio da existência onde o humano se realiza. A enfermagem é um fazer crítico humano e ao fazer, o enfermeiro se faz. O enfermeiro percebe-se como capaz de transformar a natureza e a si mesmo no trabalho. A saúde é um direito a ser conquistado e historicamente esta perspectiva passa a ganhar corpo, ainda que lentamente, na cidade moderna. Conclui-se que a cultura aparece como “seiva” que nutre a ação humana, a forma através da qual a humanidade se configura no triângulo: cultura, trabalho/enfermagem e saúde.