Inter-relações no processo de morrer no hospital: olhar do familiar cuidador / Interrelations in dying process in the hospital: family caregiver's perspective

Resumo Objetivo: Conhecer como o familiar cuidador percebe sua inter-relação com membros da equipe de enfermagem e com seu familiar enfermo no processo de morrer. Metodologia: Estudo qualitativo, desenvolvido em um hospital universitário no sul do Brasil entre março e junho de 2016, que se fundamentou na metodologia de Leininger e na teoria de Morin. Participaram 24 familiares cuidadores de indivíduos hospitalizados e em processo de morrer. Foram realizadas observações, entrevistas e análise contextual dos dados colhidos. Resultados: A partir da análise dos dados, surgiram duas categorias: Fragilidades percebidas pelos familiares cuidadores nas suas inter-relações com enfoque às rupturas nessas relações; e Potencialidades no processo inter-relacional do familiar ou cuidador, com enfoque às potencialidades dos familiares cuidadores em proporcionar melhor qualidade de vida aos indivíduos enfermos. Conclusão: Os familiares cuidadores que participaram do nosso estudo demonstraram a importância de se investir em potencialidades, buscando formas de se reorganizarem, para o enfrentamento do processo de morrer, no qual ocorre tanto desgaste físico como mental.

Resumen Objetivo: Conocer cómo el familiar cuidador percibe su interrelación con los integrantes del equipo de enfermería y con el familiar enfermo en el proceso de morir. Metodología: Estudio cualitativo, desarrollado en un hospital universitario del sur de Brasil entre marzo y junio de 2016, el cual se fundamentó en la metodología de Leininger y en la teoría de Morin. Participaron 24 familiares cuidadores de individuos hospitalizados y en proceso de morir. Se realizaron observaciones, entrevistas y un análisis contextual de los datos recolectados. Resultados: A partir del análisis de los datos, surgieron dos categorías: Debilidades percibidas por los familiares cuidadores en sus interrelaciones, con enfoque en las rupturas en estas relaciones; y Potencialidades en el proceso interrelacional del familiar cuidador, con enfoque en las potencialidades de los familiares cuidadores para proporcionar mejor calidad de vida a los individuos enfermos. Conclusión: Los familiares cuidadores de nuestro estudio demostraron la importancia de generar potencialidades, buscando formas de reorganizarse, para el afrontamiento del proceso de morir, en el cual se presenta un desgaste físico y mental.

Abstract Objective: To understand how family caregivers perceive their interrelation with members of nursing team and their ill family member in dying process. Methodology: This is a qualitative study, conducted in a university hospital from southern Brazil between March and June 2016. It was based on the Leiningerʼs methodology and the Morin's theory. Twenty-four family caregivers of individuals who were hospitalized and in dying process participated in our study. Observations, interviews and contextual analysis of data collected were carried out. Results: Two categories emerged based on data analysis: Weaknesses perceived by family caregivers in their interrelations, with a focus on breakdowns in these relations; and Potentialities in the interrelational process of family caregiver, with a focus on potentialities of family caregivers to provide a better quality of life to ill individuals. Conclusion: Family caregivers of this study demonstrated the need to build potentialities, looking for ways to reorganize, in order to cope with dying process, which demands both physical and mental weariness.

Educational process in palliative care and the thought reform.

OBJECTIVES: To know the contributions of the educational process in Palliative Care during the undergraduate level for the professional action of nurses in the care of patients at the end of life. METHODS: This is a qualitative research, with discursive thematic analysis, based on Morin's theory of complexity. It was attended by seven newly-trained nurses and six nursing teachers from a Nursing Undergraduate Course. RESULTS: It has found disruptions and the development of new ways of thinking and caring for patients at the end of life, highlighting that these patients should be treated with therapies to mitigate their signs and symptoms until death, focusing on quality of life; moreover, their psychosocial and spiritual aspects should be appreciated. CONCLUSIONS: The educational process in palliative care seems to be essential for nurses, as a way of organizing and systematizing patient care. It becomes indispensable that nursing programs also provide the students with the development of the awareness of the complexity of the human being and its relationship with the multiple biopsychosocial and spiritual aspects.