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Introdução: O cancro é uma das primordiais causas de morbidade e mortalidade a nível mundial. Afeta as pessoas em todas as dimensões humanas: física, psicológica, social e espiritual. Em particular, na dimensão espiritual, o diagnóstico de enfermagem angústia espiritual está presente em 40,8% das pessoas com cancro submetidas a quimioterapia. Os cuidados de enfermagem têm uma visão holística, em que a dimensão espiritual deve ser considerada e o reconhecimento das necessidades espirituais dos doentes deve ser uma parte fundamental desses cuidados. Porém, ainda é fraca a evidência sobre o perfil do diagnóstico de angústia espiritual ao longo do tempo ou ao longo de uma condição de saúde particular. Objetivo: Determinar o valor da angústia espiritual em pessoas com cancro ao longo da quimioterapia. Metodologia: Estudo quantitativo, observacional, longitudinal em painel e prospetivo. A população do estudo é constituída por 332 pessoas com doença oncológica que foram submetidas a quimioterapia em regime de ambulatório, num hospital do sul de Portugal. A técnica de amostragem foi aleatória simples, atendendo aos seguintes critérios de inclusão: maiores de 18 anos; saber ler e escrever; realização de quimioterapia (oral, subcutânea, endovenosa) em ambulatório no Hospital de Dia; estádio da doença: I, II, III e IV; pessoas com cancro antes de iniciar o primeiro ciclo de quimioterapia. O processo de recolha de dados teve cinco cortes, especificamente, antes de iniciar quimioterapia, após três meses, seis meses, nove meses e 12 meses após o início da quimioterapia. O instrumento de recolha de dados foi um questionário composto por cinco partes: (1) caracterização sociodemográfica; (2) o estado clínico do participante; (3) Belief Into Action Scale; (4) Spiritual Distress Scale e (5) características definidoras do diagnóstico de enfermagem angústia espiritual da NANDA-Internacional. A recolha de dados decorreu entre fevereiro de 2019 e junho de 2020. A análise dos dados foi realizada através do software Statistical Package for the Social Sciences. O estudo foi aprovado e recebeu parecer positivo da instituição onde decorreu. Resultados: O estudo reuniu 332 participantes na fase inicial e 274 participantes no último corte, revelando atrito de 17,5%. A amostra inicial foi composta maioritariamente por mulheres 56,60 % (n = 188), idade média de 60,25 anos (Desvio Padrão (DP)= ± 11,73), e uma amplitude entre 22-83 anos. A maioria tinha uma filiação religiosa (93,70%, n = 311). O tipo de cancro mais frequente foi o cancro da mama (27,70%, n = 92). A angústia espiritual no decorrer no estudo alcançou o valor mais elevado nos três meses após o início da quimioterapia e foi decrescendo até aos 12 meses, no entanto, existe uma diferença estatística significativa entre os valores de angústia espiritual que são superiores ao fim de doze meses, comparando com o momento antes do início da quimioterapia. Não foi identificada diferença do valor de angústia espiritual entre géneros. Adicionalmente, identificou-se uma correlação negativa significativa entre a angústia espiritual e o envolvimento religioso. Conclusões: O diagnóstico de angústia espiritual é uma realidade nas pessoas com cancro O período mais delicado corresponde a valores mais elevados, nos primeiros três meses após o início de quimioterapia, mas os valores de angústia espiritual ao longo da quimioterapia são superiores à fase inicial. O envolvimento religioso pode ser benéfico para amenizar a angústia espiritual ou reduzir o risco. O conhecimento sobre o diagnóstico de enfermagem angústia espiritual numa perspetiva longitudinal permite aos enfermeiros anteciparem intervenções autónomas de enfermagem com o objetivo de favorecer o bem-estar espiritual, adequadas às respostas humanas avaliadas.
Introduction: Cancer is one of the world leading causes of morbidity and mortality worldwide. Cancer affects people in all human dimensions: physical, psychological, social and spiritual. The nursing diagnosis of spiritual distress is present in 40.8% of cancer patients undergoing chemotherapy. Nursing care is based on a holistic background in which the spiritual dimension must be considered and, as so, addressing patients’ spiritual needs is critical. However, there is still weak evidence on the profile of the spiritual distress diagnosis over time or over living a particular health condition. Objective: To determine the score of spiritual distress in cancer patients during chemotherapy. Methodology: Quantitative, observational, longitudinal panel and prospective study. The data collection process comprised five cuts over the entire course of chemotherapy. The population consisted of 332 cancer patients endergoing chemotherapy in an outpatient clinic in a hospital in southern Portugal. A simple random technique sampling was used based on the following inclusion criteria: aged over 18 years; able to read and write; undergoing chemotherapy (oral, subcutaneous, intravenous) in outpatient clinic at the selected setting; stage of the disease: I, II, III and IV; cancer patients before starting the first cycle of chemotherapy. The data collection was conducted during five cuts, specifically before starting chemotherapy, after three months, six months, nine months and 12 months after starting chemotherapy. The data was collected by a questionnaire, composed of five parts: (1) sociodemographic characterization; clinical status; (3) Belief into Action Scale, to assess the religious involvement of patients; (4) Spiritual Distress Scale and (5) defining characteristics of NANDA-International spiritual distress nursing diagnosis. Data collection took place between the February 2019 and the June of 2020. Data analysis was performed using the software Statistical Package for the Social Sciences. The study was approved by the ethics committee of the institution where the study was performed. Results: A total of 332 participants were enrolled in the initial phase, and in the last cutoff moment 274 participants remained, which resulted in attrition of 17.5%. The initial sample was composed mainly of women 56.60% (n = 188), mean age of 60.25 years (Standard Deviation (SD) = ± 11.73), and a range between 22-83 years. Majority had a religious affiliation (93.70%, n = 311). The most frequent type of cancer was breast cancer (27.70%, n = 92). Spiritual distress during the study reached the highest value in the three months after starting chemotherapy and decreased until 12 months, however a statistically significant difference between the values of spiritual distress has been identified, which are higher by the end of twelve months compared to the moment before starting chemotherapy. No difference on the spiritual distress score was identified between genders. In addition, a significant negative correlation has been established between spiritual distress and religious involvement. Conclusion: The diagnosis of spiritual distress is a reality in cancer patients, in which the most delicate period corresponds to the first three months after the start of chemotherapy, but the values of spiritual distress after twelve months of chemotherapy are higher than the beginning of the treatment. Religious involvement could be a positive strategy in managing spiritual distress or risk for spiritual distress. The knowledge about the nursing diagnosis spiritual distress in a longitudinal perspective may facilitate nurses in planning autonomous nursing interventions with the aim of promoting spiritual well-being and adequate to the human responses that are assessed.
Introduction: Cancer is one of the world leading causes of morbidity and mortality worldwide. Cancer affects people in all human dimensions: physical, psychological, social and spiritual. The nursing diagnosis of spiritual distress is present in 40.8% of cancer patients undergoing chemotherapy. Nursing care is based on a holistic background in which the spiritual dimension must be considered and, as so, addressing patients’ spiritual needs is critical. However, there is still weak evidence on the profile of the spiritual distress diagnosis over time or over living a particular health condition. Objective: To determine the score of spiritual distress in cancer patients during chemotherapy. Methodology: Quantitative, observational, longitudinal panel and prospective study. The data collection process comprised five cuts over the entire course of chemotherapy. The population consisted of 332 cancer patients endergoing chemotherapy in an outpatient clinic in a hospital in southern Portugal. A simple random technique sampling was used based on the following inclusion criteria: aged over 18 years; able to read and write; undergoing chemotherapy (oral, subcutaneous, intravenous) in outpatient clinic at the selected setting; stage of the disease: I, II, III and IV; cancer patients before starting the first cycle of chemotherapy. The data collection was conducted during five cuts, specifically before starting chemotherapy, after three months, six months, nine months and 12 months after starting chemotherapy. The data was collected by a questionnaire, composed of five parts: (1) sociodemographic characterization; clinical status; (3) Belief into Action Scale, to assess the religious involvement of patients; (4) Spiritual Distress Scale and (5) defining characteristics of NANDA-International spiritual distress nursing diagnosis. Data collection took place between the February 2019 and the June of 2020. Data analysis was performed using the software Statistical Package for the Social Sciences. The study was approved by the ethics committee of the institution where the study was performed. Results: A total of 332 participants were enrolled in the initial phase, and in the last cutoff moment 274 participants remained, which resulted in attrition of 17.5%. The initial sample was composed mainly of women 56.60% (n = 188), mean age of 60.25 years (Standard Deviation (SD) = ± 11.73), and a range between 22-83 years. Majority had a religious affiliation (93.70%, n = 311). The most frequent type of cancer was breast cancer (27.70%, n = 92). Spiritual distress during the study reached the highest value in the three months after starting chemotherapy and decreased until 12 months, however a statistically significant difference between the values of spiritual distress has been identified, which are higher by the end of twelve months compared to the moment before starting chemotherapy. No difference on the spiritual distress score was identified between genders. In addition, a significant negative correlation has been established between spiritual distress and religious involvement. Conclusion: The diagnosis of spiritual distress is a reality in cancer patients, in which the most delicate period corresponds to the first three months after the start of chemotherapy, but the values of spiritual distress after twelve months of chemotherapy are higher than the beginning of the treatment. Religious involvement could be a positive strategy in managing spiritual distress or risk for spiritual distress. The knowledge about the nursing diagnosis spiritual distress in a longitudinal perspective may facilitate nurses in planning autonomous nursing interventions with the aim of promoting spiritual well-being and adequate to the human responses that are assessed.
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Keywords
Angústia espiritual Cancro Enfermagem Estudos longitudinais Quimioterapia Spiritual distress Cancer Nursing Longitudinal studies Chemotherapy