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O envelhecimento das populações e a prevalência maior de doenças crónicas, aumenta a necessidade de cuidados paliativos, que visam responder, utilizando uma abordagem multidisciplinar, às dimensões físicas, psicológicas e existenciais dos doentes e familiares nestas circunstâncias. O objetivo deste estudo é explorar os aspetos valorizados pelos médicos dos cuidados paliativos na referenciação de doentes e familiares para a intervenção psicológica. Foi utilizado o método qualitativo e realizadas entrevistas semiestruturadas a sete médicos, de dois hospitais centrais no Norte do País. A análise de conteúdo foi orientada pelos princípios da Grounded Theory e recorreu ao Software Nvivo11. Como resultados, os médicos salientam uma perspetiva holística do sofrimento dos doentes, destacando as dimensões físicas, psicológicas e existenciais. Os desafios identificados não parecem ser determinantes para a referenciação para a intervenção psicológica, sendo mais comum a referenciação tardia de doentes considerados mais graves. Nos familiares destacam-se os desafios na esfera emocional, no papel de cuidar e na comunicação. Parece existir uma preocupação menor com a família, contrariando a necessidade de intervir na díade doente/família. Concluímos que, existe a necessidade de sensibilizar os médicos sobre a eficácia das intervenções psicológicas com doentes e familiares e o papel específico do psicólogo neste contexto.
The aging of populations and the higher prevalence of chronic diseases increases the need for palliative care, which aims to respond, using a multidisciplinary approach, to the physical, psychological, and existential dimensions of patients and families in these circumstances. The aim of this study is to explore the aspects valued by doctors of palliative care teams when referring patients and families to psychological intervention. The qualitative method was used, and semi-structured interviews were conducted with seven doctors, from two central hospitals in the North of the country. The content analysis was guided by the principles of Grounded Theory and used the Nvivo Software. As a result, doctors highlight a holistic perspective on patients suffering, highlighting the physical, psychological, and existential dimension. Those challenges do not seem to be decisive for referral for psychological intervention, with referral of severe patients being more common. Family highlight challenges in the emotional sphere, in the role of caring and in communication. There seems to be less concern about family, contradicting the need to intervene in both patient/families. In conclusion, there is a need to sensitize doctors about the effectiveness of psychological interventions with patients and families and the specific role of the psychologist in this context.
The aging of populations and the higher prevalence of chronic diseases increases the need for palliative care, which aims to respond, using a multidisciplinary approach, to the physical, psychological, and existential dimensions of patients and families in these circumstances. The aim of this study is to explore the aspects valued by doctors of palliative care teams when referring patients and families to psychological intervention. The qualitative method was used, and semi-structured interviews were conducted with seven doctors, from two central hospitals in the North of the country. The content analysis was guided by the principles of Grounded Theory and used the Nvivo Software. As a result, doctors highlight a holistic perspective on patients suffering, highlighting the physical, psychological, and existential dimension. Those challenges do not seem to be decisive for referral for psychological intervention, with referral of severe patients being more common. Family highlight challenges in the emotional sphere, in the role of caring and in communication. There seems to be less concern about family, contradicting the need to intervene in both patient/families. In conclusion, there is a need to sensitize doctors about the effectiveness of psychological interventions with patients and families and the specific role of the psychologist in this context.
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Palavras-chave
Cuidados paliativos Necessidades doentes Necessidades familiares Critérios Referenciação Palliative care Patient needs Family needs Criteria Referencing