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Facilitar o perdão em cuidados paliativos : revisão scoping
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Introdução: Os Cuidados Paliativos (CP) procuram a prevenção e intervenção no sofrimento, encontrando respostas biopsicossociais e espirituais. A espiritualidade inclui, entre outras, questões de reconciliação e perdão que são fundamentais para os pacientes e famílias que enfrentam uma doença grave. Considerando que o objetivo central nos CP é reduzir o sofrimento dos pacientes e suas famílias, a intervenção "facilitar o perdão" pode representar uma resposta valiosa como uma intervenção multidisciplinar e não-farmacológica a ser realizada. Metodologia: Revisão scoping, registada e baseada nas linhas orientadoras do Joanna Briggs Institute (JBI), com o objetivo de mapear o conhecimento sobre a intervenção de facilitação de perdão em CP. A pesquisa foi realizada em Junho de 2017 e atualizada em dezembro de 2018 em bases de dados internacionais. Os resultados foram analisados por dois revisores independentes, com um terceiro revisor para casos de dúvida ou discordância. Resultados: De um total de 1581 artigos, foram incluídos 23 artigos na revisão. Os resultados sugerem um crescente interesse na facilitação do perdão em CP. O perdão é um tema importante no cuidado de fim de vida em todas as tradições espirituais e religiosas e os estudos são, predominantemente, do ponto de vista psicológico. Identificaram-se diversas atividades para a facilitação de perdão, contudo escassos detalhes estão descritos sobre as características das mesmas. Os elementos da equipa envolvidos na facilitação do perdão aparecem descritos como assistentes sociais, enfermeiros, médicos, psicólogos e em alguns casos não especificados. A intervenção parece relacionar-se com melhor bem-estar mental, físico e relacional; melhor qualidade de vida, tomada de decisão e comunicação; melhor autoestima e aumento de esperança; redução de depressão, de raiva e ansiedade; paz interior. Conclusões: O perdão e a sua facilitação apresenta-se fundamental em CP. Os resultados abrem novas perspetivas de investigação, de intervenção clínica e de preparação dos profissionais nesta área.
Introduction: Palliative Care (PC) seeks prevention and intervention in suffering, finding biopsychosocial and spiritual responses. Spirituality includes, among others, reconciliation and forgiveness, which are critical to patients and families when facing serious illnesses. Considering that the main objective of PC is to reduce patients and families suffering, "forgiveness facilitation" can represent a valuable response as a multidisciplinary and nonpharmacological intervention. Methodology: Scoping review, registered and based on the guidelines of the Joanna Briggs Institute (JBI), with the objective of mapping the knowledge of forgiveness facilitation as an intervention in palliative care. The search was conducted in June 2017 and updated in December 2018 in international databases. Two independent reviewers analyzed the results, and a third reviewer also analyzed in case of doubt or disagreement. Results: A total of 1581 articles were identified, and 23 articles were included in this review. The results suggest a growing interest in forgiveness facilitating in PC. Forgiveness is an important theme in end-of-life care in all spiritual and religious traditions, and most studies are based on a psychological perspective. Several activities related to the intervention have been identified, but few details or characteristics are described. Social workers, nurses, doctors, psychologists, and in some cases unspecified, are the team members described as involved in forgiveness facilitation. The intervention seems to be related to better mental, physical and relational well-being; better quality of life, decision making and communication; better selfesteem and enhanced hope; reduction of depression, anger and anxiety; inner peace. Conclusions: Forgiveness facilitation is fundamental in PC. These results open new perspectives for research, clinical intervention and preparation of professionals acting in this area.
Introduction: Palliative Care (PC) seeks prevention and intervention in suffering, finding biopsychosocial and spiritual responses. Spirituality includes, among others, reconciliation and forgiveness, which are critical to patients and families when facing serious illnesses. Considering that the main objective of PC is to reduce patients and families suffering, "forgiveness facilitation" can represent a valuable response as a multidisciplinary and nonpharmacological intervention. Methodology: Scoping review, registered and based on the guidelines of the Joanna Briggs Institute (JBI), with the objective of mapping the knowledge of forgiveness facilitation as an intervention in palliative care. The search was conducted in June 2017 and updated in December 2018 in international databases. Two independent reviewers analyzed the results, and a third reviewer also analyzed in case of doubt or disagreement. Results: A total of 1581 articles were identified, and 23 articles were included in this review. The results suggest a growing interest in forgiveness facilitating in PC. Forgiveness is an important theme in end-of-life care in all spiritual and religious traditions, and most studies are based on a psychological perspective. Several activities related to the intervention have been identified, but few details or characteristics are described. Social workers, nurses, doctors, psychologists, and in some cases unspecified, are the team members described as involved in forgiveness facilitation. The intervention seems to be related to better mental, physical and relational well-being; better quality of life, decision making and communication; better selfesteem and enhanced hope; reduction of depression, anger and anxiety; inner peace. Conclusions: Forgiveness facilitation is fundamental in PC. These results open new perspectives for research, clinical intervention and preparation of professionals acting in this area.
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Cuidados em fim de vida Perdão Cuidados paliativos Revisão End of life care Forgiveness Palliative care Review
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