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Abstract(s)
Introdução: Os doentes em cuidados paliativos têm uma alta probabilidade de terem
depressão e angústia espiritual, mas desconhecem-se os indicadores clínicos que podem
promover um diagnóstico diferencial entre depressão e angústia espiritual.
Objetivos: Identificar a prevalência e os indicadores clínicos de depressão e de angústia
espiritual em doentes com necessidades paliativas, acompanhados nos cuidados de
saúde primários.
Material e métodos: Estudo observacional e transversal, realizado em 2016, numa USF.
Foram incluídos trinta doentes, recrutados de um ficheiro de MGF, que completaram os
critérios de doença crônica e de Prognostic Indicator Guidance 4th edition 2011. Os
critérios de exclusão incluíam défice cognitivo e distúrbios psicóticos. Os participantes
completaram as escalas de autoavaliação HADS e FACIT-Sp12. Os dados clínicos
foram obtidos por entrevistas semiestruturadas, incluindo a presença ou ausência de
angústia espiritual e de depressão. Os dados foram analisados utilizando o SPSS
Statistics 24®.
Resultados: A prevalência de depressão foi de 23% e a prevalência de angústia
espiritual foi de 23%. Observou-se uma associação positiva e estatisticamente
significativa entre depressão e falta de sentido na vida, embora a associação entre
depressão e a expressão de sofrimento não tenha sido estatisticamente significativa. Em
57% dos doentes com o diagnóstico de angústia espiritual, observou-se a ocorrência de
antecedentes de vida traumáticos. Observou-se uma associação positiva e
estatisticamente significativa entre alcoolismo e o diagnóstico de angústia espiritual,
embora essa associação não tenha sido encontrada com depressão.
Conclusões: A angústia espiritual e a depressão parecem estar ligadas à dimensão
espiritual da pessoa humana, contudo parecem diferir no sofrimento. A angústia
espiritual parece ocorrer em pessoas que vivenciam acontecimentos da vida traumáticos
e que apresentam perturbação do uso de álcool. Os resultados devem ser interpretados
atendendo às limitações inerentes a algumas características do desenho do estudo e à
dimensão da amostra.
Introduction: Palliative care patients have been associated with high probability of having depression and spiritual distress, but there is a gap in research about the clinical indicators that can promote the differential diagnosis between depression and spiritual distress. Objectives: To identify the prevalence and the clinical indicators of depression and spiritual distress in palliative patients in primary care, to support a differential diagnosis. Methods: Observational and cross-sectional study, conducted in 2016 in a Portuguese primary care unit. A sample of 30 palliative adult patients was recruited from a General Practitioners patients’ file throughout two steps: (1) selection of patients with chronic disease criteria; (2) selection of patients with Prognostic Indicator Guidance criteria. Exclusion criteria included cognitive impairment and psychotic disorders. Participants completed the self-assessment HADS and FACIT-Sp12 scales. Clinical data collection used semi-structured interviews for the diagnosis of depression and spiritual distress. Data was analysed using SPSS Statistics 24®. Results: The prevalence of depression was 23%, while the prevalence of spiritual distress was 23%. A significantly positive association between depression and a lack of meaning in life was found, although the association between depression and the expression of suffering was not statistically significant. The researcher observed the occurrence of major past traumatic life events in 57% patients with spiritual distress. A significant association was found between alcoholism and spiritual distress diagnosis, although this association was not found with depression. Conclusions: Depression and spiritual distress seem to be both linked to the spiritual dimensions of the Human being, but seem to differ in the dimensions of suffering. Spiritual distress seems to occur in people with past traumatic life events and to be linked with alcohol use disorder. Caution in needed when reading the results considering the design and the sample size.
Introduction: Palliative care patients have been associated with high probability of having depression and spiritual distress, but there is a gap in research about the clinical indicators that can promote the differential diagnosis between depression and spiritual distress. Objectives: To identify the prevalence and the clinical indicators of depression and spiritual distress in palliative patients in primary care, to support a differential diagnosis. Methods: Observational and cross-sectional study, conducted in 2016 in a Portuguese primary care unit. A sample of 30 palliative adult patients was recruited from a General Practitioners patients’ file throughout two steps: (1) selection of patients with chronic disease criteria; (2) selection of patients with Prognostic Indicator Guidance criteria. Exclusion criteria included cognitive impairment and psychotic disorders. Participants completed the self-assessment HADS and FACIT-Sp12 scales. Clinical data collection used semi-structured interviews for the diagnosis of depression and spiritual distress. Data was analysed using SPSS Statistics 24®. Results: The prevalence of depression was 23%, while the prevalence of spiritual distress was 23%. A significantly positive association between depression and a lack of meaning in life was found, although the association between depression and the expression of suffering was not statistically significant. The researcher observed the occurrence of major past traumatic life events in 57% patients with spiritual distress. A significant association was found between alcoholism and spiritual distress diagnosis, although this association was not found with depression. Conclusions: Depression and spiritual distress seem to be both linked to the spiritual dimensions of the Human being, but seem to differ in the dimensions of suffering. Spiritual distress seems to occur in people with past traumatic life events and to be linked with alcohol use disorder. Caution in needed when reading the results considering the design and the sample size.
Description
Keywords
Depressão Angústia espiritual Cuidados paliativos Espiritualidade Depression Spiritual distress Palliative care Spirituality