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Abstract(s)
Este estudo teve como finalidade contribuir para a melhoria da assistência de enfermagem promotora de estratégias de coping melhor adaptativas potencializadoras de bem-estar espiritual e de qualidade de vida dos doentes com doença oncológica na fase final de vida. Participaram no estudo 346 doentes com doença oncológica seguidos em cuidados paliativos. O estudo desenvolveu-se em três momentos. No primeiro momento, realizaram-se estudos metodológicos de adaptação cultural e validação da Functional Assessment of Câncer Therapy-General Scale (FACT-G) versão 4, da Functional Assessment of Chronic ILLness Therapy-Spiritual Well-Being Scale (FACIT-Sp12), e de adaptação para a população em estudo da Escala Reduzida de Ajustamento Mental ao Cancro (Mini-MAC Scale). Os resultados demonstraram que estes instrumentos possuem boas propriedades psicométricas, justificando-se a sua utilização no estudo da qualidade de vida, do bem-estar espiritual e do ajustamento mental dos doentes na fase final de vida de doença oncológica em cuidados paliativos. No segundo momento, desenvolveu-se um estudo exploratório, descritivo e transversal. Os resultados revelaram que o bem-estar espiritual foi percecionado como positivo e situando-se a um nível médio, influenciado por variáveis sócio-demograficas (idade, estado civil e religião) e por variáveis de doença (conhecimento da doença, tipo de tratamento, tipo de assistência). A qualidade de vida (QV) foi percecionada como positiva, influenciada pelas variáveis sócio-demograficas (género, idade, estado civil e religião) e pelas variáveis de doença (conhecimento da doença e tipo de assistência). As estratégias de coping a que os doentes recorreram foram principalmente focadas na emoção, como o “evitamento cognitivo” e o “fatalismo”. O tipo de coping era influenciado pelas variáveis sócio-demograficas (género, idade, escolaridade, estado civil e religião) e pelas variáveis de doença (tempo de diagnóstico, tipo de tratamento e tipo de assistencial). Verificou-se a existência de correlação entre a perceção de qualidade de vida e o coping. As estratégias de tipo ”espírito de luta” e “fatalismo” demonstraram ser melhor adaptativas e por conseguinte, preditivas de melhor qualidade de vida e bem-estar espiritual. O bem-estar espiritual influenciou, de forma positiva, a QV global em todas as suas dimensões, apontando para uma abordagem da QV em oncologia e em cuidados paliativos assente num modelo biopsicossocial e espiritual. No terceiro momento, foi elaborado um modelo de intervenção em enfermagem, promotor da utilização de estratégias de coping mais adaptativas, com vista a produzir resultados positivos ao nível do bem-estar espiritual e a qualidade de vida nos doentes com doença oncológica na fase final de vida em cuidados paliativos.
This study aimed to contribute to the improvement of nursing care promotes better adaptive coping strategies potentiating of spiritual well-being and quality of life for patients with cancer in the final stage of life. Three-hundred and forty six cancer patients in end of receiving palliative care have participated in the study.The study has been developed in three phases. In the first phase, there were methodological and descriptive studies for cultural adaptation and validation of the Functional Assessment of Cancer Therapy-Genera Scale l (FACT-G),version 4, the Functional Assessment of Chronic ILLness Therapy-Spiritual well-being Scale (FACIT-Sp12), and adaptation study to the serlected population of the Mini Mental Adjustment to cancer Scale (Mini-MAC Scale). The results demonstrated that these scales have good psychometric properties, justifying its use in the study of quality of life, spiritual well-being and mental adjustment of the end of life cancer patients in palliative care. In the second phase, a exploratory, descriptive and transversal study was developed. The results showed that the spiritual well-being was perceived as positive and standing to a medium level, influenced by socio-demographic variables (age, marital status and religion) and by the disease variables (knowledge of the disease, type of treatment, type of assistance). The quality of life (QL) was perceived as positive and influenced by socio-demographic variables (gender, age, marital status and religion) and by disease variables (knowledge of the disease, type of assistance). The coping strategies used by patients were mainly emotion-focused like "cognitive avoidance" and "fatalism". Coping was influenced by both socio-demographic variables (gender, age, education, marital status and religion) and disease variables (time since diagnosis, type of treatment and type of assistance). There was correlation between quality of life perception and coping. Strategies like "fighting spirit" and "fatalism” proved to be the most adaptive and predictive of better quality of life and spiritual well-being. The spiritual well-being influences positively the global QL and all its dimensions, pointing to a QL approach based on the spiritual and biopsychosocial model in oncology and palliative care. In the third phase, a nursing intervention model was developed, which promoted the use of more adaptive coping strategies, with positive outcomes at the level of spiritual well-being and quality of life in end of life cancer patients, admitted in a palliative care.
This study aimed to contribute to the improvement of nursing care promotes better adaptive coping strategies potentiating of spiritual well-being and quality of life for patients with cancer in the final stage of life. Three-hundred and forty six cancer patients in end of receiving palliative care have participated in the study.The study has been developed in three phases. In the first phase, there were methodological and descriptive studies for cultural adaptation and validation of the Functional Assessment of Cancer Therapy-Genera Scale l (FACT-G),version 4, the Functional Assessment of Chronic ILLness Therapy-Spiritual well-being Scale (FACIT-Sp12), and adaptation study to the serlected population of the Mini Mental Adjustment to cancer Scale (Mini-MAC Scale). The results demonstrated that these scales have good psychometric properties, justifying its use in the study of quality of life, spiritual well-being and mental adjustment of the end of life cancer patients in palliative care. In the second phase, a exploratory, descriptive and transversal study was developed. The results showed that the spiritual well-being was perceived as positive and standing to a medium level, influenced by socio-demographic variables (age, marital status and religion) and by the disease variables (knowledge of the disease, type of treatment, type of assistance). The quality of life (QL) was perceived as positive and influenced by socio-demographic variables (gender, age, marital status and religion) and by disease variables (knowledge of the disease, type of assistance). The coping strategies used by patients were mainly emotion-focused like "cognitive avoidance" and "fatalism". Coping was influenced by both socio-demographic variables (gender, age, education, marital status and religion) and disease variables (time since diagnosis, type of treatment and type of assistance). There was correlation between quality of life perception and coping. Strategies like "fighting spirit" and "fatalism” proved to be the most adaptive and predictive of better quality of life and spiritual well-being. The spiritual well-being influences positively the global QL and all its dimensions, pointing to a QL approach based on the spiritual and biopsychosocial model in oncology and palliative care. In the third phase, a nursing intervention model was developed, which promoted the use of more adaptive coping strategies, with positive outcomes at the level of spiritual well-being and quality of life in end of life cancer patients, admitted in a palliative care.