A carregar...
Publicação
Organização do trabalho hospitalar e modos de envolvimento na ação nos serviços de medicina, cuidados paliativos e equipas de cuidados domiciliários no tratamento de doentes incuráveis na fase final da vida
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 3.07 MB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Os cuidados de saúde orientados para o tratamento de doentes na fase final da vida, sob
a forma de cuidados paliativos especializados ou das abordagens paliativas, apresentam
múltiplos dilemas e desafios que conduziram, nas últimas décadas, a uma reorganização
do trabalho hospitalar e domiciliário em função do número crescente de doentes com
doença crónica e incurável, que já não responde a tratamentos curativos, e que requerem
uma intervenção especializada no âmbito do Serviço Nacional de Saúde.
Se, por um lado, a discussão sobre os cuidados paliativos tem lugar nas arenas públicas,
através das reivindicações dos doentes, de interpostas pessoas e dos profissionais de
saúde e da sua introdução nas políticas públicas, por outro lado, são as equipas de
saúde, que interagem com os doentes na fase final da vida e procuram (re)organizar os
seus quotidianos trabalho e envolver-se na ação com os doentes e com as suas famílias.
Pretendemos, assim, com esta investigação contribuir para a compreensão do modo
como os profissionais de saúde organizam os seus quotidianos de trabalho em função
das trajetórias de final de vida dos doentes, assim como os modos de interação entre as
diferentes carreiras pessoais, profissionais e de doença experienciadas pelos atores
envolvidos nos cuidados de saúde e analisar os modos de envolvimento na ação
assumidos pelos atores em contexto hospitalar e domiciliário de fim de vida, colocando
o enfoque nos profissionais de saúde e nas suas competências críticas e de julgamento e
nas diferentes formas de envolvimento e coordenação na ação.
Os dados recolhidos seguiram os pressupostos de uma metodologia de caráter
qualitativo através da realização de observação etnográfica em dois serviços de
internamento em cuidados paliativos, assim como a realização de entrevistas a
profissionais da enfermagem, da medicina e do serviço social que trabalham
diretamente e em proximidade com doentes terminais e as suas famílias, quer em
contexto de internamento hospitalar – cuidados paliativos e medicina interna –, quer em
contexto de cuidados domiciliários
End of life patient treatment-oriented health care, on the form of specialized palliative care or palliative approaches, present multiple dilemmas and challenges that drove, in the last decades, to a reorganization of the hospital and homecare work and assistance, in relation to the crescent number of patients with chronical and uncurable disease, who do not respond to healing treatments, and require specialized intervention within the National Health Care system. If, on one hand, the discussion on palliative care has a space in the public arena, through patient claims, patient representatives, health care professionals, and their introduction on public policies, on the other hand, it is the health teams who interact with patients on their end of life trajectories and search to (Re)arrange their day-to-day work engaging in the action with the patients and their families. With this investigation, we pretend to contribute for the understanding of the way healthcare professionals organize their day-to-day work in relation to the patients’ end of life trajectories as well as understanding the interaction modes between the different professional, personal and sickness trajectories experienced by the involved actors in healthcare. We pretend as well to analyse the involvement modes in the action assumed by these actors in hospital and homecare end of life context, focusing on the healthcare professionals and their critical and judgment capabilities, and on the different ways of involvement and coordination within the action. The collected data followed the assumptions of a qualitative methodology, through ethnographic observation in two palliative care internment wards, as well as interviews given by the nursing, medical and social services staff, who work directly and in proximity with terminal patients and their families, either in hospital internment context – palliative care and internal medicine – or in homecare context.
End of life patient treatment-oriented health care, on the form of specialized palliative care or palliative approaches, present multiple dilemmas and challenges that drove, in the last decades, to a reorganization of the hospital and homecare work and assistance, in relation to the crescent number of patients with chronical and uncurable disease, who do not respond to healing treatments, and require specialized intervention within the National Health Care system. If, on one hand, the discussion on palliative care has a space in the public arena, through patient claims, patient representatives, health care professionals, and their introduction on public policies, on the other hand, it is the health teams who interact with patients on their end of life trajectories and search to (Re)arrange their day-to-day work engaging in the action with the patients and their families. With this investigation, we pretend to contribute for the understanding of the way healthcare professionals organize their day-to-day work in relation to the patients’ end of life trajectories as well as understanding the interaction modes between the different professional, personal and sickness trajectories experienced by the involved actors in healthcare. We pretend as well to analyse the involvement modes in the action assumed by these actors in hospital and homecare end of life context, focusing on the healthcare professionals and their critical and judgment capabilities, and on the different ways of involvement and coordination within the action. The collected data followed the assumptions of a qualitative methodology, through ethnographic observation in two palliative care internment wards, as well as interviews given by the nursing, medical and social services staff, who work directly and in proximity with terminal patients and their families, either in hospital internment context – palliative care and internal medicine – or in homecare context.
Descrição
Palavras-chave
Cuidados paliativos Sociologia da saúde Sociologia pragmática Palliative care Sociology of health Pragmatic sociology