Espiritualidade paliativa: um estudo teórico-empírico com pacientes oncológicos

Abstract

This doctoral thesis in Theology investigates spirituality in the context of health, focusing on Palliative Care (PC) for cancer patients. The main objective is to understand the spirituality experienced by these patients, analyzing how it manifests itself and influences their experiences at the end of life. This investigation highlights the relevance of spirituality in PC and the need for its inclusion by health professionals and hospital chaplaincies. The research is divided into two parts. The first, a literature review with bibliographic research methodology, presents the theoretical basis of PC and spirituality in Theology and in the context of health. The second part consists of empirical research with a cross-sectional study of mixed methods, approved by the Research Ethics Committee of Faculdades EST (CAAE 65949422.6.00005314). The instruments for collecting quantitative data were questionnaires with closed questions on sociodemographic and clinical characteristics and on the practice of spirituality of patients in oncology PC based on theoretical frameworks such as therapeutic anamnesis from the Center for Studies and Research in Spirituality and Health of the Beneficência Portuguesa de São Paulo (NEPES-BP), spiritual well-being scale (EBE) and religious coping scale (RCOPE brief). For qualitative data, to observe the practice of spirituality of these patients, semi-structured interviews with open questions were used, based on the same theoretical framework, to assess the following dimensions: self-reported spirituality, positive and negative religious/spiritual coping, spiritual experiences, spiritual/religious well-being and coping with death. Statistical analysis of quantitative data was performed with the aid of the MS-Excel spreadsheet, in its MS-Office 2013 version and the IBM SPSS Statistics (Statistical Package for the Social Sciences), in its version 25.0. Interpretative Phenomenological Analysis (IPA) was used to analyze and interpret the qualitative data. The results revealed a spirituality that acts as a palliative resource, called “Palliative Spirituality”, characterized by a non-dogmatic Christian religiosity. This spirituality provides comfort, peace, hope and a sense of life and death, promoting dignity for patients. The research also highlighted deficiencies in spiritual care in hospital chaplaincy, highlighting the urgent need for professionalization in this field. Although the research has limitations, such as the sample size and the concentration of participants in a single institution, the results obtained offer significant contributions to health professionals and hospital chaplaincy, highlighting the importance of meeting the spiritual needs of patients and aiming to improve the services provided.