A assistência paliativista, uma dimensão ignorada nos cursos de graduação em enfermagem : as perceções e as palavras dos enfermeiros
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2020
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Nos últimos anos, o número de pessoas que no Brasil necessita de cuidados paliativos
tem vindo a aumentar exponencialmente (Relatório da Organização das Nações Unidas,
2019). A maioria dos cursos de graduação em enfermagem das Faculdades públicas Federais
no Brasil, até há poucos anos, não incluam qualquer disciplina, com carácter obrigatório ou
facultativo, sobre cuidados paliativos. Neste quadro, a progressiva implementação dos
cuidados paliativos no Brasil, tem vindo a concretizar-se com recurso à contratação de
enfermeiros não capacitados. Dado existirem poucos estudos sobre esta realidade,
realizamos um estudo descritivo exploratório, com abordagem mista, com o intuito de
produzir conhecimento sobre a experiência de enfermeiros clínicos que integram equipas
intra-hospitalares de Cuidados Paliativos, em um hospital localizado em Goiânia-Goiás. Para
tal foi enviado um convite a todos os enfermeiros para participar num inquérito, através do
preenchimento de questionário semiestruturado online. Os questionários recebidos, em
conformidade com o carácter aberto ou fechado das questões, foram analisamos com recurso
à análise estatística descritiva e à análise de conteúdo. Os resultados do estudo revelam que:
os cursos de graduação frequentados pelos 25 participantes, não contemplaram os Cuidados
Paliativos, a maioria destes enfermeiros não realizou qualquer tipo de formação em CPs após
a graduação e que cerca de dois terços das equipes multidisciplinares destes profissionais
não possuem plano anual de formação contínua. O estudo permite perceber que estes
profissionais de Enfermagem adquiriram um conjunto conhecimentos e desenvolveram
competências consideradas essenciais para cuidar de pacientes em CPs. Um conjunto de
saberes experienciais, adquiridos no campo das práticas, que varia de pessoa para pessoa e
vai além da avaliação e do gerenciamento dos sintomas, inclui as capacidades de
proporcionar alívio da dor e de comunicar com pacientes e familiares, entre outras. Este
estudo permite, concluir que: a implementação da prática paliativa no Brasil demanda a
formulação de políticas complementares relativas à formação, inicial e continuada, dos
profissionais de Enfermagem; os currículos dos cursos de graduação em enfermagem
necessitam ser revistos e integrar a disciplina de cuidados paliativos e que se torna necessário
repensar os programas de formação continua dos enfermeiros em serviço nos CP, de modo a reconhecer a importância da aprendizagem colaborativa e reconhecer, validar e certificar,
os saberes e competências adquiridas no contexto das práticas, como forma de mobilização
para a formação.
In recent years, the number of people who, worldwide and in Brazil, need palliative care has been increasing exponentially (United Nations Report, 2019). Until 2016, most undergraduate nursing courses at Federal Public Colleges in Brazil did not include any discipline, with mandatory or optional character, on palliative care. In this context, the progressive implementation of palliative care in Brazil has come to fruition through the hiring of untrained nurses. Given that there are few studies on this reality, in order to produce knowledge about it, we conducted an exploratory study with the participation of clinical nurses who are part of intra-hospital Palliative Care teams, in a hospital located in Goiânia Goiás. To this end, an invitation was sent to all nurses to participate in an online survey, by completing a semi-structured questionnaire. The 25 questionnaires received were analyzed using descriptive statistical analysis and content analysis, in accordance with the nature, open or closed, of the questions. The results of the study confirm that undergraduate courses attended by different participants did not include palliative care. On the other hand, they reveal that the majority of these nurses did not undergo any type of training in PCs after graduation and that the in-hospital teams of about two thirds of the professionals do not have an annual plan for continuous training. The results also allow us to realize that these Nursing professionals have a set of knowledge and skills necessary to care for patients in PCs, which were acquired in the field of practices. A set of experiential knowledge, which varies from person to person, but goes beyond the assessment and management of symptoms, includes, among others, the ability to provide pain relief and to communicate with patients and family members. This study allows, therefore, to conclude that the implementation of palliative practice in Brazil, continues to demand the formulation of complementary policies, related to the initial and continuous training of Nursing professionals who are part of the multidisciplinary PC teams; that the curricula of undergraduate nursing courses should be reviewed and become part of the palliative care discipline and that nurses' continuing education programs should include the recognition and validation of knowledge and skills acquired in the context of practices, as a way of mobilize them to return to training.
In recent years, the number of people who, worldwide and in Brazil, need palliative care has been increasing exponentially (United Nations Report, 2019). Until 2016, most undergraduate nursing courses at Federal Public Colleges in Brazil did not include any discipline, with mandatory or optional character, on palliative care. In this context, the progressive implementation of palliative care in Brazil has come to fruition through the hiring of untrained nurses. Given that there are few studies on this reality, in order to produce knowledge about it, we conducted an exploratory study with the participation of clinical nurses who are part of intra-hospital Palliative Care teams, in a hospital located in Goiânia Goiás. To this end, an invitation was sent to all nurses to participate in an online survey, by completing a semi-structured questionnaire. The 25 questionnaires received were analyzed using descriptive statistical analysis and content analysis, in accordance with the nature, open or closed, of the questions. The results of the study confirm that undergraduate courses attended by different participants did not include palliative care. On the other hand, they reveal that the majority of these nurses did not undergo any type of training in PCs after graduation and that the in-hospital teams of about two thirds of the professionals do not have an annual plan for continuous training. The results also allow us to realize that these Nursing professionals have a set of knowledge and skills necessary to care for patients in PCs, which were acquired in the field of practices. A set of experiential knowledge, which varies from person to person, but goes beyond the assessment and management of symptoms, includes, among others, the ability to provide pain relief and to communicate with patients and family members. This study allows, therefore, to conclude that the implementation of palliative practice in Brazil, continues to demand the formulation of complementary policies, related to the initial and continuous training of Nursing professionals who are part of the multidisciplinary PC teams; that the curricula of undergraduate nursing courses should be reviewed and become part of the palliative care discipline and that nurses' continuing education programs should include the recognition and validation of knowledge and skills acquired in the context of practices, as a way of mobilize them to return to training.
Descrição
Orientação: Ana Maria de Sousa Loureiro do Vale Pereira
Palavras-chave
MESTRADO EM CIÊNCIAS DA EDUCAÇÃO, EDUCAÇÃO, ENFERMAGEM, FORMAÇÃO CONTÍNUA, CUIDADOS PALIATIVOS, APRENDIZAGEM, EDUCATION, NURSING, CONTINUING EDUCATION, PALLIATIVE CARE, LEARNING