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A Esperança no contexto dos cuidados paliativos: Perceções dos doentes e práticas de enfermagem: Desenvolvimento de competências clínicas comuns e especializadas na área de Enfermagem à pessoa em situação paliativa
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O aumento da longevidade e a consequente prevalência de doenças crónicas e incuráveis
colocam novos desafios à prestação de cuidados de saúde, nomeadamente no âmbito dos
cuidados paliativos. Estes cuidados visam promover a qualidade de vida da pessoa doente e da
sua família, através da prevenção e do alívio do sofrimento, numa abordagem holística e
centrada na pessoa. Neste contexto, a esperança assume um papel central como dimensão
essencial da experiência humana, especialmente em contextos de doença avançada e terminal,
sendo considerada um recurso terapêutico fundamental, com impacto direto no bem-estar
psicossocial e espiritual dos doentes e familiares.
O presente relatório insere-se no âmbito do 3.º Curso de Mestrado em Enfermagem Médico-
Cirúrgica, na área de especialização em Enfermagem à Pessoa em Situação Paliativa, da Escola
Superior de Enfermagem do Porto. Com recurso a uma metodologia descritiva, reflexiva e
crítica, são apresentadas e analisadas as experiências e atividades desenvolvidas durante o
Estágio de Natureza Profissional, que permitiram o desenvolvimento de competências
especializadas na área dos cuidados paliativos.
Foi atribuída especial atenção ao conceito de esperança e às suas manifestações em contextos
de doença avançada e terminal, nomeadamente enquanto força mobilizadora de sentido,
conforto e continuidade. Reconhecendo que a esperança pode coexistir com a consciência da
terminalidade, torna-se essencial que os profissionais de enfermagem saibam identificar,
valorizar e promover esta dimensão, adaptando a sua intervenção às necessidades individuais,
culturais e espirituais do doente e da sua família.
O relatório contempla uma revisão de literatura centrada na esperança em cuidados paliativos,
com o objetivo de compreender a sua relevância clínica e explorar estratégias de intervenção
que a promovam junto da pessoa em situação de doença avançada e terminal e dos seus
familiares. Adicionalmente, é apresentado e analisado criticamente um estudo de caso, o qual
permitiu aplicar o conhecimento teórico e científico a uma situação clínica real, aprofundando a
reflexão sobre o papel da esperança na prática de enfermagem.
As atividades realizadas em contexto de prática clínica, nomeadamente em Equipa Intra-
Hospitalar de Cuidados Paliativos e em Unidade de Cuidados Paliativos, permitiram consolidar
conhecimentos teóricos e competências técnicas e relacionais, com destaque para a
comunicação empática, o suporte emocional e a intervenção centrada na dignidade e na
autonomia da pessoa. A articulação entre a evidência científica e a prática clínica revelou-se
determinante para a compreensão do papel da esperança no processo de cuidar, configurando-se como eixo estruturante de uma prática ética, humanizada e competente. Descrever todo este
trajeto, aliando a componente teórica à prática clínica, constituiu um importante passo para a
consciencialização das competências desenvolvidas, bem como para o desenvolvimento
profissional e pessoal.
The increase in life expectancy and the consequent prevalence of chronic and incurable diseases present new challenges to healthcare delivery, particularly within the scope of palliative care. These care practices aim to promote the quality of life of the patient and their family through the prevention and relief of suffering, within a holistic, person-centred approach. In this context, hope assumes a central role as an essential dimension of the human experience, especially in contexts of advanced and terminal illness, being regarded as a fundamental therapeutic resource with a direct impact on the psychosocial and spiritual well-being of patients and caregivers. This report was developed within the scope of the 3rd Master's Degree in Medical-Surgical Nursing, with a specialisation in Nursing Care for the Person in a Palliative Situation, at the Nursing School of Porto. Using a descriptive, reflective and critical methodology, the experiences and activities developed during the Professional Nature Internship are presented and analysed, which enabled the development of specialised competencies in the field of palliative care. Special attention was given to the concept of hope and its manifestations in contexts of advanced and terminal illness, particularly as a driving force for meaning, comfort and continuity. Recognising that hope can coexist with the awareness of terminality, it becomes essential that nursing professionals are able to identify, value and foster this dimension, tailoring their interventions to the individual, cultural and spiritual needs of the person and their family. The report includes a literature review focused on hope in palliative care, aiming to understand its clinical relevance and explore intervention strategies that promote it in people living with advanced and terminal illness, as well as their caregivers. In addition, one case study is presented and critically analysed, allowing the application of theoretical and scientific knowledge to real-world clinical situation and deepening reflection on the role of hope in nursing practice. The activities carried out in clinical practice, namely within a Hospital Palliative Care Team and a Palliative Care Unit, allowed for the consolidation of theoretical knowledge and the development of technical and relational skills, with particular emphasis on empathetic communication, emotional support, and interventions centred on the person's dignity and autonomy. The articulation between scientific evidence and clinical practice proved essential to understanding the role of hope in the care process, positioning it as a key element of ethical, humanised and competent nursing practice. Describing this entire journey, combining theoretical foundations with clinical practice, represented a significant step in raising awareness of the competencies developed, as well as their contribution to professional and personal growth.
The increase in life expectancy and the consequent prevalence of chronic and incurable diseases present new challenges to healthcare delivery, particularly within the scope of palliative care. These care practices aim to promote the quality of life of the patient and their family through the prevention and relief of suffering, within a holistic, person-centred approach. In this context, hope assumes a central role as an essential dimension of the human experience, especially in contexts of advanced and terminal illness, being regarded as a fundamental therapeutic resource with a direct impact on the psychosocial and spiritual well-being of patients and caregivers. This report was developed within the scope of the 3rd Master's Degree in Medical-Surgical Nursing, with a specialisation in Nursing Care for the Person in a Palliative Situation, at the Nursing School of Porto. Using a descriptive, reflective and critical methodology, the experiences and activities developed during the Professional Nature Internship are presented and analysed, which enabled the development of specialised competencies in the field of palliative care. Special attention was given to the concept of hope and its manifestations in contexts of advanced and terminal illness, particularly as a driving force for meaning, comfort and continuity. Recognising that hope can coexist with the awareness of terminality, it becomes essential that nursing professionals are able to identify, value and foster this dimension, tailoring their interventions to the individual, cultural and spiritual needs of the person and their family. The report includes a literature review focused on hope in palliative care, aiming to understand its clinical relevance and explore intervention strategies that promote it in people living with advanced and terminal illness, as well as their caregivers. In addition, one case study is presented and critically analysed, allowing the application of theoretical and scientific knowledge to real-world clinical situation and deepening reflection on the role of hope in nursing practice. The activities carried out in clinical practice, namely within a Hospital Palliative Care Team and a Palliative Care Unit, allowed for the consolidation of theoretical knowledge and the development of technical and relational skills, with particular emphasis on empathetic communication, emotional support, and interventions centred on the person's dignity and autonomy. The articulation between scientific evidence and clinical practice proved essential to understanding the role of hope in the care process, positioning it as a key element of ethical, humanised and competent nursing practice. Describing this entire journey, combining theoretical foundations with clinical practice, represented a significant step in raising awareness of the competencies developed, as well as their contribution to professional and personal growth.
Descrição
Palavras-chave
Esperança Cuidados Paliativos Competências especializadas Bem-estar emocional Espiritualidade Comunicação empática