Práticas da terapia ocupacional junto a familiares de pacientes em cuidados paliativos hospitalizados

Abstract

Palliative care consists of a set of practices based on knowledge of various specialties, in which the focus of care is not based on pathology, but on the promotion of health and symptom control for all patients facing life-threatening situations. The patient's singularities are taken into consideration, as well as the care for the patient's environment, which includes the family, caregivers, and the health team, since they are also susceptible to suffering. This study sought to describe the role of the occupational therapist with family caregivers of patients in palliative care in the hospital setting. This is a descriptive research, of qualitative approach, in which five occupational therapists working in hospitals in the state of São Paulo, with experience in palliative care for at least one year, were interviewed. For data collection, the Snowball method was applied, and the information obtained was worked on by thematic analysis. It was obtained from the participation of 5 occupational therapists who presented an average time of work in the hospital area corresponding to 11 years and an average time of work in palliative care referring to 7 years. Specifically about the work with families, the participants expressed the role of occupational therapy, and 4 themes emerged, as follows a) Routine of the family member - this theme encompassed expressions about the occupational therapeutic work of evaluation and management of the impacts on the family dynamics generated by the occupation "caring" and by the hospitalization process itself; b)(Re)Construction of coping strategies - this theme involved expressions about the role of the occupational therapist aimed at promoting re-signification of experiences and promoting embracement as a way to enable coping; c) Instrumentalization of care - included notes about the role of empowering the family caregiver to perform procedures involved in daily care and to organize the environment in a more functional manner; d) Mourning - in this theme, expressions were considered referring to the role of offering support to the experience of bereavement based on the perspective of an emptying of activities associated with the role of caring and the reorganization of the routine considering the losses experienced and the singularities of each subject. From the data obtained, we observed an occupational therapist focus on routine modifications, based on the understanding of caring as an occupation that involves emotional and instrumental aspects and that can tend to promote an unbalance in the occupational repertoire, a factor that denotes that the occupational therapist has been performing interventions based on the technical repertoire of his core of knowledge in favor of the integrality of care and quality of life of the family members.