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Conhecimento dos Enfermeiros sobre a Importância do sentido de vida na família com elemento com Doença Crónica: Revisão Integrativa
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Introdução: A doença crónica constitui um grave problema de saúde pública, afetando em Portugal cerca de 42% da população, sendo um dos países europeus com maior prevalência desta condição. A sua experiência no seio familiar representa um processo de transição complexo que desafia a identidade, os papéis e os projetos de vida dos seus membros, convocando inevitavelmente a necessidade de reconstrução de um significado para aquela vivência. Perante o sofrimento associado à doença crónica, a capacidade de encontrar sentido na vida, apesar da experiência, revela-se determinante para a adaptação familiar, influenciando a forma como a família enfrenta a adversidade, reorganiza os seus recursos e mantém a esperança. Neste contexto, a dimensão espiritual emerge como um reconhecido mecanismo de adaptação, fundamental para o alívio do sofrimento pela descoberta de sentido e atribuição de significado à vida. O enfermeiro de saúde familiar, pelo conhecimento aprofundado que desenvolve da família, encontra-se numa posição privilegiada para apoiar este processo. A escassez de evidência sobre o conhecimento dos enfermeiros relativamente ao sentido de vida em contexto familiar, fundamentou a realização de uma revisão integrativa da literatura.
Objetivos: Conhecer a importância que os enfermeiros atribuem ao sentido de vida das famílias com um elemento com doença crónica.
Metodologia: Conduziu-se uma revisão integrativa da literatura, tendo sido definida uma estratégia de pesquisa sistemática, desenvolvida com base na questão de investigação e na estrutura PCC. A pesquisa foi realizada nas bases de dados eletrónicas MEDLINE (via PubMed), CINAHL (via EBSCOhost), Nursing & Allied Health Collection: Comprehensive (via EBSCOhost) e SciELO. Não foram aplicadas restrições quanto ao idioma ou à data de publicação, dada a escassez de literatura sobre o tema, com o objetivo de maximizar a amplitude da pesquisa. Foram, no entanto, definidos critérios de elegibilidade quanto ao tipo e conteúdo dos estudos, considerando elegíveis estudos empíricos que abordassem o conhecimento, as perceções ou as conceções dos enfermeiros relativamente ao sentido de vida em contextos de doença crónica, incluindo, explicitamente ou implicitamente, a família como unidade do cuidado. Foram incluídos estudos quantitativos, qualitativos e de metodologia mista com texto integral disponível. Excluíram-se artigos que focassem exclusivamente em cuidados paliativos ou fim de vida.
Resultados: Quatro estudos preencheram integralmente os critérios de inclusão e foram incluídos na revisão integrativa. Estes artigos abordam o conhecimento, as perceções ou as conceções dos enfermeiros relativamente às dimensões associadas ao sentido de vida no contexto da doença crónica, foram publicados entre 1996 e 2017 e desenvolvidos na Noruega, na Bélgica, no Brasil e na Colômbia. Todos os estudos incluíram enfermeiros como população-alvo. Contudo, apenas um estudo aborda explicitamente o conhecimento conceptual dos enfermeiros sobre o significado atribuído à vida no contexto do cuidado. Nos restantes estudos, o conhecimento sobre o sentido de vida surge de forma implícita, inferido a partir das perceções, práticas e discursos dos enfermeiros.
Relativamente ao contexto familiar, a família é abordada de forma explícita em apenas um estudo, surgindo nos restantes como contexto relacional indireto ou não sendo claramente operacionalizada.
Conclusão: Os resultados evidenciam uma lacuna clara na literatura sobre o conhecimento dos enfermeiros relativamente à importância do sentido de vida na família com um elemento com doença crónica. O conhecimento existente surge maioritariamente de forma implícita, derivado das práticas relacionais e espirituais, sendo a família raramente abordada como destinatária direta deste cuidado.
Estes resultados reforçam a necessidade de integrar de forma sistemática a dimensão espiritual e a CoCIP na formação e investigação, facilitando o Enfermeiro Especialista em Enfermagem de Saúde Familiar na orientação de famílias vulneráveis, com elemento com doença crónica, na descoberta de sentido nas suas vidas e promoção do seu consequente valor terapêutico, o controlo sobre do sofrimento inevitável.
Introduction: Chronic disease represents a serious public health problem, affecting approximately 42% of the population in Portugal, making it one of the European countries with the highest prevalence of this condition. The experience of chronic disease within the family represents a complex transition process that challenges the identity, roles, and life projects of its members, inevitably calling for the need to reconstruct meaning from that experience. Faced with the suffering associated with chronic disease, the ability to find meaning in life, despite the experience, proves to be decisive for family adaptation, influencing the way the family faces adversity, reorganizes its resources, and maintains hope. In this context, the spiritual dimension emerges as a recognized adaptation mechanism, fundamental for the relief of suffering through the discovery of meaning and attribution of significance to life. The family health nurse, through the in-depth knowledge developed of the family, is in a privileged position to support this process. The scarcity of evidence on nurses' knowledge regarding the meaning of life in a family context grounded the conduct of an integrative literature review. Objective: To understand the importance that nurses attribute to the meaning of life of families with a member with chronic disease. Methodology: An integrative literature review was conducted, with a systematic search strategy developed based on the research question and the PCC framework. The search was carried out in the electronic databases MEDLINE (via PubMed), CINAHL (via EBSCOhost), Nursing & Allied Health Collection: Comprehensive (via EBSCOhost), and SciELO. No restrictions were applied regarding language or publication date, given the scarcity of literature on the topic, with the aim of maximizing the breadth of the search. However, eligibility criteria were defined regarding the type and content of the studies, considering eligible empirical studies that addressed nurses' knowledge, perceptions, or conceptions regarding the meaning of life in chronic disease contexts, including, explicitly or implicitly, the family as the unit of care. Quantitative, qualitative, and mixed-method studies with full text available were included. Articles focusing exclusively on palliative care or end of life were excluded. Results: Four studies fully met the inclusion criteria and were included in the integrative review. These articles address nurses' knowledge, perceptions, or conceptions regarding dimensions associated with the meaning of life in the context of chronic disease, were published between 1996 and 2017, and were conducted in Norway, Belgium, Brazil, and Colombia. All studies included nurses as the target population. However, only one study explicitly addresses nurses' conceptual knowledge of the meaning attributed to life in the context of care. In the remaining studies, knowledge about the meaning of life emerges implicitly, inferred from nurses' perceptions, practices, and discourses. Regarding the family context, the family is explicitly addressed in only one study, appearing in the remaining ones as an indirect relational context or not being clearly operationalized. Conclusion: The results highlight a clear gap in the literature regarding nurses' knowledge of the importance of the meaning of life in families with a member with chronic disease. Existing knowledge emerges mostly implicitly, derived from relational and spiritual practices, with the family rarely addressed as the direct recipient of this care. These results reinforce the need to systematically integrate the spiritual dimension and CoCIP into training and research, facilitating the Family Health Nursing Specialist in guiding vulnerable families with a member with chronic disease in the discovery of meaning in their lives and the promotion of its consequent therapeutic value, the control over inevitable suffering.
Introduction: Chronic disease represents a serious public health problem, affecting approximately 42% of the population in Portugal, making it one of the European countries with the highest prevalence of this condition. The experience of chronic disease within the family represents a complex transition process that challenges the identity, roles, and life projects of its members, inevitably calling for the need to reconstruct meaning from that experience. Faced with the suffering associated with chronic disease, the ability to find meaning in life, despite the experience, proves to be decisive for family adaptation, influencing the way the family faces adversity, reorganizes its resources, and maintains hope. In this context, the spiritual dimension emerges as a recognized adaptation mechanism, fundamental for the relief of suffering through the discovery of meaning and attribution of significance to life. The family health nurse, through the in-depth knowledge developed of the family, is in a privileged position to support this process. The scarcity of evidence on nurses' knowledge regarding the meaning of life in a family context grounded the conduct of an integrative literature review. Objective: To understand the importance that nurses attribute to the meaning of life of families with a member with chronic disease. Methodology: An integrative literature review was conducted, with a systematic search strategy developed based on the research question and the PCC framework. The search was carried out in the electronic databases MEDLINE (via PubMed), CINAHL (via EBSCOhost), Nursing & Allied Health Collection: Comprehensive (via EBSCOhost), and SciELO. No restrictions were applied regarding language or publication date, given the scarcity of literature on the topic, with the aim of maximizing the breadth of the search. However, eligibility criteria were defined regarding the type and content of the studies, considering eligible empirical studies that addressed nurses' knowledge, perceptions, or conceptions regarding the meaning of life in chronic disease contexts, including, explicitly or implicitly, the family as the unit of care. Quantitative, qualitative, and mixed-method studies with full text available were included. Articles focusing exclusively on palliative care or end of life were excluded. Results: Four studies fully met the inclusion criteria and were included in the integrative review. These articles address nurses' knowledge, perceptions, or conceptions regarding dimensions associated with the meaning of life in the context of chronic disease, were published between 1996 and 2017, and were conducted in Norway, Belgium, Brazil, and Colombia. All studies included nurses as the target population. However, only one study explicitly addresses nurses' conceptual knowledge of the meaning attributed to life in the context of care. In the remaining studies, knowledge about the meaning of life emerges implicitly, inferred from nurses' perceptions, practices, and discourses. Regarding the family context, the family is explicitly addressed in only one study, appearing in the remaining ones as an indirect relational context or not being clearly operationalized. Conclusion: The results highlight a clear gap in the literature regarding nurses' knowledge of the importance of the meaning of life in families with a member with chronic disease. Existing knowledge emerges mostly implicitly, derived from relational and spiritual practices, with the family rarely addressed as the direct recipient of this care. These results reinforce the need to systematically integrate the spiritual dimension and CoCIP into training and research, facilitating the Family Health Nursing Specialist in guiding vulnerable families with a member with chronic disease in the discovery of meaning in their lives and the promotion of its consequent therapeutic value, the control over inevitable suffering.
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Palavras-chave
Conhecimento Enfermeiros Sentido de vida Família Doença crónica
Contexto Educativo
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Licença CC
Sem licença CC