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Importância da Descoberta do Sentido de Vida na Aceitação e Envolvimento nos Cuidados de Saúde em Utentes com Doença Crónica e suas Famílias: Revisão Integrativa
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Enquadramento: A doença crónica representa uma experiência prolongada e desafiante que afeta não apenas a pessoa, mas também a família, exigindo adaptações constantes a nível físico, emocional, social e existencial. Neste contexto, o sentido de vida assume particular relevância, pois influencia a forma como a pessoa compreende a sua condição, atribui significado às mudanças impostas pela doença e se envolve nos cuidados de saúde. A literatura tem vindo a reconhecer que a descoberta do sentido de vida promove um bem-estar geral ( psicológico, social e espiritual), redução da ansiedade e depressão, valorização do essencial da vida, autotranscendência, maior autoeficácia no controlo da dor crónica, e fortalece a participação ativa nos cuidados de saúde, nomeadamente na autogestão e adesão ao regime terapêutico, embora esta dimensão permaneça pouco explorada na prática clínica e na investigação em saúde.
Objetivo: Analisar a importância da descoberta do sentido de vida na aceitação, na adesão ao regime terapêutico e envolvimento nos cuidados de saúde em utentes com doença crónica e as suas famílias.
Metodologia: Conduziu-se uma revisão integrativa da literatura e optou-se por uma estratégia sensível e abrangente que permitiu mapear o maior número possível de artigos potencialmente relevantes, adequada à natureza exploratória da revisão, garantindo uma compreensão alargada e aprofundada do conhecimento do fenómeno em análise , com refinamento realizado nas fases subsequentes de seleção e de análise dos estudos. A pesquisa foi realizada em três bases de dados eletrónicas relevantes nas áreas da saúde, nomeadamente Medline, Cinahl e SciELO. Os termos de pesquisa operacionalizaram os três componentes do modelo PCC, tendo a pesquisa decorrido durante o mês de janeiro de 2026. Devido ao reduzido número de artigos, não foram aplicadas restrições quanto ao idioma, à data de publicação ou ao tipo de estudo. Foram incluídos estudos primários que analisassem a relação entre o sentido de vida e os processos de aceitação da doença, adaptação e envolvimento nos cuidados de saúde, independentemente do desenho metodológico adotado.
Foram excluídos editoriais, cartas ao editor, comentários, estudos de caso isolados, dissertações, teses e literatura cinzenta não sujeita a revisão por pares e excluíram-se estudos desenvolvidos exclusivamente no contexto de cuidados paliativos, uma vez que o enquadramento conceptual e experiencial do fim de vida difere do foco desta revisão, centrado nos processos de adaptação e envolvimento ao longo da vivência da doença crónica.
Resultados: Nove estudos incluídos demonstram diversidade metodológica, conceitual e contextual, o que possibilita uma compreensão abrangente do papel ou importância do sentido de vida na experiência da doença crónica. As amostras abrangem adultos e idosos com diferentes condições de doença crónica, incluindo cancro, dor crónica, insuficiência renal crónica, DPOC, outras doenças crónicas não transmissíveis e Long Covid. Os estudos foram conduzidos em diversos países (Europa, América do Norte, América do Sul e Ásia) e em múltiplos contextos assistenciais, incluindo cuidados de saúde primários, contextos comunitários, programas domiciliários, contextos hospitalares especializados (nefrologia, oncologia) e serviços clínicos diferenciados ( programas de reabilitação respiratória, consulta da dor orofacial).
Conclusão: A descoberta de sentido de vida constitui um elemento central na vivência da Pessoa com doença crónica, influenciando de forma consistente a aceitação, a adaptação e o envolvimento nos cuidados de saúde. A evidência reforça a necessidade de intervenções de enfermagem sensíveis às dimensões existenciais da saúde, que reconheçam a pessoa e a família como unidade indissociável de cuidado, em consonância com os princípios da Enfermagem de Saúde Familiar.
Background: Chronic illness represents a prolonged and challenging experience that affects not only the individual but also the family, requiring constant physical, emotional, social, and existential adjustments. In this context, meaning in life assumes particular relevance, as it influences how the person understands their condition, assigns significance to the changes imposed by the illness, and engages in health care. The literature has increasingly recognized that discovering a sense of meaning promotes overall well-being (psychological, social, and spiritual), reduces anxiety and depression, enhances the appreciation of what is essential in life, fosters self-transcendence, increases self-efficacy in managing chronic pain, and strengthens active participation in health care, particularly in self-management and adherence to therapeutic regimens, although this dimension remains underexplored in clinical practice and health research. Objectives: To analyse the importance of discovering meaning in life for the acceptance of illness, adherence to therapeutic regimens, and involvement in health care among individuals with chronic illness and their families. Method: An integrative literature review was conducted, and a sensitive and comprehensive search strategy was adopted to map the largest possible number of potentially relevant articles. This approach was appropriate to the exploratory nature of the review, ensuring a broad and in-depth understanding of the knowledge available on the phenomenon under analysis, with refinement carried out in the subsequent stages of study selection and analysis. The search was performed in three electronic databases relevant to the health sciences, namely Medline, Cinahl, and SciELO. The search terms operationalized the three components of the PCC model, and the search took place during January 2026. Due to the limited number of articles, no restrictions were applied regarding language, publication date, or study design. Primary studies examining the relationship between meaning in life and the processes of illness acceptance, adaptation, and engagement in health care were included, regardless of methodological design. Editorials, letters to the editor, commentaries, single case studies, dissertations, theses, and grey literature not subject to peer review were excluded, as were studies conducted exclusively in palliative care settings, given that the conceptual and experiential framework of end-of-life care differs from the focus of this review, which centers on adaptation and engagement processes throughout the experience of chronic illness. Results: Nine included studies demonstrate methodological, conceptual, and contextual diversity, which enables a comprehensive understanding of the role or significance of meaning in life in the experience of chronic illness. The samples comprise adults and older adults with different chronic conditions, including cancer, chronic pain, chronic kidney disease, COPD, other non-communicable chronic diseases, and Long Covid. The studies were conducted in several countries (Europe, North America, South America, and Asia) and across multiple care settings, including primary health care, community contexts, home-based programmes, specialised hospital settings (nephrology, oncology), and differentiated clinical services (respiratory rehabilitation programmes, orofacial pain clinics). Conclusion: The discovery of meaning in life is a central element in the experience of a person with chronic illness, consistently influencing acceptance, adaptation, and involvement in healthcare. Evidence reinforces the need for nursing interventions sensitive to the existential dimensions of health, recognizing the person and family as an inseparable unit of care, in accordance with the principles of Family Health Nursing.
Background: Chronic illness represents a prolonged and challenging experience that affects not only the individual but also the family, requiring constant physical, emotional, social, and existential adjustments. In this context, meaning in life assumes particular relevance, as it influences how the person understands their condition, assigns significance to the changes imposed by the illness, and engages in health care. The literature has increasingly recognized that discovering a sense of meaning promotes overall well-being (psychological, social, and spiritual), reduces anxiety and depression, enhances the appreciation of what is essential in life, fosters self-transcendence, increases self-efficacy in managing chronic pain, and strengthens active participation in health care, particularly in self-management and adherence to therapeutic regimens, although this dimension remains underexplored in clinical practice and health research. Objectives: To analyse the importance of discovering meaning in life for the acceptance of illness, adherence to therapeutic regimens, and involvement in health care among individuals with chronic illness and their families. Method: An integrative literature review was conducted, and a sensitive and comprehensive search strategy was adopted to map the largest possible number of potentially relevant articles. This approach was appropriate to the exploratory nature of the review, ensuring a broad and in-depth understanding of the knowledge available on the phenomenon under analysis, with refinement carried out in the subsequent stages of study selection and analysis. The search was performed in three electronic databases relevant to the health sciences, namely Medline, Cinahl, and SciELO. The search terms operationalized the three components of the PCC model, and the search took place during January 2026. Due to the limited number of articles, no restrictions were applied regarding language, publication date, or study design. Primary studies examining the relationship between meaning in life and the processes of illness acceptance, adaptation, and engagement in health care were included, regardless of methodological design. Editorials, letters to the editor, commentaries, single case studies, dissertations, theses, and grey literature not subject to peer review were excluded, as were studies conducted exclusively in palliative care settings, given that the conceptual and experiential framework of end-of-life care differs from the focus of this review, which centers on adaptation and engagement processes throughout the experience of chronic illness. Results: Nine included studies demonstrate methodological, conceptual, and contextual diversity, which enables a comprehensive understanding of the role or significance of meaning in life in the experience of chronic illness. The samples comprise adults and older adults with different chronic conditions, including cancer, chronic pain, chronic kidney disease, COPD, other non-communicable chronic diseases, and Long Covid. The studies were conducted in several countries (Europe, North America, South America, and Asia) and across multiple care settings, including primary health care, community contexts, home-based programmes, specialised hospital settings (nephrology, oncology), and differentiated clinical services (respiratory rehabilitation programmes, orofacial pain clinics). Conclusion: The discovery of meaning in life is a central element in the experience of a person with chronic illness, consistently influencing acceptance, adaptation, and involvement in healthcare. Evidence reinforces the need for nursing interventions sensitive to the existential dimensions of health, recognizing the person and family as an inseparable unit of care, in accordance with the principles of Family Health Nursing.
Descrição
Palavras-chave
Sentido de vida Doença crónica Aceitação Cuidado Família Envolvimento e adaptação
Contexto Educativo
Citação
Editora
Licença CC
Sem licença CC