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| Author(s): |
Maiara Rodrigues dos Santos
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Escola de Enfermagem (EE/SBD) |
| Defense date: | 2016-11-29 |
| Examining board members: |
Regina Szylit;
Jose Ricardo de Carvalho Mesquita Ayres;
Maria Helena Pereira Franco;
Eduardo Juan Troster;
Debra Lynn McHale Wiegand
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| Advisor: | Regina Szylit |
| Abstract | |
Introduction: The relationship established between family and healthcare providers during the childs end-of-life care is complex and multidimensional. There are few evidences which explore how these relationships during the childs last hospitalization influence familial adaptation after loss. Objective: To interpret parents experience in their relationship with healthcare providers during the childs end-of-life with cancer in the hospital. Methods: This is a qualitative research, guided by Gadamers philosophical hermeneutics. Data collection was through field observations conducted in a pediatric oncology hospital with hospitalized families in end-of-life situation, interviews with bereaved parents at least 6 month after the childs death and medical records analysis. For the data analysis, the process of transcription, reading and re-reading the data, reviewing field notes and reflection on the data with other researchers helped understand the phenomenon to generate interpretations. Therefore, units of meaning emerged from the data were grouped, and themes were inductively determined and submitted to an interpretation process. Results: Relationships between parents and healthcare providers during a childs end-of-life process unveil the encounters and interpersonal interactions phenomena in illness and loss trajectory. These relationships are permeated with human values and are established in a dynamic way with various bondings. There are evident components in a child´s end-of-life context, such as presence, silence, deteriorations, tolerance, hierarchy, collaboration and trusting, as well as internal and external factors which influence the interactions. Through relationships, parents reevaluate their own role, while they live the unexpected experience of losing a child and attribute meanings to the loss. Final considerations: Relationships serve as a basis for strengthening and supporting parents in providing excellence in the child\'s care. The quality of the relationship between parents and healthcare providers is a remarkable memory of the child\'s life during the bereavement process. Looking into the relationship between parents and providers integrating it with caring science provides a basis for non-positivist paradigms which are urgent in end-of-life situations. This study aims to contribute to end-of-life nursing policies in recognizing the components to improve the quality of the relationships as a starting point for care which will allow families to have a safe base while experiencing the child\'s illness and the bereavement process. (AU) | |
| FAPESP's process: | 12/16810-9 - Understanding the experience of families about the relationships with nurses during the dying process of hospitalized child |
| Grantee: | Maiara Rodrigues dos Santos |
| Support Opportunities: | Scholarships in Brazil - Doctorate |