interaction between family and nursing team: implications for

ISSN: 1981-8963
DOI: 10.5205/reuol.6081-52328-1-SM.0808201431
Marques DLL, Laranja COLi, Silva MCMo da.
Interaction between family and nursing team...
ORIGINAL ARTICLE
INTERACTION BETWEEN FAMILY AND NURSING TEAM: IMPLICATIONS FOR
TREATMENT OF ONCOLOGIC OF PATIENTS
INTERAÇÃO ENTRE FAMÍLIA E EQUIPE DE ENFERMAGEM: REPERCUSSÕES NA TERAPÊUTICA
DO PACIENTE ONCOLÓGICO
INTERACCIÓN ENTRE LA FAMILIA Y EL EQUIPO DE ENFERMERÍA: IMPLICACIONES EN EL
TRATAMIENTO TERAPEUTICO DE PACIENTES ONCOLÓGICOS
Dulcinéa Luzia Lima Marques1, Carolina de Oliveira Laghi Laranja2, Maria Cecília Marcolino da Silva3
ABSTRACT
Objectives: identifying the effects of cancer therapy for patients in palliative care arising from the
interaction between nursing staff and family; understanding the relationship between the nursing staff and
family of cancer patients. Method: a descriptive, exploratory study with a qualitative approach, with eight
family members of cancer patients in May 2013. The collection technique was the interview and the data
were grouped into categories and analyzed. The research project was approved by the Research Ethics
Committee, CAAE 11826913.2.0000.5245. Results: the effect on treatment for cancer patients in palliative
care as a result of the interaction between the nursing staff and family were beneficial. Conclusion: it is up
to the nursing role in creating the interaction between her and the family of cancer patients in palliative
care, and adequate communication will enable the creation of a stronger link; thus, improving the quality of
treatment. Descriptors: Palliative Care; Family; Oncology.
RESUMO
Objetivos: identificar as repercussões na terapêutica do paciente oncológico em cuidados paliativos
decorrente da interação entre equipe de enfermagem e família; compreender a relação entre a equipe de
enfermagem e a família do paciente oncológico. Método: estudo descritivo, exploratório, com abordagem
qualitativa, com oito familiares de pacientes oncológicos, em maio/2013. A técnica de coleta foi a entrevista
e os dados foram agrupados e analisados em categorias. O projeto de pesquisa foi aprovado pelo Comitê de
Ética em Pesquisa, CAAE 11826913.2.0000.5245. Resultados: as repercussões na terapêutica do paciente
oncológico em cuidados paliativos em decorrência da interação entre a equipe de enfermagem e a família
foram benéficas. Conclusão: cabe a enfermagem o papel de criar a interação entre ela e a família do
paciente oncológico em tratamento paliativo, e que a comunicação adequada possibilitará a criação de um
maior vínculo, melhorando assim a qualidade do tratamento. Descritores: Cuidado Paliativo; Família;
Oncologia.
RESUMEN
Objetivos: identificar los efectos de la terapia de los pacientes con cáncer en cuidados paliativos que surge
de la interacción entre el personal de enfermería y la familia; entender la relación entre el personal de
enfermería y familiares de pacientes con cáncer. Método: un estudio descriptivo, exploratorio, con abordaje
cualitativo, con ocho miembros de la familia de los pacientes con cáncer, en mayo de 2013. La técnica de
recolección fue la entrevista y los datos se agruparon en categorías y analizados. El proyecto de investigación
fue aprobado por el Comité de Ética en Investigación, CAAE 11826913.2.0000.5245. Resultados: el efecto
sobre el tratamiento de pacientes con cáncer en los cuidados paliativos como un resultado de la interacción
entre el personal de enfermería y familiares fueron beneficiosas. Conclusión: corresponde al enfermero la
creación de la interacción entre la paciente y la familia de los pacientes con cáncer en cuidados paliativos, y
la comunicación adecuada permitirá la creación de un vínculo más fuerte, mejorando así la calidad del
tratamiento. Descriptores: Cuidados Paliativos; Familia; Oncología.
1
Nurse, Master of Health Care Science, Center for Bone Marrow Transplantation / National Cancer Institute. Professor, School of Nursing,
Faculty Arthur Sá Earp Neto - Petropolis. Petrópolis (RJ), Brazil. Email: [email protected]; 2Student, School of Nursing, Faculty Arthur Sá
Earp Neto. Petrópolis (RJ), Brazil. Email: [email protected]; 3Nurse, Nursing Technician, Hospital São Francisco de Assis. Rio de
Janeiro (RJ), Brazil. Master of Nursing, Faculty Arthur Sá Earp Neto - Petrópolis. Petrópolis (RJ), Brazil. Email:
[email protected]
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Marques DLL, Laranja COLi, Silva MCMo da.
INTRODUCTION
Cancer is a chronic degenerative disease
that, in some cases, after some time,
becomes, or it is inevitable that it becomes
incurable, making the patient who is affected
by this disease a patient out from therapeutic
possibilities (FPT), about 518 510 people will
be affected by cancer in the year
2012/2013.1,2
Terminality is when you exhaust the rescue
possibilities of health conditions of patients
and the possibility of imminent death seems
inevitable and predictable. Despite the
difficulties in establishing this concept, the
benefits it can bring to patients, family and
professionals will not be compromised.3
Admitting that resources for rescue the
cure and the patient is moving toward the end
of life, does not mean that there is more to
do; rather, it opens up a wide range of
behaviors that can be offered to patients and
their families. Ducts in concrete plan, aiming
now pain relief, decrease discomfort; but,
especially, the possibility of situating it
against the time of end of life, accompanied
by someone who can listen to them and
sustain their desires.3
Then walked to a new perspective of
palliative care, which is the approach that
promotes quality of life of patients and their
families facing diseases that threaten the
continuity of life through the prevention and
relief of suffering.4 In this scenario
undesirable and distressing that the role of
family is emphasized. Also strengthens the
news of a sick family radically changes the
routines, ie, it is time to restore the
emotional ties that have been broken for
some reason.5
During this step one should not forget the
critical role that health professionals have,
facing this reality, for health professionals, is
to adopt the perspective of palliative care,
seeing them not as an alternative procedure,
but as a paradigm change for patients FPT.6
Patients without therapeutic possibility
require a health team, and especially nursing,
not only technical skills, not to perform
physical care, but also emotional care skills;
nursing professional is one that remains the
most time with the patient.7 Therefore, it is
justified that this study aims to:
● Identify the effects on the cancer patient
therapy in palliative care arising from the
interaction between nursing staff and family;
● Understand the relationship between the
nursing staff and family of cancer patients.
English/Portuguese
J Nurs UFPE on line., Recife, 8(8):2811-5, Aug., 2014
DOI: 10.5205/reuol.6081-52328-1-SM.0808201431
Interaction between family and nursing team...
METHOD
A descriptive, exploratory study with a
qualitative approach. The scenarios of the
study was the Municipal Hospital Alcides
Carneiro and Family Health Centers, located
in the city of Petrópolis / RJ. There were
eight family members of cancer patients who
were in palliative care. Thus, criteria for
inclusion were: family members who were in
effective monitoring of cancer patients in
palliative care, of both genders over 18 years
old. There were excluded: families who were
not in direct deals with cancer patients in
palliative care.
The subjects were informed about the
study objectives, as well as the confidentiality
of their personal identity and total freedom to
withdraw, being invited to sign the Instrument
of Consent in two ways.
Data collection occurred in May 2013, with
interview technique, using a semi-structured
script. The interviews were administered
individually and to maintain the reliability of
the statements of the subjects, the interviews
were recorded and later transcribed. At the
end of the collection, the data were grouped
into categories and analyzed, discussed in
light of Technical Analysis content.
To ensure the confidentiality of research
subjects, their names were represented by
dummy name: Diamond, Emerald, Jade,
Aquamarine, Sapphire, Topaz, Turquoise and
Amethyst.
In compliance with Resolution 196/96 of
the NHC, repealed by Resolution 466/12 of
the NHC, this study was submitted to the
Research Ethics Committee of the Faculty of
Medicine of Petropolis / Faculty Arthur Sá
Earp Neto, and approved on May 23th, 2013 ,
Opinion No. 281 379, and the number CAAE:
11826913.2.0000.5245.8
RESULTS
From the analysis of speeches of the eight
family members, it was seized up two
thematic categories:
I - Repercussions on therapeutics for
cancer patients due to the interaction
between nursing staff and family
palliative care.
In this category the majority of
respondents reported that the effects on
cancer patients in palliative care as a result of
the interaction between the nursing staff and
family therapy were beneficial, subject to the
following statements:
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Marques DLL, Laranja COLi, Silva MCMo da.
The dedication of the staff helped
psychologically my mother, gave her safety.
(Emerald)
Important to have a communication
between relatives and nurses; important
that, although knowing him, for him to feel
safe, if not he feels insecure because of the
relatives are gone and he is here, and who
stays here is Nursing. (Sapphire)
Clarification on how care is for this family.
It interferes a lot in improving because I'm
being informed of what to do she will get
better or at least proper maintenance.
(Amethyst)
II - The relationship established between
the nursing staff and family of cancer
patients who are in palliative care.
By considering the relationship established
through guidance, support and proximity from
the nursing staff about family and oncology
patients in palliative care, four respondents
answered that nursing team offers support
and guidance:
I guess so. Like I said, it's who's always
closest to the patient right. And I think he
knows much more patient. (Aquamarine)
Very, very much. (Topaz)
DISCUSSION
It is understood as cancer patient in
palliative treatment, the patient, whose
cancer is in an advanced stage, making it a
patient out of cure. In this scenario,
conventional therapies are no longer able to
help and / or influence patient’s treatment.
At this time, kicks in palliative care, which
aims to bring this patient and his family
increased comfort and quality of life to live up
to its last day. Right now rests on the nursing
responsibility to help this patient and his
family to experience this process. The nursing
staff will show your care not only reduces
execution of techniques, but it involves the
care of the whole being: physical, mental and
spiritual.
The results of this study showed that the
interaction and communication between
nursing staff and family cause greater safety,
the family and patients, leading to better
monitoring and improved treatment. The
communication effectiveness is sustained
empathy established between subjects in
relationship of care, but also in respect to
each other, to their knowledge and their
status as a participant in the communication
process.9
It is important that nursing staff tries to
increase the interaction between patients and
family, and not only interact when requested.
It should seek more for knowledge about what
is a patient in palliative care, how to
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DOI: 10.5205/reuol.6081-52328-1-SM.0808201431
Interaction between family and nursing team...
communicate with this patient and its family,
which would ensure that these patients and
their families have better quality of life, even
if the death is a condition confirmed. While
there is life, there will be the need of nursing
care. In this context, the role and interaction
of the nursing staff is paramount to offer
maximum comfort to the patient in palliative
care, helping to experience the process of
dying with dignity and quality of life for this
patient and his family use the best the
remaining time.10
Noteworthy is how it is important for
interaction and its repercussions, when
communication occurs. It is known that it is
difficult without it, so that treatment
becomes longer and sustained. Humanized
care prioritizes attitudes, such as skill and
sensitivity
in
verbal
and
nonverbal
communication. Knowing how to listen is
essential to know what and when to talk,
share ideas and decisions, since the family can
provide to nursing staff critical information to
improve the treatment, all these attitudes are
key members for the horizontal setting of
care. Thus, care assumes no individuality and
up righting, but communication from person
to person, where the nursing staff works with
the patient and family in palliative care and
not about them.11
Even though nursing staff working with
cancer patients in palliative care, ie, patients
without healing possibilities, consider the
communication with patient and his family as
an important and effective therapeutic tool,
find it difficult to communicate effectively,
lying ill prepared this point.10 Professionals
show unaware therapeutic communication
techniques, avoiding verbal contact with
patients and their families who experience
the dying process, moving away from them,
knowing not give you the feelings that the
situation of death imminent awakening
them.10
Communication to which patients and
family refer differs from the statement
identified by much of the literature on
palliative
care
as
synonymous
with
information. Patients and relatives identified
that it is not just to convey information, but
how these messages are transmitted,
expressed with words, posture and attitudes
verbal and nonverbal, that would pass
beneficially in the interaction, in care and
attention.10 Hospice care instead prioritize
healing process and through a humanized,
based on respect, ethics and truth in the
relationship
between
professional
and
12
patient.
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Marques DLL, Laranja COLi, Silva MCMo da.
The relationship between nursing staff and
family of cancer patient, who is in palliative
care, touches on the need for preparedness on
the part of professionals, which requires the
nursing staff a shift in focus and attitude: the
do to listen, perceive, understand identify
needs for only then plan actions. In this sense
the listening is not just hearing, but remain
silent, use gestures of affection and smile that
express acceptance and encourage the
expression of feelings. Realize is not only
look, but pay attention and identify the
different dimensions of the other, through
their experiences, behaviors, emotions and
spirituality.10
CONCLUSION
It was found that the interaction between
nursing staff and family resonates positively
on cancer patients in palliative care therapy.
The consequence of this interaction reflects
on the safety and reliability of patients
regarding their treatment.
The communication between nursing staff
and family was configured as prime factor of
this interaction, which must occur properly,
correct, clear, undeviating speech to be
effective.
Effective communication and good quality
of the nursing staff influences for better
interaction among family members of cancer
patients in palliative care that, consequently,
improves the quality of treatment, because
both are in a place where they feel
completely vulnerable and insecure.
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English/Portuguese
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Marques DLL, Laranja COLi, Silva MCMo da.
DOI: 10.5205/reuol.6081-52328-1-SM.0808201431
Interaction between family and nursing team...
Submission: 2013/12/19
Accepted: 2014/07/11
Publishing: 2014/08/01
Corresponding Address
Dulcinéa Luzia de Oliveira Lima Marques
Rua Dr. Agostinho Goulão, 32 / Ap. 205
Bairro Corrêas
CEP: 25730-050 ―- Petrópolis (RJ), Brazil
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