A VIVÊNCIA DO ONCOLOGISTA NA INFORMAÇÃO DO DIAGNÓSTICO DE CÂNCER À PACIENTE

• Ano de defesa: 2004
• Autor(a) principal: Vivone, Caroline Parsit Ribeiro
• Orientador(a): Souza, Camila Bernardes de
• Banca de defesa: Vizzotto, Marília Martins , Grisi, Marília Ancona-lopes e
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Metodista de São Paulo
• Programa de Pós-Graduação: PÓS GRADUAÇÃO EM PSICOLOGIA
• Departamento: Psicologia da saúde
• País: BR
• Palavras-chave em Português: Psicologia da saúde; Neoplasias - Diagnóstico; Relação médico-paciente; Fenomenologia (Psicologia); Psicologia - Teses e dissertações
• Palavras-chave em Inglês: Health Psychology; Neoplasms Diagnosis; Physician-pacient relationship; Phenomenology (Psychology)
• Área do conhecimento CNPq: CNPQ::CIENCIAS HUMANAS::PSICOLOGIA
• Link de acesso: http://tede.metodista.br/jspui/handle/tede/1333

The objective of this study, based on qualitative research and using an existing phenomenological methodology, was to investigate the thoughts, feelings and attitudes of the oncologist when informing a patient of a cancer diagnostic. Five semi-guided interviews were conducted with oncologists that provide consultations through a private clinic, and the analysis comprehensive phenomenological of the content were delimited. The results obtained indicate that: The informing of a breast cancer diagnostic to young patients in the reproductive age range was considered to be the most dramatic for the doctors, causing them the greatest concern, fear and sadness, due to the limitations imposed by the illness on the life plans of the patients and issues of motherhood. The interviews revealed that in any case the moment in which the news is given has emotional repercussions due to the experiencing of sad feeling, or due to fantasies related to responsibilities for the illness. They indicate as most difficult in this process the facing the emotional reactions of patients and the explaining of the cancer using words that minimize the impact of the information. In the face of these difficulties some mitigating topics were the evolution of medicine and the possibility of conservative surgery as well as breast reconstruction. The doctors affirmed that they informed patients in a clear, objective and gradual manner, but that not all utilized the expression cancer in all cases. They seek to encourage the patient with optimism and affirmative support, engaging in the treatment in an active, participating manner. In addition, the feel responsible for motivating those who show discouragement or who are reluctant to follow the treatment. The oncologists perceive that from the moment the patient is informed of the diagnostic they establish a bond of confidence and dependency, and in some cases this bond is reciprocal. They recognize, however, that this bond produces an emotional stress that leads to their questioning the choice of their professional specialization. It was observed that some doctors in providing a diagnostic, sometimes at the patient s request, when these previsions prove erroneous experience feeling of impotence, or failure, or guilt for not having properly prepared themselves or the patients for the moment the information is transmitted. They did not regard cases in which family members interfere with doubts or with requests to withhold the information in a negative way, however, not always do the doctors respect such requests. Those interviewed revealed some degree of learning through contact with cancer patients, or through reevaluation of their moral values, or by reflection on their own finiteness. Particularly in those cases of advanced or terminal cancer this learning covers support for moments that precede death, or the recognition of one s own impotence. Conclusion: The analysis of the results reveal the conflicts and the doubts of doctors as ethical beings when assume the risks implicit in choosing when, how and in what manner to inform the diagnostic to a patient, their guilt conscience and the existential anxiety provoked by emotional reactions of patients. Its so demonstrated their concern for existence in the world, the searching for creative encounter and that the subjectiveness is used as a pathway for understanding the patient. In addition, the possibility of failure in a project results in frustration and temporary degrading of one s confidence in their own capability. In this manner, this work demonstrates the unavoidable influence of subjective factors in the attitudes of doctors in informing cancer diagnostics to their patients and that this process is well beyond any pretence of objectiveness.