Experiência psicossocial de cuidadores no câncer, final de vida e luto: metassíntese

• Ano de defesa: 2025
• Autor(a) principal: Prizanteli, Cristiane Corsini
• Orientador(a): Franco, Maria Helena Pereira
• Tipo de documento: Tese
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Pontifícia Universidade Católica de São Paulo
• Programa de Pós-Graduação: Programa de Pós-Graduação em Psicologia: Psicologia Clínica
• Departamento: Faculdade de Ciências Humanas e da Saúde
• País: Brasil
• Palavras-chave em Português: Neoplasias; Cuidados paliativos; Cuidadores; Psicossocial; Luto; Psico-oncologia; Metassíntese
• Palavras-chave em Inglês: Neoplasms; Palliative care; Caregivers; Psychosocial; Bereavement; psycho oncology; Meta-synthesis
• Área do conhecimento CNPq: CNPQ::CIENCIAS HUMANAS::PSICOLOGIA
• Link de acesso: https://repositorio.pucsp.br/jspui/handle/handle/45476

The world population is aging, with a concomitant rise in the number of people with debilitating diseases and complex needs. Consequently, demand for palliative care is growing globally. Caring for terminally ill loved ones at the end of life can be distressing, impacting the process of bereavement and loss after death experienced by informal caregivers. Thus, support through grief should be considered an essential component of palliative care services, encompassing the period after loss. However, significant gaps are observed in evidence-based guidance aimed at supporting health professionals in decision-making related to the assessment of protective and risk factors associated with adverse grief outcomes, as well as in the implementation of appropriate bereavement interventions. There is a dearth of studies addressing the psychosocial needs and preferences of caregivers in palliative care. The factors reducing the risk of complicated grief, both before and after the loss of a loved one, are poorly understood, particularly in cases of advanced illness. Prompted by the need to bridge these gaps in the literature, this study aims to understand the psychosocial experience of caregivers as they undergo bereavement in the context of end-of-life care for a loved one with advanced cancer and following the loss, through a metasynthesis of qualitative studies. Thus, a systematized review involving six databases was performed. The contents were analyzed and incorporated into a thematic synthesis, from which three analytical themes emerged: (1) The complexity of the caregiver´s experience from care to bereavement; (2) The complexity of the integrated psychosocial support network in the journey from care to bereavement; and (3) The transition from care to farewell: overlaps of gradual decline, suffering, and psychosocial needs. Results showed that significant caregivers had unmet psychosocial needs and reported burden throughout the trajectory of end of life and bereavement. The findings also underscore the importance of developing psychosocial support initiatives tailored to the needs of these caregivers, and of implementing psychosocial interventions after loss, centered on reconstructing their identities and supporting them in the process of detachment from the caregiver role. Gaining a clearer understanding of the distress and psychosocial needs of significant caregivers in this context, as well as associated protective and risk factors, can help improve integrative psychosocial care strategies