Cuidados paliativos oncológicos em um hospital público: saúde mental de cuidadores

• Ano de defesa: 2023
• Autor(a) principal: Reis, Mauri Caldeira
• Orientador(a): Freitas, Eduarda Rezende
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Católica de Brasília
• Programa de Pós-Graduação: Programa Stricto Sensu em Gerontologia
• Departamento: Escola de Saúde e Medicina
• País: Brasil
• Palavras-chave em Português: Transtornos mentais; Pessoa idosa; Cuidados paliativos; Cuidador; Fardo de cuidar; Cuidados a doentes terminais
• Palavras-chave em Inglês: Mental disorders; Aged; Palliative care; Caregiver; Caregiver burden; Hospice care
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://bdtd.ucb.br:8443/jspui/handle/tede/3408

Among the challenges arising from the Brazilian demographic transition is the growth of neoplasms as a cause of mortality. Due to the course of these diseases, there is a large contingent of elderly individuals requiring palliative care. Therefore, the need arises for individuals that provide daily assistance, known as caregivers. Elderly individuals in palliative care and their caregivers often experience emotionally intense moments, characterized by depressive and anxious symptoms, as well as a decrease in quality of life. Considering this, the current investigation analyzed aspects of the mental health of caregivers of individuals aged 50 or older admitted to a public reference unit for oncological palliative care in Brasília through a crosssectional, quantitative, and descriptive study conducted from February to July 2023. Specifically, anxiety and depression were analyzed using the Hospital Anxiety and Depression Scale, resilience through the Wagnild and Young resilience scale, quality of life using the World Health Organization Quality of Life (abbreviated), and caregiver burden through the informal caregiver burden assessment questionnaire. During the same period, the hospitalization profile of individuals aged 50 or older from the mentioned institution was researched, aiming to find whether it characterizes palliative care or, alternatively, "hospice care." For this purpose, a sample of elderly patients hospitalized during the same aforementioned period was used, along with public data on hospital bed occupancy. Regarding the mental health of caregivers, it was found that their quality of life was positively and significantly related to income levels above 4 minimum wages. Furthermore, negative relations were shown between quality of life and being employed, daily hours of caregiving dedication, and anxiety. Concerning caregiver burden, specifically for informal caregivers, positive relations were shown with anxiety and a score equal to or greater than 7 for depression (HADS), and a negative relation with the caregiver's age. There is a need for interventions targeted at caregivers in oncological palliative care. Screening for anxiety and depression should be made a routine, possibly using standardized instruments, should be considered a strategy to reduce their burden. To improve quality of life, interventions that seek to improve family dynamics, share responsibilities, mediate conflicts, promote active coping, and provide open communication for clarification of doubts, favoring information exchange between professionals, patients, and caregivers, are proposed based on the literature and address the demands found in the present research. Regarding the characterization of hospitalizations occurring in the same period, the results show that hospital beds were used to aid in the dying process, not showing a palliative care profile. Finally, it is necessary to consider whether the use of palliative care beds is not being diverted from its purpose to offer aid that is limited to the dying process, failing to prioritize quality of life throughout oncological treatment.