Infertilidade e câncer de colo de útero: repercussões na conjugalidade e na parentalidade

Abstract

The main objective of the present dissertation was to know the main repercussions of female infertility caused by cervical cancer in the marital life, as well as in the project of parenting. To achieve this goal, the Dissertation was divided into five studies, two integrative reviews of the literature and three cross-sectional, multiple case studies based on the qualitative research methodology. Studies 1 and 2 deal with theoretical studies developed from the PRISMA protocol. The first one had as objective to know the national and international scientific production about the implications of the female infertility for the sexual relation of heterosexual couples. Study 2 aimed to know the main scientific evidence on how conjugality is affected by female infertility. The corpus of analysis of both studies consisted of productions retrieved from the index databases / libraries LILACS, PUBMED and PsycINFO between the years 2008 and 2018. From the evidence retrieved (22 articles in Study 1 and 34 in Study 2) it should be noted that this is a predominantly international production, with a quantitative approach. It has been found that infertility affects the conjugal relationship, most often negatively. It is necessary to develop actions that aim at improving the marital and sexual quality of life of couples who are undergoing diagnosis and treatment for infertility. The other productions of this Dissertation are of an empirical nature. Study 3 aimed to investigate the meanings attributed to conjugality in the context of infertility after cervical cancer. Study 4 sought to investigate the meanings attributed to the design of parenting in the context of infertility after cervical cancer. Finally, Study 5 aimed to know the main sources of support and coping strategies developed by couples in which the wife has had treatment for cervical cancer. In these three studies, three cases were used, from interviews with two couples and one wife, totaling seven individual and couple interviews. The analytical corpus was interpreted from the Positive Psychology and the literature of the areas of oncology, conjugality and parenting. The impossibility of the consanguineous parental exercise reaffirmed and strengthened the conjugal space. Spouses were mentioned as important social support as well as family. The wives reported ambiguous feelings of guilt and gratitude for this social support. Social stigma has been cited as a source of suffering, which is related to the naturalization of parental social roles. The coping strategies employed were based on the re-signification of the meanings attributed to parenting and raised the search for alternatives, such as adoption, which did not materialize due to the prejudice generated in this type of affiliation. The most used coping strategies were: re-signification of the problem and religious / spiritual support. The religiosity / spirituality allowed the construction of meanings about the illness and the attribution of a sense of gratitude as a result of the generated learning. The recognition of these aspects can lead to the development of interventions aligned with the experiences of the couples and the consequent offer of a more adequate care. It is recommended the inclusion of conjugality and the design of parenting in the interventions with these patients and their spouses / partners, potentializing the construction of a significant source of support and care.