Protocolo P-A-C-I-E-N-T-E e a comunicação de más notícias por enfermeiros em Onco-Hematologia

Abstract

Cancer is a public health problem, requiring multidisciplinary and sensitive care. Communicating bad news can adversely affect the patient's outlook, and nurses play a vital role in providing emotional support and assistance to patients and their families. Therefore, nurses, known as pillars in care, often reiterate and consolidate what has already been said by physicians to their clients and family members, playing a fundamental role in emotional support in the face of the impacts of this experience. From this perspective, the P-A-C-I-E-N-T-E Protocol manifests itself as a tool capable of helping health professionals so that difficult communication is considered effective and efficient when received by patients. The objective of this study was to verify the knowledge of nurses in an Onco-Hematology service of a hospital in the interior of Minas Gerais about the communication of bad news through the P-A-C-I-E-N-T-E Protocol. This is a descriptive observational study with a qualitative approach. Nurses participated in the study, regardless of gender or age, who had been working in the Onco-Hematology sector of a hospital in the interior of Minas Gerais for at least three months. For data collection, a semi-structured interview script was used, containing identification data about the participants, followed by guiding questions on the theme. After the interviews, the researchers used a tool called a field diary so that they could record their perceptions, meanings and emotions of the events perceived and felt during this stage. The interviews obtained through recording were listened to, transcribed in full through a voice typing resource of Google Docs®, and later analyzed according to the Content Analysis technique proposed by Bardin and the aid of the ATLAS.ti software, emerging two categories, the first being entitled "Therapeutic communication", with the subcategories "Understanding of communication of bad news", "Communication with a focus on humanization" and "Respect for the patient's autonomy" and the second called "Professional preparation and its subjectivities" and the subcategories "Difficulty of the professional to communicate bad news" and "Emotions evoked in professionals during the process of communicating bad news". From the results found in this research, it is possible to infer that the nurses were unaware of the existence of the P-A-C-I-E-N-T-E Protocol and its purposes, but they used resources from their own repertoire in an attempt to promote relief, comfort and information in a way that was oriented and personalized to the patient's desires and needs, as well as the subjectivity and individuality of each professional can impact their communicative capacity and their relationships nurses-patient.