O cuidado de enfermagem à pessoa em tratamento quimioterápico: narrativas de vida

Abstract

People with cancer and their families are vulnerable to health grievances, resulting in difficulties and suffering throughout the process, from the discovery of the diagnosis to treatment, which refers to the need for attention, health promotion and follow-up throughout the entire process. From this perspective the following guiding questions emerged: What is the understanding of the patient with lung cancer, in chemotherapy treatment about their process of falling ill and being cared for? How do patients with lung cancer undergoing chemotherapy cope with their illness? To that end, the objectives are: To identify, in the life narratives of patients with lung cancer in chemotherapy, their understanding about health promotion and the process of illness and care; to discuss the coping actions of these patients and their adjustment to the new life condition. A qualitative, descriptive study, guided by the narrative of life research method, conducted at an oncology clinic in Rio de Janeiro, from February to June 2017, with 20 lung cancer patients undergoing chemotherapy. The data production technique was the interview, recorded in an MP4 device and transcribed in full. After interviews were transcribed and data organized, the analytical process employed was the thematic analysis giving rise to two categories: the stages of the illness and the nursing care; and coping with the illness and the adjustments to the new life condition. From the life narratives, it was possible to identify that the ways in which they understand the process of illness and care are directly related to the discovery of the disease, the signs and symptoms, such as cough, fatigue, including the exams and the therapy performed. In the context of coping , various feelings and reactions such as stress, depression, despondency, discouragement, anger, anxiety, irritability were identified. But religiosity, faith, family support, and the will to continue living were highlighted as aspects of protection. In addition, it can be seen in the narratives that the protective factors contributed in an essential way creating alternatives and instruments of adjustment capable of offering the chemotherapy lung cancer patient better living conditions, such as maintaining their work, cultural and social activities. This is done through actions of health promotion directed to an evaluation of the psychological factors, including patient self-esteem and self-motivation, thus contributing to the prediction of the health behavior that one wants to achieve. It is concluded that the life narrative method was able to raise individual characteristics, lived experiences and specific behaviors from the perspective of the patient, highlighting the health promoting actions, which were implemented through the nursing consultation since the onset of chemotherapy and throughout the treatment process in a potential and favorable way so that no predicted intercurrences occurred. Thus, understanding how this process is conceived by the subjects through life narratives which warrants attention and deserves greater study.