Orientación y asistencia espiritual a pacientes en quimioterapia: una reflexión a la luz de la Teoría de Jean Watson

Mendonça, Angelo Braga; Pereira, Eliane Ramos; Barreto, Bruna Maiara Ferreira; Silva, Rose Mary Costa Rosa Andrade

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REFLECTION • Esc. Anna Nery 22 (4) • 2018 • https://doi.org/10.1590/2177-9465-EAN-2018-0081 copiar

Orientación y asistencia espiritual a pacientes en quimioterapia: una reflexión a la luz de la Teoría de Jean Watson

Autoría SCIMAGO INSTITUTIONS RANKINGS

Resumen

Objetivo:

Reflexionar sobre la utilización de intervenciones espirituales y métodos de orientación psicológica, teológica y psicoterápica aplicables a la enfermería.

Método:

Artículo de reflexión teórica, identificando las aproximaciones y los distanciamientos de los métodos de orientación e intervenciones espirituales a la Teoría del Cuidado Humano, de Jean Watson.

Resultados:

El análisis crítico de los métodos de orientación psicológica, teológica y psicoterápica indica aproximaciones a la Teoría del Cuidado Humano, lo que promueve el perfeccionamiento de las intervenciones espirituales direccionadas a los pacientes en quimioterapia.

Conclusión:

A partir de la Teoría de Jean Watson emergió una orientación creativa, original y única en enfermería.

Implicaciones para la práctica:

La comprensión de los métodos de orientación e intervenciones espirituales constituyen importantes herramientas para la práctica de enfermería oncológica, y potencializan los recursos disponibles para integrar espiritualidad y salud.

Palabras clave:
Orientación; Espiritualidad; Neoplasias; Enfermería

Qualities/requirements for counseling	Methods and spiritual counseling interventions	Caritas Processes
Empathy; spiritual self-care; compassion		Formation of a system of altruistic-humanistic values: practice of love/kindness, equity for oneself and for the other.
- need to recognize the impact of cultural and religious differences between therapist and client on counseling¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... 14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^-¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... - multicultural competences¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... - authenticity¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr...	- reading of biblical and/or religious texts¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... 14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^-¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... - prayer¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... ^,¹⁷17 Sharma V, Marin DB, Sosunov E, Ozbay F, Goldstein R, Handzo GF. The Differential Effects of Chaplain Interventions on Patient Satisfaction. J Health Care Chaplain [Internet]. 2016; [cited 2018 Mar 1]; 22(3):85-101. Available from: http://dx.doi.org/10.1080/08854726.2015.1133203 http://dx.doi.org/10.1080/08854726.2015.... 18 Brown O, Elkonin D, Naicker S. The use of religion and spirituality in psychotherapy: enablers and barriers. J Relig Health [Internet]. 2013 Dec; 52(4):1131-46. Available from: https://www.ncbi.nlm.nih.gov/pubmed/?term=The+Use+of+Religion+and+Spirituality+in+Psychotherapy%3A+Enablers+and+Barriers.+J+Relig+Health.+2013%3B52(4)%3A1131-46 https://www.ncbi.nlm.nih.gov/pubmed/?ter... ^-¹⁹19 Memaryan N, Ghaempanah Z, Saeedi MM, Aryankhesal A, Ansarinejad N, Seddigh R. Content of Spiritual Counselling for Cancer Patients Undergoing Chemotherapy in Iran: A Qualitative Content Analysis. Asian Pac J Cancer Prev [Internet]. 2017 Jul; [cited 2018 Mar 1]; 18(7):1791-7. Available from: http://www.ncbi.nlm.nih.gov/pubmed/28749107 http://www.ncbi.nlm.nih.gov/pubmed/28749... - application of elements of ethno-psychological advice¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr... - application of elements of multicultural counseling¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... - therapy of hope²⁰20 Thornton LM, Cheavens JS, Heitzmann CA, Dorfman CS, Wu SM, Andersen BL. Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence. J Consult Clin Psychol [Internet]. 2014 Dec; [cited 2018 Mar 3]; 82(6):1087-100. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/a0036959 http://doi.apa.org/getdoi.cfm?doi=10.103...	Instillation of faith and hope: to be authentically present; enable, sustain and deeply honor the belief system of self and other.
- active clinical listening - practical experience and training - awareness of one's limitations	- centralization techniques to establish spiritual connections with counseling¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/...	Cultivation of the sensibility of self and of the other: cultivation of one's own spiritual practice and a transpersonal "Self" that goes beyond one's own ego.
- congruence¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr...	- strategic counseling²¹21 Manjón González J. La Autoayuda y el Consejo como Procedimientos Psicoterapéuticos. Rev Asoc Esp Neuropsiq [Internet]. 2014 Apr/Jun;34(122):283-300. Available from: http://dx.doi.org/10.4321/S0211-57352014000200004 http://dx.doi.org/10.4321/S0211-57352014... - non-directive procedures²¹12 Watson J. Watson's theory of human caring and subjective living experiences: carative factors/caritas processes as a disciplinary guide to the professional nursing practice. Texto Context Enferm [Internet]. 2007 Jan/Mar; [cited 2018 Mar 1]; 16(1):129-35. Available from: http://dx.doi.org/10.1590/S0104-07072007000100016 http://dx.doi.org/10.1590/S0104-07072007...	Development of a relationship of help and confidence: development and permanence of an authentic relationship of care.
	- meditation¹⁵15 Miller AJ. The Spiral Staircase: A Narrative Approach to Pastoral Conversation. J Pastor Care Couns [Internet]. 2016 Dec; [cited 2018 Mar 03]; 70(1):26-33. Available from: http://journals.sagepub.com/doi/10.1177/1542305015619884 http://journals.sagepub.com/doi/10.1177/... ^,¹⁷17 Sharma V, Marin DB, Sosunov E, Ozbay F, Goldstein R, Handzo GF. The Differential Effects of Chaplain Interventions on Patient Satisfaction. J Health Care Chaplain [Internet]. 2016; [cited 2018 Mar 1]; 22(3):85-101. Available from: http://dx.doi.org/10.1080/08854726.2015.1133203 http://dx.doi.org/10.1080/08854726.2015.... - mindfulness²⁰20 Thornton LM, Cheavens JS, Heitzmann CA, Dorfman CS, Wu SM, Andersen BL. Test of mindfulness and hope components in a psychological intervention for women with cancer recurrence. J Consult Clin Psychol [Internet]. 2014 Dec; [cited 2018 Mar 3]; 82(6):1087-100. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/a0036959 http://doi.apa.org/getdoi.cfm?doi=10.103... - use of transference and countertransference as therapeutic elements in counseling²²22 Jang JE. The Interactive Play and a Persuasive God: A Psychoanalytic Approach to Re-envisioning Pastoral Care and Counseling. J Pastor Care Couns [Internet]. 2016; [cited 2018 Mar 3]; 70(2):136-42. Available from: http://dx.doi.org/10.1177/1542305016643057 http://dx.doi.org/10.1177/15423050166430...	Promoting acceptance of negative and positive feelings: being present to support the manifestation of positive and negative feelings as a means of deep connection with yourself and with individuals for care.
- know cultures and religious practices¹³13 Scorsolini-Comin F. Elementos do aconselhamento multicultural aplicados à psicoterapia em contexto etnopsicológico. Estud Pesqui Psicol [Internet]. 2015; [cited 2018 Mar 10]; 15(2):587-607. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1808-42812015000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^,¹⁴14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^,¹⁶16 Scorsolini-Comin F. Plantão Psicológico centrado na pessoa: intervenção etnopsicológica em terreiro de umbanda. Temas Psicol [Internet]. 2014;22(4):885-99. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_arttext&pid=S1413-389X2014000400016 http://pepsic.bvsalud.org/scielo.php?scr...		Systematic use of the scientific method of problem solving for decision making: use of the Self and all other knowledge recognized as part of the process of caring for engagement in a health recovery process through art.
- specialization in mental health - masters in the area of spiritual care		Promoting an interpersonal teaching-learning process: engage truly in teaching-learning experiences within the context of caring; assist another person fully and in the subjective sense of experience.
		Provision of a supportive, protective and/or corrective mental, physical, sociocultural and spiritual environment: creation of a healthy environment at all levels, both physical and non-physical, conscientious and energetically refined, whereby totality, beauty, comfort, dignity and peace are strengthened.
		Assistance from the gratification of human needs: with reverence and respect, meet basic human needs; maintain the consciential intentionality of care by touching and dealing with the embodied spirit of the other, honoring the connection of the being; allow spiritual connection.
	- application of strategies proposed by Gestalt-Therapy¹⁴14 Campos AF, Ribeiro JP. Psicoterapia e espiritualidade: da gestalt-terapia à pesquisa contemporânea. Rev abordagem gestalt [Internet]. 2017;23(2):211-8. Available from: http://pepsic.bvsalud.org/scielo.php?script=sci_abstract&pid=S1809-68672017000200009 http://pepsic.bvsalud.org/scielo.php?scr... ^,²³23 Henning-Geronasso MC, More CLOO. Influência da Religiosidade/Espiritualidade no Contexto Psicoterapêutico. Psicol Cienc Prof [Internet]. 2015;35(3):711-25. Available from: http://www.scielo.br/scielo.php?pid=S1414-98932015000300711&script=sci_abstract&tlng=pt http://www.scielo.br/scielo.php?pid=S141...	Recognition of existential phenomenological forces: openness and attention to the spiritual, mysterious, unknown and existential dimension inherent in life, death and suffering.

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[1] Corresponding author: Angelo Braga Mendonça. E-mail: angeloprimax@gmail.com