Cuidados paliativos entre discentes de fonoaudiologia e psicologia: diálogos sobre formação no âmbito da graduação

Abstract

The presence of other people near those who are in severe conditions of illness is permeated by the meanings produced towards this care. In the western contemporaneous society the professionalization of the function that becomes the one of caretaker is already consolidated as a health area professional who receives the preparation and the legitimacy to develop this work through an academic formation. In this sense, from the 60’s of the 20th century, an specific field of knowledge has begun to be constructed – the one of palliative care – understood as the follow-up undertaken by the health team along the whole therapeutic process in cases of severe health risks pathologies, focusing on the totality of physical, psychological, social and spiritual necessities of the patient and his/her family. The palliative assistance comprehends several areas of knowledge and practice, among them the Phonoaudiology and Psychology ones. Thus, this thesis defends the insertion of the specific basic assumptions about palliative care in the curricular formation of Phonoaudiology and Psychology graduation courses. And, from this intent, this research was also developed aiming to discuss the undergraduates’ perspective from these graduation courses about palliative care and its insertion in the scope of their academic formation. The research followed the qualitative guidelines and has adopted the Dialogic Discourse Analysis as the methodological approach. In order to gather this information, the procedures of semi-structured interviews and talking sessions were employed. The last ones consisted of deepen the discussions developed during the interviews. The participants, eight subjects, are undergraduates regularly enrolled in the courses of Phonoaudiology and Psychology in a public university in the State of Paraná, Southern region of Brazil, who had previously taken part in a study group aiming to discuss about palliative care offered by the university. The age of the subjects varied between twenty one and twenty five years old. The results obtained from the participants discourse were divided into two thematic axes entitled palliative care and formation and understanding about palliative care. In the first one the results showed that, from the undergraduates’ perspective, the insertion of specific knowledge about palliative care are not present or are just partially present in mandatory curricular activities of the courses. Anyway, the participants figure out that there is no systematization of contents or practices in the curricular formation which allow the fundamental knowledge about this area of activity. On the other hand, through their reports they reveal some participations in extra-curricular activities in which personal choices are implied, such as study groups, workshops and readings about the theme. Another aspect emerged through the participants’ discursive productions was the identification that the participation in extra-curricular activities about palliative care allowed new constructions of meanings related to previous personal experiences of severely ill relatives’ health care. In the second thematic axes, entitled understanding about palliative care, the participants discursive productions resulted in three different approaches for the question, which are: palliative care as a specific care on the end of human life, palliative care when there is nothing more to do, or when there is a lot more to do, and palliative care as an assistance to the patient and his/her family. The first one is focused in the comprehension that palliative care is restricted to the assistance to the patient just during the previous moments of death. The second perspective emerged from the participants’ discursive production is about the possibilities and limitations of health professionals’ procedures in the course of illness and care at life’s end. And, finally, the third one is that palliative care are careful practices not just in relation to the patient but also to his/her family members. Thus, it was possible to conclude that the participants know palliative care as well as some issues related to the context where this situation is inserted, markedly by means of their involvement in extra-curricular activities which have handled this thematic. However, in their perspectives, the formation to this health care modality is not being properly considered in graduation courses and, thus, do not allow the basic formation in its mandatory curriculum, the one which comprises all the undergraduates. So, it’s necessary to recognize and act in the sense that the formation related to palliative care must be present in the mandatory curriculum of Phonoaudiology and Psychology graduation courses covering the whole scope of undergraduates and arising, as well, the necessary debate among the professors towards the theoretical and practical aspects in order to develop this field of work.