Qualidade de vida e histórias sobre o processo de morrer e o processo de luto de pessoas idosas

Abstract

Introduction: The process of dying and the grieving process compose a kaleidoscope of meanings, rites, beliefs and, although they are accompanied by taboos and prejudices, dialogue on these themes is essential, as it integrates human relations throughout the life cycle, influences the quality of life of the people involved, and contributes to the construction of meanings about what is experienced. This thesis is composed of a collection of two studies presented in the form of scientific articles. Objective: Article 1 aimed to analyze the impact of the grieving process on the quality of life of adults and the elderly and article 2 sought to analyze the meanings that death assumes, from the perspective of elderly people. Method: article 1 was organized according to a systematic review of the literature, which included studies that evaluated the quality of life of adults and elderly people exposed to bereavement, before death and after the death of loved ones, through validated instruments. The study protocol was registered in PROSPERO (International Prospective Register of Systematic Review - Centre for Reviews and Dissemination University of York) under the number CRD42022324120, using the following databases: EMBASE, Latin American, Caribbean Health Sciences Literature (LILACS), LIVIVO, PubMed/MEDLINE, PsycINFO, Scopus and Web of Science, the additional literature search included: Google Scholar, ProQuest, Medrxiv. Article 2 isdesigned from a qualitative approach, organized according to Dialogical Discourse Analysis (DDA) and based on the philosophy of the Bakhtin Circle. The inclusion criteria allowed the participation of subjects aged 76 years or older, living in the city of Curitiba, who agreed to participate in the study and presented possibilities to establish dialogues with the researchers, through smartphone or computer, with access to a link for virtual meeting, previously scheduled. Data collection took place between the months of June and August 2021 and took place through dialogical practices that were recorded for later transcription and analysis. Results: In article 1, the databases retrieved 2299 references. After the removal of the repeated studies, 1474 studies remained. After the execution of the first phase, 1463 references were removed, which were not in accordance with the inclusion criteria, leaving 9 studies for the second phase. In phase 2, the articles were read, showing that the grieving process significantly impacts the quality of life before and, above all, one year after death, especially in the mental domain. Article 2 demonstrated that the meanings about death, for the research participants, are ambiguous and equipolent, evidencing death as: something inexplicable that is part of life, a shock, a punishment, rupture, end, invitation to eternal life, learning, joy and relief. Final considerations: the two studies converge in that they seek to analyze plural and also singular views of the dying process and the mourning process. The analysis of the plurality of the experience of the grieving process, evaluating the impact of grief on the quality of life of the bereaved, can contribute to the structuring of public policies and social support networks aimed at people who go through this process, in general. On the other hand, the singular analysis of the individual meanings for this process calls for dialogue with the other and with all their ambivalences that are sometimes rejected by society, which seeks the normalization of the grieving process, which can negatively impact on people's quality of life.