Comunicação de más notícias no campo da saúde: revisão integrativa e pesquisa clínico-qualitativa com psicólogos hospitalares

Abstract

This dissertation consists of two complementary studies on the communication of bad news in the context of health care. Study 1 aimed, through an integrative literature review, to map and analyze the national scientific production on the subject. References were located through consultations in the SciELO-Brasil and PEPsic databases. The bibliographic sample consisted of 20 references. In terms of the dimensions of analysis considered, there was a predominance of empirical research, with a qualitative approach, whose objectives – directly or indirectly – refer to protocols for communicating bad news and which were developed with physicians and/or medical students. Furthermore, the findings reported by the references reinforce that the communication of bad news often causes psychological distress both in patients and their families and in health professionals. Study 2, on the other hand, aimed to understand the meanings attributed to the communication of bad news by hospital psychologists. This is a clinical-qualitative study, in which 17 hospital psychologists who worked in sectors dedicated to urgent and emergency care took part. The instrument used was the semi-structured interview and the definition of the number of participants was based on the saturation criterion. Data collection was audio-recorded, and the corpus was composed of the transcription of the material and then submitted to content analysis. Three categories were set up, entitled “The the plate's spinner”, “just between us” and “Second aid”. The first category aggregates representative reports of the meanings attributed by the participants to the difficulties that, for them, characterize situations of communication of bad news. The second category encompasses the participants' point of view regarding the role that would be played by hospital psychologists in solving the expectations and needs of each one involved in communicating bad news. The third category gathers reports related to the meanings attributed by the participants to the role of hospital psychologists in communicating bad news based on the identification of a “before” and an “after” regarding these situations.