Vivência da espiritualidade no processo de adoecimento do paciente oncológico, sob a ótica da teoria da incerteza na doença de Merle Mishel

Abstract

Spiritual care is considered an essential part of the overall treatment designed to improve the quality of life of cancer patients and their families. Spiritual suffering is very present and ignorance about the disease and all that it means causes great uncertainty. Guided by this statement, this study aims at spirituality in the process of uncertainty in cancer patients' disease. Its objective was to analyze spirituality in the process of disease uncertainty in cancer patients, with the guiding question: How is spirituality configured in the process of disease uncertainty in cancer patients, according to the Nursing Theory of Merle Mishel? This is a qualitative research, in which Merle Mishel's Theory of Uncertainty in Disease was used as a theoretical framework, and Bardin's stages of content analysis were used as a methodological framework. As a technique for obtaining information, a semi-structured interview was used, consisting of three parts: the first, with sociodemographic data; the second, to obtain a spiritual history, using the CSI-MEMO instrument, and the third, which measured the uncertainty in the illness, using the adapted Merle Mishel's scale of uncertainty in the illness. Eleven patients undergoing treatment at the High Complexity Care Center in Oncology of the Professor Alberto Antunes University Hospital took part in the study, ten females and one male, with various types of cancer and some cases of metastasis. Through their speeches, it was possible to identify five categories: 1) Religious/spiritual beliefs as sources of comfort in the uncertainty of illness; 2) Religious/spiritual beliefs and how they influence decisions; 3) Spiritual/religious beliefs as strategies for coping with cancer; 4) Sources of support during walking and 5) Expectation around healing. The answer to the research question showed that spirituality in the face of uncertainty in the disease varies from patient to patient, acting in a unique way in each one. That is, they showed attitudes of readaptation in their reports, and the presence of spirituality in their lives acted as the main force mechanism to deal with the uncertainty in the disease, and this moment was called by Mishel as probabilistic thinking: the patient can live and to deal with your uncertainties in the perspective you receive and have the result of healing or quieting your suffering.