Idoso com insuficiência cardíaca: significados atribuídos à sua condição de adoecimento e ao tratamento

Abstract

Over the past two years following some shifts in the morbidity and mortality profile of the elderly population, cardiovascular disease is currently the leading cause of death in Brazil. There are a number of studies focusing heart failure among the elderly specifically in the biological area, but there seems to be a lack of research approaching the subject from the perspective of the elderly patient himself/herself. Thus our purpose is to investigate the meanings of being a patient with heart failure considering the older population. This is a study using the clinical-qualitative methodology among elderly people aged over 60 suffering from heart failure assisted in two hospitals. Non-directive interviews, participant observation and the method of content analysis were used to collect data and analyze them. As a theoretical framework the studies carried out by Perestrello as well as Mello Filho psychosomatics approach were used. Eleven elderly participants joined the research. Following the analysis, two categories have emerged: "The Meaning of being a heart failure patient", with some subcategories: 1. The sense of our impeding death and the fear of dying. 2. From experiences of helplessness to family support. 3. Emotional Aspects arising before the surgery and the need for Communication; and the second category: "Treatment provided by the health team to the hospitalized patient" with the subcategory: 1. Treatment for hospitalized elderly: care with humanization, multidisciplinary teamwork and communication. As a result, it was observed that due to the fact that they are ill and facing the need to undergo a cardiovascular surgery some emotions came to the surface creating conditions of physical and mental limitation which may be the cause of sadness, fear of death and anguish of the unknown. We could note that when communication does not happen properly or clearly, the understanding process becomes more difficult for the patient, causing fear, anxiety and even a wish to abandon treatment. The patients’ experience about how they were treated during the hospitalization period involves respect, caring and affection delivered by nursing technicians, registered nurse, physician, cleaning and catering service employees. They spent time with professionals who maintained a positive attitude, providing attention, talking to them and demonstrating politeness during the interaction. As an interesting finding we may remark that they express deep concern not about being physically disabled because of the disease or advanced age, but rather due to the fact that if they die they will no longer be among their families which constitutes a backward sense of loss. Besides they demonstrate an underlying need to get more affection from family members and fell mentally renewed, ready to reach goals in life. We conclude therefore that communication with the patient should be improved by means of teaching techniques that enable professionals to keep a more effective communication channel open with regard to the understanding of illness and treatment in elderly heart failure patients. It becomes relevant to make patients feel cared, as it was mentioned by them approaching the health team, and prepare the nursing team to provide humanized care allowing multiprofessional teamwork to be increasingly feasible.