Terapia da dignidade no cuidado á pessoa com esclerose lateral amiotrófica: estudo de caso

Abstract

The existential, psychosocial, and physical suffering experienced by the person with Amyotrophic Lateral Sclerosis stems from the emotional burden generated by hopelessness and helplessness, resulting from the rapid evolution on the disease, leading to total functional dependence. When faced with the fragility of dignity, Dignity Therapy emerges as an intervention capable of reaffirming the dignity of people in the process of dying. The aim to the study was to understand the effects of Dignity Therapy on the physical, existential, and psychosocial symptoms of people with Amyotrophic Lateral Sclerosis. This is a case study, exploratory and descriptive, with a mixed approach, using the concomitant triangulation strategy, in which multiple cases were used from the application of Dignity Therapy in people with Amyotrophic Lateral Sclerosis. Three participants were selected, over 18 years old, two male and one female, after applying inclusion criteria. Qualitative and quantitative data were collected simultaneously and independently. For the qualitative collection, a semi-structured interview instrument was used, contemplating social data and three evaluative questions about the therapy, in addition to the intervention with Dignity Therapy. Quantitative data were collected at three moments called moment zero, moment one and moment two corresponding to intervals of 0, 7 and 28 days based on the application of the intervention – Dignity Therapy, when the following scales were applied: Dignity Inventory of the Patient, Hospital Anxiety and Depression Scale, Spiritual Well-Being Scale, and the Edmonton Symptom Scale. The project was evaluated and approved by the Ethics and Research Committee of the School of Nursing of the Federal University of Bahia, receiving approval number 4.952.826. The results were presented from the description of the three case studies considering the description of each one of them and the three moments of application of the scales highlighting the particularities related the physical, social, emotional, spiritual, and existential dimensions based on the intervention – Dignity Therapy. The comparative analysis of the scales that aimed to understand the effects of Dignity Therapy indicated how favourable the intervention was for the participants of the case studies and how the intervention can contribute to the rescue of dignity in people in the process of finitude, being viable its application in diverse environments. It is hoped that further studies can be carried out and the therapy introduced in palliative care services in Brazil.