PERFORMANCE OF THE INTENSIVIST PSYCHOLOGIST IN NEONATAL PALLIATIVE CARE: PROTOCOL DEVELOPMENT
Palliative care; Hospital Psychology; Intensive Care Units; Neonatology.
This dissertation is divided into two articles whose central axis is the acting of the intensive care psychologist in neonatal palliative care. In the approach to palliative care, its association with the terminal stage is frequent, especially when treating cancer patients or the elderly public. However, palliative care is applied at any period of the life cycle, from the diagnosis of pathologies incompatible with life and with little response to curative treatments, including in neonates. So, aimed to analyze the practice of psychologist in neonatal palliative care and elaborate a protocol that guides attention focused on promoting the practice of intensive care psychology, oriented to the Unified Health System (SUS). A qualitative methodology was used, with the design of Research of an Interventive Nature, of the Research & Development type. For the treatment of data obtained through individual semi-structured interviews, Content Analysis was used. Five hospital psychologists with experience in Neonatal Intensive Care Units participated in the sample. The places where the research was carried out are two public hospitals in a medium-sized municipality in the Northeast region, with 10 beds in each neonatal ICU linked to SUS. The first article analyzes and describes the acting of the hospital psychologist in palliative care in this context, obtaining three thematic categories from the data analysis: the challenges of approaching palliative care in the neonatal ICU; acting of psychology in palliative care with the multidisciplinary team; and, psychology interventions with the family and the baby in palliative care. It was observed that neonatal palliative care is rarely approached, often leading to its late adoption. The second text was composed by the protocol elaboration process based on the literature and collected interviews, suggesting the following strategies for action: evaluation of palliative care criteria; data on pregnancy and childbirth; information on diagnosis, treatment and prognosis; interaction with the team and bonding with the family; identification of the mother's emotional reactions; and the development of psychological interventions. It is concluded that analyzing the psychologist's practice in this field and proposing a protocol for action contributes to his doing, favors the humanization of care and allows greater visibility of neonatal palliative care in the SUS. We emphasize the importance of the instrument not being used in a technical way, as its power lies in offering possible ways for patients and family members to experience their pain with respect and dignity.