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圣保罗市艾滋病流行期间感染病医生面对患者死亡的经历:定性研究

The experience of infectologists faced with death and dying among their patients over the course of the AIDS epidemic in the city of São Paulo: qualitative study.

作者信息

Shimma Emi, Nogueira-Martins Maria Cezira Fantini, Nogueira-Martins Luiz Antonio

机构信息

Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil.

出版信息

Sao Paulo Med J. 2010;128(2):74-80. doi: 10.1590/s1516-31802010000200006.

Abstract

CONTEXT AND OBJECTIVE

With the emergence of the acquired immunodeficiency syndrome (AIDS) in 1981, infectologists' care practices went through great changes. The objective of this study was to describe and analyze the experiences of infectologists in dealing with death and dying among their patients, over the course of the AIDS epidemic in the city of São Paulo.

DESIGN AND SETTING

A qualitative approach was used. Twenty infectologists from five hospitals that treat human immunodeficiency virus (HIV)/AIDS patients in the municipality of São Paulo were interviewed.

METHODS

The sample was formed through the snowball process. The sample size was determined using the saturation criterion. To analyze the material obtained from the interviews, the procedure of thematic analysis was used. This consisted of finding the core meaning relating to the study objective, within the set of materials obtained.

RESULTS

Analysis of the material obtained from the interviews led to three main themes: 1. The initial context of AIDS and its impact on infectologists; 2. Modifications to the infectologists' attachments to patients after the introduction of highly active antiretroviral therapy (HAART); 3. Coping with death and dying.

CONCLUSIONS

This study shows the importance of considering the distress, emotional overload and adaptive mechanisms relating to death and dying among patients, both in training and in professional practice.

摘要

背景与目的

随着1981年获得性免疫缺陷综合征(艾滋病)的出现,传染病专家的护理实践发生了巨大变化。本研究的目的是描述和分析在圣保罗市艾滋病流行期间,传染病专家在处理患者死亡问题上的经历。

设计与背景

采用定性研究方法。对圣保罗市五家治疗人类免疫缺陷病毒(HIV)/艾滋病患者的医院的20位传染病专家进行了访谈。

方法

通过滚雪球法选取样本。根据饱和标准确定样本量。为分析访谈所得资料,采用了主题分析法。该方法包括在所得资料集中找出与研究目的相关的核心意义。

结果

对访谈所得资料的分析得出三个主要主题:1. 艾滋病的初始背景及其对传染病专家的影响;2. 高效抗逆转录病毒治疗(HAART)引入后传染病专家与患者情感联系的变化;3. 应对死亡。

结论

本研究表明,在培训和专业实践中,考虑患者与死亡相关的痛苦、情感负担及适应机制具有重要意义。

相似文献

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[The social geography of AIDS in Brazil].[巴西艾滋病的社会地理学]
Rev Saude Publica. 1995 Feb;29(1):52-62. doi: 10.1590/s0034-89101995000100009.
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Death anxiety, coping resources, and comfort with dying patients among nurses in AIDS care facilities.
Psychol Rep. 1998 Dec;83(3 Pt 1):1051-7. doi: 10.2466/pr0.1998.83.3.1051.

本文引用的文献

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The inner life of physicians and care of the seriously ill.医生的内心世界与重症护理
JAMA. 2001 Dec 19;286(23):3007-14. doi: 10.1001/jama.286.23.3007.

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