Primeira hospitalização em uma unidade de onco-hematologia: vivências de pacientes no processo de transição

Abstract

The person who is affected by cancer experiences a transition. The transition experience is a period of instability, where the diagnosis of cancer drastically changes the routine of people who will have to readapt their emotional, physical and social lives. When considering the dimension of hematological neoplasms, mainly due to sudden diagnosis and the need for immediate treatment, and the imbalance in people's lives since the discovery of the diagnosis, hospitalization and beginning of treatment, it is necessary to reveal this very particular process, not only because of the human, as well as for the construction and improvement of the nursing care to be dedicated. It was decided to carry out this research based on the following guiding question: How does the transition process take place in people affected by onco-hematological disease in the first hospitalization in a specialized unit? Objective: To understand the transition process experienced by onco-hematological patients during their first hospitalization, based on Afaf Meleis' Theory of Transitions. Method: This is a qualitative, exploratory research, carried out in a public teaching hospital in Salvador - Bahia, Brazil, with eight people with onco-hematological illness, in their first hospitalization, between July 2021 and March 2022. Data were collected by through in-depth interviews, submitted to lexical analysis by the IRAMUTEQ® software, through the Descending Hierarchical Classification - CHD, and interpreted in the light of the Theory of Transitions. In this study, the meaning of living in Nietzsche's philosophy is understood. The research complied with ethical principles, having been approved by the Research Ethics Committee of the Hospital Universitário Professor Edgard Santos (CAAE: 44705321.5.0000.0049), and all participants signed an informed consent form. Results: Three thematic categories were identified: 1) Awakening to Transition (Life before hospitalization, The family as a facilitator of transition, Change in routine with illness); 2) The process for diagnosis and hospitalization (The therapeutic itinerary; Religion/religiosity as a support for coping; The moment of diagnosis and the consequences; Hospitalization and the health/disease process); 3) Events and critical points (The adaptation strategies; The use of devices and the beginning of chemotherapy; Anxieties and fears with the illness and the first hospitalization; The relationship with health professionals; The relationship with the family during hospitalization). Conclusion: From the narratives and based on the Theory of Afaf Meleis, it was possible to understand the difference between transitions for patients, as well as moving, changes, events and critical points are determinant in transitions, as well as personal, community and social conditions that act as facilitators or inhibitors of transitions.