Submitted by Filipe dos Santos (fsantos@pucsp.br) on 2018-07-30T12:24:03Z No. of bitstreams: 1 Isabel Cristina Bueno Palumbo.pdf: 2591502 bytes, checksum: b3e0518b87654e1f3ee7324ff00b14d4 (MD5) / Made available in DSpace on 2018-07-30T12:24:03Z (GMT). No. of bitstreams: 1 Isabel Cristina Bueno Palumbo.pdf: 2591502 bytes, checksum: b3e0518b87654e1f3ee7324ff00b14d4 (MD5) Previous issue date: 2018-05-29 / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES / Fundação São Paulo - FUNDASP / This thesis aimed to analyze the meaning of religion for patients in palliative care and for their relatives. We start from the hypothesis that the approximation of religion and the development of religiosity and spirituality are fundamental to reduce the anguish provoked by the proximity of death among patients in palliative care and among their loved ones. It is an exploratory research of qualitative approach and historical method. To obtain the data, we conducted 11 interviews, 8 with patients and 3 with relatives of patients. The interviews were based on a semi-structured script with questions about the life history, religious experience and religion’s approach after the diagnosis of inability to cure. The interviews were realized at the Premier Hospital, on January 04th, 06th, 09th, 2017, and January 08th, 10th, 11th, 12th, 15th, 17th, 2018. During the month of December 2016, we visited the hospital every day to know the local routine and the hospitalized patients. For the construction of the script of questions and for the analysis of the data obtained from the interviews and the fieldwork, we adopted the historical method elaborated by Franz Boas (2004) and the hermeneutic analysis developed by Gadamer (1997). We also searched the history of the main concepts that guided our study. After analyzing and discussing the data of this research, we confirmed our hypothesis: we found that the majority of respondents came closer to religion after they were known to have incurable diseases / Esta tese teve como objetivo analisar o significado da religião para os pacientes em cuidados paliativos e para seus familiares. Parti da hipótese de que a aproximação da religião e o desenvolvimento da religiosidade e da espiritualidade são fundamentais para diminuir a angústia suscitada pela proximidade da morte entre os pacientes em cuidados paliativos e seus entes queridos. Trata-se de uma pesquisa exploratória de abordagem qualitativa e método histórico. Para a obtenção dos dados, realizei 11 entrevistas, 8 com pacientes e 3 com familiares de pacientes. As entrevistas tiveram como base um roteiro semiestruturado com questões que versavam sobre a história de vida, vivência religiosa e aproximação da religião depois do diagnóstico de impossibilidade de cura, e foram realizadas no Hospital Premier, nos dias 04, 06 e 09 de janeiro de 2017, e 08, 10, 11, 12, 15 e 17 de janeiro de 2018. Durante o mês de dezembro de 2016, visitei diariamente o hospital para conhecer a rotina local e os pacientes internados. Para a construção do roteiro de questões e para a análise dos dados obtidos com as entrevistas e o trabalho de campo, adotei o método histórico elaborado por Franz Boas (2004) e a análise hermenêutica desenvolvida por Gadamer (1997). Pesquisei também a história dos principais conceitos que orientavam nosso estudo. Depois de realizar a análise e a discussão dos dados desta pesquisa, confirmei minha hipótese, ao constatar que a maior parte dos entrevistados aproximou-se mais da religião depois de saber ser portador de doença incurável

The marginalisation of palliative and pastoral care practices by conventional approaches to care for terminally ill patients, motivated the research curiosity. The significance of terminal patient's spirituality, their language practices and communities of concern are endorsed as being the major contributing factor to meaningful 'living' with terminal illness. Listening to stories has been the qualitative research practice, revealing meaning-making, quest stories. Feminist theology and post-modern ideas and discourses have assisted me, and the participants, in the deconstruction of power, patriarchy and dualism as the primary contributing factors to marginalisation of people due to illness, race, gender, poverty, culture and education. Pastoral care practices and feminist theology have guided us to emphasise the necessity to recognise the God of Grace as an important part to ensuring holistic patient care. Recognising the 'God-Self, respectful narrative and pastoral care practices paved the way to honour sacred spaces and voice stories of terminal illness. / Practical Theology / M.Th (Specialisation Pastoral Therapy)

The marginalisation of palliative and pastoral care practices by conventional approaches to care for terminally ill patients, motivated the research curiosity. The significance of terminal patient's spirituality, their language practices and communities of concern are endorsed as being the major contributing factor to meaningful 'living' with terminal illness. Listening to stories has been the qualitative research practice, revealing meaning-making, quest stories. Feminist theology and post-modern ideas and discourses have assisted me, and the participants, in the deconstruction of power, patriarchy and dualism as the primary contributing factors to marginalisation of people due to illness, race, gender, poverty, culture and education. Pastoral care practices and feminist theology have guided us to emphasise the necessity to recognise the God of Grace as an important part to ensuring holistic patient care. Recognising the 'God-Self, respectful narrative and pastoral care practices paved the way to honour sacred spaces and voice stories of terminal illness. / Philosophy, Practical and Systematic Theology / M.Th (Specialisation Pastoral Therapy)

Text in German, with German, English and Southern Sotho summaries / Includes bibliographical references (leaves 149-153) / Die praktisch-theologische Studie untersucht spirituelle Bedürfnisse von ambulanten Palliativpatienten. Dazu wurden Fokusgruppendiskussionen mit Teams aus der ambulanten Palliativversorgung in Nordhessen durchgeführt und diese nach ihren Erfahrungen und Beobachtungen gefragt. Theoretische Grundlagen zur Spiritualität im Kontext der Palliativversorgung bilden den Rahmen zur Auswertung der empirischen Masterarbeit mittels qualitativer Inhaltsanalyse. Der Befund zeigt, dass das Erkennen von spirituellen Bedürfnissen bei Patienten die Teammitglieder mehrheitlich vor Herausforderungen stellt und multiple Verunsicherung sowie Probleme im Umgang bestehen. Außerdem prägen persönliche Überzeugungen ihre Wahrnehmung maßgeblich. Die beobachtete Spiritualität ist überwiegend kirchlich geprägt und beruht auf christlichen Elementen wie Gebete, Glauben oder Begleitung durch PfarrerInnen. Teammitglieder sprechen zudem Begegnungen, „Dasein“ und (Kirchen)Musik eine spirituelle Dimension zu. Es gibt auch Patienten, die keine spirituellen Bedürfnisse haben oder derartiges ablehnen. Die Praktische Theologie könnte zukünftig als bedürfnisorientierte Kompetenzgeberin dienen, damit Mitarbeitende aus dem Gesundheitssystem befähigt werden, spirituelle Bedürfnisse ihrer Patienten wahrzunehmen, zu reflektieren und ihnen angemessen zu begegnen. / This practical theological study examined the spiritual needs of outpatient palliative care patients. Focus group discussions were conducted with outpatient palliative care teams. They were asked about their experiences and observations. Theoretical foundations of spirituality and palliative care formed the framework for the evaluation of empirical research by using qualitative content analysis. Findings show that recognition of spiritual needs in patients poses a challenge to the majority of team members, as well as insecurities and problems in dealing with them. The observed spirituality is predominantly ecclesiastical and based on Christian elements such as prayers, faith and accompaniment by pastors. Team members address encounters, "being" and music as spiritual dimensions. There are also patients who have no spiritual needs. In future, practical theology could serve as a needs-based provision of competences, so that employees of health systems can be empowered to perceive, reflect on and adequately respond to the spiritual needs of their patients. / Boithuto jwa thutobomodimo bo tlhatlhobile ditlhokwa tsa semoya tsa balwetse ba tlhokomelo ya malwetse a bofelelo ya kalafo ya balwetse ba kwa ntle. Dipuisano tsa setlhopha tsa tsepamo di ne tsa dirwa ka ditlhopha tsa tlhokomelo ya malwetse a bofelelo a kalafo ya balwetse ba kwa ntle. Ba ne ba bodiwa ka maitemogelo le ditemogo tsa bona. Metheo ya thutobomodimo le tlhokomelo ya malwetse a bofelelo di bopile letlhomeso la tlhotlhwafatso ya patlisiso ya mmatota ka go dirisa tshetshereganyo ya diteng tsa boleng. Dipatlisiso di bontsha fa kamogelo ya ditlhokwa tsa semoya mo balwetseng e tlisa kgwetlho mo bontsing jwa ditokololo tsa setlhopha, ga mmogo le go sa itshepeng go gontsi le mathata a go samagama le tsona. Bosemoya jo bo bonwang bontsi ke jwa sekeresete, mme bo ikaegile ka dielemente tsa Bokeresete jaaka dithapelo, tumelo le tshwaragano le baruti. Ditokololo tsa setlhopha di bua ka ga dikgolagano, "go nna" le mmino jaaka ditekanyo tsa semoya. Gape go na le balwetse ba ba se nang ditlhokwa tsa semoya. / Philosophy, Practical and Systematic Theology / M. Th. (Practical Theology)