Alzheimer’s disease is a debilitating illness that is the 6th leading cause of death among the elderly. The treatment of Alzheimer’s requires multiple interventions due to the complexity of the disease. The interdisciplinary group (IDG) model of care is considered a best practice for patients’ medical management (Molyneux, 2001). The IDG focuses on a holistic approach, which includes both patients and their caregivers. The IDG in hospice consists of professionals from different clinical disciplines whose collaborative knowledge and skills assist in caring for patients and their families. This study focused on what works well in an exemplary IDG, using appreciative inquiry as to the method of inquiry. Data were collected from 6 participants of an exemplary IDG caring for patients diagnosed with Alzheimer’s disease. The data were analyzed using the appreciative inquiry 4-D cycle: Discovery, Dream, Design, and Destiny. In the Discovery phase, 10 themes emerged, showing the connection to the Dream phase. The Dream phase led into the Design phase, focusing on provocative propositions, which bridge the best of what is with what might be. This then connected with the Destiny phase, bringing the dreams of the future to the present. I found that what works well with this exemplary IDG is the connection to other members of the team and the larger system; dedication; commitment; and valuing of team members, their patients, and patients’ families. The findings suggested the need for increased training of marriage and family therapists for IDG settings as the systemic thinking of marriage and family therapy appears to be a good fit for the IDG.

Made available in DSpace on 2014-08-20T13:49:48Z (GMT). No. of bitstreams: 1 Dissertacao_Isabel_Cristina_Arrieira.pdf: 1918569 bytes, checksum: 77ac6fb43da866a8be22f4bcde36bd77 (MD5) Previous issue date: 2009-10-23 / This work aimed to build the meaning of spirituality for the interdisciplinary group that takes care of people suffering from cancer through palliative care. That group participates in the Oncologic Interdisciplinary Home Admission to hospital program (PIDI), from the individual building of spirituality of each member of the group. It is about a research with a qualitative, descriptive and exploratory approach. It had Vygotsky´s Historical-Cultural Theory as a theoretical reference. Vygotsky identifies two levels of development: one is about the achievements already reached which he calls level of real or effective development and the other one is the level of potential or proximal development, which relates to the capacities on the point of being built. Eight professionals from that group participated in the research. Data collection was carried out through the focal group technique, in a total of five meetings from which the following themes appeared: meaning of spirituality: individual building; spirituality: palliative care and death; spirituality: as a harmonizing element and an opportunity of group learning; an approach about spirituality during the building and meaning of spirituality for the oncologic PIDI group. After analyzing and reflecting about the data I could notice that when we take care of people who suffer from cancer through palliative care it is essential to include a spiritual approach for every member of the interdisciplinary group. This study was an important device to develop the abilities of most group members related to the spiritual approach in taking care of PIDI patients. As a result, another important fact that appeared was that most people in the group did not have any approach about spirituality in their education. That fact becomes a challenge to teaching institutions which focus care completeness most of the time. Among the meanings built by the group the inclusion of spirituality in patients´ care in palliative care means recognizing h man beings in their entirety, respecting their individualities besides acting as facilitators in the relationships between the users, their families and the group. / Este estudo teve como objetivo construir o significado de espiritualidade para a equipe interdisciplinar que atende o ser humano portador de câncer em cuidados paliativos, internados no Programa de Internação Domiciliar Interdisciplinar (PIDI) Oncológico, partindo da construção individual de espiritualidade de cada componente da equipe. Trata-se de uma pesquisa de abordagem qualitativa, descritiva e exploratória. Teve como referencial teórico a Teoria Histórico-Cultural de Vygotsky, na qual o autor identifica dois níveis de desenvolvimento: um se refere às conquistas já efetivadas, que ele chama de nível de desenvolvimento real ou efetivo, e o outro, o nível de desenvolvimento potencial ou proximal, que se relaciona às capacidades em vias de serem construídas. Participaram da investigação oito profissionais que integram tal equipe. A coleta de dados ocorreu através da técnica de grupo focal, num total de cinco reuniões, das quais emergiram os seguintes temas: significado de espiritualidade construção individual; espiritualidade, cuidados paliativos e morte; espiritualidade como harmonizador e oportunidade de aprendizado para a equipe; abordagem do tema espiritualidade durante a formação e significado da espiritualidade para a equipe do PIDI Oncológico. Após a reflexão e análise dos dados percebo que na assistência aos portadores de câncer em cuidados paliativos torna-se imprescindível a inclusão da abordagem espiritual por todos os componentes da equipe interdisciplinar. Este estudo foi um importante dispositivo para o desenvolvimento das habilidades da maioria dos componentes da equipe em relação à abordagem espiritual no cuidado dos pacientes do PIDI. Outro dado importante que surgiu como resultado foi a ausência da abordagem do tema espiritualidade durante a formação da maioria dos integrantes da equipe. Tal fato fica como desafio para as instituições de ensino que, na maioria das vezes, tem como foco a integralidade do cuidado. Dentre os significados construídos pelo grupo a inclusão da espiritualidade no cuidado dos pacientes em cuidados paliativos significa o reconhecimento do ser humano em sua totalidade, respeitando suas individualidades, além de atuar como facilitador nas relações com os usuários, sua família e entre a equipe.