Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-08-08T12:45:59Z No. of bitstreams: 1 MarcoAntonioDiogoFerreiraDissertacao2018.pdf: 1295258 bytes, checksum: 6ce581ffe319dbada1de8fd91ef326d2 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-08-08T12:46:10Z (GMT) No. of bitstreams: 1 MarcoAntonioDiogoFerreiraDissertacao2018.pdf: 1295258 bytes, checksum: 6ce581ffe319dbada1de8fd91ef326d2 (MD5) / Made available in DSpace on 2018-08-08T12:46:10Z (GMT). No. of bitstreams: 1 MarcoAntonioDiogoFerreiraDissertacao2018.pdf: 1295258 bytes, checksum: 6ce581ffe319dbada1de8fd91ef326d2 (MD5) Previous issue date: 2018-02-19 / The present study aims to characterize the relationships of pleasure and suffering in the work of the reception attendants of specialized ambulatory clinics, of the Hospital of the armed forces of Brasilia/DF, to identify the strategies of confrontation developed by the reception attendants through the experiential reality of their work activity and understand the significance that they attribute to their professional action. Mobilized by living conflict problem, finds the attendant in front of conflicts between the institutional regulation, the expectation of the users of the health systems served in the military hospital and their own action. Is used in this study of the potentialities of the psychoanalytic clinical referential that involve the clinical investigative possibility, the signalling of a therapeutic proposition and the use of the psychoanalytic theory itself as theoretical reference for Approach of the phenomenal field of studies. It was sought to categorize the psychic dimensions of research, through propositions of the field of the psychopathology of work, according to the psychoanalytic perspective proposed by Christophè Dejours. The methodology develops through clinical interviews, analysis of the speech through the establishment of units of direction, from the cut of the speech of the attendants, the specification of these units of meaning in categories and subcategories, According to the theoretical reference used, in representation to the dimensions of pleasure, suffering and strategies of coping proposals, as well as the clinical analysis of the psychic dynamics of what is shown in the speech of the attendants. It is also proposed to establish the correlation between clinical posture and theoretical approach, phenomenological expressiveness and language, in human intersubjective relations. This study is proposed to reinsert the human being in the field of Psicopathology, as a science that studies the fundamental affective disposition of the psychic being, which must be understood within human bases and from the human, presenting it as an elaborate agent of its own history and its meaning. It mobilizes emotion, feeling, thought, reflection and action, in the effort of expliciting in the affective dynamics involved in the reality of the work of these professionals, to whom it is sought to give opportunity of own meaning through the word. / O presente estudo tem por objetivos caracterizar as relações de prazer e sofrimento no trabalho dos atendentes de recepção de clínicas ambulatoriais especializadas, do Hospital das Forças Armadas de Brasilia/DF, identificar as estratégias de enfrentamento desenvolvidas pelos atendentes de recepção mediante a realidade vivencial de sua atividade laboral e compreender a significação que atribui à sua ação profissional. Mobilizado por problemática conflitiva viva, encontra o atendente frente a conflitos entre a normatização institucional, a expectativa dos usuários dos sistemas de saúde atendidos no hospital militar e a sua própria ação. Utiliza-se neste estudo das potencialidades do referencial clínico psicanalítico que envolvem a possibilidade investigativa clínica, a sinalização de uma proposição terapêutica e a utilização da própria teoria psicanalítica como referencial teórico para abordagem do campo fenomênico de estudos. Buscou-se a categorização das dimensões psíquicas de investigação, através de proposições do campo da psicopatologia do trabalho, segundo referenciais da perspectiva psicanalítica propostas por Christophè Dejours. A metodologia desenvolve-se através de entrevistas clínicas, de análise do discurso através do estabelecimento de unidades de sentido, a partir do recorte da fala dos atendentes, da especificação destas unidades de sentido em categorias e subcategorias, conforme o referencial teórico utilizado, em representação às dimensões de prazer, sofrimento e estratégias de enfrentamento propostas, bem como da análise clínica da dinâmica psíquica do que se mostra no discurso dos atendentes. Propõe-se, ainda, estabelecer a correlação entre postura clínica e abordagem teórica, expressividade fenomenológica e linguagem, nas relações intersubjetivas humanas. Este estudo tem por proposta reinserir o ser humano no campo da psicopathologia, enquanto ciência que estuda a disposição afetiva fundamental do ser psíquico, que deve ser compreendida dentro de bases humanas e a partir do humano, apresentando-o como agente elaborador de sua própria história e de seu sentido. Mobiliza emoção, sentimento, pensamento, reflexão e ação, no esforço de explicitação na dinâmica afetiva envolvida na realidade do trabalho destes profissionais, aos quais procura-se dar oportunidade de significação própria através da palavra.

Submitted by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-11-08T11:42:20Z No. of bitstreams: 1 AngelicaGuedesDantasTese2018.pdf: 1551630 bytes, checksum: 3832180a63a267ef1133f5218b3af743 (MD5) / Approved for entry into archive by Sara Ribeiro (sara.ribeiro@ucb.br) on 2018-11-08T11:42:48Z (GMT) No. of bitstreams: 1 AngelicaGuedesDantasTese2018.pdf: 1551630 bytes, checksum: 3832180a63a267ef1133f5218b3af743 (MD5) / Made available in DSpace on 2018-11-08T11:42:48Z (GMT). No. of bitstreams: 1 AngelicaGuedesDantasTese2018.pdf: 1551630 bytes, checksum: 3832180a63a267ef1133f5218b3af743 (MD5) Previous issue date: 2018-08-30 / Faced with a crisis that has stricken the educational context, where the prevailing educational landscape has prevented teachers from professionally constituting themselves in a critical and reflective manner, impacting their actions in the classroom, leading them to illness, this thesis aims to investigate and assess the ways in which teachers develop prevention and intervention strategies to deal with suffering, school failure and violence at schools. It was conducted through a psychoanalytically-oriented interventive research, supported by listening devices and the analysis of professional practices. Eight teachers from a Public High School in the Federal District participated in the research, where they generated data through group conversations. The analysis was carried out through the elaboration of axes of meaning, which could favor the apprehension of the senses and meanings attributed by teachers to their professional practices. Those axes of meaning, chosen for the analysis and problematization of results, were: Public Policy and School Management; Teacher Suffering and its Implications in Pedagogical Practice. The conclusion points to two possible paths: that of prevention, through the formulation of educationally-oriented public policies, and that of intervention, which takes place in practice and helps teachers cope with the daily challenges imposed by their profession. On the one hand, different discourses have highlighted the dilemmas experienced by subjects in their daily school lives: the anguish, the resentments (with the profession, students, families, colleagues and superiors, even with the government and the public policies implemented in the field of education) and the psychic suffering itself. They have also highlighted the permanence of the group in a defensive and resisting position, where one can spot different attempts at remaining away from subjectivity. On the other hand, the discourses have stressed an amalgam between the development of subjectivities and the institutional and social dynamics geared towards the formulation and implementation of public policies in the field of education, notably in the current political moment. Among the obstacles faced to carry out this work, one can point to the lack of time (number of sessions undertaken, the duration of the intervention and the need to handle the end goal more carefully); the absence of an addressed demand and the resistance of the group (difficulty of implication), given the enjoyment experienced by remaining in a victimizing and complaining position. The lurking possibility that psychoanalysis could contribute to the field of education points to the urgency of a reflective perspective with regard to educational practices. It also points to the need for those who formulate public policies in the field of education to think about educational practices as tools to train the subject, all while not losing sight of the subjectivity of those willing to become teachers. / En vue de la crise qui sévit le contexte éducatif, où les formations offertes ont empêché les enseignants de se constituer professionnellement de manière critique et réflexive, ayant une incidence sur leurs performances dans la salle de classe, où ils tombent souvent malades, cette thèse a pour objectif d’étudier et d’évaluer les façons dans lesquelles les enseignants développent des stratégies de prévention et d’intervention pour faire face à la souffrance, l’échec scolaire et la violence à l’école. Elle a été menée par une rechercheintervention d’orientation psychanalytique, appuyée par les dispositifs d’écoute clinique et sur l’analyse des pratiques professionnelles. Huit professeurs d’une école publique du District Fédéral ont participé à cette recherche et les données qu’ils ont produites ont été générées par des groupes de conversation. L’analyse a été réalisée à travers l’élaboration d’axes de signification, ce qui a pu favoriser l’appréhension des sens et des significations attribuées par les professeurs à leurs pratiques professionelles. Les axes de signification choisis pour l’analyse et le questionnement des résultats ont été: Politiques Publiques et Gestion de L’école; la Souffrance de L’enseignant et ses Implications sur la Pratique Pédagogique. La conclusion souligne deux chemins possibles: celui de la prévention par la formulation des politiques publiques d’éducation et celui de l’intervention qui se déroule dans la pratique, afin d’aider les professeurs à faire face aux défis quotidiens de la profession enseignante. D’un côté, les discours ont mis en évidence les dilemmes rencontrés par les sujets dans la vie quotidienne de l’école: l’angoisse, le ressentiment (avec la profession, les étudiants, les familles, les collègues et supérieurs, même avec le gouvernement et les politiques publiques mises en oeuvre pour l’éducation) et aussi la souffrance psychique. Ils ont aussi démontré la permanence du groupe dans une position défensive et de résistance dans laquelle les tentatives d'éviter la subjectivité étaient fréquentes. D’un autre côté, les discours ont souligné un amalgame entre le développement des subjectivités et les dynamiques institutionnelles et sociales pour la formulation et la mise en oeuvre des politiques publiques pour l’éducation, notamment dans la conjoncture politique actuelle. Parmi les obstacles rencontrés à la réalisation de ce travail, nous pouvons mentionner le manque de temps (nombre de séances, la durée de l’intervention et la nécessité d’une gestion plus prudente des objectifs); l’absence d’une demande adressée et la résistance du groupe (difficulté d’implication) par le plaisir qu’ils éprouvaient de garder une position de victime et plaignante. La possibilité que la psychanalyse a de contribuer au domaine de l’éducation reste latente et signale l’urgence d’une attitude réfléchissante sur la tâche éducative. Elle pointe aussi vers la nécessité que le formulateur de politiques publiques dans le cadre de l’éducation a de réfléchir sur les pratiques educationelles en tant que formatrice des sujets, tout en ne pas oubliant la subjectivité de ceux qui se disposent à devenir enseignants. / Ante a crise que assola o contexto educativo, onde as formações oferecidas têm impedido professores de se constituírem profissionalmente de forma crítica e reflexiva, impactando na atuação deles em sala de aula, levando-os ao adoecimento, esta tese tem o objetivo de investigar e avaliar os modos pelos quais os professores desenvolvem estratégias de prevenção e de intervenção para o enfrentamento do sofrimento docente, do fracasso escolar e das violências na escola. Foi conduzida através de uma pesquisa-intervenção de orientação psicanalítica, apoiada nos dispositivos da escuta clínica e análise das práticas profissionais, da qual participaram oito professores do Ensino Médio de uma escola da rede pública do DF. Os dados foram gerados via grupo de conversação; a análise, por sua vez, foi realizada por meio de núcleos de significação, o que pôde favorecer a apreensão dos sentidos e significados atribuídos pelos professores à sua atuação profissional. Os núcleos de significação escolhidos para problematização dos resultados foram: Política Pública e Gestão da Escola; e Sofrimento Docente e Implicações na Prática Pedagógica. A conclusão aponta para dois caminhos possíveis: a prevenção que se dá pela via da formulação de políticas públicas para a educação e a intervenção que se dá na prática, com intuito de fazer face aos desafios cotidianos que a profissão docente impõe. De um lado, os discursos evidenciaram os dilemas vividos pelos sujeitos no cotidiano da escola: a angústia funcional, o ressentimento (com a profissão, alunos, famílias, colegas e superiores hierárquicos, até com o governo e as políticas públicas implementadas para área) e o sofrimento psíquico, propriamente dito. Evidenciou-se também, a manutenção do grupo em uma posição defensiva e de resistência em que foram frequentes as tentativas de evasão da subjetividade. Por outro lado, salientaram uma amálgama entre o desenvolvimento de subjetividades e as dinâmicas institucionais e sociais para formulação e implementação de políticas públicas para a educação, notadamente no momento político brasileiro. Entre os obstáculos enfrentados para a realização deste trabalho estão o tempo (número de sessões realizadas, a duração da intervenção e necessidade de manejo do fim de forma mais cuidadosa); a ausência de uma demanda endereçada e a resistência do grupo (dificuldade de implicação) ante o gozo vivenciado por manter-se numa posição vitimista e queixosa. Resta latente a possibilidade de a psicanálise contribuir para o campo da educação, apontando para a urgência de uma postura reflexiva sobre a tarefa educativa e, também, a necessidade do formulador de políticas públicas para a educação, de pensar as práticas educativas como formativas dos sujeitos, não perdendo de vista a subjetividade daquele que se dispõe a ser professor.

Orientador: Ana Teresa de Abreu Ramos Cerqueira / Banca: Sandra Fortes / Banca: Vânia Moreno / Resumo: Os serviços de atenção básica à saúde acolhem vários tipos de demandas, e vêm sendo cada vez mais solicitados pela população que busca cuidados para agravos à saúde de origem psicossocial. Este estudo foi realizado no Centro de Saúde Escola da Faculdade de Medicina com o objetivo de compreender a manifestação e expressão do sofrimento psíquico, conhecer o trajeto da busca de cuidados para esse tipo de sofrimento, e a identificar a percepção que as mulheres usuárias deste serviço têm sobre as alternativas de tratamento para sofrimento mental. A pesquisa teve um desenho qualitativo, e os dados foram obtidos por meio da técnica de Grupo Focal de Discussão, para o qual foi utilizado um roteiro de perguntas norteadoras para investigação do tema em foco. Foram compostos quatro grupos de mulheres, segundo as modalidades de tratamento que recebiam no serviço: uso exclusivo de psicofármacos, terapêuticas não medicamentosas e psicofármacos, terapêuticas não medicamentosas exclusivas e um grupo composto para recém ingressos no serviço, que estavam com o projeto terapêutico em formulação. O material obtido foi analisado segundo o procedimento da Análise de Conteúdo. Foram identificadas três grandes categorias temáticas: manifestações do sofrimento psíquico, itinerário terapêutico e alternativas de tratamento. Observou-se que o sofrimento psíquico foi expresso por ampla diversidade de sintomas físicos e psíquicos, que produziam limitações nas atividades de vida diária e no relacionamento social e afetivo. A procura por serviços de saúde ocorria quando as sensações corporais que causavam mal estar eram identificadas e traduzidas como algo que necessitava de cuidado, ou quando profissionais de saúde ou pessoas do meio familiar identificavam o sofrimento e as alterações de comportamento como sintomas de algo que deveria ser tratado. Apenas... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Basic medical care deals with various types of needs, and this level of care is increasingly sought out by the people looking for help with health problems of a psychosocial origin. This need is seen daily at the mental health service of the Teaching Health Centre, Botucatu School of Medicine, UNESP, Botucatu, SP, Brazil. This study was performed at this institution with the objective of understanding the meanings and feelings given to psychological suffering, and to know the path taken to find care for this type of suffering by this mental health service's patients. The study has a qualitative design, and data were obtained by the focus group discussion technique, using a list of questions directed towards investigating the theme in focus. There were four groups of women grouped according to type of treatment received at the service: exclusive use of medications, pharmacological plus non-pharmaclogical treatment, exclusive nonpharmacological treatment, and new patients who were on a developing treatment project. The material produced was analyzed by the Analysis of Content procedure. Three major thematic categories were identified: manifestations of psychological suffering, treatment program, and treatment alternatives. Psychological suffering was expressed through physical and psychological symptoms, which produced limitations in daily life activities and in social and affective relationships. Medical help was sought when bodily feelings causing discomfort were identified and interpreted as in need of treatment, or when health professionals or others in the family environment identified psychological symptoms in need of treatment. The health service was reported as the only proper place for mental health care; other resources, such as religion and family support were identified as reinforcing the effects of traditional conventional treatment. Psychological suffering is found... (Complete abstract click electronic access below) / Mestre

Forskning om brottsoffer är i Sverige en relativt ny disciplin. Statistik från Brottsförebyggande Rådet visar en kontinuerlig ökning av misshandelsbrott sedan 1975, framför allt en ökning av våldets grovhet och feghet. Den största offergruppen utgörs av män. De våldsdrabbade patienterna möter sjuksköterskan framför allt på akutmottagningarna. Sjuksköterskan står i en maktposition till patienten och denna makt ska användas på ett för patienten positivt sätt. Genom att vara införstådd med att de unga männen kan befinna sig i en krisreaktion kan sjuksköterskan bättre förstå patientens reaktioner och lidande. Syftet med uppsatsen är att beskriva unga mäns levda erfarenheter av att ha blivit utsatta för gatuvåld. Preciserade frågeställningar är: Vad är innebörden i den våldsdrabbade personens tankar och känslor som traumat medfört? Vad är innebörden i den våldsdrabbade personens upplevelser av sig själv och omgivningen efter traumat? Uppsatsen är en litteraturbaserad studie med kvalitativ grund. Tretton unga män berättar i två biografier och en intervjustudie om deras upplevelser där alla blivit utsatta för misshandel av en eller flera gärningsmän. Resultatet visar att de vanligaste känsloyttringarna i männens berättelser är rädsla, ilska, ångest och oro, samt känslan av att vara frånvarande. Dessa känslor tog sig uttryck i olika livsinskränkande handlingar. Männen talade också om att de upplevde att de inte blev bekräftade i sitt lidande och att de ibland möttes av attityder från omgivningen som att de efter misshandeln förväntades klara sig på egen hand. Resultatet diskuteras utifrån kristerorin beskriven av Lagerbäck, Erikssons lidandeteori samt Wiklunds teori om vårdrelationen. Dessutom ligger fokus i diskussionen på rådande fördomar i samhället om män, våld och offerskap. Genom att skaffa sig bättre förståelse av de våldsdrabbade männens lidande kan sjuksköterskan bättre bemöta och vårda patienten. / Program: Sjuksköterskeutbildning

Bakgrund: Fetma och övervikt är ett tillstånd som ständigt ökar och utgör en risk för följdsjukdomar. I Sverige har antalet personer med fetma och övervikt tredubblats de senaste 40 åren. Att genomgå en gastric bypass operation ses som sista utvägen till ett liv som inte begränsas av fetma. Syfte: Att beskriva hur personer som genomgått gastric bypass upplever hälsa efter operationen. Metod: En kvalitativ ansats användes där det gjordes en analys av narrativer i form av bloggar. Tio bloggar granskades och analyserades. Resultat: Viktnedgången som sker till följd av gastric bypass operationen blev inte som alla hade tänkt sig. De fysiska förändringarna som uppstod var möjligheten till ett rörligare och aktivare liv men medförde även nya kroppskomplex. Självbilden är svår att förändra och psykiska besvär kvarstår. Självkänslan och självförtroendet som förväntades bli bättre blev snarare sämre och hade en inverkan på relationen med vänner och familj. Konklusion: Psykisk och social problematik erfars efter operationen vilket begränsar upplevelsen av fullständig hälsa. Då uppföljning inte är tillräckligt omfattande brister stödet från sjukvården. Genom sjuksköterskans förståelse för upplevda erfarenheter kan bemötandet av dessa personer anpassas och förbättras.

SAMMANFATTNING Bakgrund:Inom vården utsätts spädbarn för flertalet medicintekniska moment som kan ge upphov till procedursmärta. För att säkerställa att spädbarnen inte upplever procedursmärta krävs omvårdnadsåtgärder som kan minska denna typ av smärta. Omvårdnadsåtgärder som förebygger och minskar procedursmärta hos spädbarn kan vara farmakologiska och icke-farmakologiska. Procedursmärta hos spädbarn ger upphov till ett sjukdomslidande, vilket bör undvikas.  Syfte:Syftet med denna litteraturstudie är att kartlägga om förebyggande farmakologiska samt icke-farmakologiska omvårdnadsåtgärder kan minska procedursmärta hos spädbarn under medicintekniska moment. Metod:För att besvara syftet gjordes en litteraturstudie med 11 kvantitativa artiklar. Resultat:De farmakologiska omvårdnadsåtgärder som minskar procedursmärta hos spädbarn är sackaros och glukos medan paracetamol är en metod som inte har denna effekt. De icke-farmakologiska omvårdnadsåtgärderna som minskar procedursmärta är bland annat amning, bekanta ljud och att linda spädbarnet. Att linda spädbarnet var även effektivt i kombination med sackaros och icke näringsrikt sugande medan icke näringsrikt sugande verkar smärtförebyggande i kombination med bröstmjölk och stödjande sammanhållning. Hud mot hud vård minskar procedursmärta både ensamt och i kombination med amning. Ingen evidens finns för att klassisk musik minskar procedursmärta hos spädbarn.  Slutsats:Det finns evidens för att farmakologiska och icke-farmakologiska omvårdnadsåtgärder minskar procedursmärta hos spädbarn under medicintekniska moment. Trygghet, beröring och närhet är viktiga faktorer för förebyggande av smärta hos spädbarn och kan uppnås genom användandet av olika icke-farmakologiska metoder. Trots att användandet av smärtförebyggande omvårdnadsåtgärder minskar procedursmärta kan frånvaro av smärta och sjukdomslidande inte säkerställas. / ABSTRACT Background:Infants are exposed to several medical technical procedures that can cause procedural pain. To ensure that infants do not experience procedural pain, it is required to find nursing methods that can reduce this type of pain. Nursing methods that prevent and reduce procedural pain in infants can be pharmacological and non-pharmacological. Procedural pain in infants leads to infants suffering from disease, which should be avoided. Aim:The aim of this literature study is to chart if preventive pharmacological and non-pharmacological nursing methods can reduce procedural pain in infants during medical technical procedures. Method:To answer the aim of the study, a literature study with 11 quantitative articles were conducted.  Result:The pharmacological methods that reduce procedural pain in infants are sucrose and glucose while paracetamol is a method that is not effective. The non-pharmacological methods that reduce procedural pain are for example breastfeeding, familiar auditory stimulus and swaddling. Swaddling was also effective in combination with sucrose and non-nutritive sucking while non-nutritive sucking had an preventing effect in combination with oral breastmilk and facilitated tucking. Skin-to-skin contact reduces procedural pain both alone and in combination with breastfeeding. There is no evidence that classical music reduces procedural pain in infants. Conclusion:There is evidence that pharmacological and non-pharmacological nursing methods reduce procedural pain in infants during medical technical procedures. Comfortability, physical contact and closeness are important factors in the prevention of pain in infants and can be achieved by use of various non-pharmacological methods. Although the use of pain prevention nursing methods reduces procedural pain, the absence of pain and suffering from disease can not be ensured.

Bakgrund: Ofrivillig barnlöshet är ett vanligt problem hos par i fertil ålder och drabbar runt 15–20 % av alla par i västvärlden som önskar få barn. Infertilitet och infertilitetsvård kan bidra till sämre hälsa och kan vara påfrestande för båda parter i paret. Processen kan även leda till ett lidande där sjuksköterskan har en viktig roll. För att bemöta par och tillgodose deras önskemål är det angeläget att studera vilka behov de upplever. Syfte: Att beskriva behov par erfar i samband med infertilitetsvård. Metod: En litteraturöversikt där datamaterial bestod av sju vetenskapliga artiklar varav två kvantitativa, fyra kvalitativa och en av mixad metod. Resultat: I resultatet framkom tre teman, Stöd, Respekt och förståelse samt En utformad och anpassad miljö. Det framkom även sex subteman. Konklusion: Att möta par inom infertilitetsvård kan vara komplext och ytterligare kunskap kring vilka behov de upplever kan vara angeläget. Som sjuksköterska är det viktigt att bidra med stöd och information gällande processen. Det är även viktigt att individualisera vården och se till varje pars egna önskemål. Respekt och förståelse samt anpassning och utveckling av organisationen är angeläget där högre instanser bör bli engagerade. / Background: Involuntary infertility is a common problem in couples of fertile age and affects around 15–20% of all couples in the Western world who wish to have children. Infertility and the care can contribute to poorer health, which can be stressful for both parties in the couple. The process can also lead to a suffering were the nurse has an important role to play. To respond to the couple and meet their wishes, it is important to study the needs they experiences. Aim: To describe the needs couple experiences in connection with infertility care. Method: A literature review where data material consisted of seven scientific articles, two of which were quantitative, four qualitative and one of mixed method. Results: From the result, three themes appeared, Support, Respect and understanding and An Adapted and developed environment. There were also six sub-themes. Conclusion: Meeting couples in infertility care can be complex and further knowledge about what needs they are experiencing can be important. As a nurse, it is important to contribute with support and information regarding the process. It is also important to individualize the care and look to each couple's own wishes. Respect and understanding as well as adaptation and development of the organization are urgent where higher instances should become involved.

Le rapport à la souffrance est un symptôme majeur du rapport à l’existence. Nietzsche met en perspective ces rapports entre la civilisation chrétienne européenne et celui de la culture grecque antique. L’invention de l’art tragique apparaît comme un moyen de sublimer les souffrances dans une extase dionysiaque, elle est à la fois la manifestation de leur volonté de puissance face aux épreuves et une thérapie.Tandis que la logique de souffrance issue du socratisme et du christianisme entraîne un profond nihilisme. Le passage d’un type de logique de souffrance à l’autre s’est opéré par le pivot socratique. La tâche du philosophe médecin est alors d’inverser ce pivot afin de préparer la transvaluation des valeurs issues de la morale chrétienne. Cela pose alors le problème de l’esthétisation de l’existence. / The relationship with suffering is a major symptom of the relationship with existence. Nietzsche puts these relationships between modern European civilization and early Greek culture into perspective. The invention of Greek tragedy can be seen as a way of sublimating suffering in Dionysiac ecstasy. It is both a demonstration of their will to power faced with tragic events and therapy. On the other hand the logic of suffering stemming from Socratism and Christianity leads to profound nihilism. The transition from one type of logic of suffering to another is brought about by a Socratic reversal. The task of the philosophical doctor is to therefore bring about this inversion in order to prepare the transvaluation of values stemming from Christian morality. This raises de novo the problem of the aestheticisation of existence.

Investigamos acerca do sofrimento humano e suas vicissitudes na clínica psicológica, a partir do pensamento de Kierkegaard, especificamente a partir do conceito de desespero. Objetivase analisar os caminhos que o psicólogo tem para compreender os fenômenos mentais, e relacioná-los com a filosofia kierkegaardiana, pautado numa metodologia qualitativa de pesquisa. Sendo o sofrimento humano um fenômeno subjetivo, ele adquire uma semântica diferente para cada indivíduo. Kierkegaard explora o sofrimento a partir da universalidade do fenômeno do desespero. No livro A doença mortal, o autor faz uma análise estrutural sobre as diversas manifestações que o desespero pode ter para cada pessoa, de acordo com os níveis de consciência que cada um possui. Nesse percurso, a proposta desta investigação articulou esses saberes à clínica psicológica naquilo que se revela no sofrimento. Para tanto, constatamos que o terapeuta precisa estar fundamentado numa epistemologia que acolha a questão do mistério e do inominável da condição humana, tal como foi examinada a partir do pensamento de Kierkegaard. Este autor analisou o desespero num horizonte filosófico e teológico. Na perspectiva clínica, vemos que o desespero encontra-se num horizonte de compreensão que paciente e terapeuta têm no instante da sessão psicoterápica / We investigated the human suffering and its vicissitudes at the psychological clinic in Kierkegaards thought, specifically on the concept of despair. The goal is to analyze the paths that the psychologist possess to understand the mental phenomena and to relate them with the kierkegaardian philosophy, based on a qualitative research methodology. Since human suffering is a subjective phenomenon it acquires different semantics for each individual. Kierkegaard explores the suffering from the universality of the phenomenon of despair. In the book The sickness unto death, the author performs an structural analysis about the diversity of despair demonstrations that can be perceived in different persons in accordance with levels of consciousness that each possesses. Therefore, this research aims to articulate these knowledges to psychological clinic regarding what is revealed in the suffering. To this end, we note that the therapist needs to be based on an epistemology that embrace the mystery and unnameable of human condition as has been examined on Kierkegaards thought. This author has analyzed the despair in a philosophical and theological horizon. From the clinical perspective, we observe that the despair is found on a horizon of understanding established between patient and therapist during the psychological session

O câncer, como toda doença que ameaça a vida, atinge, além do doente, todos aqueles que lhe são próximos. Este estudo teve por objetivo compreender como é ser companheiro da mulher com câncer de mama, na perspectiva dele. Foi utilizada uma metodologia qualitativa, fundamentada no referencial teórico-metodológico da Psicologia Fenomenológico-Existencial, fundamentada no pensamento de Martin Heidegger. Participaram dez companheiros de mulheres com câncer de mama que frequentavam um núcleo de reabilitação de mastectomizadas. No período de junho a novembro de 2014, foram realizadas entrevistas fenomenológicas, individuais, audiogravadas, a partir de uma questão norteadora: \"Como tem sido para você ser companheiro de uma mulher com câncer de mama?\" As entrevistas foram transcritas de forma literal e na íntegra, constituindo o corpus de análise. Nas sucessivas leituras empreendidas, focalizou-se o fenômeno pesquisado em busca das unidades de significado que foram agrupadas dando origem aos eixos temáticos. Foram respeitados os preceitos éticos para pesquisas com seres humanos, contidos na Resolução 466/2012 do Conselho Nacional de Saúde. Os resultados foram apresentados em sete unidades significativas: Vivendo o impacto do diagnóstico e uma desestabilização emocional; Compartilhando o cuidado à mulher com outros familiares; Compartilhando o enfrentamento da doença na relação a dois; O enfrentamento da doença e seus efeitos sobre a intimidade do casal; No horizonte do tempo, o aceno da sombra da morte; Sofrimento psicológico dos companheiros; Suporte social utilizado pelos companheiros. Os resultados demonstraram que os companheiros sofreram e se disponibilizaram ao cuidado para com suas mulheres, desde o recebimento da notícia da doença até o dia da entrevista. Também reconheceram seus sofrimentos pelas dificuldades enfrentadas, mas não buscaram nenhuma ajuda profissional para cuidar deles próprios / Cancer, like any disease that threatens life, reaches beyond the sick, those who are closest to him. The purpose of this study is to understand how to be companion of women with breast cancer, in his perspective. A qualitative methodology, grounded on the theoretical framework of Phenomenological-Existential Psychology, based in the thought of Martin Heidegger was used. A total of ten partners of women with breast cancer who attended one mastectomy rehabilitation center. In the period from June to November 2014, phenomenological interviews, individual audio recorded were carried out, from a guiding question: \"How has it been for you to be companion of a woman with breast cancer?\" The interviews were transcribed literally and in full, constituting the corpus of analysis. Undertaken in successive readings, focused to the phenomenon researched in search of the meaning units were grouped giving rise to the themes. The ethical principles were respected for research with human beings contained in the National Health Council Resolution 466/2012. The results were presented in seven major units: Living the impact of diagnosis and emotional instability; Sharing the care of women with other family members; Sharing coping with the disease in couple\'s relationship; The coping with the disease and its effect on the couple\'s intimacy; In the time horizon, the beckon of the shadow of death; Psychological suffering of companions; Social support used by companions. The results showed that the companions suffered and made themselves available to care for their women from receiving the news of the disease until the day of the interview. They also acknowledged their suffering by the difficulties encountered, but did not seek any professional help to take care of themselves