“You died on me”: internist narratives about the caring patients in the final hours or days of life

Background: In Portugal, two thirds of deaths occur in the hospital and it is estimated that these numbers will increase considerably in the coming decades. The Internist is, therefore, called upon to take care of patients for whom cure is not expected and whose confrontation with the limits of existence is palpable. This is a great opportunity to assume the Suffering of the Other as a therapeutic target, but also to invite reflection on the limits of science, opening space for the relationship. Narrative medicine aims not only to validate the patient's experience, but also to stimulate the physician's creativity and self-reflection and to reinforce the clinical bond. Aim(s): The goal of this project is to characterize the experience of Portuguese internists in the follow-up of their patient(s) in the final phase of their life(s). Methods: A semi-structured questionnaire will be used using a narrative medicine work methodology - parallel chart, focusing on a convenience panel of doctors with the specialty of Internal Medicine. The data will be analyzed in four cycles: In the first cycle, the NVivo software will be used, which allows the analytical process of the data, not replacing the researcher's responsibility in the interpretation of the results. In the second cycle, the analysis of parallel clinical records will be guided by the following narrative categories (and the questions that emerge from them): Voice, Characters, Time, Space and Plot. A third cycle of analysis will follow, in which the autobiographical/personal elements will be identified in the texts; dialogic/interpersonal; socio-cultural and institutional. The fourth and final cycle of analysis will allow the evaluation of previous cycles and the identification of contents that stand out for their novelty and/or relevance. Results: The collection of records is underway. Conclusions: The appreciation of the results of the reflection will lead to relevant contributions for the construction of a training model for the integral care of patients in the last hours or days of life by the national Internal Medicine, the main purpose of the MiMI Project (Morte Iminente em Medicina Interna) of the Portuguese Society of Internal Medicine.