Depressão e angústia espiritual em doentes adultos com necessidades paliativas acompanhados nos cuidados de saúde primários

: estudo piloto

Abstract

Introduction: Palliative care patients have been associated with high probability of having depression and spiritual distress, but there is a gap in research about the clinical indicators that can promote the differential diagnosis between depression and spiritual distress. Objectives: To identify the prevalence and the clinical indicators of depression and spiritual distress in palliative patients in primary care, to support a differential diagnosis. Methods: Observational and cross-sectional study, conducted in 2016 in a Portuguese primary care unit. A sample of 30 palliative adult patients was recruited from a General Practitioners patients’ file throughout two steps: (1) selection of patients with chronic disease criteria; (2) selection of patients with Prognostic Indicator Guidance criteria. Exclusion criteria included cognitive impairment and psychotic disorders. Participants completed the self-assessment HADS and FACIT-Sp12 scales. Clinical data collection used semi-structured interviews for the diagnosis of depression and spiritual distress. Data was analysed using SPSS Statistics 24®.Results: The prevalence of depression was 23%, while the prevalence of spiritual distress was 23%. A significantly positive association between depression and a lack of meaning in life was found, although the association between depression and the expression of suffering was not statistically significant. The researcher observed the occurrence of major past traumatic life events in 57% patients with spiritual distress. A significant association was found between alcoholism and spiritual distress diagnosis, although this association was not found with depression.Conclusions: Depression and spiritual distress seem to be both linked to the spiritual dimensions of the Human being, but seem to differ in the dimensions of suffering.Spiritual distress seems to occur in people with past traumatic life events and to be linked with alcohol use disorder. Caution in needed when reading the results considering the design and the sample size.

Date of Award	26 Jun 2018
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Sílvia Caldeira (Supervisor) & Manuel Luís Capelas (Co-Supervisor)