Terminalidade, morte e luto na pandemia de COVID-19: demandas psicológicas emergentes e implicações práticas
Palavras-chave:
Cuidados paliativos na terminalidade da vida, Infecções por coronavírus, Pandemias, Saúde mentaResumo
A doença causada pelo novo coronavírus (COVID-19) tem sido considerada uma grave crise sob o ponto de vista epidemiológico e, também, psicológico. Além das perdas em massa em curto espaço de tempo, as dificuldades para realização de rituais de despedida entre pessoas na iminência da morte e seus familiares, bem como de rituais funerários, podem dificultar a experiência de luto. O objetivo deste estudo é sistematizar conhecimentos sobre os processos de terminalidade, morte e luto no contexto da pandemia de COVID-19. Por meio de revisão narrativa da literatura, foram sumarizadas experiências relatadas em diferentes países durante a pandemia. Apresentam-se características das demandas psicológicas emergentes e implicações para a prática profissional do psicólogo. Considerando que expressões de afeto, condolências e espiritualidade sofrem alterações nesse cenário, discute-se a importância de potencializar formas alternativas e respeitosas para ritualização dos processos vividos, o que parece essencial para ressignificar perdas e enfrentar desafios durante e após a vigência da pandemia.
Downloads
Referências
Albuquerque, A. N. (2020, 21 de abril). Enterros triplicam, e cemitério de Manaus abre valas comuns para vítimas do coronavírus. Folha de S. Paulo. Recuperado de https://www1.folha.uol.com.br/cotidiano/2020/04/enterros-triplicam-e-cemiterio-de-manaus-abre-valas-comuns-para-vitimas-do-coronavirus.shtml
Arango, C. (2020). Lessons learned from the coronavirus health crisis in Madrid, Spain: how COVID-19 has changed our lives in the last two weeks [Ahead of Print]. Biological Psychiatry. https://dx.doi.org/10.1016/j.biopsych.2020.04.003
Bajwah, S., Wilcock, A., Towers, R., Costantini, M., Bausewein, C., Simon, S. T., ... Higginson, I. J. (2020). Managing the supportive care needs of those affected by COVID-19. European Respiratory Journal, 55, 2000815. https://dx.doi.org/10.1183/13993003.00815-2020
Biondo, C. S., Ferraz, M. O. A., Silva, M. L. M., & Yarid, S. D. (2017). Espiritualidade nos serviços de urgência e emergência. Revista Bioética, 25(3), 596-602. https://dx.doi.org/10.1590/1983-80422017253216
Costantini, M., Sleeman, K. E., Peruselli, C., & Higginson, I. J. (2020). Response and role of palliative care during the COVID-19 pandemic: a national telephone survey of hospices in Italy [Ahead of Print]. Palliative Medicine. https://dx.doi.org/10.1101/2020.03.18.20038448
Crepaldi, M. A., Schmidt, B., Noal, D. S., Bolze, S. D. A., & Gabarra, L. M. (2020). Terminalidade, morte e luto na pandemia de COVID-19: demandas psicológicas emergentes e implicações práticas. Scielo Preprints. Versão 1. https:// doi.org/10.1590/SciELOPreprints.491
Eisma, M. C., Boelen, P. A., & Lenferink, L. I. (2020). Prolonged grief disorder following the Coronavirus (COVID-19) pandemic. Psychiatry Research, 288, 113031. https://dx.doi.org/10.1016/j.psychres.2020.113031
Enumo, S. R. F., Weide, J. N., Vicentini, E. C. C., Araujo, M. F., & Machado, W. L. (2020). Enfrentando o estresse em tempos de pandemia: proposição de uma cartilha. Estudos de Psicologia (Campinas), 37, e200065. http://dx.doi.org/10.1590/1982-0
Ferguson, N., Laydon, D., Nedjati Gilani, G., Imai, N., Ainslie, K., ... Ghani, A. (2020). Report 9: impact of Non-Pharmaceutical Interventions (NPIs) to reduce COVID19 mortality and healthcare demand. London: Imperial College. Retrieved from http://hdl.handle.net/10044/1/77482
Ferrari, R. (2015). Writing narrative style literature reviews. Medical Writing, 24(4), 230-235. https://dx.doi.org/10.1179/2047480615Z.000000000329
Fundação Oswaldo Cruz. (2020a). Saúde mental e atenção psicossocial na pandemia COVID-19: processo de luto no contexto da COVID-19. Rio de Janeiro: Autor. Recuperado de https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/sa%c3%bade-mental-e-aten%c3%a7%c3%a3o-psicossocial-na-pandemia-covid-19-processo-de-luto-no-contexto-da-covid-19.pdf
Fundação Oswaldo Cruz. (2020b). Saúde mental e atenção psicossocial na pandemia COVID-19: cuidados paliativos. Rio de Janeiro: Autor. Recuperado de https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/sa%c3%bade-e-mental-e-aten%c3%a7%c3%a3o-psicossocial-na-pandemia-covid-19-cuidados-paliativos-orienta%c3%a7%c3%b5es-aos-profissionais-de-sa%c3%bade.pdf
Fundação Oswaldo Cruz. (2020c). Saúde mental e atenção psicossocial na pandemia COVID-19: orientações às/aos psicólogas/os hospitalares. Rio de Janeiro: Autor. Recuperado de https://www.fiocruzbrasilia.fiocruz.br/wp-content/uploads/2020/04/cartilha_psicologos_hospitalares.pdf
Hernández, A. R., & Berman, M. (2020, March 23). Grief amid the pandemic: live-streamed funerals, canceled services and mourning left ‘unfinished’. The Washington Post. Retrieved from https://www.washingtonpost.com/national/grief-amid-the-pandemic-live-streamed-funerals-canceled-services-and-mourning-left-unfinished/2020/03/23/9201e996-6bdf-11ea-abef-020f086a3fab_story.html
Ho, C. S., Chee, C. Y., & Ho, R. C. (2020). Mental health strategies to combat the psychological impact of COVID-19 beyond paranoia and panic. Annals, Academy of Medicine, Singapore, 49(1), 1-3. Retrieved from http://www.anmm.org.mx/descargas/Ann-Acad-Med-Singapore.pdf
Ingravallo, F. (2020). Death in the era of the COVID-19 pandemic. The Lancet Public Health, 5(5), e258. https://dx.doi.org/10.1016/S2468-2667(20)30079-7
Kunz, R., & Minder, M. (2020). COVID-19 pandemic: palliative care for elderly and frail patients at home and in residential and nursing homes. Swiss Medical Weekly, 150(w20235), 1-2. https://dx.doi.org/10.4414/smw.2020.20235
Lisbôa, M. L., & Crepaldi, M. A. (2003). Ritual de despedida em familiares de pacientes com prognóstico reservado. Paidéia, 13(25), 97-109. https://dx.doi.org/10.1590/S0103-863X2003000200009
Liu, J. J., Bao, Y., Huang, X., Shi, J., & Lu, L. (2020). Mental health considerations for children quarantined because of COVID-19. The Lancet Child & Adolescent Health, 4(5), 347-349. https://dx.doi.org/10.1016/S2352-4642(20)30096-1
Lloyd-Sherlock, P., Ebrahim, S., Geffen, L., & McKee, M. (2020). Bearing the brunt of covid-19: older people in low and middle income countries. BMJ, 368, m1052. https://dx.doi.org/10.1136/bmj.m1052
Meyer, E. P. (2016). Death in the age of eternity: how Facebook users cope with personal loss (Unpublished master’s thesis). Iwoa State University. Retrieved from https://lib.dr.iastate.edu/cgi/viewcontent.cgi?article=6779&context=etd
Ministério da Saúde (2020). Manejo de corpos no contexto do novo coronavírus – COVID-19. Brasília: Autor. Recuperado de https://www.saude.gov.br/images/pdf/2020/marco/25/manejo-corpos-coronavirus-versao1-25mar20-rev5.pdf
Ornell, F., Schuch, J. B., Sordi, A. O., & Kessler, F. H. P. (2020). “Pandemic fear” and COVID-19: mental health burden and strategies [Ahead of Print]. Brazilian Journal of Psychiatry. Retrieved from https://www.rbppsychiatry.org.br/details/943/en-us/-pandemic-fear--and-covid-19--mental-health-burden-and-strategies
Pattison, N. (2020). End-of-life decisions and care in the midst of a global coronavirus (COVID-19) pandemic. Intensive and Critical Care Nursing, 102862, 1-3. https://dx.doi.org/10.1016/j.iccn.2020.102862
Pautasso, M. (2020). The structure and conduct of a narrative literature review. In R. S. Tubbs, S. M. Buerger, M. M. Shoja, A. Arynchyna, & M. Karl (Eds.), A guide to the scientific career: virtues, communication, research, and academic writing (pp.299-310). Hoboken: Wiley Blackwell.
Scanlon, J., & McMahon, T. (2011). Dealing with mass death in disasters and pandemics. Disaster Prevention and Management, 20(2), 172-185. https://dx.doi.org/10.1108/09653561111126102
Schmidt, B., Crepaldi, M. A., Bolze, S. D. A., Neiva-Silva, L., & Demenech, L. M. (2020). Saúde mental e intervenções psicológicas diante da pandemia do novo coronavírus (COVID-19). Estudos de Psicologia (Campinas), 37, e200063. http://dx.doi.org/10.1590/1982-0275202037e200063
Schmidt, B., Gabarra, L. M., & Gonçalves, J. R. (2011). Intervenção psicológica em terminalidade e morte: relato de experiência. Paidéia, 21(50), 423-430. https://dx.doi.org/10.1590/S0103-863X2011000300015
Shojaei, S. F., & Masoumi, R. (2020). The importance of mental health training for psychologists in COVID-19 outbreak. Middle East Journal of Rehabilitation and Health Studies, 7(2), e102846. https://dx.doi.org/10.5812/mejrh.102846
Social Science in Humanitarian Action Platform. (2020). Key considerations: dying, bereavement and mortuary and funerary practices in the context of COVID-19 (Brief). Retrieved from https://www.ids.ac.uk/publications/key-considerations-dying-bereavement-and-mortuary-and-funerary-practices-in-the-context-of-covid-19-april-2020/
Taylor, S. (2019). The psychology of pandemics: preparing for the next global outbreak of infectious disease. Newcastle upon Tyne: Cambridge Scholars Publishing.
Victor, G. S., & Ahmed, S. (2019). The importance of culture in managing mental health response to pandemics. In D. Huremovic (Ed.), Psychiatry of pandemics: a mental health response to infection outbreak (pp.55-64). Cham: Springer.
Walker, P. G., Whittaker, C., Watson, O., Baguelin, M., Ainslie, K. E. C., Bhatia, S., ... Ghani, A. C. (2020). The global impact of COVID-19 and strategies for mitigation and suppression. London: Imperial College. Retrieved from https://www.imperial.ac.uk/media/imperial-college/medicine/sph/ide/gida-fellowships/Imperial-College-COVID19-Global-Impact-26-03-2020v2.pdf
Wallace, C. L., Wladkowski, S. P., Gibson, A., & White, P. (2020). Grief during the COVID-19 pandemic: considerations for palliative care providers [Ahead of Print]. Journal of Pain and Symptom Management. https://dx.doi.org/10.1016/j. jpainsymman.2020.04.012
Walsh, F. (2016). A dimensão espiritual da vida familiar. In F. Walsh (Ed.), Processos normativos da família: diversidade e complexidade (pp.347-371). Porto Alegre: Artmed.
Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in china. International Journal of Environmental Research and Public Health, 17(5), 1729. https://dx.doi.org/10.3390/ijerph17051729
Wang, S. S., Teo, W. Z., Yee, C. W., & Chai, Y. W. (2020). Pursuing a good death in the time of COVID-19 [Ahead of Print]. Journal of Palliative Medicine. https://dx.doi.org/10.1089/jpm.2020.0198
Weaver, M. S., & Wiener, L. (2020). Applying palliative care principles to communicate with children about COVID-19 [Ahead of Print]. Journal of Pain and Symptom Management. https://dx.doi.org/10.1016/j.jpainsymman.2020.03.020
Weir, K. (2020a, April, 1). Grief and COVID-19: mourning our bygone lives. American Psychological Association. Retrieved from https://www.apa.org/news/apa/2020/04/grief-covid-19
Weir, K. (2020b, April 6). Grief and COVID-19: saying goodbye in the age of physical distancing. American Psychological Association. Retrieved from https://www.apa.org/topics/covid-19/grief-distance
World Health Organization. (2020a). WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. Geneve: Author. Retrieved from https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
Word Health Organization. (2020b). Infection prevention and control during health care when novel coronavirus (nCoV) infection is suspected. Geneve: Author. Retrieved from https://www.who.int/publications-detail/infection-prevention-and-control-during-health-care-when-novel-coronavirus-(ncov)-infection-is-suspected-20200125
Worden, J. W. (2018). Grief counseling and grief therapy: a handbook for the mental health practitioner. New York: Springer.
Zhang, C., Yang, L., Liu, S., Ma, S., Wang, Y., Cai, Z., ... Zhang, B. (2020). Survey of insomnia and related social psychological factors among medical staffs involved with the 2019 novel coronavirus disease outbreak. Frontiers in Psychiatry, 11, 1-9. https://dx.doi.org/10.3389/fpsyt.2020.00306
Zibell, M. (2020, 1 de abril). Mortos em casa e cadáveres nas ruas: o colapso funerário causado pelo coronavírus no Equador. BBC News Brasil. Recuperado de https://www.bbc.com/portuguese/internacional-52129845
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Maria Aparecida CREPALDI, Beatriz SCHMIDT, Débora da Silva NOAL, Simone Dill Azeredo BOLZE, Letícia Macedo GABARRA
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.