Convivendo entre fragilidades e motivações: experiências de famílias com o câncer gestacional

Abstract

The family of the pregnant/postpartum woman experiences with them the joys and fears inherent in the birth of a child and is organized to meet new care needs. The diagnosis of cancer, in this context, makes the family need to reorganize itself for another type of demand, different from the one for which it was preparing. Pregnancy complicated by cancer is a relatively rare condition that occurs in one in every 1000 pregnancies. As women currently tend to postpone pregnancy to the third or fourth decade of life, this phenomenon has become more and more frequent. The objectives of this study were, therefore: to understand the experience of families facing the illness of a family member due to gestational cancer; apprehend the meanings of the family's actions in the face of illness due to gestational cancer and elaborate a substantive theory representative of the families' experience. Symbolic Interactionism was the theoretical framework used, and Grounded Theory, the methodological framework. The study participants were twelve families who had the experience of having, among its members, a woman who fell ill from cancer or during pregnancy or up to one year postpartum. As a criterion for inclusion to participate in the interview, it was having a family bond (biological, emotional or affinity) with the woman who was diagnosed with cancer during pregnancy and having accompanied her during her illness and treatment. As a family, it was considered to have, at the time of the interview, at least two people, one of whom may be the woman herself. Data collection took place through an instrument of social and clinical characterization of women and information about family members and included the genogram; also by in-depth interview. The organization, description and analysis of the information followed the Constant Comparative Method. The analysis of the data took place through the substantive and theoretical coding, which allowed the elaboration of the substantive theory “Living among weaknesses and motivations: experiences of families with gestational cancer”, which has, as its central concept “Living among losses that weaken and the arrival of the child who strengthens”, built from six concepts with contextual relationships, cause, conditions and consequences. All ethical precepts that govern research with human beings were respected, according to Resolution No. 466/2012. The research project was approved by the research ethics committee due to the opinion of 2,435,385. The substantive theory allowed the knowledge that families that go through gestational cancer perceive themselves in a situation of duality, a condition that needs to be valued with a view to individualized and comprehensive care for these families. There is potential in the study of innovation since the theme is little explored and, therefore, provides visibility to the occurrence and experience with gestational cancer. As an impact for the nursing practice, there is a need for the particularities of the experience to be considered in the care planning for this group and that these are directed to the needs punctuated by the family. Equally important are professional actions for the early detection of cancer during pregnancy and postpartum and health education practices that make women and families co-participants in care.