Representações sociais sobre espiritualidade e religiosidade no cuidado de crianças em fim de vida

Abstract

Introduction: Although death is a natural and inevitable process, it remains a topic rarely addressed in the education of health professionals, particularly when it involves children, leading to significant emotional impacts on healthcare teams. The predominance of the biomedical model limits the inclusion of subjective aspects such as spirituality and religiosity, which are important in end-of-life care. Despite recognition of their relevance, these themes are seldom integrated into training curricula. Objectives: To analyze the social representations of spirituality and religiosity and their expressions in the care provided by health professionals to pediatric patients at the end of life; to describe the social representations of spirituality and religiosity among professionals who care for pediatric patients at the end of life; to describe actions and/or practices considered by professionals as enabling the expression of spirituality and/or religiosity in the care of pediatric patients at the end of life; to analyze the expressions of spirituality and religiosity in the actions and/or care provided by professionals to pediatric patients at the end of life; and to propose strategies aimed at addressing spirituality in care, based on the social representations of professionals who work in this context. Method: This is a qualitative, descriptive study conducted with 30 health professionals working in a pediatric hospital in Rio de Janeiro between April and July 2024. Data collection was carried out through semi-structured interviews to explore participants' social representations on the investigated topic. The empirical material was analyzed using a lexical approach with the Alceste-2012 software, and descriptive statistics were used to characterize the participants' profiles. Results: Most participants were women, with over 20 years of professional experience and postgraduate education. A large portion of the professionals identified as spiritual and believers in deities, with affiliations mainly to Kardecist Spiritism, Catholicism, and Evangelical Christianity. Although participants acknowledged the importance of spirituality and religiosity as sources of comfort and coping at the end of life, gaps were observed in their conceptual understanding and practical application in professionais settings. The most cited expressions included prayer, meditation, and contact with nature. However, significant obstacles to integrating these dimensions into care were also reported, such as the lack of specific training, institutional limitations, and insufficient infrastructure in healthcare services. Conclusion: The social representations of religiosity and spirituality among health professionals reveal their potential as coping resources both for pediatric patients at the end of life and for the professionals themselves. Despite their acknowledged importance, persistent gaps in training and institutional structures hinder their effective integration into care. Ethical dilemmas and uncertainties regarding the practical application of spirituality and religiosity were also identified, requiring sensitive and respectful preparation. Therefore, it is recommended that these topics be included in professional training, along with the development of institutional guidelines and welcoming spaces, to ensure more ethical, humanized, and holistic care.