La conciencia en el umbral del tránsitoexperiencias cercanas a la muerte

Résumé

A lo largo de la historia el ser humano se ha ido acercando y alejando al concepto de la muerte dependiendo del contexto sociocultural, siendo la muerte entendida y aceptada, o alejada y ocultada en función de estos factores. Más allá de esto, ha habido un aspecto de la muerte que ha ayudado al ser humano a sobrellevar la pérdida tanto propia como ajena y ha sido la dimensión trascendental. En este sentido las Experiencias cercanas a la muerte (ECM) aparecen como la posible confirmación de esta dimensión espiritual del ser humano. Las personas que han vivido una ECM, describen una serie de elementos comunes ocurridos durante su experiencia relacionados con un mundo sobrenatural al que aseguran haber visitado. Elementos tales como atravesar un túnel, ver una luz al final del mismo, ver a sus familiares ya fallecidos, verse desde fuera de su cuerpo, sensación de una extraordinaria paz y tranquilidad, etc. Además de estas experiencias de muerte temporal que en la mayoría de los casos tienen lugar durante una parada cardiorrespiratoria, una operación o desmayo entre otras, las experiencias cercanas a la muerte aparecen en los pacientes que están próximos a morir, son las llamadas experiencias al final de la vida (EFV), donde el enfermo suele ver a familiares ya fallecidos que, en muchos casos, les dicen que han venido a recogerles. Estas experiencias, tanto las experiencias de muerte temporal como experiencias al final de la vida, complementan esa visión de la trascendencia de la conciencia más allá de la mera creencia debido fundamentalmente a que son objeto de investigaciones científicas en diferentes países de todo el mundo. En la presente tesis, teniendo en cuenta lo anteriormente expuesto se han propuesto como objetivos los siguientes: - Establecer la incidencia de las ECM en Murcia. - Analizar si el contenido de las Experiencias de Muerte Temporal y de las Experiencias al Final de la Vida en Murcia es similar a las estudiadas en el extranjero. - Verificar la influencia de los procesos emocionales y cognitivos de la ansiedad ante la muerte del personal de enfermería y si es necesario que el profesional sanitario esté informado sobre las ECMs. - Proporcionar propuestas de mejora asistencial en relación al acompañamiento y al abordaje de las ECMs. En la metodología utilizada se establecieron dos diseños de investigación, el fenomenológico y el transversal descriptivo, cualitativo y cuantitativo, según la etapa de investigación. Los instrumentos para la obtención de información utilizados fueron: la observación, la entrevista y cuestionarios. Los datos se obtuvieron en dos escenarios, el hospitalario, en el servicio de UCI del Hospital General Universitario Reina Sofía de Murcia y en el área de cuidados paliativos y en el ámbito no hospitalario se obtuvo a través de entrevistas personales fuera del hospital y de los cuestionarios enviados por email. En los resultados obtenidos se ha podido comprobar que: - Los elementos encontrados son los mismos que se encontraron en ECM y EFV en las investigaciones previas. - Una formación adecuada sobre la muerte y las ECM en los servicios de UCI beneficiaría tanto al profesional como a la asistencia a los pacientes y familiares, ya que, carecen en su mayoría, del conocimiento requerido para aportar el nivel de atención necesario. - Conocer que las ECMs ocurren con relativa frecuencia, ayudaría a una mayor comprensión de lo vivido, y el paciente mejoraría con más rapidez física y mentalmente, lo que implicaría un ahorro importante a los servicios públicos de salud. - Es necesario la creación de un servicio de atención a los trabajadores, especialmente dirigido a aquellos que tienen más contacto con situaciones emocionalmente estresantes. Over the course of history, mankind has been approaching and moving away from the concept of death depending on the sociocultural context. Death has been either understood and accepted or pushed away and hidden depending on these factors. Even more so, there has been an aspect of death that has helped mankind to bear personal loss as well as other people's losses and this aspect is the transcendental dimension. In this sense, near-death experiences (NDE) appear as the possible confirmation of this spiritual dimension of the human being. People who have experienced an NDE, describe a number of common elements that happened during their experience related to a supernatural world that they claim to have visited. Elements such as walking through a tunnel, seeing a bright light at the end of it, seeing their deceased relatives, seeing themselves from outside of their body, feeling an extraordinary peace and quiet, etc. In addition to these experiences of temporary death, that in most cases take place during a cardiac arrest, an operation or fainting among others, near death experiences occur in patients who are close to dying, they are called End of life experiences (ELE), where the patient usually is able to see deceased relatives who, in many cases, tell them that they have come to pick them up. These experiences, both temporal death experiences as well as experiences at the end of life, complement this vision of transcendence of consciousness beyond mere belief, basically because they are the subject of scientific research in different countries around the world. In this thesis, considering the previous content, the following objectives have been proposed: - To establish the incidence of NDEs in Murcia. - To analyze whether the content of Temporary Death Experiences and End of Life Experiences in Murcia is similar to those studied abroad. - To verify the influence of emotional and cognitive processes of death anxiety in nurses and verify if it is necessary for health professionals to be informed about NDEs. - To provide proposals for healthcare assistance regarding accompaniment and approach towards NDEs. Regarding the methodology used, two investigation designs were established, phenomenological and descriptive, qualitative and quantitative transversal, according to the investigation stage. The instruments used to obtain information were: observation, interviews and questionnaires. The data was obtained in two scenarios, a hospital environment, in the service of ICU in the General Hospital of the University of Reina Sofía in Murcia in the palliative care area, and a non-hospital environment was obtained through personal interviews outside of the hospital, using questionnaires sent by email. In the results obtained it has been able to prove that: - The revealed elements are the same as elements found in NDE and ELE in previous investigations. - Appropriate training in ICU regarding death and ECM would benefit both professional care as well as those who assist patients and families, since they lack for the most part, the knowledge required to provide the level of care needed. - Knowledge that NDEs occur in a relatively frequent manner would help further understanding of experiences and the patient would improve physically and mentally more quickly, which would mean significant savings to public health services. - The creation of a service in attention to workers, especially aimed at those who have more contact with emotionally stressful situations, is necessary. Over the course of history, mankind has been approaching and moving away from the concept of death depending on the sociocultural context. Death has been either understood and accepted or pushed away and hidden depending on these factors. Even more so, there has been an aspect of death that has helped mankind to bear personal loss as well as other people's losses and this aspect is the transcendental dimension. In this sense, near-death experiences (NDE) appear as the possible confirmation of this spiritual dimension of the human being. People who have experienced an NDE, describe a number of common elements that happened during their experience related to a supernatural world that they claim to have visited. Elements such as walking through a tunnel, seeing a bright light at the end of it, seeing their deceased relatives, seeing themselves from outside of their body, feeling an extraordinary peace and quiet, etc. In addition to these experiences of temporary death, that in most cases take place during a cardiac arrest, an operation or fainting among others, near death experiences occur in patients who are close to dying, they are called End of life experiences (ELE), where the patient usually is able to see deceased relatives who, in many cases, tell them that they have come to pick them up. These experiences, both temporal death experiences as well as experiences at the end of life, complement this vision of transcendence of consciousness beyond mere belief, basically because they are the subject of scientific research in different countries around the world. In this thesis, considering the previous content, the following objectives have been proposed: - To establish the incidence of NDEs in Murcia. - To analyze whether the content of Temporary Death Experiences and End of Life Experiences in Murcia is similar to those studied abroad. - To verify the influence of emotional and cognitive processes of death anxiety in nurses and verify if it is necessary for health professionals to be informed about NDEs. - To provide proposals for healthcare assistance regarding accompaniment and approach towards NDEs. Regarding the methodology used, two investigation designs were established, phenomenological and descriptive, qualitative and quantitative transversal, according to the investigation stage. The instruments used to obtain information were: observation, interviews and questionnaires. The data was obtained in two scenarios, a hospital environment, in the service of ICU in the General Hospital of the University of Reina Sofía in Murcia in the palliative care area, and a non-hospital environment was obtained through personal interviews outside of the hospital, using questionnaires sent by email. In the results obtained it has been able to prove that: - The revealed elements are the same as elements found in NDE and ELE in previous investigations. - Appropriate training in ICU regarding death and ECM would benefit both professional care as well as those who assist patients and families, since they lack for the most part, the knowledge required to provide the level of care needed. - Knowledge that NDEs occur in a relatively frequent manner would help further understanding of experiences and the patient would improve physically and mentally more quickly, which would mean significant savings to public health services. - The creation of a service in attention to workers, especially aimed at those who have more contact with emotionally stressful situations, is necessary.