Palliative care and the practice of hospital psychology

a theoretical study from the perspective of institutional analysis

Abstract

This theoretical study aims to identify the institutional demands of psychology in the hospital context and the instituting potential of its care interventions for patients without a prognosis of cure. An Institutional Analysis was conducted, taking as a reference the practices of hospital psychology focused on palliative care. The use of the analyzers "centrality of medical power," "role of psychology in the hospital institution," and "palliative care as prioritization of the person and their health" made it possible to understand the paradigms of health promotion and disease remediation, mainly in processes of prioritizing quality of life and finitude, considering psychological practice in palliative care as a promoter of care for life in the predictability of death. The analysis revealed that the centrality of medical knowledge and a hospital organization predominantly guided by the logic of cure create tensions that limit consideration of the subjectivity of patients and their families. In contrast, palliative care emerges as an instituting movement capable of shifting the focus from disease to the person, fostering interdisciplinary practices, valuing psychological listening, supporting healthcare teams, and promoting the humanization of care at the end of life. Thus, it can be concluded that psychology has the potential to challenge the hospital institution founded on the principle of cure, with palliative care constituting a point of inflection in healthcare by placing the subject at the center of intervention rather than the cure of disease.