The relationship between clinical team and patients is dynamically established in objective and subjective contexts, where social, individual, and interpersonal aspects interface with scientific, political, and cultural factors [1]. These complexities are seen in the clinical and therapeutic environment, where psychological processes play a crucial role and are not always noticeable, but shape the clinical relationship and, consequently, the decision-making process.
Two key elements in this context are the phenomena of transference and countertransference [2]. Transference refers to the emotions and attitudes of the patient concerning the healthcare professional, often reproducing patterns from previous relationships. On the other hand, countertransference refers to the emotions and reactions that healthcare professionals may experience in response to patients, often unaware, especially when challenges arise when managing this relationship. It may happen due to the characteristics of the disease, and the individual particularities of the patient or the family [2, 3]. Therefore, transference originates in the patient, while countertransference is recognized and managed by the healthcare professional. However, these emotions are not always managed by healthcare professionals, exposing them to distress when they experience situations that go beyond the disease, challenging them in the context of the healthcare professional-patient relationship [3].
Therefore, the relationship between health professionals and patients involves emotions and feelings that, depending on the disease and the patient profile, can have a negative emotional impact on both. This way, health professionals experience an emotional burden with several patients, each with their unique way of handling the disease [4]. In the case of professionals who treat patients with Head and Neck Cancer (HNC), these are recurring experiences.
HNC is a disease that has grown in Brazil, both in prevalence and mortality. It predominantly affects male individuals over 50 years of age with a history of high tobacco and alcohol consumption [5, 6]. This context follows international statistics, which list HNC as the sixth most common cancer worldwide, with 878,348 new cases and 444,347 deaths estimated in 2020 [7, 8]. Most patients with HNC present locally advanced disease at diagnosis, and the standard therapy for these cases involves surgical resection and/or chemoradiation, which are commonly accompanied by physical and functional abnormalities. The treatment is complex and involves several specialists in a therapeutic proposal to minimize the impacts of interventions and improve the quality of life [5, 9]. Therefore, these professionals must have interpersonal skills for the clinical management of these patients due to certain emotional and psychosocial demands observed since the beginning of treatment.
The analysis of these complex emotional processes of healthcare professionals in the relationship with HNC patients can provide important insights into the underlying perceptions and attitudes of these patients [10, 11]. It allows healthcare professionals to improve their understanding of the patient’s individual needs and emotional reactions to diagnosis and treatment. This in-depth understanding can support the formulation of personalized therapeutic strategies, contributing to more appropriate and effective clinical decisions [11].
Studies show that investing in support for the healthcare team can enrich the quality of therapeutic relationships, promoting a more empathetic and collaborative environment between healthcare professionals and patients [12, 13]. Consequently, it may reduce the psychological stress associated with HNC treatment, contributing to improved patient engagement, which may have a positive impact on clinical outcomes. By recognizing and appropriately managing the personal emotions involved in the relationship with the patient, healthcare professionals and institutions can promote a more compassionate and sensitive approach to care, resulting in a more humanized experience for the patient during the treatment process [12].
In this context, to suppress distress resulting from the patient’s situation of fragility and vulnerability, health professionals end up facing some emotional disorganization when treating patients with HNC [4]. By not understanding this phenomenon, these healthcare teams feel emotional exhaustion, mainly influencing clinical decisions and the process of building therapeutic relationships for humanized care [4–6].
Therefore, this study was based on the hypothesis that a conscious understanding of the emotions of healthcare professionals in the clinical relationship with patients can be perceived as better management of emotional exhaustion, contributing to a healthier work setting and humanization of care. So, this study aimed to interpret the perceptions reported and meanings attributed by health professionals to the clinical management of patients with HNC in a specialised clinical service at a general hospital of a Brazilian public university.