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Efetividade dos cuidados de enfermagem à pessoa com diabetes tipo 2 : a educação terapêutica e resultados em cuidados de saúde primários
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| 7.04 MB | Adobe PDF |
Abstract(s)
Introdução: A qualidade dos cuidados de saúde é uma questão central. Os sistemas de saúde e também os enfermeiros são impelidos a demonstrar que os cuidados que providenciam são efetivos e alcançam os resultados a que se propõem. A diabetes é uma doença crónica cujos números alcançam proporções epidémicas, sendo premente que se demonstre o valor dos cuidados prestados pelos enfermeiros e a sua efetividade nesta área. Objetivo geral: avaliar a efetividade dos cuidados de enfermagem respeitantes à educação terapêutica à pessoa com diabetes tipo 2. Metodologia: Com o intuito de ir ao encontro do objetivo geral desenvolvemos 3 estudos tendo em consideração os princípios éticos inscritos na declaração de Helsinquia: - O primeiro estudo de análise quantitativa permitiu validar/revalidar os instrumentos de medida em duas amostras não probabilísticas, uma de 104 enfermeiros e outra de 292 utentes com diabetes. - O segundo estudo, de caráter descritivo, teve como objetivo específico descrever as condições para o exercício da prática de enfermagem (estrutura), o processo de cuidados de enfermagem e os resultados da pessoa com diabetes, recorrendo a uma amostra não probabilística de 49 enfermeiros prestadores de cuidados a utentes com diabetes em cuidados de saúde primários e a uma amostra não probabilística de 292 utentes com diabetes tipo 2, cuidados por aqueles enfermeiros. - O terceiro estudo, de natureza correlacional, permitiu testar o modelo NREM de análise da efetividade dos cuidados de enfermagem adaptado à área da diabetes, na amostra caraterizada no estudo anterior. Considerando a revisão da literatura efetuada, foram testadas as hipóteses propostas de relação entre a estrutura, processo e resultado. Resultados: Os resultados do primeiro estudo indicam adequação dos instrumentos para avaliar os construtos a que se propõem. Todos os instrumentos apresentam boas caraterísticas psicométricas não só na fidelidade como na validade de constructo. Os resultados do segundo estudo permitiram caraterizar o ambiente da prática de cuidados e os dados demográficos e profissionais dos enfermeiros e caraterizar o processo de educação terapêutica ao utente com diabetes e a educação relativa aos comportamentos de autocuidado. Em relação ao utente, este permitiu caraterizar a situação clínica e sociodemográfica, a satisfação com os cuidados, o autocuidado com a diabetes e os conhecimentos sobre a diabetes. O modelo estrutural resultante do terceiro estudo revelou qualidade pelas capacidades preditivas e relações estatisticamente significativas apuradas. Verificou-se haver relações estatisticamente significativas entre as variáveis da estrutura e as do processo e entre estas e os resultados obtidos. Conclusão e implicações: Os resultados obtidos poderão reverter para a área da investigação, do ensino e da prática, uma vez que se identificou a contribuição dos cuidados de enfermagem (educação terapêutica) para os resultados, permitindo sublinhar o valor e a efetividade dos cuidados de enfermagem na área da educação terapêutica à pessoa com diabetes.
Introduction: The quality of care is a central issue. Health systems and nurses also are compelled to demonstrate that the care they provide is effective and achieve the results which are proposed. Diabetes is a chronic disease whose numbers reach epidemic proportions, being important to demonstrate the value of care provided by nurses and their effectiveness in this area. General objective: to evaluate the effectiveness of nursing care to people with type 2 diabetes in what concerns to therapeutic education. Methodology: In order to meet the overall objective we develop 3 studies taking into account the ethical principles contained in the Helsinki Declaration. -The first study of quantitative analysis allowed validate/revalidate measuring instruments in two non-probabilistic samples, one of 104 nurses and another of 292 users with diabetes. -- The second study, of descriptive nature, had the objective of describing the conditions for the exercise of nursing practice (structure), the process of nursing care and the results of the person with diabetes, using a non-probabilistic sample of 49 nurses care providers to users with diabetes in primary care and a non-probabilistic sample of 292 users with type 2 diabetes, care by those nurses. - The third study, of correlational nature, allowed testing NREM model analysis of the effectiveness of nursing care adapted to the area of diabetes, in the sample characterized in the previous study. Considering the revision of the literature made, the hypotheses of relationship between structure, process and outcome were tested. Results: The results of the first study indicate adequacy of instruments to assess the proposed constructs. All instruments feature good psychometric characteristics not only in fidelity as in construct validity. The results of the second study allowed feature the practice environment of care and the demographic and professional data of nurses and feature the therapeutic education process to the patient with diabetes and their education regarding self-care behaviours. In relation to the user, this allowed feature the clinical and socio demographic situation, satisfaction with the care, self-care with diabetes and knowledge about diabetes. The structural model resulting from the third study revealed quality predictive abilities and statistically significant relationships. It was found to be statistically significant relationships between variables of the structure and the process and between these and the results obtained. Conclusion and implications: The results obtained may revert to the area of research, teaching and practice, once identified the contribution of nursing care (therapeutic education) for the results, allowing stressing the value and effectiveness of nursing care in the area of therapeutic education to the person with diabetes.
Introduction: The quality of care is a central issue. Health systems and nurses also are compelled to demonstrate that the care they provide is effective and achieve the results which are proposed. Diabetes is a chronic disease whose numbers reach epidemic proportions, being important to demonstrate the value of care provided by nurses and their effectiveness in this area. General objective: to evaluate the effectiveness of nursing care to people with type 2 diabetes in what concerns to therapeutic education. Methodology: In order to meet the overall objective we develop 3 studies taking into account the ethical principles contained in the Helsinki Declaration. -The first study of quantitative analysis allowed validate/revalidate measuring instruments in two non-probabilistic samples, one of 104 nurses and another of 292 users with diabetes. -- The second study, of descriptive nature, had the objective of describing the conditions for the exercise of nursing practice (structure), the process of nursing care and the results of the person with diabetes, using a non-probabilistic sample of 49 nurses care providers to users with diabetes in primary care and a non-probabilistic sample of 292 users with type 2 diabetes, care by those nurses. - The third study, of correlational nature, allowed testing NREM model analysis of the effectiveness of nursing care adapted to the area of diabetes, in the sample characterized in the previous study. Considering the revision of the literature made, the hypotheses of relationship between structure, process and outcome were tested. Results: The results of the first study indicate adequacy of instruments to assess the proposed constructs. All instruments feature good psychometric characteristics not only in fidelity as in construct validity. The results of the second study allowed feature the practice environment of care and the demographic and professional data of nurses and feature the therapeutic education process to the patient with diabetes and their education regarding self-care behaviours. In relation to the user, this allowed feature the clinical and socio demographic situation, satisfaction with the care, self-care with diabetes and knowledge about diabetes. The structural model resulting from the third study revealed quality predictive abilities and statistically significant relationships. It was found to be statistically significant relationships between variables of the structure and the process and between these and the results obtained. Conclusion and implications: The results obtained may revert to the area of research, teaching and practice, once identified the contribution of nursing care (therapeutic education) for the results, allowing stressing the value and effectiveness of nursing care in the area of therapeutic education to the person with diabetes.
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Keywords
Efetividade Enfermagem Diabetes Educação terapêutica Effectiveness Nursing Therapeutic education
Pedagogical Context
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