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Advisor(s)
Abstract(s)
Actualmente um novo paradigma reconhece à pessoa o direito à autonomia, o que tem
gerado movimentos a favor da participação activa de cada um no seu processo de
cuidados de saúde, numa perspectiva de cidadania. É neste quadro que o conceito de
parceria na saúde ganha realce. Por outro lado, o envelhecimento demográfico pode
trazer o aumento de doenças crónicas e um número elevado de doentes idosos com
necessidades de cuidados continuados no domicílio. Assim, este estudo tem como
objectivo compreender a natureza, a estrutura e o processo da parceria entre o
enfermeiro e o doente idoso, na relação de cuidados em contexto domiciliário.
Utilizou-se uma abordagem qualitativa, seguindo o método da grounded theory. Os
participantes, 10 enfermeiros e 28 doentes idosos, foram seleccionados por amostragem
teórica. As técnicas de colheita de dados foram a observação participante, as entrevistas
e a análise de documentos. A recolha de dados realizou-se entre Dezembro de 2006 a
Março de 2009. Efectuaram-se 50 registos de observação, 29 entrevistas a doentes
idosos (15 formais e 14 informais) e 22 entrevistas a enfermeiros (10 formais e 12
informais). A análise dos dados realizou-se pelo método das comparações constantes.
Os resultados mostram que na construção do processo de parceria, num contexto de
vulnerabilidade e dependência, são condições estruturais ver a pessoa idosa como ser de
projecto e de cuidado e ter tempo e espaço para estabelecer uma relação de qualidade.
As estratégias passam por partilhar significados da experiência na construção de uma
acção conjunta, quando o doente idoso tem autonomia, ou a construção de uma acção
em que o cuidado de Si é assegurado pelo enfermeiro, quando este não tem autonomia.
As consequências destas acções e interacções são o assumir ou o assegurar o cuidado de
Si. A construção do processo de parceria caracteriza-se por cinco fases: revelar-se;
envolver-se; capacitar ou possibilitar; comprometer-se; assumir o controlo de Si ou
assegurar o cuidado do Outro. Conclui-se que a parceria como a construção de uma
acção conjunta que promova o cuidado de Si, no respeito pela singularidade da pessoa
ou como a construção de uma acção que tem como objectivo assegurar o cuidado do
Outro, permite que a pessoa possa assumir o controlo sobre o seu projecto de vida e de
saúde ou prosseguir a sua trajectória de vida, qualquer que seja a sua circunstância.
Nowadays, a new paradigm recognizes the person's right to autonomy, which has originated movements towards the active participation of each one in the process of care under a perspective of citizenship. Within this framework, the concept of partnership in health is pointed out. Moreover, the demographic aging may increase the chronic diseases and the high number of elderly patients needing continued nursing care at home. Thus, this study aims to understand the nature, structure and process of the partnership between nurse and elderly patient at home environment. A qualitative approach was carried out based on grounded theory method. The participants, 10 nurses and 28 elderly patients, were selected by theoretical sampling. The techniques of data collection were participant observation, interviews and document analysis. Data collection took place between December 2006 and March 2009: 50 observation records were made, 29 interviews to elderly patients (15 formal and 14 informal interviews) and 22 interviews to nurses (10 formal and 12 informal interviews) were carried out. According to the methodology, data analysis was developed by the method of constant comparisons. The results show that to develop a partnership process the structural conditions are to see the elderly as a being of project and care, as well as to have time and space to establish a relationship of quality, namely when patients are dependent and vulnerable. The strategies comprise the sharing of meanings of the experience in the construction of a joined action when the elderly patient has autonomy, or the construction of an action where the care of Oneself is ensured by the nurse when that one does not have autonomy. The consequences of these actions and interactions are the ability to assume or to ensure the care of Oneself. The development of the partnership process is characterized by five stages: to reveal oneself; involve oneself; to capacitate or to enable; to commit; to take control of himself/herself or to ensure the care of the Other. The conclusion is that the partnership, as the construction of a joint action which promotes the care of Oneself, respecting the person’s singularity, or as a construction of an action which has the aim of ensuring the care of the Other, enables the person to assume the control of his/her project of life and health, or to prosecute his/her own trajectory of life, whatever their circumstances are.
Nowadays, a new paradigm recognizes the person's right to autonomy, which has originated movements towards the active participation of each one in the process of care under a perspective of citizenship. Within this framework, the concept of partnership in health is pointed out. Moreover, the demographic aging may increase the chronic diseases and the high number of elderly patients needing continued nursing care at home. Thus, this study aims to understand the nature, structure and process of the partnership between nurse and elderly patient at home environment. A qualitative approach was carried out based on grounded theory method. The participants, 10 nurses and 28 elderly patients, were selected by theoretical sampling. The techniques of data collection were participant observation, interviews and document analysis. Data collection took place between December 2006 and March 2009: 50 observation records were made, 29 interviews to elderly patients (15 formal and 14 informal interviews) and 22 interviews to nurses (10 formal and 12 informal interviews) were carried out. According to the methodology, data analysis was developed by the method of constant comparisons. The results show that to develop a partnership process the structural conditions are to see the elderly as a being of project and care, as well as to have time and space to establish a relationship of quality, namely when patients are dependent and vulnerable. The strategies comprise the sharing of meanings of the experience in the construction of a joined action when the elderly patient has autonomy, or the construction of an action where the care of Oneself is ensured by the nurse when that one does not have autonomy. The consequences of these actions and interactions are the ability to assume or to ensure the care of Oneself. The development of the partnership process is characterized by five stages: to reveal oneself; involve oneself; to capacitate or to enable; to commit; to take control of himself/herself or to ensure the care of the Other. The conclusion is that the partnership, as the construction of a joint action which promotes the care of Oneself, respecting the person’s singularity, or as a construction of an action which has the aim of ensuring the care of the Other, enables the person to assume the control of his/her project of life and health, or to prosecute his/her own trajectory of life, whatever their circumstances are.