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Advisor(s)
Abstract(s)
Introdução: A diabetes tipo 2 é um problema crescente com grande impacto social e económico uma vez que implica uma grande carga nos custos psicossociais e económicos, quer para os doentes e famílias quer para o Sistema Nacional de Saúde.
Os enfermeiros devem ter um lugar relevante na prestação de cuidados à pessoa com diabetes tipo 2, uma vez que os estudos apontam que uma grande parte desses cuidados podem ser prestados por enfermeiros, desde que estruturados e orientados por protocolos detalhados ou Normas de Orientação Clínica (NOC).
Objectivos: O objectivo principal deste trabalho foi o de contribuir com conhecimentos baseados em evidência para o desenvolvimento e promoção da consulta de enfermagem à pessoa com diabetes tipo 2.
Como objectivos secundários estabelecemos: 1) Consensualizar as intervenções que devem ser realizadas pelos enfermeiros na consulta à pessoa com diabetes mellitus (DM) 2 em Cuidados de Saúde Primários (CSP); 2) Elaborar uma NOC para orientação da consulta de enfermagem à pessoa com DM2 em CSP, com base nas intervenções de consenso e nas recomendações baseadas em evidência das NOCs; 3) Identificar diferenças entre a prática corrente dos enfermeiros na consulta à pessoa com DM2 em CSP e as recomendações da NOC elaborada.
Métodos: Para dar resposta a cada um dos objectivos, este estudo desenvolveu-se em três fases distintas mas interligadas. Na 1ª fase elaborámos um Painel de Delphi para consensualizar as intervenções a realizar pelos enfermeiros na consulta à pessoa com diabetes tipo 2 em CSP.
Na 2ª fase realizámos pesquisa bibliográfica, suportada na metodologia da ADAPTE Collaboration, para sustentarmos as intervenções em recomendações baseadas em evidência e elaborarmos uma NOC.
Na 3ª fase construímos e aplicámos um questionário aos enfermeiros que realizam consulta à pessoa com diabetes tipo 2 em CSP que teve por objectivo identificar as diferenças entre a prática corrente dos enfermeiros e as recomendações da Norma elaborada.
Resultados: À excepção da avaliação do pulso, todas as intervenções de consenso são suportadas por recomendações baseadas em evidência. Entre a prática corrente e o preconizado pela NOC elaborada, a maior diferença existe no registo dos valores de Hemoglobina Glicosilada.
Conclusões: Existem poucas diferenças entre as recomendações avaliadas da NOC e a prática referida dos enfermeiros que constituíram a amostra.
Introduction: Type 2 Diabetes is a growing problem with social and economic impact because it involves psychosocial and economic costs for patients, families and for the National Health System. Nurses should have an important place in providing care to patients with type 2 diabetes. Studies show that a large part of care provided by nurses can be as long as structured and guided by protocols or by clinical guidelines. Mains: The principal main of this study was to contribute with evidence based knowledge to the development and promotion of nursing consultation to patients with type 2 diabetes. As secondary objectives we established: 1) Obtain consensus that interventions should be undertaken by nurses in consultation to patients with type 2 diabetes in Primary Health Care (PHC), 2) Based interventions of consensus and evidence based recommendations from existing guidelines; 3) Identify differences between the current practice of nurses in consultation of patients with type 2 diabetes in PHC, and recommendations from the guideline. Methods: This study was developed in three separate but affiliated phases: Phase 1, we developped a Delphi Panel to achieve consensus about interventions that nurses should be undertaken at consultation of patients with type 2 diabetes in PHC. Phase 2, to sustain the interventions in evidence based recommendations and to elaborate a guideline, we conducted literature search supported in ADAPT Collaboration. Phase 3, to identify differences between current practice and guidelines recommendations, we drafted and applied a questionnaire to nurses who performs patients with type 2 diabetes consultation. Results: All interventions supported by consensus recommendations are based on evidence, except assessment of the pulse rate. The difference between current practice and guidelines recommendations are in the glycosylated hemoglobin registry values.Conclusions: There are a few differences between guideline recommendations and current practice of nurses.
Introduction: Type 2 Diabetes is a growing problem with social and economic impact because it involves psychosocial and economic costs for patients, families and for the National Health System. Nurses should have an important place in providing care to patients with type 2 diabetes. Studies show that a large part of care provided by nurses can be as long as structured and guided by protocols or by clinical guidelines. Mains: The principal main of this study was to contribute with evidence based knowledge to the development and promotion of nursing consultation to patients with type 2 diabetes. As secondary objectives we established: 1) Obtain consensus that interventions should be undertaken by nurses in consultation to patients with type 2 diabetes in Primary Health Care (PHC), 2) Based interventions of consensus and evidence based recommendations from existing guidelines; 3) Identify differences between the current practice of nurses in consultation of patients with type 2 diabetes in PHC, and recommendations from the guideline. Methods: This study was developed in three separate but affiliated phases: Phase 1, we developped a Delphi Panel to achieve consensus about interventions that nurses should be undertaken at consultation of patients with type 2 diabetes in PHC. Phase 2, to sustain the interventions in evidence based recommendations and to elaborate a guideline, we conducted literature search supported in ADAPT Collaboration. Phase 3, to identify differences between current practice and guidelines recommendations, we drafted and applied a questionnaire to nurses who performs patients with type 2 diabetes consultation. Results: All interventions supported by consensus recommendations are based on evidence, except assessment of the pulse rate. The difference between current practice and guidelines recommendations are in the glycosylated hemoglobin registry values.Conclusions: There are a few differences between guideline recommendations and current practice of nurses.