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Advisor(s)
Abstract(s)
Esta tese, integrada no doutoramento em Enfermagem, na área de “História e Filosofia
de Enfermagem”, visa conhecer os fundamentos do agir utilizados pelos enfermeiros
face aos os problemas éticos de início de vida. O estudo insere-se no campo da decisão
ética e procura conhecer os seus alicerces.
Assim, para a prossecução desse objetivo, traçamos um estudo qualitativo, do tipo
exploratório-descritivo, e recorremos às entrevistas semiestruturadas para recolha de
material a 26 enfermeiros que desenvolvem o seu exercício profissional no âmbito de
início de vida. Estas entrevistas foram submetidas a análise de conteúdo, mais
concretamente a análise categorial. As categorias de problemas éticos foram elencadas
anteriormente por Nunes (2006) e Deodato (2014), tendo sido igualmente identificadas
neste trabalho algumas categorias já nomeadas anteriormente. Nesta investigação
surgiram igualmente novas categorias, como: Lidar com o aborto espontâneo,
Necessidade de conforto psicológico, Gravidez de menores, Malformações graves
detetadas no momento do nascimento, Consentimento relativamente a cuidados durante
o parto, Identificação de um problema ético, Reconhecimento social do enfermeiro e
Não envolvimento da pessoa no trabalho de parto. As restantes categorias foram
adaptadas do conhecimento anterior (Nunes, Deodato) à luz do conhecimento daquilo
que é o problema ético de enfermagem, segundo Deodato.
Na segunda fase do trabalho, procuramos conhecer a fundamentação utilizada por estes
enfermeiros perante o problema ético de início de vida, partindo de Deodato, que já
tinha identificado estes fundamentos para a decisão ética do enfermeiro, em geral.
Contudo, neste estudo surgiram novas categorias como os fundamentos “pessoais”,
“espirituais” e os relacionados com os “recursos disponíveis”.
Perante estes resultados, concluímos que os enfermeiros se defrontam com diversos
problemas éticos, sendo que alguns deles provocam um impacto inefável na sua atuação
profissional. Perante estas situações e a intensidade com que são vividas, surgem
fundamentos para a decisão a tomar. Os fundamentos “éticos” são os mais
interiorizados no seu agir, mas surgem com grande relevância os fundamentos
“deontológicos”, o que nos leva a concluir que os enfermeiros integram este
conhecimento também na sua ação clínica. Os fundamentos “profissionais” e ainda
outros que apresentamos no local próprio, surgem igualmente nesta investigação.
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Com este estudo, e conhecendo estes resultados, procuramos com a sua divulgação
contribuir para a ajuda à decisão neste campo que nos surge à partida como uma área de
esperança e de alegria, mas que esconde por detrás desta evidência inúmeras situações
de sofrimento para todos os envolvidos.
Esperamos assim cumprir o objetivo de contribuir para o conhecimento que auxilie os
enfermeiros a decidir da melhor forma. Estando cientes de que mais entrevistas, mais
localizações geográficas ou uma amostra mais diversificada relativamente ao género
poderiam, eventualmente, dar outras perspetivas, todavia consideramos que atingimos
os objetivos propostos.
This thesis, integrated in the PhD in Nursing, in the area of “History and Philosophy of Nursing”, aims to understand the fundamentals of nurse’s actions used by nurses in the face of ethical problems at the beginning of life. The study is within the scope of ethical decision and seeks to know its foundations. Thus, in order to achieve this goal, we designed a qualitative study, of a descriptive type, and we used semi-structured interviews to collect material from 26 nurses who develop their professional practice in the context of early life. These interviews were submitted to content analysis, more specifically to categorical analysis. Nunes (2006) and Deodato (2014), previously listed categories of ethical problems and some of those categories were also identified in this work. Numerous new categories have also emerged in this investigation, such as: Dealing with miscarriage of desired pregnancy, Need for psychological comfort, Pregnancy of minors, Serious malformations detected at birth, Consent regarding care during childbirth, Identification of an ethical problem, Nurses social recognition and Non-involvement of the person during childbirth. The remaining categories were adapted from previous knowledge (Nunes, Deodato), adapting the definition of ethical problem in nursing activity, of Deodato (2014). In the second part of this work, we intend to know how nurse’s deal in the face of ethical problems related to the beginning of life, starting from Deodato, who had already identified these fundamentals for the nurse's ethical decision, in general. However, in this study, new categories emerged such as “personal foundation”, “spiritual foundation” and those foundations related to the “available resources”. The “ethical” foundations (Deodato) are the most interiorized in their actions, but the “deontological foundations” (Deodato) also appear with great relevance, which leads us to conclude that nurses also integrate this knowledge in their clinical action. The “professional” fundamentals, and others that we present in the proper place, also appear in this investigation. Taking the results into account, we conclude that nurses face several ethical problems, some of which have an ineffable impact on their professional performance. Considering these results and the intensity with which they are experienced, there are also numerous grounds for the decision to be taken. We seek to disseminate this study and its results, contributing to help the decisionmaking process in this field that at a first glance is an area of hope and joy, but also hides behind this evidence countless situations of suffering for all involved. vii Thus, we hope to fulfill the objective of contributing to the knowledge that helps nurses to decide in the best way. Being aware that more interviews, more geographic locations or a more diverse sample in relation to gender could, eventually, give other perspectives, however we consider that we have reached the proposed objectives.
This thesis, integrated in the PhD in Nursing, in the area of “History and Philosophy of Nursing”, aims to understand the fundamentals of nurse’s actions used by nurses in the face of ethical problems at the beginning of life. The study is within the scope of ethical decision and seeks to know its foundations. Thus, in order to achieve this goal, we designed a qualitative study, of a descriptive type, and we used semi-structured interviews to collect material from 26 nurses who develop their professional practice in the context of early life. These interviews were submitted to content analysis, more specifically to categorical analysis. Nunes (2006) and Deodato (2014), previously listed categories of ethical problems and some of those categories were also identified in this work. Numerous new categories have also emerged in this investigation, such as: Dealing with miscarriage of desired pregnancy, Need for psychological comfort, Pregnancy of minors, Serious malformations detected at birth, Consent regarding care during childbirth, Identification of an ethical problem, Nurses social recognition and Non-involvement of the person during childbirth. The remaining categories were adapted from previous knowledge (Nunes, Deodato), adapting the definition of ethical problem in nursing activity, of Deodato (2014). In the second part of this work, we intend to know how nurse’s deal in the face of ethical problems related to the beginning of life, starting from Deodato, who had already identified these fundamentals for the nurse's ethical decision, in general. However, in this study, new categories emerged such as “personal foundation”, “spiritual foundation” and those foundations related to the “available resources”. The “ethical” foundations (Deodato) are the most interiorized in their actions, but the “deontological foundations” (Deodato) also appear with great relevance, which leads us to conclude that nurses also integrate this knowledge in their clinical action. The “professional” fundamentals, and others that we present in the proper place, also appear in this investigation. Taking the results into account, we conclude that nurses face several ethical problems, some of which have an ineffable impact on their professional performance. Considering these results and the intensity with which they are experienced, there are also numerous grounds for the decision to be taken. We seek to disseminate this study and its results, contributing to help the decisionmaking process in this field that at a first glance is an area of hope and joy, but also hides behind this evidence countless situations of suffering for all involved. vii Thus, we hope to fulfill the objective of contributing to the knowledge that helps nurses to decide in the best way. Being aware that more interviews, more geographic locations or a more diverse sample in relation to gender could, eventually, give other perspectives, however we consider that we have reached the proposed objectives.
Description
Keywords
Enfermagem Início de vida humana Ética do cuidado Ética Códigos de ética Nursing Beginning of human life Ethics of care Ethics Code of ethics