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Perfil de saúde das famílias e suas necessidades em cuidados de enfermagem : contributos para a tomada de decisão clínica
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Abstract(s)
Introdução: As mudanças de âmbito social, económico e cultural, ocorridas nas últimas décadas, têm vindo a provocar graduais processos de transformação no seio familiar e a originar diversas formas de convivência familiar. As famílias contemporâneas apresentam uma grande diversidade no que respeita à composição, origem étnica, orientação religiosa e espiritual, na forma como comunicam e passam o tempo em conjunto, no compromisso que assumem com os seus membros, na interação com a comunidade e ainda na forma como gerem o stresse e se adaptam às mudanças. A par desta diversidade surgem também novas necessidades em saúde nas famílias, as quais interpelam fortemente os enfermeiros a inovar e antecipar as respostas perante as mesmas. Objetivos: Foram definidos como objetivos deste estudo identificar a existência de diferentes perfis de saúde das famílias com filhos menores a seu cargo e as suas necessidades em Cuidados de Enfermagem; determinar a relação entre os perfis de saúde das famílias e as variáveis de caraterização da saúde individual e familiar; construir uma matriz de apoio à tomada de Decisão Clínica em Enfermagem de Saúde Familiar, tendo como cliente as famílias com filhos menores a seu cargo. Metodologia: Para prosseguir com estes objetivos realizou-se um estudo quantitativo de natureza observacional, composto por duas fases. Na primeira fase concretizou-se o estudo do tipo observacional, com uma amostra constituída por famílias com filhos menores a seu cargo que frequentaram as consultas de enfermagem de saúde infantil e juvenil, com recurso à aplicação de um questionário autoadministrado. Por forma a validar os resultados emergentes da interpretação dos dados produzidos na fase anterior e da sustentação da análise produzida realizou-se, na segunda fase, um Painel Delphi, com uma amostra constituída por peritos na área da Enfermagem de Saúde Familiar e com a aplicação de um instrumento de recolha de dados difundido via email. Como referencial teórico e operativo foi utilizado o Modelo Dinâmico de Avaliação e Intervenção Familiar, proposto por Figueiredo, no qual os pressupostos reconhecem a complexidade do sistema familiar, considerando as suas propriedades, partindo do princípio que os cuidados de enfermagem centrados na família, enquanto cliente e unidade de intervenção, são regidos por uma abordagem sistémica, que promova a potencialização das suas forças, recursos e competências. Resultados: Foram encontrados 5 perfis de saúde das famílias com filhos menores a seu cargo tendo sido o cluster 4 a registar piores resultados em saúde e o cluster 5 melhores resultados. No cluster 4 foram identificados como focos de maior relevância de intervenção de enfermagem o abuso do álcool, padrão alimentar, padrão de higiene oral, comportamento de procura de saúde (adesão às consultas médicas e /ou de enfermagem; adesão ao rastreio da doença oncológica - mama, colo do útero e próstata e adesão às consultas de saúde oral), regime de imunização, atitude face ao estado de saúde, sono, status psicológico, processo familiar e o processo do sistema regulador. Verificou-se ainda que as necessidades em cuidados de enfermagem são inversamente proporcionais ao score do funcionamento familiar, parecendo encontrar-se valores inferiores deste, associados a piores resultados em saúde. Conclusão: Suportados numa revisão, reflexão e resultados desta investigação, foi possív ao permitir a interligação entre as etapas do processo de enfermagem pretende constituir-se um instrumento orientador da prática de enfermagem às famílias. Neste sentido, aumentará o potencial do exercício profissional dos Enfermeiros de Família para responder às necessidades das famílias com filhos menores a seu cargo, através da adoção de práticas de saúde que apoiam as famílias num todo e os seus membros individualmente, na superação de eventuais momentos de crise.
Introduction: Social, economic, and cultural changes in recent decades have gradually transformed family dynamics, giving rise to various forms of family life. Contemporary families exhibit great diversity in terms of composition, ethnic origin, religious and spiritual orientation, communication patterns, shared leisure activities, commitment to family members, interaction with the community, as well as in how they manage stress and adapt to these changes. Alongside this diversity, new health needs also arise within families, affecting a powerful motivation for nurses to innovate and anticipate responses to these needs. Objectives: The objectives of this study were defined as follows: to identify the existence of different health profiles among families whose children are minors, and in their care, and their nursing care needs; to determine the relationship between family health profiles and individual and family health characterization variables; and finally, to build a matrix to support clinical decision-making in family health nursing, with a primary focus on families with minor children under their care. Methodology: To pursue these objectives, a quantitative observational study was conducted, entailing two phases. In the first phase, an observational study was carried out with a sample composed of families, whose minor children were under their care, and who attended child and adolescent health nursing consultations, where the families willingly responded to the health questionnaire designated for this study on their own. To validate the results from the interpretation of this data and to support the analysis, a Delphi Panel was conducted in the second phase, with a sample consisting of experts in the field of Family Health Nursing, using a different data collection instrument disseminated via email. The theoretical and operational framework used was the Dynamic Model of Family Assessment and Intervention, proposed by Figueiredo, which presumes the recognition of the complexity of the family system, considering its properties, and where nursing care focused on the family, as the client and unit of intervention, is guided by a systemic approach that promotes the enhancement of y’ strengths, resources, and competences. Results: The health profiles of five families with minor children under their care were identified, with cluster 4 registering the worst health outcomes and cluster 5 the best outcomes. In cluster 4, the most relevant nursing intervention focuses were identified as alcohol abuse, dietary patterns, oral hygiene patterns, health- k v (k / − v − ) w health status, sleep, psychological status, family process, and regulatory system process. Healthcare needs were also found to be inversely proportional to the family functioning score, with lower values of family functioning associated with worse health outcomes. Conclusion: Based on review, reflection, and the results of this research, a Decision Support Matrix in Family Health Nursing was created. By interconnecting the stages of the nursing process, the resulting matrix constitutes a guidance tool for nursing practice with families. As such, the matrix will increase the potential of the professional practice of Family Nurses to respond to the needs of families with minor children under their care, through the adoption of health practices with new perspectives that support not just families as a whole but also the individual family members in overcoming any moments of crisis.
Introduction: Social, economic, and cultural changes in recent decades have gradually transformed family dynamics, giving rise to various forms of family life. Contemporary families exhibit great diversity in terms of composition, ethnic origin, religious and spiritual orientation, communication patterns, shared leisure activities, commitment to family members, interaction with the community, as well as in how they manage stress and adapt to these changes. Alongside this diversity, new health needs also arise within families, affecting a powerful motivation for nurses to innovate and anticipate responses to these needs. Objectives: The objectives of this study were defined as follows: to identify the existence of different health profiles among families whose children are minors, and in their care, and their nursing care needs; to determine the relationship between family health profiles and individual and family health characterization variables; and finally, to build a matrix to support clinical decision-making in family health nursing, with a primary focus on families with minor children under their care. Methodology: To pursue these objectives, a quantitative observational study was conducted, entailing two phases. In the first phase, an observational study was carried out with a sample composed of families, whose minor children were under their care, and who attended child and adolescent health nursing consultations, where the families willingly responded to the health questionnaire designated for this study on their own. To validate the results from the interpretation of this data and to support the analysis, a Delphi Panel was conducted in the second phase, with a sample consisting of experts in the field of Family Health Nursing, using a different data collection instrument disseminated via email. The theoretical and operational framework used was the Dynamic Model of Family Assessment and Intervention, proposed by Figueiredo, which presumes the recognition of the complexity of the family system, considering its properties, and where nursing care focused on the family, as the client and unit of intervention, is guided by a systemic approach that promotes the enhancement of y’ strengths, resources, and competences. Results: The health profiles of five families with minor children under their care were identified, with cluster 4 registering the worst health outcomes and cluster 5 the best outcomes. In cluster 4, the most relevant nursing intervention focuses were identified as alcohol abuse, dietary patterns, oral hygiene patterns, health- k v (k / − v − ) w health status, sleep, psychological status, family process, and regulatory system process. Healthcare needs were also found to be inversely proportional to the family functioning score, with lower values of family functioning associated with worse health outcomes. Conclusion: Based on review, reflection, and the results of this research, a Decision Support Matrix in Family Health Nursing was created. By interconnecting the stages of the nursing process, the resulting matrix constitutes a guidance tool for nursing practice with families. As such, the matrix will increase the potential of the professional practice of Family Nurses to respond to the needs of families with minor children under their care, through the adoption of health practices with new perspectives that support not just families as a whole but also the individual family members in overcoming any moments of crisis.
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Família Enfermagem de saúde familiar Saúde da família Family Family health nursing Family health
Pedagogical Context
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Without CC licence