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Abstract(s)
Das áreas de atenção sensíveis aos cuidados de enfermagem no processo de transição para a vida com um estoma de ventilação, o autocuidado destaca-se como um dos mais significativos. Apesar do reconhecimento da sua importância, não existia evidência sobre as intervenções de enfermagem com relevância para a promoção do autocuidado na pessoa com um estoma de ventilação. Paralelamente, os cuidados prestados eram frequentemente descritos como descontínuos, insuficientes e variáveis. Assim, foi definido como objetivo desta investigação construir e estudar a viabilidade de um programa de intervenção de enfermagem para a promoção do autocuidado na pessoa com um estoma de ventilação, capaz de sistematizar a prática clínica. Para tal, foi realizada a construção teórica e estudo da viabilidade de um programa de intervenção, com base nas recomendações do Medical Research Council. Primeiramente, foi efetuada uma revisão de âmbito sobre as intervenções de enfermagem para a promoção do autocuidado na pessoa com um estoma de ventilação e seus resultados. Posteriormente, foram realizados dois estudos qualitativos com os envolvidos: as pessoas com um estoma de ventilação e os enfermeiros da prática clínica, para conhecer as suas expectativas, preferências e dificuldades. De seguida, o programa foi desenhado com recurso aos critérios de Aranda (2008). Procedeu-se também à construção e avaliação de materiais educativos escritos, enquanto recursos de suporte à implementação do programa. Depois, foi avaliada a adequação do programa por peritos e a sua aceitação pelos enfermeiros da prática clínica, através de um estudo qualitativo do tipo grupo focal. O programa de intervenção criado é constituído por seis módulos temáticos sequenciais. Em cada um dos módulos foi definido o objetivo, os dados que devem ser obtidos antes da sua implementação, o momento certo para intervir, as intervenções de enfermagem, os conteúdos que concretizam as intervenções, os seus métodos de administração e a dose. Foram ainda elaborados os manuais educativos escritos: “Viver após uma traqueotomia” e “Viver após uma laringectomia total”. Os participantes dos estudos de avaliação consideraram que o programa e os manuais são adequados, bem estruturados e clinicamente úteis. Esta investigação possibilitou melhorar o conhecimento disciplinar sobre a promoção do autocuidado na transição para a vida com um estoma de ventilação. Por outro lado, poderá contribuir para a melhoria da prática clínica, por conceber um programa de intervenção baseado na evidência, na perceção dos envolvidos e avaliado por peritos, que cumpre o rigor metodológico exigido para o desenvolvimento de intervenções complexas na área da saúde.
Of the areas of attention that are sensitive to nursing care in the process of transition to life with a tracheostomy, self-care stands out as one of the most significant. Despite the recognition of its importance, there was no evidence on nursing interventions to promote self-care in people with a tracheostomy. At the same time, the care provided was often described as discontinuous, insufficient, and variable. Thus, the objective of this investigation was to develop and to study the feasibility of a nursing intervention program to promote self-care in people with a tracheostomy, capable of systematizing clinical practice. To this end, the theoretical development and feasibility study of an intervention program was carried out, based on the recommendations of the Medical Research Council. First, a scoping review was carried out on nursing interventions to promote self-care in people with a tracheostomy and their results. Subsequently, two qualitative studies were carried out with those involved: people with a tracheostomy and nurses in clinical practice, to learn about their expectations, preferences, and difficulties. Then, the program was designed using the criteria of Aranda (2008). Written educational materials were also designed and assessed as resources to support the implementation of the program. Afterwards, the suitability of the program was assessed by experts and its acceptance by nurses in clinical practice, through a qualitative focus group study. The intervention program created consists of six sequential thematic modules. In each of the modules, the objective was defined, the data that must be obtained before its implementation, the right moment to intervene, the nursing interventions, the contents of the interventions, their administration methods, and the dose. The written educational manuals "Living after a tracheotomy" and "Living after a total laryngectomy" were also developed and assessed. Participants in the evaluation studies found the program and manuals to be adequate, well-structured, and clinically useful. This research has made it possible to improve disciplinary knowledge about promoting self-care in the transition to life with a tracheostomy. On the other hand, it may contribute to the improvement of clinical practice, by designing an intervention program based on evidence, in the perception of those involved and evaluated by experts, which meets the methodological rigor required for the development of complex interventions in the health area.
Of the areas of attention that are sensitive to nursing care in the process of transition to life with a tracheostomy, self-care stands out as one of the most significant. Despite the recognition of its importance, there was no evidence on nursing interventions to promote self-care in people with a tracheostomy. At the same time, the care provided was often described as discontinuous, insufficient, and variable. Thus, the objective of this investigation was to develop and to study the feasibility of a nursing intervention program to promote self-care in people with a tracheostomy, capable of systematizing clinical practice. To this end, the theoretical development and feasibility study of an intervention program was carried out, based on the recommendations of the Medical Research Council. First, a scoping review was carried out on nursing interventions to promote self-care in people with a tracheostomy and their results. Subsequently, two qualitative studies were carried out with those involved: people with a tracheostomy and nurses in clinical practice, to learn about their expectations, preferences, and difficulties. Then, the program was designed using the criteria of Aranda (2008). Written educational materials were also designed and assessed as resources to support the implementation of the program. Afterwards, the suitability of the program was assessed by experts and its acceptance by nurses in clinical practice, through a qualitative focus group study. The intervention program created consists of six sequential thematic modules. In each of the modules, the objective was defined, the data that must be obtained before its implementation, the right moment to intervene, the nursing interventions, the contents of the interventions, their administration methods, and the dose. The written educational manuals "Living after a tracheotomy" and "Living after a total laryngectomy" were also developed and assessed. Participants in the evaluation studies found the program and manuals to be adequate, well-structured, and clinically useful. This research has made it possible to improve disciplinary knowledge about promoting self-care in the transition to life with a tracheostomy. On the other hand, it may contribute to the improvement of clinical practice, by designing an intervention program based on evidence, in the perception of those involved and evaluated by experts, which meets the methodological rigor required for the development of complex interventions in the health area.
Description
Keywords
Autocuidado Enfermagem Intervenções complexas Ostomia Traqueostomia Complex interventions Nursing Ostomy Self-care Tracheostomy