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Abstract(s)
envelhecimento demogrĂĄfico constitui, hoje, um fenĂłmeno com elevada expressĂŁo e que
tendencialmente estĂĄ a agravar-se. NĂŁo obstante envelhecer, nĂŁo seja sinĂłnimo de
dependĂȘncia, sabemos que este processo de vida acompanha-se de perdas, as quais podem
ainda ser mais ampliadas pela presença de comorbilidades. Face às necessidades de cuidados
desta população, Ă© a famĂlia que responde na sua grande maioria. Desta problemĂĄtica emerge
a necessidade de preparar esses prestadores de cuidados, que integram diferentes realidades e
que até a um dado momento de suas vidas não apresentavam qualquer afinidade com åreas do
cuidado e hoje constituem a resposta pronta face Ă s necessidades de um dado familiar. A sua
preparação contempla necessidades que advĂ©m da condição de saĂșde da pessoa com
dependĂȘncia, mas tambĂ©m das dificuldades inerentes ao processo de transição situacional que
os prestadores de cuidados vivenciam, bem como do resultante do impacte face ao exercĂcio
do papel de prestador de cuidados na vida e pessoa destes. Face a tal complexidade Ă©
finalidade deste estudo contribuir para o desenvolvimento de uma teoria explicativa da
intervenção de enfermagem face ao papel do prestador de cuidados, num contexto estratégico
que permita ter em consideração a preparação para o regresso a casa de idosos com
compromisso do autocuidado; e o potencial para desenvolvimento da capacidade de
desempenho do prestador de cuidados. De modo a darmos cumprimento Ă finalidade a que
nos propusemos formulamos os seguintes objectivos: identificar quais as necessidades
expressas dos prestadores de cuidados; identificar quais os diagnĂłsticos de enfermagem mais
frequentes que emergem dessas necessidades; analisar os diagnĂłsticos de enfermagem mais
frequentes que emergem dessas necessidades; identificar as intervençÔes de enfermagem
implementadas, que tomam por beneficiĂĄrio o prestador de cuidados; caracterizar as
intervençÔes de enfermagem implementadas, que tomam por beneficiårio o prestador de
cuidados; perceber a concepção de cuidados subjacente ao modelo de atendimento vigente, a
esta população alvo e explicitar o modelo de acompanhamento do prestador de cuidados de
idosos com compromisso do autocuidado.
Na consecução da finalidade e dos objectivos delineados optamos por realizar um estudo
mĂșltiplo, sequencial, com uma vertente exploratĂłria. Este integra quatro estudos. O primeiro,
âcaracterização de prestadores de cuidados de idosos com compromisso do autocuidadoâ, Ă©
um estudo descritivo de natureza exploratĂłria. Recorremos a uma amostra de conveniĂȘncia. A
colheita de dados decorreu entre 01 de Setembro de 2007 e 29 de Fevereiro de 2008, tendo sido caracterizados, 115 prestadores de cuidados e respetivos idosos (115) com compromisso
do autocuidado (total de prestadores de cuidados contactĂĄveis e localizĂĄveis) inscritos no
Centro de SaĂșde de Leça da Palmeira e respetivas extensĂ”es de saĂșde: Lavra, Perafita e Santa
Cruz do Bispo.
O segundo estudo, âcaracterização dos diagnĂłsticos de enfermagem e respetivas
intervençÔes, documentados no sistema de informação de enfermagemâ, Ă© tambĂ©m de carater
exploratório e recorreu ao método misto. Incorporou uma amostra intencional, a qual integrou
os registos de enfermagem documentados no Sistema de Apoio Ă PrĂĄtica de Enfermagem
(SAPE), de 1 de Setembro de 2007 e 29 de Fevereiro de 2008, dos 115 participantes que
integram o estudo I.
O terceiro estudo, âPerceção dos enfermeiros quanto Ă estruturação do processo de cuidados,
considerando as necessidades de cuidados do prestador de cuidadosâ, Ă© exploratĂłrio de
natureza qualitativa e recorremos a uma amostra de conveniĂȘncia, a qual integrou o total de
enfermeiros (33) que trabalhavam no Centro de SaĂșde de Leça da Palmeira e respetivas
extensĂ”es de saĂșde: Lavra, Perafita e Santa Cruz do Bispo. Para tal recorremos Ă entrevista
semiestruturada. A colheita de dados decorreu entre, 1 de Junho e 30 de Julho de 2010. Este
terceiro estudo adveio da necessidade, face ao constatado entre as necessidades de cuidados
(estudo I) dos prestadores de cuidados e o que Ă© registado pelos enfermeiros (estudo II), no
sistema de informação de enfermagem, de aclarar qual a conceção de cuidados subjacente, de
modo a: conhecermos quais as necessidades que identificam nos prestadores de cuidados;
percebermos quais as estratégias e os meios que utilizam para responder a estas necessidades;
conhecermos qual o local e motivaçÔes que os enfermeiros privilegiam para prestar
assistĂȘncia a estes prestadores de cuidados e percebermos as limitaçÔes com que se deparam e
as razÔes subjacentes que condicionam as suas respostas às necessidades de cuidados dos
prestadores de cuidados.
O quarto estudo, âPreparação do regresso a casa do prestador de cuidados do idoso com
compromisso do autocuidado - estruturação de um modelo de acompanhamentoâ, assume-se
enquanto corolĂĄrio do apurado nos trĂȘs estudos, citados anteriormente. Para tal recorremos a
grupos focais, cujas entrevistas se realizaram entre Junho e Outubro de 2011. Para o
tratamento da informação, procedemos Ă anĂĄlise de conteĂșdo segundo Strauss e Corbin. Do
apurado induzimos um modelo de acompanhamento dos prestadores de cuidados de idosos com compromisso do autocuidado, no decurso do processo de regresso a casa. Conforme o
salientado anteriormente Ă© nosso intento testar o referido modelo, sob a forma de um estudo
quase-experimental, apĂłs a conclusĂŁo do nosso doutoramento. Este modelo integra trĂȘs
Ăąmbitos:
âą As competĂȘncias do prestador de cuidados, procurando perceber como podemos
avaliar inicialmente e no decurso do desempenho das suas funçÔes o conhecimento e
as habilidades, do prestador de cuidados, face Ă s necessidades do idoso de quem cuida.
âą A intensidade, situando-nos na frequĂȘncia e tipo de contactos entre a enfermeira de
famĂlia e o prestador de cuidados. Considerando ainda na fase inicial uma frequĂȘncia
mais estreita, podendo ser mais espaçada numa fase posterior. Os contactos poderão
ser de natureza presencial ou via telefone, conciliando-os numa conjugação ajustada Ă
realidade de cuidados.
⹠A didåtica, na qual descreveremos os métodos de ensino, as estratégias e os meios
mais ajustados aos prestadores de cuidados de idosos com compromisso do
autocuidado.
The aging population is today a phenomenon with high expression and that is tended to worsen. However aging, is not synonymous of dependency, we know that this process is accompanied life losses, which can be further enhanced by the presence of comorbidities. Considering the care needs of this population, it is the family that responds mostly. This problem arises the need to prepare these caregivers that integrate different realities and that to a certain point in their lives showed no affinity for areas of care and are now ready to answer to the needs of a given family. Their preparation includes requirements that comes from the health condition of the person with dependency, but also the difficulties inherent in the situational transition process that caregivers experience as well as the resulting impact against the exercise of the role of caregiver in life and person of these. Considering this complexity, the purpose of this study is to contribute to the development of a theory of nursing intervention over the role of care provider, in a strategic context to take into account the preparation for the return home for the elderly with impaired self-care, and potential for development of performance capacity of the caregiver. In order to give fulfillment to the purpose we set ourselves formulated the following objectives: identify which expressed needs of carers; identifying the nursing diagnoses frequently emerging from these requirements; analyze nursing diagnoses more frequently; identify nursing interventions implemented to the caregiver family; characterize the nursing interventions implemented to the caregiver family; understand the conception of nursing care to this population and explain the model for monitoring the caregiver family for the elderly with impaired self-care. In achieving the purpose and objectives outlined we chose we decided to conduct a multiple, sequential, with one strand exploratory study. This includes four studies. The first, "Characterization of caregivers of older people with impaired self-care" is a descriptive exploratory study. We use a convenience sample. Data collection took place between 1 September 2007 and 29 February 2008, having been featured, 115 caregivers and their elderly patients (115) with impaired self-care (total of caregivers contacted and locatable) enrolled in the Health Center of Leca da Palmeira and their health extensions: Lavra, Perafita and Santa Cruz do Bispo. For this we turn to several instruments that allowed us to characterize the target population of our study. The second study, "Characterization of nursing diagnoses and related interventions documented in the nursing information system", is using the mixed method and is also exploratory study. Incorporated a purposive sample, which integrated the nursing records documented in System Support Nursing Practice (SAPE), from 1 September 2007 and 29 February 2008, of the 115 participants included in the study I. The third study, "Perceived nurses how to structure the process of care, taking care needs of the care provider" is a qualitative exploratory and resorted to a convenience sample, which included the total number of nurses (33) who worked at the Health Centre of Leca da Palmeira health and their extensions: Lavra, Perafita and Santa Cruz do Bispo. For this we used the semi-structured interview. Data collection took place between June 1 and July 30, 2010. This third study came from the need to face recorded between care needs (Study I) and health care providers who are registered nurses (Study II), the information system of nursing, which clarify the underlying conception care of so: we know what needs to identify caregivers; realize what strategies and methods they use to meet these needs; know which location and motivations that nurses privilege to assist these caregivers and realize the limitations faced and the reasons that affect their answers to the care needs of caregivers. The fourth study, "Preparing the Homecoming care provider for the elderly with impaired self-care - a model for structuring monitoring", it is assumed as a corollary of determined in three studies cited above. For this we turn to focus groups, whose interviews were carried out between June and October 2011. For data processing, we performed a content analysis according to Strauss and Corbin. Induce a model of accurate monitoring of caregivers of older people with impaired self-care during the process of Homecoming. As noted above it is our intent to test that model in the form of a quasi-experimental study, after completion of our PhD. This model integrates three areas: âą The skills of the caregiver, looking to see how we can assess initially and during the performance of their duties with the knowledge and skills of the carer, meet the needs of elderly caregivers. âą The intensity, standing in the frequency and type of contacts between the nurse and family caregiver. Considering also in the initial phase a frequency closer and can be spaced more later. In the contacts we may use the presential contact or the phone, reconciling them in conjunction adjusted to the reality of care.âą The didactic, in which we describe the teaching methods, strategies and means more adjusted to caregivers of elderly with impaired self-care.
The aging population is today a phenomenon with high expression and that is tended to worsen. However aging, is not synonymous of dependency, we know that this process is accompanied life losses, which can be further enhanced by the presence of comorbidities. Considering the care needs of this population, it is the family that responds mostly. This problem arises the need to prepare these caregivers that integrate different realities and that to a certain point in their lives showed no affinity for areas of care and are now ready to answer to the needs of a given family. Their preparation includes requirements that comes from the health condition of the person with dependency, but also the difficulties inherent in the situational transition process that caregivers experience as well as the resulting impact against the exercise of the role of caregiver in life and person of these. Considering this complexity, the purpose of this study is to contribute to the development of a theory of nursing intervention over the role of care provider, in a strategic context to take into account the preparation for the return home for the elderly with impaired self-care, and potential for development of performance capacity of the caregiver. In order to give fulfillment to the purpose we set ourselves formulated the following objectives: identify which expressed needs of carers; identifying the nursing diagnoses frequently emerging from these requirements; analyze nursing diagnoses more frequently; identify nursing interventions implemented to the caregiver family; characterize the nursing interventions implemented to the caregiver family; understand the conception of nursing care to this population and explain the model for monitoring the caregiver family for the elderly with impaired self-care. In achieving the purpose and objectives outlined we chose we decided to conduct a multiple, sequential, with one strand exploratory study. This includes four studies. The first, "Characterization of caregivers of older people with impaired self-care" is a descriptive exploratory study. We use a convenience sample. Data collection took place between 1 September 2007 and 29 February 2008, having been featured, 115 caregivers and their elderly patients (115) with impaired self-care (total of caregivers contacted and locatable) enrolled in the Health Center of Leca da Palmeira and their health extensions: Lavra, Perafita and Santa Cruz do Bispo. For this we turn to several instruments that allowed us to characterize the target population of our study. The second study, "Characterization of nursing diagnoses and related interventions documented in the nursing information system", is using the mixed method and is also exploratory study. Incorporated a purposive sample, which integrated the nursing records documented in System Support Nursing Practice (SAPE), from 1 September 2007 and 29 February 2008, of the 115 participants included in the study I. The third study, "Perceived nurses how to structure the process of care, taking care needs of the care provider" is a qualitative exploratory and resorted to a convenience sample, which included the total number of nurses (33) who worked at the Health Centre of Leca da Palmeira health and their extensions: Lavra, Perafita and Santa Cruz do Bispo. For this we used the semi-structured interview. Data collection took place between June 1 and July 30, 2010. This third study came from the need to face recorded between care needs (Study I) and health care providers who are registered nurses (Study II), the information system of nursing, which clarify the underlying conception care of so: we know what needs to identify caregivers; realize what strategies and methods they use to meet these needs; know which location and motivations that nurses privilege to assist these caregivers and realize the limitations faced and the reasons that affect their answers to the care needs of caregivers. The fourth study, "Preparing the Homecoming care provider for the elderly with impaired self-care - a model for structuring monitoring", it is assumed as a corollary of determined in three studies cited above. For this we turn to focus groups, whose interviews were carried out between June and October 2011. For data processing, we performed a content analysis according to Strauss and Corbin. Induce a model of accurate monitoring of caregivers of older people with impaired self-care during the process of Homecoming. As noted above it is our intent to test that model in the form of a quasi-experimental study, after completion of our PhD. This model integrates three areas: âą The skills of the caregiver, looking to see how we can assess initially and during the performance of their duties with the knowledge and skills of the carer, meet the needs of elderly caregivers. âą The intensity, standing in the frequency and type of contacts between the nurse and family caregiver. Considering also in the initial phase a frequency closer and can be spaced more later. In the contacts we may use the presential contact or the phone, reconciling them in conjunction adjusted to the reality of care.âą The didactic, in which we describe the teaching methods, strategies and means more adjusted to caregivers of elderly with impaired self-care.
Description
Keywords
MĂ©todo misto Estudo mĂșltiplo Grupos focais Cuidador informal Prestador de cuidados Mixed method Multiple study Focus groups Informal caregiver Caregiver