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Adaptação da Família às Perdas em Contexto Paliativo, a Intervenção de Enfermagem Especializada - Projeto de desenvolvimento de competências clínicas
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Advisor(s)
Abstract(s)
As doenças crónicas e ameaçadoras da vida têm um grande impacto na qualidade de vida das pessoas e famílias, constituindo uma importante causa de sofrimento.
Os cuidados paliativos constituem uma abordagem centrada na promoção da qualidade de vida das pessoas com doença limitante de vida e das suas famílias, por meio da prevenção e do alívio do sofrimento. Requerem a identificação precoce, a avaliação e o tratamento eficaz da dor e de outros sintomas físicos, e abrangem resposta aos problemas de natureza física, psicossocial e espiritual da unidade recetora de cuidados constituída pela díade cliente/família, incluindo o apoio no luto.
O objetivo da abordagem interventiva dirigida à família deve ter por base a promoção da adaptação emocional, individual e coletiva, à situação de doença terminal; a capacitação para a realização de cuidados ao cliente e o autocuidado da família; a preparação para a perda e a prevenção do luto patológico.
O presente relatório enquadra-se no âmbito do 1º Curso de Mestrado em Enfermagem Médico- Cirúrgica na área de Enfermagem à Pessoa em Situação Paliativa da Escola Superior de Enfermagem do Porto, e visa espelhar o processo de aprendizagem desenvolvido durante o estágio de natureza profissional, em dois contextos clínicos hospitalares, na valência de Equipa Intra-hospitalar de Suporte em Cuidados Paliativos e na valência de Unidade de Internamento de Cuidados Paliativos, de duas unidades hospitalares distintas da zona norte do país, entre fevereiro e junho de 2023. Refere-se ao desenvolvimento de competências clínicas na área da Enfermagem à pessoa em situação paliativa, e abrange as competências comuns e específicas do enfermeiro especialista, descritas no Regulamento de Competências Comuns do Enfermeiro Especialista nº 140/2019 e no Regulamento de Competências Específicas do Enfermeiro Especialista em Enfermagem Médico-Cirúrgica n.º 429/2018, respetivamente. Compreende uma metodologia descritiva, reflexiva e crítica, suportada por evidência científica.
Inserido no contexto de uma equipa multidisciplinar, o enfermeiro de cuidados paliativos desempenha um conjunto de ações autónomas e interdependentes voltadas para a concretização de metas assistenciais previamente discutidas e negociadas com a pessoa doente, a família e com a restante equipa de saúde, visando o alívio do sofrimento e a melhoria da qualidade de vida. É ainda um agente ativo facilitador do processo de adaptação da pessoa doente e da família às mudanças e às perdas geradas pela doença grave e ameaçadora da vida, e no luto. No decorrer do estágio, privilegiámos o treino de competências relacionais e de comunicação, reconhecendo o seu valor terapêutico na resposta às necessidades de educação, apoio emocional, social e espiritual, geradas pela doença grave e avançada, e na promoção da esperança e do conforto durante o processo de adaptação à perda. Salientamos o valor da formação enquanto um dos alicerces imprescindíveis no desenvolvimento da ação profissional de Enfermagem, sobretudo no que diz respeito às respostas humanas associadas à perda, à morte e ao sofrimento.
Chronic and life-threatening illnesses have a major impact on the quality of life of individuals and their families, constituting an important cause of suffering. Palliative care is an approach focused on promoting quality of life to people with life-limiting illnesses and their families, through prevention and relief of suffering. It requires early identification, assessment and effective treatment of pain and other physical symptoms and includes response to physical, psychosocial and spiritual nature problems to the care receiving unit, constituted by the client/family dyad, including bereavement support. The objective of the family-directed intervention approach must be based on promoting individual and collective emotional adaptation at terminal illness situation; training to provide client care and family self-care; preparing for loss and preventing pathological grief. This report falls within the scope of the 1st Master's Course in Medical-Surgical Nursing in the area of Nursing for People in Palliative Situations at the Escola Superior de Enfermagem do Porto, and aims to mirror the learning process developed during the professional internship, in two hospital clinical contexts, as an Intra-hospital Palliative Care Support Team and as an Inpatient Palliative Care Unit, at two different hospital units in the north of the country, in the period between February and June 2023. Refers to the development of clinical skills in the area of Nursing for people in a palliative situation, covering the common skills of the specialist nurse, described in the Regulation of Common Skills of the Specialist Nurse No. 140/2019, and the specific skills of the specialist nurse in Medical Nursing -Surgery in the area of Nursing for Persons in Palliative Situations, defined in the Regulation of Specific Competencies of the Specialist Nurse in Medical-Surgical Nursing No. 429/2018. It comprises a descriptive, reflective and critical methodology, supported by scientific evidence. Palliative care nursing, inserted in the context of a multidisciplinary team, performs a set of autonomous and interdependent actions aimed to achieving care goals previously discussed and negotiated with the sick person, their significant others and the rest of the health team, aiming to the relief of suffering and improvement of quality of life. He is also an active agent, that facilitates the adaptation process of sick person and family to the changes and losses caused by serious and life-threatening illness, as in grief. During professional internship, we privileged the training of relational and communication skills, recognizing their therapeutic value in responding to the needs of education, emotional, social and spiritual support, related to the serious and advanced illness, and in the promotion of hope and comfort during the loss adaptation process. We also recognize the value of training as one of the essential foundations for professional nursing action development, especially with regard to human responses associated with loss, death and suffering.
Chronic and life-threatening illnesses have a major impact on the quality of life of individuals and their families, constituting an important cause of suffering. Palliative care is an approach focused on promoting quality of life to people with life-limiting illnesses and their families, through prevention and relief of suffering. It requires early identification, assessment and effective treatment of pain and other physical symptoms and includes response to physical, psychosocial and spiritual nature problems to the care receiving unit, constituted by the client/family dyad, including bereavement support. The objective of the family-directed intervention approach must be based on promoting individual and collective emotional adaptation at terminal illness situation; training to provide client care and family self-care; preparing for loss and preventing pathological grief. This report falls within the scope of the 1st Master's Course in Medical-Surgical Nursing in the area of Nursing for People in Palliative Situations at the Escola Superior de Enfermagem do Porto, and aims to mirror the learning process developed during the professional internship, in two hospital clinical contexts, as an Intra-hospital Palliative Care Support Team and as an Inpatient Palliative Care Unit, at two different hospital units in the north of the country, in the period between February and June 2023. Refers to the development of clinical skills in the area of Nursing for people in a palliative situation, covering the common skills of the specialist nurse, described in the Regulation of Common Skills of the Specialist Nurse No. 140/2019, and the specific skills of the specialist nurse in Medical Nursing -Surgery in the area of Nursing for Persons in Palliative Situations, defined in the Regulation of Specific Competencies of the Specialist Nurse in Medical-Surgical Nursing No. 429/2018. It comprises a descriptive, reflective and critical methodology, supported by scientific evidence. Palliative care nursing, inserted in the context of a multidisciplinary team, performs a set of autonomous and interdependent actions aimed to achieving care goals previously discussed and negotiated with the sick person, their significant others and the rest of the health team, aiming to the relief of suffering and improvement of quality of life. He is also an active agent, that facilitates the adaptation process of sick person and family to the changes and losses caused by serious and life-threatening illness, as in grief. During professional internship, we privileged the training of relational and communication skills, recognizing their therapeutic value in responding to the needs of education, emotional, social and spiritual support, related to the serious and advanced illness, and in the promotion of hope and comfort during the loss adaptation process. We also recognize the value of training as one of the essential foundations for professional nursing action development, especially with regard to human responses associated with loss, death and suffering.
Description
Keywords
Cuidados Paliativos Família Luto Adaptação Enfermagem Relatório de estágio