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Contributos para a sistematização das intervenções de enfermagem promotoras da adaptação da mulher ao cancro da mama
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| 3.25 MB | Adobe PDF |
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Abstract(s)
A identificação das intervenções de enfermagem com vista a promover a adaptação da mulher ao cancro da mama carece de um processo de sistematização e proficiência para poderem ser implementadas pelos enfermeiros na prática clínica.
O presente estudo surge nesta perspetiva. Para o efeito, seguimos os modelos de desenvolvimento de intervenções de enfermagem propostos por Meijel et al. (2004) e Aranda (2008), que descrevem etapas e categorias convergentes deste processo de sistematização.
Pretendemos identificar e sistematizar as intervenções de enfermagem muito relevantes, na perspetiva dos enfermeiros, para promover a adaptação da mulher ao cancro da mama, no sentido de a capacitar para que seja capaz de realizar todas as atividades inerentes ao autocuidado, de uma forma responsável e consciente. Desta forma, pretendemos igualmente contribuir para uma melhoria das práticas assistenciais de enfermagem neste contexto.
Realizamos uma revisão integrativa da literatura de acordo com o modelo proposto por Mendes et al. (2008) no sentido de obter a mais recente evidência sobre as intervenções de enfermagem promotoras da adaptação da mulher ao cancro da mama, entre 16 de março e 14 de abril de 2016 em todas as bases de dados presentes nos agregadores de conteúdos que tivemos acesso via Escola Superior de Enfermagem do Porto, EBSCOhost Web, Scopus e Web of ScienceTM. Utilizamos a estratégia PVO para construção da pergunta de pesquisa e definidos os termos a incluir na pesquisa. Dos 356 artigos retornados das bases de dados consultadas, analisamos 30 artigos de acordo com o modelo de análise criado com as categorias de evidências emergentes dos modelos de Meijel et al. (2004) e Aranda (2008). O processo de revisão dos artigos foi efetuado por dois investigadores, de forma independente.
XII
Várias são as evidências disponíveis que se encontram ao serviço dos enfermeiros que acompanham as mulheres com cancro da mama, desde o referencial teórico que sustenta as intervenções, a população alvo a quem se destina, a complexidade e forma de implementação das intervenções, a integridade, a ―dose terapêutica‖ e as formas de verificação das intervenções.
As terapêuticas do tipo informar e educar são as que se destacam neste contexto, com vista em capacitar a mulher para a promoção das atividades de autocuidado, mais na perspetiva de desvio à saúde.
As formas de implementação predominantes passam por sessões informativas e educativas, com suporte verbal e escrito no sentido de reforçar a informação. O recurso a novas tecnologias para apoiar neste sentido tem vindo a crescer, acompanhando o desenvolvimento tecnológico, como são os casos das estratégias com recurso a equipamentos de multimédia, aplicações interativas online e acompanhamento via telenursing, todos com boa recetividade da população.
O referencial teórico dominante dos artigos analisados é a Teoria do Défice de Autocuidado de Orem (2001) e recorrem, predominantemente, a práticas de enfermagem da Teoria dos Sistemas de Enfermagem, nomeadamente no apoio educativo que é proporcionado às mulheres com vista na capacitação das mesmas para realizarem as atividades inerentes ao autocuidado.
The identification of nursing interventions aiming at promoting the adaptation of women to breast cancer lacks systematic approach and proficiency in order to be implemented by nurses in clinical practice. The present study emerges from such gap. To this end, we followed the development models of nursing interventions proposed by Meijel et al. (2004) and Aranda (2008) that describe the converging steps and categories of such systematization process. We intended to identify and systematize highly relevant nursing interventions, from the perspective of nurses, which promote the adjustment of women to breast cancer, thus allowing these individuals to be able to perform all activities involved in self-care in a responsible and conscientious way. In this way, we aim at contributing to the improvement of nursing assistance practices in such setting. We undertook an integrative literature review according to the model proposed by Mendes et al. (2008) in order to obtain the latest evidence regarding nursing interventions that promote the adaptation of women to breast cancer, between March 16, 2016 and April 14, 2016 from all online databases available at the Nursing School of Porto, EBSCOhost Web, Scopus and Web of Science™. We used the PVO strategy for establishing a search question and defining the terms to be included in the search. Of the 356 articles returned, we considered 30 articles according to the analysis model created with evidence categories emerging from the models of Meijel et al. (2004) and Aranda (2008). The review process of these articles was performed independently by two investigators. There is substantial evidence available to nurses assisting women with breast cancer, including theoretical background that supports XIV interventions, target populations for interventions, complexity and implementation strategies of interventions, integrity, ―therapeutic doses‖ and assessment approaches for interventions. Therapeutics such as informing and educating are the ones highlighted in such context in order to enable women to promote self-care activities, mainly from a health deviation perspective. The predominant means of implementation include information and education sessions, with verbal and written support in order to reinforce information. The use of new technologies for backing information has been increasing alongside technological progresses, namely in the case of strategies including the use of multimedia equipment, interactive online apps and follow-up via telenursing, all of which have been shown popular among target populations. The predominant theoretical framework of assessed articles is Orem’s Self-Care Deficit Theory (2001), being frequently based on nursing practices from the Nursing Systems Theory, namely by providing educational support to women for performing activities concerning self-care.
The identification of nursing interventions aiming at promoting the adaptation of women to breast cancer lacks systematic approach and proficiency in order to be implemented by nurses in clinical practice. The present study emerges from such gap. To this end, we followed the development models of nursing interventions proposed by Meijel et al. (2004) and Aranda (2008) that describe the converging steps and categories of such systematization process. We intended to identify and systematize highly relevant nursing interventions, from the perspective of nurses, which promote the adjustment of women to breast cancer, thus allowing these individuals to be able to perform all activities involved in self-care in a responsible and conscientious way. In this way, we aim at contributing to the improvement of nursing assistance practices in such setting. We undertook an integrative literature review according to the model proposed by Mendes et al. (2008) in order to obtain the latest evidence regarding nursing interventions that promote the adaptation of women to breast cancer, between March 16, 2016 and April 14, 2016 from all online databases available at the Nursing School of Porto, EBSCOhost Web, Scopus and Web of Science™. We used the PVO strategy for establishing a search question and defining the terms to be included in the search. Of the 356 articles returned, we considered 30 articles according to the analysis model created with evidence categories emerging from the models of Meijel et al. (2004) and Aranda (2008). The review process of these articles was performed independently by two investigators. There is substantial evidence available to nurses assisting women with breast cancer, including theoretical background that supports XIV interventions, target populations for interventions, complexity and implementation strategies of interventions, integrity, ―therapeutic doses‖ and assessment approaches for interventions. Therapeutics such as informing and educating are the ones highlighted in such context in order to enable women to promote self-care activities, mainly from a health deviation perspective. The predominant means of implementation include information and education sessions, with verbal and written support in order to reinforce information. The use of new technologies for backing information has been increasing alongside technological progresses, namely in the case of strategies including the use of multimedia equipment, interactive online apps and follow-up via telenursing, all of which have been shown popular among target populations. The predominant theoretical framework of assessed articles is Orem’s Self-Care Deficit Theory (2001), being frequently based on nursing practices from the Nursing Systems Theory, namely by providing educational support to women for performing activities concerning self-care.
Description
Keywords
Neoplasia mamária Autocuidado