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Enfermeiro de referência na pessoa com doença renal crónica em hemodiálise
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Abstract(s)
O presente relatório, elaborado no contexto do curso de Mestrado em
Enfermagem Médico-Cirúrgica, na Vertente Nefrológica, demonstra a aquisição de
competências do Enfermeiro Especialista, apresentando-se as reflexões
consequentes das atividades desenvolvidas em estágios e, também, explana as
competências de mestre que foram adquiridas com a concretização de uma revisão
scoping com o título: “Enfermeiro de Referência na pessoa com doença renal crónica
em hemodiálise”.
As pessoas com Doença Renal Crónica (DRC) enfrentam grandes dificuldades
na adaptação ao tratamento de Hemodiálise (HD), por ser um processo terapêutico
complexo, exaustivo, exigente e sujeito a várias complicações, pelo que necessitam
de ajuda consistente e permanente por parte da equipa de enfermagem.
As pessoas em HD necessitam de alterar a sua dinâmica de vida, sendo
fundamental manterem um papel ativo, de forma a evitar ou reduzir complicações intra
e interdialíticas, na possível redução da morbilidade/mortalidade e na promoção do
seu bem-estar físico, psicológico, social e espiritual. Devido a esta problemática,
torna-se essencial que os cuidados de enfermagem sejam individualizados e
centrados na promoção da adaptação da pessoa às limitações ocasionadas pela
doença e respetivo tratamento.
A Metodologia de Enfermeiro de Referência (MER) baseia-se num modelo de
prestação de cuidados que valoriza uma intervenção holística, centrada na pessoa e
com uma intervenção individualizada. O Enfermeiro de Referência assume a
responsabilidade total da gestão dos cuidados de uma pessoa com DRC (ou várias)
específica(s), durante todo o período terapêutico.
Com a revisão scoping constatou-se que o Enfermeiro de Referência em
Nefrologia deve estabelecer um acompanhamento individualizado e contínuo a cada
pessoa, guiado pela melhor evidência científica. Adicionalmente, este profissional tem
um papel fundamental na educação e formação desta população, sendo a sua
principal função capacitar as pessoas para encarar esta nova condição de saúde.
Desta forma, cada pessoa deve tornar-se responsável pela sua saúde, garantindo a
redução de possíveis complicações e promovendo a adaptação a este tratamento e
condição de vida
This report, prepared in the context of the master’s degree in Medical-Surgical Nursing with specialisation in Nephrology, proves the acquisition of skills of the specialist nurse through reflection on the activities developed in internships and it also demonstrates the master skills that were gained from carrying out a scoping review with the title: 'Primary Nurse for the patient with chronic kidney disease on hemodialysis'. The patient with chronic kidney disease (CKD) faces great difficulties in adapting to hemodialysis (HD) treatment, as it is a complex therapeutic process. It is a very exhaustive, demanding treatment and subject to several complications, so people need consistent and permanent help from the nursing team. People in HD need to change their life dynamics, an active role is vital in order to avoid or reduce intra and interdialytic complications, in the possible reduction of morbidity/mortality and in the promotion of their physical, psychological and social well being. Due to this problem, it is essential that nursing care is individualised and focused on promoting the patient's adaptation to the limitations caused by the disease and treatment. The Primary Nurse Methodology (PNM) is based on a care delivery model that values a holistic, person-centred and individualized intervention. The Primary Nurse assumes full responsibility for the management of the care of a specific patient (or several) during the entire therapeutic period. With the scoping review, it was found that the Primary Nurse in nephrology should establish an individualised and continuous follow-up to each patient, guided by the best scientific evidence. We conclude that the intervention conducted by the Primary Nurse through support, education and prevention of complications is an essential tool to reduce and control symptoms. It was found that this professional also has a vital role in the education and training of the population, with their main function being to enable the patient to face this new health condition. Therefore, the patient becomes responsible for their health, ensuring the reduction of possible complications and promoting adaptation to this treatment and life condition.
This report, prepared in the context of the master’s degree in Medical-Surgical Nursing with specialisation in Nephrology, proves the acquisition of skills of the specialist nurse through reflection on the activities developed in internships and it also demonstrates the master skills that were gained from carrying out a scoping review with the title: 'Primary Nurse for the patient with chronic kidney disease on hemodialysis'. The patient with chronic kidney disease (CKD) faces great difficulties in adapting to hemodialysis (HD) treatment, as it is a complex therapeutic process. It is a very exhaustive, demanding treatment and subject to several complications, so people need consistent and permanent help from the nursing team. People in HD need to change their life dynamics, an active role is vital in order to avoid or reduce intra and interdialytic complications, in the possible reduction of morbidity/mortality and in the promotion of their physical, psychological and social well being. Due to this problem, it is essential that nursing care is individualised and focused on promoting the patient's adaptation to the limitations caused by the disease and treatment. The Primary Nurse Methodology (PNM) is based on a care delivery model that values a holistic, person-centred and individualized intervention. The Primary Nurse assumes full responsibility for the management of the care of a specific patient (or several) during the entire therapeutic period. With the scoping review, it was found that the Primary Nurse in nephrology should establish an individualised and continuous follow-up to each patient, guided by the best scientific evidence. We conclude that the intervention conducted by the Primary Nurse through support, education and prevention of complications is an essential tool to reduce and control symptoms. It was found that this professional also has a vital role in the education and training of the population, with their main function being to enable the patient to face this new health condition. Therefore, the patient becomes responsible for their health, ensuring the reduction of possible complications and promoting adaptation to this treatment and life condition.
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Keywords
Enfermagem em nefrologia Insuficiência renal crónica Cuidados de enfermagem Hemodiálise