Loading...
Publication
A pessoa com compromisso renal em programa regular de hemodiálise: Projeto de desenvolvimento de competências clínicas especializadas, na área de enfermagem à pessoa em situação crónica
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| 1.35 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
Viver com doença crónica tem repercussões pessoais, familiares e sociais significativas. Esta
realidade muito se deve à complexidade e imprevisibilidade desta condição clínica. A
complexidade decorre dos processos corporais e do processo de transição, tornando
imprevisível o curso da doença crónica, que é responsável por parte significativa da mortalidade
e da morbilidade em todo o mundo, antevendo-se um aumento substancial nos próximos anos.
A doença crónica, bem como as respetivas comorbilidades, geram, frequentemente, condições
clínicas de grande complexidade responsáveis por um elevado consumo de cuidados de saúde,
nomeadamente internamentos (e reinternamentos), seja por agudização, seja por evolução da
doença crónica. No contexto das doenças crónicas, o compromisso renal com programa regular
de hemodiálise é uma das condições de saúde que desafia diariamente os enfermeiros e os
clientes, devido às especificidades da doença e do regime terapêutico subjacente, bem como ao
processo de transição saúde-doença que os doentes vivenciam.
No âmbito do Mestrado em enfermagem médico-cirúrgica, na área de enfermagem à pessoa em
situação crónica, com o objetivo de desenvolver competências especializadas, concebemos um
projeto para o estágio curricular orientado a pessoas com doença renal crónica em programa
regular de hemodiálise. Esta escolha baseou-se no nosso interesse por esta área de atuação
profissional e da consciência que temos do impacto que esta condição tem na vida das pessoas,
no sistema de saúde e na sociedade. Estabelecemos objetivos e definimos as atividades para os
alcançar, privilegiando as áreas de conhecimento que pretendíamos desenvolver. As atividades
planeadas foram concretizadas numa unidade de nefrologia (internamento) e numa unidade de
hemodiálise (ambulatório) que constituem o serviço de nefrologia. Esta experiência permitiu-nos
um contacto experiencial aprofundado e uma análise crítico-reflexiva, acompanhada de uma
alargada revisão da literatura, com múltiplos casos de pessoas com doença crónica, na qual
procurámos desenvolver competências especializadas. Apresentamos, ainda, dois casos clínicos
em que procurámos explorar o processo de conceção de cuidados de enfermagem.
Ao longo desta jornada, percebemos que os desafios colocados aos enfermeiros relacionados
com a suscetibilidade e a fragilidade da pessoa com doença crónica são maiores do que
havíamos percecionado. Para além da velhice, há outros fatores com menos visibilidade, como a
autogestão da doença crónica ou o autocuidado, que exigem respostas profissionais adequadas,
nomeadamente por parte do enfermeiro especialista em enfermagem médico-cirúrgica. Esta
realidade desafia os enfermeiros a alcançarem a expertise e a desenvolverem a arte do cuidar.
Living with a chronic illness has significant personal, family and social repercussions. This reality is largely due to the complexity and unpredictability of this clinical condition. The complexity stems from bodily processes and the transition process, making the course of chronic illness unpredictable. It is responsible for a significant part of mortality and morbidity worldwide, and is expected to increase substantially in the coming years. Chronic disease and its comorbidities often lead to highly complex clinical conditions which are responsible for a high level of health care consumption, namely hospitalizations (and readmissions), either due to exacerbation or to the evolution of the chronic disease. In the context of chronic diseases, renal impairment with a regular hemodialysis program is one of the health conditions that challenges nurses and clients on a daily basis, due to the specificities of the disease and the underlying therapeutic regimen, as well as the health-disease transition process that patients experience. As part of the Master's degree in medical-surgical nursing, in the area of nursing the chronically ill, with the aim of developing specialized skills, we designed a project for the curricular internship aimed at people with chronic kidney disease on a regular hemodialysis program. This choice was based on our interest in this area of professional practice and our awareness of the impact this condition has on people's lives, the health system and society. We set ourselves objectives and defined the activities to achieve them, focusing on the areas of knowledge we wanted to develop. The planned activities were carried out in a nephrology unit (inpatient) and a hemodialysis unit (outpatient) which make up the nephrology service. This experience allowed us to have in-depth experiential contact and a critical-reflective analysis, accompanied by an extensive literature review, with multiple cases of people with chronic illness, in which we sought to develop specialized skills. We also presented two clinical cases in which we tried to explore the process of designing nursing care. Throughout this journey, we realized that the challenges for nurses related to the susceptibility and fragility of people with chronic illnesses are greater than we had anticipated. In addition to old age, there are other less visible factors, such as self-management of chronic illness or selfcare, which require appropriate professional responses, particularly from nurses specializing in medical-surgical nursing. This reality challenges nurses to achieve expertise and develop the art of caring.
Living with a chronic illness has significant personal, family and social repercussions. This reality is largely due to the complexity and unpredictability of this clinical condition. The complexity stems from bodily processes and the transition process, making the course of chronic illness unpredictable. It is responsible for a significant part of mortality and morbidity worldwide, and is expected to increase substantially in the coming years. Chronic disease and its comorbidities often lead to highly complex clinical conditions which are responsible for a high level of health care consumption, namely hospitalizations (and readmissions), either due to exacerbation or to the evolution of the chronic disease. In the context of chronic diseases, renal impairment with a regular hemodialysis program is one of the health conditions that challenges nurses and clients on a daily basis, due to the specificities of the disease and the underlying therapeutic regimen, as well as the health-disease transition process that patients experience. As part of the Master's degree in medical-surgical nursing, in the area of nursing the chronically ill, with the aim of developing specialized skills, we designed a project for the curricular internship aimed at people with chronic kidney disease on a regular hemodialysis program. This choice was based on our interest in this area of professional practice and our awareness of the impact this condition has on people's lives, the health system and society. We set ourselves objectives and defined the activities to achieve them, focusing on the areas of knowledge we wanted to develop. The planned activities were carried out in a nephrology unit (inpatient) and a hemodialysis unit (outpatient) which make up the nephrology service. This experience allowed us to have in-depth experiential contact and a critical-reflective analysis, accompanied by an extensive literature review, with multiple cases of people with chronic illness, in which we sought to develop specialized skills. We also presented two clinical cases in which we tried to explore the process of designing nursing care. Throughout this journey, we realized that the challenges for nurses related to the susceptibility and fragility of people with chronic illnesses are greater than we had anticipated. In addition to old age, there are other less visible factors, such as self-management of chronic illness or selfcare, which require appropriate professional responses, particularly from nurses specializing in medical-surgical nursing. This reality challenges nurses to achieve expertise and develop the art of caring.
Description
Keywords
Doença crónica Compromisso renal Enfermeiro especialista Competência Relatório de estágio