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A fragilidade na pessoa com doença renal crónica em hemodiálise
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Abstract(s)
O envelhecimento sociodemográfico traduz-se numa população cada vez mais idosa e que convive com Doenças Crónicas. A Doença Renal Crónica tem na Hemodiálise uma possibilidade de tratamento que não permite ao cliente a cura, mas prolonga o seu tempo de vida. Associado a este facto, a Fragilidade é uma síndrome multidimensional que predispõe a pessoa a efeitos adversos à sua saúde, sendo um problema comum nos clientes com doença renal crónica em Hemodiálise, com um impacto considerável na sua qualidade de vida.
Tendo como ponto de partida esta problemática, desenvolveu-se um projeto de estágio em três contextos distintos – uma unidade hospitalar e duas unidades de hemodiálise, assente no objetivo de adquirir competências como enfermeiro mestre e especialista em Enfermagem Médico-Cirurgica na área de Enfermagem à Pessoa em Situação Crónica. Como metodologia, optou-se pela metodologia de trabalho de projeto. As principais teorias orientadoras dos cuidados prestados foram a Teoria das Transições (Meleis, et al., 2000) e o Modelo Integral da Fragilidade (Gobbens et al.,2010). Este percurso foi também guiado pelo modelo de aquisição de competências de Dreyfus (Benner, 2001).
Como resultados das atividades realizadas salientam-se a aquisição de conhecimentos sobre a fragilidade na pessoa com doença renal crónica em hemodiálise, a aplicação dos modelos teóricos à prática clínica, a capacitação dos profissionais e a realização de uma revisão integrativa da literatura sobre os indicadores de fragilidade nesta população.
As conclusões deste projeto revelam a intervenção do enfermeiro especialista como elemento diferenciador e fundamental na prestação de cuidados especializados na prevenção, diagnóstico e tratamento da Fragilidade na pessoa com Doença Renal Crónica em Hemodiálise, contribuindo de forma significativa para o desenvolvimento de competências especializadas e de mestre.
Sociodemographic ageing is leading to an increasingly elderly population living with chronic diseases. Hemodialysis is a treatment for chronic kidney disease that doesn’t cure the patient but increases his lifetime. Frailty is a multidimensional syndrome that leads to adverse effects on patients' health. This is a common problem in patients with chronic kidney disease on hemodialysis and has a considerable impact on their quality of life. With this problem as a starting point, an internship project was developed in three different contexts - a hospital unit and two hemodialysis units, based on the objective of acquiring skills as a master's degree nurse and specialist in Medical-Surgical Nursing in Nursing for Patients in Chronic Diseases. The methodology chosen was the project work. The main theories guiding the care provided were the Transitions Theory (Meleis, et al., 2000) and the Integral Conceptual Model of Frailty (Gobbens et al., 2010). This path was also guided by the Dreyfus Model of skills acquisition (Benner, 2001). The results of the activities carried out include the acquisition of knowledge about frailty in people with chronic kidney disease on hemodialysis, the application of theoretical models to clinical practice, and the training of healthcare professionals. An Integrative Literature Review was also carried out on frailty indicators in this population. The conclusions of this project reveal the fundamental role of the specialist nurse as a differentiating element in the provision of specialized care in the prevention, diagnosis, and treatment of frailty in people with chronic kidney disease on hemodialysis, making a significant contribution to the development of specialized and master nurse skills.
Sociodemographic ageing is leading to an increasingly elderly population living with chronic diseases. Hemodialysis is a treatment for chronic kidney disease that doesn’t cure the patient but increases his lifetime. Frailty is a multidimensional syndrome that leads to adverse effects on patients' health. This is a common problem in patients with chronic kidney disease on hemodialysis and has a considerable impact on their quality of life. With this problem as a starting point, an internship project was developed in three different contexts - a hospital unit and two hemodialysis units, based on the objective of acquiring skills as a master's degree nurse and specialist in Medical-Surgical Nursing in Nursing for Patients in Chronic Diseases. The methodology chosen was the project work. The main theories guiding the care provided were the Transitions Theory (Meleis, et al., 2000) and the Integral Conceptual Model of Frailty (Gobbens et al., 2010). This path was also guided by the Dreyfus Model of skills acquisition (Benner, 2001). The results of the activities carried out include the acquisition of knowledge about frailty in people with chronic kidney disease on hemodialysis, the application of theoretical models to clinical practice, and the training of healthcare professionals. An Integrative Literature Review was also carried out on frailty indicators in this population. The conclusions of this project reveal the fundamental role of the specialist nurse as a differentiating element in the provision of specialized care in the prevention, diagnosis, and treatment of frailty in people with chronic kidney disease on hemodialysis, making a significant contribution to the development of specialized and master nurse skills.
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Keywords
Enfermagem médico-cirúrgica Fragilidade Insuficiência renal crónica Hemodiálise Cuidados de enfermagem