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A Pessoa com diabetes mellitus em situação crónica: Projeto de desenvolvimento de competências clínicas especializadas em enfermagem médico-cirúrgica, na área da enfermagem à pessoa em situação crónica
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Advisor(s)
Abstract(s)
As doenças crónicas resultam da combinação de vários fatores, desde os fisiológicos e genéticos, aos comportamentais e ambientais. A diabetes mellitus é uma doença crónica caracterizada por um síndrome metabólico de carboidratos, gorduras e proteínas, causado pela diminuição da sensibilidade dos tecidos à insulina ou pela ausência de insulina, que se traduz em hiperglicemia. A diabetes mellitus, a longo prazo, acarreta complicações micro e macrovasculares, podendo impactar negativamente a qualidade de vida da pessoa. O controlo desta condição implica a adoção de comportamentos de autogestão de um regime terapêutico, que obriga a tomada de decisões diárias
O papel do enfermeiro revela-se fundamental neste processo, pois facilita a transição dos clientes e das suas famílias para a nova realidade imposta pela doença. Portanto, a intervenção de enfermagem no controlo e acompanhamento das pessoas com doenças crónicas, principalmente a diabetes, é um recurso valioso e indispensável. A compreensão das respostas humanas ao processo de transição da pessoa com diabetes é, portanto, essencial para a definição de estratégias de intervenção adequadas e eficazes.
Baseado nestes pressupostos, foi desenvolvido um projeto de âmbito académico com o objetivo de auxiliar no desenvolvimento de competências em Enfermagem Médico-Cirúrgica, na área de Enfermagem à Pessoa em Situação Crónica, mais especificamente no desenvolvimento de competências especializadas no cuidado à pessoa com diabetes mellitus em situação crónica. Norteados por este objetivo geral, e tendo por base as competências definidas pela Ordem dos Enfermeiros, foram definidos objetivos específicos que também nos indicam os resultados que pretendemos alcançar, bem como as atividades que permitem operacionalizar esses objetivos específicos. O presente relatório pretende expor os resultados da aplicação desse projeto no Estágio de Natureza Profissional, em contexto de internamento, num Serviço de Endocrinologia, e em contexto de consulta externa da diabetes.
Destaca-se neste documento a reflexão feita sobre aspetos como: o exame físico aos pés da pessoa com diabetes mellitus; a autovigilância e cuidados aos pés; a autogestão do regime terapêutico, nomeadamente fatores de não adesão ao regime medicamentoso. A conceção de cuidados relativa aos casos acompanhados encontra-se explanada através de dois planos de cuidados desenvolvidos nos dois momentos do Estágio, com recurso à plataforma educacional “E4Nursing”.
Chronic diseases result from the combination of several factors, from physiological and genetic, to behavioral and environmental. Diabetes mellitus is one such chronic disease, characterized by a metabolic syndrome affecting carbohydrates, fats, and proteins. This is caused by either a decrease in tissue sensitivity to insulin or the absence of insulin. This condition results in elevated blood glucose levels, a state known as hyperglycemia. Over time, diabetes mellitus can lead to both microvascular and macrovascular complications, which can adversely affect an individual’s quality of life. Controlling this condition involves adopting self-management behaviors in a therapeutic regimen, which requires daily decision-making. The role of the nurse proves to be fundamental in this process, as it facilitate the transition of clients and their families to the new reality imposed by the disease. Therefore, nursing interventions in controlling and monitoring individuals with chronic diseases, particularly diabetes, are invaluable and indispensable resources. Understanding human responses to the transition process of people with diabetes is, therefore, essential for defining appropriate and effective intervention strategies. Building upon these assumptions, an academic project was initiated with the objective of fostering skill development in Medical-Surgical Nursing. This project focuses on Nursing for Individuals in Chronic Conditions, specifically aimed at the development of specialized skills for the care of individuals with diabetes mellitus in a chronic situation. Guided by this general objective and based on the competencies defined by the Portuguese Order of Nurses, specific objectives were defined that also indicate the results we intend to achieve, as well as the activities that allow these specific objectives to be operationalized. This report aims to present the results of the application of this project in the Professional Internship, in an hospitalization context, in an Endocrinology Service, and in an external diabetes consultation context. This document highlights the reflection made on aspects such as: the physical examination of the feet of the person with diabetes mellitus; self-monitoring and foot care; self-management of the therapeutic regimen, namely factors of non-adherence to the medication regimen. The conception of care relating to the cases monitored is explained through two care plans developed at both stages of the Internship, using the educational platform “E4Nursing”.
Chronic diseases result from the combination of several factors, from physiological and genetic, to behavioral and environmental. Diabetes mellitus is one such chronic disease, characterized by a metabolic syndrome affecting carbohydrates, fats, and proteins. This is caused by either a decrease in tissue sensitivity to insulin or the absence of insulin. This condition results in elevated blood glucose levels, a state known as hyperglycemia. Over time, diabetes mellitus can lead to both microvascular and macrovascular complications, which can adversely affect an individual’s quality of life. Controlling this condition involves adopting self-management behaviors in a therapeutic regimen, which requires daily decision-making. The role of the nurse proves to be fundamental in this process, as it facilitate the transition of clients and their families to the new reality imposed by the disease. Therefore, nursing interventions in controlling and monitoring individuals with chronic diseases, particularly diabetes, are invaluable and indispensable resources. Understanding human responses to the transition process of people with diabetes is, therefore, essential for defining appropriate and effective intervention strategies. Building upon these assumptions, an academic project was initiated with the objective of fostering skill development in Medical-Surgical Nursing. This project focuses on Nursing for Individuals in Chronic Conditions, specifically aimed at the development of specialized skills for the care of individuals with diabetes mellitus in a chronic situation. Guided by this general objective and based on the competencies defined by the Portuguese Order of Nurses, specific objectives were defined that also indicate the results we intend to achieve, as well as the activities that allow these specific objectives to be operationalized. This report aims to present the results of the application of this project in the Professional Internship, in an hospitalization context, in an Endocrinology Service, and in an external diabetes consultation context. This document highlights the reflection made on aspects such as: the physical examination of the feet of the person with diabetes mellitus; self-monitoring and foot care; self-management of the therapeutic regimen, namely factors of non-adherence to the medication regimen. The conception of care relating to the cases monitored is explained through two care plans developed at both stages of the Internship, using the educational platform “E4Nursing”.
Description
Keywords
Enfermagem médico-cirúrgica Doença crónica Diabetes mellitus Autogestão Tomada de decisão clínica Relatório de estágio