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Contributos do enfermeiro obstetra na experiência da transição para a paternidade em contexto pandémico
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Advisor(s)
Abstract(s)
O presente Relatório de Estágio (RE), surge integrado no programa da Unidade
Curricular de Estágio com Relatório do 11º Curso de Mestrado em Enfermagem de
Saúde Materna e Obstetrícia (CMESMO). Além do processo de investigação
proposto, este relatório relata também a minha reflexão sobre o meu percurso de
aprendizagem e desenvolvimento das competências, para a obtenção do título de
Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica (EEESMO)
e do grau de Mestre.
As mudanças que ocorreram nas unidades hospitalares, devido à pandemia
causada pelo vírus Severe Acute Respiratory Syndrome Coronavírus 2 (SARS-CoV 2), reportam as medidas excecionais de prevenção e controlo implementadas pela
Direção Geral de Saúde (DGS), com o intuito de minimizar o risco de transmissão da
infeção por SARS-CoV-2, em meio hospitalar. Estas medidas criaram uma nova
dinâmica no quotidiano das maternidade, impossibilitando o pai de vivenciar e
participar nos primeiros momentos de vida do seu Recém-Nascido (RN).
Neste sentido, a concretização deste RE pretende além de descrever a minha
reflexão acerca do meu percurso de aprendizagem e do desenvolvimento das minhas
competências, pretende responder à seguinte questão de partida: “Como é que a
transição para a paternidade é afetada pela ausência do acompanhamento do
pai no pós-parto?”. A Teoria de Enfermagem que sustentou e norteou o presente
RE, bem como a minha prática de cuidados foi o Modelo Conceptual de Afaf Meleis,
tendo em conta, o significado do conceito de transição e a problemática em estudo.
No decurso do processo formativo, assim como na base de elaboração deste
relatório, a metodologia usada assentou na Prática Baseada na Evidência e na
Scoping Review (SR), em alinhamento com a metodologia proposta pelo Joanna
Briggs Institute (JBI) (2021). Através de recurso à plataforma EBSCOhost, a pesquisa
foi limitada à escolha de três bases de dados, com o intuito de mapear toda a
evidência científica relevante sobre a temática. Foi aplicado um Instrumento de
Recolha de Dados (IRD) a cento e seis progenitores masculinos que vivenciaram a
transição para a paternidade em contexto pandémico, com o objetivo de compreender
se o processo de envolvimento emocional entre o pai e o RN foi afetado pela ausência
do pai no decurso do pós-parto, recorrendo para o efeito à Mother-to-Infant Bonding
Scale (Taylor et al. 2005), versão Portuguesa alargada de Figueiredo et al. (2005).
Os artigos resultantes da SR, evidenciam que cada vez mais os pais procuram
capacitar-se enquanto cuidadores, a fim de potenciar a sua implicação no processo
educativo, não só através da prestação de cuidados diretos mas também de cuidados
indiretos, tais como o estabelecimento de uma relação de afetividade com o RN. Esta
mudança de paradigma dota o homem não só para prestar cuidados ao RN, como
também para proporcionar apoio emocional e físico à puérpera. A Mother-to-Infant
Bonding Scale (Taylor et al. 2005), versão Portuguesa alargada de Figueiredo et al.
(2005), reconheceu que os pais não desenvolveram ou desenvolveram pouco as
emoções referentes ao “Bonding Negativo” em relação ao seu RN.
A análise de conteúdo concretizada, evidencia que o EEESMO ao incentivar a
presença e participação paterna no pós-parto e o pós-parto imediato, conduziu à
promoção de um ambiente facilitador à transição para a paternidade. Já como
obstáculo à promoção de um ambiente facilitador à transição para a paternidade no
internamento, as causas são adjudicadas às restrições instituídas dada a situação
pandémica.
This Internship Report (RE) integrates the Internship Curricular Unit Program with Report of the 11th Master's Course in Maternal Health and Obstetrics Nursing. In addition to the proposed investigation process, this report accounts a self-reflection on my learning journey and skills development process, to obtain both, the titles of Specialist Nurse in Maternal and Obstetric Health Nursing and Master's degree. The changes that took place in hospital units, due to the pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus refer exceptional prevention-control measures implemented by the Direção Geral de Saúde (DGS) to minimize the risk of transmission of SARS-CoV 2 infection in hospital environment. These preventive measures created a new dynamic in the daily context of maternity services, making it impossible for the father to experience and participate in the first moments of life of his Newborn. Subsequently, this research process in the internship context intended to answer the following starting question: "How is the transition to fatherhood affected by the absence of the father's follow-up in the postpartum period?" Considering the problem under study, the Nursing Theory that supported and guided this IR, as well as my care practice, was the Conceptual Model of Afaf Meleis focused on the concept of transition. Throughout my training process, as well as in the making of this report, the methodology used was based on Evidence-Based Practice and Scoping Review (SR), in line with the methodology proposed by the Joanna Briggs Institute (JBI) (2021). Using the EBSCOhost platform, the research was limited to the choice of three databases, with the aim of mapping all the relevant scientific evidence on the subject. A Data Survey Instrument, was applied to one hundred and six male parents who experienced the transition to parenthood in a pandemic context, with the purpose of understanding if the process of emotional involvement between the father and the NB was affected by the father's absence during the postpartum period, using the Mother-toInfant Bonding Scale (Taylor et al. 2005), Portuguese version of Figueiredo et al. (2005). The articles resulting from the SR showed that parents were increasingly seeking training as caregivers, in order to strengthen their involvement in the education process, not only through the provision of direct care, but also indirect care, such as the establishment of an affectionate relationship with the NB. This paradigm shift equips men not only to provide care to the NB, but also to provide emotional and physical support to the puerperal woman. The Mother-toInfant Bonding Scale (Taylor et al. 2005), Portuguese version extended by Figueiredo et al. (2005), recognised that fathers did not or only slightly developed emotions related to "Negative Bonding" towards their NB. The content analysis carried out showed that, by encouraging the paternal presence and participation in the postnatal and immediate postnatal periods, the Specialist Nurse in Maternal and Obstetric Health Nursing promoted a facilitating environment for the transition to parenthood. As an obstacle to the promotion of a facilitating environment for the transition to inpatient paternity, the causes were attributed to the restrictions imposed by the pandemic situation.
This Internship Report (RE) integrates the Internship Curricular Unit Program with Report of the 11th Master's Course in Maternal Health and Obstetrics Nursing. In addition to the proposed investigation process, this report accounts a self-reflection on my learning journey and skills development process, to obtain both, the titles of Specialist Nurse in Maternal and Obstetric Health Nursing and Master's degree. The changes that took place in hospital units, due to the pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus refer exceptional prevention-control measures implemented by the Direção Geral de Saúde (DGS) to minimize the risk of transmission of SARS-CoV 2 infection in hospital environment. These preventive measures created a new dynamic in the daily context of maternity services, making it impossible for the father to experience and participate in the first moments of life of his Newborn. Subsequently, this research process in the internship context intended to answer the following starting question: "How is the transition to fatherhood affected by the absence of the father's follow-up in the postpartum period?" Considering the problem under study, the Nursing Theory that supported and guided this IR, as well as my care practice, was the Conceptual Model of Afaf Meleis focused on the concept of transition. Throughout my training process, as well as in the making of this report, the methodology used was based on Evidence-Based Practice and Scoping Review (SR), in line with the methodology proposed by the Joanna Briggs Institute (JBI) (2021). Using the EBSCOhost platform, the research was limited to the choice of three databases, with the aim of mapping all the relevant scientific evidence on the subject. A Data Survey Instrument, was applied to one hundred and six male parents who experienced the transition to parenthood in a pandemic context, with the purpose of understanding if the process of emotional involvement between the father and the NB was affected by the father's absence during the postpartum period, using the Mother-toInfant Bonding Scale (Taylor et al. 2005), Portuguese version of Figueiredo et al. (2005). The articles resulting from the SR showed that parents were increasingly seeking training as caregivers, in order to strengthen their involvement in the education process, not only through the provision of direct care, but also indirect care, such as the establishment of an affectionate relationship with the NB. This paradigm shift equips men not only to provide care to the NB, but also to provide emotional and physical support to the puerperal woman. The Mother-toInfant Bonding Scale (Taylor et al. 2005), Portuguese version extended by Figueiredo et al. (2005), recognised that fathers did not or only slightly developed emotions related to "Negative Bonding" towards their NB. The content analysis carried out showed that, by encouraging the paternal presence and participation in the postnatal and immediate postnatal periods, the Specialist Nurse in Maternal and Obstetric Health Nursing promoted a facilitating environment for the transition to parenthood. As an obstacle to the promotion of a facilitating environment for the transition to inpatient paternity, the causes were attributed to the restrictions imposed by the pandemic situation.
Description
Keywords
Enfermagem obstétrica Pai Recém-nascido Parentalidade COVID-19