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Cuidados à pessoa com doença renal crónica em programa regular de hemodiálise: Desenvolvimento de competências especializadas em Enfermagem Médico - Cirúrgica , na área de Enfermagem à Pessoa em Situação Crónica
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As Doenças Crónicas são condições de saúde que se caracterizam pela sua duração prolongada
e frequentemente progressiva, exigindo cuidados contínuos e monitorização ao longo do tempo.
Estas representam um dos maiores desafios para a saúde pública no século XXI, afetando
diretamente a qualidade de vida das pessoas. A Doença Renal Crónica, enquanto doença
crónica, é uma condição que requer um acompanhamento rigoroso e contínuo, especialmente
nas pessoas que se encontram em programa regular de hemodiálise que, para além da
prevenção e deteção precoce de complicações, exige a adaptação à doença e à gestão do seu
regime terapêutico.
Este relatório descreve o desenvolvimento de competências clínicas especializadas, no âmbito
do estágio de natureza profissional, inserido no Mestrado em Enfermagem Médico-Cirúrgica da
Escola Superior de Enfermagem do Porto, na vertente da Pessoa em Situação Crónica. O estágio
teve como objetivo a concretização de um projeto de desenvolvimento focado no cuidado à
pessoa em Programa Regular de Hemodiálise, com vista à aquisição de competências
especializadas. Ao longo do estágio, foi possível aprofundar a compreensão sobre a gestão de
cuidados especializados em doenças crónicas, destacando a importância de uma intervenção de
enfermagem que vá além dos cuidados clínicos diretos. A educação em saúde foi uma das
estratégias implementadas, com o objetivo de promover a adesão ao tratamento e a
capacitação da pessoa para a autogestão da doença e do regime terapêutico. Também foi dada
particular atenção ao acompanhamento psicológico e social, reconhecendo o impacto emocional
da doença no seu bem-estar e qualidade de vida.
O estágio seguiu a prática crítico-reflexiva e a evidência científica para implementar planos de
cuidados individualizados. A gestão de riscos e a prevenção de complicações, como infeções
relacionadas com o acesso vascular, foram abordadas com foco na segurança e na qualidade
dos cuidados. A pesquisa bibliográfica, reflexão contínua e a discussão com os tutores e
orientadores consolidou o pensamento crítico e a tomada de decisão fundamentada, essenciais
para a prática especializada. O estágio revelou-se crucial para o desenvolvimento de
competências, enfatizando a promoção da qualidade de vida e a autogestão do tratamento. A
abordagem holística destacou-se como essencial para garantir um cuidado adaptado às
necessidades de cada pessoa, melhorando o seu bem-estar e gestão da doença crónica,
conduzindo a uma maior aceitação da sua condição de saúde/doença.
Chronic Diseases are health conditions characterized by their prolonged duration and often progressive nature, requiring continuous care and long-term monitoring. They represent one of the greatest challenges for public health in the 21st century, directly impacting individuals' quality of life. Chronic Kidney Disease, as a chronic illness, is a condition that requires rigorous and ongoing follow-up, especially for individuals undergoing a regular haemodialysis program. In addition to the prevention and early detection of complications, it also demands adaptation to the illness and the management of its therapeutic regimen. This report describes the development of specialized clinical competencies within the scope of a professional internship, part of the Master degree of Medical-Surgical Nursing at the Escola Superior de Enfermagem do Porto, with a focus on People Living with Chronic Conditions. The purpose of the internship was to carry out a development project focused on the care of a person in a regular haemodialysis program, with a view to acquiring specialized skills. Throughout the internship, it was possible to deepen the understanding of specialized care management in chronic illnesses, highlighting the importance of nursing interventions that go beyond direct clinical care. Health education was one of the strategies implemented, aiming to promote treatment adherence and empower individuals in the self-management of their condition and therapeutic regimen. Particular attention was also given to psychological and social support, recognizing the emotional impact of the disease on well-being and quality of life. The internship was guided by critical-reflective practice and scientific evidence to implement individualized care plans. Risk management and the prevention of complications, such as infections related to vascular access, were addressed with a focus on safety and quality of care. Literature review, continuous reflection, and discussions with tutors and supervisors strengthened critical thinking and evidence-based decision-making, which are essential for specialized practice. The internship proved to be crucial for the development of competencies, emphasizing the promotion of quality of life and self-management of treatment. The holistic approach proved to be crucial to ensure that care is tailored to the person needs, improving their well-being and management of chronic disease, and leading to greater acceptance of their health condition.
Chronic Diseases are health conditions characterized by their prolonged duration and often progressive nature, requiring continuous care and long-term monitoring. They represent one of the greatest challenges for public health in the 21st century, directly impacting individuals' quality of life. Chronic Kidney Disease, as a chronic illness, is a condition that requires rigorous and ongoing follow-up, especially for individuals undergoing a regular haemodialysis program. In addition to the prevention and early detection of complications, it also demands adaptation to the illness and the management of its therapeutic regimen. This report describes the development of specialized clinical competencies within the scope of a professional internship, part of the Master degree of Medical-Surgical Nursing at the Escola Superior de Enfermagem do Porto, with a focus on People Living with Chronic Conditions. The purpose of the internship was to carry out a development project focused on the care of a person in a regular haemodialysis program, with a view to acquiring specialized skills. Throughout the internship, it was possible to deepen the understanding of specialized care management in chronic illnesses, highlighting the importance of nursing interventions that go beyond direct clinical care. Health education was one of the strategies implemented, aiming to promote treatment adherence and empower individuals in the self-management of their condition and therapeutic regimen. Particular attention was also given to psychological and social support, recognizing the emotional impact of the disease on well-being and quality of life. The internship was guided by critical-reflective practice and scientific evidence to implement individualized care plans. Risk management and the prevention of complications, such as infections related to vascular access, were addressed with a focus on safety and quality of care. Literature review, continuous reflection, and discussions with tutors and supervisors strengthened critical thinking and evidence-based decision-making, which are essential for specialized practice. The internship proved to be crucial for the development of competencies, emphasizing the promotion of quality of life and self-management of treatment. The holistic approach proved to be crucial to ensure that care is tailored to the person needs, improving their well-being and management of chronic disease, and leading to greater acceptance of their health condition.
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Palavras-chave
Enfermagem Médico-Cirúrgica Doença renal crónica Hemodiálise Gestão regime terapêutico Competências