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Gestão da doença crónica na pessoa com diabetes MELLITUS: Desenvolvimento de competências clínicas especializadas em Enfermagem Médico-Cirúrgica, na área de Enfermagem à Pessoa em Situação Crónica
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As doenças crónicas caracterizam-se por ser prolongadas, com evolução gradual, que exigem
cuidados e tratamentos continuados ao longo do tempo e que provocam potenciais
incapacidades. O aumento crescente das doenças crónicas constitui-se um dos principais
desafios no âmbito da saúde em Portugal, havendo objetivos definidos a nível nacional para a
prevenção de complicações ou agudizações e para a educação, visando a autogestão da
doença. A Diabetes mellitus é uma síndrome metabólica causada pela ausência de secreção de
insulina ou pelo aumento da resistência dos tecidos à insulina que se traduz em hiperglicemia e,
que provoca uma alteração metabólica dos hidratos de carbono, dos lípidos e das proteínas.
Esta patologia, de elevada prevalência em Portugal, exige devido à sua complexidade e
complicações associadas, a adoção de comportamentos de autogestão da doença e do regime
terapêutico.
O enfermeiro especialista em Enfermagem Médico-Cirúrgica na área de Enfermagem à Pessoa
em Situação Crónica desempenha um papel essencial na prestação de cuidados à pessoa com
Diabetes mellitus, promovendo um ambiente terapêutico adequado em colaboração com os
clientes e cuidadores. Este profissional facilita a transição para um novo estado de equilíbrio,
incentivando o autocuidado e a autogestão da doença e do regime terapêutico.
Este relatório foi elaborado no âmbito do Estágio de Natureza Profissional com Relatório Módulo
II, do Mestrado em Enfermagem Médico-Cirúrgica na área de Enfermagem à Pessoa em Situação
Crónica, da Escola Superior de Enfermagem do Porto. O documento descreve e analisa, de
forma crítico-reflexiva, o desenvolvimento das competências comuns e específicas do
enfermeiro especialista. O estágio de natureza profissional teve como alicerce o projeto
individual de desenvolvimento profissional "Gestão da Doença Crónica na Pessoa com Diabetes
mellitus", desenvolvido no segundo semestre do curso, com objetivos alinhados às
competências exigidas pela Ordem dos Enfermeiros.
Neste documento inclui-se um estudo de caso, com a explanação da conceção de cuidados, com
recurso à plataforma pedagógica e4nursing, que tem no seu backend a ontologia de
enfermagem. Destaca-se a importância da promoção da autogestão do regime terapêutico e de
uma transição saudável como pilares da assistência especializada. Foi possível, ao longo deste
percurso, o desenvolvimento de competências do enfermeiro especialista na referida área de
especialidade.
Chronic diseases are characterized by their prolonged nature, gradual progression, and the need for continuous care and treatment over time, often leading to potential disabilities. The increasing prevalence of chronic diseases is one of the main challenges in the healthcare sector in Portugal, with nationally defined objectives aimed at preventing complications or acute exacerbations and promoting education to support disease self-management. Diabetes mellitus is a metabolic syndrome caused by either insufficient insulin secretion or increased tissue resistance to insulin, resulting in hyperglycaemia and metabolic alterations in carbohydrates, lipids, and proteins. Due to its high prevalence in Portugal, this condition requires the adoption of self-management behaviours and adherence to a therapeutic regimen, given its complexity and associated complications. The specialist nurse in Medical-Surgical Nursing, focusing on Nursing for Individuals with Chronic Conditions, plays a crucial role in providing care for individuals with Diabetes mellitus. This professional promotes a therapeutic environment in collaboration with patients and caregivers, facilitating the transition to a new state of balance by encouraging self-care and selfmanagement of both the disease and therapeutic regimen. This report was produced as part of the Professional Internship with Report – Module II of the Master’s Degree in Medical-Surgical Nursing, specialising in Nursing for Individuals with Chronic Conditions, at Escola Superior de Enfermagem do Porto. This document provides a critical and reflective-analysis of the development of both the common and specific competencies of the specialist nurse. The professional internship was structured around the individual professional development project "Chronic Disease Management in Individuals with Diabetes mellitus", developed during the second semester of the course, with objectives aligned with the competencies required by the Portuguese Nursing Council. This document includes a case study that outlines the conceptualisation of care through the e4nursing educational platform, which integrates a nursing ontology in its backend. Emphasis is placed on the importance of promoting self-management of the therapeutic regimen and facilitating a healthy transition, as fundamental pillars of specialised care. Throughout this process, the development of the competencies required for the specialist nurse in this field was achieved.
Chronic diseases are characterized by their prolonged nature, gradual progression, and the need for continuous care and treatment over time, often leading to potential disabilities. The increasing prevalence of chronic diseases is one of the main challenges in the healthcare sector in Portugal, with nationally defined objectives aimed at preventing complications or acute exacerbations and promoting education to support disease self-management. Diabetes mellitus is a metabolic syndrome caused by either insufficient insulin secretion or increased tissue resistance to insulin, resulting in hyperglycaemia and metabolic alterations in carbohydrates, lipids, and proteins. Due to its high prevalence in Portugal, this condition requires the adoption of self-management behaviours and adherence to a therapeutic regimen, given its complexity and associated complications. The specialist nurse in Medical-Surgical Nursing, focusing on Nursing for Individuals with Chronic Conditions, plays a crucial role in providing care for individuals with Diabetes mellitus. This professional promotes a therapeutic environment in collaboration with patients and caregivers, facilitating the transition to a new state of balance by encouraging self-care and selfmanagement of both the disease and therapeutic regimen. This report was produced as part of the Professional Internship with Report – Module II of the Master’s Degree in Medical-Surgical Nursing, specialising in Nursing for Individuals with Chronic Conditions, at Escola Superior de Enfermagem do Porto. This document provides a critical and reflective-analysis of the development of both the common and specific competencies of the specialist nurse. The professional internship was structured around the individual professional development project "Chronic Disease Management in Individuals with Diabetes mellitus", developed during the second semester of the course, with objectives aligned with the competencies required by the Portuguese Nursing Council. This document includes a case study that outlines the conceptualisation of care through the e4nursing educational platform, which integrates a nursing ontology in its backend. Emphasis is placed on the importance of promoting self-management of the therapeutic regimen and facilitating a healthy transition, as fundamental pillars of specialised care. Throughout this process, the development of the competencies required for the specialist nurse in this field was achieved.
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Palavras-chave
Enfermagem Médico-Cirúrgica Doença crónica Diabetes mellitus Autogestão do Regime Terapêutico Competências