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Cuidados não traumáticos à criança e família : Intervenção de enfermagem baseada no modelo dos cuidados sensíveis ao trauma
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Advisor(s)
Abstract(s)
Ao longo da infância as crianças vivenciam experiências positivas e negativas que influenciam a sua saúde, o crescimento e desenvolvimento. As situações de doença e a hospitalização constituem frequentemente momentos de crise e disrupção com elevada ansiedade e stress para a criança e família. A exposição constante a situações geradoras de stress, sem que os fatores protetores sejam eficazes para o gerir/suprimir as respostas internas da criança, tem consequências negativas na saúde a longo prazo. Por este motivo, é essencial que o enfermeiro intervenha na prevenção e minimização das experiências traumáticas associadas aos cuidados de enfermagem na criança e família.
O objetivo do presente relatório de estágio foi refletir sobre a experiência e percurso formativo em estágio que visou o desenvolvimento de competências de enfermeira especialista em enfermagem de saúde infantil e pediátrica, ancorado na temática: cuidados não traumáticos na prevenção do stress e trauma associados aos cuidados de enfermagem.
Este percurso baseou-se numa metodologia de projeto e reflexiva, essencial para a transformação do conhecimento alicerçado em conceções teóricas norteadoras, como o modelo dos sistemas de Betty Neuman e o modelo dos cuidados sensíveis ao trauma. Para o mesmo concorreram as filosofias de cuidados em enfermagem pediátrica, os cuidados centrados na família e os cuidados não traumáticos, assim como os regulamentos e os guias orientadores da profissão.
As experiências vivenciadas nos diferentes contextos e as suas especificidades contribuíram para a construção de uma visão mais ampla da intervenção diferenciada do enfermeiro na prevenção e minimização do stress e trauma associados aos cuidados de enfermagem à criança e família.
Basear a intervenção de enfermagem no modelo dos cuidados sensíveis ao trauma permite atuar de forma preventiva na minimização das situações potencialmente traumáticas reduzindo o stress, a ansiedade e a dor associados aos cuidados de enfermagem.
As intervenções autónomas de enfermagem neste âmbito passam pela gestão diferenciada da dor, comunicação adequada à idade e compreensão da criança e família, identificação de sinais e comportamentos de stress, escuta ativa dos medos, dúvidas e preocupações, assim como a inclusão da família ao longo dos cuidados, contribuindo para uma prestação de cuidados.
Por reconhecer que existe alguma dificuldade em operacionalizar e integrar estes conceitos na prática de cuidados no espaço e tempo desejáveis, pretendo continuar a adquirir e desenvolver conhecimentos na área dos cuidados sensíveis ao trauma, assim como a desenvolver práticas sustentadas nestes princípios melhorando a sua implementação nos cuidados de enfermagem.
Children are subject to positive and negative experiences which influence their health, growth and development. Illness and hospitalisation are often high anxiety and stress moments of crisis and disruption for the child and family. Constant exposure to stress-generating situations, without effective protective factors to manage/suppress the child's internal responses, has negative health outcomes. Therefore, nursing intervention should be aimed to prevent and minimise traumatic experiences associated with nursing care for children and families. Reflecting on the experiences and training that took place during the internship was the purpose of this report, aiming to develop the skills of a nurse specialist in child and paediatric health nursing. The main subject being atraumatic care in prevention of stress and trauma associated with nursing care. The educational path was based on a project methodology and reflection, essential for the transformation of knowledge anchored on guiding theoretical concepts, such as Betty Neuman's systems model and the trauma informed care model. Paediatric nursing care philosophies, family-centred and atraumatic care, as well as the regulations and guidelines of the profession were also considered. Experiences in different contexts and their specificities have contributed to building a broader vision of the differentiated intervention of specialists nurses in preventing and minimising stress and trauma associated with nursing care for children and families. Trauma informed care nursing intervention allows prevention in minimising potentially traumatic situations by reducing the stress, anxiety and pain associated with nursing care. Autonomous nursing interventions in this area include differentiated pain management, age-appropriate communication and understanding of the child and family, identification of signs and behaviours of stress, active listening to fears, doubts and concerns, as well as the inclusion of the family throughout care, contributing to the provision of care. Difficulties in operationalising and integrating these concepts into care practice in the desired space and time was recognised. Therefore, I intend to continue acquiring and developing knowledge in trauma informed care in nursing, as well as practices development based on these principles, improving their implementation in nursing care.
Children are subject to positive and negative experiences which influence their health, growth and development. Illness and hospitalisation are often high anxiety and stress moments of crisis and disruption for the child and family. Constant exposure to stress-generating situations, without effective protective factors to manage/suppress the child's internal responses, has negative health outcomes. Therefore, nursing intervention should be aimed to prevent and minimise traumatic experiences associated with nursing care for children and families. Reflecting on the experiences and training that took place during the internship was the purpose of this report, aiming to develop the skills of a nurse specialist in child and paediatric health nursing. The main subject being atraumatic care in prevention of stress and trauma associated with nursing care. The educational path was based on a project methodology and reflection, essential for the transformation of knowledge anchored on guiding theoretical concepts, such as Betty Neuman's systems model and the trauma informed care model. Paediatric nursing care philosophies, family-centred and atraumatic care, as well as the regulations and guidelines of the profession were also considered. Experiences in different contexts and their specificities have contributed to building a broader vision of the differentiated intervention of specialists nurses in preventing and minimising stress and trauma associated with nursing care for children and families. Trauma informed care nursing intervention allows prevention in minimising potentially traumatic situations by reducing the stress, anxiety and pain associated with nursing care. Autonomous nursing interventions in this area include differentiated pain management, age-appropriate communication and understanding of the child and family, identification of signs and behaviours of stress, active listening to fears, doubts and concerns, as well as the inclusion of the family throughout care, contributing to the provision of care. Difficulties in operationalising and integrating these concepts into care practice in the desired space and time was recognised. Therefore, I intend to continue acquiring and developing knowledge in trauma informed care in nursing, as well as practices development based on these principles, improving their implementation in nursing care.
Description
Keywords
Enfermagem pediátrica Cuidados de enfermagem Pediatria Meio ambiente Estresse fisiológico