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Avaliação e intervenção familiar em famílias nucleares com membros idosos - Desenvolvimento de competências Clínicas Especializadas em Enfermagem Comunitária na área de Enfermagem de Saúde Familiar
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O presente relatório descreve o percurso experienciado no âmbito das Unidades
Curriculares “Estágio de Natureza Profissional com Relatório – Módulo I e II”,
integradas no Mestrado em Enfermagem Comunitária, na área da Enfermagem
de Saúde Familiar, da Escola Superior de Enfermagem do Porto.
O objetivo principal consistiu na prestação de cuidados a famílias nucleares com
membros muito idosos, bem como aos seus membros ao longo do ciclo vital e
nos diferentes níveis de prevenção. Paralelamente, procurou-se fomentar a
liderança e a colaboração em processos de intervenção no âmbito da
Enfermagem de Saúde Familiar.
A família é um sistema constituído por pessoas que desenvolvem entre si
interações particulares, que lhe conferem singularidade. O processo de
envelhecimento representa um desafio significativo para as famílias, exigindo
adaptações nos padrões de comportamento, aquisição de conhecimentos, de
competências e transformação das relações familiares. Neste contexto, foram
desenvolvidos cuidados de enfermagem, com base no Modelo Dinâmico de
Avaliação e Intervenção Familiar, que tem como referenciais, entre outros, o
Modelo Calgary de Avaliação Familiar e o Modelo Calgary de Intervenção
Familiar. Complementarmente foram também utilizados o Modelo de Cuidar
Baseado nas Forças e a Teoria das Transições.
Neste sentido, foram realizadas consultas em contexto domiciliário junto de seis
famílias nucleares com membros muito idosos, sendo também prestados
cuidados aos seus membros. As áreas de atenção que se destacaram foram a
Precaução de Segurança, Processo familiar e Papel de Prestador de Cuidados,
tendo sido identificados diagnósticos de enfermagem e implementadas
intervenções dirigidas a cada uma das dimensões. As intervenções passaram
por aplicação de técnicas de intervenção específicas e transversais como o
reenquadramento, a conotação positiva, rituais terapêuticos, abordagens
voltadas para a solução ou a escultura, tendo resultado em ganhos em saúde
para as famílias. Quanto aos cuidados prestados aos membros das famílias,
estes tiveram por base a Teoria das transições de Afaf Meleis. Foram
mobilizados, articulados e geridos recursos das famílias e da comunidade para
assegurar a qualidade dos cuidados prestados. Foi dinamizada a liderança e
colaboração nos processos de intervenção no âmbito da Enfermagem de Saúde
Familiar, através da sensibilização da equipa de enfermagem sobre as áreas de
atenção da Enfermagem de Saúde Familiar e a importância dos registos. Estes
processos foram executados através de implementação de uma sessão
formativa com estudo de caso, aplicação de conhecimentos baseados em
evidência científica e de uma prática crítico-reflexiva e colaborativa, voltada para
a melhoria contínua dos cuidados em Enfermagem de Saúde Familiar.
This report describes the experience developed within the scope of the curricular units “Professional Internship with Report – Module I and II,” integrated in the master’s degree in Community Nursing, in the area of Family Health Nursing, at the Escola Superior de Enfermagem do Porto. The main objective was to provide care for nuclear families with very elderly members, as well as to their individual members throughout the life cycle and across different levels of prevention. Simultaneously, the internship aimed to promote leadership and collaboration in intervention processes within the scope of Family Health Nursing. The family is a system composed of individuals who establish particular interactions that confer uniqueness to the unit. The ageing process represents a significant challenge for families, requiring adjustments in behavior patterns, acquisition of knowledge and skills, and transformation of family relationships. In this context, nursing care was developed based on the Dynamic Model of Family Assessment and Intervention, which draws, among others, on the Calgary Family Assessment Model and the Calgary Family Intervention Model. Additionally, the Strengths-Based Nursing Care Model and the Theory of Transitions were also applied. Home visits were conducted with six nuclear families with very elderly members, and care was also provided for their individual members. Key areas of focus included Safety Precaution, Family Process, and Caregiver Role. Nursing diagnoses were identified, and interventions were implemented targeting each of these dimensions. The interventions involved the application of specific and cross-cutting intervention techniques such as reframing, positive connotation, therapeutic rituals, solution-focused approaches, and sculpting, resulting in health gains for the families. The care provided to family members was based on Afaf Meleis’s Theory of Transitions. Family and community resources were mobilized, articulated, and managed to ensure the quality of care provided. Leadership and collaboration were promoted in intervention processes in Family Health Nursing through the sensitization of the nursing team regarding the areas of focus in Family Health Nursing and the importance of accurate documentation. These processes were carried out through the implementation of a training session with a case study, the application of evidence-based knowledge, and a critically reflective and collaborative practice aimed at the continuous improvement of care in Family Health Nursing.
This report describes the experience developed within the scope of the curricular units “Professional Internship with Report – Module I and II,” integrated in the master’s degree in Community Nursing, in the area of Family Health Nursing, at the Escola Superior de Enfermagem do Porto. The main objective was to provide care for nuclear families with very elderly members, as well as to their individual members throughout the life cycle and across different levels of prevention. Simultaneously, the internship aimed to promote leadership and collaboration in intervention processes within the scope of Family Health Nursing. The family is a system composed of individuals who establish particular interactions that confer uniqueness to the unit. The ageing process represents a significant challenge for families, requiring adjustments in behavior patterns, acquisition of knowledge and skills, and transformation of family relationships. In this context, nursing care was developed based on the Dynamic Model of Family Assessment and Intervention, which draws, among others, on the Calgary Family Assessment Model and the Calgary Family Intervention Model. Additionally, the Strengths-Based Nursing Care Model and the Theory of Transitions were also applied. Home visits were conducted with six nuclear families with very elderly members, and care was also provided for their individual members. Key areas of focus included Safety Precaution, Family Process, and Caregiver Role. Nursing diagnoses were identified, and interventions were implemented targeting each of these dimensions. The interventions involved the application of specific and cross-cutting intervention techniques such as reframing, positive connotation, therapeutic rituals, solution-focused approaches, and sculpting, resulting in health gains for the families. The care provided to family members was based on Afaf Meleis’s Theory of Transitions. Family and community resources were mobilized, articulated, and managed to ensure the quality of care provided. Leadership and collaboration were promoted in intervention processes in Family Health Nursing through the sensitization of the nursing team regarding the areas of focus in Family Health Nursing and the importance of accurate documentation. These processes were carried out through the implementation of a training session with a case study, the application of evidence-based knowledge, and a critically reflective and collaborative practice aimed at the continuous improvement of care in Family Health Nursing.
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Palavras-chave
Enfermagem de Saúde Familiar Envelhecimento Família