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Intervenção especializada em consulta de enfermagem pré-operatória para capacitação do autocuidado de doentes oncológicos propostos para ostomia de eliminação urinária
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| 9.15 MB | Adobe PDF |
Advisor(s)
Abstract(s)
A cistectomia radical com conduto ileal é um dos tratamentos indicados para o
tumor invasivo da bexiga, criando um estoma, o que tem um enorme impacto na vida
da pessoa, ao alterar todas as funções da bexiga, que influenciam a autoestima, o
trabalho, o bem-estar e sexual, e a afetividade pela ansiedade e medo que gera. Os
desvios de saúde que surgem criam défices de autocuidado, que exigem uma
adaptação da pessoa, que vai depender da capacitação do autocuidado devendo ser
iniciada no período pré-operatório, para a pessoa ter tempo para assimilar a
informação dada, e que também conduz a um consentimento plenamente informado,
e gerir as emoções e atitudes na nova situação. A equipa de enfermagem de um
serviço de urologia reconheceu a omissão de uma CE de OEU sistematizada de pré operatório, pelo que foi colocada a questão de: Quais as intervenções de
enfermagem para capacitar para o autocuidado a pessoa com doença oncológica
que irá ter uma OEU, durante a fase pré-operatória? Esta questão foi respondida por
uma revisão de literatura feita com recurso à metodologia das revisões scoping, o
que permitiu, em articulação com 3 estágios feitos, em CE de estomaterapia,
elaborar um “Procedimento para marcação pré-operatória de estoma de eliminação
urinária”, um “Programa educativo para capacitação para o autocuidado”, um folheto
informativo “1ºPasso para viver com uma urostomia”, e o procedimento setorial da
CE de OEU pré-operatória, o qual este integra indicadores de enfermagem, com o
objetivo de avaliar a efetividade do programa de qualidade de cuidados de
enfermagem, que aguardo autorização do gabinete da qualidade. No último estágio
realizou-se um estudo descritivo-prospetivo, autorizado pela CES, para avaliar o
conhecimento sobre o autocuidado das pessoas propostas para OEU numa 1ª e
numa 2ª CE do pré-operatório, medido com a “Escala de avaliação do
conhecimento para promover o autocuidado da ostomia de eliminação” (Anexo
III) respetivamente antes e depois de uma intervenção educativa presencial (1ª CE)
seguido ao “Programa Educativo para a Capacitação para o Autocuidado”. A amostra
de conveniência limitante de 3 pessoas, revelou que todos adquiriram conhecimento
para promover o autocuidado da OEU, passando a pontuação de 3, 0, 0 da 1ª CE
para 12, 14, 14 respetivamente na 2ªCE.
The radical cystectomy with ileal conduct is one of the advised treatments for the invasive bladder tumour, creating a huge impact on the person’s life due to having a stoma, as it implicates alteration of body image and with all the bladder functions that the person as to deal, but also on the social and psychological side, due to all the disturbances to the person´s self-esteem, to the sexual wellbeing and also on the affection side because of all the anxiety and fear felt. The health deviations that emerge creates deficits of self-care, that demand a person to adapt, that will depend on the capability of self-care, that should start in the pre-op, so that the person can assimilate the information that was passed on, which will also lead to a fully informed consent and manage the emotions and attitudes in the new condition. The Urology nursing team recognized the omission of a systemic Nursing Appointment regarding pre-op Urinary Elimination Ostomy, for which the following question was raised: What are the nursing interventions required to empower self-care of the oncology patient that is about to have an urinary urostomy during a preoperative phase? This question was answered through a literature review on the methodology of scoping revisions, which allowed, aligned with 3 internships, within a Stomatherapy Nursing Appointment to create a “Stoma siting procedure preoperatively of stoma of urinary elimination”, an “Education program to empower self-care”, an information leaflet “First step to live with an Stoma” and a Sectorial procedure of pre-op stoma of urinary elimination nursing appointments, which integrates nursing indicators, with the objective to evaluate the effectiveness of the quality program quality of the nursing care, for which I am waiting permission from the quality department. On the last internship it was carried out a descriptive-prospective study, allowed by the Health Etic Commission, in order to evaluate the self-care knowledge on the needs that a person proposed for a urinary urostomy requires, on the preoperative 1 st and 2nd Nursing Appointment, measured with the “Knowledge Evaluation scale to promote selfcare of the elimination stoma” (Annex III), before and after an in-person education intervention (1st) followed by the “Education Program for the Empowerment for self-care”. The convenience sample, limited to 3 persons, revelled that all have acquired knowledge to promote selfcare on an Urinary Elimination Ostomy, with a score of 3, 0, 0 on the first Nursing Appointment and a later score of 12, 13 and 14 on the second appointment.
The radical cystectomy with ileal conduct is one of the advised treatments for the invasive bladder tumour, creating a huge impact on the person’s life due to having a stoma, as it implicates alteration of body image and with all the bladder functions that the person as to deal, but also on the social and psychological side, due to all the disturbances to the person´s self-esteem, to the sexual wellbeing and also on the affection side because of all the anxiety and fear felt. The health deviations that emerge creates deficits of self-care, that demand a person to adapt, that will depend on the capability of self-care, that should start in the pre-op, so that the person can assimilate the information that was passed on, which will also lead to a fully informed consent and manage the emotions and attitudes in the new condition. The Urology nursing team recognized the omission of a systemic Nursing Appointment regarding pre-op Urinary Elimination Ostomy, for which the following question was raised: What are the nursing interventions required to empower self-care of the oncology patient that is about to have an urinary urostomy during a preoperative phase? This question was answered through a literature review on the methodology of scoping revisions, which allowed, aligned with 3 internships, within a Stomatherapy Nursing Appointment to create a “Stoma siting procedure preoperatively of stoma of urinary elimination”, an “Education program to empower self-care”, an information leaflet “First step to live with an Stoma” and a Sectorial procedure of pre-op stoma of urinary elimination nursing appointments, which integrates nursing indicators, with the objective to evaluate the effectiveness of the quality program quality of the nursing care, for which I am waiting permission from the quality department. On the last internship it was carried out a descriptive-prospective study, allowed by the Health Etic Commission, in order to evaluate the self-care knowledge on the needs that a person proposed for a urinary urostomy requires, on the preoperative 1 st and 2nd Nursing Appointment, measured with the “Knowledge Evaluation scale to promote selfcare of the elimination stoma” (Annex III), before and after an in-person education intervention (1st) followed by the “Education Program for the Empowerment for self-care”. The convenience sample, limited to 3 persons, revelled that all have acquired knowledge to promote selfcare on an Urinary Elimination Ostomy, with a score of 3, 0, 0 on the first Nursing Appointment and a later score of 12, 13 and 14 on the second appointment.
Description
Keywords
Enfermagem oncológica Estomia Período pré-operatório Autocuidado