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Intervenções especializadas de enfermagem à mulher com cancro da mama em contexto perioperatório
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Advisor(s)
Abstract(s)
O diagnóstico do cancro da mama (CM) incita a mulher e sua família a enfrentar diversos
desafios, incluindo grandes dificuldades e incapacidades na adaptação às novas condições
de vida. O seu tratamento pode envolver várias modalidades terapêuticas, entre as quais a
cirurgia, radioterapia, quimioterapia, hormonoterapia, isoladas ou em associação,
dependendo do tipo de neoplasia. A abordagem terapêutica mais comum é a cirurgia, à qual
estão associadas um conjunto de necessidades de apoio/suporte educativo e emocional,
traduzindo-se em necessidades de autocuidado. Neste sentido, surge a necessidade de
promover o autocuidado da mulher, com vista à autogestão e melhoria da sua qualidade de
vida.
Numa análise reflexiva sobre o contexto da prática de cuidados, foi identificada uma
lacuna nos cuidados de enfermagem à mulher com CM, em contexto perioperatório, ao nível
da sua capacitação para o autocuidado. De forma a dar resposta a esta problemática, foi
elaborado um projeto de intervenção tendo como ponto de partida a questão de investigação
“Quais as intervenções de enfermagem na promoção do autocuidado da mulher submetida a
oncocirurgia da mama no perioperatório?”.
No intuito de fundamentar os cuidados de enfermagem com a melhor evidência
científica, foi realizada uma revisão scoping que corroborou a importância do papel do
enfermeiro na abordagem da mulher com CM, em contexto perioperatório, e que permitiu
categorizar a sua intervenção ao nível do suporte educativo e emocional, no sentido de
melhorar o nível de conhecimento das mulheres sobre a cirurgia, diminuir a sua ansiedade e
contribuir para a diminuição de complicações e uma rápida recuperação cirúrgica. Destaca se a criação da figura do Enfermeiro de referência, integrado na equipa multidisciplinar, no
Acompanhamento de Enfermagem à mulher ao longo do período perioperatório.
O desenvolvimento e implementação do projeto teve como finalidade a aquisição de
competências de Enfermeiro Especialista em Enfermagem na Área de Intervenção de
Enfermagem Oncológica e competências do 2º ciclo do ensino superior, correspondente ao
grau académico de Mestrado. Para o desenvolvimento destas competências foram efetuados
três estágios, em diferentes contextos, os quais permitiram a análise crítica e reflexiva dos
achados da revisão da literatura, recorrendo à metodologia de projeto e ao referencial teórico
de Dorothea Orem, mais especificamente a Teoria do Défice do Autocuidado de Enfermagem.
Assim, concluímos que este percurso permitiu uma aprendizagem pessoal, profissional
e académica, promovendo uma continua reflexão sobre a prática, e a melhoria contínua da
qualidade dos cuidados de enfermagem ao nível da capacitação para o autocuidado e bem estar da mulher com cancro da mama, em contexto perioperatório. Para tal, foram elaborados
instrumentos de suporte educativo (Checklist das intervenções de enfermagem na promoção
do autocuidado, Guia de Orientação à mulher submetida a cirurgia mamária e Folheto
informativo especifico sobre a Mastectomia), um Procedimento Multissetorial que visa a
uniformização das Intervenções da equipa de Enfermagem nos cuidados à mulher com
Cancro da Mama (CM), no período perioperatório, um Poster sobre a intervenção
especializada de enfermagem no percurso perioperatório da mulher com CM, que inclui o
algoritmo da intervenção do Enfermeiro de Referência no período perioperatório, e uma
Sessão Formativa com o intuito de contribuir para a capacitação da Equipa de Enfermagem.
The diagnosis of breast cancer (BC) incites the woman and her family to face various challenges, including great difficulties and disabilities in adapting to the new conditions of life. Its treatment may involve various therapeutic modalities, among which are surgery, radiotherapy, chemotherapy, hormone therapy, isolated or in association, depending on the type of neoplasm. The most common therapeutic approach is surgery, to which a set of educational and emotional support needs are associated, translating into self-care needs. In this sense, there is a need to promote women's self-care, with a view to self-management and improvement of their quality of life. In a reflective analysis of the context of care practice, a gap was identified in the nursing care provided to women with BC in perioperative care, in terms of their empowerment for self care. In order to address this issue, an intervention project was developed based on the research question "What are the nursing interventions for the improvement of self-care in women undergoing breast oncology surgery in the perioperative period? In order to base nursing care on the best scientific evidence, a scoping review was conducted which corroborated the importance of the nurse's role in the approach to women with BC in perioperative contexts, and which allowed us to categorise their intervention at the level of educational and emotional support to improve women's level of knowledge about the surgery, reduce their anxiety and contribute to reducing complications and a rapid surgical recovery. We highlight the creation of the figure of the Reference Nurse, integrated into the multidisciplinary team, in the Nursing care provided to women throughout the perioperative period. The development and implementation of the project aimed at acquiring the skills of Nurse Specialists in the Nursing Intervention Area of Oncological Nursing and skills for the 2nd cycle of higher education, corresponding to the academic degree of Master. Three internships were carried out in different contexts to develop these skills, which allowed for a critical and reflective analysis of the findings of the literature review, using the project methodology and Dorothea Orem's theoretical framework, more specifically the Theory of Nursing Self-Care Deficit. Thus, we concluded that this journey allowed personal, professional and academic learning, promoting a continuous reflection on the practice and the continuous improvement of the quality of nursing care in terms of empowerment for self-care and well-being of women with breast cancer in perioperative settings. To this end, educational support tools were developed (Checklist of nursing interventions for the promotion of self-care, Guidance Guide for women undergoing breast surgery and a specific information leaflet on Mastectomy), a Multisectoral Procedure aimed at standardising the Nursing team's interventions in the care of women with breast cancer (BC), in the perioperative period, a Poster on the specialised nursing intervention in the perioperative course of women with breast cancer, which includes the algorithm for the intervention of the Reference Nurse in the perioperative period, and a Training Session aimed at contributing to the empowerment of the Nursing Team.
The diagnosis of breast cancer (BC) incites the woman and her family to face various challenges, including great difficulties and disabilities in adapting to the new conditions of life. Its treatment may involve various therapeutic modalities, among which are surgery, radiotherapy, chemotherapy, hormone therapy, isolated or in association, depending on the type of neoplasm. The most common therapeutic approach is surgery, to which a set of educational and emotional support needs are associated, translating into self-care needs. In this sense, there is a need to promote women's self-care, with a view to self-management and improvement of their quality of life. In a reflective analysis of the context of care practice, a gap was identified in the nursing care provided to women with BC in perioperative care, in terms of their empowerment for self care. In order to address this issue, an intervention project was developed based on the research question "What are the nursing interventions for the improvement of self-care in women undergoing breast oncology surgery in the perioperative period? In order to base nursing care on the best scientific evidence, a scoping review was conducted which corroborated the importance of the nurse's role in the approach to women with BC in perioperative contexts, and which allowed us to categorise their intervention at the level of educational and emotional support to improve women's level of knowledge about the surgery, reduce their anxiety and contribute to reducing complications and a rapid surgical recovery. We highlight the creation of the figure of the Reference Nurse, integrated into the multidisciplinary team, in the Nursing care provided to women throughout the perioperative period. The development and implementation of the project aimed at acquiring the skills of Nurse Specialists in the Nursing Intervention Area of Oncological Nursing and skills for the 2nd cycle of higher education, corresponding to the academic degree of Master. Three internships were carried out in different contexts to develop these skills, which allowed for a critical and reflective analysis of the findings of the literature review, using the project methodology and Dorothea Orem's theoretical framework, more specifically the Theory of Nursing Self-Care Deficit. Thus, we concluded that this journey allowed personal, professional and academic learning, promoting a continuous reflection on the practice and the continuous improvement of the quality of nursing care in terms of empowerment for self-care and well-being of women with breast cancer in perioperative settings. To this end, educational support tools were developed (Checklist of nursing interventions for the promotion of self-care, Guidance Guide for women undergoing breast surgery and a specific information leaflet on Mastectomy), a Multisectoral Procedure aimed at standardising the Nursing team's interventions in the care of women with breast cancer (BC), in the perioperative period, a Poster on the specialised nursing intervention in the perioperative course of women with breast cancer, which includes the algorithm for the intervention of the Reference Nurse in the perioperative period, and a Training Session aimed at contributing to the empowerment of the Nursing Team.
Description
Keywords
Enfermagem oncológica Neoplasias da mama Cuidados de enfermagem Período pré-operatório Autocuidado