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Cuidar da pessoa com doença renal crónica: Projeto de desenvolvimento de competências clínicas especializadas em Enfermagem Médico-Cirúrgica, na área de Enfermagem à Pessoa em Situação Crónica
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Advisor(s)
Abstract(s)
A Doença Renal Crónica (DRC) é um importante problema de saúde pública, com um peso
considerável nos sistemas de saúde. Em Portugal, é estimado que mais de 800 mil pessoas
sofram de DRC, com tendência crescente na ordem dos 4 a 5% ao ano.
Viver com a DRC e com os tratamentos associados tem um forte impacto nas vivências da
pessoa e na sua qualidade de vida. É uma doença incurável e progressiva e tem efeitos na vida
dos doentes e das famílias, com implicações fisiológicas, psicológicas e socioeconómicas.
O enfermeiro desempenha um papel importante na gestão da DRC ao fornecer intervenções
preventivas, educacionais e práticas no cuidado da pessoa e família/cuidador, como a avaliação
e monitorização, educação sobre autocuidado, gestão da terapêutica medicamentosa, regime
alimentar, regime de exercício físico e o suporte emocional.
Neste relatório descrevo o percurso nos dois contextos clínicos, para o desenvolvimento das
competências especializadas, tendo por base as orientações da Ordem dos Enfermeiros,
nomeadamente o regulamento de competências comuns e específicas do enfermeiro
especialista em Enfermagem Médico-cirúrgica, na área de Enfermagem à Pessoa em Situação
Crónica.
Através das experiências desenvolvidas, foi possível desenvolver competências na identificação
das necessidades da pessoa e da família/cuidador na gestão da DRC; na promoção de
intervenções especializadas facilitadoras do processo de transição saúde/doença e na
monitorização dos resultados dessas intervenções; na liderança no desenvolvimento de
intervenções de prevenção, intervenção e controlo de infeção. No âmbito da maximização do
ambiente terapêutico, desenvolvi competências de gestão dos processos terapêuticos, com
maior preponderância no desenvolvimento de capacidades na promoção do autocuidado da
fístula arteriovenosa (FAV) na pessoa com DRC; na gestão das circunstâncias que potenciam a
ocorrência de eventos adversos; e na promoção de estratégias de prevenção de risco e
desenvolvimento da cultura de segurança.
Chronic Kidney Disease (CKD) is an important public health problem with a considerable burden on health systems. In Portugal, it is estimated that more than 800 thousand people suffer from CKD with an increasing trend of around 4 to 5% per year. On December 31, 2022, according to the Portuguese Society of Nephrology, 21198 people are dependent on renal replacement therapy to survive, including hemodialysis, peritoneal dialysis and kidney transplantation. Living with CKD and associated treatments has a strong impact on a person's experiences and quality of life. It is an incurable and progressive disease and has effects on the lives of patients and families, with physiological, psychological, and socioeconomic implications. The nurse plays an important role in the management of CKD by providing preventive, educational and practical interventions in the care of people with CKD and their families, among others, assessment and monitoring, education on self-care, management of medication therapy, diet, physical exercise and emotional support for the person and the family/caregiver. This report seeks to describe the journey in clinical contexts, based on a refined and wellfounded critical reflection, demonstrating the development of specialized skills acquired based on the activities carried out and the guidelines of the Ordem dos Enfermeiros in the regulation of common and specific skills of the nurse specialist in medical-surgical nursing in nursing for people with chronic conditions. Through experiences developed in clinical contexts, it was possible to develop skills in identifying the needs of the person and the family/caregiver in management of CKD; in promoting specialized interventions with the person and family/caregiver, helping in the health/disease transition process, and monitoring the results of these interventions; and leading the development of infection prevention and control interventions. In the context of maximizing the therapeutic environment, I developed skills in management of therapeutic processes, with emphasis on developing skills in promoting AVF self-care in people with CKD; in management of environmental circumstances that increase the occurrence of adverse events; and promoting risk prevention strategies and developing a safety culture.
Chronic Kidney Disease (CKD) is an important public health problem with a considerable burden on health systems. In Portugal, it is estimated that more than 800 thousand people suffer from CKD with an increasing trend of around 4 to 5% per year. On December 31, 2022, according to the Portuguese Society of Nephrology, 21198 people are dependent on renal replacement therapy to survive, including hemodialysis, peritoneal dialysis and kidney transplantation. Living with CKD and associated treatments has a strong impact on a person's experiences and quality of life. It is an incurable and progressive disease and has effects on the lives of patients and families, with physiological, psychological, and socioeconomic implications. The nurse plays an important role in the management of CKD by providing preventive, educational and practical interventions in the care of people with CKD and their families, among others, assessment and monitoring, education on self-care, management of medication therapy, diet, physical exercise and emotional support for the person and the family/caregiver. This report seeks to describe the journey in clinical contexts, based on a refined and wellfounded critical reflection, demonstrating the development of specialized skills acquired based on the activities carried out and the guidelines of the Ordem dos Enfermeiros in the regulation of common and specific skills of the nurse specialist in medical-surgical nursing in nursing for people with chronic conditions. Through experiences developed in clinical contexts, it was possible to develop skills in identifying the needs of the person and the family/caregiver in management of CKD; in promoting specialized interventions with the person and family/caregiver, helping in the health/disease transition process, and monitoring the results of these interventions; and leading the development of infection prevention and control interventions. In the context of maximizing the therapeutic environment, I developed skills in management of therapeutic processes, with emphasis on developing skills in promoting AVF self-care in people with CKD; in management of environmental circumstances that increase the occurrence of adverse events; and promoting risk prevention strategies and developing a safety culture.
Description
Keywords
Doença Renal Crónica Enfermeiro Especialista Competências Autocuidado Relatório de estágio