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Gestão da doença crónica na pessoa com IC: Um constructo para uma enfermagem avançada: Desenvolvimento profissional de competências clínicas especializadas em Enfermagem Médico-Cirúrgica na área da Pessoa em Situação Crónica
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A concretização do presente relatório compõe a etapa final do processo de desenvolvimento e
consolidação de competências referente à componente clínica do ciclo de estudos do Mestrado
em Enfermagem Médico-Cirúrgica conducentes à atribuição do título profissional de Enfermeiro
Especialista, na área de Enfermagem à Pessoa em Situação Crónica. Este exercício procurou
capturar e documentar, através de uma metodologia descritiva e reflexiva, as experiências
vivenciadas nos diferentes contextos de ensino clínico, à luz do enquadramento legal presente
nos regulamentos n.° 140/2019 e n.° 429/2018, apoiando-se numa base teórica que articulou os
conhecimentos científicos e práticos adquiridos, bem como as competências consolidadas ao
longo deste percurso formativo.
O estágio de natureza profissional teve dois propósitos fundamentais, a materialização do
projeto de desenvolvimento profissional, intitulado Gestão da Doença Crónica na Pessoa com
Insuficiência Cardíaca — Um Construto para uma Enfermagem Avançada, e a integração deste
projeto como uma ferramenta essencial para o aprimoramento e consolidação das
competências do enfermeiro especialista, reforçando a prática avançada como um elemento
catalisador nos cuidados à pessoa em situação crónica.
A insuficiência cardíaca é uma doença crónica, complexa, debilitante, com uma importante
expressão em Portugal. Esta síndrome constitui a principal causa de internamentos hospitalares,
é responsável por elevados índices de morbilidade, apresentando-se como um verdadeiro
obstáculo, tanto no autocuidado, como na qualidade de vida destas pessoas. No sentido de
desenvolver uma ação profissionalizada no futuro que facilitasse intervenções adequadas às
respostas humanas aos processos de vida, saúde e doença, postulou-se uma entrega total aos
contextos de estágio. O desenvolvimento de competências nesta área exigiu uma reflexão
profunda sobre os referenciais teóricos que melhor sustentam e legitimam a prática
especializada, assim como o melhor conhecimento específico disponível da prática atual dos
cuidados de enfermagem avançada, tendo em conta o processo de transição saúde-doença.
Analisando cuidadosamente cada etapa do projeto, observaram-se progressos sólidos no
desenvolvimento de competências especializadas, através do exercício intensivo de atividades
que fortaleceram a capacidade de atuar de forma diferenciada no âmbito da atuação junto da
pessoa com doença crónica. Este percurso revelou-se um epicentro de aprendizagens
significativas, essenciais à prática de uma enfermagem avançada.
This report is the final stage in the process of developing and consolidating competences in the clinical component of the Master's programme in Medical-Surgical Nursing, leading to the recognition of the professional title of Specialist Nurse in the area of Nursing for the Chronically ill. This exercise sought to capture and document, through a descriptive and reflective methodology, the experiences lived in the different clinical teaching contexts, in the light of the legal framework present in regulations no. 140/2019 and no. 429/2018, supported by a theoretical basis that articulated the scientific and practical knowledge acquired, as well as the competences consolidated throughout this training programme. The professional internship had two fundamental purposes: the materialisation of the professional development project, entitled Chronic Disease Management in People with Heart Failure - A Construct for Advanced Nursing, and the integration of this project as an essential tool for improving and consolidating the competences of specialist nurses, reinforcing advanced practice as a catalysing element in the care of people in chronic situations. Heart failure is a chronic, complex and debilitating disease that is very prevalent in Portugal. This syndrome is the main cause of hospital admissions, is responsible for high rates of morbidity, and is a real obstacle to both self-care and quality of life for these people. In order to develop professionalised action in the future that would facilitate appropriate interventions in human responses to the processes of life, health and illness, a total commitment to the internship contexts was postulated. Developing skills in this area required in-depth reflection on the theoretical frameworks that best support and legitimise specialised practice, as well as the best available specific knowledge of the current practice of advanced nursing care, taking into account the health-disease transition process. Carefully analysing each stage of the project, a solid progress was made in the development of specialised skills, through the intensive exercise of activities that strengthened the ability to act in a differentiated way when working with people with chronic illnesses. This journey proved to be an epicentre of significant learning, essential to the practice of advanced nursing.
This report is the final stage in the process of developing and consolidating competences in the clinical component of the Master's programme in Medical-Surgical Nursing, leading to the recognition of the professional title of Specialist Nurse in the area of Nursing for the Chronically ill. This exercise sought to capture and document, through a descriptive and reflective methodology, the experiences lived in the different clinical teaching contexts, in the light of the legal framework present in regulations no. 140/2019 and no. 429/2018, supported by a theoretical basis that articulated the scientific and practical knowledge acquired, as well as the competences consolidated throughout this training programme. The professional internship had two fundamental purposes: the materialisation of the professional development project, entitled Chronic Disease Management in People with Heart Failure - A Construct for Advanced Nursing, and the integration of this project as an essential tool for improving and consolidating the competences of specialist nurses, reinforcing advanced practice as a catalysing element in the care of people in chronic situations. Heart failure is a chronic, complex and debilitating disease that is very prevalent in Portugal. This syndrome is the main cause of hospital admissions, is responsible for high rates of morbidity, and is a real obstacle to both self-care and quality of life for these people. In order to develop professionalised action in the future that would facilitate appropriate interventions in human responses to the processes of life, health and illness, a total commitment to the internship contexts was postulated. Developing skills in this area required in-depth reflection on the theoretical frameworks that best support and legitimise specialised practice, as well as the best available specific knowledge of the current practice of advanced nursing care, taking into account the health-disease transition process. Carefully analysing each stage of the project, a solid progress was made in the development of specialised skills, through the intensive exercise of activities that strengthened the ability to act in a differentiated way when working with people with chronic illnesses. This journey proved to be an epicentre of significant learning, essential to the practice of advanced nursing.
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Enfermagem avançada Doença crónica Transição Autogestão Empowerment