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Promoção do autocuidado à pessoa submetida a colonoscopia de rastreio do cancro colorretal :
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| 7.41 MB | Adobe PDF |
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Advisor(s)
Abstract(s)
O cancro mantém-se atualmente como uma das principais causas de morte a nível global.
O cancro colo retal (CCR), em particular, é o terceiro tumor com maior incidência no
nosso país, com uma taxa de 3,5% de mortalidade. A colonoscopia, pela sua capacidade
diagnóstica e terapêutica, é considerada o método preferencial de rastreio do CCR. Num
serviço de exames endoscópicos foram detetados três indicadores de qualidade que
careciam de intervenção: 1) a preparação intestinal, 2) o consentimento informado e 3)
sedação, dor e conforto do paciente. Surgindo assim a questão de investigação: “Quais
as intervenções de enfermagem promotoras do autocuidado ao indivíduo submetido a
colonoscopia de rastreio do CCR, necessárias à realização de uma colonoscopia de
qualidade, em contexto de ambulatório?”. Inicialmente foi realizada uma revisão scoping
e dois estágios em serviços de exames endoscópicos. No decorrer destes foram
observadas consultas de enfermagem telefónicas pré-colonoscopia, tendo sido feito um
“Guião da consulta de enfermagem telefónica pré-colonoscopia” e um “Formulário de
satisfação pós-colonoscopia”. No último estágio foi implementada a consulta de
enfermagem telefónica pré-colonoscopia, e entregue o formulário de satisfação pós colonoscopia, tendo sido pedida autorização à comissão de ética em saúde, para a sua
divulgação. Das 144 consultas de enfermagem telefónicas realizadas, foi possível obter
uma preparação intestinal de 91% na BBPS, 96,3%(105) realizaram exames com apoio
anestésico, e 1,8% (2) referiram dor de nível 1 e 5 durante o exame e 2,8% (3)
desconforto nível 1 e 2. Depois do exame, 2,8% (3) mencionam ter sentido dor após o
exame, de nível 5 e 3. Em 6,7% (7), referiram desconforto de nível 3 após o exame, Mais
de 90,0% das pessoas tinham conhecimento sobre, o exame, a importância, os
benefícios, e 82,6% (90) os riscos. Em 99,9% (108) das pessoas sentiam-se esclarecidas
antes do exame, e assinaram o consentimento, e 97,2% (106) referem ter existido uma
preocupação por parte do enfermeiro relativamente ao seu esclarecimento.
Cancer remains nowadays one of the main causes of death worldwide. Colorectal cancer, particularly, is the third major cause of death by cancer in Portugal with an incidence of 3.5% mortality. Colonoscopy, used as a method for diagnosis and treatment, is the preferred procedure for colorectal cancer screening. Within an endoscopy department, there were identified three quality indicators which were requiring improvement. These were 1) bowel preparation, 2) informed consent prior to procedure and 3) adequate sedation, pain management and patient comfort. This has led to the question for investigation “What are the necessary nursing interventions to promote selfcare to the person undergoing bowel cancer screening in order to achieve high standard colonoscopy within an ambulatory setting?” The initial stage was a scoping review and two nursing placements in endoscopy departments. During these placements, pre assessment telephone nursing consultations were observed having resulted in a documented intitled “Guide for nursing telephone consultation pre-colonoscopy” and a “patient feedback questionnaire post procedure”. In the last placement the pre-assessment nursing consultation was implemented for patients undergoing a colonoscopy procedure (using the guide for reference) and patients were requested to complete the feedback form post procedure, having requested authorization to the ethics Committee for Research in Health Sciences for its use. A total of 144 nursing telephone consultations were performed, which resulted in an adequate bowel preparation of 91% in BBPS, 96.3% (105) underwent the procedure with anesthaetic support, 1.8% (2) assessed own pain levels of 1 and 5 during the procedure and 2.8% (3) only an unconformable feeling with pain levels of 1 and 2. In terms of post procedure outcomes, 2.8% (3) mentioned pain levels of 5 and 3 whereas 6.7% (7) mentioned pain levels of 3 and below. More than 90% of patients were aware of what the exam entailed, its importance and benefits and finally 82.6% (90) were aware of the risks of undergoing this procedure. A total of 99.0% (108) of patients stated they felt informed prior to the procedure and signed the consent form and 97.2% (106) stated they felt there was a concern from the nursing team to ensure patients were fully aware of the procedure.
Cancer remains nowadays one of the main causes of death worldwide. Colorectal cancer, particularly, is the third major cause of death by cancer in Portugal with an incidence of 3.5% mortality. Colonoscopy, used as a method for diagnosis and treatment, is the preferred procedure for colorectal cancer screening. Within an endoscopy department, there were identified three quality indicators which were requiring improvement. These were 1) bowel preparation, 2) informed consent prior to procedure and 3) adequate sedation, pain management and patient comfort. This has led to the question for investigation “What are the necessary nursing interventions to promote selfcare to the person undergoing bowel cancer screening in order to achieve high standard colonoscopy within an ambulatory setting?” The initial stage was a scoping review and two nursing placements in endoscopy departments. During these placements, pre assessment telephone nursing consultations were observed having resulted in a documented intitled “Guide for nursing telephone consultation pre-colonoscopy” and a “patient feedback questionnaire post procedure”. In the last placement the pre-assessment nursing consultation was implemented for patients undergoing a colonoscopy procedure (using the guide for reference) and patients were requested to complete the feedback form post procedure, having requested authorization to the ethics Committee for Research in Health Sciences for its use. A total of 144 nursing telephone consultations were performed, which resulted in an adequate bowel preparation of 91% in BBPS, 96.3% (105) underwent the procedure with anesthaetic support, 1.8% (2) assessed own pain levels of 1 and 5 during the procedure and 2.8% (3) only an unconformable feeling with pain levels of 1 and 2. In terms of post procedure outcomes, 2.8% (3) mentioned pain levels of 5 and 3 whereas 6.7% (7) mentioned pain levels of 3 and below. More than 90% of patients were aware of what the exam entailed, its importance and benefits and finally 82.6% (90) were aware of the risks of undergoing this procedure. A total of 99.0% (108) of patients stated they felt informed prior to the procedure and signed the consent form and 97.2% (106) stated they felt there was a concern from the nursing team to ensure patients were fully aware of the procedure.
Description
Keywords
Enfermagem oncológica colonoscopia Indicadores de qualidade em assistência à saúde Neoplasias colorretais