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A Intervenção de Enfermagem no Alívio do Sofrimento da Pessoa adulta e idosa com Doença hemato-oncológica : Administração de terapêutica antineoplásica
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Resumo(s)
O sofrimento é uma constante na vida das pessoas com doença hemato-oncológica, pelas representações sociais ligadas à doença, pela incerteza na trajetória da doença, bem como pelos efeitos secundários inerentes ao tratamento medicamentoso. Perante estes sobreviventes a intervenção de enfermagem decorre do diagnóstico de enfermagem que permite assegurar cuidados que visam minimizar o sofrimento. Os enfermeiros despendem muito tempo na administração de protocolos terapêuticos e na sua vigilância. Estes cuidados repetem-se ao longo do dia em interações de proximidade podendo ter potencial terapêutico se forem desenvolvidos com intencionalidade e respeito pela individualidade do doente. Pretendemos avaliar o resultado da “administração de quimioterapia como intervenção de enfermagem individualizada” no alívio do sofrimento da pessoa adulta internada com doença hemato-oncológica. Utilizamos um desenho multimétodo, seguindo os estádios da estrutura metodológica para investigar intervenções complexas. Os participantes dos estudos foram os enfermeiros e doentes internados. Decorrente do estudo exploratório (estudo 1) e descritivo (estudo 2) identificaram as atividades de enfermagem desenvolvidas para aliviar o sofrimento e a perceção dos enfermeiros sobre cuidados individualizados. Em seguida foram criadas condições formativas para a implementação da intervenção modulada num estudo quasi-experimental (estudo 3). Como medidas do resultado da intervenção desenhada utilizamos o Inventario das Experiências Subjetivas do Sofrimento na Doença, o Termómetro do Distress e a Escala visual da Dor. Verificamos que independentemente do momento de avaliação (pré e pós – interação) o sofrimento, distress e a dor foram mais baixos no grupo experimental do que no grupo controle. A intervenção individualizada de enfermagem na administração de quimioterapia antineoplásica condiciona positivamente a diminuição do sofrimento. Os dados apurados permitem sublinhar a importância de o cuidado de enfermagem ser intencional, centrado na pessoa, com respeito pela sua individualidade e autonomia. Concluímos também que as utilizações de métodos mistos de investigação otimizaram a compreensão dos componentes da intervenção.
Suffering is constant in people who live with hemato-oncologic diseases. That is related with the social representations associated with the disease, by the incertitude of the natural history, and by the adverse effects of drug treatment. Nurse intervention is a consequence of nurse diagnosis that allows care to minimize suffering. Nurse spend long time in the administration of drugs that belongs to therapy protocols and in the monitoring of the process. During the day these care actions repeat with close interactions that can have a therapeutic potential if they are developed with intentionality and respect by the patient individuality. We aimed to evaluate the result of “the administration of chemotherapy as an individualized nurse intervention” in the relief of suffering of the adult admitted with haemato-oncologic disease. We selected a multimethod drawing, following the methodologic structure stages for complex interventions. The participants in the study were nurses and patients admitted in the ward. After the exploratory study (study 1) and the descriptive study (study 2) we identified respectively the nurse activities developed to mitigate suffering and nurse perceptions of the individualized care. Then formative conditions were created for the implementation of a modulated intervention in a quasi-experimental study (study 3). As end points of the intervention we used the Subjective Experience of Suffering in Disease Inventory, the Distress Thermometer and the Pain Visual Scale. We checked that suffering, distress and pain were lower in the experimental than in the control group, regardless of the evaluation moment (before and after interaction). The nurse individualized intervention during the chemotherapy administration has a positive effect in the suffering reduction. Data suggest to the relevance of dimensions of nurse care – intentionality, patient-centered, respect towards individuality and autonomy We also concluded that mixed methods of investigation optimized the understanding of the intervention components.
Suffering is constant in people who live with hemato-oncologic diseases. That is related with the social representations associated with the disease, by the incertitude of the natural history, and by the adverse effects of drug treatment. Nurse intervention is a consequence of nurse diagnosis that allows care to minimize suffering. Nurse spend long time in the administration of drugs that belongs to therapy protocols and in the monitoring of the process. During the day these care actions repeat with close interactions that can have a therapeutic potential if they are developed with intentionality and respect by the patient individuality. We aimed to evaluate the result of “the administration of chemotherapy as an individualized nurse intervention” in the relief of suffering of the adult admitted with haemato-oncologic disease. We selected a multimethod drawing, following the methodologic structure stages for complex interventions. The participants in the study were nurses and patients admitted in the ward. After the exploratory study (study 1) and the descriptive study (study 2) we identified respectively the nurse activities developed to mitigate suffering and nurse perceptions of the individualized care. Then formative conditions were created for the implementation of a modulated intervention in a quasi-experimental study (study 3). As end points of the intervention we used the Subjective Experience of Suffering in Disease Inventory, the Distress Thermometer and the Pain Visual Scale. We checked that suffering, distress and pain were lower in the experimental than in the control group, regardless of the evaluation moment (before and after interaction). The nurse individualized intervention during the chemotherapy administration has a positive effect in the suffering reduction. Data suggest to the relevance of dimensions of nurse care – intentionality, patient-centered, respect towards individuality and autonomy We also concluded that mixed methods of investigation optimized the understanding of the intervention components.
Descrição
Palavras-chave
Sofrimento intervenção individualizada enfermagem administração de quimioterapia antineoplásica doença hemato-oncológica Suffering individualized intervention nursing anti-neoplastic chemotherapy administration hemato-oncologic disease