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A construção das práticas em enfermagem : a formatividade nos cuidados aos diabéticos em contexto comunitário
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Resumo(s)
Nas últimas décadas, assistimos a constantes mutações sociais e técnicas em todas as
ciências. A Enfermagem não constitui excepção, pelo que a actualização exige o
desenvolvimento de competências e práticas que deverão fluir do processo de formação.
Desta forma, questionámos as práticas profissionais, centrámo-nos na formação em
contexto de trabalho, partindo do pressuposto que a formatividade implica os actores
sociais no seu todo. Seleccionámos a população dos diabéticos, no contexto comunitário,
pela problemática que os envolve no seu meio ambiente e exige respostas integradoras.
Com o presente estudo analisámos as dinâmicas formativas que ocorrem no projecto de
cuidados aos diabéticos, onde se relacionam o processo de socialização, formação e saúde,
através da compreensão da formatividade das práticas de Enfermagem, em contexto de
trabalho.
Como estratégia metodológica, utilizámos o estudo de caso. A unidade de análise foi o
centro de saúde no qual decorre o projecto de cuidados aos diabéticos. Para recolha de
informação empírica utilizámos a observação participante, entrevistas semi-estruturadas a
diabéticos e enfermeiros e para complementar efectuámos a análise documental.
Concluímos que o processo de construção das práticas de cuidados aos diabéticos está
relacionado com o processo de socialização profissional, inserido no contexto de trabalho,
onde se articulam, o espaço, o tempo e as pessoas que, conjuntamente, promovem uma
dinâmica formativa. Nos cuidados aos diabéticos ocorre um trabalho de reflexividade
crítica sobre as práticas, onde a experiência é o saber de referência para enfermeiros e
diabéticos. A construção dos cuidados a nível comunitário assenta na articulação de um
conjunto de dispositivos informais e não-formais, que promovem uma globalidade
potencialmente formativa. Neste contexto, a construção de competências profissionais
correspondem a um processo simultaneamente individual e colectivo. As práticas de
Enfermagem que ocorrem no projecto exigem uma visão holística do utente, pelo que é
desenvolvida uma abordagem transcultural da saúde, no sentido da promoção da saúde.
Com esta investigação, pretendemos contribuir para a compreensão e desenvolvimento das
práticas em Enfermagem, através de uma abordagem centrada nas pessoas e nos seus
contextos.
In the last decades, there have been continuous social and technical changes in every science. Nursing is no exception. Updating demands placed on those going through the training process, in order to increase standards of competency, has done this. For this reason questions have arisen about professional practices and, while focusing the training in a work context, it is assumed that training implicates all types of social players. For this study diabetics in the community were selected due to the problems these patients face in their socio-cultural environment. In the current research we analyzed the training dynamics that occur in the diabetics' care activities. The socialization occurs during these training and health activities and is combined with the understanding of the Nursing practices for training in the workplace. The case study was used as a methodological strategy. The location under observation was the health center in which the research of diabetics* care was developed. To collect empiric information we used participative observation along with semi-structured interviews to diabetic patients and nurses. In order to complement this study we did a documental analysis. It was concluded that the elaboration process of diabetics' care practices is related to the process of professional socialization, inserted in the workplace, where space, time and people articulate and together encourage training dynamics. In diabetics' care a process of critical thought occurs about the practices. Experience has become the reference and knowledge for nurses and people with diabetes. The training of community care articulately lays out a set of informal devices that promote a potentially training whole. In this context, the build up of professional competency corresponds to a process which is simultaneously individual and collective. The Nursing practices used in this project of diabetics' care demand a holistic vision of the user, so this "transcultural" approach is developed in order to promote health. This research was intended to contribute to the understanding and development of nursing practices, through an approach centered on people in their own environments.
In the last decades, there have been continuous social and technical changes in every science. Nursing is no exception. Updating demands placed on those going through the training process, in order to increase standards of competency, has done this. For this reason questions have arisen about professional practices and, while focusing the training in a work context, it is assumed that training implicates all types of social players. For this study diabetics in the community were selected due to the problems these patients face in their socio-cultural environment. In the current research we analyzed the training dynamics that occur in the diabetics' care activities. The socialization occurs during these training and health activities and is combined with the understanding of the Nursing practices for training in the workplace. The case study was used as a methodological strategy. The location under observation was the health center in which the research of diabetics* care was developed. To collect empiric information we used participative observation along with semi-structured interviews to diabetic patients and nurses. In order to complement this study we did a documental analysis. It was concluded that the elaboration process of diabetics' care practices is related to the process of professional socialization, inserted in the workplace, where space, time and people articulate and together encourage training dynamics. In diabetics' care a process of critical thought occurs about the practices. Experience has become the reference and knowledge for nurses and people with diabetes. The training of community care articulately lays out a set of informal devices that promote a potentially training whole. In this context, the build up of professional competency corresponds to a process which is simultaneously individual and collective. The Nursing practices used in this project of diabetics' care demand a holistic vision of the user, so this "transcultural" approach is developed in order to promote health. This research was intended to contribute to the understanding and development of nursing practices, through an approach centered on people in their own environments.
Descrição
Tese de mestrado em Ciências da Educação (Área de especialização em Formação de Adultos), apresentada à Universidade de Lisboa através da Faculdade de Psicologia e de Ciências da Educação, 2004
Palavras-chave
Enfermagem Diabetes Promoção da saúde Socialização profissional Formação profissional