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Abstract(s)
Introdução: O estágio em enfermagem de saúde materna e obstétrica é fundamental para
complementar a formação de enfermeiro especialista em enfermagem de saúde materna e
obstétrica, e desenvolver competências comuns e especificas, exigidas pela profissão,
dando cumprimento às respetivas diretivas europeias e aos requisitos da Ordem dos
Enfermeiros. Na componente empírica, adquire-se o fundamento de uma prática
emancipada. A perda gestacional é um fenómeno complexo e exigente profissionalmente
que requer conhecimento específico e investigação permanente de modo a capacitar os
profissionais para cuidados sensíveis e de proximidade que empoderem os casais na
vivência do processo de luto.
Objetivos: Componente de estágio - Analisar as atividades desenvolvidas para a aquisição
de competências do Enfermeiro Especialista em Enfermagem de Saúde Materna e
Obstétrica; Componente de investigação - compreender a experiência vivida por
mulheres/casais com perda gestacional; identificar a perceção de mulheres/casais com
perda gestacional sobre as práticas em Enfermagem de Saúde Materna e Obstétrica no
cuidado face ao luto perinatal.
Participantes e métodos: Componente de estágio - assenta numa reflexão crítica, objetiva
e contextualizada das competências adquiridas, das experiências vivenciadas e das
atividades desenvolvidas ao longo dos estágios, tendo por base o perfil das competências
do Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica e os padrões de
qualidade em Enfermagem de Saúde Materna e Obstétrica, da Ordem dos Enfermeiros.
Componente de investigação - estudo qualitativo com abordagem fenomenológica
hermenêutica, seguindo os pressupostos de Max Van Manen. Selecionada uma amostra
intencional, pelo método de bola de neve, de 15 participantes, sendo o instrumento para a
recolha de dados uma entrevista semiestruturada onde se cumpriram os procedimentos
formais éticos da investigação. Os dados recolhidos foram alvo de análise fenomenológica
suportada pelo software MAXQDA®.
Resultados: Componente de estágio - O desenvolvimento de práticas ao longo das
diferentes áreas específicas de intervenção possibilitou a aquisição de competências
comuns e específicas inerentes ao exercício profissional do Enfermeiro Especialista em
Enfermagem de Saúde Materna e Obstétrica, bem como ao cumprimento das experiências
mínimas legalmente exigidas. Componente de investigação – através da análise qualitativa
das entrevistas realizadas foram desocultadas duas grandes dimensões: Vivendo a primeira
gravidez – composta por três categorias (Expetativas do casal; Sentimentos do casal; O
corpo que se transforma) e a dimensão – Vivendo a perda gestacional e o processo de luto
8
– constituída por seis categorias (Vivenciando a perda gestacional em contexto dos
cuidados de saúde; Sentimentos do casal perante a perda gestacional; Desenvolvendo
estratégias de luto; Significado atribuído à perda gestacional e processo de luto;
Sentimentos em gravidezes subsequentes à perda gestacional; Impacto da perda
gestacional no casal enlutado).
Conclusão: A componente de estágio é de extrema importância, porque permite-nos não só
alargar os conhecimentos obtidos na componente teórica num contexto real, como também
pela forma como nos prepara na avaliação, orientação e comunicação de todo o tipo de
situações, permitindo-nos uma prática especializada e avançada, essencial na promoção de
cuidados eficazes, seguros e de elevada qualidade. Da componente de investigação
conclui-se que a perda gestacional é uma experiência marcante na vida de um casal
deixando marcas a curto, médio e longo prazo. Existe a necessidade de refletir sobre as
práticas realizadas uma vez que foram observadas falhas ao nível dos cuidados, apoio e
acompanhamento prestados pelos enfermeiros a estas mulheres/casais/famílias. Emerge a
necessidade de mudança ao nível do paradigma assistencial por forma a prestar cuidados
mais adequados qualificando a assistência prestada e possibilitando uma vivência do luto de
forma mais saudável.
Abstract Introduction: The internship in maternal health and obstetric nursing is essential to complement the training of specialist nurses in maternal and obstetric health nursing, and to develop common and specific skills required by the profession, complying with the respective European directives and Nurse’s order requirements. In the empirical component, the foundation of an emancipated practice is acquired. Pregnancy loss is a complex and professionally demanding phenomenon that requires specific knowledge and ongoing research in order to train professionals to provide sensitive and close care that empowers couples in experiencing the grieving process. Objectives: Internship component - Analyze the activities developed to acquire the skills of Specialist Nurse in Maternal Health and Obstetric Nursing; Research component - understand the experience of women/couples with pregnancy loss; identify the perception of women/couples with pregnancy loss about Maternal Health and Obstetric Nursing practices in the care of perinatal bereavement. Participants and methods: Internship component - is based on a critical, objective and contextualized reflection of the skills acquired, experiences and activities developed throughout the internships, based on the Specialist Nurse skills profile and quality standards in Maternal Health and Obstetric Nursing defined by Nurse’s Order. Research component - qualitative study with a hermeneutic phenomenological approach, following the assumptions of Max Van Manen. An intentional sample was selected, using the snowball method, of 15 participants, with the instrument for data collection being a semi-structured interview where formal ethical research procedures were followed. The data collected was subject to phenomenological analysis supported by the MAXQDA® software. Results: Internship component - The development of practices throughout the different specific areas of intervention enabled the acquisition of common and specific skills inherent to the professional practice of Specialist Nurses in Maternal Health and Obstetric Nursing, as well as compliance with the minimum legally required experiences. Research component – through the qualitative analysis of the interviews carried out, two major dimensions were uncovered: Experiencing the first pregnancy – made up of three categories (Expectations of the couple; Feelings of the couple; The body that transforms) and the dimension – Experiencing pregnancy loss and the grieving process – consisting of six categories (Experiencing pregnancy loss in the context of health care; Couple's feelings regarding pregnancy loss; Developing mourning strategies; Meaning attributed to pregnancy loss and the grieving process; Feelings in pregnancies subsequent to loss gestational; Impact of pregnancy loss on the bereaved couple). 10 Conclusion: The internship component is extremely important, because it allows us not only to extend the knowledge obtained in the theoretical component into a real context, but also because of the way it prepares us in the assessment, guidance and communication of all types of situations, allowing us to perform a specialized and advanced practice, essential in promoting effective, safe and high-quality care. From the research component, it is concluded that pregnancy loss is a remarkable experience in the life of a couple, leaving marks in the short, medium and long term. There is a need to reflect on the practices carried out, once flaws were observed in terms of care, support and monitoring provided by nurses to these women/couples/families. The need for change in terms of the care paradigm emerges in order to provide more appropriate care, qualifying the assistance provided and enabling a healthier experience of grief.
Abstract Introduction: The internship in maternal health and obstetric nursing is essential to complement the training of specialist nurses in maternal and obstetric health nursing, and to develop common and specific skills required by the profession, complying with the respective European directives and Nurse’s order requirements. In the empirical component, the foundation of an emancipated practice is acquired. Pregnancy loss is a complex and professionally demanding phenomenon that requires specific knowledge and ongoing research in order to train professionals to provide sensitive and close care that empowers couples in experiencing the grieving process. Objectives: Internship component - Analyze the activities developed to acquire the skills of Specialist Nurse in Maternal Health and Obstetric Nursing; Research component - understand the experience of women/couples with pregnancy loss; identify the perception of women/couples with pregnancy loss about Maternal Health and Obstetric Nursing practices in the care of perinatal bereavement. Participants and methods: Internship component - is based on a critical, objective and contextualized reflection of the skills acquired, experiences and activities developed throughout the internships, based on the Specialist Nurse skills profile and quality standards in Maternal Health and Obstetric Nursing defined by Nurse’s Order. Research component - qualitative study with a hermeneutic phenomenological approach, following the assumptions of Max Van Manen. An intentional sample was selected, using the snowball method, of 15 participants, with the instrument for data collection being a semi-structured interview where formal ethical research procedures were followed. The data collected was subject to phenomenological analysis supported by the MAXQDA® software. Results: Internship component - The development of practices throughout the different specific areas of intervention enabled the acquisition of common and specific skills inherent to the professional practice of Specialist Nurses in Maternal Health and Obstetric Nursing, as well as compliance with the minimum legally required experiences. Research component – through the qualitative analysis of the interviews carried out, two major dimensions were uncovered: Experiencing the first pregnancy – made up of three categories (Expectations of the couple; Feelings of the couple; The body that transforms) and the dimension – Experiencing pregnancy loss and the grieving process – consisting of six categories (Experiencing pregnancy loss in the context of health care; Couple's feelings regarding pregnancy loss; Developing mourning strategies; Meaning attributed to pregnancy loss and the grieving process; Feelings in pregnancies subsequent to loss gestational; Impact of pregnancy loss on the bereaved couple). 10 Conclusion: The internship component is extremely important, because it allows us not only to extend the knowledge obtained in the theoretical component into a real context, but also because of the way it prepares us in the assessment, guidance and communication of all types of situations, allowing us to perform a specialized and advanced practice, essential in promoting effective, safe and high-quality care. From the research component, it is concluded that pregnancy loss is a remarkable experience in the life of a couple, leaving marks in the short, medium and long term. There is a need to reflect on the practices carried out, once flaws were observed in terms of care, support and monitoring provided by nurses to these women/couples/families. The need for change in terms of the care paradigm emerges in order to provide more appropriate care, qualifying the assistance provided and enabling a healthier experience of grief.
Description
Keywords
Cônjuges Enfermagem obstétrica Enfermeiros obstetras Gravidez Luto Morte fetal Mulher grávida Nado-morto Puerpério Revisão Bereavement Fetal death Nurse midwives Obstetric nursing Postpartum period Pregnancy Pregnant women Review Spouses Stillbirth