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Cuidar da pessoa com DPOC no domicílio : Perspetiva dos enfermeiros especialistas em enfermagem de reabilitação
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Introdução: A exigência técnica e científica requerida aos cuidados de saúde e,
consequentemente, aos cuidados de Enfermagem, traduz-se numa necessidade de maior
diferenciação e especialização. A atribuição do título de enfermeiro especialista pressupõe
um conjunto de competências comuns, partilhadas por todas as especialidades e a
reabilitação engloba conhecimentos e procedimentos específicos que permitem ajudar as
pessoas a maximizar o seu potencial funcional e independência. A Doença Pulmonar
Obstrutiva Crónica (DPOC) é uma condição respiratória progressiva, caracterizada por
sintomas persistentes, com obstrução crónica do fluxo aéreo. Em Portugal, a prevalência
atinge 14,2% da população com mais de 40 anos, segundo a DGS. O Enfermeiro Especialista
em Enfermagem de Reabilitação (EEER) tem uma intervenção de relevo na continuidade de
cuidados e na resposta às necessidades da pessoa com DPOC no domicílio.
Objetivos: Descrever o processo de aquisição de competências comuns do enfermeiro
especialista e de competências específicas em Enfermagem de Reabilitação; explorar a
perceção dos EEER sobre a sua intervenção em pessoas com DPOC em contexto
domiciliário.
Metodologia: O relatório é composto por duas partes: a primeira reflete o estágio clínico e
analisa criticamente o processo de desenvolvimento de competências ao longo dos diversos
contextos clínicos; a segunda parte apresenta um estudo qualitativo intitulado “Cuidar da
Pessoa com DPOC no domicílio: perspetiva dos Enfermeiros Especialistas em Enfermagem
de Reabilitação”.
Resultados: Fez-se uma reflexão, de forma consciente e fundamentada, sobre as
competências adquiridas e desenvolvidas, que possibilitaram um olhar renovado sobre as
práticas, o contexto e o conhecimento. Analisaram-se os objetivos traçados, as atividades
desenvolvidas e as dificuldades encontradas. A componente de investigação analisou as
perspetivas dos EEER sobre o cuidado à pessoa com DPOC em contexto domiciliário. Os
resultados destacam estratégias eficazes na promoção da independência e controlo dos
sintomas, a importância do envolvimento familiar ou os fatores facilitadores/barreiras ao
cuidado domiciliário destes utentes.
Conclusão: As competências comuns e as competências específicas foram desenvolvidas e
consolidadas ao longo dos estágios. O trabalho de investigação permitiu perceber que o
EEER desempenha um papel estruturante no processo de gestão da DPOC, como agente de
educação para a saúde, contribuindo para a para a diminuição de sintomas, para o aumento
da motivação na continuidade do exercício físico e para a adaptação à vida familiar e social.
Conclui-se que o percurso formativo permitiu o desenvolvimento efetivo de competências
especializadas, ao mesmo tempo que reforçou a relevância da enfermagem de reabilitação
na resposta às necessidades complexas das pessoas com DPOC em contexto domiciliário.
Palavras-chave: Enfermagem de Reabilitação; Enfermeiro Especialista; Competências;
DPOC; Cuidados domiciliários, Reabilitação respiratória.
Abstract Introduction: The technical and scientific demands required in healthcare, and consequently in nursing care, highlight the need for greater differentiation and specialization. The attribution of the specialist nurse title implies the development of a set of core skills shared by all specialties. Rehabilitation encompasses specific knowledge and procedures that enable people to maximize their functional potential and independence. Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition characterized by persistent symptoms and chronic airflow limitation. In Portugal, its prevalence reaches 14.2% of the population over 40 years old, according to the Directorate-General of Health (DGS). The Rehabilitation Nursing Specialist (RNS) plays a key role in care continuity and in responding to the needs of people with COPD in home care. Objectives: To describe the process of acquiring the core skills of the specialist nurse and the specific skills of the Rehabilitation Nursing Specialist; to explore RNS perceptions of their intervention with COPD patients at their home environment. Methodology: The report is divided into two parts: the first part reflects the clinical training and critically analyzes the process of skills development across different clinical settings; the second presents a qualitative study entitled “Caring for People with COPD at Home: Perspectives of Rehabilitation Nursing Specialists.” Results: A conscious and evidence-based analysis of the processo f acquiring and developing of nursing skills was carried out, allowing for a renewed perspective on practices, contexts, and knowledge. The objectives, activities and challenges encountered were analyzed. The research component explored RNS perspectives on caring for people with COPD in the home context. Findings highlight effective strategies in promoting independence and symptom control, the importance of family involvement, and the facilitating factors/barriers to homebased care for these patients. Conclusion: Both core and specific competencies were developed and consolidated throughout the clinical placements. The research study revealed that the RNS plays na importante role in managing COPD, acting as a health educator and contributing to symptom reduction, increased motivation for physical exercise adherence and adaptation to family and social life. It is concluded that the internships enabled the effective development of specialized competencies, while reinforcing the relevance of rehabilitation nursing in addressing the complex needs of people with COPD in the home setting. Keywords: Rehabilitation Nursing; Specialist Nurse; Nursing Skills; COPD; Home Care; Pulmonary Rehabilitation.
Abstract Introduction: The technical and scientific demands required in healthcare, and consequently in nursing care, highlight the need for greater differentiation and specialization. The attribution of the specialist nurse title implies the development of a set of core skills shared by all specialties. Rehabilitation encompasses specific knowledge and procedures that enable people to maximize their functional potential and independence. Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition characterized by persistent symptoms and chronic airflow limitation. In Portugal, its prevalence reaches 14.2% of the population over 40 years old, according to the Directorate-General of Health (DGS). The Rehabilitation Nursing Specialist (RNS) plays a key role in care continuity and in responding to the needs of people with COPD in home care. Objectives: To describe the process of acquiring the core skills of the specialist nurse and the specific skills of the Rehabilitation Nursing Specialist; to explore RNS perceptions of their intervention with COPD patients at their home environment. Methodology: The report is divided into two parts: the first part reflects the clinical training and critically analyzes the process of skills development across different clinical settings; the second presents a qualitative study entitled “Caring for People with COPD at Home: Perspectives of Rehabilitation Nursing Specialists.” Results: A conscious and evidence-based analysis of the processo f acquiring and developing of nursing skills was carried out, allowing for a renewed perspective on practices, contexts, and knowledge. The objectives, activities and challenges encountered were analyzed. The research component explored RNS perspectives on caring for people with COPD in the home context. Findings highlight effective strategies in promoting independence and symptom control, the importance of family involvement, and the facilitating factors/barriers to homebased care for these patients. Conclusion: Both core and specific competencies were developed and consolidated throughout the clinical placements. The research study revealed that the RNS plays na importante role in managing COPD, acting as a health educator and contributing to symptom reduction, increased motivation for physical exercise adherence and adaptation to family and social life. It is concluded that the internships enabled the effective development of specialized competencies, while reinforcing the relevance of rehabilitation nursing in addressing the complex needs of people with COPD in the home setting. Keywords: Rehabilitation Nursing; Specialist Nurse; Nursing Skills; COPD; Home Care; Pulmonary Rehabilitation.
Descrição
Palavras-chave
Atitude perante a saúde Competência profissional Doença pulmonar obstrutiva crónica - reabilitação Enfermagem de reabilitação Serviços de cuidados domiciliários Attitude to health Home care services Professional competence Pulmonary disease chronic obstructive - rehabilitation Rehabilitation nursing