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Intervenção precoce do enfermeiro especialista em enfermagem de reabilitação na pessoa submetida a amputação major : Uma scoping review
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O presente relatório, desenvolvido no âmbito da Unidade Curricular Estágio em Enfermagem de Reabilitação II e Relatório do VII Curso de Mestrado em Enfermagem de Reabilitação da Escola Superior de Saúde do Instituto Politécnico de Viseu, integra de forma articulada a componente de estágio e a componente de investigação, refletindo um percurso formativo orientado para a prática especializada e baseada na evidência.
A componente de estágio assenta numa análise crítico-reflexiva das experiências desenvolvidas em diferentes contextos de cuidados — hospitalar, comunitário, cuidados de saúde primários e Rede Nacional de Cuidados Continuados Integrados — totalizando 408 horas de prática clínica. Este percurso evidenciou o papel central do Enfermeiro Especialista em Enfermagem de Reabilitação na promoção da funcionalidade, na capacitação da pessoa e na facilitação dos processos de transição saúde/doença. A vivência em contextos de neurologia e ortopedia destacou a importância de uma intervenção precoce, estruturada e centrada na pessoa, particularmente em situações de perda funcional significativa e risco de dependência.
A componente de investigação corresponde à realização de uma scoping review sobre a intervenção precoce do Enfermeiro Especialista em Enfermagem de Reabilitação na pessoa submetida a amputação major do membro inferior. A revisão foi conduzida segundo a metodologia do Joanna Briggs Institute e as orientações PRISMA-ScR, com recurso à estratégia PCC, tendo sido incluídos 14 estudos. A análise de conteúdo permitiu identificar cinco áreas nucleares de intervenção: mobilidade e função, autocuidados e independência, integridade cutânea e gestão do coto, controlo da dor e adaptação psicossocial.
Os resultados evidenciam que a intervenção precoce do Enfermeiro Especialista em Enfermagem de Reabilitação constitui um determinante crítico na prevenção de complicações, na recuperação funcional e na promoção da autonomia, com impacto direto na qualidade de vida e participação social. Contudo, a evidência disponível revela-se ainda fragmentada e metodologicamente limitada, reforçando a necessidade de investigação mais robusta que sustente a sistematização das intervenções e a consolidação da prática baseada na evidência.
Este trabalho evidencia a relevância da integração entre prática clínica e investigação, afirmando o contributo diferenciado da enfermagem de reabilitação na resposta a situações de elevada complexidade funcional e na construção de cuidados verdadeiramente centrados na pessoa.
Palavras-chave: Enfermagem de Reabilitação; Amputação major do membro inferior; Intervenção precoce; Funcionalidade; Transições
Abstract This report, developed within the scope of the Curricular Unit Clinical Practice in Rehabilitation Nursing II and Final Report of the 7th Master’s Degree in Rehabilitation Nursing at the School of Health of the Polytechnic Institute of Viseu, integrates both the clinical practice and research components in an articulated manner, reflecting a training pathway oriented towards specialized and evidence-based practice. The clinical practice component is based on a critical-reflective analysis of experiences developed in different care settings — hospital, community, primary health care and the National Network of Integrated Continuous Care — totaling 408 hours of clinical practice. This pathway highlighted the central role of the Rehabilitation Nurse Specialist in promoting functionality, empowering individuals, and facilitating health–illness transition processes. Experience in neurological and orthopedic contexts emphasized the importance of early, structured and person-centered intervention, particularly in situations of significant functional loss and risk of dependency. The research component consists of a scoping review on the early intervention of the Rehabilitation Nurse Specialist in individuals undergoing major lower limb amputation. The review was conducted according to the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, using the PCC framework, and included 14 studies. Content analysis identified five core areas of intervention: mobility and function, self-care and independence, skin integrity and stump management, pain management, and psychosocial adaptation. The findings highlight that early intervention by the Rehabilitation Nurse Specialist is a critical determinant in preventing complications, promoting functional recovery and enhancing autonomy, with a direct impact on quality of life and social participation. However, the available evidence remains fragmented and methodologically limited, reinforcing the need for more robust research to support the systematization of interventions and the consolidation of evidence-based practice. This work highlights the relevance of integrating clinical practice and research, emphasizing the distinctive contribution of rehabilitation nursing in addressing situations of high functional complexity and in delivering truly person-centered care. Keywords: Rehabilitation Nursing; Major Lower Limb Amputation; Early Intervention; Functionality; Transitions
Abstract This report, developed within the scope of the Curricular Unit Clinical Practice in Rehabilitation Nursing II and Final Report of the 7th Master’s Degree in Rehabilitation Nursing at the School of Health of the Polytechnic Institute of Viseu, integrates both the clinical practice and research components in an articulated manner, reflecting a training pathway oriented towards specialized and evidence-based practice. The clinical practice component is based on a critical-reflective analysis of experiences developed in different care settings — hospital, community, primary health care and the National Network of Integrated Continuous Care — totaling 408 hours of clinical practice. This pathway highlighted the central role of the Rehabilitation Nurse Specialist in promoting functionality, empowering individuals, and facilitating health–illness transition processes. Experience in neurological and orthopedic contexts emphasized the importance of early, structured and person-centered intervention, particularly in situations of significant functional loss and risk of dependency. The research component consists of a scoping review on the early intervention of the Rehabilitation Nurse Specialist in individuals undergoing major lower limb amputation. The review was conducted according to the Joanna Briggs Institute methodology and PRISMA-ScR guidelines, using the PCC framework, and included 14 studies. Content analysis identified five core areas of intervention: mobility and function, self-care and independence, skin integrity and stump management, pain management, and psychosocial adaptation. The findings highlight that early intervention by the Rehabilitation Nurse Specialist is a critical determinant in preventing complications, promoting functional recovery and enhancing autonomy, with a direct impact on quality of life and social participation. However, the available evidence remains fragmented and methodologically limited, reinforcing the need for more robust research to support the systematization of interventions and the consolidation of evidence-based practice. This work highlights the relevance of integrating clinical practice and research, emphasizing the distinctive contribution of rehabilitation nursing in addressing situations of high functional complexity and in delivering truly person-centered care. Keywords: Rehabilitation Nursing; Major Lower Limb Amputation; Early Intervention; Functionality; Transitions
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Palavras-chave
Amputação cirúrgica Enfermagem de reabilitação Membro inferior Revisão scoping Amputation surgical Lower extremity Rehabilitation nursing Scoping review