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Satisfação da mulher com os cuidados pré-natais : Contributo do cuidado humano em enfermagem durante a gravidez
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Enquadramento: No 2º ano do Curso de Mestrado em Enfermagem de Saúde Materna e
Obstétrica, 1.ª Edição, constituído pela UC de Estágio com Relatório Final preconiza-se o
desenvolvimento de competências inerentes ao grau de Mestre em Enfermagem de Saúde
Materna e Obstétrica as quais foram desenvolvidas ao longo de 36 semanas de estágio nas
diferentes áreas de intervenção, e se cumpriu o número de experiências mínimas exigidas,
apresentadas na primeira parte deste relatório denominado de componente clínica. Na
segunda parte do relatório apresenta-se a componente de investigação, desenvolvida
durante o estágio.
Objetivo: Relatar as atividades desenvolvidas durante o estágio inerentes à aquisição de
competências para a atribuição do grau de mestre em Enfermagem de Saúde Materna e
Obstétrica; Identificar a satisfação da mulher com os cuidados pré-natais; e analisar o
contributo do Cuidado Humano em Enfermagem durante a gravidez.
Metodologia: Análise crítico-reflexiva da prática clínica desenvolvida em contexto de estágio
em Enfermagem de Saúde Materna e Obstétrica, tendo por base os referenciais teóricos,
nomeadamente a Teoria das Transições de Afaf Meleis e a Ciência do Cuidado Humano de
Jean Watson, os padrões de qualidade da Mesa do Colégio da Especialidade da área, os
regulamentos das competências comuns e especificas, e as Diretivas europeias. Na
componente de investigação realizou-se um estudo quantitativo, descritivo-correlacional e
transversal, realizado com 301 mulheres. A recolha de dados foi efetuada através de um
questionário de caracterização sociodemográfica e obstétrica e da Escala de Satisfação com
o Cuidado Humano em Enfermagem durante a Gravidez. Os dados foram submetidos a
análise descritiva, análise fatorial exploratória, análise da consistência interna e análise
inferencial.
Resultados: Adquiridas as competências comuns e específicas inerentes ao Enfermeiro
Especialista em Enfermagem de Saúde Materna e Obstétrica, tendo sido cumpridas as
exigências mínimas consagradas nas diretivas europeias. Participaram no estudo 301
mulheres, com idade média de 31,5 anos (DP=4,88). As participantes apresentaram
elevados níveis de satisfação com o Cuidado Humano em Enfermagem durante a gravidez,
destacando-se as dimensões Confidencialidade e Dignidade (M=4,50; DP=0,48), Presença e
Relação (M=4,36; DP=0,51), Personalização e Autonomia (M=4,34; DP=0,52) e
Continuidade e Acessibilidade (M=4,21; DP=0,59). A análise fatorial exploratória identificou
quatro dimensões da satisfação, explicando 82,1% da variância total, e revelou excelentes
propriedades psicométricas (KMO=0,959; teste de Bartlett: χ²=7700,7; p<0,001). A
consistência interna da escala mostrou-se elevada, com valores de Alfa de Cronbach entre
0,884 e 0,959. Verificaram-se diferenças estatisticamente significativas na satisfação em
função da idade, da escolaridade e da realização de consulta pré-concecional, observandose
níveis mais elevados de satisfação entre as mulheres mais velhas, com ensino superior e
que realizaram consulta pré-concecional.
Conclusão: O estágio permitiu o desenvolvimento das competências, inerentes ao cuidado
especializado em enfermagem de Saúde Materna e Obstétrica. O Cuidado Humano em
Enfermagem constitui um importante contributo para a satisfação da mulher com os
cuidados pré-natais. A promoção da autonomia, da dignidade, da relação terapêutica, da
comunicação e da continuidade dos cuidados favorece experiências positivas durante a
gravidez e contribui para a qualidade dos cuidados prestados pelo Enfermeiro Especialista
em Enfermagem de Saúde Materna e Obstétrica. O desenvolvimento deste estudo permitiu,
simultaneamente, consolidar competências científicas, metodológicas e clínicas inerentes à
prática especializada em Saúde Materna e Obstétrica, reforçando a importância da
investigação como suporte da tomada de decisão e da melhoria contínua da qualidade dos
cuidados.
Abstract Background: The second year of the Master’s Degree in Maternal and Obstetric Health Nursing (1st Edition) includes the Clinical Placement with Final Report curricular unit, which aims to develop the competencies required for the award of the Master’s degree in Maternal and Obstetric Health Nursing. These competencies were acquired over 36 weeks of clinical placement across the different areas of practice, during which the minimum clinical experiences required by the European Directives were achieved. The first part of this report presents the clinical component, while the second part describes the research component developed throughout the placement. Objective: To describe the activities undertaken during the clinical placement leading to the acquisition of the competencies required for the award of the Master’s degree in Maternal and Obstetric Health Nursing; to assess women’s satisfaction with antenatal care; and to analyse the contribution of Human Caring in Nursing during pregnancy. Methodology: A critical and reflective analysis of clinical practice undertaken during the clinical placement in Maternal and Obstetric Health Nursing was conducted, drawing upon relevant theoretical frameworks, namely Afaf Meleis’ Transitions Theory and Jean Watson’s Theory of Human Caring, as well as the quality standards established by the College of the Nursing Specialty, the regulations governing common and specific specialist competencies, and the European Directives. The research component comprised a quantitative, descriptivecorrelational, cross-sectional study involving 301 women. Data were collected using a sociodemographic and obstetric questionnaire together with the Satisfaction with Human Caring in Nursing During Pregnancy Scale. Data were analysed using descriptive statistics, exploratory factor analysis, internal consistency analysis and inferential statistics. Results: The common and specific competencies required for the Specialist Nurse in Maternal and Obstetric Health Nursing were successfully achieved, together with the minimum clinical requirements established by the European Directives. A total of 301 women participated in the study, with a mean age of 31.5 years (SD = 4.88). Participants reported high levels of satisfaction with Human Caring in Nursing during pregnancy, particularly in the dimensions of Confidentiality and Dignity (M = 4.50; SD = 0.48), Presence and Relationship (M = 4.36; SD = 0.51), Personalisation and Autonomy (M = 4.34; SD = 0.52), and Continuity and Accessibility (M = 4.21; SD = 0.59). Exploratory factor analysis identified four dimensions of satisfaction, explaining 82.1% of the total variance, and demonstrated excellent psychometric properties (KMO = 0.959; Bartlett’s test: χ² = 7700.7; p < 0.001). The scale also demonstrated high internal consistency, with Cronbach’s alpha coefficients ranging from 0.884 to 0.959. Statistically significant differences in satisfaction were found according to age, educational level and attendance at a preconception consultation, with higher satisfaction levels reported by older women, those with higher education, and those who had attended a preconception consultation. Conclusion: The clinical placement enabled the development of the competencies required for specialist practice in Maternal and Obstetric Health Nursing. Human Caring in Nursing makes an important contribution to women’s satisfaction with antenatal care. The promotion of autonomy, dignity, therapeutic relationships, effective communication and continuity of care fosters positive pregnancy experiences and contributes to the quality of care provided by Specialist Nurses in Maternal and Obstetric Health Nursing. Furthermore, this study strengthened the scientific, methodological and clinical competencies underpinning specialist practice in Maternal and Obstetric Health Nursing, highlighting the importance of research as a foundation for evidence-based decision-making and the continuous improvement of healthcare quality. Keywords: Midwife; pregnant woman/significant other; antenatal care; satisfacti
Abstract Background: The second year of the Master’s Degree in Maternal and Obstetric Health Nursing (1st Edition) includes the Clinical Placement with Final Report curricular unit, which aims to develop the competencies required for the award of the Master’s degree in Maternal and Obstetric Health Nursing. These competencies were acquired over 36 weeks of clinical placement across the different areas of practice, during which the minimum clinical experiences required by the European Directives were achieved. The first part of this report presents the clinical component, while the second part describes the research component developed throughout the placement. Objective: To describe the activities undertaken during the clinical placement leading to the acquisition of the competencies required for the award of the Master’s degree in Maternal and Obstetric Health Nursing; to assess women’s satisfaction with antenatal care; and to analyse the contribution of Human Caring in Nursing during pregnancy. Methodology: A critical and reflective analysis of clinical practice undertaken during the clinical placement in Maternal and Obstetric Health Nursing was conducted, drawing upon relevant theoretical frameworks, namely Afaf Meleis’ Transitions Theory and Jean Watson’s Theory of Human Caring, as well as the quality standards established by the College of the Nursing Specialty, the regulations governing common and specific specialist competencies, and the European Directives. The research component comprised a quantitative, descriptivecorrelational, cross-sectional study involving 301 women. Data were collected using a sociodemographic and obstetric questionnaire together with the Satisfaction with Human Caring in Nursing During Pregnancy Scale. Data were analysed using descriptive statistics, exploratory factor analysis, internal consistency analysis and inferential statistics. Results: The common and specific competencies required for the Specialist Nurse in Maternal and Obstetric Health Nursing were successfully achieved, together with the minimum clinical requirements established by the European Directives. A total of 301 women participated in the study, with a mean age of 31.5 years (SD = 4.88). Participants reported high levels of satisfaction with Human Caring in Nursing during pregnancy, particularly in the dimensions of Confidentiality and Dignity (M = 4.50; SD = 0.48), Presence and Relationship (M = 4.36; SD = 0.51), Personalisation and Autonomy (M = 4.34; SD = 0.52), and Continuity and Accessibility (M = 4.21; SD = 0.59). Exploratory factor analysis identified four dimensions of satisfaction, explaining 82.1% of the total variance, and demonstrated excellent psychometric properties (KMO = 0.959; Bartlett’s test: χ² = 7700.7; p < 0.001). The scale also demonstrated high internal consistency, with Cronbach’s alpha coefficients ranging from 0.884 to 0.959. Statistically significant differences in satisfaction were found according to age, educational level and attendance at a preconception consultation, with higher satisfaction levels reported by older women, those with higher education, and those who had attended a preconception consultation. Conclusion: The clinical placement enabled the development of the competencies required for specialist practice in Maternal and Obstetric Health Nursing. Human Caring in Nursing makes an important contribution to women’s satisfaction with antenatal care. The promotion of autonomy, dignity, therapeutic relationships, effective communication and continuity of care fosters positive pregnancy experiences and contributes to the quality of care provided by Specialist Nurses in Maternal and Obstetric Health Nursing. Furthermore, this study strengthened the scientific, methodological and clinical competencies underpinning specialist practice in Maternal and Obstetric Health Nursing, highlighting the importance of research as a foundation for evidence-based decision-making and the continuous improvement of healthcare quality. Keywords: Midwife; pregnant woman/significant other; antenatal care; satisfacti
Descrição
Palavras-chave
Competência profissional Cuidado pré-natal Enfermagem obstétrica Gravidez Satisfação do paciente Obstetric nursing Patient satisfaction Pregnancy Prenatal care Professional competence