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Experiência vivida por grávidas em contexto de incerteza pelo encerramento das urgências obstétricas em Portugal
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Introdução: O presente relatório foi desenvolvido no âmbito da Unidade Curricular Estágio com Relatório Final: Enfermagem de Saúde Materna e Obstétrica, integrada no 1.º Curso de Mestrado em Enfermagem de Saúde Materna e Obstétrica da Escola Superior de Saúde de Viseu. Estrutura-se em duas componentes complementares: uma componente clínica, que integra uma análise crítica e reflexiva do percurso formativo realizado nos diferentes contextos de estágio, suportada na evidência científica e nos normativos da Ordem dos Enfermeiros; uma componente de investigação, correspondente ao estudo intitulado "Experiência vivida por grávidas em contexto de incerteza pelo encerramento das urgências obstétricas em Portugal".
Objetivos: Na componente clínica, relatar o desenvolvimento de competências comuns e específicas do Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica, através de uma prática clínica crítico-reflexiva e baseada na evidência. Na componente de investigação, compreender a experiência vivida pelas grávidas perante o encerramento das urgências obstétricas em Portugal e interpretar os significados atribuídos a essa vivência.
Metodologia: A componente clínica baseou-se numa análise crítico-reflexiva das experiências desenvolvidas nos diferentes contextos de estágio em Enfermagem de Saúde Materna e Obstétrica. A componente de investigação consistiu num estudo qualitativo de natureza fenomenológico-hermenêutica, fundamentado na abordagem de Max van Manen. A recolha de dados realizou-se através de entrevistas fenomenológicas, posteriormente transcritas e submetidas a análise fenomenológica com recurso ao AIQDA e ao software MAXQDA®, permitindo a identificação dos temas essenciais da experiência vivida pelas participantes.
Resultados: A componente clínica permitiu consolidar competências especializadas na prestação de cuidados à mulher, ao recém-nascido e à família ao longo do ciclo gravídico-puerperal, promover uma prática clínica ética, humanizada, baseada na evidência e centrada na mulher. A componente investigativa demonstrou que o encerramento das urgências obstétricas foi vivido como uma experiência marcada pela incerteza, insegurança, ansiedade e medo, condicionando a vivência da gravidez e do parto. Emergiram estratégias de adaptação e resiliência mobilizadas pelas mulheres perante as dificuldades sentidas, bem como a importância do apoio familiar e dos Enfermeiros Especialistas em Enfermagem de Saúde Materna e Obstétrica na atenuação do impacto emocional desta realidade.
Conclusão: A elaboração deste relatório contribuiu para o desenvolvimento e consolidação das competências necessárias ao exercício profissional enquanto Enfermeira Especialista em Enfermagem de Saúde Materna e Obstétrica, sustentadas na reflexão crítica, na evidência científica e na prestação de cuidados humanizados. O estudo mostrou a necessidade de se garantir a acessibilidade, a continuidade e a segurança nos cuidados de saúde materna, bem como de desenvolver estratégias organizacionais e políticas de saúde que promovam experiências positivas e seguras durante a gravidez e o parto.
Palavras-chave: Gravidez; urgências obstétricas; experiência vivida; fenomenologia hermenêutica; enfermagem obstétrica.
Abstract Introduction: This report was developed as part of the Clinical Placement with Final Report: Maternal and Obstetric Health Nursing course unit, within the Master's Degree in Maternal and Obstetric Health Nursing at the Viseu School of Health. It is structured into two complementary components: a clinical component, comprising a critical and reflective analysis of the learning undertaken across the different clinical placement settings, supported by scientific evidence and the professional standards established by the Portuguese Nursing Council; and a research component, corresponding to the study entitled "The Lived Experience of Pregnant Women Facing Uncertainty Due to the Closure of Obstetric Emergency Departments in Portugal". Objectives: The clinical component aimed to describe the development of the common and specialist competencies of the Maternal and Obstetric Health Nurse Specialist through critical, reflective, and evidence-based clinical practice. The research component aimed to understand the lived experiences of pregnant women facing the closure of obstetric emergency departments in Portugal and to interpret the meanings they attributed to those experiences. Methods: The clinical component was based on a critical and reflective analysis of the experiences acquired in different maternal and obstetric health nursing clinical placements. The research component consisted of a qualitative study using a hermeneutic phenomenological approach, based on Max van Manen's methodology. Data were collected through phenomenological interviews, which were transcribed and subjected to phenomenological analysis using AIQDA and MAXQDA® software, enabling the identification of the essential themes of the participants' lived experiences. Results: The clinical component enabled the consolidation of specialist competencies in providing care to women, newborns, and families throughout the pregnancy, childbirth, and postpartum period, promoting ethical, woman-centred, humanised, and evidence-based clinical practice. The research component demonstrated that the closure of obstetric emergency departments was experienced as a situation characterised by uncertainty, insecurity, anxiety, and fear, affecting women's experiences of pregnancy and childbirth. Strategies of adaptation and resilience emerged, together with the recognised importance of support from families and Maternal and Obstetric Health Nurse Specialists in mitigating the emotional impact of this situation. Conclusion: The preparation of this report contributed to the development and consolidation of the competencies required for professional practice as a Maternal and Obstetric Health Nurse Specialist, grounded in critical reflection, scientific evidence, and the provision of humanised care. The study highlighted the need to ensure accessibility, continuity, and safety in maternal healthcare, as well as to develop organisational strategies and health policies that promote positive and safe experiences throughout pregnancy and childbirth. Keywords: Pregnancy; obstetric emergency departments; lived experience; hermeneutic phenomenology; obstetric nursing.
Abstract Introduction: This report was developed as part of the Clinical Placement with Final Report: Maternal and Obstetric Health Nursing course unit, within the Master's Degree in Maternal and Obstetric Health Nursing at the Viseu School of Health. It is structured into two complementary components: a clinical component, comprising a critical and reflective analysis of the learning undertaken across the different clinical placement settings, supported by scientific evidence and the professional standards established by the Portuguese Nursing Council; and a research component, corresponding to the study entitled "The Lived Experience of Pregnant Women Facing Uncertainty Due to the Closure of Obstetric Emergency Departments in Portugal". Objectives: The clinical component aimed to describe the development of the common and specialist competencies of the Maternal and Obstetric Health Nurse Specialist through critical, reflective, and evidence-based clinical practice. The research component aimed to understand the lived experiences of pregnant women facing the closure of obstetric emergency departments in Portugal and to interpret the meanings they attributed to those experiences. Methods: The clinical component was based on a critical and reflective analysis of the experiences acquired in different maternal and obstetric health nursing clinical placements. The research component consisted of a qualitative study using a hermeneutic phenomenological approach, based on Max van Manen's methodology. Data were collected through phenomenological interviews, which were transcribed and subjected to phenomenological analysis using AIQDA and MAXQDA® software, enabling the identification of the essential themes of the participants' lived experiences. Results: The clinical component enabled the consolidation of specialist competencies in providing care to women, newborns, and families throughout the pregnancy, childbirth, and postpartum period, promoting ethical, woman-centred, humanised, and evidence-based clinical practice. The research component demonstrated that the closure of obstetric emergency departments was experienced as a situation characterised by uncertainty, insecurity, anxiety, and fear, affecting women's experiences of pregnancy and childbirth. Strategies of adaptation and resilience emerged, together with the recognised importance of support from families and Maternal and Obstetric Health Nurse Specialists in mitigating the emotional impact of this situation. Conclusion: The preparation of this report contributed to the development and consolidation of the competencies required for professional practice as a Maternal and Obstetric Health Nurse Specialist, grounded in critical reflection, scientific evidence, and the provision of humanised care. The study highlighted the need to ensure accessibility, continuity, and safety in maternal healthcare, as well as to develop organisational strategies and health policies that promote positive and safe experiences throughout pregnancy and childbirth. Keywords: Pregnancy; obstetric emergency departments; lived experience; hermeneutic phenomenology; obstetric nursing.
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Acessibilidade aos serviços de saúde Entrevista como assunto Gestante - psicologia Gravidez - psicologia Satisfação do paciente Serviço de urgência hospitalar - organização e administração Emergency service hospital - organization and administration Health services accessibility Interview as topic Patient satisfaction Pregnancy - psychology Pregnant people - psychology