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Cuidado intercultural em enfermagem de saúde materna e obstétrica durante o puerpério : Experiências dos profissionais
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Introdução: Este relatóriofinal, resultante do estágio profissional, visa demonstrar o
desenvolvimento das competências necessárias à atribuição do grau de Mestre e do título
de Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica, nos diferentes
contextos de intervenção. Estrutura-se em duas partes. A primeira corresponde ao relatório
de estágio, no qual se descreve e analisa criticamente o percurso formativo desenvolvido. A
segunda integra a componente de investigação, centrada na compreensão do cuidado
intercultural no puerpério na perspetiva dos Enfermeiros Especialistas em Enfermagem de
Saúde Materna e Obstétrica(EE-ESMO), com base nas suas experiências na prestação de
cuidados a puérperas imigrantes.
Objetivos: Relatar as atividades desenvolvidas nos diferentes contextos de estágio para a
aquisição e consolidação de competências em Enfermagem de SaúdeMaterna e Obstétrica;
compreender as experiências dos EE-ESMO na prestação de cuidados interculturais à
puérpera imigrante.
Metodologia: No percurso formativo em estágio foi adotada uma metodologia de análise
crítico-reflexiva da prática clínica. A componente de investigação consistiu num estudo
qualitativo de natureza fenomenológico-hermenêutica, fundamentado na abordagem de Max
van Manen e aprovado pela Comissão de Ética. A recolha de dados realizou-se através de
entrevistas fenomenológicas a 22EE-ESMO com experiência na prestação de cuidados a
puérperas imigrantes. Após transcrição, as entrevistas foram submetidas a análise
fenomenológica, com recurso ao AIQDA e ao software MAXQDA®.
Resultados: O desenvolvimento da prática clínica em seis contextos de estágio permitiu a
aquisição das competências comuns e específicas do Enfermeiro Especialista em
Enfermagem de Saúde Materna e Obstétrica, em conformidade com os padrões de
qualidade da especialidade. Da análise emergiram dez temas fenomenológicos, que
evidenciam a competência cultural como um processo dinâmico, contínuo e
multidimensional. Os temas fenomenológicos mais representativos foram Modos de
desenvolvimento de competências culturais, Constrangimentos na prestação de cuidados
interculturais à puérpera e Competências ético-interculturais. Os subtemas Aprendizagem
pela experiência, Adaptação cultural dos cuidados, Formação profissional e
Constrangimentos comunicacionais apresentaram maior expressividade. A integração dos
temas fenomenológicos no Modelo de Competência Cultural de Campinha-Bacote (2011)
demonstrou que o desenvolvimento da competência cultural resulta da interação entre
Desejo Cultural, Consciência Cultural, Conhecimento Cultural, Habilidade Cultural e
Encontros Culturais.
Conclusão: A formação em Enfermagem de Saúde Materna e Obstétrica constitui um
elemento essencial para o desenvolvimento de competências científicas, técnicas, éticas,
relacionais e culturais, indispensáveis à prestação de cuidados individualizados, seguros e
culturalmente congruentes. Os resultados demonstram que a crescente diversidade cultural
dos contextos assistenciais exige EE-ESMO preparados para responder às necessidades
específicas das puérperas imigrantes, destacando a relevância das competências
comunicacionais, relacionais e ético-interculturais. Confirmou-se a adequação do Modelo de
Competência Cultural de Campinha-Bacote (2011) para interpretar esta experiência e
reforçou-se a necessidade de investir na formação em competência cultural, comunicação
intercultural e diversidade cultural, promovendo cuidados mais inclusivos, equitativos,
humanizados e culturalmente congruentes.
Palavras-chave: enfermeiro obstetra; mulheres/puérperas; imigrantes; cuidados
interculturais.
Abstract Introduction: This final report, resulting from the professional clinical placement, aims to demonstrate the development of the competencies required for the award of the Master's degree and the professional title of Specialist Nurse in Maternal and Obstetric Health Nursing (EE-ESMO) across different clinical settings. It is structured in to two parts. The first consists of the clinical placement report, which describes and critically analyses the learning pathway undertaken. The second comprises the research component, focusing on understanding intercultural postpartum care from the perspective of Specialist Nurses in Maternal and Obstetric Health Nursing, based on their experiences of providing care to migrant postpartum women. Objectives: To describe the activities undertaken in the different clinical placement settings for the acquisition and consolidation of competencies in Maternal and Obstetric Health Nursing, and to understand the experiences of Specialist Nurses in Maternal and Obstetric Health Nursing in providing intercultural care to migrant postpartum women. Methodology: During the clinical placement, a critical-reflective approach was adopted to analyse clinical practice. The research component consisted of a qualitative phenomenological-hermeneutic study based on Max van Manen's approach and approved by the Ethics Committee. Data were collected through phenomenological interviews with 22 Specialist Nurses in Maternal and Obstetric Health Nursing (EE-ESMO) with experience in providing care to migrant postpartum women. Following transcription, the interviews were subjected to phenomenological analysis using AIQDA and MAXQDA® software. Results: Clinical practice undertaken across six placement settings enabled the acquisition of the common and specific competencies required of the Specialist Nurse in Maternal and Obstetric Health Nursing, in accordance with the quality standards of the speciality. Ten phenomenological themes emerged from the analysis, demonstrating that cultural competence is a dynamic, continuous and multidimensional process. The most prominent phenomenological themes were Ways of Developing Cultural Competence, Constraints in Providing Intercultural Care to Migrant Postpartum Women and Ethical-Intercultural Competencies. The subthemes Learning through Experience, Cultural Adaptation of Care, Professional Training and Communication Constraints were the most prominent. Integrating the phenomenological themes in toCampinha-Bacote's Model of Cultural Competence (2011) demonstrated that the development of cultural competence results from the interaction between Cultural Desire, Cultural Awareness, Cultural Knowledge, Cultural Skill and Cultural Encounters. Conclusion: Specialist education in Maternal and Obstetric Health Nursing is fundamental to the development of scientific, technical, ethical, relational and cultural competencies required to provide individualised, safe and culturally congruent care. The findings demonstrate that the increasing cultural diversity of health care settings requires Specialist Nurses in Maternal and Obstetric Health Nursing who are prepared to respond to the specific needs of migrant postpartum women, highlighting the importance of communication, relational and ethical- intercultural competencies. The findings alsoconfirmed the suitability of Campinha-Bacote's Model of Cultural Competence (2011) for interpreting this experience and reinforce the need to strengthen education in cultural competence, intercultural communication and cultural diversity in order to promote more inclusive, equitable, human and culturally congruent care. Keywords: obstetric nurse; women/postpartum women; immigrants; intercultural care.
Abstract Introduction: This final report, resulting from the professional clinical placement, aims to demonstrate the development of the competencies required for the award of the Master's degree and the professional title of Specialist Nurse in Maternal and Obstetric Health Nursing (EE-ESMO) across different clinical settings. It is structured in to two parts. The first consists of the clinical placement report, which describes and critically analyses the learning pathway undertaken. The second comprises the research component, focusing on understanding intercultural postpartum care from the perspective of Specialist Nurses in Maternal and Obstetric Health Nursing, based on their experiences of providing care to migrant postpartum women. Objectives: To describe the activities undertaken in the different clinical placement settings for the acquisition and consolidation of competencies in Maternal and Obstetric Health Nursing, and to understand the experiences of Specialist Nurses in Maternal and Obstetric Health Nursing in providing intercultural care to migrant postpartum women. Methodology: During the clinical placement, a critical-reflective approach was adopted to analyse clinical practice. The research component consisted of a qualitative phenomenological-hermeneutic study based on Max van Manen's approach and approved by the Ethics Committee. Data were collected through phenomenological interviews with 22 Specialist Nurses in Maternal and Obstetric Health Nursing (EE-ESMO) with experience in providing care to migrant postpartum women. Following transcription, the interviews were subjected to phenomenological analysis using AIQDA and MAXQDA® software. Results: Clinical practice undertaken across six placement settings enabled the acquisition of the common and specific competencies required of the Specialist Nurse in Maternal and Obstetric Health Nursing, in accordance with the quality standards of the speciality. Ten phenomenological themes emerged from the analysis, demonstrating that cultural competence is a dynamic, continuous and multidimensional process. The most prominent phenomenological themes were Ways of Developing Cultural Competence, Constraints in Providing Intercultural Care to Migrant Postpartum Women and Ethical-Intercultural Competencies. The subthemes Learning through Experience, Cultural Adaptation of Care, Professional Training and Communication Constraints were the most prominent. Integrating the phenomenological themes in toCampinha-Bacote's Model of Cultural Competence (2011) demonstrated that the development of cultural competence results from the interaction between Cultural Desire, Cultural Awareness, Cultural Knowledge, Cultural Skill and Cultural Encounters. Conclusion: Specialist education in Maternal and Obstetric Health Nursing is fundamental to the development of scientific, technical, ethical, relational and cultural competencies required to provide individualised, safe and culturally congruent care. The findings demonstrate that the increasing cultural diversity of health care settings requires Specialist Nurses in Maternal and Obstetric Health Nursing who are prepared to respond to the specific needs of migrant postpartum women, highlighting the importance of communication, relational and ethical- intercultural competencies. The findings alsoconfirmed the suitability of Campinha-Bacote's Model of Cultural Competence (2011) for interpreting this experience and reinforce the need to strengthen education in cultural competence, intercultural communication and cultural diversity in order to promote more inclusive, equitable, human and culturally congruent care. Keywords: obstetric nurse; women/postpartum women; immigrants; intercultural care.
Descrição
Palavras-chave
Atitude do pessoal de saúde Competência profissional Emigrantes e imigrantes Enfermagem obstétrica Enfermagem transcultural Entrevista como assunto Fenomenologia Puerpério Attitude of health personnel Emigrants and immigrants Interview as topic Obstetric nursing Phenomenology Postpartum period Professional competence Transcultural nursing