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O enfermeiro de família no acompanhamento à parentalidade : Desafios e estratégias de intervenção
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Abstract(s)
Introdução: A família é reconhecida como a unidade básica da sociedade e desempenha um papel central na promoção da saúde e do bem-estar dos seus membros, constituindo o primeiro espaço de socialização, aprendizagem e desenvolvimento humano. A parentalidade, enquanto transição crítica do ciclo vital familiar, implica alterações profundas na dinâmica conjugal e parental, exigindo redefinição de papéis, reorganização de projetos de vida e reconfiguração de limites relacionais com a família e a comunidade. Este período, simultaneamente desafiante e potenciador de crescimento, traduz-se em necessidades acrescidas de suporte, de modo a garantir a adaptação saudável e a promoção de práticas de parentalidade positiva.
Objetivos: Avaliar as famílias em transição para a parentalidade de acordo com o Modelo Dinâmico de Avaliação e Intervenção Familiar (MDAIF), identificar as necessidades emergentes em cada uma das suas dimensões, estabelecer planos de intervenção ajustados às singularidades de cada família e monitorizar os ganhos em saúde.
Métodos: O estudo de caso múltiplo teve por base a matriz operativa do MDAIF, que integra dimensões estruturais, de desenvolvimento e funcionais da família, associadas a instrumentos de avaliação como o genograma, o ecomapa, a escala de Graffar adaptada, o FACES II e o APGAR Familiar. Participaram quatro famílias inscritas na lista de utentes da enfermeira tutora, selecionadas segundo critérios previamente definidos: grávidas com idade gestacional igual ou superior a 34 semanas e/ou famílias com crianças até seis meses à data de 01.10.2024. Todas as famílias consentiram, por escrito, a sua participação no estudo Family2Care. A recolha de dados decorreu entre outubro de 2024 e janeiro de 2025, através de visitas domiciliárias, consultas de saúde infantil e sessões de educação em grupo, complementadas pela Entrevista Familiar Sistémica (EFS).
Resultados: As intervenções implementadas promoveram ganhos em saúde nas quatro famílias acompanhadas, através da capacitação para a mobilização de recursos internos e externos, do reforço das competências parentais e da promoção de vínculos afetivos seguros. A análise dos casos demonstrou que, embora inicialmente tivesse sido identificado o diagnóstico de “Papel Parental Não Adequado”, a intervenção sistemática do enfermeiro de família contribuiu para a sua evolução para “Papel Parental Adequado”, refletindo-se em maior confiança, autonomia e consistência disciplinar. Destaca-se ainda o papel do suporte intergeracional, sobretudo dos avós, e a relevância da articulação comunitária no fortalecimento da resiliência familiar.
Conclusão: O estudo de caso múltiplo e o MDAIF demonstrou ser uma abordagem metodológica valiosa para a enfermagem de saúde familiar (ESF), permitindo identificar padrões comuns, compreender singularidades e implementar intervenções eficazes, personalizadas e culturalmente adaptadas. Os resultados confirmam o papel estratégico do enfermeiro de família na promoção da parentalidade positiva, reforçando a sua função enquanto facilitador de competências parentais, mediador das relações familiares e articulador de redes de suporte, no âmbito dos Cuidados de Saúde Primários (CSP).
Palavras-Chave: Enfermagem Familiar, Saúde da Família, Parentalidade, Cuidados de Saúde Primários
Abstract Introduction: The family is recognized as the basic unit of society and plays a central role in promoting the health and well-being of its members, constituting the first space for socialization, learning, and human development. Parenthood, as a critical transition in the family life cycle, entails profound changes in conjugal and parental dynamics, requiring role redefinition, reorganization of life projects, and reconfiguration of relational boundaries with both the family of origin and the community. This period, while challenging, also fosters growth and creates an increased need for support to ensure healthy adaptation and the promotion of positive parenting practices. Objectives: To assess families transitioning to parenthood according to the Dynamic Model of Family Assessment and Intervention (MDAIF), to identify emerging needs in each of its dimensions, to establish intervention plans tailored to the uniqueness of each family, and to monitor health gains. Methods: This multiple case study was based on the operational matrix of the MDAIF, which integrates structural, developmental, and functional family dimensions, along with assessment tools such as the genogram, ecomap, adapted Graffar scale, FACES II, and Family APGAR. Four families registered on the tutor nurse’s patient list were included, selected according to predefined criteria: pregnant women with gestational age ≥34 weeks and/or families with children up to six months as of October 1, 2024. All families gave written consent to participate in the Family2Care study. Data collection took place between October 2024 and January 2025, through home visits, child health consultations, and group sessions, complemented by the Systemic Family Interview. Results: The interventions implemented promoted health gains across the four families through empowerment to mobilize internal and external resources, reinforcement of parenting skills, and promotion of secure affective bonds. Case analysis showed that although the initial diagnosis was “Ineffective Parental Role,” the systematic intervention of the family nurse contributed to its evolution into “Effective Parental Role,” reflected in greater confidence, autonomy, and consistent discipline. The intergenerational support, particularly from grandparents, and the relevance of community articulation were highlighted as key factors in strengthening family resilience. Conclusion: The multiple case study and the MDAIF proved to be valuable methodological approaches in family health nursing, enabling the identification of common patterns, the understanding of singularities, and the implementation of effective, personalized, and culturally adapted interventions. The results confirm the strategic role of the family nurse in promoting positive parenting, reinforcing their function as facilitators of parental skills, mediators of family relationships, and coordinators of support networks within Primary Health Care. Keywords: Family Nursing, Family Health, Parenting, Primary Health Care
Abstract Introduction: The family is recognized as the basic unit of society and plays a central role in promoting the health and well-being of its members, constituting the first space for socialization, learning, and human development. Parenthood, as a critical transition in the family life cycle, entails profound changes in conjugal and parental dynamics, requiring role redefinition, reorganization of life projects, and reconfiguration of relational boundaries with both the family of origin and the community. This period, while challenging, also fosters growth and creates an increased need for support to ensure healthy adaptation and the promotion of positive parenting practices. Objectives: To assess families transitioning to parenthood according to the Dynamic Model of Family Assessment and Intervention (MDAIF), to identify emerging needs in each of its dimensions, to establish intervention plans tailored to the uniqueness of each family, and to monitor health gains. Methods: This multiple case study was based on the operational matrix of the MDAIF, which integrates structural, developmental, and functional family dimensions, along with assessment tools such as the genogram, ecomap, adapted Graffar scale, FACES II, and Family APGAR. Four families registered on the tutor nurse’s patient list were included, selected according to predefined criteria: pregnant women with gestational age ≥34 weeks and/or families with children up to six months as of October 1, 2024. All families gave written consent to participate in the Family2Care study. Data collection took place between October 2024 and January 2025, through home visits, child health consultations, and group sessions, complemented by the Systemic Family Interview. Results: The interventions implemented promoted health gains across the four families through empowerment to mobilize internal and external resources, reinforcement of parenting skills, and promotion of secure affective bonds. Case analysis showed that although the initial diagnosis was “Ineffective Parental Role,” the systematic intervention of the family nurse contributed to its evolution into “Effective Parental Role,” reflected in greater confidence, autonomy, and consistent discipline. The intergenerational support, particularly from grandparents, and the relevance of community articulation were highlighted as key factors in strengthening family resilience. Conclusion: The multiple case study and the MDAIF proved to be valuable methodological approaches in family health nursing, enabling the identification of common patterns, the understanding of singularities, and the implementation of effective, personalized, and culturally adapted interventions. The results confirm the strategic role of the family nurse in promoting positive parenting, reinforcing their function as facilitators of parental skills, mediators of family relationships, and coordinators of support networks within Primary Health Care. Keywords: Family Nursing, Family Health, Parenting, Primary Health Care
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Keywords
Cuidados primários de saúde Enfermagem de família Rntrevista como assunto Pais Responsabilidade parental Saúde da família Family health Family nursing Interview as topic Parenting Parents Primary health care
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