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Projeto de intervenção em enfermagem de reabilitação : Projeto Learn2Care
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Introdução: A perda de massa, força e qualidade muscular, associadas ao envelhecimento,
frequentemente resulta em diminuição da mobilidade e declínio funcional, condicionando
dependência nas atividades de vida diária, podendo acarretar complicações físicas e
psicossociais, com afetação da qualidade de vida de forma irreversível. Esta condição,
associada à inatividade, frequentemente verificada durante o internamento hospitalar, conduz a
um aumento de dias de internamento, aumento do risco de quedas, acarretando maior
morbilidade e mortalidade.
Objetivo: Desenvolver um Projeto de Intervenção em Enfermagem de Reabilitação dirigido à
pessoa internada (Projeto Learn2Care) e avaliar os ganhos obtidos com a sua implementação.
Métodos: Foi desenvolvido um Trabalho de Projeto que utilizou o trabalho de campo, a
observação e a entrevista como instrumentos de recolha dados. Posteriormente foi feito um
estudo descritivo, retrospetivo de natureza quantitativa. Incluídas pessoas internadas num
serviço de Medicina Interna duma unidade hospitalar da região centro de Portugal, com critérios
de inclusão no programa. Foram aplicados os instrumentos de avaliação: Índice de Barthel,
Escala de Braden, Escala de Morse, Medical Research Council Scale (MRCS), Escala de
Avaliação do Equilíbrio (integrado no Sclínico), Sit To Stand (STS) em 30 s e Timed Up and
Go Test (TUGT) em 3 momentos: Internamento (M0- avaliação inicial) e (M1- avaliação no
momento da alta) e Consulta de Follow up (FUp) (M2 – Follow up).
Resultados: O Trabalho de Projeto permitiu o desenvolvimento de um Projeto de Intervenção
em Enfermagem de Reabilitação (Projeto Learn2Care), cuja implementação abrangeu 19
pessoas internadas. Após a intervenção do Enfermeiro de Reabilitação verificou-se uma
variação positiva significativa na média de valores da força muscular (t=0,726; p<0,001) e uma
variação positiva de 21% nos valores do equilíbrio, ainda que sem significância estatística
(H=4,430; p=0,109). Observaram-se ganhos significativos na capacidade de sentar e levantar
(t=0,863; p<0,001), no teste de marcha (t=0,870; p<0,001), na Independência funcional
(t=0,657; p=0,002), no risco de queda (t=0,731; p<0,001) e risco de desenvolvimento de úlcera
de pressão (t=0,547; p=0,015), confirmando a eficácia da intervenção.
Conclusões: As pessoas internadas inseridas no Programa Learn2Care apresentaram uma
melhoria da força muscular, equilíbrio, marcha e independência funcional, traduzido pela
evolução favorável dos instrumentos de avaliação aplicados, contribuindo positivamente para
ganhos em saúde.
Palavras Chave: Enfermagem de Reabilitação, familiar cuidador, capacitação, continuidade
de cuidados.
Abstract Introduction: The loss of muscle mass, strength, and quality associated with aging often results in decreased mobility and functional decline, leading to dependence on activities of daily living and potentially leading to physical and psychosocial complications, with irreversible impacts on quality of life. This condition, coupled with inactivity, often observed during hospitalization, leads to increased length of stay, increased risk of falls, and increased morbidity and mortality. Objective: To develop a Rehabilitation Nursing Intervention Project addressed to the hospitalized person (Learn2Care Project) and evaluate the benefits obtained from its implementation. Methods: A project was developed using fieldwork, observation, and interviews as data collection tools. Subsequently, a descriptive, retrospective, quantitative study was conducted. Patients admitted to an Internal Medicine department of a hospital in central Portugal met the program's inclusion criteria. The following assessment instruments were applied: Barthel Index, Braden Scale, Morse Scale, Medical Research Council Scale (MRCS), Balance Assessment Scale (integrated with the Clinical Scale), 30-s Sit-to-Stand (STS), and Timed Up and Go Test (TUGT) at three time points: Admission (M0 - initial assessment) and (M1 - discharge assessment), and Follow-up Consultation (FUp) (M2 - Follow-up). Results: The project work allowed the development of a Rehabilitation Nursing Intervention Project (Learn2Care Project), whose implementation covered 19 inpatients. After the Rehabilitation Nurse's intervention, there was a significant positive change in the mean muscle strength values (t=0.726; p<0.001) and a 21% positive change in balance values, although not statistically significant (H=4.430; p=0.109). Significant gains were observed in the ability to sit and stand (t=0.863; p<0.001), the gait test (t=0.870; p<0.001), functional independence (t=0.657; p=0.002), fall risk (t=0.731; p<0.001), and pressure ulcer risk (t=0.547; p=0.015), confirming the effectiveness of the intervention. Conclusions: Hospitalized individuals enrolled in the Learn2Care Program showed improvements in muscle strength, balance, gait, and functional independence, reflected in the favorable progress of the assessment instruments applied, contributing positively to health gains. Keywords: Rehabilitation Nursing, family caregiver, training, continuity of care.
Abstract Introduction: The loss of muscle mass, strength, and quality associated with aging often results in decreased mobility and functional decline, leading to dependence on activities of daily living and potentially leading to physical and psychosocial complications, with irreversible impacts on quality of life. This condition, coupled with inactivity, often observed during hospitalization, leads to increased length of stay, increased risk of falls, and increased morbidity and mortality. Objective: To develop a Rehabilitation Nursing Intervention Project addressed to the hospitalized person (Learn2Care Project) and evaluate the benefits obtained from its implementation. Methods: A project was developed using fieldwork, observation, and interviews as data collection tools. Subsequently, a descriptive, retrospective, quantitative study was conducted. Patients admitted to an Internal Medicine department of a hospital in central Portugal met the program's inclusion criteria. The following assessment instruments were applied: Barthel Index, Braden Scale, Morse Scale, Medical Research Council Scale (MRCS), Balance Assessment Scale (integrated with the Clinical Scale), 30-s Sit-to-Stand (STS), and Timed Up and Go Test (TUGT) at three time points: Admission (M0 - initial assessment) and (M1 - discharge assessment), and Follow-up Consultation (FUp) (M2 - Follow-up). Results: The project work allowed the development of a Rehabilitation Nursing Intervention Project (Learn2Care Project), whose implementation covered 19 inpatients. After the Rehabilitation Nurse's intervention, there was a significant positive change in the mean muscle strength values (t=0.726; p<0.001) and a 21% positive change in balance values, although not statistically significant (H=4.430; p=0.109). Significant gains were observed in the ability to sit and stand (t=0.863; p<0.001), the gait test (t=0.870; p<0.001), functional independence (t=0.657; p=0.002), fall risk (t=0.731; p<0.001), and pressure ulcer risk (t=0.547; p=0.015), confirming the effectiveness of the intervention. Conclusions: Hospitalized individuals enrolled in the Learn2Care Program showed improvements in muscle strength, balance, gait, and functional independence, reflected in the favorable progress of the assessment instruments applied, contributing positively to health gains. Keywords: Rehabilitation Nursing, family caregiver, training, continuity of care.
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Palavras-chave
Enfermagem de reabilitação Prestadores de cuidados - ensino Promoção da saúde Caregivers - education Health promotion Rehabilitation nursing