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Abstract(s)
Enquadramento: O presente trabalho enquadra-se no Curso de Mestrado em Enfermagem
de Saúde Materna Obstetrícia e Ginecologia e Curso de Pós-Licenciatura de Especialização
em Enfermagem de Saúde Materna e Obstétrica composto por uma componente clínica e
uma componente de investigação. Assenta nos pressupostos inerentes ao desenvolvimento
de competências na área, tendo sido para tal necessário ter em conta o Regulamento de
competências comuns enumeradas no Regulamento das Competências Comuns,
Regulamento nº140/2019; e especificas, enumeradas no Regulamento de Competências
Específicas do Enfermeiro Especialista em Enfermagem de Saúde Materna e Obstétrica,
Regulamento nº391/2019; os padrões de qualidade dos cuidados especializados em
enfermagem de saúde materna e obstétrica; Diretiva 2013/55/UE do Parlamento Europeu e
do Conselho; Conceções teóricas e filosóficas nomeadamente a Teoria de Enfermagem de
Hildegard Peplau – Teoria das Relações Interpessoais em Enfermagem. Tendo por base uma
problemática da prática profissional, e a sua importância para a saúde das populações,
desenvolve-se um estudo primário sobre as experiências vividas por puérperas/casais e
Enfermeiros Especialistas em Enfermagem de Saúde Materna e Obstétrica nas visitas
domiciliares no pós-parto, no âmbito do aleitamento materno.
O título de Especialista em Enfermagem de Saúde Materna e Obstétrica exige o
desenvolvimento de um perfil de competências específicas ao Enfermeiro Especialista em
Enfermagem de Saúde Materna e Obstétrica e de competências comuns, com padrões de
qualidade nos diversos objetivos e intervenções de enfermagem, dependendo de cada projeto
de saúde da mulher. Para isso foi definido no 2º ano do Curso de Mestrado em Enfermagem
de Saúde Materna Obstetrícia e Ginecologia, – 7ª Edição um plano de estudo constituído por
um estágio com duração de 36 semanas que incorpora um trabalho de investigação, no
relatório final. Nas diferentes unidades de estágio são proporcionados contextos à aplicação
de conhecimentos pormenorizados em obstetrícia, ginecologia, farmacologia no domínio da
obstetrícia, recém-nascidos, relação entre o estado de saúde e o ambiente físico e social de
cada pessoa e do seu comportamento. Para além do estágio, constrói-se um relatório final no
âmbito da saúde materna obstétrica e ginecológica.
Objetivos: Na componente clínica, através das unidades de estágio com relatório final, tem se como objetivo geral a formação de Mestres e Especialistas em Enfermagem de Saúde
Materna e Obstétrica capazes de conceber, planear, executar e avaliar intervenções
relacionados à promoção da saúde reprodutiva e prestar cuidados especializados nos
diferentes projetos em cada fase da vida da mulher. Na componente de investigação, elabora se um relatório final com o objetivo de compreender a experiência vivida por puérperas/casais
e Enfermeiros/as Especialistas em Enfermagem de Saúde Materna e Obstétrica durante a
visita domiciliar no pós-parto, no âmbito do aleitamento materno.
Metodologia: Na componente clínica frequenta-se diferentes unidades de estágio com objetivos
específicos e número de experiências mínimas. No que se refere à componente de investigação,
desenvolve-se um estudo qualitativo, hermenêutico, com base nos pressupostos de Max Van
Manen, através de entrevistas a puérperas/casais e Enfermeiros Especialistas em Enfermagem de
Saúde Materna e Obstétrica, usando a técnica bola de neve.
Resultados: Na componente clínica, responde-se aos diferentes objetivos e intervenções de
cada unidade de estágio, com base nos padrões de qualidade dos cuidados especializados
em enfermagem de saúde materna e obstétrica, conforme o regulamento das competências
específicas e segundo a diretiva europeia. Na componente de investigação, apresenta-se um
estudo qualitativo, hermenêutico, seguindo os pressupostos de Max Van Manen com a
20
questão de investigação “Qual a experiência vivida por puérperas/casais e Enfermeiros/as
Especialistas em Enfermagem de Saúde Materna e Obstétrica durante a visita domiciliar no
pós-parto, no âmbito do aleitamento materno?”. Segundo a evidência científica há uma
diminuição do aleitamento materno devido às dificuldades e necessidades das
puérperas/casais, bem como à falta de apoio por parte dos profissionais de saúde
especializados após a alta hospitalar.
Conclusão: No que se refere à componente clínica alcança-se as experiências mínimas
expostas na diretiva nº2005/36/CE do Parlamento Europeu e do Conselho, transportada para
o direito interno português pela Lei 9/2009 de 4 março para o título de EEESMO, para além de
adquirir competências específicas de EEESMO, segundo o Regulamento nº391/2019. Na
componente de investigação, conclui-se que em Portugal existe uma grande lacuna ao nível das
visitas domiciliares no pós-parto, atualmente realizadas por enfermeiros de cuidados gerais com
pouca ou nenhuma formação em aleitamento materno. As mulheres/casais sentem-se desapoiadas
após a alta hospitalar, por não terem acompanhamento ou acompanhamento ineficaz no pós-parto,
acarretando consequências no sucesso, exclusividade e duração do aleitamento materno.
Palavras-chave: Unidade de estágio, cuidados especializados, enfermeiro especialista em
saúde materna e obstetra, amamentação, pós-parto, aleitamento materno.
Abstract Background: This work is part of the Master's Degree in Maternal Health, Obstetrics and Gynaecology Nursing and the Postgraduate Specialization Course in Maternal Health and Obstetrics Nursing, which consists of a clinical component and a research component. It is based on the assumptions inherent in the development of competences in the area, and for this it was necessary to take into account the Regulation of common competences listed in the Regulation of Common Competences, Regulation no. 140/2019; and specific, listed in the Regulation of Specific Competences of the Specialist Nurse in Maternal and Obstetric Health Nursing, Regulation nº391/2019; the quality standards of specialized care in maternal and obstetric health nursing; Directive 2013/55/EU of the European Parliament and of the Council; Theoretical and philosophical concepts, namely Hildegard Peplau's Nursing Theory - Theory of Interpersonal Relationships in Nursing. Based on a problem of professional practice and its importance for the health of the population, a primary study was carried out on the experiences of puerperal women/couples and specialist nurses in Maternal and Obstetric Health Nursing during home visits in the postpartum period, in the context of breastfeeding. The title of specialist in Maternal and Obstetric Health Nursing requires the development of a profile of competences specific to the Specialist Nurse in Maternal and Obstetric Health Nursing and of common competences, listed in the Regulation of the Specific Competences of the Specialist Nurse in Maternal and Obstetric Health Nursing, with quality standards in the various nursing objectives and interventions, depending on each woman's health project. To this end, the 2nd year of the Master's Degree in Maternal Health Nursing - Obstetrics and Gynecology, 7th Edition has defined a study plan consisting of a 36-week internship that incorporates research work in the final report. In the different internship units, contexts are provided for the application of detailed knowledge in obstetrics, gynecology, pharmacology in the field of obstetrics, newborns, the relationship between the state of health and the physical and social environment of each person and their behavior. In addition to the internship, a final report is written on maternal obstetric and gynecological health. Objectives: In the clinical component, through the internship units with a final report, the general objective is to train Masters and Specialists in Maternal and Obstetric Health Nursing capable of designing, planning, executing and evaluating interventions related to the promotion of reproductive health and providing specialized care in the different projects at each stage of a woman's life. In the research component, a final report will be drawn up with the aim of understanding the experience lived by puerperal women/couples and Maternal and Obstetric Health Nurse Specialists during the postpartum home visit, in the context of breastfeeding. Methodology: In the clinical component, different internship units are carried out with specific objectives and a minimum number of experiences. As far as the research component is concerned, a qualitative, hermeneutic study is carried out, based on Max Van Manen's assumptions, through interviews with puerperal women/couples and Nurses Specializing in Maternal and Obstetric Health Nursing, using the snowball technique. Results: In the clinical component, the different objectives and interventions of each internship unit are answered, based on the quality standards of specialized care in maternal health and obstetric nursing, according to the regulation of specific competences and according to the European directive. In the research component, a qualitative, hermeneutic study is presented, following Max Van Manen's assumptions with the research question “What is the lived experience of puerperal women/couples and Maternal and Obstetric Health Nursing 22 Specialists during the postpartum home visit, in the context of breastfeeding?”. According to scientific evidence, there is a decrease in breastfeeding due to the difficulties and needs of puerperal women/couples, as well as the lack of support from specialized health professionals after hospital discharge. Conclusion: As far as the clinical component is concerned, the minimum experiences set out in Directive 2005/36/EC of the European Parliament and of the Council, which was transposed into Portuguese law by Law 9/2009 of March 4, are achieved for the title of EHESMO, in addition to acquiring specific EHESMO competencies, according to Regulation 391/2019. The research component concludes that there is a major gap in Portugal in terms of postpartum home visits, which are currently carried out by general care nurses with little or no training in breastfeeding. Women/couples feel unsupported after being discharged from hospital because they have no follow-up or ineffective follow-up in the postpartum period, with consequences for the success, exclusivity and duration of breastfeeding. Keywords: Internship unit, specialized care, nurse specialist in maternal health and obstetrics, breastfeeding, postpartum, breastfeeding.
Abstract Background: This work is part of the Master's Degree in Maternal Health, Obstetrics and Gynaecology Nursing and the Postgraduate Specialization Course in Maternal Health and Obstetrics Nursing, which consists of a clinical component and a research component. It is based on the assumptions inherent in the development of competences in the area, and for this it was necessary to take into account the Regulation of common competences listed in the Regulation of Common Competences, Regulation no. 140/2019; and specific, listed in the Regulation of Specific Competences of the Specialist Nurse in Maternal and Obstetric Health Nursing, Regulation nº391/2019; the quality standards of specialized care in maternal and obstetric health nursing; Directive 2013/55/EU of the European Parliament and of the Council; Theoretical and philosophical concepts, namely Hildegard Peplau's Nursing Theory - Theory of Interpersonal Relationships in Nursing. Based on a problem of professional practice and its importance for the health of the population, a primary study was carried out on the experiences of puerperal women/couples and specialist nurses in Maternal and Obstetric Health Nursing during home visits in the postpartum period, in the context of breastfeeding. The title of specialist in Maternal and Obstetric Health Nursing requires the development of a profile of competences specific to the Specialist Nurse in Maternal and Obstetric Health Nursing and of common competences, listed in the Regulation of the Specific Competences of the Specialist Nurse in Maternal and Obstetric Health Nursing, with quality standards in the various nursing objectives and interventions, depending on each woman's health project. To this end, the 2nd year of the Master's Degree in Maternal Health Nursing - Obstetrics and Gynecology, 7th Edition has defined a study plan consisting of a 36-week internship that incorporates research work in the final report. In the different internship units, contexts are provided for the application of detailed knowledge in obstetrics, gynecology, pharmacology in the field of obstetrics, newborns, the relationship between the state of health and the physical and social environment of each person and their behavior. In addition to the internship, a final report is written on maternal obstetric and gynecological health. Objectives: In the clinical component, through the internship units with a final report, the general objective is to train Masters and Specialists in Maternal and Obstetric Health Nursing capable of designing, planning, executing and evaluating interventions related to the promotion of reproductive health and providing specialized care in the different projects at each stage of a woman's life. In the research component, a final report will be drawn up with the aim of understanding the experience lived by puerperal women/couples and Maternal and Obstetric Health Nurse Specialists during the postpartum home visit, in the context of breastfeeding. Methodology: In the clinical component, different internship units are carried out with specific objectives and a minimum number of experiences. As far as the research component is concerned, a qualitative, hermeneutic study is carried out, based on Max Van Manen's assumptions, through interviews with puerperal women/couples and Nurses Specializing in Maternal and Obstetric Health Nursing, using the snowball technique. Results: In the clinical component, the different objectives and interventions of each internship unit are answered, based on the quality standards of specialized care in maternal health and obstetric nursing, according to the regulation of specific competences and according to the European directive. In the research component, a qualitative, hermeneutic study is presented, following Max Van Manen's assumptions with the research question “What is the lived experience of puerperal women/couples and Maternal and Obstetric Health Nursing 22 Specialists during the postpartum home visit, in the context of breastfeeding?”. According to scientific evidence, there is a decrease in breastfeeding due to the difficulties and needs of puerperal women/couples, as well as the lack of support from specialized health professionals after hospital discharge. Conclusion: As far as the clinical component is concerned, the minimum experiences set out in Directive 2005/36/EC of the European Parliament and of the Council, which was transposed into Portuguese law by Law 9/2009 of March 4, are achieved for the title of EHESMO, in addition to acquiring specific EHESMO competencies, according to Regulation 391/2019. The research component concludes that there is a major gap in Portugal in terms of postpartum home visits, which are currently carried out by general care nurses with little or no training in breastfeeding. Women/couples feel unsupported after being discharged from hospital because they have no follow-up or ineffective follow-up in the postpartum period, with consequences for the success, exclusivity and duration of breastfeeding. Keywords: Internship unit, specialized care, nurse specialist in maternal health and obstetrics, breastfeeding, postpartum, breastfeeding.
Description
Keywords
Aleitamento materno Cônjuges Enfermagem obstétrica Enfermeiros obstetras Entrevista como assunto Puerpério Serviços de cuidados domiciliários Breast feeding Home care services Interview as topic Nurse midwives Obstetric nursing Postpartum period Spouses