A importância da Consulta de Enfermagem de Estomaterapia na qualidade de vida da pessoa ostomizada na comunidade
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2014-01-31
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Uma ostomia pode causar profundas alterações na vida da pessoa e família, que se manifestam em desajustes físicos, psíquicos, emocionais e sociais, influenciando o processo de adaptação e a qualidade de vida (Nugent et al., 1999). Da revisão bibliográfica realizada, emergem vários instrumentos construídos com o intuito de avaliar a qualidade de vida da pessoa ostomizada. O primeiro remonta ao ano 1983, foi construído por Grant e cols. e designa-se “Quality of Life Index” (Grant et al., 2004). É neste âmbito que surge este estudo que tem como objetivo geral: Verificar a relação entre a qualidade de vida dos ostomizados e a consulta de enfermagem de estomaterapia, dirigida às pessoas portadoras de ostomia de eliminação intestinal.
Trata-se de um estudo transversal, com uma componente descritiva e outra correlacional, de abordagem quantitativa. A população é composta por 100 pessoas portadoras de ostomia de eliminação intestinal, número total de pessoas que frequenta a consulta de enfermagem de estomaterapia, às quais foi aplicado um questionário-entrevista, que inclui uma escala de avaliação da qualidade de vida. O tratamento dos dados foi efetuado através do programa informático Statistical Package for the Social Sciences 20.
A maioria dos questionados é do sexo masculino (68%), com uma média de idade de 68 anos e, antes da cirurgia, casados (75%). Em relação às habilitações académicas dos participantes, 54% tem o 1º ciclo do ensino básico, a maioria são reformados (78%), enquadrando-se na classe social média (83%). Constatamos que na sua maioria (67%) os respondentes apresentam uma perceção positiva da sua qualidade de vida e em sentido contrário, 33% uma perceção negativa. Os resultados mostraram-nos que existem correlações positivas entre os quatro domínios da qualidade de vida e a pontuação total da escala e que a perceção da qualidade de vida é influenciada pela etiologia, tipo de ostomia, número de consultas de estomaterapia frequentadas, preparação prévia e marcação do local do estoma. Os indivíduos ostomizados são da opinião que a consulta de enfermagem de estomaterapia contribuiu para aumentar os conhecimentos relacionados com a sua condição, melhoria da sua integridade cutânea e da sua adaptação à nova realidade de vida. As necessidades sentidas pela maioria dos participantes no estudo em contexto comunitário são: a dificuldade de gestão dos sentimentos; a aceitação da condição de ostomizado; a aquisição dos produtos de ostomia adequados à situação e respetivo reembolso quando indicado; e a falta de apoio no domicílio.
Perante os resultados do estudo, concluímos ter sido pertinente a criação da consulta de enfermagem de estomaterapia e a manutenção da mesma. Do estudo emerge ainda a importância da elaboração de um protocolo entre os cuidados de saúde diferenciados e os cuidados de saúde primários, que facilite a continuidade dos cuidados na comunidade à pessoa ostomizada, e a proposta de um plano formativo dirigido aos enfermeiros das unidades funcionais de saúde pertencentes aos Agrupamentos de Centros de Saúde da região.
An ostomy can cause profound changes in one's life and family, manifesting in imbalances physical, psychological, emotional and social, influencing the process of adaptation and quality of life (Nugent et al., 1999). From the literature review, several emerging tools built with the purpose of evaluating the person ostomy patient quality of life. The first dates back to 1983, was built by Grant and cols. and is called "Quality of Life Index" (Grant et al., 2004). It is in this context that this study appears that the general aims: To investigate the relationship between quality of life of ostomates and nursing consultation stomatherapy directed at people living with an ostomy for bowel elimination. This is a cross-sectional study with a descriptive component and other correlational, quantitative approach. The population is composed of 100 people with ostomy intestinal elimination, the total number of people attending the nursing consultation stomatherapy, to which was applied a questionnaire-interview, which includes a rating scale of quality of life. Data analysis was performed using the computer program Statistical Package for the Social Sciences 20. Most respondents are male (68%) with a mean age of 68 years and, prior to surgery, married (75%). Regarding the academic qualifications of the participants, 54% have the 1st cycle of basic education, most are retired (78%) and it fits in the middle class (83%). We found that the majority (67%) respondents have a positive perception of their quality of life and to the contrary, 33% a negative perception. The results showed us that there are positive correlations between the four domains of quality of life and total score. We also verified that the study group has a positive perception about their quality of life and that this perception is influenced by etiology, type of ostomy, stomatherapy number of appointments attended, prior preparation and marking of the stoma site. Individuals ostomates are of the opinion that the nursing consultation stomatherapy contributed to increasing knowledge related to their condition, improve their skin integrity and its adaptation to the new reality of life. The needs felt by most participants in the study in a community context are: the difficulty of managing feelings; acceptance condition of ostomy; acquisition of ostomy products appropriate to the situation and respective reimbursement when indicated, and the lack of support at home. Given the results of the study, we concluded it was appropriate to create a nursing consultation stomatherapy and maintenance of the same. Study emerges the importance of developing a protocol between hospital care and primary care that facilitates continuity of care in the community ostomy patient person and a proposed training plan aimed at nurses of the functional units of health belonging to Groupings Health Centre in the region.
An ostomy can cause profound changes in one's life and family, manifesting in imbalances physical, psychological, emotional and social, influencing the process of adaptation and quality of life (Nugent et al., 1999). From the literature review, several emerging tools built with the purpose of evaluating the person ostomy patient quality of life. The first dates back to 1983, was built by Grant and cols. and is called "Quality of Life Index" (Grant et al., 2004). It is in this context that this study appears that the general aims: To investigate the relationship between quality of life of ostomates and nursing consultation stomatherapy directed at people living with an ostomy for bowel elimination. This is a cross-sectional study with a descriptive component and other correlational, quantitative approach. The population is composed of 100 people with ostomy intestinal elimination, the total number of people attending the nursing consultation stomatherapy, to which was applied a questionnaire-interview, which includes a rating scale of quality of life. Data analysis was performed using the computer program Statistical Package for the Social Sciences 20. Most respondents are male (68%) with a mean age of 68 years and, prior to surgery, married (75%). Regarding the academic qualifications of the participants, 54% have the 1st cycle of basic education, most are retired (78%) and it fits in the middle class (83%). We found that the majority (67%) respondents have a positive perception of their quality of life and to the contrary, 33% a negative perception. The results showed us that there are positive correlations between the four domains of quality of life and total score. We also verified that the study group has a positive perception about their quality of life and that this perception is influenced by etiology, type of ostomy, stomatherapy number of appointments attended, prior preparation and marking of the stoma site. Individuals ostomates are of the opinion that the nursing consultation stomatherapy contributed to increasing knowledge related to their condition, improve their skin integrity and its adaptation to the new reality of life. The needs felt by most participants in the study in a community context are: the difficulty of managing feelings; acceptance condition of ostomy; acquisition of ostomy products appropriate to the situation and respective reimbursement when indicated, and the lack of support at home. Given the results of the study, we concluded it was appropriate to create a nursing consultation stomatherapy and maintenance of the same. Study emerges the importance of developing a protocol between hospital care and primary care that facilitates continuity of care in the community ostomy patient person and a proposed training plan aimed at nurses of the functional units of health belonging to Groupings Health Centre in the region.
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Dissertação de Mestrado em Enfermagem Comunitária
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Enfermagem em saúde comunitária , Qualidade de vida , Ostomia , Estomaterapia