Fabíola Vládia Freire da Silva

CUIDADO DE ENFERMAGEM A PESSOAS COM HIPERTENSÃO FUNDAMENTADO NA TEORIA DE PARSE

Resumen This study proposes the nursing care, based on Parse’s principles, to people with hypertension assisted in the Family Health Strategy. Descriptive study of qualitative approach carried out from March to May 2011, with fourteen nurses in the municipality of Itapajé-CE, Brazil. For data collection we used semi-structured interview and for analysis we used the subjects’ discourse. Three categories emerged based on Parse’s principles: The multidimensional meanings – the nurse leads to the meanings report; Synchronization of rhythms – the nurse helps identifying harmony and disharmony; Mobilization of transcendence – the nurse guides the plan of changes. It was verified the approach of discourses to Parse’s theory when mentioned seeking a humanized care, with family participation, valuing autonomy, use of health education, with individual orientations. It was noticed the viability in the implementation of nursing care based on Parse’s theory to people with hypertension.Este estudo propoe o cuidado de enfermagem, baseado nos principios de Parse, a pessoas com hipertensao consultadas na Estrategia Saude da Familia. Estudo descritivo, de cunho qualitativo, realizado de marco a maio de 2011, com quatorze enfermeiros no municipio de Itapaje-Ceara. Para coleta das informacoes utilizou-se a entrevista semiestruturada e, para analise, o discurso dos sujeitos. Emergiram tres categorias baseadas nos principios de Parse: Multidimensao dos significados - o enfermeiro conduz ao relato dos significados; Sincronizacao de ritmos - o enfermeiro ajuda a identificar harmonia e desarmonia; Mobilizacao da transcendencia - o enfermeiro guia o plano de mudancas. Notou-se aproximacao dos discursos ao teorizado por Parse quando citaram buscar um cuidado humanizado, com a participacao da familia, valorizacao da autonomia, utilizacao da educacao em saude, com orientacoes individuais. Percebeu-se a viabilidade na implementacao do cuidado de enfermagem fundamentado na Teoria de Parse a pessoas com hipertensao.

Contribuição do cuidado transpessoal ao ser-cardiopata no pós-operatório de cirurgia cardíaca

Objetivo: Conhecer a contribuicao da teoria de Watson para o cuidado de enfermagem dirigido ao ser com cardiopatia no pos-operatorio de cirurgia cardiaca. Metodos: Pesquisa qualitativa, por meio do metodo de pesquisa-cuidado, realizado com dez pessoas que realizaram cirurgia cardiaca em um hospital especializado, de junho a agosto de 2013, no municipio de Fortaleza-CE. Os dados foram submetidos a analise de conteudo, com base no processo Clinical Caritas . Resultados: Foram construidas quatro categorias tematicas: Consciencia de ser cuidado por outro ser, Sistema de crencas e subjetividade, Relacao de ajuda-confianca e Expressao dos sentimentos. Compreendeu-se que a realizacao da cirurgia acarretou transformacoes na vida dos pesquisados-cuidados, as quais foram relacionadas ao processo de serem cuidados por outras pessoas. Consideracoes Finais: Concluiu-se que, ao utilizar a teoria de Watson no cuidado ao ser com cardiopatia no pos-operatorio, foi possivel compreender a importância do cuidado transpessoal para expansao dos cuidados da enfermeira. Palavras-chave: Teoria de enfermagem. Cardiopatias. Cuidados de enfermagem. Cirurgia toracica.OBJECTIVE To know the contribution of Watsons theory to nursing care for cardiac patients in the postoperative period of cardiac surgery. METHODS This is a qualitative study based on the research-care method conducted with ten patients who underwent cardiac surgery in a specialised hospital from June to August 2013, in the city of Fortaleza, Ceará, Brazil. Data were submitted to content analysis based on the Clinical Caritas Process. RESULTS The results led to four thematic categories: Awareness of being cared for by another being, System of beliefs and subjectivity, Relation of support and trust, and Expression of feelings. Surgery transformed the lives of the patients related to the process of being cared for by other people. FINAL CONSIDERATIONS The application of Watsons theory to care for cardiac patients after heart surgery shed valuable light on the importance of transpersonal care for the expansion of nursing care.

Cuidado de enfermagem no domicílio ao paciente com insuficiência cardíaca: revisão integrativa Nursing care at home patient with heart failure: integrative review

Objetivo: Analisar a producao cientifica acerca do cuidado de enfermagem no domicilio ao paciente com insuficiencia cardiaca. Metodo: O levantamento dos artigos ocorreu pela consulta a periodicos de enfermagem, com publicacoes disponiveis online e na integra, indexadas nas bases de dados LILACS e MEDLINE. Foram identificados 599 artigos, dos quais 17 compuseram a amostra do estudo. Resultados: Os textos originaram as seguintes categorias: cuidado domiciliar, equipe de saude no cuidado domiciliar e propostas para melhor qualidade do atendimento. Conclusao: Considera-se importante o despertar para a necessidade de maiores investimentos e pesquisas nesta area, que mostrou-se uma proposta bastante positiva de cuidado humanizado, pois possibilita ao paciente estar no conforto do seu lar, contando com o apoio da sua familia, alem de incentivar o autocuidado e possibilitar maior autonomia. Descritores: Literatura de Revisao como Assunto; Cuidados de Enfermagem; Insuficiencia Cardiaca.

Vital signs and nursing procedures in postoperative period of cardiac surgery

Objective: developing a comparative analysis of the vital signs of patients after cardiac surgery by exposure to bed bath and renewal of dressings. Method: an exploratory descriptive study with a quantitative approach, conducted in the ICU postoperative cardiac surgeries with 18 patients. As a tool for data collection, we used a form, administered before and after nursing procedures, and then, were stored in Microsoft Excel, version Windows Vista, and processed using SPSS version 14.0, organized on a worksheet. The research project was approved by the Research Ethics Committee, Opinion n. 08133595-4. Results: according to evidencing the diversity of values of vital signs recorded after performing nursing procedures, interventions implemented reproduce differentiated biological changes. Conclusion: nursing care given to the patient should consider, beyond the subjectivity of the patient, the potential to cause changes in their physiological responses. Descriptors: Nursing Care; Vital Signs; Postoperative Care. RESUMO Objetivo: desenvolver uma análise comparativa dos sinais vitais de pacientes em pós-operatório de cirurgia cardíaca mediante a exposição ao banho no leito e renovação de curativos. Método: estudo descritivoexploratório, com abordagem quantitativa, realizado na Unidade de Terapia Intensiva de pós-operatório de cirurgias cardíacas com 18 pacientes. Como instrumento para coletar os dados, usou-se um formulário, aplicado antes e após os procedimentos de enfermagem; em seguida, foram armazenados no programa Microsoft Excel, versão Windows Vista, e processados no programa SPSS versão 14.0, organizados em planilha. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, parecer no 08133595-4. Resultados: segundo evidenciou a diversidade de valores de sinais vitais, constatados após a realização dos procedimentos de enfermagem, as intervenções executadas reproduzem alterações biológicas diferenciadas. Conclusão: os cuidados de enfermagem dispensados ao paciente devem considerar, além da subjetividade do paciente, a potencialidade de ocasionar modificações nas suas respostas fisiológicas. Descritores: Cuidados de Enfermagem; Sinais Vitais; Cuidados Pós-Operatórios. RESUMEN Objetivo: desarrollar un análisis comparativo de los signos vitales de los pacientes después de la cirugía cardíaca por la exposición al baño en la cama y la renovación de los apósitos. Método: un estudio descriptivo exploratorio con abordaje cuantitativo, realizado en la Unidad de Terapia Intensiva de postoperatorio de cirugías cardiacas con 18 pacientes. Como una herramienta para recopilar los datos, se utilizó un formulario, administrado antes y después de los procedimientos de enfermería, y después se almacenaron en el programa Microsoft Excel, versión de Windows Vista, y procesados en el programa SPSS versión 14.0, organizados en una hoja de cálculo. El proyecto de investigación fue aprobado por el Comité de Ética de Investigación, Opinión No. 08133595-4. Resultados: De acuerdo con el destacado, la diversidad de los valores de las constantes vitales registrados después de realizar los procedimientos de enfermería, las intervenciones implementadas reproducen cambios biológicos diferenciados. Conclusión: debe considerar la atención proporcionada al paciente, más allá de la subjetividad del paciente, el potencial de provocar cambios en sus respuestas fisiológicas. Descriptores: Cuidados de Enfermería; Signos Vitales; Cuidados Postoperatorios. Nurse, Professor of Nursing, School of Graduate in Nursing / Postgraduate Program in Clinical Care Nursing and Health, State University of Ceará/PPCCLIS/UECE. Nurse of the Hospital of Messejana Dr. Carlos Alberto Studart Gomes. Fortaleza (CE), Brazil. E-mail: luciadefatima.ce@terra.com.br; Nurse, Master of Clinical Nursing, Nurse at the District Hospital Gonzaga Mota (Messejana). Fortaleza (CE), Brazil. E-mail: adrianafamiranda2@yahoo.com.br; Nurse, Master of Clinical Nursing, Doctorate Student, Postgraduate Clinical Care in Nursing and Health, State University of Ceará/PPCCLIS/UECE. Fortaleza (CE), Brazil. E-mail: fabiolafreire@yahoo.com.br; Nurse, Master Student, Postgraduate Program in Clinical Care Nursing and Health, State University of Ceará/PPCCLIS/UECE. Scholarship Student of Ceará Foundation for Scientific and Technological Development/FUNCAP. Fortaleza (CE), Brazil. E-mail: anacleidesr@hotmail.com; Statistician, Professor in Public Health, School of Graduate Nursing / Postgraduate Program in Clinical Care Nursing and Health, State University of Ceará/PPCCLIS/UECE. Fortaleza (CE), Brazil. E-mail: pc49almeida@gmail.com; Nurse, Master of Clinical Nursing, Doctorate Student, Postgraduate Clinical Care in Nursing and Health, State University of Ceará/PPCCLIS/UECE. Scholarship Student of the Coordination for Improvement of Higher Education Personnel/CAPES. Fortaleza (CE), Brazil. E-mail: keilinhaponte@hotmail.com ORIGINAL ARTICLE Silva LF da, Miranda AFA, Silva FVF da et al. Vital signs and nursing procedures in... English/Portuguese J Nurs UFPE on line., Recife, 8(3):719-25, Mar., 2014 720 ISSN: 1981-8963 DOI: 10.5205/reuol.5149-42141-1-SM.0803201429 Cardiovascular diseases (CVD) are increasingly reaching a large portion of the population. In Brazil, CVDs are responsible for high morbidity and mortality and is the leading cause of death in adults. The treatment of cardiovascular problems has achieved therapeutic advances in both medical and surgical. Surgical treatment appears as a possibility of a better quality of life when clinical treatment no longer performs effect. The performance of a surgical procedure, especially the heart, involves a series of physical and psychological issues that are reflected in biological changes observed in a proper assessment of the complaints exhibited by the patient. Such organic manifestations resonate with clinical data analysis, which can be measured and observed. There are cited as a way to these physiological manifestations measures vital signs, which direct biological stability with changes in blood pressure, the heart and respiratory rates, and also influencing the body temperature as significant. Opportunities to assess the physiological changes based on changes in vital signs are promising when associated with the presence of certain procedures, which appear to interfere in the changes of blood pressure (BP), heart rate (HR), respiratory rate (RR) and temperature (T). The realization of the bed bath and renewal of dressings are examples of procedures considered clinical nursing care aimed at the welfare and comfort that contribute to the satisfactory evolution of the state of health of the person in postoperative. By observing the inconvenience of providing the sick, during its execution, greater metabolic demand, the realization of these procedures has sparked interest and the following question: there are changes in vital signs during its occurrence? Thus, it was established that observation bed bath and dressing changes to confer the discomfort with nursing procedures, and hence its impact on vital signs. This led the authors to construct the hypothesis that patients who experience major annoyances, such as more intense and/or exposure privacy pain when undergoing wound dressing and bed bath, have larger changes in vital signs. Are called vital signs measurements of blood pressure, heart and respiratory rates and body temperature. For blood pressure means the force exerted by the blood on the inside of the arteries. Their values can be technically measured with the aid of sphygmomanometers and stethoscopes . As stated in the VI Brazilian Guidelines on Hypertension pressure, measures of BP in people above 18 years old are satisfactory when the systolic blood pressure (SBP), which demonstrates the myocardial contraction, comes in values between 130-139 mmHg and diastolic blood pressure (DBP), which represents the cardiac relaxation in the filling of blood through the heart, oscillates within 85-89 mmHg. The evaluation values of respiratory frequency based on the amount of ventilation given in person during one minute. These values are acceptable when, in the adults, these results are reported in the range of 1418 breaths per minute (bpm) for males and 16-20 (bpm) for women. On the external body temperature refers to heat produced by the body to maintain the body homeostasis, which allows adults to suitable values between 36,4°C and 37,3°C (axillary measurement), with the central regulation of the hypothalamic temperature. According to studies, the heart rate is assessed by curling palpable feeling in peripheral arteries, produced by ventricular contractions in one minute. In the adult, it is usually in the range of 60-100 beats per minute. As proposed, the observation by nurses, behavioral and physiological aspects is essential for the identification of pathological changes. Even before verbal hindrance for a broad interpretation of the symptoms reported by the patient, analysis of associated physiological signals , in the form of tachycardia, increased blood pressure, tachypnea, pallor, sweating or changes in muscle tension may be suggestive of postoperative responses inadequate. From these references it can be considered that the performance of nursing procedures such as bed bath and dressing changes, are elements that generate differentiated physiological responses in patients after cardiac surgery. The analysis of this relationship constitutes a subject of this investigation. Based on advances in research in postoperative period, it is expected to collaborate for an expanded vision of clinical nursing in their proposal to carry out procedures, making this study feasible. ● Developing comparative analysis of the vital signs of patients after cardiac surgery by exposure to bed bath and renewal of dressings. INTRODUCTION

Nursing care to people with hypertension based on Parse's theory

Resumen This study proposes the nursing care, based on Parse’s principles, to people with hypertension assisted in the Family Health Strategy. Descriptive study of qualitative approach carried out from March to May 2011, with fourteen nurses in the municipality of Itapajé-CE, Brazil. For data collection we used semi-structured interview and for analysis we used the subjects’ discourse. Three categories emerged based on Parse’s principles: The multidimensional meanings – the nurse leads to the meanings report; Synchronization of rhythms – the nurse helps identifying harmony and disharmony; Mobilization of transcendence – the nurse guides the plan of changes. It was verified the approach of discourses to Parse’s theory when mentioned seeking a humanized care, with family participation, valuing autonomy, use of health education, with individual orientations. It was noticed the viability in the implementation of nursing care based on Parse’s theory to people with hypertension.Este estudo propoe o cuidado de enfermagem, baseado nos principios de Parse, a pessoas com hipertensao consultadas na Estrategia Saude da Familia. Estudo descritivo, de cunho qualitativo, realizado de marco a maio de 2011, com quatorze enfermeiros no municipio de Itapaje-Ceara. Para coleta das informacoes utilizou-se a entrevista semiestruturada e, para analise, o discurso dos sujeitos. Emergiram tres categorias baseadas nos principios de Parse: Multidimensao dos significados - o enfermeiro conduz ao relato dos significados; Sincronizacao de ritmos - o enfermeiro ajuda a identificar harmonia e desarmonia; Mobilizacao da transcendencia - o enfermeiro guia o plano de mudancas. Notou-se aproximacao dos discursos ao teorizado por Parse quando citaram buscar um cuidado humanizado, com a participacao da familia, valorizacao da autonomia, utilizacao da educacao em saude, com orientacoes individuais. Percebeu-se a viabilidade na implementacao do cuidado de enfermagem fundamentado na Teoria de Parse a pessoas com hipertensao.

Atención de enfermería a personas con hipertensión basada en la teoría de Parse

Resumen This study proposes the nursing care, based on Parse’s principles, to people with hypertension assisted in the Family Health Strategy. Descriptive study of qualitative approach carried out from March to May 2011, with fourteen nurses in the municipality of Itapajé-CE, Brazil. For data collection we used semi-structured interview and for analysis we used the subjects’ discourse. Three categories emerged based on Parse’s principles: The multidimensional meanings – the nurse leads to the meanings report; Synchronization of rhythms – the nurse helps identifying harmony and disharmony; Mobilization of transcendence – the nurse guides the plan of changes. It was verified the approach of discourses to Parse’s theory when mentioned seeking a humanized care, with family participation, valuing autonomy, use of health education, with individual orientations. It was noticed the viability in the implementation of nursing care based on Parse’s theory to people with hypertension.Este estudo propoe o cuidado de enfermagem, baseado nos principios de Parse, a pessoas com hipertensao consultadas na Estrategia Saude da Familia. Estudo descritivo, de cunho qualitativo, realizado de marco a maio de 2011, com quatorze enfermeiros no municipio de Itapaje-Ceara. Para coleta das informacoes utilizou-se a entrevista semiestruturada e, para analise, o discurso dos sujeitos. Emergiram tres categorias baseadas nos principios de Parse: Multidimensao dos significados - o enfermeiro conduz ao relato dos significados; Sincronizacao de ritmos - o enfermeiro ajuda a identificar harmonia e desarmonia; Mobilizacao da transcendencia - o enfermeiro guia o plano de mudancas. Notou-se aproximacao dos discursos ao teorizado por Parse quando citaram buscar um cuidado humanizado, com a participacao da familia, valorizacao da autonomia, utilizacao da educacao em saude, com orientacoes individuais. Percebeu-se a viabilidade na implementacao do cuidado de enfermagem fundamentado na Teoria de Parse a pessoas com hipertensao.

Experiences of mothers of children living with cardiopathies: a care research study

Objetivo: Analisar a vivencia de maes de criancas com cardiopatias a luz da Teoria do Cuidado Transpessoal. Metodo: Pesquisa-cuidado, de abordagem qualitativa, realizada em maio e junho de 2011. Amostra: 21 maes que acompanhavam seus filhos durante tratamento em um hospital especializado em adoecimento cardiopulmonar, em Fortaleza-Ceara. Resultados: A mae vivencia processos de transformacao na vida social por ter de se dedicar ao filho com cardiopatia, alem de enfrentar sentimentos como ansiedade, medo, tristeza e angustia pelo risco iminente de morte do filho. Para ter forca e sustentacao, ela utiliza a fe. Discussao: A utilizacao dos elementos do Processo Clinical Caritas colabora para o desenvolvimento do cuidado de enfermagem humanizado. Conclusao: A aplicabilidade desta teoria favorece a compreensao da experiencia da mae como cuidadora e como ser que necessita de cuidado