ResumoEnquadramento: A confeção de um estoma constitui-se como um evento gerador de mudanças influenciado por diversos fatores, nomeadamente a presença de complicações do estoma e/ou pele periestomal. Estima-se que 80% das pessoas com ostomia experienciam, pelo menos, uma complicação relacionada com o estoma ao longo da sua vida. Objetivos: Identificar os fatores de risco associados ao desenvolvimento de complicações do estoma de eliminação e da pele periestomal. Metodologia: Revisão da literatura, com base na estratégia metodológica do Instituto Joanna Briggs para Scoping Reviews. Foram identificados 1492 artigos, sendo incluídos para análise 22. Resultados: A maioria dos fatores de risco para o desenvolvimento de complicações não é modificável. Dos sensí-veis à intervenção do enfermeiro evidenciam-se a educação pré e pós-operatória, a marcação do local do estoma e o acompanhamento após a alta hospitalar. Conclusão: O reconhecimento de fatores de risco associados ao desenvolvimento de complicações do estoma permite ao enfermeiro, por um lado, identificar precocemente indicadores de vulnerabilidade nos seus clientes e, por outro lado, intervir de forma mais efetiva. Palavras-chave: ostomia; fatores de risco; cuidados de enfermagem AbstractBackground: Stoma formation leads to changes that are influenced by several factors, namely the presence of stoma and/or peristomal skin complications. It is estimated that 80% of ostomy patients have at least one stoma-related complication throughout their life. Objectives: To identify the risk factors associated with the development of elimination stoma and peristomal skin complications. Methodology: Literature review, based on the methodological strategy of the Joanna Briggs Institute for scoping reviews. A total of 1,492 articles were identified, of which 22 were included for analysis. Results: Most of the risk factors for the development of complications are non-modifiable. Pre and postoperative education, stoma site marking, and follow-up after hospital discharge are some of the nursing-sensitive factors. Conclusion:The identification of risk factors associated with the development of stoma complications allows nurses to early identify patients' vulnerability indicators and intervene more effectively.
Aims and objectives: To map nursing interventions, their characteristics, and outcomes, in promoting self-care of the person with a tracheostomy. Background: The development of competencies in self-care of a person with a tracheostomy is recognised as one of the most significant nursing intervention areas for the promotion of autonomy, prevention of complications and adaptation. Identifying nursing interventions for the promotion of self-care of the person with a tracheostomy enables enhanced clinical practice knowledge within different care contexts and the identification of gaps in the available evidence. Design: The Joanna Briggs Institute (JBI) methodology was used to perform this scoping review. Method: A search was conducted on the CINAHL, Scopus, Web of Science, PubMed, JBI Database of Systematic Reviews and Implementation Reports, and Cochrane Database of Systematic Reviews. The search for grey literature included Portugal´s Open Access Scientific Repository, OpenGrey, and ProQuest Dissertations and Theses. Studies published in Portuguese, English, Spanish and French were included. The PRISMA-ScR checklist was used.Results: From a total of 4,224 identified articles, 31 were included in this review.Multiple nursing interventions were identified and grouped into four types of action: informing, managing, determining and attending. Although most interventions are implemented with the face-to-face method, there is a growing interest in using technologies for this purpose. The dose is the characteristic most poorly described in interventions. Various results were obtained; however, valid assessment tools were not always used.Conclusions: Designing and testing intervention programmes for the promotion of self-care of the person with a tracheostomy is necessary, based on available and robust evidence to guide clinical practice.Relevance to clinical practice: This review allowed to systematise nursing interventions to promote self-care of the person with a tracheostomy. The use of combined interventions and methodologies is likely to be more effective in care delivery.
Objectives: To identify nursing interventions, their characteristics, and outcomes for promoting self-care in candidates for a bowel elimination ostomy. Materials and methods: A scoping review was carried out based on the Joanna Briggs Institute’s recommendations. For this, studies published in Portuguese, English, and Spanish on the Web of Science, CINAHL, and Scopus databases and without a time limit were selected on November 9, 2020. Results: Of 2248 articles identified, 41 were included in this review. We identified 20 nursing interventions associated with the self-care of patients with an ostomy; most of them have gaps in their content, method, and frequency or dosing. More than 30 indicators were identified to assess the impact of nursing interventions; however, most of them were indirect assessments. Conclusion: There is scarce evidence regarding the different aspects that must be involved in nursing interventions for patients with a stoma. Moreover, there is no standardization in methods, frequency, or dosing of intervention. It is urgent to define the content, method, and frequency of nursing interventions necessary to promote self-care in patients with a bowel elimination ostomy and to use assessment tools that directly measure stoma self-care competence.
Enquadramento: O desenvolvimento da competência de autocuidado na pessoa com ostomia de ventilação é descrito como impulsionador de uma transição saudável para a vida com uma traqueostomia. Um instrumento que permita avaliar a competência de autocuidado na pessoa com ostomia de ventilação auxilia a tomada de decisão do enfermeiro e promove a melhoria dos cuidados. Objetivos: Construir um instrumento de avaliação da competência de autocuidado na pessoa com ostomia de ventilação. Metodologia: Estudo de investigação metodológico. A validade de conteúdo foi obtida através do julgamento de peritos, com uma metodologia de tipo focus group. A fidelidade foi avaliada através do coeficiente alpha de cronbach. O instrumento foi aplicado numa amostra com 80 participantes, cuja técnica de amostragem foi não probabilística de conveniência. Resultados: O estudo resultou num formulário constituído por 39 indicadores, organizados em 6 domínios, com boa consistência interna (alpha=0,89) e reconhecida validade de conteúdo. Conclusão: A versão final do formulário construído é aplicável, sendo-lhe conferido potencial para uma futura investigação da sua validade. Palavras-chave: Autocuidado; ostomia; traqueostomia; cuidados de enfermagem Marco contextual: El desarrollo de la competencia del autocuidado en personas con ostomía de ventilación es un factor que fomenta una transición saludable a la vida con una traqueostomía. Un instrumento para evaluar la competencia del autocuidado en la persona con una ostomía de ventilación ayuda en la toma de decisiones a los enfermeros y promueve la mejora de la atención. Objetivos: Desarrollar un instrumento para evaluar la competencia del autocuidado en personas con una ostomía de ventilación. Metodología: Investigación metodológica. La validez del contenido se obtuvo a través del juicio de expertos con un grupo de enfoque. La fidelidad se evaluó mediante el coeficiente alfa de Cronbach. El instrumento se aplicó a una muestra de 80 participantes y la técnica de muestreo fue no probabilística de conveniencia. Resultados: El estudio dio lugar a un formulario que consta de 39 indicadores, organizados en 6 áreas, que mostró buena consistencia interna (alfa = 0,89) y validez de contenido. Conclusión: La versión final del formulario es aplicable y tiene potencial para realizar futuras investigaciones sobre su validez. Palabras clave: Autocuidado; ostomía; traqueostomía; atención de enfermería Background: The development of the self-care competence in the person with a tracheostomy is described as a key driver for a healthy transition to life with a tracheostomy. An instrument for assessing the self-care competence of the person with a tracheostomy contributes to nurses' decision-making and promotes the quality of care. Objectives: To develop a tool for assessing the self-care competence of the person with a tracheostomy. Methodology: A methodological study was conducted. Content validity was obtained through the judgment of experts, with a focus group methodology. Reliability was assessed using Cronbac...
Background & Aim: The construction of an ostomy has a physical, psychological, and social impact, requiring the need to adapt. The way this event is experienced is influenced by several factors, namely ostomy self-care competence, the aspect most referred to in the literature. Nurses' specific and systematic intervention positively influences the person's adaptation to the ostomy. This study aimed to describe the perception of nurses and people with ostomies about promoting ostomy self-care. Methods & Materials: A qualitative descriptive study was conducted. Semi-structured interviews were conducted with ten nurses specializing in stoma therapy and twelve people with bowel elimination ostomy. Content analysis was performed according to Bardin with categorical analysis. Results: Two themes emerged from the interviews: the promotion of awareness, with three categories and four sub-categories, and the promotion of ostomy self-care, with five categories and twenty-four sub-categories. In promoting awareness, the participants mentioned key contents that could be included in the nurse’s approach: assessing awareness, content for promoting awareness, and awareness indicators. Within the scope of promoting self-care, categories emerged, such as the intervention standardization, the contents, the methodologies, and the resources to promote self-care. Conclusion: This study adds to evidence about promoting awareness of bowel elimination ostomy and self-care competence after the procedure. These results can be useful for nurses, allowing them to reflect on clinical practice and helping to improve the planning of their intervention in promoting stoma self-care.
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