Resumo Objetivo estabelecer os contextos da experiência de estar (des)confortável, conforme percepções de pacientes com doença renal crônica, durante tratamento hemodialítico. Método estudo qualitativo, realizado em clínica de hemodiálise, entre maio e junho de 2018, com 30 pacientes com doença renal crônica, em tratamento hemodialítico, capazes de comunicar-se verbalmente. Utilizou-se da entrevista semiestruturada, com perguntas norteadoras que buscaram elucidar os contextos de experiência de sentir-se e estar confortável, baseadas no referencial teórico de Kolcaba. Dados submetidos à análise de conteúdo temática. Resultados emergiram quatro categorias analíticas, no tocante aos contextos de (des)conforto: físicos (imobilidade, hipotensão, dor, fome, cãibra, cansaço, poliúria, prurido, edema, sede); ambientais (luz, barulho, cadeira, frio); psicoespirituais (desespero, sensibilidade, isolamento social); e sociais (mudança de rotina). Considerações finais o significado do conforto para pacientes em tratamento hemodialítico se configurou como necessidade humana básica, pois os pacientes apresentaram desconfortos diários relacionados aos contextos físicos, ambientais, psicoespirituais e sociais. Implicações para a prática os resultados do estudo possibilitam que profissionais de saúde realizem assistência ao paciente renal crônico de forma holística, pautada na promoção do conforto.
Objective: to understand the meaning and dimensionality of state of comfort from chronic hemodialysis patients’ perspectives. Method: this is a qualitative study conducted with 30 patients from a hemodialysis clinic from May to June 2018. A semi-structured interview with guiding questions was used. Data were analyzed according to Bardin’s content analysis method, supported by Kolcaba’s theoretical framework. Results: five subcategories for being and feeling comfortable emerged: psychological well-being; Silent environment; Good quality of care; No health changes; Reduction in the frequency/duration of hemodialysis. Regarding dimensionality to achieve comfort, there were three subcategories according to the adopted states. Regarding dimensionality, relief is achieved when a patient is disconnected from the machine, does not attend any session or does not present clinical manifestations of hemodialysis complications. In calm, visible discomforts are linked to change of routine, abandonment of work activities, financial difficulties and poor family support, and psychospiritual issues that weaken in their daily life, making them vulnerable to discomfort. In transcendence, absence of symptoms, attachment to religion, faith or spirituality and resilience to the new routine figured as indexes. States do not act individually, they are related to the experiences of contexts. Conclusion: comfort has meaning of relief from discomfort, state of having met basic human needs, mental and physical well-being, physical, mental and environmental comfort, and final state of nursing therapeutic actions, which permeate the contexts and states of relief, calm, and transcendence. These elements combine with each other to generate unique responses.
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