Diagnósticos e intervenções de enfermagem para pacientes cardiológicos em cuidados paliativos

Abstract

RESUMOObjetivo: caracterizar o perfil clínico e sociodemográfico e identificar os principais diagnósticos e intervenções de Enfermagem. Método: trata-se de estudo quantitativo, transversal, retrospectivo e descritivo com 23 pacientes cardíacos com indicação de cuidados paliativos. Realizou-se a coleta de dados com um questionário. Submeteu-se o banco de dados à análise estatística. Resultados: caracterizou-se a amostra por pacientes do sexo feminino, com 70 anos, casados e com ensino fundamental completo, portadores de doença renal crônica, infarto agudo do miocárdio, miocardiopatia, hipertensão arterial e Diabetes Mellitus. Revela-se que os diagnósticos de Enfermagem “Deficit no autocuidado para a alimentação” e “Deficit no autocuidado para o banho” foram os mais frequentes. Detalha-se que suas intervenções foram o controle da nutrição, do ambiente, os cuidados com alimentação enteral, o posicionamento no leito, a massagem de conforto, os cuidados com unhas, cabelo e couro cabeludo, a manutenção da saúde oral e a realização de banho no leito. Conclusão: evidenciaram-se uma assistência pouco focada em aspectos espirituais e psicológicos e a falta de evidências, na literatura, que fortaleçam alguns diagnósticos e intervenções de Enfermagem específicos para a população estudada. Descritores: Enfermagem de Cuidados Paliativos; Insuficiência Cardíaca; Cuidado Paliativo; Enfermagem; Cardiologia; Unidade de Terapia Intensiva.ABSTRACT Objective: to characterize the clinical and sociodemographic profile and to identify the main Nursing diagnoses and interventions. Method: this is a quantitative, cross-sectional, retrospective and descriptive study with 23 cardiac patients with indication of palliative care. Data was collected with a questionnaire. The database was submitted to statistical analysis. Results: the sample was characterized by female patients, 70 years old, married and with complete primary education, with chronic kidney disease, acute myocardial infarction, myocardiopathy, hypertension and Diabetes Mellitus. It is revealed that the Nursing diagnoses "Deficit in self-care for eating" and "Deficit in self-care for bathing" were the most frequent. Their interventions included control of nutrition, the environment, enteral feeding care, bed placement, comfort massage, nail care, hair and scalp care, oral health maintenance, and bath in bed. Conclusion: there was a lack of care focused on spiritual and psychological aspects and the lack of evidence in the literature that strengthens some specific Nursing diagnoses and interventions for the studied population. Descriptors: Nursing Palliative Care; Heart Failure; Palliative Care; Nursing; Cardiology; Intensive Care Unit.RESUMEN Objetivo: caracterizar el perfil clínico y sociodemográfico, identificar los principales diagnósticos e intervenciones de enfermería. Método: estudio cuantitativo, transversal, retrospectivo y descriptivo, con 23 pacientes cardiacos con indicación de cuidados paliativos. Se realizó la recolección de datos con un cuestionario. Se sometió la base de datos al análisis estadístico. Resultados: se caracterizó la muestra por pacientes del sexo femenino, con 70 años, casados, y con enseñanza fundamental completa, portadores de enfermedad renal crónica, infarto agudo de miocardio, miocardiopatía, hipertensión arterial y diabetes mellitus. Los diagnósticos de enfermería "Déficit en el autocuidado para alimentación" y "Déficit en el autocuidado para baño", fueron los más frecuentes. Sus intervenciones fueron el control de la nutrición, del ambiente, cuidados con alimentación entera, colocación en el lecho, masaje de confort, cuidados con uñas, cabello y cuero cabelludo, mantenimiento de la salud oral y realización de baño en el lecho. Conclusión: se evidenció una asistencia poco enfocada en aspectos espirituales y psicológicos y falta de evidencias en la literatura que fortalezcan algunos diagnósticos e intervenciones de enfermería específicas para la población estudiada. Descriptores: Enfermería de Cuidados Paliativos; Insuficiencia cardíaca; Cuidado Paliativo; Enfermería; Cardiología; Unidad de terapia intensiva.

Nursing diagnoses in patients under palliative care: an integrative Review

“…Consequently, it is of paramount importance the follow-up of patients under PC and the need to ensure that their relatives understand that they will never be abandoned. 37 With regard to the ND 'Impaired physical mobility' , a study 25 pointed out "activity intolerance" and the "prescribed restrictions on movement" as related factors. This ND is characterized by dyspnea on effort, difficulty in turning around, and uncoordinated movements.…”

Nursing diagnoses representative of the demand for care in hospitalized elderly people / Diagnósticos de enfermagem representativos da demanda de cuidados em pessoas idosas hospitalizadas

“…It is the role of nursing to recognize such changes, considering the wear and tear of the organic system, as well as the specific differences of each individual under palliative care, meeting the needs of the elderly, in the hospital environment. 20 Elderly impaired bed mobility is defined as "limitation of independent movement from one position to another in the bed". 8 In this regard, a survey found that 83.4% of elderly people in hospital were diagnosed with nursing.…”

“…8 In accordance with the present research, studies have pointed out the prevalence of the diagnosis risk of integrity of damaged skin in hospitalized elderly people. 17 , 20 Analyzing the aforementioned nursing diagnosis, it is emphasized that such risk corroborates the occurrence of integrity of damaged skin, defined as "epidermis and/or dermis altered". 8 The impaired physical mobility was also another diagnosis that was highlighted in this study.…”

Palliative Care in Heart Failure: An Integrative Review of Nurse Practice

“…The approach in the control of physical symptoms was the category most frequently addressed in the studies that make up this integrative review. [21][22][23]25,[27][28][29][30][31][32] For the relief of symptoms, it is necessary first to recognize them and understand how they affect the patient's routine. To make this assessment, one can make use of symptom assessment instruments, such as the Edmonton Symptom Assessment Scale (ESAS).…”