O Papel do enfermeiro na adesão ao tratamento de pessoas com transtorno afetivo bipolar: o que os registros dizem?

Abstract

Trata-se de estudo descritivo-exploratório que descreve o papel do enfermeiro na adesão ao tratamento da pessoa com transtorno afetivo bipolar (TAB), através do levantamento de registros feitos por estudantes e enfermeiras nos prontuários, e aplicação de uma escala em um serviço comunitário de saúde mental. Utilizou-se a metodologia clínicoqualitativa e, como instrumento de coleta, um diário de campo. A escala foi aplicada no primeiro e último contato com cinco sujeitos do interior paranaense, no período de um mês, em 2010. Percebeu-se uma evolução mais significativa na adesão ao tratamento em somente uma das pacientes. Os registros não relatam conduta de enfermagem na maioria das vezes e possuem aspectos da psiquiatria organicista em sua descrição. O enfermeiro deve registrar suas intervenções e resultados adequadamente.

The applicability of the nursing process in caring for psychiatric patients: an integrative review

“…Thus, one of the studies analyzed showed that the nurse in a care home, a communitybased service, used the NP in the treatment of one of the residents with a long-standing mental disorder, resulting in an improvement in the clinical status (14) , in this way, in the context of psychiatric nursing care, the focus of the NP is aimed a goals and based on a decision-making or problem resolving model that aims to improve patients' response to health problems and, in the patient in question, the goal was to better deal with their psychological suffering (5,14,28) . Another aspect to be considered in caring for patients with mental illness is adherence to treatment, defined as the degree to which patients adopt the health care professional's recommendations (6) , s two of the studies indicated that applying Irving's NP enabled two patients with mental disorders to adhere to treatment (15,19) , as it strengthened the treatment relationship between the nurse and the patient through developing the stages of the NP together, the linked between the subject and the nursing professional grew much closer (5) . At the same time, the NO contributes to constructing the treatment project as it enables the subjects' needs and responses to the health problems to be known, encouraging the drawing up of an individualized nursing care plan (5) .…”

“…Moreover, the studies show that a formal record of applying the NP was made, summarizing the data collected about the patient and their family, as well as interaction with the collective, at a specific moment in the subject's health-illness process, which will serve to guide the patient's treatment as well as proving the NP has been carried out (6) . Another of the studies portrayed the issue of identifying nursing phenomena identified in articles in journals on nursing care for adults admitted to psychiatric wards, concluding that in psychiatric nursing care, it is necessary to name and record the patients' problems and causes/related factors and triggers, as well as signs and symptoms (20) .…”

“…2015;11 (4): treatment and retake their place in society (2)(3)(4) . Thus, the psychiatric nurse as an agent of treatment, using the Nursing Process (NP) to support their professional activity, is able to systematize nursing activities and contribute to developing an individualized care plan for each patient, this being an instrument which assists in qualified care, one of the objectives of which is to motivate the patient to adhere to the proposed treatment (5)(6) . As NP is a model for organizing nursing care, collecting patient data and thus allowing the care needs, health problems or vital processes contained in their responses to be identified, heling to define the need for professional action, the results of which are evaluated, with the Systematization of Nursing Care used as a way of organizing and operationalizing NP (5,7) .…”

“…NP is organized into five stages: patient history and diagnosis, planning, implementation and evaluation, which must be recorded in the patient's medical records and which, when used properly, encourages better communication between the health care team members, enabling them to identify alterations in the patient's state of health (7)(8)(9) . In the context of psychiatric nursing, the treatment relationship established between the nurse and patient encourages application of the NP, enabling a treatment project to be constructed by the nurse and patient, contributing to outlining the nurse's field of action and aiding in decision making, care planning and evaluating the care provided (5)(6) . Another aspect of developing NP to be highlighted is the use of taxonomies so as to standardize the language used among the nursing professionals for a more dynamic interaction between them (5) .…”

“…Another aspect of developing NP to be highlighted is the use of taxonomies so as to standardize the language used among the nursing professionals for a more dynamic interaction between them (5) . This study is, then, justified given the importance of the use of NP in clinical practice in psychiatric nursing, providing qualified care and conveying autonomy on psychiatric nurses in their work, enabling care to be organized so as to consider the subjectivity of the patients, differing from psychiatric care in the lunatic asylum model (1)(2)(4)(5)(6) …”