Acur?cia das caracter?sticas definidoras do diagn?stico de enfermagem baixa autoestima situacional em estomizados

Autor: Melo, Marjorie Dantas Medeiros
Jazyk: portugalština
Rok vydání: 2016
Předmět:
Zdroj: Repositório Institucional da UFRNUniversidade Federal do Rio Grande do NorteUFRN.
Druh dokumentu: masterThesis
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Pacientes estomizados t?m sua perspectiva de vida alterada, principalmente pela imagem corporal negativa, devido ? presen?a do estoma associado ? bolsa coletora, aos padr?es de elimina??o alterados, as modifica??es nos h?bitos alimentares e de higiene, resultando muitas vezes, em autoestima diminu?da, sexualidade comprometida e at? em isolamento social. Tendo em vista, as dificuldades e complica??es apontadas, ainda que de forma sucinta, percebe-se que as pessoas com estomias necessitam prioritariamente serem estimuladas para o desenvolvimento da autoestima, e os profissionais de enfermagem por meio do processo de estabelecimento de diagn?sticos acurados s?o essenciais para uma assist?ncia integral. Estudo transversal e descritivo, com o objetivo de analisar a acur?cia das caracter?sticas definidoras do diagn?stico de enfermagem ?Baixa autoestima situacional? em pessoas estomizadas cadastradas no Centro de Reabilita??o de adultos do Rio Grande do Norte ? CERHRN. Realizou-se a coleta de dados entre os meses de janeiro a mar?o de 2015, mediante a utiliza??o de dois instrumentos: um deles composto por quest?es referentes a aspectos sociodemogr?ficos e cl?nicos dos pacientes, caracter?sticas do estoma e do efluente e suas complica??es, e um instrumento com base na NANDA-I e na Escala de autoestima de Rosenberg (RSES). O processo de amostragem foi determinado por conveni?ncia, resultando em um total de 90 estomizados. Para inferir sobre a presen?a ou a aus?ncia do diagn?stico de enfermagem em estudo, assim como de suas caracter?sticas definidoras, procedeu-se a etapa de infer?ncia diagn?stica, com a participa??o de ju?zes. A pesquisa obteve parecer favor?vel mediante o processo n? 421.342 CEP-HM Na caracteriza??o sociodemogr?fica, houve predomin?ncia do sexo masculino (62,2%), com faixa et?ria a partir de 50 anos (58,9%), de cor parda (50%), com companheiro (58,9%), aposentados (46,7%), com escolaridade at? o ensino fundamental (71,1%), cat?licos (65,6%) e com renda superior a um sal?rio m?nimo (66,7%). Com rela??o aos aspectos cl?nicos e do estoma houve predom?nio de estomizados sem comorbidades (54,4%), colostomizados (80%), com perman?ncia definitiva (63,3%) como principal causa da confec??o do estoma a neoplasia (60%), que fizeram tratamento quimioter?pico (50%), com 25 meses de estomia ou mais (53,3%). Com rela??o ?s vari?veis sociodemogr?ficas, observou-se associa??o da autoestima com a escolaridade (p=0,007). O diagn?stico de enfermagem Baixa autoestima situacional estava presente em (23,3%) da amostra. Dentre as caracter?sticas definidoras prevalentes destacaram-se: verbaliza??es autonegativas (33,3%), comportamento indeciso (28,8%) e comportamento n?o assertivo (26,1%). As caracter?sticas definidoras que apresentaram maiores raz?es de preval?ncia foram express?es de sentimento de inutilidade, relata verbalmente desafio situacional atual ao seu pr?prio valor e avalia??o de si mesmo como incapaz de lidar com situa??es ou eventos. As caracter?sticas com maior sensibilidade foram comportamento indeciso e express?es de sentimento de inutilidade e as mais espec?ficas foram relata verbalmente desafio situacional ao seu pr?prio valor, express?es de sentimento de inutilidade, avalia??o de si mesmo como incapaz de lidar com situa??es e eventos, express?es de desemparo. Conclui-se que a identifica??o das caracter?sticas definidoras mais sens?veis e especificas, permite predizer a real presen?a ou aus?ncia do diagn?stico Baixa Autoestima Situacional, auxiliando na assist?ncia de enfermagem a popula??o dos estomizados.
Stomatal patients have their life prospects altered, mainly by negative body image, due to the presence of the stoma associated with the collection bag, altered patterns of elimination, changes in eating and hygiene habits, often resulting in decreased self-esteem, compromised sexuality And even in social isolation. In view of the difficulties and complications pointed out, however succinctly, it is perceived that people with stomies need to be stimulated for the development of self-esteem, and nursing professionals through the process of establishing accurate diagnoses are essential For comprehensive assistance. A cross - sectional study and descriptive approach, aiming at analyzing the accuracy of the defining characteristics of the nursing diagnosis "Low situational self - esteem" in stomized persons enrolled in the Adult Rehabilitation Center of Rio Grande do Norte - CERHRN. Data collection was carried out between January and March 2015, using two instruments: one of them consisting of sociodemographic and clinical aspects of the patients, characteristics of the stoma and effluent, and their complications and characteristics. Self-care, and an instrument based on NANDA-I and the Rosenberg Self-Esteem Scale (RSES). The sampling process was determined by convenience, resulting in a total of 90 stomatal. In order to infer about the presence or absence of the nursing diagnosis under study, as well as its defining characteristics, a diagnostic inference step was performed, with the participation of judges. In the socio-demographic characterization, there was a predominance of males (62.2%), aged 50 years and over (58.9%), brown (50% ), With a partner (58.9%), retired (46.7%), with primary schooling (71.1%), Catholic (65.6%) and income higher than a minimum wage (66, 7%). With respect to the clinical and stomatal aspects, there was a predominance of stomates without comorbidities (54.4%), colostomized (80%), with definitive permanence (63.3%) as the main cause of the stoma to neoplasia (60%), Who underwent chemotherapy (50%), with 25 months of estomy or more (53.3%). Regarding sociodemographic variables, we observed an association between self-esteem and schooling (p = 0.007). The nursing diagnosis Low situational self-esteem was present in (23.3%) of the sample. Among the prevalent defining characteristics were: self-negative verbalizations (33.3%), undecided behavior (28.8%) and non-assertive behavior (26.1%). The defining characteristics that presented the highest prevalence reasons were expressions of feeling of worthlessness, verbally reporting current situational challenge to their own value, and evaluating themselves as unable to cope with situations or events. The most sensitive characteristics were undecided behavior and expressions of feeling of worthlessness and the most specific were verbally reports situational challenge to their own value, expressions of feeling of worthlessness, self-evaluation as unable to cope with situations and events, expressions of unpair. It is concluded that the identification of the most sensitive and specific defining characteristics, allows predicting the real presence or absence of the diagnosis Low Situational Self-esteem, assisting nursing care to the population of the stomates.
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