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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
21

Edificando uma fortaleza: a experiência dos pais no cuidado do filho estomizado no Brasil e na Colômbia / Building a fortress: the parents experience of caring for a child with a colostomy in Brazil and Colombia

Guerrero Gamboa, Nidia Sandra 02 March 2009 (has links)
Apesar do número de estudos que existem sobre o impacto da criança estomizada na família pouco se conhece na América do Sul a respeito da experiência dos pais no cuidado dessas crianças e como eles definem sua experiência. Este estudo teve como objetivo compreender a experiência dos pais no cuidado da criança com colostomia. Foram realizadas entrevistas abertas em profundidade com dez casais pais de crianças com colostomia, residentes nas cidades de São Paulo (Brasil) e Bogotá (Colômbia). Todo o processo da investigação pauto-se pelo referencial teórico do Interacionismo Simbólico e a análise dos dados na Teoria Fundamentada nos Dados. A experiência dos pais está estruturada nos fenômenos Sentindo-se frágeis e Tornando-se fortes, que atuam como condição causal e estratégia respectivamente. Elas representam a complexidade existente entre ser pais e ser os provedores de cuidado especializado à criança. Edificando uma fortaleza, emergiu como a categoria central da experiência que é conseqüência de um processo intencional de construção interior dos pais, mediante o uso de estratégias para transformar significados e erguer um cenário de cuidados para protegerem-se a si mesmo, à criança e à família e para renovar as forças necessárias a fim de conseguirem enfrentar e resistir às ameaças presentes na experiência / Despite the number of existing studies about the impact of children with a colostomy on their families, there is however very limited information about parental experience of caring for these children and how they define their experience in South America. This study intends to understand the parental experience of caring for children with a colostomy. The method for data collection was an open interview involving 10 couples residing in the cities of São Paulo (Brazil) and Bogota (Colombia). The entire investigation process was guided by the referential theory of Symbolic Interactions and the data analysis was done by the Grounded Theory. The parental experience is supported in the phenomena Feeling fragile and Becoming strong as a causal condition and strategy, respectively. They represent the tension of being parents and special care providers of the child. \"Building a fortress\" emerged as the central category that represents an experience which is the consequence of a deliberate process of internal construction of parents by using strategies to transform meanings and build a scenario of care to protect themselves, the child and family and to renew the forces necessary to confront and resist the threats present in the experiment
22

Coping with colorectal cancer and the creation of a colostomy in the Thai context

Rattanajarana, Sahattaya, n/a January 2005 (has links)
The number of patients who suffer from colorectal cancer in Thailand has increased during the last three decades as a result of the change to a Westem-style diet. Due to many patients presenting at a late stage and the location of tumours in the rectum, patients have a higher probability of needing a colostomy. This study explores the experiences, coping strategies and the factors that influence coping strategies over a sixmonth period in a group of Thai colorectal cancer patients who have a colostomy. The conceptual framework used in this study was based on the Moos and Schaefer conceptual model of the stress and coping process. A case study methodology was employed to collect both quantitative and qualitative data from eleven participants at three points in time: within one month after the operation to create a colostomy, three months and six months after the operation. Data were collected from structured interviews, which followed the Coping Responses Inventory (CRI), the Ostomy Adjustment Scale (OAS), the Personal Resources Questionnaire 2000 (PRQ 2000), the Life Orientation Test-Revised (LOT-R), and the Functional Assessment Cancer Therapy- Colon (FACT-C). These data provided information on the participants' levels of coping strategies, adjustment to a colostomy, social support, optimism and quality of life. Indepth interviews with open-ended questions provided a deeper understanding of the participants' experiences in relation to their colostomy. Findings from quantitative data showed statistically significant changes in the participants' quality of life over time, particularly in their physical and functional wellbeing. An examination of the coping focus used (approach and avoidance) indicated that participants utilised both approach and avoidance coping at the same time, although approach coping was more common. Changes in the most frequently and the least frequently used coping subtypes at six months after the operation were observed. Correlation tests showed various relationships between the levels of quality of life domains and coping subtypes as time passed. Multidimensional scaling procedures uncovered a consistent pattern of coping which involved 'problem solving' and 'seeking guidance and support'. Six major qualitative themes emerged through content analysis of the in-depth interview data. The themes described how participants' psychological and emotional concerns changed over time; the steady improvements in physical health after the operation; the difficulties of adjusting to life with a stoma; facing up to the reality of the new circumstances; the spiritual aspects of their lives; and the level of social support experienced. Religious beliefs such as the 'Law of Kanna', as well as a variety of religious rituals and other practices such as Buddhist chanting and "making merit" played important roles in coping. The findings from the quantitative and qualitative data were used in a complementary and confirmatory manner to provide a richer understanding of the participants' experiences as they coped with this life changing event. The findings of the study are significant as they provide important indicators for improvements in nursing service, particularly the development of nursing procedures to enhance the psychological aspects of care. In addition, they offer important indicators for improvement of the nursing curriculum and directions for further research in Thai culture and the health care system.
23

Význam stomické sestry pro chirurgické oddělení / The importance of the ostomy nurse for the surgical department

ZRONKOVÁ BROŽOVSKÁ, Alena January 2014 (has links)
Surgical procedures of gastrointestinal diseases often lead to the creation of an ostomy. The number of clients with an ostomy is increasing as the Czech Republic ranks among the countries with the largest incidence of malignant colon disease. Health care professionals in any field can often encounter the client with a stoma. Therefore, it is essential for them to understand and manage this issue well. Nursing care of such individuals is very extensive and specialized. Nursing team usually focuses only on physical care but other problems associated with stomas are pushed aside. The only highly knowledgeable and qualified expert in this area is a stoma nurse specialist (an ostomy nurse). This thesis deals with the importance of the role of the stoma nurse specialist in the postoperative phase from the perspective of nurses from surgical departments as well as from the perspective of patients with a colostomy. The thesis is divided into theoretical and empirical part. The theoretical part is further divided into four chapters: colostomy, care about stoma patients, life with a colostomy, an ostomy nurse. Two objectives were determined for processing of the empirical part. We used a combination of quantitative and qualitative research to achieve our goals. The first objective was to determine whether general nurses have the knowledge to care for a client with colostomy in the postoperative phase. To obtain data for the quantitative part of the survey the method of anonymous interviews using a questionnaire, in which the research group was formed by general nurses, was selected. The survey results revealed that nurses have sufficient knowledge to treat and educate clients with a stoma. Although not all general nurses encounter colostomy patients, they widely believe the knowledge of this issue is important for the occupation of a nurse. For the quantitative part three hypotheses were selected and tested statistically. Hypothesis 1: General nurses have the knowledge to treat the client with a colostomy. It was confirmed. Hypothesis 2: General nurses have enough knowledge to educate the client with a colostomy. It was confirmed. Hypothesis 3: General nurses positively evaluate the benefits of an ostomy nurse in care for stoma patients in the postoperative phase in the surgical department. It was confirmed. The second objective was to determine the significance of the stoma nurse for clients with a colostomy. For the qualitative part of the survey the method of direct questioning by means of a semi-structured interview with open questions was chosen. The study group consisted of patients with a colostomy. For this part of the survey a research questions was specified: What is the importance of an ostomy nurse for the stoma patient in the postoperative period? We concluded that the ostomy nurse is viewed as an educator, counselor and psychological support. The ostomy nurse is the only one who can provide stoma clients with coherent and comprehensive information they need to live with a colostomy. Both groups of respondents agree that the stoma nurse is the irreplaceable specialist. Shift nurses fail to provide comprehensive care stoma patients need. An ostomy nurse needs to be a part of nursing care not only in the postoperative phase, but also in the preoperative period. There is need for closer cooperation between general nurses and the ostomy nurse. Nurses indicate their willingness to be educated in this area, while preferring seminars, lectures and conferences. The results also led us to create information material Care of the client with colostomy, as the nurses indicated that they would welcome a brief, clear, visual information material.
24

Estomas em neonatologia: um resgate da memória materna / Stomas in neonatology: a maternal rescue memory

Andreia Cascaes Cruz 20 December 2010 (has links)
O panorama da produção científica no que concerne à família e estomas é carente de estudos sobre o tema, em especial sobre esta experiência no período neonatal da criança, que é permeada por crenças, sentimentos e expectativas que envolvem o nascimento de um novo membro da família e as mudanças que este evento acarreta na vida familiar. O presente estudo teve como objetivo geral compreender a experiência da mãe que tem um filho estomizado durante o período neonatal ou durante o tempo de internação em UTI Neonatal. Utilizando a História Oral como referencial metodológico, foram realizadas entrevistas com nove mães focalizando o impacto do evento sobre suas histórias. O resgate das memórias individuais permitiu a elaboração das narrativas, que por meio de um processo analítico possibilitaram a construção memória da coletiva, organizada em quatro temas: SONHOS VERSUS REALIDADE, PROTEÇÃO PERDIDA, NA COMPANHIA DO MEDO e É PRECISO EXERCER A MATERNIDADE. Os resultados do estudo revelaram que eventos inesperados e indesejados, dentre eles a criação do estoma no filho, são geradores de profundo impacto na vida das mulheres e de suas famílias, fazendo com que a realidade muito diferente da sonhada seja vivenciada com medo e sofrimento. A mãe vive a experiência acreditando que é dever da mãe cuidar do filho e que é preciso exercer a maternidade, e ao mesmo tempo vendo-se impedida de exercer plenamente o seu papel. Os resultados permitem uma reflexão sobre a importância de medidas mais eficazes que contribuam para autonomia e alívio do sofrimento da mãe na UTI Neonatal, onde a assistência de enfermagem possa ser orientada pelos princípios do Cuidado Centrado na Família que enfatizam a dignidade e o respeito, compartilhamento de informações, participação e colaboração. / The scientific production overview that concerns the family and stomas urges for studies about the subject, especially about the experience in neonatal period that is pervaded with beliefs, feelings and expectations implicated in the birth of a new member of a family and the changes that this event brings along for family life. The present study aimed to comprehend mothers experience about stomized children during neonatal period or the hospitalization period in Neonatal Intensive Care Unit. The methodological approach adopted in this study was Oral History, where interviews were conducted with nine mothers, focusing on the impact of the event on their stories. The rescue of individual memories enabled the elaboration of narratives in an analytical process which consequently resulted in rescuing of collective memory, organized in four themes: DREAMS VERSUS REALITY, LOST PROTECTION, IN FEARS COMPANY and MOTHERHOOD IS NEEDED. The results revealed that unwanted and unexpected events, such as stomas, might generate profound impact in womens and families lives. Such factors turn dreams into a very different reality which are likely to be lived with fear and suffering. Mother lives the experience believing that is her duty care of her child and that motherhood is need, and at the same time perceiving prevented herself from exercising her role. The results allow a reflection about the importance of more effective actions that contribute to the autonomy and relief of suffering of the mother in Neonatal Intensive Care Unit, where nursing care can be guided by the principles of Family Centered Care which emphasize dignity and respect, sharing information, participation and collaboration.
25

Edificando uma fortaleza: a experiência dos pais no cuidado do filho estomizado no Brasil e na Colômbia / Building a fortress: the parents experience of caring for a child with a colostomy in Brazil and Colombia

Nidia Sandra Guerrero Gamboa 02 March 2009 (has links)
Apesar do número de estudos que existem sobre o impacto da criança estomizada na família pouco se conhece na América do Sul a respeito da experiência dos pais no cuidado dessas crianças e como eles definem sua experiência. Este estudo teve como objetivo compreender a experiência dos pais no cuidado da criança com colostomia. Foram realizadas entrevistas abertas em profundidade com dez casais pais de crianças com colostomia, residentes nas cidades de São Paulo (Brasil) e Bogotá (Colômbia). Todo o processo da investigação pauto-se pelo referencial teórico do Interacionismo Simbólico e a análise dos dados na Teoria Fundamentada nos Dados. A experiência dos pais está estruturada nos fenômenos Sentindo-se frágeis e Tornando-se fortes, que atuam como condição causal e estratégia respectivamente. Elas representam a complexidade existente entre ser pais e ser os provedores de cuidado especializado à criança. Edificando uma fortaleza, emergiu como a categoria central da experiência que é conseqüência de um processo intencional de construção interior dos pais, mediante o uso de estratégias para transformar significados e erguer um cenário de cuidados para protegerem-se a si mesmo, à criança e à família e para renovar as forças necessárias a fim de conseguirem enfrentar e resistir às ameaças presentes na experiência / Despite the number of existing studies about the impact of children with a colostomy on their families, there is however very limited information about parental experience of caring for these children and how they define their experience in South America. This study intends to understand the parental experience of caring for children with a colostomy. The method for data collection was an open interview involving 10 couples residing in the cities of São Paulo (Brazil) and Bogota (Colombia). The entire investigation process was guided by the referential theory of Symbolic Interactions and the data analysis was done by the Grounded Theory. The parental experience is supported in the phenomena Feeling fragile and Becoming strong as a causal condition and strategy, respectively. They represent the tension of being parents and special care providers of the child. \"Building a fortress\" emerged as the central category that represents an experience which is the consequence of a deliberate process of internal construction of parents by using strategies to transform meanings and build a scenario of care to protect themselves, the child and family and to renew the forces necessary to confront and resist the threats present in the experiment
26

"Educação sexual de grupos de adultos portadores de estomas intestinais definitivos: processo da implantação e implementação" / "Sexual Education of adults with definitive intestinal stomas: creation and implementation process"

Adriana Pelegríni dos Santos Pereira 23 June 2006 (has links)
Trata-se de uma pesquisa de natureza qualitativa, do tipo descritivo exploratório, que teve como proposta descrever o processo de implantação e implementação de um grupo de pacientes portadores de estomas intestinais definitivos e identificar a percepção desses quanto à sexualidade como uma dimensão importante de suas vidas. Para a coleta de dados, foram utilizadas as falas dos sujeitos participantes do grupo durante os encontros realizados, transcritas na íntegra pela pesquisadora. As falas, posteriormente foram analisadas segundo a análise de prosa de André (1983). Foram realizados 14 encontros com 3 horas de duração cada, participaram do grupo 19 portadores de estomas definitivos de São José do Rio Preto e região, uma coordenadora (pesquisadora), um coloproctologista, uma psicóloga e uma observadora não-participante. Toda dinâmica do grupo obedeceu a uma programação feita previamente pela pesquisadora. Os dados obtidos permitiram concluir que essa atividade grupal proporcionou aos portadores um espaço no qual puderam trocar experiências, adquirir conhecimentos, criar vínculos, encontrar cumplicidade, companheirismo e aceitar a sua condição, pois ouviram as vivências dos outros e não se sentiram únicos a terem problemas, facilitando o sentimento de universalidade. Quanto à percepção da sexualidade como uma dimensão importante em suas vidas identificou-se ser esse um tema pouco abordado pelos profissionais de saúde e necessário para o reajustamento sexual satisfatório. Evidenciou-se que a saúde sexual não foi inibida pela doença, pois quanto mais orientados adequadamente, e mais estimulados para a prática sexual, mais satisfeitos e interessados se mostraram para buscar caminhos, superando obstáculos como: a recusa do parceiro, disfunção erétil, alteração imagem e o próprio estoma. Alguns caminhos apontados para atingir a satisfação sexual foram a troca de parceiro, busca de profissionais especializados, criatividade no ato sexual e alguns cuidados com o dispositivo. Nesse espaço evidenciou-se que a prática sexual seja ela qual for, é importante e necessária para a vida de cada um. A experiência de vida de cada integrante permitiu o desenvolvimento da autonomia sexual e fez com que os portadores reconhecessem a necessidade de mantê-la ou buscar auxílio, para o alcance do prazer, satisfação e retorno à vida. / This is a descriptive exploratory qualitative research, with the goal to describe the creation and implementation process of a group of patients with definitive intestinal stomas and to identify their perceptions with respect to sexuality as an important dimension of their lives. In order to collect data, the author used the speech of the subjects who participated in the group during their meetings that were transcribed by the researcher. Their speeches were analyzed according to André’s prose analysis. The group met 14 times, with meetings of about 3 hours each. 19 patients from the city of São José do Rio Preto and region with definitive stomas participated in the meetings with the researcher, one physician, one psychologist and one non-participant observer. The dynamics of the group followed the researcher’s program. Data showed that this activity gave to patients a space to exchange experiences, to learn and create links, to find complicity and colleagues as well as to accept their condition as they listen the others experiences and feel that they are not the only ones who have problems, facilitating the feeling of “universality”. With respect to their sexuality perception as an important dimension of their lives, author identified that this theme was not often mentioned by the health professionals and that this is necessary to a satisfactory sexual readjustment.. The author found out that when sexual health was not inhibited by the disease, they were adequately oriented and stimulated to sexual practice and were satisfied and interested to find ways and overcome some problems such as: the partner refusal, erectile dysfunction, image alteration and the stoma. Some ways used to have sexual satisfaction were to change partners, to search for the care of specialized professionals, creativity during sexual intercourse and to pay attention to the device. In this space, the author found that the sexual practice is important and necessary to their lives. The life experience of each one of the members enabled the development of sexual autonomy and the need to maintain it or to search for health in order to have pleasure, satisfaction and to feel alive.
27

Programa de ostomizados: os significados para estomizados intestinais e familiares / Ostomy Program: the meanings for ostomates and family members

Nariman de Felício Bortucan Lenza 09 September 2011 (has links)
Trata-se de um estudo de abordagem qualitativa sob a perspectiva socioantropológica, que teve como objetivo interpretar os significados do Programa de Ostomizados para os estomizados intestinais e familiares, em um município do interior paulista. Foram entrevistadas catorze pessoas, entre estomizados intestinais e familiares, com experiência de cadastramento no Programa de Ostomizados. A coleta de dados ocorreu no período de dezembro de 2010 a janeiro de 2011, na residência dos informantes. Utilizou-se o referencial metodológico do estudo de caso instrumental, do método do relato oral, com entrevista semiestruturada em profundidade, apreendendo-se os significados do Programa de Ostomizados para estes informantes, por meio da análise de conteúdo indutivo. Foram decodificados dois núcleos de sentidos denominados de \"Estomizado intestinal: busca e superação de barreiras para a resolução do problema de saúde\" e \"Cadastramento e atendimento no Programa de Ostomizados e mudanças na vida de pacientes e familiares\". A partir destes, construimos três núcleos temáticos: \"Estomizado intestinal: da acessibilidade aos serviços de saúde à concretude de sua condição\"; \"Assistência ao estomizado intestinal no Programa de Ostomizados\"; e \"Programa de Ostomizados: intermediação da identidade e da vida do estomizado intestinal e da família\". No primeiro núcleo temático interpretamos as dificuldades enfrentadas pelos estomizados intestinais no itinerário em busca da definição do diagnóstico, da internação e cirurgia, da assistência hospitalar e do encaminhamento para o Programa de Ostomizados. No segundo tema emergiram como principais aspectos o direito à aquisição de equipamentos e o aprendizado do autocuidado, a focalização da reunião bimestral como a principal estratégia, bem como a sua importância para os entrevistados. No terceiro tema abordamos a condição de ser estomizado intestinal como o principal foco de preocupação inicial, que ao longo do processo é substituído pelo direito de aquisição de bolsas coletoras, considerada condição imprescindível para a manutenção da vida cotidiana. Os significados do Programa de Ostomizados são construídos pelas experiências individuais, familiares, de acessibilidade e atendimento no sistema de saúde, das relações com os profissionais, além do acesso aos equipamentos, constituindo-se em um espaço cotidiano de reconquista da sua normalidade e de direito de cidadania. Acreditamos que este estudo poderá subsidiar o planejamento da assistência prestado a essa clientela, principalmente no que tange ao contexto vivido por essas pessoas, as dificuldades e as possibilidades, com ampliação do alcance de resultados neste Programa. / This qualitative and socio-anthropological study aimed to interpret the meanings of the Ostomy Program for ostomates and family members in a city of the interior of the state of São Paulo, Brazil. Fourteen people were interviewed including ostomates and family members, with the experience of registration in the Ostomy Program. Data collection occurred between December 2010 and January 2011, at the residence of the participants. It was used the methodological approach for instrumental case study of the method of oral reports, with in-depth semi-structured interviews, searching for the meanings of the Ostomy Program for these participants through inductive content analysis. Two groups of meaning called \"Intestinal ostomy: search and overcome of barriers to solving the problem of health\" and \"Enrollment and care in the Ostomy Program and changes in the lives of patients and families\" were decoded. From these, three thematic groups were identified: \"Intestinal ostomy patients: from accessibility to health services to the concreteness of their condition,\" \"Care to the intestinal ostomy patients in the Ostomy Program\", and \"Ostomy Program: mediation of identity and life of intestinal ostomy patients and family\". In the first thematic group, it was interpreted the difficulties faced by intestinal ostomy patients on the itinerary in search of definition of diagnosis, hospitalization and surgery, hospital care and referral to the Ostomy Program. In the second thematic group, the major issues were the right to acquire equipment and the learning of self-care, the focus of the bimonthly meeting as the main strategy as well as its importance to respondents. In the third thematic group, it was addressed the condition of being intestinal ostomy patient as the main focus of initial concern that throughout the process is replaced by the right to acquire collection bags, which was considered the essential condition for the maintenance of everyday life. The meanings of the Ostomy Program are built by the experiences of individuals, family members, and accessibility and care in the health care system, relationships with professionals, besides of the access to equipment, thus becoming an everyday space of reconquest of normality and right to citizenship. This study may help the planning of care provided to these clients, especially with regard to the environment in which these people live, the difficulties and possibilities, expanding the reach of this Program results.
28

CONSULTA DE ENFERMAGEM A PESSOAS EM SITUAÃÃO DE ESTOMIA INTESTINAL: CONSTRUÃÃO DE UM INSTRUMENTO E VALIDAÃÃO DE SEU CONTEÃDO / Nursing consultation to people suffering from intestinal stoma: construction of an instrument and validation of its content.

JoÃo Carlos dos Santos 21 August 2013 (has links)
Intestinal ostomies are surgical interventions carried out in the colon or small intestine which consist in externalizing an intestinal segment through the stomach wall, therefore creating an artificial opening for the discharge of body waste. A nursing consultation, which is a nurseâs exclusive job, is used primarily to further improve health and good quality of life. An adequate instrument for these consultations will contribute to a systemized work which will meet the specific needs of each health condition. In this context, the objective of this study was to construct and validate the content of an instrument to be used in nursing consultation aimed at people suffering from intestinal stoma, based on Oremâs Self-care Theory, as this one has shown to be the most adequate theory. In this developmental study the instrument for nursing consultation was constructed based on literature, Oremâs theory and on the researcherâs experience. Pasqualiâs methodology for analysis of the content of instruments was used to validate the content of the instrument. This analysis is done by specialists in the area studied who are called âjudgesâ due to their task of judging the items of the instrument. Six judges took part in this study and the questionnaires were given back within an average of nine days. Descriptive statistics was used for evaluation and the results were given in frequency and percentage. A percentage ≥ 80% of agreement among the judges, together with the analysis of the observations and suggestions presented by them, resulted in maintaining, reformulating or excluding the item. Some questions were reformulated for the construction of the final instrument. These reformulations were based on the percentages of the answers, and on the observations and suggestions presented by the judges. Questions considered irrelevant received no significant percentage or observations which could lead to their exclusion. The study showed the inexistence of a standard instrument to be used in nursing consultation to patients suffering from intestinal stoma; that the method for validation of the content of instruments through evaluation by judges consists in an adequate method for the consolidation of an instrument to be used in the daily professional practice; the final version of the instrument to be used in nursing consultation to people suffering from intestinal stoma is ready to be used in the professional practice; this instrument has been submitted to a process of evaluation for validation of its use in patients attended to at the proctology ward at the Walter CantÃdio University Hospital at the Federal University of CearÃ. / Estomias intestinais sÃo intervenÃÃes cirÃrgicas realizadas no cÃlon ou no intestino delgado, consistem na exteriorizaÃÃo de um segmento intestinal, atravÃs da parede abdominal, criando assim uma abertura artificial para a saÃda do conteÃdo fecal. A consulta de enfermagem - atividade privativa do enfermeiro à utilizada prioritariamente para a promoÃÃo da saÃde e da boa qualidade de vida. Um instrumento adequado à realizaÃÃo destas consultas contribui para um trabalho sistematizado que contemple as necessidades especÃficas de cada condiÃÃo de saÃde. Neste contexto objetivou-se com este estudo construir e validar o conteÃdo de um instrumento para consulta de enfermagem, direcionado para pessoas em situaÃÃo de estomia intestinal baseado na Teoria do Autocuidado de Orem por ser esta a teoria mais adequada. Trata-se de um estudo de desenvolvimento onde o instrumento para consulta de enfermagem foi construÃdo com base na literatura, na Teoria de Orem e na experiÃncia do pesquisador. Para a validaÃÃo do conteÃdo do instrumento, utilizou-se a metodologia de anÃlise do conteÃdo de instrumentos proposta por Pasquali. Esta anÃlise à feita por especialistas na Ãrea em estudo que sÃo denominados âjuÃzesâ, em face de sua tarefa consistir em ajuizar os itens do instrumento. Seis juÃzes participaram deste estudo, os questionÃrios foram devolvidos em um prazo mÃdio de nove dias. Utilizou-se para avaliaÃÃo, estatÃstica descritiva com resultados dados em frequÃncia e porcentagem. Um percentual ≥ a 80% de concordÃncia entre os juÃzes bem como a anÃlise das observaÃÃes e sugestÃes apresentadas por estes, resultou na manutenÃÃo, reformulaÃÃo ou exclusÃo do item. Foram procedidas reformulaÃÃes de alguns quesitos quando da elaboraÃÃo do instrumento final, estas reformulaÃÃes se ancoraram nos percentuais das respostas e nas observaÃÃes e sugestÃes apresentadas pelos juÃzes. Nenhum quesito considerado irrelevante obteve percentual ou observaÃÃes significativas que conduzissem à sua exclusÃo. O estudo demonstrou a inexistÃncia de um instrumento padrÃo para consulta de enfermagem pra pacientes em situaÃÃo de estomia intestinal; o mÃtodo de validaÃÃo de conteÃdo de instrumentos por meio de avaliaÃÃo por juÃzes se constitui um mÃtodo adequado para a consolidaÃÃo de um instrumento para a aplicaÃÃo na prÃtica cotidiana profissional; a versÃo final do instrumento para consulta de enfermagem a pessoas em situaÃÃo de estomia intestinal està pronto para ser utilizado na prÃtica profissional; este instrumento foi submetido a processo de avaliaÃÃo para validaÃÃo do uso junto aos pacientes no ambulatÃrio de proctologia do Hospital UniversitÃrio Walter CantÃdio da Universidade Federal do CearÃ.
29

A experiência cirúrgica de ressecção do câncer colorretal e suas consequências na perspectiva do paciente / The experience of surgical resection of colorectal cancer and its consequences on the patient\'s perspective

Talita Tavares Della Motta 10 September 2013 (has links)
Trata-se de um estudo de abordagem qualitativa sob a perspectiva antropológica, que teve como objetivo apreender os sentidos da experiência cirúrgica de ressecção do câncer colorretal (CCR) e suas consequências na perspectiva do paciente. Utilizou-se o referencial teórico da antropologia interpretativa e o método etnográfico para apreender a experiência de treze pacientes em tratamento cirúrgico por CCR, que foram entrevistados em dois momentos, no pré e pós-operatórios, na unidade de internação de um hospital terciário. A coleta de dados ocorreu no período de junho a dezembro de 2012, por meio de entrevistas semiestruturadas gravadas em áudio, observações participantes e anotações em um diário de campo, cujos dados foram analisados por meio da análise de conteúdo indutiva. Os dados foram decodificados em dois núcleos temáticos, denominados de \"Esperança de cura pelo tratamento cirúrgico\" e \"Busca de confirmação de cura pela cirurgia\". No primeiro núcleo temático, da experiência de adoecimento relatada pelos pacientes foram extraídos os principais aspectos como o momento do aparecimento dos sintomas e do problema, a busca por atendimento à saúde e a suspeita do câncer, a notícia do diagnóstico oncológico, as expectativas e preocupações sobre o tratamento cirúrgico indicado, as consequências, os insucessos dos tratamentos prévios e a possibilidade da estomia intestinal. Com a interpretação destes dados verificamos que, independente dos acontecimentos, os pacientes buscam agregar informações, comportamentos e fatos para a manutenção da esperança de cura com a ressecção do CCR e consideram a estomia intestinal como uma necessidade para a possibilidade de cura. No segundo núcleo temático abordamos a experiência com o tratamento cirúrgico, no qual emergiram as expectativas em relação à ressecção do CCR, a utilização de estratégias de enfrentamento como redes de apoio, suporte profissional e atitudes otimistas na busca por confirmação de cura do câncer com a cirurgia e a estomia intestinal determina a gravidade do seu problema de saúde, contudo conseguem voltar a pensar em projetos de vida futuros. Com a interpretação destes dois núcleos temáticos, apreendemos que a cirurgia é considerada a única chance de cura para conseguirem retomar a sua vida familiar e cotidiana, e para tanto, buscam superar o estigma do câncer e todos os acontecimentos decorrentes do tratamento cirúrgico e do ambiente hospitalar, com canalização dos seus esforços para manter a esperança de que tudo dará certo. No pós-operatório, os pacientes buscam pistas sobre o sucesso da cirurgia e a sua evolução clínica passa a ser o indicativo da obtenção de cura para a nova chance de vida e surge a preocupação de aprendizagem dos cuidados com a estomia intestinal. Os resultados deste estudo poderão contribuir na melhoria do planejamento da assistência perioperatória ao paciente com CCR, com atendimento das suas necessidades / This is a qualitative study from the perspective of anthropology, which aimed to understand the meanings of the experience of surgical resection of colorectal cancer (RCC) and its impact on the patient\'s perspective. The theoretical framework of interpretive anthropology and ethnographic method to capture the experience of thirteen patients in surgical treatment for RCC has been used, who were interviewed on two occasions, before and after surgery, in the inpatient unit of a tertiary hospital. Data collection occurred from June to December 2012, through semi-structured interviews recorded on audio, participant observations and notes in a diary, and data were analyzed using inductive content analysis. The data were decoded in two thematic groups, called \"Hope for healing through surgical treatment\" and \"Seeking confirmation f the cure by surgery.\" \". In the first thematic group, the experience of illness reported by patients, the main aspects such as time of onset of symptoms and the problem were extracted, the search for health care and suspicion of cancer, the news of the cancer diagnosis, expectations and concerns about surgical treatment indicated, the consequences of the failure of previous treatments and the possibility of permanent intestinal ostomy. With the interpretation of these data it was found that regardless the events, patients seek to add information, facts and behaviors to maintain hope of cure with resection of RCC and consider the intestinal ostomy a necessity for the possibility of healing. In the second thematic group the experience with surgical treatment in which emerged the expectations for resection of RCC was addressed, the use of coping strategies such as support networks, professional support and optimistic attitudes in seeking confirmation of curing cancer with ostomy surgery and determine the severity of the health problem, however patients can think about future life plans again. With the interpretation of these two theme groups, we can see that the surgery is considered the only chance of cure and this way patients will be able to have their family life back, and therefore, they seek to overcome the stigma of cancer and all events resulting from surgical treatment and hospital environment, thus, channeling their efforts to keep the hope that everything will be alright. Postoperatively, patients seek clues about the success of surgery and clinical evolution becomes the target of achieving cure for the new chance of life and the concern of ostomy care occurs. The results of this study will contribute to the improvement of perioperative care planning for patients with RCC, with their needs attended
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Personers upplevelser av en kolostomi : En litteraturstudie / People´s experiences of a colostomy : A literature study

Johansson, Emelie, Suleiman, Shelan January 2020 (has links)
Begreppet stomi härstammar från grekiska ordet stoma och definieras som mun eller öppning. Det finns olika varianter av stomier, men av alla stomier som utförs i Norden utgör kolostomier cirka 60% av dessa. Det kirurgiska ingreppet som används kallas för Hartmanns operation som innebär att den sjuka delen av tjocktarmen avlägsnas och resterande delen av tarmen konstrueras till en kolostomi. Syfte var att belysa personers upplevelser av en kolostomi. Metoden hade ett induktivt förhållningssätt och resultatartiklarna var kvalitativa vetenskapliga artiklar. Artikelsökningarna genomfördes i PubMed och Cinahl. Utifrån dataanalysen presenterades fyra huvudkategorier personers upplevelser av försämrad livskvalité, personers upplevelser av sociala relationer, personers upplevelser av otillräcklig information och personers upplevelser av livsstilsförändringar samt fyra subkategorier, upplevelser av osäkerhet i sociala sammanhang, upplevelser av nära relationer i samband med en kolostomi, att anpassa sina kläder och att anpassa sin kost. Resultatet beskrev att personerna upplevde en försämrad livskvalitet i förhållande till begränsningar i vardagen, påverkan på sociala relationer, livsstilsförändringar och brist på information från vårdgivare. Litteraturstudien kan bidra till en fördjupad kunskap och förståelse för personers upplevelser av en kolostomi. / The word ostomy originates from the Greek word stoma and is defined as mouth or opening. There are different types of stomas, but out of all stomas in Scandinavia approximately 60% of these are colostomies. The procedure that is used for colostomies is called Hartmann's surgery, which means that the diseased part of the intestine is removed and the remaining part is constructed as a colostomy. The aim was to illustrate people’s experiences of a colostomy. The method was based on an inductive approach and qualitative articles. The search was conducted in PubMed and Cinahl. The findings of this study resulted in four main categories, people's experiences of deteriorated quality of life, people's experiences of social relationships, people's experiences of insufficient information and experiences of lifestyle changes and four subcategories, experiences of insecurity in social contexts, experiences of close relationships in relation to a colostomy, to adapt their clothes and to adapt their diet. In conclusion, the results described low quality of life related to limitations in the daily life, impact on social relationships, lifestyle changes and lack of information from healthcare providers. This literature study can contribute in deeper knowledge and understanding of people’s experiences of a colostomy.

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