Criação e avaliação de um programa de intervenção em enfermagem de estomaterapia

: contributos na adaptação à ostomia e qualidade de vida

Abstract

The elimination ostomy (EO) confronts each person with changes in their daily dynamics, where life projects may have to be reoriented, in search of better physical, emotional, family and social adjustment. The transition process is neither easy nor easily surpassed. Because of this, the enterostomal therapy nursing care is an important resource to help patients manage these new challenges, and be able to adapt and experience a better quality of life (QoL). Are constituted as main objectives, to create a enterostomal therapy nursing intervention program (ETNIP) and to implement it in people with EO, evaluating its effect on QoL and in adjustment to ostomy, using up to this, four studies. Through the first study, we identified sensitive areas to nursing intervention in enterostomal therapy, which can affect people with OE and we could detect discrepancies between the need of care and the response of nurses of the Community Health Care. This influenced the decision to develop a nursing intervention program in stoma care in the following study, structured around six relevant focuses of the enterostomal nursing practice (Self Care, Self-Conception, Acceptance, Social Interaction, Sexual Interaction and Hope). In the third study, we created an instrument that is sensitive to the interventions of nurses in promoting the adaptation to EO (used in the study fourth). The analysis of these metric properties revealed the acceptable criterion for both validity and reliability, allowing the tool to be useful in practice and nursing research. In the last study, we implemented and evaluated the effects of the ETNIP, on the adjustment and QoL for patients with EO. For this, we designed a quasi-experimental study with a sample of 105 participants with EO, distributed by an intervention group (IG), subject to the ETNIP, and a control group (CG) established in hospitals with and without enterostomal therapist consultation, respectively. Data collection occurred one and six months after hospital discharge, using as instruments, a questionnaire constructed for this purpose, the Ostomy Quality of Life Index, translated and validated for the portuguese population, and the Elimination Ostomy Adjustment Scale, created in the third study. Our results indicated that, in the first month, the QoL and the ostomy adjustment perceived were satisfactory and similar in both groups. However, in the sixth month the perception of QoL and the ostomy adaptation for the IG were significantly greater than in the CG, and the previous evaluations of two groups in the first month. The CG did not suffer any changes between the first and second evaluation. In conclusion, overtime systematic interventions of a nurse specialized in ostomy care has shown to have positive effects in the transition process. This is due to the development of proficiency in ostomy self-care, stimulation of self-confidence, and the search for other available resources, which in turn reflected favorably on the QoL perception.

Date of Award	1 Jun 2018
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Célia Samarina Vilaça de Brito Santos (Supervisor)