Fatores que contribuem para a tomada de decisão dos enfermeiros no cuidado à pessoa adulta com ferida crónica

Abstract

Introduction: Decision making is an important issue for nurses and quality of care. So, we thought it pertinent to study the decision in the specific context of nursing, poorly researched, care to adult chronic wound. Methodology: The study starts with the question, “Which factors contribute towards the decision making of nurses in the care of adult chronic wounds. We defined as a specific objectives, identifying the decision-making as autonomous or interdependent in the care process of the adult with chronic wound, identify the factors that contribute to the decision making of nurses in the care of adult chronic wound, examine how the identified the factors contribute to the decision making of nurses in the care of adult chronic wound, and describe the method of decision in the care of people with chronic wound. We opted for a descriptive exploratory research, following a qualitative approach. Data was collected through semi-structured interviews, applied to nurses who care for adults with chronic wounds by a snowball type technique of non-probability sampling until saturation of the same. For the analysis of narratives, we opted for the content analysis according to Bardin. Results: We noticed that the nurse considers autonomous decision making. We identified several factors that contribute to the decision making of nurses when providing care to people with chronic wounds, such as: evaluation of nurses, available resources, mobilization of knowledge, use of third parties, customer opinion, results of planned nursing, clinical experience, available time, scientific security. We obtained two ways to decide. The first participants use the nursing process, but added the phases decision making within multidisciplinary team, care continuity and encouragement to client and family self-care, while the second do not use the nursing process, do it through non deliberate decision or other professional decision. Conclusion: Responsibility for the prevention and treatment of persons with chronic wounds is attributed to the nurse, in decision-making to have into account various factors for choosing the optimal alternative. However, it is intended to be a work in a multidisciplinary team with a comprehensive and holistic approach, seeking to abandon the "wound person" concept, and giving up visibility "to the person with the wound.

Date of Award	2014
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Sérgio Deodato (Supervisor)