Diagnósticos de enfermagem identificados em puérperas no período imediato e tardio no contexto da comunidade
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2008-07-16
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Universidade Federal de Goiás
Resumo
The puerperium occurs concomitant to the efetive exercise of maternity, in
which a woman experiences profounds changes, within biological and in
psychological and socio-cultural. The planned assistance, with the lifting of data,
identification of human responses to problems or events from the life cycle in
individual aspects, considering the context in which this woman is embedded is
crucial during the post-partum phase. Studies with focus on nursing diagnosis (ND)
identified in the puerperium have been made eminently at the hospital's context. This
survey aimed to analyze the occurrence of 26 diagnosis of nursing care in the
interest of immediate and late puerperium in the context of the community. This is a
descriptive study of quantitative approach, carried out between February and May
2008. For the data gathering has been prepared an instrument from the defining
characteristics and related factors / risk factors of diagnosis of interest, the NANDA
Taxonomy II, version 2007-2008. The data gathering has included procedures for
interview, physical examination and observation. A researcher conducted the
fieldwork, completed the roadmap for collection and noted the diagnosis inference.
Two experts reviewed the material for analysis of evidence about the presence of
diagnosis reported. In the analysis was adopted procedures of descriptive statistics
and inferential (Mann-Whitney, chi-square and its variants, P ≤ 0.05). It was even
used Segment analysis, considering the typology of diagnosis made. Participated in
the sample 40 puerperium during immediate and late periods, belonging to the
team's area of coverage of family health team in the east region, after having been
read and signed the term of free and informed consent. The socio-demographic
characteristics of the participants were: predominant age group between 21 to 25
years (37.5%); brown color that self (65%), marital status or married with stable
partner (82.5%); incomplete primary education (47.5%), 60% with housing itself;
family income was, predominantly, from 1 to 2 (32.5%) or 3 to 4 (42.5%) minimum
wage; family income over the male figure, since 55% of puerperium reported as
occupying housewives. In this sample 65% had caesarian childbirth, the majority
(70%) had up to two children, 80% began prenatal care in the first trimester of
pregnancy, 80% performed at least 6 consultations, 90% had to full-term child; 32.5%
claimed to have had urinary tract infection during pregnancy. Has been identified in
this sample the occurrence of 24 of the 26 ND studied. Besides evidence of two new
ND. The number of ND ranged from 08 to 16 in each puerperal woman, with an
average of 13, totaling 521 ND, with 266 real diagnosis, 168-risk and 87 welfare or
health promotion. In examining the relationship between the diagnosis of nursing and
socio-demographic variables and obstetric (chi-square and its variants) was found a
significant association for the diagnosis of breastfeeding interrupted and type of
housing (p = 0.028); risk of breastfeeding interrupted and type of housing (p = 0.028);
impaired tissue integrity and type of delivery (p = 0.011); risk for impaired integrity
skin and number queries from prenatal (p = 0.020); impaired integrity skin and
household income (p = 0.043)/number queries from prenatal (p = 0.032); altered
nutrition: less than body requirements and housing (p = 0.001)/self that color (p =
0.021)/parity (p = 0.020); provision for improved nutrition and that self color (p =
0.044); altered nutrition: more than body requirements and type of housing (p =
0.001); acute pain and family income (p = 0.032)/self that color (p = 0.032 )/days of postpartum (p = 0.013)/type of delivery (p = 0.002); risk of constipation and type of
delivery (p = 0.017); situational low self-esteem and family income (p=0,022). In
examining the relationship between the number of diagnosis identified and the
variables of interest, were not significantly different (Mann-Whitney). In the analysis
of segments were found two cluster, which prevailed in the first segment more ND
real and potential, than those related to psychological and social aspects. The
characteristics of the two subgroups are presented descriptively. It was concluded
that the diagnoses initially predicted were found in postpartum period at early and
late period's, representing more human responses than those that have traditionally
been exploited in monitoring the puerperal period, and is necessary to review the
approach of nursing in this area under the education, assistance, research and public
policies.
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Citação
VIEIRA, Flaviana. Nursing Diagnosis identified in Puerperium at the immediate and late period at the comunity context. 2008. 203 f. Dissertação (Mestrado em Cuidado em Enfermagem) - Universidade Federal de Goiás, Goiânia, 2008.