Analysis Of Adhesion And Self-Care In Patients Submitted To Lung Transplant In Outpatient Clinic Follow-Up

Introduction: The lung transplant is the only option of survival of the patient affected by a deadly lung disease. The outpatient clinic follow-up requires the patient discipline and responsibility in the face of complex care suggested by the multidisciplinary team.  Objectives: Meet aspects related to adhesion to treatment and self-care of patients submitted to the lung transplant, accompanied, in outpatients, in a referral hospital in Fortaleza-Ceará-Brazil. Methods: Exploratory research with qualitative approach, in a referral hospital in cardiovascular and pulmonary diseases in Fortaleza-Ceará, in the period September 2015 to January 2016. 10 patients transplanted lung were interviewed, after approval by the ethics committee of this institution. The Organization and analysis of the data was backed up on phenomenological and theoretical saturation used to meet the significant units. Results: It was noticed the strong bond established by patients and professionals of the team that accompanies them. That bond is characterized by a relationship of trust between patient and professional, stimulating attendance and adhesion of the transplanted in outpatient visits. Outpatient consultations in lung transplant marked commitment, the accuracy of both periodical transplanted as part of some professional multidisciplinary team. On the other hand, it was observed the lack of autonomy of some categories. Conclusion: The treatment is complex and requires a commitment of both transplanted and the professionals who make up the lung transplant team. There was the patient's commitment in to adhere to consultations and interest in following the guidance of care. Is necessary joint participation and integral of all categories, in order to promote multiple interventions and educational practices in the singular therapeutic plan of transplanted

DECISÕES DO GOVERNO BRASILEIRO NO ENFRENTAMENTO DA COVID-19: REPERCUSSÕES PARA O CUIDADO CLÍNICO DE ENFERMAGEM

Objective: to analyze the repercussions of the decisions of the Brazilian federal government proposed to face COVID-19 in clinical nursing care. Method: documentary study based on publications from January 2020 to June 2021 published on the official website of the federal government. A total of 144 documents were obtained, which were analyzed in full, presented in a flowchart and Descending Hierarchical Classification (CHD), the latter generated by the IRaMuTeQ Software. Results: CHD generated six classes: social scope, public management, economics in the pandemic and health care targeting. Decisions focused on recognizing the existence of the pandemic scenario and establishing the creation of committees for management and confrontation, management of hospital supplies, redefinition of goals related to health indicators and combating violence. Final considerations: the determinations to face the pandemic presented actions limited, primarily, to the curative aspects that impacted the offer of clinical nursing care by reinforcing the biomedical model of health care.Objetivo: analizar las repercusiones de las decisiones del gobierno federal brasileño propuestas para enfrentar la COVID-19 en la atención clínica de enfermería. Método: estudio documental basado en publicaciones de enero de 2020 a junio de 2021 publicadas en el sitio web oficial del gobierno federal. Se obtuvo un total de 144 documentos, los cuales fueron analizados en su totalidad, presentados en un diagrama de flujo y Clasificación Jerárquica Descendente (CHD), esta última generada por el Software IRaMuTeQ. Resultados: la CHD generó seis clases: alcance social, gestión pública, economía en la pandemia y focalización de la atención en salud. Las decisiones se centraron en reconocer la existencia del escenario de pandemia y establecer la creación de comités de gestión y enfrentamiento, gestión de insumos hospitalarios, redefinición de metas relacionadas con indicadores de salud y combate a la violencia. Consideraciones finales: las determinaciones para enfrentar la pandemia presentaron acciones limitadas, principalmente, a los aspectos curativos que impactaron la oferta de cuidados clínicos de enfermería reforzando el modelo biomédico de atención a la salud.Objetivo: analisar as repercussões das decisões do Governo Federal brasileiro no enfrentamento da COVID-19 no cuidado clínico de enfermagem. Método: estudo documental baseado nas publicações de janeiro de 2020 a junho de 2021 divulgadas no site oficial do governo federal. Obtiveram-se 144 documentos que foram analisados na íntegra, apresentados em fluxograma e em Classificação Hierárquica Descendente, esta gerada pelo software IRaMuTeQ. Resultados: a Classificação Hierárquica Descendente gerou seis classes condensadas em: COVID-19 no Brasil, âmbito social, gestão pública, economia na pandemia e direcionamento da assistência em saúde. As decisões centraram-se em reconhecer a existência do cenário pandêmico e estabelecer criação de comitês para gestão e enfrentamento, gestão de insumos hospitalares, redefinição de metas relacionadas aos indicadores de saúde e combate à violência. Considerações finais: as determinações para enfrentamento da pandemia apresentaram ações circunscritas, prioritariamente aos aspectos curativistas, que impactaram na oferta dos cuidados clínicos de enfermagem ao reforçarem o modelo biomédico de atenção à saúde. Descritores: Governo. Pandemias. COVID-19. Políticas. Cuidado de Enfermagem

Outpatient nursing care: perception of the heart transplant patients on outpatient nursing consultation Assistência de enfermagem ambulatorial: percepção de transplantados cardíacos sobre a consulta de enfermagem ambulatorial

Resumo Objetivo: Conhecer a percepção de transplantados cardíacos em relação à consulta de enfermagem em um ambulatório na Unidade de Transplante e Insuficiência Cardíaca (UTIC). Método: Estudo descritivo, de abordagem qualitativa, realizado na UTIC de um hospital público, localizado em Fortaleza, Ceará, de julho a novembro de 2013, com 11 pacientes transplantados cardíacos. Os discursos foram obtidos através da entrevista semiestruturada e organizados segundo os pressupostos teóricos da hermenêutica. Resultados: Os pacientes revelaram o impacto sofrido pelo transplante cardíaco e satisfação no acolhimento pelos profissionais, em especial, a enfermeira. Expressaram o reconhecimento das orientações prestadas, das modificações estabelecidas nesse processo e do vínculo entre enfermeira-paciente. Conclusão:Os transplantados cardíacos compreenderam que a enfermeira age de forma humanizada, acolhedora, cria vínculos e promove o autocuidado a fim de garantir melhorias na saúde, por meio da consulta de enfermagem ambulatorial. Descritores: Transplante de coração, Ambulatório hospitalar, Enfermagem

Experiences Of Mothers Of Children With Congenital Heart Disease

Introduction: This article discusses the experience of mothers during the process of falling ill of their children with congenital heart disease. Method: This is a descriptive research with qualitative approach conducted with nine mothers who had their babies admitted to a pediatric cardiology unit in a reference center for treatment of congenital heart disease in the North and Northeast regions in Brazil located in Fortaleza, Ceará. Information and reports on the experience of these mothers emerging from the diagnosis process, surgery, treatment and hospitalization were collected in semi-structured individual interviews. After interviews, the testimonies of mothers were transcribed in full-length, identifying the speeches with the codes M1, M2,...M9, thereby ensuring anonymity. We used the thematic analysis technique of Minayo (2012) for treatment of information and design of the content of this article. This article is part of the research project: Breastfeeding babies with heart disease, approved by the Research Ethics Committee of the Messejana Hospital, under Opinion No 1,285,784. Results: The study demonstrated that infants with congenital heart disease require specific and specialized care and that mothers undertake a long and sometimes painful journey in the search for the healing of their child. Conclusion: Based on the collected speeches, we learned that mothers also need to be assisted by professionals of the health team. They must support the mother's empowerment in the child care and strengthen the relationship of the mother-infant binomial, and help in coping and adapting to the reality in the process of falling ill and healing of their child.   Key words: Congenital heart disease. Experience of mother

Diretivas Antecipadas de Vontade em pacientes sob Cuidados Paliativos no contexto da COVID-19: uma revisão integrativa

Objectives: To evaluate the use of advance directives in patients in palliative care in the context of COVID-19. Methodology: Integrative literature review, performed in the SciELO, LILCAS, MEDLINE, PubMed, Scopus and Web of Science databases, resulting in 22 articles, characterized in the level of evidence and main findings. Results: The advance directives guide care and reduce the possibility of iatrogenic and unwilling treatments, preserving the right to autonomy and preferences of the subjects involved in the process, especially in the current pandemic context. Conclusion: The COVID-19 pandemic foments ethical and legal dilemmas, reinforcing the demand for advance directives and the importance of debate on the subject.  Esta pesquisa tem por objetivo aAnalisar as evidências científicas sobre utilização das Diretivas Antecipadas de Vontade em pacientes sob Cuidados Paliativos no contexto da COVID-19.  Foi realizada uma revisão integrativa da literatura nas bases de dados SciELO, LILCAS, MEDLINE, PubMed, Scopus e Web of Science, resultando em 22 artigos, caracterizados quanto ao nível de evidência e principais achados. As diretivas antecipadas de vontade orientam o cuidado e reduzem a possibilidade de tratamentos iatrogênicos e contra a vontade, preservando o direito à autonomia e preferências dos sujeitos envolvidos no processo, especialmente no contexto pandêmico atual. A pandemia de COVID-19 fomenta dilemas éticos e legais, reforçando a demanda por diretivas antecipadas de vontade e a importância do debate sobre o tema