Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado

Detalhes bibliográficos
Ano de defesa: 2017
Autor(a) principal: Souza, Bruna Felisberto de
Orientador(a): Wernet, Monika lattes
Banca de defesa: Não Informado pela instituição
Tipo de documento: Dissertação
Tipo de acesso: Acesso aberto
Idioma: por
Instituição de defesa: Universidade Federal de São Carlos
Câmpus São Carlos
Programa de Pós-Graduação: Programa de Pós-Graduação em Enfermagem - PPGEnf
Departamento: Não Informado pela instituição
País: Não Informado pela instituição
Palavras-chave em Português:
Palavras-chave em Inglês:
Palavras-chave em Espanhol:
Área do conhecimento CNPq:
Link de acesso: https://repositorio.ufscar.br/handle/ufscar/9763
Resumo: Innumerous specificities of the pregnancy-puerperal cycle lead and claim for health practices aimed at qualified listening, empathy and acceptance, especially in the face of the understanding of this phenomenon in its physical, psychic and social transformations. However, the current health obstetrical model is supported by the biomedical view, which disrespects and ignores women’s right to health, from a perspective of little involvement in their care, limiting access and information. This reality infers that women have a submissive role in the system, especially in situations of greater vulnerability, as in the case of gestating and giving birth in a condition of high risk. This qualitative and field study aimed at characterizing and discussing the nursing care practice of a maternity nursing team to hospitalized high risk pregnant women. We used Integrality and Care in health practices as theoretical conceptual basis and as a methodological reference Content Analysis, in its thematic modality. The data were collected in a municipality in the interior of the state of São Paulo, through non-participant observation of nursing care to high-risk pregnant women followed by an individual and open interview with six nurses, four nursing technicians and two nursing assistants, totaling twelve participants, responsible for direct care to hospitalized pregnant women at risk. The analysis of empirical data allowed us to identify that the care practice of hospitalized high risk pregnant women is anchored in three processes, portrayed by the thematic categories “Emotional welcome”, “Information support” and “Evaluation and monitoring of gestational risk”. In the first thematic category, we noted efforts to provide a practice guided by empathy and acceptance, with recognition of these axes as aspects that base the humanization of care. Another integrating front of the practice of care is the provision of information, supported by the recognition of insufficiency and even the lack of information to women about the risk situation. However, they prioritize instrumental practice as an assistance core, referencing the nurse in support of this practice. It is concluded that, in fact, nursing care practice is central in instrumental actions and support to the physician. However, in its intentions it denotes centrality in the women's desire for emotional and informational reception, when they invest in achieving good interpersonal relationships with pregnant women. Relations between these issues are poorly interconnected, with emphasis on technical successes, with weaknesses in terms of practical successes, which does not allow them to be classified as integral. Attitudinal and structural changes are thus necessary, with attention to the humanistic and integrality precepts and, above all, focused on the practical success of the actions.
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spelling Souza, Bruna Felisberto deWernet, Monikahttp://lattes.cnpq.br/6056127658896265Bussadori, Jamile Claro de Castrohttp://lattes.cnpq.br/4549657176930635http://lattes.cnpq.br/59619149977332542018-04-16T19:34:28Z2018-04-16T19:34:28Z2017-11-22SOUZA, Bruna Felisberto de. Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado. 2017. Dissertação (Mestrado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2017. Disponível em: https://repositorio.ufscar.br/handle/ufscar/9763.https://repositorio.ufscar.br/handle/ufscar/9763Innumerous specificities of the pregnancy-puerperal cycle lead and claim for health practices aimed at qualified listening, empathy and acceptance, especially in the face of the understanding of this phenomenon in its physical, psychic and social transformations. However, the current health obstetrical model is supported by the biomedical view, which disrespects and ignores women’s right to health, from a perspective of little involvement in their care, limiting access and information. This reality infers that women have a submissive role in the system, especially in situations of greater vulnerability, as in the case of gestating and giving birth in a condition of high risk. This qualitative and field study aimed at characterizing and discussing the nursing care practice of a maternity nursing team to hospitalized high risk pregnant women. We used Integrality and Care in health practices as theoretical conceptual basis and as a methodological reference Content Analysis, in its thematic modality. The data were collected in a municipality in the interior of the state of São Paulo, through non-participant observation of nursing care to high-risk pregnant women followed by an individual and open interview with six nurses, four nursing technicians and two nursing assistants, totaling twelve participants, responsible for direct care to hospitalized pregnant women at risk. The analysis of empirical data allowed us to identify that the care practice of hospitalized high risk pregnant women is anchored in three processes, portrayed by the thematic categories “Emotional welcome”, “Information support” and “Evaluation and monitoring of gestational risk”. In the first thematic category, we noted efforts to provide a practice guided by empathy and acceptance, with recognition of these axes as aspects that base the humanization of care. Another integrating front of the practice of care is the provision of information, supported by the recognition of insufficiency and even the lack of information to women about the risk situation. However, they prioritize instrumental practice as an assistance core, referencing the nurse in support of this practice. It is concluded that, in fact, nursing care practice is central in instrumental actions and support to the physician. However, in its intentions it denotes centrality in the women's desire for emotional and informational reception, when they invest in achieving good interpersonal relationships with pregnant women. Relations between these issues are poorly interconnected, with emphasis on technical successes, with weaknesses in terms of practical successes, which does not allow them to be classified as integral. Attitudinal and structural changes are thus necessary, with attention to the humanistic and integrality precepts and, above all, focused on the practical success of the actions.Inúmeras especificidades do ciclo gravídico-puerperal conduzem e exigem práticas em saúde que visam escuta qualificada, empatia e acolhimento, principalmente frente à compreensão deste fenômeno nas suas transformações físicas, psíquicas e sociais. Contudo, o modelo de atenção à saúde e obstétrico em vigência, é amparado pelo olhar biomédico, que desrespeita e ignora o direito à saúde das mulheres, sob uma perspectiva de pouco envolvê-la em seu cuidado, limitando o acesso e a informação. Tal realidade outorga à mulher um papel de submissa frente ao sistema, especialmente nas situações de maior vulnerabilidade, como no caso do gestar e parir na condição de alto risco gestacional. O presente estudo, qualitativo e de campo, objetivou caracterizar e discutir a prática assistencial da equipe de enfermagem de uma maternidade às gestantes de alto risco hospitalizadas. Elencou-se como base teórico-conceitual a Integralidade e Cuidado nas práticas de saúde e como referencial metodológico a Análise de Conteúdo, na modalidade temática. A coleta dos dados se deu em um município do interior paulista, por meio de observação não participante da assistência de enfermagem às gestantes de alto risco seguida de entrevista individual e aberta com seis enfermeiros, quatro técnicos de enfermagem e dois auxiliares de enfermagem, totalizando doze participantes, responsáveis pelo cuidado direto às gestantes de risco hospitalizadas. A análise dos dados empíricos permitiu identificar que a prática assistencial às gestantes de alto risco hospitalizadas está ancorada em três processos, retratados pelas categorias temáticas “Acolhimento emocional”, “Apoio informacional” e “Avaliação e monitoramento do risco gestacional”. Na primeira categoria temática, nota-se esforços da equipe de enfermagem para prover uma prática norteada por empatia e acolhimento, com reconhecimento desses eixos enquanto aspectos que fundamentam a humanização do cuidado. Outra frente integrante da prática assistencial é a oferta de informações, sustentada pelo reconhecimento de insuficiência e até mesmo, ausência de informação às mulheres acerca da situação de risco. Contudo, priorizam a prática instrumental enquanto núcleo assistencial, referenciando a enfermeira no suporte à essa prática. Conclui-se que, em ato, a prática assistencial de enfermagem tem a centralidade nas ações instrumentais e atendimento médico. Contudo, em intenções, denota centralidade no desejo de acolhimento emocional e informacional da mulher, quando assumem investimentos no alcance de boas relações interpessoais com as gestantes. As relações entre estas questões estão pouco interligadas, sobressaindo a orientação aos êxitos técnicos, com fragilidades para assumir alcances em termos de sucessos práticos, o que não permite qualifica-las como integrais. Faz-se necessário mudanças atitudinais e estruturais, com atenção aos preceitos humanísticos e de integralidade e sobretudo, voltadas ao sucesso prático das ações.Não recebi financiamentoporUniversidade Federal de São CarlosCâmpus São CarlosPrograma de Pós-Graduação em Enfermagem - PPGEnfUFSCarIntegralidade em saúdeEnfermagem obstétricaHumanização da assistênciaGravidez de alto riscoEquipe de enfermagemIntegralidad en saludEnfermería obstétricaHumanización de la atenciónEmbarazo de alto riesgoGrupo de enfermeríaHealth integralityObstetric nursingHumanization of assistanceNursing, teamPregnancy, High-riskCIENCIAS DA SAUDE::ENFERMAGEMCIENCIAS DA SAUDE::ENFERMAGEM::ENFERMAGEM OBSTETRICAEnfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidadoNursing and hospitalized high-risk pregnant women : challenges to the integrality of careinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisOnlineinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFSCARinstname:Universidade Federal de São Carlos (UFSCAR)instacron:UFSCARLICENSElicense.txtlicense.txttext/plain; charset=utf-81957https://{{ getenv "DSPACE_HOST" "repositorio.ufscar.br" }}/bitstream/ufscar/9763/3/license.txtae0398b6f8b235e40ad82cba6c50031dMD53ORIGINALSOUZA_Bruna_2018.pdfSOUZA_Bruna_2018.pdfapplication/pdf1860508https://{{ getenv "DSPACE_HOST" "repositorio.ufscar.br" }}/bitstream/ufscar/9763/4/SOUZA_Bruna_2018.pdf10c1916a5ed368f443d81aca7346ad19MD54TEXTSOUZA_Bruna_2018.pdf.txtSOUZA_Bruna_2018.pdf.txtExtracted texttext/plain186187https://{{ getenv "DSPACE_HOST" "repositorio.ufscar.br" }}/bitstream/ufscar/9763/5/SOUZA_Bruna_2018.pdf.txtf4f81e18bb4a542edc9cb3a6da1595bbMD55THUMBNAILSOUZA_Bruna_2018.pdf.jpgSOUZA_Bruna_2018.pdf.jpgIM Thumbnailimage/jpeg6878https://{{ getenv "DSPACE_HOST" "repositorio.ufscar.br" }}/bitstream/ufscar/9763/6/SOUZA_Bruna_2018.pdf.jpg34878c200f3c321ebe4b5ad147900b76MD56ufscar/97632019-09-11 02:55:15.759oai:repositorio.ufscar.br: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Repositório InstitucionalPUBhttps://repositorio.ufscar.br/oai/requestopendoar:43222023-05-25T12:55:15.484358Repositório Institucional da UFSCAR - Universidade Federal de São Carlos (UFSCAR)false
dc.title.por.fl_str_mv Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
dc.title.alternative.eng.fl_str_mv Nursing and hospitalized high-risk pregnant women : challenges to the integrality of care
title Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
spellingShingle Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
Souza, Bruna Felisberto de
Integralidade em saúde
Enfermagem obstétrica
Humanização da assistência
Gravidez de alto risco
Equipe de enfermagem
Integralidad en salud
Enfermería obstétrica
Humanización de la atención
Embarazo de alto riesgo
Grupo de enfermería
Health integrality
Obstetric nursing
Humanization of assistance
Nursing, team
Pregnancy, High-risk
CIENCIAS DA SAUDE::ENFERMAGEM
CIENCIAS DA SAUDE::ENFERMAGEM::ENFERMAGEM OBSTETRICA
title_short Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
title_full Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
title_fullStr Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
title_full_unstemmed Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
title_sort Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado
author Souza, Bruna Felisberto de
author_facet Souza, Bruna Felisberto de
author_role author
dc.contributor.authorlattes.por.fl_str_mv http://lattes.cnpq.br/5961914997733254
dc.contributor.author.fl_str_mv Souza, Bruna Felisberto de
dc.contributor.advisor1.fl_str_mv Wernet, Monika
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6056127658896265
dc.contributor.advisor-co1.fl_str_mv Bussadori, Jamile Claro de Castro
dc.contributor.advisor-co1Lattes.fl_str_mv http://lattes.cnpq.br/4549657176930635
contributor_str_mv Wernet, Monika
Bussadori, Jamile Claro de Castro
dc.subject.por.fl_str_mv Integralidade em saúde
Enfermagem obstétrica
Humanização da assistência
Gravidez de alto risco
Equipe de enfermagem
topic Integralidade em saúde
Enfermagem obstétrica
Humanização da assistência
Gravidez de alto risco
Equipe de enfermagem
Integralidad en salud
Enfermería obstétrica
Humanización de la atención
Embarazo de alto riesgo
Grupo de enfermería
Health integrality
Obstetric nursing
Humanization of assistance
Nursing, team
Pregnancy, High-risk
CIENCIAS DA SAUDE::ENFERMAGEM
CIENCIAS DA SAUDE::ENFERMAGEM::ENFERMAGEM OBSTETRICA
dc.subject.spa.fl_str_mv Integralidad en salud
Enfermería obstétrica
Humanización de la atención
Embarazo de alto riesgo
Grupo de enfermería
dc.subject.eng.fl_str_mv Health integrality
Obstetric nursing
Humanization of assistance
Nursing, team
Pregnancy, High-risk
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::ENFERMAGEM
CIENCIAS DA SAUDE::ENFERMAGEM::ENFERMAGEM OBSTETRICA
description Innumerous specificities of the pregnancy-puerperal cycle lead and claim for health practices aimed at qualified listening, empathy and acceptance, especially in the face of the understanding of this phenomenon in its physical, psychic and social transformations. However, the current health obstetrical model is supported by the biomedical view, which disrespects and ignores women’s right to health, from a perspective of little involvement in their care, limiting access and information. This reality infers that women have a submissive role in the system, especially in situations of greater vulnerability, as in the case of gestating and giving birth in a condition of high risk. This qualitative and field study aimed at characterizing and discussing the nursing care practice of a maternity nursing team to hospitalized high risk pregnant women. We used Integrality and Care in health practices as theoretical conceptual basis and as a methodological reference Content Analysis, in its thematic modality. The data were collected in a municipality in the interior of the state of São Paulo, through non-participant observation of nursing care to high-risk pregnant women followed by an individual and open interview with six nurses, four nursing technicians and two nursing assistants, totaling twelve participants, responsible for direct care to hospitalized pregnant women at risk. The analysis of empirical data allowed us to identify that the care practice of hospitalized high risk pregnant women is anchored in three processes, portrayed by the thematic categories “Emotional welcome”, “Information support” and “Evaluation and monitoring of gestational risk”. In the first thematic category, we noted efforts to provide a practice guided by empathy and acceptance, with recognition of these axes as aspects that base the humanization of care. Another integrating front of the practice of care is the provision of information, supported by the recognition of insufficiency and even the lack of information to women about the risk situation. However, they prioritize instrumental practice as an assistance core, referencing the nurse in support of this practice. It is concluded that, in fact, nursing care practice is central in instrumental actions and support to the physician. However, in its intentions it denotes centrality in the women's desire for emotional and informational reception, when they invest in achieving good interpersonal relationships with pregnant women. Relations between these issues are poorly interconnected, with emphasis on technical successes, with weaknesses in terms of practical successes, which does not allow them to be classified as integral. Attitudinal and structural changes are thus necessary, with attention to the humanistic and integrality precepts and, above all, focused on the practical success of the actions.
publishDate 2017
dc.date.issued.fl_str_mv 2017-11-22
dc.date.accessioned.fl_str_mv 2018-04-16T19:34:28Z
dc.date.available.fl_str_mv 2018-04-16T19:34:28Z
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dc.identifier.citation.fl_str_mv SOUZA, Bruna Felisberto de. Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado. 2017. Dissertação (Mestrado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2017. Disponível em: https://repositorio.ufscar.br/handle/ufscar/9763.
dc.identifier.uri.fl_str_mv https://repositorio.ufscar.br/handle/ufscar/9763
identifier_str_mv SOUZA, Bruna Felisberto de. Enfermagem e gestantes de alto risco hospitalizadas : desafios para integralidade do cuidado. 2017. Dissertação (Mestrado em Enfermagem) – Universidade Federal de São Carlos, São Carlos, 2017. Disponível em: https://repositorio.ufscar.br/handle/ufscar/9763.
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Câmpus São Carlos
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dc.publisher.initials.fl_str_mv UFSCar
publisher.none.fl_str_mv Universidade Federal de São Carlos
Câmpus São Carlos
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