Vivências de enfermagem no cuidado à pessoa idosa em Unidade de Terapia Intensiva no contexto da Covid-19

• Ano de defesa: 2022
• Autor(a) principal: Mendes, Kathiane Magalhães
• Orientador(a): Silva, Henrique Salmazo da
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Católica de Brasília
• Programa de Pós-Graduação: Programa Stricto Sensu em Gerontologia
• Departamento: Escola de Saúde e Medicina
• País: Brasil
• Palavras-chave em Português: Pessoa idosa; Idosos; Profissionais de saúde; Pandemia; Covid-19; SARSCoV2; Assistência de enfermagem; Estresse ocupacional
• Palavras-chave em Inglês: Elderly; Health professionals; Pandemic; Nursing care; Occupational
• Área do conhecimento CNPq: CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM; CNPQ::CIENCIAS DA SAUDE
• Link de acesso: https://bdtd.ucb.br:8443/jspui/handle/tede/3171

Introduction: Although pandemics happen sparingly, when present in human history, they cause devastation. In December 2019 the world was surprised by the emergence of a new pandemic disease, the coronavirus disease, which has become one of the deadliest and most feared emerging infections to emerge in recent history. Elderly people and health professionals have gained prominence in the pandemic context. The crisis driven by the SARS-CoV2 pandemic revealed the weaknesses of health services, in addition to highlighting the difficulties experienced by health professionals in their daily work activities. Objective: To analyze the experiences of Nursing professionals in the process of caring for the elderly in an Intensive Care Unit in the context of covid-19, as well as the level of occupational stress of these professionals. Method: This is a qualitative, analytical, cross-sectional, and observationalstudy carried out in the Intensive Care sector of a hospital located in Brasília - DF. The sample had 38 participants among Nurses and Nursing Technicians. A structured instrument called Inventory on Work and Illness Risks – ITRA was used. In addition to this instrument, a questionnaire was applied for sociodemographic evaluation and a semi-structured interview to survey experiences related to Nursing care for the elderly in an Intensive Care Unit in the context of the covid-19 pandemic. qualitative analysis of the participants' testimonies. Results: The results were presented in five academic articles, in order to contextualize the complexity ofthe quantitative and qualitative findings. Each semi-structured interview question was broken down into an article. In the first article, it was observed that Psychological and Social Harm received a critical assessment, while Physical Harm received a severe assessment, suggesting the presence of occupational harm. In the experiences of pleasure and suffering, there was a critical classification for the indicators of professional achievement, freedom of expression and lack of recognition. The emotional exhaustion indicator obtained a severe classification. There was a positive correlation between time working at the institution and years of experience in the ICU (P=0.033), level of professional exhaustion (p=0.046) and lack of recognition (p=0.018); and a negative correlation between time working at the institution and the professional fulfillment domain (p=0.028). With regard to the other variables, there was a positive correlation between the number of jobs, workload (p<0.01) and psychological damage on the EADRT scale (p=0.025). Most participants said they felt drained and exhausted. In study 2, presented in article 2, two categories and six subcategories were listed. In the pillar Age as a lethality marker, the ethical dilemmas involving chronological age as a decision variable for prioritizing treatments in scenarios of resource depletion were addressed. In the infantilization axis of the elderly, the issue of ageism in nursing care for patients aged sixty or more and their implications for ethical and humanized care. In study 3, when contextualizing the narratives about stress at work, wearing and undressing care stressors, scarcity of human resources, work overload and failures in the communication process were considered. Each one with its specificities aroused important loads of stress in nursing professionals. In study 4, when analyzing the narratives about Nursing experiences in caring for the elderly in the pandemic context of covid-19, three categories were established. In the first pillar, the severity of patients facing a lethal disease was discussed. The second axis, portraits of the pandemic, addressed the dilemma of hospitalization of people from the same family and co-workers. And finally, in the third category, the lack of knowledge about covid-19 and the team's feelings of fear and vulnerability were discussed. In study 5, on management conditions, the following results were observed: despite the international recognition and the role of Nursing in measures to combat the pandemic, it is noted that the understanding of these professionals about their role and importance in the institution where they work still is marked by devaluation and indifference. Two categories were established for the analysis of the discourses. In the pillar The visibility of the invisible, the lack ofspace in management and decision-making scenarios was addressed. In the issue of priority axis, the concern with PPE issues and the lack of support for the psychosocial needs of professionals was highlighted. Final considerations: It is time for reflection, to rethink work process management models to meet fundamental needs and envisage adjustments in favor of a more efficient and qualified health system, with adequate resources and innovative care models that provide means to stimulate the ability of professionals to face situations with a higher level of pressure and suffering.