Understandings and practices of nursing and injured clients: a case study


Carla Lucia Goulart Constant Alcoforado1, Fátima Helena do Espírito Santo2

1Minas Gerais Federal University
2Fluminense Federal University


In the city of Cruzeiro do Sul, Brazil, it is common to see clients using treatment for wounds that are against the proven techniques of scientific nursing. This makes it necessary to know their understandings and practices in order to guide an interaction with this clientele in order to plan adequate care in terms of their needs.

Aim: to describe how the members of the health team take care of injured clients; to identify how these clients take care to themselves; and to discuss the understandings and practices among the members of the nursing team.
Method: This is a case study which adopts a qualitative approach, with a data analysis based on the topic.
Results: The way that professionals conduct the caring process is directly related to the knowledge acquired during professional education, and also based on personal values, experiences and culture, in general. The self-care done by the clients has been learned and shared throughout life. There is an association between popular methods and professional ones as a means of treating injuries.
Conclusion: Caring needs to be planned in conjunction with the client, and their beliefs must be understood instead of being ignored.
Descriptors: Nursing; Nursing Care; Cultural Diversity.



In the city of Cruzeiro do Sul, Brazil, it is common to see injured clients use forms of treatment that are against the scientific nursing guidelines. This makes it necessary that the members of the nursing team know the settings of the beliefs, values, understandings and practices of their clients, in order to better guide and interact with such clients(1).  This is necessary in order to be aware of their actions since the appearance of the injury, to plan not only the technical proceedings, but also to guide the necessary care, aiming for an awareness of the importance of self-care at home(2). From this premise, this study described how members of the nursing team who take care of injured clients, identify how these clients practice self-care and how the members of the nursing team discuss the understandings and practices of their clients.



This is a case study which adopts a qualitative, descriptive and exploratory approach. It was performed in the municipality of Cruzeiro do Sul, Brazil; the scenario was the emergency ward of the Basic Care Unit Dr. Abel Pinheiro. The subjects of this research were the members of the nursing team who worked directly with injured clients of the above-mentioned ward, and clients over 18 years of age, who were being cared for in this ward, after formalizing their participation by signing a Free and Clear Consent Agreement. This research was approved by the Ethics Committee of Antonio Pedro College Hospital/Fluminense Federal University, under protocol 187/09. To collect the data, simple observation techniques and semi-structured interviews were used, recorded on an MP4 device. At the end of the data collection, details of the observation noted, the interviews were transcribed, and, to treat the data, a Topic Analysis method was used.



The data was grouped and presented in categories: the practices of caring on the part of the nursing team and of the injured clients; the understandings of the injured clients and the implications for nursing care. The format that the professionals use to provide care are related to the knowledge acquired during their professional education, and also relate to their personal values, habits, experiences and culture, in general. However, in some situations, the professionals directed their attention to the characteristics of the injury and the topic treatment, despite working towards a holistic care. The caring done by the clients, their understandings and practices, were learned and shared throughout their lives. There is an association with popular caring and professional caring when it comes to treating injuries. While the injury is compromising, the clients search for professional healthcare. However, when noting some progress in the healing of the wound, they abandon the basic care unit service and make use of their popular understanding with regard to the process of healing. The clients use many different practices such as hygiene and antisepsis of the wound using tap water or well water to wash the lesion. Sometimes, they use soap and a rag to rub the wound, and there are some reports of the use of alcohol, talc powder and salt water. The use of virgin olive oil and andiroba oil after cleansing was also mentioned as, according to the clients, these oils facilitate cicatrization and heal the wounds. The use of plants for teas and poultices is common among women of advanced age. Dietary restrictions, such as “fat” fish and pork meat, are reported. However, armadillo and deer meat are also suggested, because they are quiet animals, and the ingestion of such meat does not interfere with the cicatrization of the injury. The clients also valorize their faith in God, as it helps to improve the healing, or even can lead to a cure.



The caring practices must be planned with the client, who needs to have his beliefs understood(3). To see the client in his integrality, keeping a dialogic relationship, rethinking the assistive practices(4), and developing the caring that allows the professional system to work together with popular health remedies are necessary attitudes in order to develop an adequate caring practice, consonant with the needs of the clientele(1).



1. Muller, C.P; Araújo, U.E; Bonilha, A.L.L. Possibilidade de inserção do cuidado congruente. REE [ Serial on line ]. 2007; Sep-Dec; 9 (3): 858-865.

2. Silva, D.M.S.da; Mocelin, K.R. O cuidado de enfermagem ao cliente portador de feridas sob a ótica do cuidado transcultural. Revista Nursing. 2007; Feb. São Paulo, 9 (105), p.81-88.

3. Saito, R.X.S. Politicas de saúde- Princípios, Diretrizes e Estratégias para a Estruturação de um SUS. In: Ohara, E.C; Ribeiro; Saito.R.X.S. Saúde da Família: Considerações Teóricas e Aplicabilidade. São Paulo. Martinari, 2008. 429p.

4. Oriá MOB, Ximenes LB, Alves MDS. Madeleine Leininger and the Theory of the Cultural Care Diversity and Universality: an Historical Overview. Online Braz J Nurs (OBJN-ISSN 1676-4285) [ online ] 2005 August; 4(2) Available 




Carla Lucia Goulart Constant Alcoforado: the Master student developed the study in the municipality of Cruzeiro do Sul, Brazil, including literature review, data collection, analysis and discussion.
Fátima Helena do Espírito Santo: study/dissertation tutor.

PLACE, DATE OF DEFENSE: Niterói, Brazil. December 2nd 2010.
EXAMINERS: Prof. Dr. Fatima Helena do Espírito Santo (Head of the Board); Prof. Dr. Marilda Andrade (Member of the Board), Prof. Dr. Isaura Setenta Porto (Member of the Board).
BIBLIOGRAPHICAL REFERENCE: Alcoforado CLGC. Entre o científico e o popular: saberes e práticas da equipe de enfermagem e clientes com feridas: um estudo de caso no município Cruzeiro do Sul – Acre [ dissertation ]. Niterói: Universidade Federal Fluminense, Escola de Enfermagem Aurora de Afonso Costa; 2010. 145f



Received: 29/08/2013
Revised: 05/09/2013
Approved: 07/09/2013