Nursing care model in palliative care: convergent care research
Gleyce Any Freire de Lima Carvalho1, Bertha Cruz Enders1, Anne Karoline Candido Araújo1, Marcela Paulino Moreira da Silva1
1 Federal University of Rio Grande do Norte
ABSTRACT
Objective: Develop and validate a model of nursing care for people in palliative care in the context of Home Care. Method: Methodological study Convergent Care Research, with a qualitative approach. The research scenario will be the Home Care Service of the Municipality of Natal, Rio Grande do Norte, Brazil. After the consent of those responsible for the service, and acceptance by the nursing professionals who will be included in the study, the researcher will follow the nursing actions carried out at home through a script, field diary, interview and focus group. In the data analysis, the assistance of the Atlas Ti.1® software will be used and the construction of the model will be anchored in Kolcaba's theory of comfort. Results: it is expected that the model developed and validated with the professionals can contribute to the nursing practice of the person in palliative care at home.
Keywords: Nursing Theory; Palliative Care; Home Care Service.
INTRODUCTION
The nursing practice in the world, and in Brazil, develops for individuals with care needs throughout the life cycle. These are life stages affected by different health conditions in view of the growing number of people with chronic health conditions, increased aging and palliative care. The Ministry of Health established Home Care as a health modality at home that offers health promotion actions, prevention, treatment of diseases and rehabilitation, with guaranteed continuity of care in the Network. At home people in palliative care are accompanied by multiprofessional home care teams and a multiprofessional support team from the Home Care Service(1). The study presents an innovative proposal that moves the research environment from the laboratory to the real world in which nursing encounters with the community occur (2). A scientifically based model of nursing leads to reflective work in addition to the constant search for improving care. It is hoped that this nursing model can favor the results of home care services and contribute to care practice.
GUIDING QUESTION
What is the knowledge and practice of nursing professionals carried out at home for people in palliative care?
GENERAL OBJECTIVE
Develop and validate a model of nursing care for people in palliative care in the context of Home Care.
SPECIFIC OBJECTIVES
Describe the know-how of nursing professionals to the person in palliative care at home.
Analyze the know-how of nursing care provided to people in palliative care at home.
Develop a conceptual structure in a model form that represents the know-how of nursing professionals to the person in palliative care at home.
Validate the model with nursing professionals for the person in palliative care.
THEORETICAL REFERENCE
The study in question will use Kolcaba's Theory of Comfort as a theoretical framework to guide the construction of the model. It is a medium-range theory of direct applicability to nursing practice. The taxonomic structure of comfort involves four contexts of human experience. The theorist managed to evolve the technical definition of holistic comfort. So, comfort is the immediate experience of being strengthened by having needs for relief, ease and transcendence. Comfort involves the contexts of human experience: (Psychic), related to bodily and physical dimensions, the (psychospiritual) meaning of a person's life towards others, the (sociocultural) refers to interpersonal relationships and the (environmental) that belongs to the external factors of the environment.
METHOD
It is a Convergent Care Research, with a qualitative approach. Studies in this modality are based on the idea that the research problems that arise from professional practice make it possible to identify the proposition of appropriate solutions to a specific context. It covers five phases: conception, instrumentation, scanning, analysis and interpretation. When the objective of Convergent Care Research is the construction of a theoretical model, the same phases are used, through the inductive-deductive process aimed at theoretical construction. Data collection will use techniques of moderate participant observation, field diary, formal and informal interview and focus group. To construct the analysis of the Model data, three processes will be used, the synthesis of the information from the data apprehended in other phases with the assistance of the Atlas Ti.1® software until conjectures are reached, which can be explained by using illustrative material. Theorization, through the assumptions at the level of abstraction based on Kolcaba's theory of comfort and the transfer, through the model itself to cover the care practice of the investigated scenario. The research scenario will be the Home Care Service, located in the Municipality of Natal, Rio Grande do Norte, Brazil. The data collection period will be from 2018 to 2019. Twelve nursing professionals belonging to the two multiprofessional support teams of the home care service at Hospital Monsenhor Walfredo Gurgel will participate in this study. Inclusion criteria will be being a nursing technician or nurse, belonging to one of the multidisciplinary support teams and accepting to participate in the research. Professionals who are on sick leave or on vacation in one of the research stages will be excluded. The study refers to an excerpt from the Doctoral Thesis project entitled: “Elaboration of a nursing model in palliative care in home care”, approved by the Ethics Committee of the Federal University of Rio Grande do Norte, obtaining a favorable opinion, under No 2,803,186, on August 6, 2018. Ethical and legal aspects were respected according to resolution 466/12 regarding research with human beings.
REFERENCES
1. Brasil. Ministério da Saúde. Portaria nº 963, de 27 de maio de 2013. Redefine a atenção domiciliar no âmbito do Sistema Único de Saúde (SUS). Diário oficial da União. Brasília: 27 maio 2013.
2. Trentini M, Paim L, Silva DMGV. Pesquisa Convergente Assistencial (PCA): delineamento provocador de mudanças nas práticas de saúde. 3. ed. Porto Alegre: Moriá; 2014.
3. Kolkaba K. Comfort theory and practice: a vision for holistic health care and research. Nova York: Springer Publishing Company; 2003.
Received: 08/28/2019
Approved: 02/11/2020