Autocuidado na promoção da saúde de pessoas com doença renal crônica: Narrativas de vida

• Autor(a) principal: Terra, Barbara dos Santos
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
• Texto Completo: http://www.bdtd.uerj.br/handle/1/11197
• topic: Nursing; Chronic Kidney Disease; Self-care; Health Promotion; Enfermagem; Insuficiência renal crônica; Autocuidado; Promoção da saúde; CNPQ::CIENCIAS DA SAUDE::ENFERMAGEM

Chronic Kidney Disease is characterized by a progressive, irreversible loss of the glomerular, tubular and endocrine functions of the kidneys. It is regarded as one of the most serious of all chronic diseases due to the aggravated injuries, as well as the physical and psychological damage and the consequences for the persons daily routine influencing self- care. There is no cure, nor specific medications for treatment, thus requiring self-care to promote health, reduce harm and slow down the evolution of the disease. The general aim is to analyze how self-care is related to health promotion in the life histories of persons with chronic kidney disease. And the specific aims are as follows: To identify, in the life histories of persons with chronic kidney disease, how they understand and develop self-care; To describe the associations of self-care when promoting health in the means to cope with chronic kidney disease. This is a qualitative an descriptive study, oriented by the life history approach, developed in a university hospital in Rio de Janeiro from August to October 2019, with 14 subjects undergoing conservative therapy for chronic kidney disease. The inclusion criteria were the following: Subjects must be over 18 years old, regardless of gender, religious belief or ethnicity, at stage-3 and stage-4 of chronic kidney disease undergoing conservative therapy. And the exclusion criteria were: subjects with chronic kidney disease in other stages of the disease, those with altered level of consciousness, people with mental illness and difficulty to answer the questions. The project was approved by the Plataforma Brasil Ethics Committee under Registry No. 03769518.8.0000.5282. The data production technique was the interview, recorded using a smartphone application and fully transcribed. After transcription of the interviews and data organization, the analytical process used was the thematic analysis based on Bertaux. Two categories emerged from the data organization, namely: The discovery of the disease and the need for self-care; The coping of persons with chronic kidney disease for self-care. The characterization of respondents showed that most of them are female, 6 self-described as being pardos (brown) and 6 white, aged between 21 and 73 years; eight of them were considered young adults, most of them with superior education level complete, displaying changes in body weight. and hypertension and diabetes as underlying pathology. The study showed that the diagnosis of chronic kidney disease was confirmed differently for each respondent, in routine medical appointments, on a random basis, or from other pathology undergoing treatment, all of which evolving to the aggravation of the disease with several self-care requirements, due to the respondents being unaware of the health process, illness, loss of energy when searching for treatment, delay, lack of access to health care and aggravation of the clinical conditions. Concerning coping mechanisms, the family had the key role to cope with the diseases and the necessary support to carry out self- care activities related to changes in eating habits and physical activity. Thus, we conclude that the life history approach was able to highlight the relationship of self-care when promoting health by presenting experiences and situations experienced by respondents when coping with the illness. The nurse has a key role in the development of creative practices for self-care and Nola Pender's Health Promotion Model is a possibility to influence the self-care mechanisms.