Abstract
OBJECTIVE: construct an explanatory theoretical model about nurses' adherence to the Kangaroo Care Method at the Neonatal Intensive Care Unit, based on the meanings and interactions for care management. METHOD: qualitative research, based on the reference framework of the Grounded Theory. Eight nurses were interviewed at a Neonatal Intensive Care Unit in the city of Rio de Janeiro. The comparative analysis of the data comprised the phases of open, axial and selective coding. A theoretical conditional-causal model was constructed. RESULTS: four main categories emerged that composed the analytic paradigm: Giving one's best to the Kangaroo Method; Working with the complexity of the Kangaroo Method; Finding (de)motivation to apply the Kangaroo Method; and Facing the challenges for the adherence to and application of the Kangaroo Method. CONCLUSIONS: the central phenomenon revealed that each nurse and team professional has a role of multiplying values and practices that may or may not be constructive, potentially influencing the (dis)continuity of the Kangaroo Method at the Neonatal Intensive Care Unit. The findings can be used to outline management strategies that go beyond the courses and training and guarantee the strengthening of the care model.
Highlights
Professional adherence does not involve watertight, preprogrammed behaviors to comply with normative requirements, but is directly related to the professional’s insertion in the world, in society, in work and potential to transform him/herself, the practices and the context
The scenario was an Neonatal Intensive Care Unit (NICU) of a public university hospital in the city of Rio de Janeiro (RJ), which is a referral institution for highrisk pregnancy, especially regarding fetal risk
Four main categories emerged from the coding process which integrate the main concepts of this research and contain the relations among the symbols, actions, social interactions and meanings that emerged in daily work at the NICU
Summary
Professional adherence does not involve watertight, preprogrammed behaviors to comply with normative requirements, but is directly related to the professional’s insertion in the world, in society, in work and potential to transform him/herself, the practices and the context. In the context of the Neonatal Intensive Care Unit (NICU), nursing care management should meet the technological and infrastructural advances, and the integrality of care, as a guiding axis of the work processes. Within this logic, the workers, managers and infants/relatives should be considered as protagonists in the production of health[1]. The adoption of the Kangaroo Method essentially aims to change attitudes towards care and handling the baby and towards the family’s participation This objective, in turn, encompasses some aspects of professional knowledge/actions, like the communicative and creative approach, the opening of spaces and the relation established for care[2]
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