O autocuidado em pacientes com estomia intestinal à luz de Dorothea Orem: da reflexão ao itinerário terapêutico

Abstract

The stomized person is all that is subordinated to a surgical intervention with exteriorization of the digestive, respiratory and urinary system, creating an artificial exteriorized opening called stoma. The making of an omen results in changes in the person's routine, which will be evidenced at all levels of his life, where he can mention the need for self-care to maintain the quality of life and daily routine of this patient. In regard to self-care, Orem says that all human beings have the potential to develop their intellectual and practical skills, as well as the essential motivation for self-care. It also states that self-care is intended for the performance or practice of activities that individuals perform for their benefit to maintain life, health and well being. The model proposes that all patients be encouraged to take care of themselves and have an active participation in the care process. In view of the problematic presented, it is possible to emphasize as object of study the self-care of the patient estomizado the light of Dorothea Orem. This research had as objective: To discuss the self-care performed by the patient estomizado in the light of Dorothea Orem. Regarding the method, this was a descriptive exploratory study, having as information source the field research and qualitative approach on self-care performed by the stomized patient in a city of the Metropolitan II and will be held at the Center for Health Care of the Person Estomized at the Orencio de Freitas Hospital in the city of Niteroi, state of Rio de Janeiro. The participants were patients who were attended to by free demand and scheduled, who met the inclusion criteria and accepted, of their own free will, to participate in this research. The data collection was performed through an interview with semi-structured script, with audio recording for better treatment and transcription of the data later, and, in turn, the data were analyzed in the optics of Dorothea Orem. As a result of this study, the prevalence of intestinal stomies in the male sex was mainly due to the diagnosis of rectal cancer, in view of the characteristics of the 32 participating subjects, with a significant evidence of the subjects' low level of education and, in turn, low family compensation that can be seen with a large offender for self-care enforcement. However, the research subjects showed that they live better when they understand and accept the stoma, and this process can be facilitated by the nurse through the Nursing Consultation, especially when she adopts Dorothea Orem's theory of self-care in her care practice. which advocates three activities: initial contact with the patient who demands the care that translates into a system that contemplates the therapeutic requirements and means of assistance; continuity of this contact for the development of nursing actions, including family members or caregivers to act in current and future moments; and the stage of preparation of the patient to conduct care actions independently. In this phase, both the patient and family members are already trained in basic care for the hygiene and exchange of intestinal devices, among other necessary care. Therefore, it is important to use Orem's theoretical framework to approach this clientele in order to help them solve their self-care deficits by providing them with useful information, emotional and psychological support. Therefore, it is through the support-education system, which makes up the theory of nursing systems, that this process can be effective