Humanização da pratica pelo cuidado : um marco de referencia para a enfermagem em unidades criticas

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciencias da SaudeO estudo teve o objetivo construir um marco de referência de cuidado humano para a transformação da prática, a partir de um processo reflexivo entre a pesquisadora e um grupo de enfermeiras de unidades críticas de um hospital de ensino. Este processo foi desenvolvido em oito encontros com os temas: valores, motivação, cuidado, enfermagem, ser humano, ambiente, escolhidos pelas participantes e fundamentados em determinados fatores de cuidado de Watson (l979,1985). Os discursos foram analisados segundo Bardin (l991), revelando temas que serviram de base para a elaboração do marco, constituído de conceitos e sub-conceitos: ser humano cuidador - ser cuidado, filosofia, ciência e arte do cuidar/cuidado, ambiente institucional. A partir da reflexão pode-se abstrair alternativas como: a capacitação dos cuidadores no processo interacional; a valorização e o aperfeiçoamento humano pelo reconhecimento da ciência de Enfermagem voltada à prestação de cuidados; a reflexão da prática diária e desenvolvimento de pesquisas que possam trazer a fundamentação teórico filosófica para desvelar novos caminhos. O trabalho demonstra ser a humanização da prática pelo cuidado humano, uma necessidade das enfermeiras, assim como instiga futuras pesquisas para a aplicabilidade do marco de referência proposto. Abstract : This study had the objective of providing a framework point on human-caring for the transformation of practice. It was originated from a reflexive process of a group of nurses in the University Hospital of Parana State, inspired on determined carative factors by Jean Watson. The search was facilitated by the following guided question: ?What concepts can be utilized in the construction of a framwork for human care in Critical Units, in accordance with Watson's ideas, in such a way as to be incorpored, permanente adopted and utilized by nurses?? To produce the speeches , the researcher worked side by side with seven nurses, observing the group experience, gathering and analysing information collected during the discussion of the following themes: care, nursing, human being and environment. After long period of reflexion on the material gathered, it has been possible to come up with concepts that helped produce this framework. Based on the themes, it was elaborated a reference point composed by the following concepts and subconcepts: care provider- care recipient, intersubjective, self-respect, self-care, self knowledge, integrality, exclusivity, spirituality, well being, satisfaction, relationship, vocation and motivation- nursing as philosophy, science and art of carel caring, nursing sensibility and responsability, love and affection, profissional self- concept, visibility of caring (valorization), ethic (dignity and respect)- environment, tecnology, ethic ideology, management, interaction, engagement and interference. Through reflexion, we realize the necessite of- revertion of the picture being currently experienced in Nursing practice, reviewing pattems of conduct with regarding to the mechanical act of technique, offering alternatives for combating lack of motivation and action of professionals, which can be achieved through training of care-providing personnel in the interactive process-, human valorization and growth by means of recognition of a Nursing science that focuses on caring; reflection about daily practice and development of research that can provide Nursing practice with theoretical - philosophical foundation in order to unveil new altematives. This work demonstrares that humanization of pratice through human care is a requirement that meets the destres of nurses who work in Critical Units, as wefi as encourages future research related to the applicability of the framework in Critical Care Units as in other areas