RESUMO
Living with spinal cord injury (SCI) is a challenge that begins in the acute phase, when the disease, the limitations, and the treatments fill the days at the hospital. This study aims to understand the healthcare experience of the person with SCI in the acute phase, based on the Activities of Living Nursing Model (ALNM). It is a qualitative and phenomenological study based on the Standards for Reporting Qualitative Research. Data were collected via semi-structured interviews. Content analysis was performed using the ATLAS.ti software and Bardin's methodology. The article was written following the COREQ guidelines. The categories were defined using the Roper-Logan-Tierney Model for Nursing. The sample included 16 people with incomplete SCI, different etiology, and neurological levels. Eleven of the twelve ALNM emerged from the interviews. The activities of mobilizing, eliminating, maintaining a safe environment, and communicating were emphasized the most. Controlling body temperature was not relevant. Mobility deficits and pain increased dependence. Feelings of motivation, encouragement, and frustration were highlighted. Professional expertise, rehabilitation resources, and support equipment promoted independence. The results in this sample revealed that people with SCI in the acute phase have complex challenges related to dependence awareness and treatments, but they always keep recovery expectations in mind.
RESUMO
A Lesão Medular é um evento devastador para a pessoa que a vivencia. Pode surgir em qualquer fase do ciclo vital e tem consequências na sua vida pessoal, familiar e social. Manifesta-se por alterações motoras e sensitivas abaixo do nível da lesão e tem repercussões na função gastrointestinal, na sexualidade e na eliminação vesical. Objetivo: Perceber como vivenciam as pessoas com LM na fase aguda, a transição dos processos de eliminação urinária durante o internamento hospitalar. Métodos: Estudo qualitativo com abordagem fenomenológica, através de entrevistas semiestruturadas a dezasseis pessoas com LM que tiveram um internamento em neurocirurgia. A informação transcrita foi validada pelos participantes, organizada e submetida à análise de conteúdo tendo como referência para categorização o modelo conceptual de enfermagem de Afaf Meleis. O tratamento de dados realizou-se com auxílio da ferramenta AtlasTi. Resultados: Dos 16 participantes, 13 apresentavam alterações da sua eliminação vesical. Nas narrativas das vivências, foram identificadas as categorias: Viver uma Transição, Fatores Facilitadores e Inibidores da Transição, Padrões de resposta (indicadores de processo e resultado) e Terapêuticas de Enfermagem. A transição saúde/doença foi vivenciada pelos participantes. A consciencialização, os pontos e eventos críticos, foram propriedades identificadas na transição. A volição, o conhecimento prévio, a família e os recursos da comunidade foram fatores influenciadores da gestão da eliminação vesical. Os indicadores Coping, o Sentir-se Ligado, a Mestria e Reformulação da Identidade, foram facilmente identificados nas narrativas. As Terapêuticas de Enfermagem foram valorizadas pelos participantes, onde a ligação, o suporte emocional dado por estes profissionais e o ensino das técnicas, foram determinantes na gestão dos processos de eliminação vesical. Conclusão: As pessoas com LM no internamento em fase aguda, vivenciam uma transição de saúde/doença em que as terapêuticas de enfermagem e os fatores facilitadores foram as categorias determinantes para uma transição saudável e uma boa gestão da eliminação vesical.
Spinal cord injury is a devastating event for the person who experiences it. It can occur at any stage of life and has consequences for personal, family and social life. It is manifested by motor and sensory alterations below the level of the injury and has repercussions on gastrointestinal function, sexuality and bladder elimination. Aim: Understand how people with SCI experience in the acute phase, the transition of urinary elimination processes during hospitalization. Methods: Qualitative study with a phenomenological approach, through semi- structured interviews with sixteen people with SCI who had been hospitalized in neurosurgery. The transcribed information was submitted to thematic-categorical content analysis, in the light of Afaf Meleis conceptual nursing model, using the content analysis technique and the AtlasTi tool. Results: Of the 16 participants, 13 had alterations to their bladder elimination. In the narratives of the experiences, were identified the following categories: Living a Transition, Transition Facilitating and Inhibiting Factors, Response Patterns (process and outcome indicators) and Nursing Therapies. The health/illness transition was experienced by the participants. Awareness, critical points and events were properties of the transitions manifested. Volition, prior knowledge, family and community resources was facilitating factors of bladder elimination management. Indicators Coping, Feeling Connected, Mastery and Identity Reformulation were easily identified in the narratives. Nursing Therapies were valued by the participants, where the connection, emotional support given by these professionals and the teaching of techniques were decisive in the management of bladder elimination processes. Conclusion: People with SCI in acute hospitalization experience a health/illness transition in which nursing therapies and facilitating factors were the determining categories for a healthy transition and good bladder elimination management.
