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Análise das estratégias de comunicação em enfermeiros de um serviço de urgência
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Este relatório surge no âmbito do 1.º Curso de Mestrado de Enfermagem Médico-Cirúrgica, na área de Enfermagem à Pessoa em Situação Crítica. A estrutura do relatório está dividida em duas partes. A primeira parte tem como propósito o desenvolvimento de competências, tanto gerais quanto específicas, relacionadas com a prática da Enfermagem Médico-Cirúrgica na área da pessoa em situação crítica. A segunda parte apresenta um estudo de investigação centrado nas estratégias de comunicação que promovem a humanização dos cuidados à pessoa em situação crítica.
O objetivo geral deste estudo consistiu em analisar a comunicação no cuidado de enfermagem à pessoa em situação crítica. Foi realizado um estudo descritivo correlacional e transversal, de abordagem quantitativa, permitindo analisar relações entre variáveis sem estabelecer causalidade. Para tal, foi aplicado um questionário a enfermeiros que exercem funções no Serviço de Urgência de uma Unidade Local de Saúde da região Norte de Portugal. A amostra ficou constituída por 50 enfermeiros, que aceitaram participar voluntariamente, após esclarecimento dos objetivos e garantia de anonimato e confidencialidade. Foi utilizado um método de amostragem não probabilística por conveniência, atendendo à acessibilidade dos participantes no contexto da prática clínica. A maioria dos elementos da amostra pertence ao sexo feminino, com idades compreendidas entre os 20 e os 40 anos.
Os resultados demonstraram que a maioria dos enfermeiros reconhece a relevância da atualização de conhecimentos na área da comunicação em situações de urgência. Entre as estratégias alternativas de comunicação mais frequentemente assinaladas destacaram-se os gestos, as expressões faciais, a postura e o toque, considerados pelos participantes como meios privilegiados de interação com o doente.
A comunicação com a pessoa em situação crítica apresenta-se como um processo desafiador, com intensidade variável, mas raramente inexistente. Verificou-se que as dificuldades comunicacionais são transversais aos enfermeiros, independentemente das suas características profissionais ou académicas, destacando a complexidade inerente à comunicação com o doente com alterações comunicacionais. Destacaram-se diferenças estatisticamente significativas entre o tempo de exercício profissional (Kruskal-Wallis: p<0,001), a experiência profissional em Serviço de Urgência (Kruskal-Wallis: p<0,019) e as estratégias de comunicação. A amostra enquadra-se maioritariamente em profissionais com experiência consolidada, capazes de mobilizar competências técnicas e emocionais de forma integrada. Uma vez que os enfermeiros numa posição intermédia revelam valorizar menos a atitude corporal, poderá refletir a necessidade de se focarem no comprometimento de órgãos vitais num ambiente altamente volátil como o SU, dando prevalência a outras estratégias de comunicação não-verbal de mais fácil aplicação.
Conclui-se que a comunicação não verbal assume um papel central no cuidado ao doente impossibilitado de comunicar verbalmente, sendo um recurso essencial para promover a humanização da prática clínica em situações críticas, o que reforça a relação terapêutica e a segurança do doente. Estes resultados evidenciam a importância da valorização e da formação contínua dos profissionais de enfermagem no desenvolvimento de competências comunicacionais adaptadas a contextos de urgência.
O ensino clínico proporcionou experiências práticas que reforçam a aplicação de cuidados especializados, centrados nas necessidades da pessoa em situação crítica e nos seus familiares e consolidam uma prática clínica humanizada e competente. As competências relacionadas com a comunicação verbal e não verbal revelaram-se uma componente fundamental do cuidar. Ao longo deste percurso, foi possível prestar cuidados não só à pessoa em situação crítica, mas também à sua família com acompanhamento no decorrer do processo de doença. Esta experiência permitiu a aplicação de cuidados de enfermagem especializados, centrados nas necessidades e fragilidades da pessoa em situação crítica, o que reforçou uma prática clínica humanizada, competente e ajustada às exigências destes contextos complexos.
This report is part of the 1st Master's Degree Course in Medical-Surgical Nursing, in the area of Nursing Care for Critically Ill Individuals. The report is divided into two parts. The first part aims to develop general and specific competencies related to the practice of Medical-Surgical Nursing in the area of critically ill individuals. The second part presents a research study focused on communication strategies that promote the humanization of care for critically ill individuals. The overall objective of this study was to analyze communication in nursing care for critically ill individuals. A descriptive, correlational, and cross-sectional study with a quantitative approach was conducted, allowing for the analysis of relationships between variables without establishing causality. To this end, a questionnaire was applied to nurses working in the Emergency Department of a Local Health Unit in the Northern region of Portugal. The sample consisted of 50 nurses who voluntarily agreed to participate after being informed of the objectives and guaranteed anonymity and confidentiality. A non-probabilistic convenience sampling method was used, taking into account the accessibility of participants in the context of clinical practice. The majority of the sample members were female, aged between 20 and 40 years. The results showed that most nurses recognize the importance of updating their knowledge in the area of communication in emergency situations. Among the alternative communication strategies most frequently mentioned were gestures, facial expressions, posture, and touch, considered by participants as privileged means of interaction with the patient. Communication with a critically ill person is a challenging process, with varying intensity, but rarely nonexistent. It was found that communication difficulties are transversal to nurses, regardless of their professional or academic characteristics, highlighting the inherent complexity of communicating with patients with communication disorders. Statistically significant differences were found between professional experience (Kruskal-Wallis: p<0.001), professional experience in Emergency Services (Kruskal-Wallis: p<0.019), and communication strategies. The sample consists mostly of professionals with consolidated experience, capable of mobilizing technical and emotional skills in an integrated way. Since nurses in na intermediate position show less value for body language, this may reflect the need to focus on the compromise of vital organs in a highly volatile environment such as the ER, giving prevalence to other non-verbal communication strategies that are easier to apply. It is concluded that non-verbal communication plays a central role in the care of patients unable to communicate verbally, being an essential resource to promote the humanization of clinical practice in critical situations, which reinforces the therapeutic relationship and patient safety. These results highlight the importance of valuing and continuously training nursing professionals in the development of communication skills adapted to emergency contexts. Clinical teaching provided practical experiences that reinforce the application of specialized care, focused on the needs of the person in a critical situation and their family members, and consolidate a humanized and competente clinical practice. Skills related to verbal and non-verbal communication proved to be a fundamental component of care. Throughout this journey, it was possible to provide care not only to the critically ill person, but also to their family, with support throughout the illness process. This experience allowed for the application of specialized nursing care, focused on the needs and vulnerabilities of the critically ill person, which reinforced a humanized, competent clinical practice adapted to the demands of these complex contexts.
This report is part of the 1st Master's Degree Course in Medical-Surgical Nursing, in the area of Nursing Care for Critically Ill Individuals. The report is divided into two parts. The first part aims to develop general and specific competencies related to the practice of Medical-Surgical Nursing in the area of critically ill individuals. The second part presents a research study focused on communication strategies that promote the humanization of care for critically ill individuals. The overall objective of this study was to analyze communication in nursing care for critically ill individuals. A descriptive, correlational, and cross-sectional study with a quantitative approach was conducted, allowing for the analysis of relationships between variables without establishing causality. To this end, a questionnaire was applied to nurses working in the Emergency Department of a Local Health Unit in the Northern region of Portugal. The sample consisted of 50 nurses who voluntarily agreed to participate after being informed of the objectives and guaranteed anonymity and confidentiality. A non-probabilistic convenience sampling method was used, taking into account the accessibility of participants in the context of clinical practice. The majority of the sample members were female, aged between 20 and 40 years. The results showed that most nurses recognize the importance of updating their knowledge in the area of communication in emergency situations. Among the alternative communication strategies most frequently mentioned were gestures, facial expressions, posture, and touch, considered by participants as privileged means of interaction with the patient. Communication with a critically ill person is a challenging process, with varying intensity, but rarely nonexistent. It was found that communication difficulties are transversal to nurses, regardless of their professional or academic characteristics, highlighting the inherent complexity of communicating with patients with communication disorders. Statistically significant differences were found between professional experience (Kruskal-Wallis: p<0.001), professional experience in Emergency Services (Kruskal-Wallis: p<0.019), and communication strategies. The sample consists mostly of professionals with consolidated experience, capable of mobilizing technical and emotional skills in an integrated way. Since nurses in na intermediate position show less value for body language, this may reflect the need to focus on the compromise of vital organs in a highly volatile environment such as the ER, giving prevalence to other non-verbal communication strategies that are easier to apply. It is concluded that non-verbal communication plays a central role in the care of patients unable to communicate verbally, being an essential resource to promote the humanization of clinical practice in critical situations, which reinforces the therapeutic relationship and patient safety. These results highlight the importance of valuing and continuously training nursing professionals in the development of communication skills adapted to emergency contexts. Clinical teaching provided practical experiences that reinforce the application of specialized care, focused on the needs of the person in a critical situation and their family members, and consolidate a humanized and competente clinical practice. Skills related to verbal and non-verbal communication proved to be a fundamental component of care. Throughout this journey, it was possible to provide care not only to the critically ill person, but also to their family, with support throughout the illness process. This experience allowed for the application of specialized nursing care, focused on the needs and vulnerabilities of the critically ill person, which reinforced a humanized, competent clinical practice adapted to the demands of these complex contexts.
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Palavras-chave
Técnicas de comunicação Serviços de emergência hospitalar Cuidados de enfermagem Cuidados críticos Comunicação em saúde