Cuidados paliativos na insuficiência cardíaca: o conforto como desfecho do cuidar em enfermagem

Abstract

The aim of this study was to verify whether Katherine Kolcaba's Comfort Theory applied to nursing visits for HF patients in palliative care based on the systematization of nursing care, using taxonomies NANDA-NIC-NOC, promotes greater comfort. This is an open clinical trial, pre and post, conducted in a federal hospital located in Rio de Janeiro with a sample of 20 subjects. For evaluation of comfort, it was used the "End of life comfort questionnaire - patient" and the Nursing Outcome (NOC - State of Comfort). The questionnaire assessments occurred in the first, third and sixth nursing visits and the NOC one at every visit. Data collection was conducted between the November 2012 and May 2013. To analyze the data it was used the SPSS 19.0. The chi-square tests, Fisher's exact and Mann-Whitney tests were used to assess the association of nursing diagnoses and interventions with comfort measured by the questionnaire applied in three stages. ANOVA test (analysis of variance) was used to assess the improvement in subjects comfort condition through the questionnaires and also the NOC Status Comfort verified in the six visits. As a result it was found three nursing diagnoses and two nursing interventions related to greater patient comfort (p <0.05). Associated with lower comfort, 08 diagnoses and 12 interventions were found. The comfort considered by the questionnaires as well as the NOC, increased significantly (p <0.001) during the 06 months follow-up. The alternative hypothesis was confirmed after analysis of the data. Thus it can be said that the introduction of the principles of Katherine Kolcaba s theory in nursing visits is associated with the increased comfort of HF patients in palliative care. The study has contributed to reassure that when the nursing theory is used to support the profession practice and research, the development of the care system becomes clearer.