Cuidado das mulheres com gravidez de risco à luz da Teoria de Swanson: contribuições para o desenvolvimento das tecnologias não invasivas de cuidado de enfermagem

Abstract

Quality of care for women in childbirth has been sought by health policies. With the aim of humanizing patient care, nursing proposes Non-Invasive Nursing Care Technologies (TNICE). We have thus defined the object of our research as the perceptions of women with risk pregnancies about the use of TNICE in labor and childbirth. This dissertation aimed to identify women's feelings about risk pregnancy; to analyze those women’s perceptions about applying TNICE in labor, in the light of Kristen Swanson’s Care Theory; and to discuss the impact of non-invasive technologies on those women’s well-being during childbirth. This is a descriptive research with a qualitative approach, conducted in a tertiary maternity hospital linked to a teaching hospital in the city of Rio de Janeiro, Brazil. The semi-structured interviews were conducted with 20 puerperal women and analyzed according to Bardin’s content analysis technique. This analysis led to the construction of the following categories: 1) “Women’s feelings related to their experience of pregnancy and childbirth with associated obstetric risk”; 2) “Perceptions of women with risk pregnancies about non-invasive care technologies in the light of Kristen Swanson's Theory” and 3) “The well-being of women with risk pregnancies as a result of the deployment of non-invasive care technologies in labor.” Participating puerperal women realize that the diagnosis of a risk pregnancy involves physiological, biological and psychological transformations. Labor and childbirth are viewed with fear due to uncertainty about their outcome. Their main feelings are insecurity, anxiety, fear, trepidation, doubts, apprehension, worry and denial, which highlights the importance of valuing the subjective aspects in the care provided by nurses by means of TNICE. Swanson’s Theory of Care has been fundamental in the analysis of the perceptions of women with risk pregnancies and allowed us to understand the care process of nurses applying TNICE and the full potential of these techniques. In this type of care helpful and respectful relationships occur, and the bond between the parturient women and the nurses, which fosters more attention and support and inspires positive feelings, such as understanding, appreciation, hope, companionship, safety, comfort, acceptance, respect and well-being. The nurses’ care is based on respect for human dignity, as well as for women’s individuality and singularity, enabling a harmonious relationship with their culture, their values and beliefs. Through TNICE, nursing care in light of Swanson’s Theory of Care has non-invasive characteristics, promotes the parturient women’s well-being and a perception of satisfaction, safety and comfort. These are essential for a high-quality care and a successful outcome for all women in their pregnancy and childbirth, even when there is an associated risk or morbidity.