Negociações das enfermeiras obstétricas frente a não adesão das mulheres às tecnologias não invasivas de cuidado

Abstract

The object of this study is the negotiation process of obstetric nurses in the face of women's non-adherence to non-invasive technologies of nursing care during parturition. Its objectives are: To know the way in which obstetric nurses approach non-invasive technologies of obstetric nursing care (TNICEO) with women during the parturition process; Identify the factors that interfere in the approach of obstetric nurses and in the adherence by women to the use of TNICEO; Discuss the strategies and effects of negotiation of unmedicalized care adopted by obstetric nurses in the face of non-adherence. This is an exploratory qualitative research, in which 17 semi-structured interviews were carried out with obstetric nurses who had at least one year of experience in the delivery room of a public health institution. As a technique to analyze the data, the content analysis described by Bardin was used. The theoretical support was anchored in Madeleine Leininger's Theory of Diversity and Universality of Cultural Care. The results were grouped into 3 categories: “The approach of TNICEO by obstetric nurses with parturient women”, “Factors that interfere with women's adherence and in the approach of obstetric nurses to TNICEO” and “The process of negotiating the unmedicalized care adopted by nurses obstetric in the face of women's non-adherence to TNICEO”. The first category resulted in two subcategories, where nurses approach TNICEO by building a bond with the parturient woman, creating a relationship of trust and sharing their knowledge through educational practices. The second category presented the medicalized socialization of the parturient and the clashes present in the obstetric nurse's work process as factors that contribute to women's non-adherence to TNICEO. The third category showed us the nurses' main negotiation strategies in the face of non-adherence, such as the use of communication through verbal and non-verbal language, the collaboration of another professional and the companion, and the use of insistence. We conclude that obstetric nurses can restructure care when women adhere to TNICEO and preserve culturally medicalized care when they respect the woman's decision not to adhere to their technologies.