Tecnologia para telenfermagem em estomaterapia: uma estratégia baseada no apoio ao autocuidado

Abstract

The object of this research is the development of technology for telenursing in stomatherapy, aiming to support remote self-care for people with wounds, stomies and incontinence. With the growing number of people with chronic conditions receiving outpatient care and the reduction in the average length of hospital stay, there is a need to develop new forms of care, especially with regard to wounds, ostomies and incontinence. Thus, distance care emerges as a facilitator, capable of providing the individual with knowledge and autonomy to understand self-care and encourage it. Telenursing can be used in the context of stomatherapy to (i) reinforce the guidance provided during consultations, (ii) clarify doubts that may arise during self-care at home, (iii) monitor the health status of clients and the evolution of injuries , (iv) detect complications in the health-disease process of individuals or, (v) actively look for people who do not attend the service, providing many benefits to the patient and family. The general objective of this study was to create software to support self-care for people undergoing stoma therapy treatment through telenursing. The following specific objectives were listed: 1) develop tools to support self-care for people with skin problems, stomies and incontinence, through telenursing; 2) validate the instruments produced to support self-care through telenursing in stomatherapy; 3) evaluate the applicability of these instruments in supporting self-care for people with skin injuries, stomies and incontinence, through telenursing. The theoretical framework was based on Dorothea Orem's self-care theory. The thematic reference was based on the knowledge and practice of stomatherapy, the history of technology and its respective use in healthcare and the use of telenursing as a technological innovation for stomatherapy care. This is a methodological study, such as investigation of methods for obtaining, organizing and analyzing data, as well as elaboration, validation and evaluation of research instruments and techniques. The study was developed in four stages: 1) construction of three instruments for telenursing (wounds, stomies and incontinence), divided into five blocks (patient identification; general aspects; assessment and recording; self-care; and instructions from the stomatherapist) and selection and invitation to experts to judge the instrument items; 2) content validation of the instruments, with verification of the level of agreement between the twenty-one stomatherapist judges; 3) pre-test with thirty patients undergoing stomatherapy to understand and interpret the instruments with the target population; and 4) construction of the software through the contribution of a computer technician, based on the consolidated development of telenursing instruments in stomatherapy. A profile of the judges and participants in the pre-test phase was drawn up. It is concluded that telenursing in stomatherapy points to (i) continuity in care initiated in the face-to-face consultation; (ii) empowerment in self-care; and (iii) the development of nursing care, through the use of software, to better serve people undergoing stomatherapy, with attention to the demands and needs of the population.