Dimensões do cuidado das enfermeiras obstétricas no contexto da pandemia de Covid-19: um olhar a partir da teoria de Jean Watson

Abstract

This is a descriptive research, with a qualitative approach, whose object of study is the perceptions of obstetric nurses about the care of women in labor during the Covid-19 pandemic. The objectives were: to describe the perceptions of obstetric nurses about the care of women in labor during the Covid-19 pandemic and to discuss the dimensions of the care of obstetric nurses in this context, in the light of Jean Watson. The research had as participants 40 obstetric nurses from the state of Rio de Janeiro who worked to assist women in labor. Data were collected from May to July 2021, through individual semi-structured interviews and the analysis used was Minayo's content analysis. The results were grouped into two categories entitled: Perceptions of obstetric nurses on the care of parturient women during the Covid-19 pandemic and Strategies of obstetric nurses for maintaining the principles of humanization of childbirth during the pandemic: Dimensions of nursing care in light of Jean Watson. In the first category, which generated three subcategories, the repercussions of the pandemic on general obstetric care were addressed; about humanized nursing care for women in labor and about the emotional state of women in labor and nurses. In the second category, the dimensions of nursing care were highlighted in light of Jean Watson's Clinical Caritas Process, materialized in four subcategories. The interviewees noticed the misinformation of pregnant women; restrictions regarding the presence of the companion; the increase in unnecessary interventions during childbirth; misinformation and lack of knowledge about the hospital environment due to the suspension of Rede Cegonha’s activities. Furthermore, it was observed that physical contact with women was reduced and there were restrictions regarding the movement of pregnant women. The nurses also expressed the feeling of fear of Covid-19 contamination and realized that some pregnant women showed this same feeling, and others did not. The dimensions of care were revealed in the strategies for maintaining the principle of humanization used by those studied in their care process. In this way, the action of replacing the shawl with the sheet to carry out the rebozo and using the glove filled with heated water instead of thermal bags was called the Creative dimension; sharing care with the companion regarding the massage stimulus; the prioritization of women in labor who had a greater degree of need for access to instruments and encouragement of their use in individual spaces and demonstrated concern about environmental factors. The Cultural Humanistic dimension was identified in the establishment of relational care actions between nurses and parturient women, observed in the reception, respect for bodily freedom, active listening and expression of affection. The spiritual dimension was observed through respect for women's beliefs and the educational dimension through the establishment of teaching-learning spaces. It was concluded that although obstetric nurses perceived that the pandemic was an adverse context for obstetric care, they overcame the logic of fragmentation, prescriptive linearity and one-dimensionality of nursing care, by developing strategies to maintain the principles of humanization of nursing care childbirth.