Self-care of chronic wounds in the household environment: an analysis from the perspective of Dorothea Orem

Keywords: Self care. Wounds and injuries. Home health nursing. Nursing theory

Abstract

Objective: To analyze the self-care of people with chronic wounds at home. Method: Qualitative, descriptive exploratory study. Twenty patients from an ambulatory clinic in Santa Catarina participated. Data collection took place from September to October 2016, through interviews. The content analysis identified three categories that were discussed in the light of Orem's framework: Therapeutic demand of self-care, Individuals' skills for self-care and competencies of Nursing for management of self-care. Results: it was identified as an altered therapeutic demand of self-care the increased necessity for rest due to pain. As for development: restriction of daily activities of life, due to limited movement. As for health deviations: deficits in competence (self-medication, lack of knowledge about bandages/dressings and complications). Self-care was influenced by internal factors (ignorance, doubts) and external factors (medical assistance, valorization of curative procedures and provision of material). The competence of Nursing was enacted in the identification of the wound, dressing and guidance. Final considerations: This context presents potentialities for the promotion of self-care, either through the implementation of a protocol instituted for the treatment of wounds, or for the training of professionals aimed at a more resolutive care that encompasses the aspects of prevention, promotion and rehabilitation in health.

Downloads

Download data is not yet available.

Author Biographies

Maria Elisa Kindel

Enfermeira, Rio do Sul, Santa Catarina, Brasil. Graduação em Enfermagem. Centro Universitário para o Desenvolvimento do Alto Vale do Itajaí.

Walnice Jung

Enfermeira. Mestre em Enfermagem. Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). Doutoranda do Programa de Pós- Graduação em Enfermagem da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, Estado do Rio Grande do Sul, Brasil.

Regina Rigatto Witt

Enfermeira. Doutora em Enfermagem em Saúde Pública. Professora da Escola de Enfermagem da UFRGS, Porto Alegre, Estado do Rio Grande do Sul, Brasil.

Idevânia Geraldina Costa

Enfermeira. Doutora em Enfermagem. Assistant Professor School of Nursing Lake Head University. Thunder Bay, Ontário, Canadá.

Daniele Delacanal Lazzari

Enfermeira. Doutora em Enfermagem. Professora. Universidade Federal de Santa Catarina, Florianópolis, SC, Brasil.

Kety Bernardes Carballo

Enfermeira. Mestre em Ciências da Educação. Instituto Tecnológico Bolivariano. Guayaquil, Equador.

References

Bester P, Van Deventer Y. Holisticcare for patients living withchronicwounds. WoundHealing Southern Africa [on-line]. 2015; 8(2): 78-81. Disponível em: http://www.woundhealingsa.co.za/index.php/WHSA/article/view/183

Kapp S, Miller C, Santamaria N. The qualityoflifeofpeoplewhohavechronicwoundsandwho self-treat. J ClinNurs[on-line]. 2018; 27(1-2):182-192. doi: 10.1111 / jocn.13870.

Abbade LPF, Lastória S. Abordagem de pacientes com úlcera da perna de etiologia venosa. A.Bras.Dermatol. [on-line]. 2016; 81(6):509-228. doi: https://doi.org/10.1590/S0365-05962006000600002.

Santos VLCG, Oliveira AS, Amaral AFS, Nishi ET, Junqueira JB, Kim SHP. Quality of life in patients with chronic wounds: magnitude of changes and predictive factors. Rev. Esc. Enferm. USP [on-line]. 2017, 51, e03250. doi: https://doi.org/10.1590/s1980-220x2016049603250

Costa IG. The Journey to ward self-care management of diabetic foot ulcer: A grounded theory study. 2017. [thesis]. School of nursing, Queen’sUniversity., Kingston, Ontario, Canada. 2017. Disponível em: https://qspace.library.queensu.ca/handle/1974/24959.

Batas R. Community nursing care for chronic wounds: a case study of optimal home treatment of a venous leg ulcer. Gastrointestinal Nursing [on-line]. 2019, 17, No. Sup5Clinical. doi: https://doi.org/10.12968/gasn.2019.17.Sup5.S32

Rocha ACAA, Carneiro FAZ, Souza MS. Tratamento domiciliar de feridas crônicas: relato de experiência da extensão na prática do cuidar. Revista Ciência e Estudos Acadêmicos de Medicina [on-line]. 2015, 1(02): 20-30. Disponível em: https://periodicos.unemat.br/index.php/revistamedicina/article/view/354/338

Orem DE. Nursing: concepts of practice. (6th ed.). St. Louis, MO: Mosby. St. Louis, MO: 2001.

Rosa J, Melo LAS, Kaiser DE, Duarte ERM, Paz PO. (2017). Users with a stoma: the self-care experience. Ciênc Cuid Saúde [on-line]. 2017 [citado em 2017, Jul], 16(3). doi: https://doi.org/10.4025/cienccuidsaude.v16i3.35539 .

Younas A. A foundationalanalysisofdorotheaOrem's self-caretheoryandevaluationof its significance for nursing practice and research. Creat Nursing [on-line]. 2017, 23(1), 13-23. Doi:10.1891 / 1078-4535.23.1.13 .

Hjelm K, Apelqvist J. Influence of beliefs about health and illnesson self-care and care-seeking in foreign-born people with diabetic foot ulcers: dissimilarities related to origin. J Wound Care [on-line]. 2016, 25(11): 602-616. doi:https://doi.org/10.12968 / jowc.2016.25.11.602

Lemos CS, Rodrigues AGL, Queiroz Ana CCM, Galdino H, Malaquias SG. Práticas integrativas e complementares em saúde no tratamento de feridas crônicas: revisão integrativa da literatura. Aquichan [on-line]. 2018, 18(3): 327-342. doi:http://dx.doi.org/10.5294/aqui.2018.18.3.7.

Minayo MCS. O desafio do conhecimento: pesquisa qualitativa em saúde. 12ª ed. São Paulo: Hucitec: 2010.

Garcia AB, Müllera, PV, Paz PO, Duarte ERM, Kaiserb DE. Percepção do usuário no autocuidado de úlcera em membros inferiores. Rev Gaúcha Enferm [on-line]. 2018, 39, e2017-0095. doi:https://doi.org/10.1590/1983-1447.2018.2017-0095.

Maslakpak MH, Shahbaz A, Parizad N,Ghafourifard M. Preventing and managing diabetic foot ulcers: application of Orem’s self-care model. Int J Diabetes DevCtries[on-line]. 2018, 38, 165–172. doi:https://doi.org/10.1007/s13410-017-0570-5

Lacerda FKL, Ferreira SL, Nascimento ER, Costa DO, Cordeiro RC. Déficits de autocuidado em mulheres com úlceras de perna e doença falciforme. RevBrasEnferm [on-line]. 2019, 72(3), 72-78. doi: https://doi.org/10.1590/0034-7167-2018-0005.

Costa IG, Camargo-Plazas P, Tregunno D. “I Amthe Boss”: Patients' PerceptionofTheir Role in ManagingTheirDiabeticFootUlcer. CanadianJournalofDiabetes [on-line]. 2018 [citado em 2020, Mai], 42(5):S25. doi:http://doi.org/10.1016/j.jcjd.2018.08.065

Sharoni SKA, Razi MNM, Rashid NFA, Mahmood YE. Self-efficacyoffootcarebehaviourofelderlypatientswith diabetes. Malaysian Family Physician [on-line]. 2017. doi:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5791827/pdf/MFP-12-02.pdf

Munkombwe WM, Petersson K, Elgán C. Nurses’ experiences of providing non pharmacological pain management in palliative care: A qualitative study. Journal of Clinical Nursing [on-line]. 2020, 29(9-10):1643-1652. doi:https://onlinelibrary.wiley.com/doi/epdf/10.1111/jocn.15232

Apóstolo J, Bobrowicz-Campos E, Rodrigues M, Castro I, Cardoso D. The effectiveness of non-pharmacological interventions in older adults with depressive disorders: A systematic review. Int J Nurs Stud [on-line]. 2016, 58:59-70. doi:https://www.ncbi.nlm.nih.gov/pubmed/27087298

Kelechi TJ, Morena G, Bonham PA, Crestodina, L, Droste LR, Ratliff CR, Varnado MF. Guideline for management ofwounds in patientswith lower-extremityvenousdisease (LEVD). J Wound Ostomy Continence Nurs [on-line], 2020, 47(2):97-110.Disponível em: https://www.ncbi.nlm.nih.gov/pubmed/32150136

Macedo MML, Souza DAS, Lanza FM, Cortez DN, Moreira BA, Rodrigues RN. Cuida-me! Percepções de pessoas com úlceras de perna sobre as orientações de enfermagem. R EnfermCent O Min [on-line]. 2015, 5(2): 1586-1593. doi: http://dx.doi.org/10.19175/recom.v0i0.733.

Medeiros L, Medeiros M, M, Enders B, Mesquita XS, Sena J, Martins MG, Martins AJ, Costa AI. Utilized theories by nursing in the care of people with anostomy: Integrative Review. Open JournalofNursing [on-line]. 2016, 6, 600-609. doi:http://dx.doi.org/10.4236/ojn.2016.68064

Published
2020-10-13
How to Cite
Kindel, M. E., Jung, W., Witt, R. R., Costa, I. G., Lazzari, D. D., & Carballo, K. B. (2020). Self-care of chronic wounds in the household environment: an analysis from the perspective of Dorothea Orem. Ciência, Cuidado E Saúde, 19. https://doi.org/10.4025/ciencuidsaude.v19i0.50399
Section
Original articles