Processo de enfermagem para melhoria da qualidade de vida de pessoas com úlcera venosa à luz da teoria das necessidades humanas básicas

Abstract

Venous ulcers are chronic lower limb injuries caused by chronic venous disorder. It is a condition that affects the quality of life of individuals in the physical, functional, social and mental health aspects. This research aimed to propose interventions to improve the quality of life of people with venous ulcer, in light of the theory of basic human needs, using the nursing process. This is a case study with 54 people with UV in the family health strategy of Parnamirim / Rio Grande do Norte in the period from August to October 2017. Was used for data collection: sociodemographic and health characterization form, the short-form 36, the Charing Cross Venous Ulcer Questionnaire, instruments with the basic human needs proposed by Wanda Horta and the international classifications of diagnoses, results and interventions nursing. The project obtained a favorable opinion from the ethics committee (CAAE nº 65941417.8.0000.5537). According to the SF-36, the domains related to physical and functional health were the most compromised. By CCVUQ, the domains of emotional and aesthetic state were the most affected. Psychobiological and psychosocial needs were found and the titles of the diagnoses that were present in more than 50% of participants were: impaired tissue integrity, poor community health, risk of infection, impaired comfort, risk of falls, impaired physical mobility, impaired walking, fatigue, chronic pain, syndrome of chronic pain, risk of low situational self-esteem, risk of feeling impotent, disposition for improved resilience, anxiety, chronic sadness, risk-prone health behavior, impaired social interaction, and body image disorder. It was proposed a set of interventions: community program development, group and supportive therapy, teaching: group, community health development, support system improvement, disease process education, health education, circulatory care: venous insufficiency, monitoring of lower extremities, care of non-healing lesions, irrigation and care of lesions, supervision and skin care: topical treatment, referrals, self-modification assistance, behavior modification and control, learning facilitation, prevention of falls and infection, promotion of body mechanics, pain control, active listening, employee development, energy control, facilitating self-responsibility, improving socialization, self-perception and body image, assertiveness training, complex relationship building, met patient engagement, merit assignment, assertiveness training, promotion of resilience, non-pharmacological treatments, emotional support, risk identification, decision support, counseling, exercise promotion, and walking therapy. The interventions were prioritized, elaborating a community health program, support group and group therapy, from which the others will be made. The priority nursing outcome for all interventions was quality of life. It was proposed program-based interventions with weekly actions in a support group and activities for physical, functional, emotional and social health, behavior change, dressings and compressive therapy, performed. More studies are needed to delve into interventions for quality of life in people with venous ulcer.