O acompanhamento da parturiente pela enfermeira obstétrica: estudo de caso das vivências das mulheres e das profissionais
The accompaniment of women in labour by nurse-midwives: a case study of experiences as seen from both the perspective of women and of the professionals attending them
Publication year: 2001
O pressuposto geral desta pesquisa é estudar a assistência prestada de forma personalizada, no qual a enfermeira obstétrica busca atender às necessidades das mulheres, nos âmbitos físicos e emocional, durante o trabalho de parto, parto e pós-parto imediato. Teve como objetivo conhecer as experiências tidas neste processo, segundo a ótica das puérperas e das enfermeiras obstétricas que o vivenciaram. Este estudo qualitativo foi desenvolvido por meio do recurso do estudo de caso. Foi realizado no Centro Obstétrico do Hospital Universitário da Universidade de São Paulo, entre novembro de 2000 a fevereiro de 2001 e, dele participaram, treze mulheres com gestação normal e de termo e as quatro enfermeiras, que fizeram o acompanhamento destas parturientes. São apresentadas as narrativas das puérperas e das enfermeiras obstétricas, cujo conteúdo foi analisado com a finalidade da construção de categorias, realizadas mediante constante reavaliação e aprimoramento de conceitos, que resultou na composição de esquemas conceituais, que retratam os aspectos mais relevantes do conjunto de dados. Nas narrativas das puérperas, evidenciou-se que elas têm a expectativa de serem internadas quando em trabalho de parto; o primeiro atendimento recebido no hospital tem grande importância; a experiência do parto é influenciada por inúmeros fatores; a assistência prestada pela enfermeira obstétrica foi positiva e seus cuidados valorizados; e a experiência de parto delas foi positiva. As enfermeiras obstétricas revelaram que o cotidiano de trabalho delas é repleto de atividades; o manual de normas e rotinas, a filosofia do hospital e a formação profissional guiam a assistência prestada por elas; identificaram fatores facilitadores e dificultadores para a realização do trabalho proposto e avaliaram positivamente a participação na pesquisa. Neste estudo de caso, constatou-se que o acompanhamento contínuo ) das parturientes pelas enfermeiras obstétricas foi uma experiência positiva que está relacionada à qualidade da assistência. As enfermeiras obstétricas demonstraram grande satisfação na valorização do papel profissional. Os relatos das puérperas confirmam a valorização do acompanhamento contínuo pela profissional. As enfermeiras obstétricas são conscientes da necessidade do acompanhamento contínuo de todo o processo de parto e desejam pôr em prática esse tipo de assistência.
The general objective of this research is to study individualized assistance offered to women by nurse-midwives, characterized by the attempt to attend to both their physical and emotional needs during labour, childbirth and the period immediately after birth. The intention was to become acquainted with experiences occurring during this process from the perspective of both nurse-midwives and the women attended by them. This qualitative research was carried out by utilizing the expedient of the case study. Research was conducted in the Obstetric Center of the São Paulo University Hospital between November 2000 and February 2001. Thirteen women were interviewed in their immediate puerperium. All of them had normal pregnancies and delivered at term. The four nurse-midwives who attended them were also interviewed. The narratives of the women as well as the nurse-midwives were analyzed and resulted in the construction of categories. Concepts were continually submitted to re-evalutions and refinements, resulting in the assemblage of conceptual schemes which reveal the most revelant aspects of the data as a whole. The narratives of the women who had just given birth indicates that they share the expectation of being interned when they are in labour; that the first experience with assistance as soon as they enter the hospital is very important; childbirth experience is influenced by innumerous factors; assistance provied by nurse-midwives was evaluated positively and care was valued. As a whole, childbirth experience was well appraised. The nurse midwives revealed that their daily routine is full of activities. The guidelines for assistance as practiced within the institution are, according to them, provided by the manual of norms and routines, the hospital´s philosophy and their professional training. They identified factors which facilitate and others which create obstacles towards the fulfillment of their objectives at work. They evaluated their participation in this research in a positive manner. The results of this case study indicate that continual support to women in labour by nurse-midwives was a positive experience which is related to the quality of assistance. Nurse-midwives demonstrated great satisfaction with respect to the recognition and esteem they were granted in carrying out their professional role. The narratives of women in their immediate puerperium, who were given continual support by nurse-midwives in labor and childbirth, confirmed the positive evalution of this aspect of care. Nurse-midwives are aware of the need for continual support during the entire process of labour and childbirth and wish to provid this kind of assistance.
