Conforto e lógica hospitalar: análise a partir da evolução histórica do conceito conforto na enfermagem

Análise do conceito de conforto: contribuições para o diagnóstico de Disposição para Conforto melhorado

RESUMO Objetivos Analisar o conceito de conforto à luz do modelo de análise conceitual evolucionista de Rodgers e incorporar elementos da análise conceitual na estrutura do diagnóstico de enfermagem “Disposição para conforto melhorado” (00183). Métodos Estudo de análise de conceito com aplicação das sete etapas do modelo evolucionário de Rodgers, sendo orientado para a condução da fase 1 de validação do diagnóstico de enfermagem. O material para análise foi obtido com a estratégia de revisão integrativa da literatura. Resultados e discussão Apresenta-se perspectiva histórico-desenvolvimental do conceito de quatro períodos temporais. Evidencia atributos, antecedentes, consequentes, termos substitutos e definições conceituais obtidos da decomposição conceitual, utilizando-os para a atualização dos componentes da “Disposição para conforto melhorado” (00183). Conclusão e implicações para a prática A abordagem evolucionária de análise do conceito mostrou ser apropriada para clarificar o conceito de conforto, dela emergindo tanto uma perspectiva orientada para o bem-estar quanto para as alterações do desconforto. A análise do conceito de conforto no método evolucionário contribuiu para a atualização do diagnóstico de enfermagem em tela. Os resultados obtidos fornecem elementos para a realização de futuros estudos de validação diagnóstica por experts e de validação clínica o que impacta positivamente no uso da linguagem diagnóstica.

Validation of the Comfort scale for relatives of people in critical states of health

OBJECTIVE

this methodological study aims to present the construct validity of the Comfort scale for family members of people in a critical state of health (ECONF).

METHOD

this is a methodological study. The sample was made up of 274 family members of adults receiving inpatient treatment in six Intensive Care Units (ICU) in the State of Bahía responded to 62 items distributed in 7 dimensions. The validation procedures adopted were based on the techniques of the Classical Test Theory.

RESULTS

the analysis of dimensionality was undertaken through principal components analysis, a scale being obtained with 55 items distributed in four factors: Safety, Support, Family member-relative interaction and Integration with oneself and the everyday. The analysis of the items' , discriminative power, undertaken by the item-total correlation-coefficient showed a good relationship of the items with their respective factors. From the ECONF's reliability test, from the analysis of internal consistency, a raised Alpha Cronbach coefficient was obtained for the 4 factors and the general measurement.

CONCLUSION

the comfort scale presented satisfactory psychometric parameters, thus constituting the first valid instrument for evaluating the comfort of family members of people in a critical state of health. The advance made by the study lies in its theoretical framework on comfort, and provides the health team with a scale based on empirical evidence.

[Comfort of the patient's family in an Intensive Care Unit related to welcoming]

This study aimed to identify the level of comfort of families of patients in a critical health condition related to the welcoming practices performed by the hospital staff. Interviews were conducted with 250 relatives in hospitals of the state Bahia, using a Likert scale. Data were analyzed as percentages and quartiles. For nine of the 12 statements of the scale, most relatives scored their comfort level between very and totally comfortable, median of 4,revealing kindness, tranquility and friendly communication with family members. More than half of the sample scored its level as not at all to more or less comfortable, median of 3, for statements about demonstration of interest towards the relative by the staff and flexible visiting of the patient. The necessity of greater interest of the team in the condition and needs of the family was observed. Promoting comfort from the dimension of welcoming demands interdisciplinary actions grounded in humanistic philosophy, in which the nurse has an important role to play.