Proposal for intervention to improve the quality of life of people with venous ulcer
Primary Health Care; Nursing; Varicose Ulcer; Quality of life.
Venous ulcers are characterized by lesions of skin with loss of tissues, usually located in the distal third of the leg, of variable width and depth. The rates of failure in healing are very high and, in addition, the wound can cause pain, depression, low self-esteem, deficits in body self-image, social isolation, frustration, anger, anxiety, impairment in sexual activity and limitations in daily living activities. The purpose of this study was to analyze the quality of life of people with venous ulcers and to propose nursing interventions to improve the quality of life, starting from the nursing process, in the city of Parnamirim, Rio Grande do Norte, Brazil. This is a methodological, analytical study, with a quantitative approach, performed with 54 people in the primary care of the municipality of Parnamirim, Rio Grande do Norte, Brazil, with people with active venous ulcer. Socio-demographic, clinical and care data, health-related quality of life and venous ulcer were evaluated from the Short Form 36 and Charing Cross Venous Ulcer Questionnaire, respectively. From the data found, nursing diagnoses were drawn, expected results and proposed nursing interventions. The project was approved by the Research Ethics Committee of the Federal University of Rio Grande do Norte, with CAAE nº 65941417.8.0000.5537. Predominant female, elderly, low income and schooling, people without partners, with associated chronic diseases, good sleep, non smokers and alcoholics, with chronic injury and pain. People performed the dressing at home, have been not use compression, received professional guidance and had difficulty accessing the angiologist. There was impairment in quality of life. The emotional aspect presented a significant discrepancy between the instruments. Adults had better social interaction and worse score for esthetics. In relation to nursing diagnoses, priority was given to the following titles: poor community health, impaired tissue integrity, risk of infection, followed by impaired comfort, risk of falls, risk of low self-esteem, risk-prone health behavior, mobility physically impaired, among others less frequently. The interventions were proposed: development of community health, promotion of venous circulation, protection against infection, infection control, anxiety reduction, environmental control, aromatherapy, energy control, relaxation therapy, fall prevention, strengthening of self-esteem, control behavior training, ambulation training, occupational therapy, stretching exercises, balance and muscle control. In relation to nursing diagnoses, priority was given to the following titles: poor community health, impaired tissue integrity, risk of infection, followed by impaired comfort, risk of falls, risk of low self-esteem, risk-prone health behavior, mobility physically impaired, among others less frequently. The interventions were proposed: development of community health, promotion of venous circulation, protection against infection, infection control, anxiety reduction, environmental control, aromatherapy, energy control, relaxation therapy, fall prevention, strengthening of self-esteem, control behavior training, ambulation training, occupational therapy, stretching exercises, balance and muscle control. It is proposed that the interventions be done in groups, with weekly meetings lasting two hours, where the dressing and application of compressive therapy will be performed, in addition to collective activities of setting goals, actions for adaptation, self-development, change of health behavior. The observation of care being given to other individuals, the judgments of the participants in relation to one another, the emotional state, stress, anxiety and excitement will be worked out in the moments of intervention. In this way, the results can allow nursing and multiprofessional interventions focused on the quality of life of the person with venous injury, assisted in Primary Health Care, with a reduction in injury time and working hours, health promotion and self-care incentive.