Bath for dependent patients: theorizing aspects of nursing care in rehabilitation

Prado, Athaynne Ramos de Aguiar; Ramos, Ricardo Luiz; Ribeiro, Olga Maria Pimenta Lopes; Figueiredo, Nébia Maria Almeida de; Martins, Maria Manuela; Machado, Wiliam César Alves

doi:10.1590/0034-7167-2016-0258

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REFLECTION • Rev. Bras. Enferm. 70 (6) • Nov-Dec 2017 • https://doi.org/10.1590/0034-7167-2016-0258 copy

Bath for dependent patients: theorizing aspects of nursing care in rehabilitation

Baño del paciente dependiente: aspectos teorizantes de la atención de Enfermería en rehabilitación

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to produce a reflective essay on what has been produced in relation to bath as a procedure related to nursing care and diagnosis for dependent patients undergoing mediate and immediate rehabilitation processes after a traumatic event.

Method:

discursive, reflective study supported by classical content analysis consisting of the following stages: a) reading of the texts in their most comprehensive form; b) emphasizing the relevant elements produced about bathing; c) reflection on texts and what is produced about bathing.

Results:

the texts point out to three categories for nursing practice and reflection: Meaning to patients on the purposes of bathing; Representation for nurses in the work process; Representation for nurses in the management of care and nursing care planning.

Conclusion:

the reflection points out understandings on bathing as a care focused on the autonomy of nursing rehabilitation patients, requiring further investigations.

Descriptors:
Rehabilitation Nursing; Nursing Care; Self Care; Baths; Skin Care

Authors	Emerging themes
Figueiredo, Carvalho and Tyrrell, 2006.	What nurses report about bathing • Action that involves self-knowledge (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Institutionalized profession ^(@) @ what the bath represents for nurses in their work and health process; • Regulated by law ^(@) @ what the bath represents for nurses in their work and health process; • Physical strength to mobilize ^(@) @ what the bath represents for nurses in their work and health process; • Change of beddings ^(@) @ what the bath represents for nurses in their work and health process; • Occupational fatigue ^(@) @ what the bath represents for nurses in their work and health process; • Absenteeism ^(@) @ what the bath represents for nurses in their work and health process; •
Machado and Scramin, 2010.	Functional dependence on home caregiver • Improvement of health indicators ( ^& & what the bath represents for nurses in the management and planning of nursing care. ) • Reduction of incidence and recurrence of bladder infection (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Minimization of the incidence of pressure ulcers (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Satisfaction of users (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Postural, motor, and sensitivity deficit (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Spinal cord injury (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Lima and Lacerda, 2010.	Bath in critical hospitalized adult patients: review • Thermal regulation ( ^& & what the bath represents for nurses in the management and planning of nursing care. ) • Oxyhemodynamic equilibrium (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Microbiology (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Patient satisfaction (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Dutra and Gouvinhas, 2010.	Development of shower chair prototype – spastic quadriplegia During aspersion bath keep attentive to: • Absence of postural control ( ^& & what the bath represents for nurses in the management and planning of nursing care. ) • Head and trunk control deficit (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Use of accessories (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Promotion of stability (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Safety and comfort (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Appropriate posture for caregivers (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Penaforte and Martins, 2011.	In shift records of nurses • Altered mobility ( ^& & what the bath represents for nurses in the management and planning of nursing care. ) • Some pathologies (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Musculoskeletal disability (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Complex care (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Willingness or knowledge to perform (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Lopes, Nogueira-Martins, Andrade and Barros, 2011.	Perception of patients about shower and bed bath • Ease suffering ^(#) # what the bath means to patients in the purposes of nursing; • Unpleasant ^(#) # what the bath means to patients in the purposes of nursing; • Embarrassing ^(#) # what the bath means to patients in the purposes of nursing; • Important ^(#) # what the bath means to patients in the purposes of nursing; • Difficult ^(#) # what the bath means to patients in the purposes of nursing; • Uncomfortable ^(#) # what the bath means to patients in the purposes of nursing; • Does not clean ^(#) # what the bath means to patients in the purposes of nursing; • Dry ^(#) # what the bath means to patients in the purposes of nursing; • Cold ^(#) # what the bath means to patients in the purposes of nursing; • Incomplete Inhuman ^(#) # what the bath means to patients in the purposes of nursing; • Unsatisfactory ^(#) # what the bath means to patients in the purposes of nursing; • Time consuming ^(#) # what the bath means to patients in the purposes of nursing; • Dependent ^(#) # what the bath means to patients in the purposes of nursing; • Health professionals do not care ^(#) # what the bath means to patients in the purposes of nursing; •
Lopes, Nogueira-Martins, Barbosa and Barros, 2013.	In informative manuals on bathing • Functional dependents ( ^& & what the bath represents for nurses in the management and planning of nursing care. ) • Institutional environments (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Minimization of negative feelings (^& & what the bath represents for nurses in the management and planning of nursing care. ) • New experiences and feelings (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Promotion of quality of life (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Figueiredo, Machado and Porto, 2014.	Field diary records • Providing care for significant people ( ^& & what the bath represents for nurses in the management and planning of nursing care. ) • Disabling neurological injury (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Total dependence (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Postural balance (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Spasticity assessment (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Tactile and thermal sensitivity assessment (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Motor coordination and strength (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Body responses (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Major challenge ^(@) @ what the bath represents for nurses in their work and health process; • Mobilizing affective, physical, and emotional dimensions (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Affective involvement with patients (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Reconciling bath with the predisposition of the patient ^(@) @ what the bath represents for nurses in their work and health process; • Breaking with the routine care standards of the institution ^(@) @ what the bath represents for nurses in their work and health process; • Work overload ^(@) @ what the bath represents for nurses in their work and health process; • Invasion of privacy ^(#) # what the bath means to patients in the purposes of nursing; • Self-care (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Basic technical scientific deployment procedure (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Professors should emphasize the importance of observation during bath (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Providing support for care planning (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Technical aspect (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Minor activity appearance (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Bath is not important from the scientific perspective (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Bed bath until the patient reaches balance to sit (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Being attentive to the responses of the patient's body (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Meeting the determinants for planning care actions (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Moller and Magalhães, 2015.	Work overload and safety of patients • Intense physical strength ^(@) @ what the bath represents for nurses in their work and health process; • Bath is not important from the scientific perspective (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Unpleasant ^(#) # what the bath means to patients in the purposes of nursing; • Embarrassing ^(#) # what the bath means to patients in the purposes of nursing; • Inhuman ^(#) # what the bath means to patients in the purposes of nursing; • Time consuming and unsatisfactory ^(#) # what the bath means to patients in the purposes of nursing; • Mobilizing patients ^(@) @ what the bath represents for nurses in their work and health process; • Changing the beddings ^(@) @ what the bath represents for nurses in their work and health process; • Complaints of fatigue ^(@) @ what the bath represents for nurses in their work and health process; • Musculoskeletal injuries ^(@) @ what the bath represents for nurses in their work and health process; • Absences at work ^(@) @ what the bath represents for nurses in their work and health process; • Nurses delegate it to nursing aides and technicians Omission of records (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Resistance by students in relation to learning to bathe (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Nurses rarely perform the procedure (^& & what the bath represents for nurses in the management and planning of nursing care. ) •
Lopes, Barbosa, Nogueira-Martins, Barros, (2015)	• Anxiety ^(#) # what the bath means to patients in the purposes of nursing; • Opportunity to train (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Promotion of well-being (^& & what the bath represents for nurses in the management and planning of nursing care. ) • Provide care to individuals ^@ @ what the bath represents for nurses in their work and health process;

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[1] AUTOR CORRESPONDIENTE Wiliam César Alves Machado E-mail: wilmachado@uol.com.br