Nurses’ recommendations to the psychoaffective dimensions of patients hospitalized in nephrology

Azevedo, Albert Lengruber de; Araújo, Sílvia Teresa Carvalho de; Pessoa Júnior, João Mário; Cunha, Lidiane Passos; Neves, Keila do Carmo; Bastos, Soraia do Socorro Furtado; Moreira, Alessandra Guimarães Monteiro

doi:10.1590/0034-7167-2020-0821

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Revista Brasileira de Enfermagem

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ORIGINAL ARTICLE • Rev. Bras. Enferm. 74 (2) • 2021 • https://doi.org/10.1590/0034-7167-2020-0821 copy

Nurses’ recommendations to the psychoaffective dimensions of patients hospitalized in nephrology

Recomendaciones de enfermeras a las dimensiones psicoaffectivas de pacientes hospitalizados en nefrología

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objectives:

to analyze nurses’ recommendations on the psycho-affective dimensions of patients hospitalized in nephrology.

Methods:

a qualitative, exploratory and descriptive study, carried out by applying a sociodemographic and training questionnaire, reading a clinical case and conducting a semi-structured interview. Fourteen nurses from a reference hospital in nephrology in the Southeast participated. In the technical input of data treatment, thematic content analysis was used.

Results:

the recommendations included the exercise of empathy; monitoring of emotions from the implementation of the nursing consultation; continuous sharing of tensions, anxieties and desires; knowledge of one’s emotion; increased availability to listen; effectiveness of the approach in teams and social groups.

Conclusions:

recognizing patients’ psycho-affective dimensions, in the context of nurses’ performance, favors the expansion of therapeutic listening spaces, welcoming and interpersonal coexistence in nephrology, essential in the production of comprehensive health care.

Descriptors:
Nursing Care; Affect; Patients; Hospitalization; Nephrology

Records Unit	Statements
Empathy exercise	[...] the first exercise is empathy. It is looking at patients not from their pathology, but from far beyond it. (N3) [...] I need to know if he is receptive, as he can often feel attacked. If he is receptive, I will hold his hand, look at him, in his eyes, speak calmly about what needs to be changed. (N8) [...] sometimes we think that patients with chronic kidney disease are the same as everyone. No. It is individualized! [...] when nurses identify what he needs, know what to do to improve his life. (N1)
Monitoring of emotions, from nursing consultations	The nursing consultation, the nursing evaluation itself. But it is very difficult to be able to talk to all patients on a daily basis. You end up talking more with those who are entering, who are starting treatment, because they come with more doubts, with greater need for care.(N7) [...] that an initial consultation was made, a nursing consultation, mainly with hemodialysis patients. (N10) Through an interview, an anamnesis that could be done every month, every week. [...] to view the problems it will present; and nurses interfere as needed. (N4)
Continuous sharing of tensions, anxieties and desires	We pay a lot of attention to management, a lot of attention to scale, a lot of attention to the hemodialysis machine, because even today, the machine is considered the differential within hemodialysis. The machine is the one that scares, the machine is the one that gives problems, the machine is the big star of the situation, when in fact the big star should be patients being treated. (N5) [...] I think this issue of individualizing patients, seeing them as a whole, this helps a lot. (N1)
Recognition of one's emotion	[...] that nurses are open, that they allow themselves to be aware of the psycho-affective dimensions, which are not always included in their actions. (N2)
Increased availability to listen	[...] nurses will only be able to reach these psycho-affective dimensions [...] if he is willing to listen to [...] and still [...] to establish dialogue; create a bond with patients; to be willing to listen to. (N6) Nurses guide, guide, guide, and do not listen [...] many times, patients want to talk, but nurses are more concerned with passing on information. (N8) [...] I would observe. And to attend, I would always talk to this patient, keep close, ask some simple questions, such as: how was your day? How are you? How was the week? How are you feeling? trying to open a dialogue, and from that opening, I will go deeper. (N13) [...] listening a lot, being able to listen, observing, using communication, mainly, to understand this patient as a whole. (N14) [...] it is very complicated for you to talk to patients inside the dialysis room, why? Because the friend listens to what you say. (N7)
Effective team approach	If you are a nurse leader on duty, you will involve the team, you will supervise, you will see if the team is dealing with patients in a welcoming way, in a pleasant way, if you are being cordial, and if you are being able to listen to patients. [...] sometimes, nurses encourage the team, but the dynamics of the dialysis center itself do not allow this to happen. The direction of nursing ends up being inferior, according to the Ordinance, with RDC, which says that it can be a nurse for every 75 patients, but it is not possible. (N2) First study. Always watching, reading articles by other nzurses [...] seeking to bring me the experience of others, reading articles on mental health, reading books and listening to. (N14) I think that having the resources to welcome and encourage patients is as important as knowing how to perform a well-made puncture, how to handle hemodialysis equipment safely. [...] having a nurse equipped to deal with psycho-affective dimensions is as important as mastering the technique, handling the machine, performing the dressing on the catheter. In my view, there are two aspects that complement each other: the safe performance of the technique and the fulfillment of these psycho-affective dimensions of patients. (N11)
Effectiveness of social groups	[...] that nurses negotiate with the direction of the dialysis center, and that he [...] try to establish social groups, where people can talk in the presence of psychologists or that nurses can be facilitators of these meetings. (N2)

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[1] Corresponding author: Albert Lengruber de Azevedo. E-mail: alberenfermagem@yahoo.com.br