STANDARDS OF KNOWLEDGE THAT FOUND NURSING PERFORMANCE IN HOME CARE

qualitative study using a single case study strategy, supported by the dialectical methodological framework. Thirteen nurses who work in home care services from two municipalities in Minas Gerais, Brazil, participated. The data were obtained in 266.5 hours of participant observation and 8 hours and 58 minutes of interview and submitted to Critical Discourse Analysis.

Results:

empirical knowledge was revealed to be fundamental for clinical, managerial and educational care at home. The adaptations specific to this environment require aesthetic knowledge. The relational and educational actions, the decisions responsible for benefiting the individual and his family, the doubt and willingness to learn when dealing with unpredictable cases and the assessment of the socioeconomic conditions of the family, represent, respectively, personal, ethical, lack of knowledge and sociopolitical aspects present in the practice of nurses in home care.

Conclusion:

the particularities of home care trigger different patterns of knowledge to ensure creative, sensitive, human and responsible care. Innovation and availability to learn are part of nurses' performance in home care. The need for differentiated training is reinforced in order to respond to the increasing complexity in this field.

DESCRIPTORS:
Knowledge; Nursing care; Nursing; Home nursing; Home care; Home care services

Universidade Federal de Santa Catarina, Programa de Pós Graduação em Enfermagem Campus Universitário Trindade, 88040-970 Florianópolis - Santa Catarina - Brasil, Tel.: (55 48) 3721-4915 / (55 48) 3721-9043 - Florianópolis - SC - Brazil
E-mail: textoecontexto@contato.ufsc.br

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[1] CORRESPONDING AUTHOR
Angelica Mônica Andrade angelicamonica.andrade@gmail.com

Empirical	- Scientific and theoretical knowledge: care which seeks to follow scientific principles; organization of the service and care plan; link with other services; training of patients and caregivers; performance of varied procedures (dressings, administration of medications, catheterizations, punctures, oxygen therapy); evaluation and clinical care.
Aesthetic	- Creative and intuitive knowledge in the process of interaction between nurse and patient/caregiver: orientations according to the resources available at home; adaptations of theoretical knowledge to the reality of each family; Resolutive and creative care. - Empathy in seeking to provide comfort to patients and family members.
Personal	- Know how to build an effective relationship with patients and family members: to be willing and receptive to others; establishment of bonds and relationship of trust with patient and family; respect, emotional support, dialogue, active listening; guidance to caregivers for continuity of care; guidelines in a playful way, understanding the need of the other. - Transformations in the ways of acting and being of nurses.
Ethical	- Notion of responsibility and decisions to benefit the individual and his family: respect for the legal precepts of the profession; adaptations responsibly; commitment to truth with family members; respect for family privacy.
Lack of knowledge	- Willingness to learn in each care situation: recognition of lack of knowledge in the face of the particularity of the home context and the unpredictability inherent to work in the; discoveries regarding the complexity of home care; search for knowledge to act in relation to individual differences in order to create a positive and resolutive result; the need to learn to adapt theoretical knowledge to the reality of each family, through the proper context of HC; learning with the patient, the team and the situation experienced; continuous learning in and for work; recognition of insufficient academic training and the need for continuing education.
Sociopolitical	- Knowing how to act in the social context: solidarity and activation of other services when performing and seeking donation for the family; recognition of the complexity of the home context and adequacy to the reality conferred by social differences.