O CUIDADO DE ENFERMAGEM NA PROMOÇÃO DA CONTINÊNCIA URINÁRIA DA PESSOA IDOSA HOSPITALIZADA À LUZ DA TEORIA DE DONABEDIAN

Abstract

Urinary incontinence is defined as any involuntary loss of urine. Considered as a multifactorial geriatric syndrome, it is associated with intrinsic factors of the elderly person and extrinsic factors such as environment and health care management. Associating the problem with the conceptual model of Avedis Donabedian, constituted by the triad structure, process and result, it is understood that the extrinsic factors range from the macro, which would be the structure of the health institution to the microreactions of care offered (process dimension), thus determining this outcome / outcome during the hospitalization process. Objective: to analyze how care of the nursing team occurs to promote the urinary continence of hospitalized elderly people. And specifically: to verify the influence of the components of the Donabedian triad "structure" and "process" in the provision of care to promote the urinary continence of hospitalized elderly people and to apprehend how the nursing team perceives the influence of the "structure" and "process "In the" result "of their care, aiming to promote the urinary continence of hospitalized elderly people. Method: qualitative-descriptive-exploratory qualitative research, whose locus was a unit of medical clinic of a University Hospital of the city of Salvador-Bahia; the triangulation of data collection techniques was carried out, consisting of the collection of scientific evidence related to the topic, followed by systematic observation in the collection field and focus group workshops with nursing team professionals working in the unit. For analysis, the Bardin content analysis technique was used, raising thematic categories anchored in the Donabedian theory and codified as to their exact frequency with the aid of the WebQDA qualitative research analysis software. Results: three thematic categories emerged. The first deals with the influence of structural aspects in the provision of this care; where aspects were highlighted beyond the physical structure, but also factors such as human and material resources available in the unit. The second emphasized the "process," and addressed the culture of the use of urinary control devices during hospitalization; where the indiscriminate and unjustified use of geriatric diapers in elderly people was emphasized; the greater stimulus of the use of urinals in older men than in women in the elderly; factors such as modesty, fear and dependence as an influence on the use of diapers in these people; the low association of nursing professionals with bladder catheter use with the occurrence of urinary incontinence and the lack of approach to post-catheter removal care to track the occurrence of urinary incontinence; already the third and last category, anchored in the "outcome" component, dealt with the actions of nursing care to promote the urinary continence of the hospitalized elder identified in the scenario and how to extend them. Conclusion: the results of the study show that nursing care in this aspect occurs timidly, punctually and not systematized, alerting to the need to create validated instruments and protocols based on evidence that guide this practice and the need for awareness of the multiprofessional team, mainly nursing to the problem.