Subconjunto terminológico CIPE® para o cuidado de gestantes com doença falciforme à luz da teoria do autocuidado.

Abstract

Pregnant women with sickle cell disease require high-risk prenatal care, considering the possibilities of maternal and fetal complications to which they are exposed. Therefore, it is necessary to know and systematically plan nursing care for pregnant women with sickle cell disease, from the perspective of promoting self-care and taking into account the individualities of each woman to reduce the possibilities of complications. The objective of the study was to build an ICNP® Terminology Subset for pregnant women with SCD, contemplating diagnoses/outcomes and nursing interventions in light of the Self-Care Theory. Methodological research, based on the Brazilian method for developing terminology subsets, carried out in seven stages: 1) Identification of terms relevant to nursing practice in the care of pregnant women with sickle cell disease; 2) Cross-mapping of terms identified with ICNP® Version 2019; 3) Validation of the allocation process of non-constant terms; 4) Structuring of nursing diagnosis/outcome statements, elaboration of operational definitions and selection of nursing interventions; 5) Cross-mapping of nursing diagnoses/outcomes/interventions; 6) Validation of the content of nursing diagnoses/outcomes and the structuring of the Terminology Subset; 7) Structuring of the ICNP® Terminology Subset for the care of pregnant women with sickle cell disease. The automatic extraction of terms through the PORONTO Software and the automatic cross-mapping provided by MappICNP represent innovative advances and essential tools in the development of ICNP® Terminology Subsets. After content validation by 12 specialist nurses, the ICNP® Terminology Subset for the care of pregnant women with sickle cell disease, structured based on Orem's Self-Care Theory, is composed of 55 nursing diagnoses/outcomes, 9 of which are classified as universal requirements, 21 as developmental requirements, and 25 as health deviation requirements, and 343 nursing interventions (considering the interventions). The nursing diagnoses/outcomes Risk of death and Risk of suffering racism have a significant impact on the lives of pregnant women with sickle cell disease and should be considered in nursing care, as structural racism impacts access to and quality of care, exacerbating the fear of death due to complications of the disease and historical neglect in the health of the black population. Nursing care should address these dimensions, promoting a safe and equitable environment, and offering emotional support and information to mitigate fear and ensure adequate monitoring. Nursing care should address universal, developmental and health deviation requirements, highlighting the need for holistic care that considers social vulnerabilities and health determinants, in addition to clinical aspects. Structural racism, by influencing access to and quality of care, worsens prognosis and fear of death, requiring nursing interventions that promote equity and safety.