Protocolo para idosos no pós-operatório de fratura de fêmur proximal por queda: construção convergente assistencial

Abstract

The falls suffered by the elderly are considered a public health problem. They can cause proximal femoral fracture which, usually, it is treated by surgery. The recovery of this procedure demands specific cares in the post-surgery. The objective was to develop a protocol of service to the care and the Education in Health in the post-surgery period of the elderly people hospitalized which experienced proximal femoral fracture caused by fall. This is a qualitative investigation with the convergent care research based on freireanos theoretical framework of awareness and of dialogic education, beyond of Education in Health. Participated 16 nurses from the Unit of General Surgery – Service of hospitalization, 102 elderly people in the post-surgery of correction of proximal femoral fracture caused by fall and their escort. The production of the data happened from January to December 2016 by means of conversational interviewing and participant observation with the elderly, escort and nurses. With the elderly it was applied a semi-structured form and mini mental state examination. By the researcher were oriented 23 elderly people and their escorts. With the nurses it was realized convergence groups. It was analyzed the forms and mini mental by univariate analysis and descriptive statistics of variables and the subjective data according to the steps of convergent care research: apprehension, synthesis, theorization and transference. Approval was obtained by the Ethics Committee under number 1.394.524. The results originated six categories: characterization of the elderly hospitalized post correction of proximal femoral fracture caused by fall; elderly’s demands with correction of proximal femoral fracture and realized actions; welfare practice of the nurses with elderly post correction of proximal femoral fracture and their escort; instrumentalization with the nurses from Unit by means of convergence groups; meeting between research, assistance and dialogic education: possibility to the theoretical construction; and, socialization of the results: strategies to reflect about the assistance to elderly post correction of proximal femoral fracture caused by fall. It was found that the awareness raising the nurses to the construction of a protocol is freedom practice to the emancipation through the Education in Health in dialogic relationship, with elderly post correction of proximal femoral fracture caused by fall and their escorts and it promotes the transformation of the reality of care. It is concluded that it is necessary to demystify conceptions of to maintain the elderly at rest for the recovery. It is indispensable the elderly ’s and their escorts’ empowerment about mobilization, ways of obtaining and use the walker, adaptation of the environments to avoid new falls and to reduce post-surgery complications. Education in Health has to be guided by the problematization seeking out strategies to intervene in reality. The deepening about specificities in the care to elderly through the elaboration of protocol it is a tool to improve the nurse’s assistance to elderly and escort.