Diagnósticos de enfermagem em gestantes : revisão integrativa da literatura

Abstract

This study aimed to search and assess the available evidences in the literature on the Nursing Diagnoses in pregnant women. For this purpose, we performed integrative literature review, following the steps proposed by Whittemore and Knafl (2005). The search and selection of studies were conducted in the LILACS, CINAHL, MEDLINE and SCOPUS databases. The sample consisted of 14 non-experimental studies with evidence level VI. The studies were assessed and divided into three thematic categories: nursing diagnoses in healthy pregnant women; nursing diagnoses in sick pregnant women; and specific nursing diagnoses. Regarding the results, the studies were published between 1999 and 2010, were Brazilians, in Portuguese language, with authors associated to nursing. The first category consisted of five studies, of which the 15 most frequent diagnoses were reported; related to physiological changes of pregnancy. With special reference to the diagnoses Knowledge, deficient; Sleep pattern disturbance; Nausea; and Risk for infection. The second category consisted of seven studies that investigated the presence of nursing diagnoses in patients with diseases such as Hypertension Syndrome of Pregnancy, Premature Rupture of Membranes, Preterm Labor, Acquired Immunodeficiency Syndrome, Iron-deficiency Anemia, i.e. high-risk pregnancies. In this category, diagnoses tended to appear separately in each study, correlated with the pathology that affected the pregnant women who were being investigated. The 33 most frequent diagnoses were highlighted, with emphasis on the diagnoses: Knowledge, deficient; Risk for infection; Acute pain; Impaired home maintenance; Anxiety; Fear; and Ineffective health maintenance. The third and final category consisted of two studies that investigated how the nursing diagnoses Fatigue; Sleep deprivation; and Sleep pattern disturbance occur in pregnancy. The diagnoses portrayed in the review were related to biological, psychological, social and family aspects of the pregnant women, which meets the need to investigate the pregnant woman integrally, as well as to provide holistic care to this population and family. This integrative review followed the appropriate methodological rigor and identified and assessed the nursing diagnoses in pregnant women. Moreover, it allowed the theoretical deepening on the evidence-based practice, the integrative review methods, the nursing diagnoses and the nursing process related to pregnancy. We identified the need to develop experimental or quasi-experimental studies involving the topics of nursing diagnoses in pregnant women, since studies in this review were classified as evidence level VI. Understanding that efforts are needed to develop researches with designs that produce strong evidence related to the issue, thus, raising the generalization of findings. With this review, we aimed to encourage nurses to consume search results, as well as to produce researches that result in a quality clinical practice, helping the health promotion of pregnant women, their fetuses and family. And, above all, for the Evidence-Based Nursing.