RESUMO
This case study aims at presenting the follow-up of a patient who underwent allogeneic bone marrow transplantation and the experience of the nursing team of the Centro de Transplante de Medula Ossea (Bone Marrow Transplantation Center) at the Hospital de Clínicas de Porto Alegre, Brazil, during the development of the systematization of the nurse practice emphasizing the period of elaboration of the nursing diagnosis. Twenty-six diagnosis established in this case are discussed and put together in the format of a table to allow the reader to have a view of their initial and ending periods, during the in-patient treatment time.
Assuntos
Transplante de Medula Óssea/enfermagem , Leucemia-Linfoma de Células T do Adulto/enfermagem , Diagnóstico de Enfermagem , Complicações Pós-Operatórias/enfermagem , Transplante Homólogo/enfermagem , Adulto , Ansiedade/diagnóstico , Ansiedade/enfermagem , Transplante de Medula Óssea/psicologia , Seguimentos , Humanos , Leucemia-Linfoma de Células T do Adulto/complicações , Leucemia-Linfoma de Células T do Adulto/cirurgia , Masculino , Distúrbios Nutricionais/diagnóstico , Distúrbios Nutricionais/enfermagem , Complicações Pós-Operatórias/diagnóstico , Transtornos do Sono-Vigília/diagnóstico , Transtornos do Sono-Vigília/enfermagem , Estomatite/diagnóstico , Estomatite/enfermagem , Condicionamento Pré-Transplante/efeitos adversos , Condicionamento Pré-Transplante/enfermagem , Transplante Homólogo/psicologia , Desequilíbrio Hidroeletrolítico/diagnóstico , Desequilíbrio Hidroeletrolítico/enfermagemRESUMO
It is described the follow-up of 48 patients on which kidney transplantation was performed at the Instituto de Investigaciones Médicas de la Universidad de Buenos Aires. This work was carried out with a psychosomatic outlook, which considers the patient as a whole. There were periodically sessions applying a psychotherapeutical and pharmacological treatment to the recipient, donor and/or family group, according to needs. Special importance is given to the psychotherapeutical performance to the physician. What has been observed in these 48 patients is compared to a previous sample group of 80 patients. What has been observed in these 48 patients is compared to a previous sample group of 80 patients. In this first group, it could be noticed that to get on with their treatment these patients needed a good tolerance to frustrations, combined with a supporting family group. It is also necessary the establishment to a close dependent relationship with some relative, and/or physician and or institution which takes care of very regressive anxieties. The main problem here, is the handling of aggression caused by the combination of the patients's psychological background and the characteristics of the treatment. The patients that showed low tolerance to frustrations, extreme dependence and psychopathic handling of aggression, combined with the absence of a supporting family group, presented, as in the preceding sample, suicidal behaviour (2 cases). Some of the observations made in the previous work, were confirmed and the psychiatric pathology found in the second group is noticeably inferior. They are described in the comparative table. The authors conclude that the positive changes are due to the fact that in these patients, a more precise pattern of selections from the immunological point of view was applied. This diminished complications and side-effects and therefore psychological trauma also diminished, contributing to a better adaptation.