PUNCIÓN VENOSA PERIFÉRICA Y CONTRASTE EN EXÁMENES RADIOLÓGICOS: REPRESENTACIONES SOCIALES ANCLADAS EN LOS ESTRESORES DE NEUMAN

Lemos, Romanda da Costa Pereira Barboza; Arreguy-Sena, Cristina; Melo, Laércio Deleon de; Brandão, Marcos Antônio Gomes; Braga, Luciene Muniz; Krempser, Paula

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Original Article • Texto contexto - enferm. 31 • 2022 • https://doi.org/10.1590/1980-265X-TCE-2022-0030en copiar

PUNCIÓN VENOSA PERIFÉRICA Y CONTRASTE EN EXÁMENES RADIOLÓGICOS: REPRESENTACIONES SOCIALES ANCLADAS EN LOS ESTRESORES DE NEUMAN

Autoría SCIMAGO INSTITUTIONS RANKINGS

RESUMEN

Objetivo:

discutir las representaciones sociales sobre la venopunción periférica y el uso de medios de contraste en personas sometidas a exámenes radiológicos, refiriéndose al concepto de estresores.

Método:

investigación cualitativa, enmarcada en el enfoque procedimental de la Teoría de las Representaciones Sociales, realizada con 57 usuarios sometidos a tomografía computarizada y resonancia magnética en un hospital universitario de Juiz de Fora, Minas Gerais, Brasil. Se realizaron entrevistas individuales en profundidad desencadenadas por preguntas orientadoras en enero de 2019. Los contenidos de las entrevistas se transcribieron íntegramente y se realizó un análisis de contenido en tres etapas (preanálisis, exploración del material y tratamiento/interpretación de los resultados). El análisis de contenido temático-categoría establecido a partir de las dimensiones y orígenes representacionales permitió discutir los hallazgos anclados en los conceptos de estresores, permitiendo la identificación de tres categorías a partir de estresores intrapersonales, interpersonales y transpersonales.

Resultados:

la punción y el examen fueron representados por las experiencias individuales y grupales, con los profesionales y el ambiente terapéutico, clasificados en las categorías: itinerario y concepciones sobre punción y exámenes contrastados, a partir de estresores intrapersonales; relaciones compartidas sobre punción y examen, basadas en estresores interpersonales; y experiencias en el ambiente terapéutico de un servicio de diagnóstico por imagen, basado en estresores transpersonales.

Conclusión:

las representaciones sociales fueron significadas por el examen, los resultados y los impactos en la vida, retratando estresores a partir de imágenes/sentimientos de duda y comportamientos positivos justificados racionalmente, que explican las respuestas humanas a los contenidos cosificados, posibilitando la reestructuración de los cuidados de salud y enfermería.

DESCRIPTORES:
Enfermería radiológica y de imágenes; Cateterismo periférico; Medios de contraste; Diagnóstico por imagen; Psicología social; Teoría de enfermería

Fragments of speeches
Dimensions	1. Itinerary and conceptions on puncture and contrast examinations	2. Shared relationships on peripheral puncture and contrast examinations	3. Experiences in the therapeutic environment of an imaging diagnostic service
Dimensions	Behavioral and attitudinal:We are nervous, concerned, afraid (e502). I was never afraid of a needle (e514). There is a contrast that, although I have taken it before, it still scares me out a little bit (e530). Cognitive and informational: I am not afraid of needles [...] my wife, just seeing a needle, she faints [...] her veins are very thin (e508). I don’t know the examination, I never did it, then we get nervous (e502). Value: My veins are good for puncturing (e508). Ah! Terrible, pure panic (puncture) [...] before doing (puncture), my God, it’s terrible. [...] If I had known it was, I forgot that... CT requires the use of contrast, because, honestly, if I had remembered, it I would not have come (e020). Objective: I’m terrified of doing something that I know will cause me pain (e502). I do not like to watch, just to think that I will have to feel the needle entering my vein ... (e534).	Behavioral and attitudinal:I ask the girl (professional) to give me a lot of attention, because I easily break down (e007). I keep watching to see if the person won’t get the wrong vein, so as not to hurt me (e505). I’m afraid something will happen due to the use of contrast and I’m closed inside (e533). Cognitive and informational: Many times, people faint, you know? Several symptoms (contrast) (e508). It seems to increase or lighten the image (contrast), for them (professionals) to be sure of the diagnosis (e015). Value: We are more nervous about not knowing, because if someone explained to us how the contrast and the examination is, I think at least I would be calmer and would not be so afraid (e502). The bad thing is only when it is by hand (puncture) (e526). I like that they use this vein here (e533). Objective: All of them, the nurses, all nice people. They help a lot. First God, then the class is very cool, right? (e006). When the needle is stuck, I am afraid it will get out of the vein (e529). I think it depends on the professional who will do it, there are some who talk, calm me down, now there are others who do not (e534).	Behavioral and attitudinal:I’ve always been curious. I keep looking and all (e520). I am more anxious for the result (exam) (e504). I only think about finishing soon (puncture) [...] anxious to be able to do (exam), to be able to see what will happen, we are in that expectation, right? (e019). Cognitive and informational: I have faith that the result will be positive [...] from it I will know whether or not my treatment was effective (e534). They (professionals) speak, “Do not move, you cannot move”. Then, they put us inside the machine (e018). Value: A lot of noise there (exam), Jesus! It makes noise all the time, a lot of noise! (e009). Because a result can come from there, sometimes unpleasant (e511). By the time you injected it (contrast), it hurts a lot, it hurts a lot, lucky me that it goes away soon. [...] I was dying to finish and get out of there (e520). I felt suffocated in the examination room [...] horrible is the word that defines it (the contrast) (e526). This examination I’m going to take is very important (e532). Objective: They put us inside a machine (e020). I am more concerned about the result (e504). The examination is fine, but now it looks like I’m going to have to use a contrast, that’s the problem, I’ve never used contrast (e515).

Fragments of speeches
Origin and stressors	1. Itinerary and conceptions on puncture and contrast examinations	2. Shared relationships on peripheral puncture and contrast examinations	3. Experiences in the therapeutic environment of an imaging diagnostic service
	Intrapersonal stressor	Interpersonal stressor	Transpersonal stressor
	Own:I’m afraid(e502). I get anxious, nervous, you know? (e530). I keep thinking before If I’m going to be very anxious inside, if I’m going to start freaking out, if I’m going to start shaking, you know? (e507). When nurses came to use my vein, I was very anxious (e536). It was fine, both outside and inside. All fine! (e537). I forgot that... CT requires the use of contrast, because, honestly, if I had remembered, I would not have come (e020).	Family:My cousin passed away taking this examination. She had a cardiac arrest at the time she applied contrast(e530). My sister, they went to use her vein and her hand swelled like a ball (e507). Her arms (mother) usually turn purple (e508). My mother’s throat already closed and we took her to the hospital. She took medicine in the vein to cut the effect and was hospitalized. So, every time she needs to take this exam, she is hospitalized. She and my brother are allergic (e504). Acquaintances, neighbors, friends:I know other people who are very terrified of that machine (e520). I have colleagues who are very afraid of puncture (e514). Many people say that the examination is bad (e519). Professional: If you had listened to me, you wouldn’t have had to keep making holes in my grandson, right? (e533). The professional has to be patient to look for it (vein). It makes me nervous. I feel agonized (e534).	Media, internet and informational materials: I search on the internet to find out about the examination [...]. I went to look for information (e015). I think, in the general population, through informational materials. There is not much. Or the internet itself, a means of communication in general to inform about how and why the examination is(e016). Imaging service: I don’t like the “sticking” of needles (e501). There is a contrast that, although I have taken it before, it still scares me out a little bit (e530). I get a little anxious during preparation, when professionals are there (e535). Because we stay in a place alone, locked, you know? (e513). To carry out this exam, it is when we are inside and we have to hold our breath, hold our breath, you know? [...] The contrast site feels very painful afterwards (e532). I am more insecure about the result [...] We are a little apprehensive because the result will decide the course of my life (e511).

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[1] CORRESPONDING AUTHOR
Romanda da Costa Pereira Barboza Lemos romanda.barboza@gmail.com