Journal of Nursing and Socioenvironmental Health
2015, 2(1):23-27 - http://www.jonse.com.br
Received: 1 December, 2014 - Accepted: 1 May, 2015
DOI: 10.15696/2358-9884/jonse.v2n1p23-27
Nursing consultation as education strategy on health
to postpartum woman
Dóris Helena Ribeiro Farias1, Giovana Calcagno Gomes2, Daiani Modernel Xavier3,
Carla Rosana Mazuco dos Santos4, Valéria Lerch Lunardi5, Aline Campelo Pintanel6
ABSTRACT
This is a theoretical reflection that aimed to show the importance of nursing consultation to postpartum women as a health education strategy. To this end,
we discussed: education as knowledge-building strategy and the nursing consultation as an educational technology for self-care. We believe that, through
nursing consultation, the nurse, as an educator in health, proves to be co-responsible for building the autonomy of postpartum women, helping to make
them better able to make choices and to assume their role in promoting their own health.
Descriptors: Women’s Health; Health Education; Postpartum Period; Nursing
Consulta de enfermagem como estratégia de educação em saúde à mulher no puerpério
RESUMO
Trata-se de uma reflexão teórica que teve por objetivo mostrar a importância da consulta de enfermagem à puérpera, como uma estratégia de educação em
saúde. Para tanto, discutimos: a educação como estratégia de construção do conhecimento e a consulta de enfermagem como tecnologia educativa para o
autocuidado. Consideramos que, através da consulta de enfermagem, a enfermeira, como educadora em saúde, revela-se co-responsável pela construção
da autonomia da puérpera, contribuindo para torná-la mais capaz de fazer escolhas e assumir seu papel na promoção de sua própria saúde.
Descritores: Saúde da Mulher; Educação em Saúde; Período Pós-Parto; Enfermagem
Mestre em Enfermagem pela Universidade Federal do Rio Grande (FURG). Membro do Grupo de Estudos em Pesquisa em Saúde da Criança e Adolescente (GEPESCA) da
FURG. E-mail: [email protected]
2
Doutora em Enfermagem. Docente da Escola de Enfermagem da FURG. Líder do GEPESCA/ FURG. Rio Grande/ RS/ Brasil. E-mail: [email protected]
3
Doutoranda do Programa de Pós-graduação em Enfermagem da FURG. Bolsista CAPES. Membro do GEPESCA/ FURG. Rio Grande/ RS/Brasil. E-mail: [email protected]
4
Enfermeira da Prefeitura Municipal de Saúde do Rio Grande. Membro do GEPESCA/ FURG. Rio Grande/ RS/ Brasil. E-mail: [email protected]
5
Doutora em Enfermagem. Docente da Escola de Enfermagem da FURG. Rio Grande/ RS/ Brasil. E-mail: [email protected]
6
Doutora em Enfermagem. Docente da Escola de Enfermagem da FURG. Líder do GEPESCA/ FURG. Rio Grande/ RS/ Brasil. E-mail: [email protected]
1
Nursing consultation as education strategy on health to postpartum woman
Introduction
Women’s health, in recent decades, has been a
source of concern in health programs in Brazil, as
we observe a noticeable evolution in public policies
related to this issue. Female participation has been
proving increasingly intense in the discussion on
women’s health, since the 1980s. The engagement of
women in the struggle for their rights and better living
conditions drove the first official measures of the
Ministry of Health. The Program of Comprehensive
Care for Women’s Health - PAISM, in Portuguese
- created in 1984, was important for the health of
Brazilian women by emphasizing the need of care at
all stages of their life cycle1.
The attention to women’s health needs to include
a number of aspects that include psychological,
social, biological, sexual, environmental and
cultural issues, enabling us to extend the concept of
health, by adopting practices that consider women’s
experiences with their health, applying strategies
that raise the quality of life and health humanization.
It is understood that humanizing and qualifying
health care means learning to share knowledge and
recognizing rights. The humanized and quality
care implies the establishment of relations between
subjects, similar beings, although they may present
themselves very distinct regarding their social, racial,
ethnic, cultural and gender conditions2:59.
During woman’s life cycle, specifically postpartum,
women should receive special attention. In this period,
they become more vulnerable to complications, such
as bleeding, infections, problems associated with
breastfeeding and postpartum depression, and need
to adapt to new demands related to caring for the
newborn, being a mother, being a wife and a woman.
They often experience this stage of life according to
previous experiences, beliefs and cultural values and
have different care demands 3.
To serve them in their needs it is necessary to learn
the multiple singularities of women in this period,
i.e., their desires, their difficulties, their relationship
with their family, their self-image, their relationship
with their body, their feelings, their way to experience
the postpartum period. Thus, the postpartum period
is characterized by presenting itself as a phase of
profound changes in the social, psychological and
physical ambits of women4.
24
In a study that aimed to know how mothers
experienced postpartum consultation, the authors
found that they seek a return visit later, that
their cultural knowledge is not considered, that
breastfeeding is the focus of the guidelines and that
they do not have their needs fully met5.
In this perspective, it is understood that it is
necessary that nurses review their educational
activities, in order to provide a multidimensional
care, covering, in the care planning, biopsychosocial
aspects, valuing cultural aspects, focusing on the
comprehensiveness of women, thus contributing
effectively for a healthy postpartum.
It is considered that the nursing consultation can
establish itself as a privileged space to qualify the
health care for women who experience the postpartum
period in face of the possibilities of nurse-client
interaction and humanization in this process, so that
the user sees the nurse as a professional that is receptive
to their different manifestations related to being a
woman, wife and mother. The nursing consultation
is recognized as a reception space because it allows
dialogue and free expression of doubts, feelings, and
experiences6.
Thus, through a theoretical reflection, we aim to
show the importance of nursing consultation as an
educational technology of care to women postpartum.
To this end, we discuss: education as knowledgebuilding strategy and nursing consultation as an
educational technology for self-care.
Education as KnowledgeBuilding Strategy
Education is a care component that can instruct
individuals making them autonomous, so that they
conquer better living conditions, promoting their
empowerment7. Health education requires exchange
of spaces and awareness so that they recognize the
existing challenges and potentials in their concrete
reality. The proposed health promotion contributes to
greater understanding of the need to involve different
individuals in the whole process of social construction
of health8.
Through health education, nurses can be
considered as agents for transformation, as long as in
their daily practice they promote their own reflection
and user’s reflection, enabling the exchange of
knowledge, as someone who mobilizes this process.
J. Nurs. Socioe. Health, 2015, 2(1):23-27
Farias DHR, Gomes GC, Xavier DM, Santos CRM, Lunardi VL, Pintanel AC
Transformation, in this sense, is understood as a
result of action and reflection on reality, contributing
to modify it9-10.
Educational practice enables individuals to
understand their process of living. For this to happen,
the educational process requires participation of
all subjects involved, knowledge of their beliefs,
interaction between student and educator, respect for
their ideas, search for consensus and understanding
through argument, understanding that the limits of
freedom are established in the relation to the other as
a subject rather than an object of this practice.
In nursing, health education is a key tool for good
quality care. It is a teaching process with the aim that
users learn self-care, and become multipliers of health
care knowledge11.
As an aid to construction of knowledge, education
presents itself as a complex and holistic process that
values the daily life, the living and the uniqueness of
each individual. The health education process needs
to provide conditions for individuals to develop
responsibility for self-care and deserves consideration
as one of the most important links between the
perspectives of individuals and health practices.
Health education is characterized as a key strategy for
achieving better life / health conditions12.
The conception of education is conditioned to
the environment and the conception of man and
world predominant in society. Thus, educational
practices should be committed to an education that
dialogue with the political and social issues, helping
to overcome them9.
The educator Paulo Freire revealed that the man
becomes subject by a reflection on his situation, about
his concrete environment. The more they reflect on
the reality of their situation, the more they emerge
fully conscious, committed, and ready to intervene
in reality to change it. “An education that seeks to
develop the awareness and critical attitude, thanks to
which man chooses and decides, frees them”13:35 .
The nurse can, through health education, help
postpartum women to experience this period more
calmly. Educational activities are of fundamental
importance, but to be effective, they need to
understand their reality, enhance their knowledge,
their relationships and know the environment in
which they live. So, we can, more easily and together
with them, plan educational activities that train them
for self-care.
J. Nurs. Socioe. Health, 2015, 2(1):23-27
Nursing Consultation as an
Educational Technology
for Self-Care
Nursing Consultation emerged in Brazil in the
sixties, being in the field of Law No. 7498/86, which
regulates the practice of nursing and determined it as a
prerogative of the nurse. In 1993, the Federal Council
of Nursing (COFEN), through Resolution COFEN
/ 159, established the obligation of conducting the
nursing consultation in all health care levels in public
or private institutions. This aims to systematize, give
consistency, sense, record and memory to nursing
care in the three levels of care to human health14.
Postpartum women have special care needs, which
implies in certain knowledge to enable them to fulfill
them. The nursing consultation is an educational
strategy to become women more independent in their
thinking and acting throughout their health-disease
process, and is an appropriate educational technology
used by nurses in their daily practice. The nursing
consultation is permeated with understanding and a
sensitive listening and allows that nurses make room
for the mothers to express their needs and enables the
establishment of a dialogical relationship in which the
reflection is present, making this a shared process15.
Nurses have, in nursing consultation, a privileged
place where they can integrate care and health
education, targeted at mothers. The consultation is
also a process of interaction between the nurse and
the assisted woman, in the pursuit of promoting
their health, disease prevention and limitation of
damages. So that the interaction occurs effectively,
the development of refined communication skills is
necessary for the exercise of listening and dialogical
action15.
The nursing consultation is a space for reflection
and discussion about the postpartum period in a crosscultural perspective, as a strategy for the promotion
of a nursing care that is not aimed only to meeting
the physical, emotional and social needs of mothers
individually, but that, in a more global way, develops
their cultural potential to think, plan and act in order
to provide them better living conditions.
The awareness of the need to provide a more
globalized nursing care that meets in an effective and
humane way the postpartum woman’s needs during
the nursing consultations may enable us to rebuilt the
care reality to this clientele. Currently, it is not possible
25
Nursing consultation as education strategy on health to postpartum woman
anymore to provide nursing care without reflecting
about it and its impact on society16.
In nursing consultation, the possibility of full
understanding of postpartum women and their
health-disease process, which is the object of health
work, goes through a multicultural approach. The
pursuit of comprehensive care to postpartum women
requires an understanding of their history, their
beliefs and values; it requires that nurses develop
strategies for care practice and for teaching care, using
technologies that consider the economic, cultural,
political and social aspects of the mothers’ lives2.
The nurse, being the health professional that has
a closest contact with mothers, needs to be alert to
factors that may interfere with the apprehension of
the given guidelines. The role of the nurse in the
nursing consultation must create an environment
of trust that provides emotional support necessary
for postpartum women verbalize their questions,
concerns and needs.
This relationship of the nurse with the puerperal
woman needs to be warm, mobilizing their knowledge,
helping them to build the knowledge necessary to
experience this period more positively17. During the
nursing consultation to postpartum women, nurses
can develop enough sensitivity to realize, in gestures
and expressions of women, meanings that allow them
to establish a dialogical relationship so that a concrete
action of health education is established, favoring the
effectiveness in nursing care.
The nursing consultation enables establishing
a therapeutic bond with women, which provides
a humanized care, and this is done by listening,
supporting and identifying their problems, which
assist in drawing up plans for care to meet their needs.
The expertise of the nurse in the locus of women’s
health and puerperal consultation should consider,
in particular, the use of educational and relational
technologies. This type of technology can provide
building relationships where real subjects (nurses
and mothers) in real situations (context of life and
health), are able to identify needs and envision ways
to overcome17.
The educational process carried out in nursing
consultation must be based on ethics and respect
the dignity and autonomy of postpartum women.
“Teaching does not mean transferring knowledge,
but creating the possibility for its production or
construction”18:25.
26
Thus, it is necessary that professionals who perform
the nursing consultation get to know the postpartum
women, regarding their health-disease process and
their needs, to help them to build more effective
strategies for transforming their reality from their
own health and disease references: care is an end in
nursing work and a means of professional development
when it is done with art (creativity, aesthetics) ethics
(respect, understanding) and science (knowledge,
research). Care produces well-being and good living.
As educational technology of care, nursing
consultation is an important strategy for the care to
postpartum women, as it helps the nurse to know
them, their subjectivity, their relationships, their role
in society and in the family, enabling to intervene and
interact with them in order to improve their welfare,
building a welcoming environment, permeated by
trust and respect.
Final Considerations
The nurse, as an educator in health, can help
postpartum women to build knowledge that
answer their questions, strengthening them for
the performance of their maternal role, as wife and
woman, reflecting on the process of postpartum and
their feelings. The nurse proves to be co-responsible
for building the autonomy of postpartum women,
making them able to make safe choices about their
health-disease process and assume their role in the
promotion of their health.
The nursing consultation makes it possible to
build a relationship between the nurse and puerperal
women, giving support to the transformation of
reality in which puerperal women are inserted,
awakening their consciousness. It presents itself as
an educational technology for self-care since it can
be understood as a mediator between professional
and popular knowledge based on the social reality of
postpartum women.
Conflicts of Interest
“The authors declared that there is no conflict of
interest of any nature.”
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