Plan de cuidados de enfermería para el abordaje del duelo perinatal según la teoría del duelo disfuncional. Caso clínico

Abstract

We present the clinical case report of a 33-year-old woman who, after a perinatal death, presents a complicated grieving process.

The aim is to apply an individualized care plan that allows a reestablishment of the balance of the woman and her environment after an experience of perinatal death.

During the first visit to her midwife, the Athens Insomnia, Continuituing Bonds and Goldberg Anxiety and Depression scales were applied. Focused assessment was made using the Gordon patterns and based on the nursing approach described in Dysfunctional Grief Theory.

Six International NANDA diagnostic labels were identified (maladaptative grieving, insomnia, hopelessness, ineffective motherhood process, moral distress and anxiety), and they were prioritized using clinical network reasoning using the Outcome Present State (OPT) model, observing the relationships between the labels, diagnoses and identifying how they affected the rest.

For each International NANDA diagnostic labels, the nursing outcomes were planned nursing interventions. The expected results included the description of the evaluation indicators using the Likert scales. Both results and interventions were agreed between the professional and the woman.

The care plan raises the difficulty that nursing professionals pose in assisting in situations of complicated grief, and specifically, associated with perinatal death. This situation makes key competencies necessary in training as well as the need to know new nursing approaches.