Ressecamento ocular: desenvolvimento de uma teoria de enfermagem de médio alcance

Abstract

It is a theoretical research, analytical in nature, with a qualitative approach. The general objective was to develop a mid-range nursing theory of ocular dryness based on Roy's adaptation model. The strategies for the development of theories proposed by Walker and Avant (2019) were adopted, choosing the concept analysis strategy for the presentation of concepts, the establishment of relational statements from the statement synthesis and the theory derivation strategy to model the theory. This study took place in five stages, namely: scoping review, concept analysis, statement synthesis, derivation of the theory and construction of elements for taxonomies of nursing interventions (Nursing Interventions Classification) and results (Nursing Outcomes Classification) from the theory developed. In the first stage, a scoping review was carried out. After identifying the research question, a search protocol was established and based on the descriptors “dry eye syndromes” and “keratoconjuntivitis sicca”, a controlled search was carried out on the bases: Scopus, Web of Science, Science Direct, the identified synonyms were used in the form of keywords in the electronic search engine. A sample of 184 studies was obtained, including articles, theses and dissertations that served as a basis for the construction of the elements of the theory. The concept and statements were obtained from the primary studies included in this sample. When analyzed and synthesized, these were modeled from the derivation of Roy's adaptation model. From the concept analysis, insufficient volumetry was identified as an attribute of ocular dryness. The background ranges from environmental, behavioral and biological factors. As a consequence, ocular signs and symptoms were verified. From the analysis of the theory, it was found that this model starts from the metaparadigmatic understanding that the environment is an actor in human adaptive systems; health as a state in which the person seeks to promote through adaptation; nursing as a profession that promotes adaptation; and the person as an adaptive system that is controlled by stimuli, control and feedback. The central proposition of this medium-range theory is that the ocular dryness event occurs as a result of the activation of focal (intrinsic factors that cause decreased tear production), contextual (environmental factors) and residual stimuli, which can generate adaptation or a problem of adaptation. Nursing, based on the identification of the unwanted human response, provides conditions that act effectively and are able to reiterate the human adaptive mechanisms promoting eye health. From the construction of the theory, propositions of taxonomic elements were elaborated that will serve as a basis for the individual to recover the adaptive mechanisms and obtain eye health. The proposition of the nursing result entitled: behavior to prevent dry eye was constructed and a proposal for the construction of the nursing intervention entitled: control of dry eye. It is concluded that the medium-range theory of dry eye was developed and will be able to subsidize the practice by proposing to describe, explain, predict and intervene in the phenomenon under study.