Processo de punção de vasos e trauma vascular em uma Unidade de Diagnóstico por Imagem: estudo de método misto

Abstract

The aim of this study were to analyze the process of puncture of peripheral vessels and the occurrence of vascular trauma in people undergoing imaging and to understand the symbolic constructions and their origin elaborated by users regarding the process of puncture of peripheral vessels, the use of contrasts, the performance of diagnostic imaging and intravascular catheter removal. Converged parallel mixed method study operationalized in: retrospective puncture card cohort; prospective cohort and structural and procedural approach of the Social Representation Theory (SRT) on vessel puncture, examination, contrast use and intravascular catheter removal with users seen in the research setting; and elaboration of bundle from the evidences found. Data collected from May 2018 to May 2019, using specific instruments for each methodological approach. Characterization data and prospective and retrospective cohorts treated with correlative descriptive statistics (CI = 95%); evoked conjuncts treated by dictionary technique and prototypic analysis; discursive contents and field diary records treated with the support of the NVIVO Pro11 program, using Pearson values ≥0.7 as theoretical. A total of 114 SUS users participated and 2,946 assessed puncture sheets comprised the retrospective cohort. In the prototypic analysis, the cognitive / informative, behavioral / attitudinal, evaluative and objective dimensions were corroborated with speech fragments of the participants. In the retrospective cohort, the incidence of contrast extravasation was 8.4% and, in the prospective cohort, the incidence of vascular trauma manifestations was 52.6%, predominantly erythema (25%), vein dilation (17.1%). %), blood residue (13.2%), bruise (9.2%) and hardened (3.9%). Significant associations were identified in the retrospective cohort for gender, punctured limb and examination performed. No significant associations were identified between prospective cohort variables. The bundle was structured from the evidence identified with the mixed method approach. Stressors that emerged from the users' perception of the process of puncture of peripheral vessels used for imaging purposes were identified. The origin of these stressors, according to Neuman, was intrapersonal, interpersonal and transpersonal, based on fragmented conceptions about users' knowledge about the exam and the puncture of peripheral vessels for the use of contrast.