Estudo de caso de adolescente com Pectus Excavatum: intervenção de Enfermafem na promoção de um autoconceito positivo

Abstract

Introduction: Pectus excavatum is characterized by a depression in the anterior wall of the chest, resulting from the exaggerated growth of the costal cartilages. This congenital condition develops during puberty due to rapid growth. Although generally asymptomatic, it can cause dyspnea, fatigue, retrosternal pain, palpitations, and arrhythmia. Physical changes can affect adolescents' self-image and self-esteem, benefiting from nursing intervention to promote a positive self-concept. Objective: To describe the nursing decision-making process regarding an adolescent undergoing surgical correction of pectus excavatum. Materials and Methods: A case study was conducted in a simulated clinical setting, utilizing the nursing process methodology based on nursing ontology. Results: A 13-year-old adolescent, on the 3rd day after Nuss surgery, maintained a negative self-image, expressing feelings of worthlessness and shame. Several nursing diagnoses were identified, with compromised self-concept being a priority, as it influenced recovery. Interventions included continuous assessment of self-concept, support in emotional expression, identification of personal strengths, and self-control strategies in response to bullying, among others. The final evaluation showed that the adolescent recognized that the surgery would improve his appearance. Conclusions: Nursing intervention is essential in promoting a positive self-concept in the postoperative period of pectus excavatum. Although it is a lengthy process, it contributes to adolescents transitioning to an active and functional adult life in society. While generalization may not be possible, the study allows for reflection on the design and prioritization of nursing care.