title: Guidelines for a Comprehensive Care Program to Ostomized Patients and Families: a Nursing proposal.
abstract: OBJECTIVE
  describe care needs and demands that mark the discursive practices of ostomized clients and family members and discuss guidelines for a comprehensive care program to ostomized clients and their families, organized by macrosociological categories.
  
  
  METHODS
  Creative and Sensitive, involving 17 ostomized subjects and family members at a municipal outpatient clinic. The ethical aspects were complied with. A characterization form was used, as well as Creativity and Sensitivity Dynamics: "speaking map", "body-knowledge" and "calendar". Critical Discourse Analysis was applied.
  
  
  RESULTS
  the health needs and care demands of the ostomized patients and their family members, in their multiple dimensions, were constituted in the home and community, outpatient and social context, implying new orientations for nursing care. The unveiling of the data brought elements that constituted guidelines, in a macrosociological approach, to achieve the expanded integrality of nursing care.
  
  
  CONCLUSIONS
  the ostomized clients are unique in their genre/peculiar from Latin sui generis, calling for strategies that respond to and distinguish their specificities. Elaborating a Public Health Policy that improves and reorganizes the care demands, taking into account these individual biopsychosocial and spiritual aspects, is a possible and irrevocable target in the attempt to achieve better conditions of health and wellbeing.
authors.affiliation: Conselho Regional de Enfermagem, Rio de Janeiro, RJ, Brazil.
authors.forename: Paula Alvarenga
authors.initials: PA
authors.lastname: de Figueiredo
authors.affiliation: Escola de Enfermagem Anna Nery, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Neide Aparecida Titonelli
authors.initials: NA
authors.lastname: Alvim
mesh_terms: D000328:Adult; D000368:Aged; D005190:Family; D005260:Female; D017408:Guidelines as Topic; D006301:Health Services Needs and Demand / Q000941:ethics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010030:Ostomy / Q000451:nursing* / Q000523:psychology; D036301:Qualitative Research