Proposal for Portable Shower for Comfort and Relief of Patients, Family, and Professionals

The hospital scenario or home hospitalization brings feeling of insecurity to patients and families that accentuate when they depend on basic care such as hygiene, food, and physical mobility. The professional has the opportunity to focus his/her care actions making an integrated connection between the tasks normalized by the institution together with the possibilities to better assist the patient and the family to ensure comfort and safety [1]. However, caring is not limited to the execution of technical activities, but it evolves the patient as a whole, his/her history, expectations, and feelings, rescuing the importance of emotional, psychological and physical aspects welcoming and valuing them in all their dimensions [2].

The care has scientific and technological, ethical and philosophical, aesthetic and interactional dimensions aimed at the human being, considered as a physical, social, cultural and sensitive organism. In this sense, care represents an act with therapeutic intent, which requires technical competence, commitment, and ethics of its agents, who interact with each other. Thus, care is an action to become one state of discomfort, or pain into another of more and more comfortable with less pain. Therefore, it has a therapeutic perspective on an individual who has a physical and mental nature [3]. Bathing is highlighted among the numerous activities involved in the treatment of the patient. Considered as a healing practice more than two millennia before Christ, bathing is changing in the course of time and with the variation of places and cultures, establishing some standards for its execution among the people [4]. Currently, there are three types of most common bathing practice: Bathing in the bathtub, sprinkling (bath in the shower) and bathing in the bed [5].
Bathing in the bed is a widely used practice in homes as well as clinics and hospitals that perform care for people who are bedridden or have illnesses that require rest or temporary immobilization, preventing them from performing their own hygiene. Such a procedure requires much maturity of the executor and wisdom to explain the technique to the patient or family member and, during this practice, not embarrassing the patient in any way [6]. This bathing practice promotes therapeutic actions because it increases the peripheral circulation due to water temperature and physical examination by observing and touching the entire body of the patient. Bathing is not only an activity for body hygiene but a therapeutic action based on a set of scientific knowledge [7]. This hygiene process is an instrument of care and it has a scientifically proven guide to be followed, seeking comfort and allowing the opportunity of patient evaluation, objectivity, and agility by the professionals avoiding prolonged exposure and guarantees his safety. The successful technique of this procedure may represent relief from pain because the patient is bedridden and feeling comfortable with pleasant and totally subjective sensations [8].
According to the Ministry of Health, bathing to the bedridden patient should be done from head to toes, leaving the private parts to the last stage with the aid of a soft cloth and basin with water, at appropriate temperature, where the performer will moisten the cloth and perform the technique of body hygiene. However, there are also other materials suitable for bathing in some stores and institutions [5].
The dynamics of the bath in the bed generates an intense physical mobility to the professional, producing complaint of fatigue and pain with consequent occupational illness with absences in their work shifts. Work-related osteomuscular diseases occur in great proportion due to the overload of procedures performed by the nursing team and unfavorable conditions in the work environment. These problems are caused by poor physical space and ergonomically inadequate materials [9].
Bathing in the bed offers risks to the nursing team and it is imperative to search for alternative methods that minimize these damages. This search takes place through the acquisition of knowledge and studies in the development of devices that offer less adversity and more ergonomics [10]. One of the work methods adopted and well accepted by the nursing is the functional method. This method seeks to save time and agility in performing activities and procedures in a safe and efficient manner. To execute this resource, the development of alternative research and propaedeutic techniques are necessary [11]. And the portable shower is one of them.
Professor Jose Paulo Muniz Junior is a nurse and has worked with health care in Brazilian hospitals of the private-public network for more than 10 years. He has developed two devices ( Figure 1) and patented them when evaluating his practice and seeking improvements for patients who need to bathe in the bed, families that often need to take care of their dependents at home and also his colleagues health professionals who all day perform several baths in the bed and which by repetition, weight of patient and the materials face unbearable pains, self-medication, breakdowns among other problems. The devices aim to reduce weight for nursing, ease of heating the water, saving water, time and laundry services (by reducing the weight of the bed linen) among other benefits. A device with capacity of 1000 ml for bath water and another with 100ml capacity for the liquid soap we developed. Image courtesy of Prof. Jose Paulo Muniz Junior, creator of the devices and owner of the patent: BR2020150054187. Bathing in the bed is not a procedure properly valued of its extreme importance. It should be considered as an essential necessity, as it guarantees the patient's hygiene by ridding him of some pathogens, as well as providing a sensation of relief, lightness, and comfort, and this action should be evaluated and intensified in the sick individual [12]. The purpose of this action is to achieve comfort and well-being and provide the patient with positive memories since he is in a moment of suffering. Many professionals are focused on performing their daily activities in a timely manner, not recognizing the patient's feelings [13]. The proposal of portable shower is to bring sprinkler bath feeling even if this is impossible to the patient, thus reducing feelings of anxiety and fear. The conventional technique of bathing in the bed (bucket and basin) does not refer to remembering the ideal bath for the patient because it does not provide the expected comfort, especially when the patient will need this procedure for several days [14].
Certainly, people who are taking care of their family members at home will also benefit from the product because it is easy to handle, takes up little space, and does not require training to use it. Many studies are needed to complement these statements, to make relevant and understand the complexities of patient care at rest in the bed, to promote comfort to the patient as well as to evaluate the professional ergonomic issue, guaranteeing the development of devices to the professional, such as portable shower, which promotes well-being, practicality and efficiently as a working tool in their daily practice.