Gestão do cuidado pelo cuidador familiar na atenção domiciliar ao idoso após a alta hospitalar

Abstract

The subject of the study was the elderly’s family caregiving management after hospital discharge. The study aimed to understand how the patient’s family deal with the management of home care after hospital discharge provided by the Brazilian National Health System’s (Sistema Único de Saúde – SUS) Home Care Program. A qualitative investigation was carried out using the Dialectal Hermeneutics approach according to the conception that Cecília Minayo has been undertaking to this method. In an early stage an exploratory study was used to describe the care scenario of elderly patients after discharge in the period of April 1, 2017 to March 31, 2018, Data taken from the Brazilian National Hospital Information Systems, e-SUS System, identified 6,825 discharges, and From patient’s charts and city’s local data from the Home Care Program Better at Home (Melhor em Casa) 89 elder patients were admitted. From this sample were chosen 11 family caregivers aged 18 years old or older, living in streets adscribed to the primary care unity of eight geographic regions. Data were collected at home, by direct observation and guided interview by semi-structured script. The analysis followed three phases: organization, ordering, storage and textual editing. The Open Logos 2.0 program was used to help on horizontal and vertical coding, following up the categorization and final analysis. Analytical categories: family changes after taking over the home care of dependent elderly patient after hospital discharge; family participation and home caregiver’s routine of dependent elderly people after discharge; caregiver’s management of the several care procedures, relationship between family caregiver and / or elderly and health care network and the relative caregiver’s requests to the nursing service. From this last category, four subcategories were built up related to the primary care unity’s support; nursing home care service of Health Family Strategy (Estratégia Saúde da Família) and seeking service on the network. The results pointed out a gap in the existing knowledge in the management of home care by families and indicated the need to strengthen the care practice directed to the elderly population that needs home care after hospital discharge in the context of home care of the Unified Health System.