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Previous issue date: 2012 / Com o aumento na expectativa de vida e da incidencia de doencas cronicas, a desospitalizacao se constitui num premente desafio. Alem da insufiCiência de recursos publicos, a familia, em geral, tem dificuldades de assumir o cuidado do paciente na residencia, criando nessas condicoes uma zona de impasses a serem enfrentados pela equipe multiprofissional no tocante a educacao em Saúde no momento da alta hospitalar. Este estudo teve como objetivo identificar dificuldades de desospitalizacao do paciente idoso - dependente atendido em Servico de Emergencia do Hospital São Paulo, tendo em vista subsidiar propostas de orientacao de alta. O estudo foi composto, num primeiro momento, pela caracterizacao do perfil do paciente e qualificacao do nivel de dependencia para atividades de vida diaria. Em um segundo momento, foram entrevistados os familiares identificando fatores problematicos relacionados a desospitalizacao e, finalmente, em um terceiro momento, procedeu-se a avaliacao da orientacao de alta, com vistas a repensar esse processo. A partir do sistema de informacao da Unidade de Emergencia do Hospital São Paulo e de entrevistas com familiares obtivemos dados que contemplaram itens sobre a configuracao familiar, instalacao residencial, situacao financeira e recursos de apoio. Cerca de 40% dos pacientes internados no Pronto Socorro eram idosos, revelando importancia do treinamento nos cuidados dos mesmos. Atraves da percepcao familiar os fatores apresentados como condicionantes da alta hospitalar e cuidados domiciliares foram: adaptacao de custos; articulacao da rede social de apoio; aquisicao de equipamentos; adaptacoes na residencia. Alem disso, cuidadores externaram: sobrecarga fisica e emocional; escasso apoio para cuidado; mudanca no estilo de vida e aspectos emocionais (inseguranca, impotencia, tristeza, desesperanca, desamparo). Ainda foram apresentados, em relacao a orientacao de alta: fragmentacao da acao; confusao na identificacao dos profissionais; duvidas na realizacao dos procedimentos de cuidado; falta de treinamento; problemas de relacionamento com a equipe e discordancia de alta por inalteracao ou piora do quadro clinico. O estudo aponta elevado numero de pacientes idosos dependentes de alta do Pronto Socorro a serem desospitalizados. Familiares destes idosos necessitam orientacao sistematizada sobre cuidados domiciliares afim de efetivarem a alta com seguranca para o paciente e o cuidador. O assistente social, por seu carater investigativo e interventivo, possui papel relevante na organizacao do trabalho em equipe. Com base na teoria da Aprendizagem Significativa Critica, afirma-se a suspeita de que e possivel identificar espacos de mobilizacao pacientes u familiares na orientacao da alta hospitalar em servicos de emergencia, no sentido de potencializar a desospitalizacao / With the growth of life expectancy and the incidence of chronic illness, the de
-
hospitalization is a pressing challenge. Besides the public resources insufficiency, the
family in general has had difficulties to assume the patient care in
their homes, creating
in these conditions a difficult environment to be faced by multi
-
professional team
regarding health education at the de
-
hospitalization.
This study’s main objective was to identify de
-
hospitalization difficulties for aging
patients
–
someone who depends on the Hospital São Paulo Emergency Service, with
the objective of subsidizing an orientation proposal of discharge from the hospital.
The study was composed, at the first moment, by profile characterization of the patient
and qualifica
tion level of dependency regarding his daily life activities. At the second
moment, families were interviewed in order to identify problematic factors regarding to
de
s
-
hospitalization and, finally, at a third moment, the evaluation of discharge from the
ho
spital was followed with the objective of rethinking this process. Base
d
on the
information system of Hospital São Paulo Emergency Unit and an interview with
family, we have obtained data that complemented items about family configuration,
home installatio
n, financial situation and support resources.
Around 40% of hospitalized patients on Emergency were elderly, which revealed the
importance of training on their self care. Through family perception, the factors showed
as conditions for discharge from the ho
spital and home care were
:
cost adaptation;
social network; equipment acquisition; home adaptation. Beside this, caregivers voiced
physical and emotional overcharge (insecurity, impotence, sadness, desperation,
abandonment). It has also been presented, reg
arding to orientation
of discharge from the
hospital:
a fragmentation of action; a misunderstanding on professionals identification
in charge of the treatment; doubts on care procedures performance; lack of training;
problems regarding team and disagreemen
t concerning the discharge from the hospital
due to unchanged situation or the worsening of the clinical scenario.
The study shows a high number of elderly patients depending on the discharge from the
hospital of Emergency to be de
-
hospitalized. The family
of this elderly needs systematic
orientation about home care in order to perform the discharge from the hospital with
security to the caregiver and patient. The social assistants, because of their investigative
and hospitalized experience character, have
relevant role on team work organization.
Based on Meaningful Critical
Learning
, it is understood the possibility of identifying
spaces for patient
–
family
mobilization on discharge from the hospital on emergency
services, with the objective of empowering
the de
-
hospitalization / BV UNIFESP: Teses e dissertações
| Identifer | oai:union.ndltd.org:IBICT/oai:repositorio.unifesp.br:11600/22220 |
| Date | January 2012 |
| Creators | Alcântara, Ana Maria Santana de [UNIFESP] |
| Contributors | Universidade Federal de São Paulo (UNIFESP), Goldenberg, Paulete [UNIFESP] |
| Publisher | Universidade Federal de São Paulo (UNIFESP) |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | Portuguese |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/masterThesis |
| Format | 113 p. |
| Source | reponame:Repositório Institucional da UNIFESP, instname:Universidade Federal de São Paulo, instacron:UNIFESP |
| Rights | info:eu-repo/semantics/openAccess |
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