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Advisor(s)
Abstract(s)
Problemática: O envelhecimento da população portuguesa irá acentuar-se no futuro (INE, 2020) e será, potencialmente acompanhado, do aumento da prevalência de pessoas dependentes no autocuidado e de cuidados de terceiros. Esta situação, é suscetível de resultar no aumento da necessidade de cuidados continuados. É desejável, e reúne cada vez maior consenso, a ideia de que, a resposta em cuidados continuados, deve priorizar e privilegiar os cuidados domiciliários. Esta realidade, exigirá novos modelos de cuidados e/ou reforma dos existentes. Pensá-los exige investigação que permita uma melhor compreensão das necessidades das pessoas dependente a viver em casa, e de como se pode garantir completude de cuidados.
Objetivo: Identificar, as necessidades de cuidados das pessoas dependentes no autocuidado que vivem em suas casas, que cuidados lhes são efetivamente prestados e quem os presta.
Material e métodos: Há duas fases nesta investigação. Fase 1: estudo observacional, quantitativo, descritivo e transversal, numa amostra de pessoas assistidas em 13 ECCI de um Agrupamento de Centros de Saúde de Portugal, que consistiu na avaliação dos cuidados necessários a 130 pessoas dependentes no autocuidado, com recurso à utilização de um formulário. Fase 2: levámos a cabo um “focus group” procurando a compreensão dos fenómenos sociais observados.
Resultados: As pessoas dependentes no autocuidado, assistidas em ECCI estudadas, são maioritariamente homens, com idade média de 77 anos, casados/união de facto, reformados, com baixa escolaridade, com dependência média há 2,5 anos. 77,7% estão “acamados”. Famílias constituídas pelo casal, em que a esposa, mulher, portuguesa, com idade média de 67 anos, é a cuidadora principal, tendo cerca de 1/3 mais de 75 anos, o que se repercute na incapacidade de assegurar os cuidados que progride com a idade. Uma elevada percentagem apresenta compromissos nos focos de atenção avaliados: andar (96,2%); higiene pessoal (91,5 %); vestir-se e despir-se (82,3 %); equilíbrio (81,5%); autogestão do regime terapêutico (76,9%); transferir-se (71,5%); desuso (66,2%); ventilação e no virar-se, a (64,6%); sentar-se (58,5%), rigidez articular (47,7%), mastigação (42,3%); dor (41,5%) incontinência urinária (37,7%), incontinência intestinal e alimentação (33,1%), deglutição (30,0%), consciência comprometida (28,5%), paresia (26,2%); intolerância à atividade (25,4%); desidratação (24,6%); comunicação e limpeza das vias aéreas e hiperglicemia (23,8%), perfusão dos tecidos (22,3%), úlcera de pressão (21,5%). A média global da proporção de implementação das intervenções necessárias às pessoas avaliadas face ao esperado foi de 66,7%. Verificou-se que ficavam por fazer 33,3% dos cuidados considerados necessários. Os Enfermeiros explicam as razões da incompletude dos cuidados por dois motivos principais: a “falta tempo” e porque “a família não tem condições para o exercício do papel”. A incompletude de cuidados é um processo que gera mal-estar nos enfermeiros e sentimentos de impotência e angústia.
Conclusão: O fenómeno das necessidades de cuidados às pessoas dependentes no autocuidado a viver no domicílio e a sua provisão revelaram-se como realidades complexas e multidimensionais, não estando garantida a completude de cuidados.
Background: The aging of the Portuguese population will accentuate in the future (INE, 2020) and will be, potentially, accompanied by the increase in the prevalence of dependent people in self-care and care of third parties. This situation is likely to result in an increased need for continued care. As there is a growing consensus, the idea that the answer in continuous care should prioritize and privilege home care. This reality will require new models of care and/or reform of existing ones. Thinking about them requires research that allows for a better understanding of the needs of people dependent on living at home, and how to ensure complete care. Objective: Identify the care needs of dependent people in self-care who live in their homes, what care is actually provided to them, and who provides it. Material and methods: Investigation in 2 phases. Phase 1: observational, quantitative, descriptive and cross-sectional study, in a sample of people assisted in 13 ECCIs from a group of Health Centres in Portugal, which consisted of evaluating the necessary care of 130 dependent people in self-care, by using of a form. Phase 2: a “focus group”, seeking to understand the social phenomena observed, was carried out. Results: The dependent people in self-care, assisted in studied ECCI, are mostly men, with an average age of 77 years, married/domestic partners, retired, with lower education, with average dependency for 2.5 years. 77.7% are “bedridden”. Families constituted by the couple, in which the wife, woman, Portuguese, with an average age of 67 years, is the main caregiver, where 1/3 are over 75 years of age, having an impact on the inability to ensure the care that progresses with age. A high percentage shows commitments in the evaluated focuses of attention: walking (96.2%); personal hygiene (91.5%); dressing and undressing (82.3%); balance (81.5%); self-management of the therapeutic regime (76.9%); transfer (71.5%); disuse (66.2%); ventilation and turning around, (64.6%); sitting (58.5%), joint stiffness (47.7%), chewing (42.3%); pain (41.5%) urinary incontinence (37.7%), intestinal incontinence and food (33.1%), swallowing (30.0%), impaired consciousness (28.5%), paresis (26.2% ); activity intolerance (25.4%); dehydration (24.6%); communication, cleaning of the airways and hyperglycaemia (23.8%), tissue perfusion (22.3%), pressure ulcers (21.5%). The global average of the proportion of implementation of the interventions needed by the people evaluated compared to what was expected was 66.7%. It was found that 33.3% of the care considered to be necessary remained to be done. Nurses explain the reasons for incomplete care for two main reasons: “lack of time” and because “the family is unable to exercise the role”. The incomplete care is a process that generates malaise in nurses and feelings of helplessness and anguish. Conclusion: The phenomenon of care needs for dependent people in self-care living at home and their provision revealed themselves to be complex and multidimensional realities, with the completion of care not being guaranteed.
Background: The aging of the Portuguese population will accentuate in the future (INE, 2020) and will be, potentially, accompanied by the increase in the prevalence of dependent people in self-care and care of third parties. This situation is likely to result in an increased need for continued care. As there is a growing consensus, the idea that the answer in continuous care should prioritize and privilege home care. This reality will require new models of care and/or reform of existing ones. Thinking about them requires research that allows for a better understanding of the needs of people dependent on living at home, and how to ensure complete care. Objective: Identify the care needs of dependent people in self-care who live in their homes, what care is actually provided to them, and who provides it. Material and methods: Investigation in 2 phases. Phase 1: observational, quantitative, descriptive and cross-sectional study, in a sample of people assisted in 13 ECCIs from a group of Health Centres in Portugal, which consisted of evaluating the necessary care of 130 dependent people in self-care, by using of a form. Phase 2: a “focus group”, seeking to understand the social phenomena observed, was carried out. Results: The dependent people in self-care, assisted in studied ECCI, are mostly men, with an average age of 77 years, married/domestic partners, retired, with lower education, with average dependency for 2.5 years. 77.7% are “bedridden”. Families constituted by the couple, in which the wife, woman, Portuguese, with an average age of 67 years, is the main caregiver, where 1/3 are over 75 years of age, having an impact on the inability to ensure the care that progresses with age. A high percentage shows commitments in the evaluated focuses of attention: walking (96.2%); personal hygiene (91.5%); dressing and undressing (82.3%); balance (81.5%); self-management of the therapeutic regime (76.9%); transfer (71.5%); disuse (66.2%); ventilation and turning around, (64.6%); sitting (58.5%), joint stiffness (47.7%), chewing (42.3%); pain (41.5%) urinary incontinence (37.7%), intestinal incontinence and food (33.1%), swallowing (30.0%), impaired consciousness (28.5%), paresis (26.2% ); activity intolerance (25.4%); dehydration (24.6%); communication, cleaning of the airways and hyperglycaemia (23.8%), tissue perfusion (22.3%), pressure ulcers (21.5%). The global average of the proportion of implementation of the interventions needed by the people evaluated compared to what was expected was 66.7%. It was found that 33.3% of the care considered to be necessary remained to be done. Nurses explain the reasons for incomplete care for two main reasons: “lack of time” and because “the family is unable to exercise the role”. The incomplete care is a process that generates malaise in nurses and feelings of helplessness and anguish. Conclusion: The phenomenon of care needs for dependent people in self-care living at home and their provision revealed themselves to be complex and multidimensional realities, with the completion of care not being guaranteed.
Description
Keywords
Cuidados domiciliários Autocuidado Pessoa dependente Familiar cuidador Home care Self-care Dependent person Family caregiver