Serviço de atenção domiciliar a crianças e adolescentes com necessidades especiais de saúde

Abstract

This study aimed to analyze the care provided to children and adolescents with special health needs in home care services in the state of Rio Grande do Sul. For this purpose, quantitative and qualitative research was carried out. In the quantitative stage, data collection was developed through a instrument, sent to the coordinator of each of the four participating home care services. These data were organized and tabulated using the Excel® program and analyzed using descriptive statistics. In the qualitative stage, a semi-structured interview, genogram and ecomap was developed with eight family caregivers of children and adolescents accompanied by the services. Qualitative data were subjected to double independent transcription and thematic analysis. Ethical aspects were respected according to Resolution 466/2012 of the National Health Council. The results of this study revealed that home care services in Rio Grande do Sul assist a reduced number of children and adolescents when compared to adults and the elderly. . The services are coordinated by nurses, work during the day, have their own telephone, perform a caregiver preparation routine and rely on the mutual performance of a multiprofessional home care and support team. Half of them have their own headquarters and cars and have an interconnected electronic medical record. Half of them have their own headquarters and cars and have an interconnected electronic medical record. The entrance doors for users in the services are hospitals and basic health units and the entire team evaluates the eligibility and inclusion criteria. The children monitored by the services are mainly infants, the diagnosis that was highlighted was of neurological etiology and the demands for care were technological. In the perception of family caregivers, home visits consist of routine follow-up and assistance with materials and medicines provided by the service is essential for the quality of care. Multiprofessional teams carry out and reinforce guidelines regarding the care routine, as well as being available over the phone when necessary. The benefits of the service consist of the centralization of care that reduces the pilgrimage of family caregivers and guarantees access to other health institutions, in addition to providing comfort and security through the support and constant support. The limitations of care for children with special needs refer mainly to the difficulty in acquiring medicines, supplies and access to rehabilitation services, resulting in socioeconomic fragility faced by family caregivers that provide overload and psychological problems. The support groups were identified as an important strategy to face these limitations. Family caregivers express their expectations regarding the expansion of access to health and qualification of assistance to this population. In addition, the genograms and ecomaps illustrate the broad network of social support of family caregivers, although there are some weaknesses in their constitution. It is concluded that the home care service and its mechanisms of action, make it possible to develop strategies that qualify care and mitigate gaps regarding the continuity of care for children with special needs after hospital discharge. Still, it was shown that, although the number of children and adolescents monitored by the service is small, it confers several benefits to this population and their families, as well as qualifies and humanizes care.