Cuidado de enfermeiras para transição hospital-domicílio a pessoas com enfermidade onco-hematológica

Abstract

In Brazil, non-communicable chronic diseases are one of the main causes of morbidity and mortality, establishing a serious public health problem. Among them, onco-hematological disease reveals a considerable increase in hospitalization rates. The hospital discharge process is a moment that generates doubts and adversities for people affected by the disease, family members and caregivers, who may have needs about how home care will be. The transition of care (hospital-home) is fundamental for the reduction of hospital readmissions through actions that guarantee the continuity of post-discharge care. To identify the actions of nurses in the hospital-home transition care of people with onco-hematological illness. Descriptiveexploratory study, of a qualitative nature, part of the matrix project “Hospital-home transitional care for adults and elderly people”. The research was carried out at the Onco-Hematological Unit of a University Hospital in the city of Salvador, Bahia, Brazil with clinical nurses. Data collection took place through semi-structured interviews, between October 25 and November 10, 2022. Data were analyzed according to the Thematic Content Analysis method proposed by Bardin. The matrix project was approved under Opinion No. 5,282,090 on March 9, 2022. Seven nurses aged between 33 and 49 years and working time in the locus unit between three and seven years participated in the study. Four categories emerged: Conception about the initiation and completion of transition care from hospital to home and use of protocol for discharge; Instrumentalization for the continuity of care and the participation of family members/caregivers; Post-discharge communication between nurses, patients and family members/caregivers and Difficulties and facilities for implementing ideal transitional care. The nurses' actions for hospital discharge planning were evidenced. Self-care guidelines, use of instruments for planning, participation of family members and caregivers for the continuity of treatment at home and referrals after discharge were favorable factors for the transition of care, along with joint work with the care team. Low health literacy and low educational level were reported as predisposing factors for unsatisfactory results related to understanding transitional care.