O cuidado de transição organizacional na desospitalização da pessoa idosa com câncer em cuidado paliativo

Abstract

Transitional care is essential in the process of transferring elderly people with cancer in palliative care to home. In this way, the transition encourages the individual to incorporate new knowledge and behaviors, defining their social context as a healthy or sick being, considering their internal and external needs and the way in which they influence their health status. Primary objective: Understand the organizational transition care carried out by nurses in the dehospitalization of elderly people with cancer in palliative care. Method: This is a Convergent Care Research. Data collection was carried out using the following techniques: 1) documentary research; 2) participant observation; 3) individual interview. Such techniques were carried out in two phases. The research participants were nurses who carry out their activities in the research scenario. Of 23 nurses working at the institution, we had an eligible sample of 17 nurses participating in stage one of data collection and 9 nurses participating in stage two. The setting was a hospital specializing in oncology care, located in a medium-sized city in Minas Gerais. Data collection took place from March to September 2023. In the first phase, data was collected through documentary research and participant observation. The sources of information for the documentary research were the instruments related to the dehospitalization process adopted by the health institution, the research scenario. Participant observation was carried out during the participants' work process, following up with individual interviews. Subsequently, the interviews were fully transcribed and analyzed with the support of the Interface de R pourles Analyzes Multidimensionnelles de Textes et de Questionnaires software, which assists in processing qualitative research date. Results: The analysis of the material resulted in three categories called: Experiencing the phases, milestones and points of change in the process of returning home; Facilitating and inhibiting conditions of the organizational transition process and Contributions of the multidisciplinary health team in the transition process. The categories highlighted elements that constitute the transitional care carried out by nurses and highlighted the different particularities and needs of the elderly person undergoing palliative care and the family/caregiver, inherent to the care process. It was observed that despite the existence of points that weaken transitional care, it is carried out, mainly, with actions that infer communication and health education between nursing professionals and patients/family members/caregivers. Final considerations: from data triangulation it was possible to understand how organizational transition care takes place in a complex way and permeated by facilitating and inhibiting conditions that determine the promotion of a healthy transition or not. In the midst of this process, nurses have established themselves as professionals who play a central and challenging role in promoting transitions in the institution. Ethical aspects: This research was developed in accordance with the ethical precepts of Resolutions of the National Health Council (Res. n. 466/2012; 510/2015 and 622/200). Data collection began only after approval by the Ethics Committee for Research with Human Beings under Consubstantiated opinion 5.822.947 and CAAE number 65698622.1.0000.5147.