Cuidados transicionais à pessoa idosa/família que vivencia uma demência na perspectiva de enfermeiros da Atenção Primária à Saúde

Abstract

Introduction: Transitional nursing care from the Family Health Strategy for elderly people and families experiencing the emergence of dementia has been recommended, aiming for healthy transitions in the continuity of home care: with safety, effectiveness, less wear and tear on caregivers, prevention of hospitalizations, visits to emergency services and negative outcomes. Objective: To analyze the perspectives of care of nurses from the Family Health Strategy with elderly people/families in transition from illness to the first signs of dementia or who are diagnosed with dementia. Method: Single, qualitative case study, developed using the method guided by Robert Yin, with input from the Transitional Care theory of Afaf Ibrahim Meleis. The real and contemporary phenomenon studied was the transitional nursing care of the Family Health Strategy with elderly people/families living in the community after the onset of dementia. Multiple data sources were used: health service documents; observation notes of care processes, including Home Visits; interview with a structured script using Google forms and in-depth interviews guided by a script containing open questions. The data collection units were nurses who work in Family Health Strategy Teams in Primary Health Care Services in Juiz de Fora, a medium-sized municipality in Minas Gerais, the third state with the highest number of elderly people in the country. The data were analyzed using a deductive-inductive interpretative process. The ethical precepts set out in the Resolutions of the National Health Council (Res. n. 466/2012; 510/2015 and 622/2022) were followed. The research was approved by the Human Research Ethics Committee of the Federal University of Juiz de Fora, under number 5.889.674. Results: The analytical process enabled the construction of four analytical categories: 1) Work dynamics of nurses from the Family Health Strategy in Primary Health Care; 2) Conditions that inhibit and facilitate the health-disease transition to dementia; 3) Properties and indicators of nursing care in the transition to dementia; 4) Therapeutic Nursing Interventions in dementia. Final considerations: The Theory of Transitions was not known by the nurses interviewed, and was therefore not adopted in identifying the inhibiting and facilitating conditions involved in the transitions experienced by elderly people and families towards the onset of dementia. The nurse's perspectives of care for this group are based on: 1) the management of care according to the organization of work in the Basic and Health Unit, according to Policies or Programs or administrative demands of the health system; 2) in care offered to elderly people and families according to demand, through guidance for self-care, use of medications, protection, immunizations and support for the caregiver according to assessment and/or demand. The theory of transitions appears to be a powerful tool to support the development and management of an individualized care plan with therapeutic interventions relevant to each case.