Contribuições da terapia ocupacional no atendimento a usuários com insuficiência renal crônica no contexto de hospitalização

Abstract

Introduction: Chronic renal insufficiency (CRI) and its treatment cause restrictions and damages to the physical, mental, functional and social health of the affected users. The attention developed by Occupational Therapy with this population from the perspective of integral care during the period of hospitalization contributes to improve the setting, qualification of hospitalization time, functional recovery and emotional support. Objective: To identify and analyze the contributions of Occupational Therapy in health care of users with CRI in hospital context. Method: Qualitative study of descriptive type that used documentary analysis of the occupational therapy reports referring to the appointments made by this professional from April 2015 to April 2018. Results: 42 occupational therapy reports were analyzed, the majority of users were male, aged 60 or over and with some degree of functional dependence. The interventions of the Occupational Therapy were categorized in four main themes: initial contact and reception of the needs; support for resignification of the health-disease process; assistance to adapt to the new health condition and preparation for hospital discharge and the new routine of care. Conclusion: The Occupational Therapy allowed that aspects of patients' life altered by the CRI, hospitalization and changes in lifestyle due to the disease, were approached through different therapeutic techniques aimed at the reception of needs, stimulation of functional capacity, promotion of independence, (re) organization of daily life and insertion into the service network.

Perspectivas de terapia ocupacional na atenção aos usuários com doenças do aparelho circulatório no contexto hospitalar de média complexidade

“…MBI tracks individuals' dependency according to a score of 0-100 and classifies it as total dependence (25 or fewer points), severe dependence (50-26 points), moderate dependence (75-51 points), mild dependence (99-76 points) and totally independence (100 points) (Shah et al, 1989). The medical record contained social and demographic, family, occupational and professional history; patients' expectations, habits, attitudes, expressions, and speeches; therapeutic approaches such as guidelines and techniques used; interaction with the team; referrals to the network of services and clinical information from clinical records (Pereira et al, 2020).…”

“…As PNHOSP (Brasil, 2013) points out, there must be an articulation with the other points of the Health Care Network for the continuity of care. Thus, the importance of clarifying the maintenance of the link with the health services available in the community is highlighted, and the challenge of patients and family members due to the new responsibilities and tasks of care to be performed at home (Pereira et al, 2020). Therefore, as stated in the analyzed documents, for extrahospital care, occupational therapists guided the patients on the continuity of care, and developed strategies such as writing reports with a brief description of the patient's health conditions and referrals to occupational therapy professionals who worked in other points of care, such as Psychosocial Care Centers and Specialized Rehabilitation Centers.…”

“…The multi-professional team must be composed of different professions: Nutritionists, Nurses, Doctors, Physiotherapists, Occupational Therapists, Psychologists, Social Workers, among others. In the context of hospitalization, the team is often mediators of the occupational therapist's contact with the patient, requesting care and partnerships in the case discussions and joint actions (Pereira et al, 2020).…”

Atuação terapêutica ocupacional em um ambulatório de reabilitação pulmonar

“…O terapeuta ocupacional é o profissional apto para trabalhar com as questões relacionadas às mudanças e adaptações dos hábitos de vida e rotina ocupacional, bem como junto à motivação do usuário no engajamento das mudanças exigidas por circunstâncias inesperadas, como o adoecimento (Pereira et al, 2020).…”

Occupational repercussions in people with end-stage chronic kidney disease who attend hemodialysis: an occupational justice framework

“…The problem would lie in the lack of enforcement of compliance with the rules. Even though the EHG benefits do not include care associated with addressing the emotional, physical, or occupational repercussions that this pathology entails, it occurs in other health systems, for example in Brazil, where the TCKD approach considers the start of Occupational Therapy care once the diagnosis is delivered, which includes actions such as accompaniment to guide self-care techniques, restructuring of routines and articulation of networks for continuity of care (Pereira et al, 2020). Neither are psychology, kinesiology, or nutritionist services considered in the access guarantees.…”