Development care for children with special health needs in home care at Paraná - Brazil

Abstract

Objective: To describe the development of care for children with special health needs in Paraná services of homecare. Method: Quantitative, descriptive, exploratory, and multiple case study was applied. Data were collected by telephone and e-mail, with professionals from the eight services of homecare of Parana, from October 2016 to January 2017. The data was treated with descriptive statistics analysis. Results: Among 35 children in homecare, 25.7% had cerebral palsy, 60% had a tracheostomy. The care provided by the services includes a management of tubes, administration of medication, changing dressings, caregiver guidance for tracheostomy suctioning and a management of diet. Conclusions and implications for practice: Services weaknesses were mainly related to low utilization of the singular therapeutic project and the counter-reference to primary care. The flow of successful practices are developed in the municipality of an isolated manner. Showing positive experiences promotes reflection and improvement of the work process of caring for children with special health needs in homecare.

Child with special health needs at one hospital of the brazilian unified health system Criança com necessidades de saúde especiais de um hospital do sistema único de saúde

“…Both determine complex care that requires knowledge and practices that are not common in family caregivers' lives. 18,[22][23][24][25] If, on the one hand, access to the specialized and highly complex care network of the Unified Health System ensured continuous and complex health care; on the other, it determined challenges for the hospital-home transition in articulation with the primary care network and the follow-up in specialized care. In this sense, a discharge when coordinated by the three care networks (primary, specialized and high complexity) has contributed to overcome the challenges of this transition after discharge from the hospital.…”

Equipe multiprofissional no preparo para a alta hospitalar de crianças com condições crônicas/Multi-professional team in hospital discharge of children and adolescents with chronic conditions

“…O preparo para a alta seguro, concreto e eficaz, é decorrente de ações de educação em saúde permeadas pelo diálogo, escuta e vínculo, com vistas à empoderar a família e favorecer sua autonomia com os cuidados em âmbito domiciliar (6) .…”

“…A criação de material educativo pelos Cienc Cuid Saude 2020;19:e50418 profissionais da equipe colabora no processo de capacitação familiar e constitui-se como estratégia promissora no preparo de alta hospitalar. Esse material impresso reforça as orientações como também serve de instrumento de consulta em caso de dúvidas quando a família desenvolve os cuidados no domicílio (6) . Entretanto, por meio dos termos "ensinar a técnica" e "adaptar a mãe ao cuidado"utilizados pelas entrevistadas percebe-se um processo de ensino-aprendizagem permeado pela narração de conteúdo voltada para o ensino de técnicas padronizadas, buscando a aquisição de habilidades e destrezas para a execução de determinada atividade.…”

“…Nesse sentido, surge a necessidade de preparar a família para a transição dos cuidados do hospital para o domicílio, utilizando estratégias adequadas para atender às demandas de forma integral, continuada e humanizada (6) , com o desafio de colaborar no enfrentamento da família diante ao aprendizado de saberes e práticas incomuns no cotidiano.…”

(In)visibility of children with special health needs and their families in primary care

“…In Brazil, the Home Care Service (HCS) acts as a complementary aid for hospitalization, by training caregivers to carry out activities with the sick person and to expand the autonomy of users, with the support of Multiprofessional Home Care Teams and Multiprofessional Support Teams (19) . However, carrying out this service is still restricted to a few locations in the country and, in many areas, children and adolescents are not included in the HCS.…”