O processo de elaboração e efetivação da alta de usuários de um centro especializado em reabilitação de média complexidade

Abstract

Pereira GF. The process of assessment and discharge of users from a centre specialised in medium complexity rehabilitation [dissertation]. São Paulo: University of São Paulo, Faculty of Dentistry; 2023. Versão Corrigida.The Care Network for Persons with Disabilities aims to widen the access and certify care for people with disabilities on SUS (Brazil's national health service network). The Centros Especializados em Reabilitação (Specialised Rehabilitation Centres) are considered the points of care in the network responsible for the most numerous offers of rehabilitation services. One of the aspects commonly pointed out as critical in health care is the process of elaborating and carrying out the discharge, due to gaps during the out in the process of monitoring users in rehabilitation centres, causing insecurity amongst professionals within that process. Objective:The purpose of this study is aimed at analysing and understanding how the process of assessments and effecting discharge of users occurs, as part of the coordination of care at the Specialised Rehabilitation Centre in the city of São Paulo. Method: An exploratory and qualitative methodology was employed, developed from the application of semi-structured individual questionnaires, through interviews, with the professional team of the Centro Especializado em Reabilitação II Jardim Campos, and the preparation of a field diary of routine activities, from March 2019 to April de 2019. For data analysis, Thematic Analysis was used.Results: All the 23 professionals who make up the multidisciplinary team participated in the research, who have heterogeneous characteristics, training time and professional experience.Qualitative data gave rise to five categories: discharge in place of non-care; conceptions and perceptions about the rehabilitation process, public health and health policy; collaborative work as a transformer of practice: about us and about us; health care networks and territory: about disconnections, connections and connectors and the discharge in place of care. The results pointed to the need to further understand the meaning of discharge in the care process, because due to historical, social and cultural issues, or depending on the way them said process is organised, discharge can assume a place of "non-care" during rehabilitation. It became evident the importance of adequate awareness among the rehabilitation centre professionals in regard to disabled persons' specific needs in relation to rehabilitation, public health and health policies.The study has identified difficulties in the organisation of the multidisciplinary work; it has also encountered potential in the role of the team of professionals to find solutions, indicating that the use of assistive technologies such as the elaboration of the Singular Therapeutic Project and the matrix support can bring greater security for the elaboration of the discharge. The articulation with the Health Care Network was reinforced and recognition of other equipment in the territory, such as leisure and soc...