AbstractBackground: The aging of the Portuguese population will accentuate in the future (INE, 2020) and will be, potentially, accompanied by the increase in the prevalence of dependent people in self-care and care of third parties. This situation is likely to result in an increased need for continued care. As there is a growing consensus, the idea that the answer in continuous care should prioritize and privilege home care. This reality will require new models of care and/or reform of existing ones. Thinking about them requires research that allows for a better understanding of the needs of people dependent on living at home, and how to ensure complete care.
Objective: Identify the care needs of dependent people in self-care who live in their homes, what care is actually provided to them, and who provides it.
Material and methods: Investigation in 2 phases. Phase 1: observational, quantitative, descriptive and cross-sectional study, in a sample of people assisted in 13 ECCIs from a group of Health Centres in Portugal, which consisted of evaluating the necessary care of 130 dependent people in self-care, by using of a form. Phase 2: a “focus group”, seeking to understand the social phenomena observed, was carried out.
Results: The dependent people in self-care, assisted in studied ECCI, are mostly men, with an average age of 77 years, married/domestic partners, retired, with lower education, with average dependency for 2.5 years. 77.7% are “bedridden”. Families constituted by the couple, in which the wife, woman, Portuguese, with an average age of 67 years, is the main caregiver, where 1/3 are over 75 years of age, having an impact on the inability to ensure the care that progresses with age. A high percentage shows commitments in the evaluated focuses of attention: walking (96.2%); personal hygiene (91.5%); dressing and undressing (82.3%); balance (81.5%); self-management of the therapeutic regime (76.9%); transfer (71.5%); disuse (66.2%); ventilation and turning around, (64.6%); sitting (58.5%), joint stiffness (47.7%), chewing (42.3%); pain (41.5%) urinary incontinence (37.7%), intestinal incontinence and food (33.1%), swallowing (30.0%), impaired consciousness (28.5%), paresis (26.2% ); activity intolerance (25.4%); dehydration (24.6%); communication, cleaning of the airways and hyperglycaemia (23.8%), tissue perfusion (22.3%), pressure ulcers (21.5%). The global average of the proportion of implementation of the interventions needed by the people evaluated compared to what was expected was 66.7%. It was found that 33.3% of the care considered to be necessary remained to be done. Nurses explain the reasons for incomplete care for two main reasons: “lack of time” and because “the family is unable to exercise the role”. The incomplete care is a process that generates malaise in nurses and feelings of helplessness and anguish.
Conclusion: The phenomenon of care needs for dependent people in self-care living at home and their provision revealed themselves to be complex and multidimensional realities, with the completion of care not being guaranteed.
|Date of Award||22 Jul 2021|
|Supervisor||Abel Avelino Paiva e Silva (Supervisor)|
- Home care
- Dependent person
- Family caregiver
- Doutoramento em Enfermagem